HomeMy WebLinkAboutDoc 403 - Amend 7 to OHA AgrmtDeschutes County Board of Commissioners
1300 NW Wall St.~ Suite 200~ Bend~ OR 97701-1960
(541) 388-6570 -Fax (541) 385-3202 -www.deschutes.org
AGENDA REQUEST & STAFF REPORT
For Board Business Meeting of August 6, 2014
DATE: July 25,2014
FROM: Nancy Mooney, Contract Specialist, Deschutes County Health Services, 322-7516
TITLE OF AGENDA ITEM:
Consideration of Board Signature of Document #2014-403, Amendment #7 to Intergovernmental Financial
Agreement Award #142008 between the Local Public Health Department and the Oregon Health Authority for the
financing of Local Public Health Services for fiscal year 2013-2015.
PUBLIC HEARING ON THIS DATE? No.
BACKGROUND AND POLICY IMPLICATIONS:
OHA is at the forefront of lowering and containing costs, improving quality and increasing access to health care
The Oregon Health Authority (OHA) was created by the 2009 Oregon legislature to bring most health-related
programs in the state into a single agency to maximize its purchasing power; the amendment to
Intergovernmental Agreement (#142008) outlines the services and financing for fiscal year 2013-2014.
There are separate grants associated with individual public health programs represented in the
Intergovernmental Agreement, ranging from disease prevention and maternal child health to school based
health centers, women, infants and children (WI C), bioterrorism preparedness and family planning. Each grant
has an associated set of Program Assurances that are the service and quality performance expectations
connected with the delivery of the various components of the program itself.
Amendment #7 outlines the funding for Deschutes County's Public Health Division for fiscal year 2014-2015
and modifies the language for the following program element descriptions:
Program Element #07: HIV Prevention Services;
Program Element #12: Public Health Emergency Preparedness Program;
Program Element #41: Reproductive Health Program;
Program Element #44: School-Based Health Centers.
Funding for program element #12 will be outlined in a separate amendment.
FISCAL IMPLICATIONS:
Maximum funding reimbursement for this Amendment is $2,277,389. Total contract compensation for FY13-15,
inclusive of all amendments is $5,962,393.
RECOMMENDATION & ACTION REQUESTED:
Approval and signature of Document #2014-403, Amendment #4 to Intergovernmental Financial Agreement Award
#142008 between the Local Public Health Dept. and the Oregon Health Authority is requested.
ATTENDANCE: Tom Kuhn, Program Supervisor
DISTRIBUTION OF DOCUMENTS:
Please return executed documents to Nancy Mooney, Contract Specialist
DESCHUTES COUNTY DOCUMENT SUMMARY
(NOTE: This fonn is required to be submitted with ALL contracts and other agreements, regardless of whether the document is to be
on a Board agenda or can be signed by the County Administrator or Department Director. If the document is to be on a Board
agenda, the Agenda Request Fonn is also required. If this fonn is not included with the document, the document will be retumed to
the Department. Please submit documents to the Board Secretary for tracking purposes, and not directly to Legal Counsel, the
County Administrator or the Commissioners. In addition to submitting this fonn with your documents, please submit this fonn
electronically to the Board Secretary.)
Please complete all sections above the Official Review line.
Date: Quly 15, 2014 [
Department: I Health Services, Public Health Division .\
Contractor/Supplier/Consultant Name: I Oregon Health Authority I
Contractor Contact: t Connie Thies, Office of Contracts & Procurements I
Contractor Phone #: I 503-373-7889 I
Type of Document: Amendment #7 to Intergovernmental Agreement #142008
Goods and/or Services: This amendment outlines the funding for fiscal year 2014-2015
and modifies language for specific program elements.
Background & History: The Oregon Health Authority (OHA) was created by the 2009
Oregon legislature to bring most health-related programs in the state into a single agency
to maximize its purchasing power; the amendment to Intergovernmental Agreement
(#142008) outlines the services and financing for fiscal year 2013-2014.
There are separate grants associated with individual public health programs
represented in the Intergovernmental Agreement, ranging from disease prevention and
maternal child health to school based health centers, women, infants and children
(WIC), bioterrorism preparedness and family planning. Each grant has an associated
set of Program Assurances which are the service and quality performance expectations
connected with the delivery of the various components of the program itself.
Amendment #7 outlines the funding for Deschutes County's Public Health Division for
fiscal year 2014-2015 and modifies the language for the following program element
descriptions:
Program Element #07: HIV Prevention Services;
Program Element #12: Public Health Emergency Preparedness Program;
Program Element #41: Reproductive Health Program;
Program Element #44: School-Based Health Centers.
Funding for program element #12 will be outlined in a separate amendment.
Agreement Starting Date: I July 1, 2013 I Ending Date: I June 30, 2015
Annual Value or Total Payment: i $5,962,393.
i
I7/15/2014
Check all that apply:
D RFP, Solicitation or Bid Process
D Informal quotes «$150K)
~ Exempt from RFP , Solicitation or Bid Process (specify -see DCC §2.37)
Funding Source: (Included in current budget? [gJ Yes D No
If No, has budget amendment been submitted? DYes D No
Is this a Grant Agreement providing revenue to the County? DYes IZI No
Special conditions attached to this grant:
Deadlines for reporting to the grantor: ,--I_---'
If a new FTE will be hired with grant funds, confirm that Personnel has been notified that
it is a grant-funded position so that this will be noted in the offer letter: DYes D No
Contact information for the person responsible for grant compliance : Name: D
Phone#:D
Department Director Approval: "--"::"'J'I-=~'---P""'-...:.--'---=--
Departmental Contact and Title: Nancy Mooney, Contract Specialist
Phone #: I 541-322-7516 I
Distribution of Document: Please or e-mail the amendment to Connie Thies;
e-mail: connie.thies@state.or.us, Fax 503-373-7889. Please return executed
documents to Nancy Mooney, Contract Specialist
Official Review:
County Signature Required (check one): 0 BOCC ~Department Director (if <$25K)
o Administrator (if >$25K but <$150K; if >$150K, BOCC Order No. ____-l)
Legal Review ~lfY\J Date -:::rtf f bc;
Document Number =20-=-1",-4,--~--,~.....,lbrL--_____
7115/2014
RE't'E" 'IE B -I
--aM7V I
In compliance with the Americans with Disabilities Act, this document is available in
alternate formats such as Braille, large print, audio recordings, Web-based
communications and other electronic formats. To request an alternate format, please
send an e-mail to dhs-oha.publicationrequest@state.or.us or call 503-378-3486 (voice)
or 503-378-3523 (TTY) to arrange for the alternative format.
Agreement #142008
SEVENTH AMENDMENT TO OREGON HEALTH AUTHORITY
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE
FINANCING OF PUBLIC HEALTH SERVICES
This Seventh Amendment to Oregon Health Authority 2013-2015 Intergovernmental Agreement
for the Financing of Public Health Services, effective July I, 2013 (as amended the "Agreement"), is
between the State of Oregon acting by and through its Oregon Health Authority ("OHA") and Deschutes
County, acting by and through its Deschutes County Health Services ("LPHA"), the entity designated,
pursuant to ORS 431.375(2), as the Local Public Health Authority for Deschutes County.
RECITALS
WHEREAS, OHA and LPHA wish to modify the set of Definitions set forth in Exhibit A of the
Agreement;
WHEREAS, OHA and LPHA wish to modify the set of Program Element Descriptions set
forth in Exhibit B of the Agreement;
WHEREAS, OHA and LPHA wish to add the initial award of financial assistance for fiscal
year 2014-2015 to the existing Financial Assistance Award for fiscal year 2013-2014 set forth in
Exhibit C of the Agreement;
WHEREAS, OHA and LPHA wish to modify the HIPAA Compliance requirements set forth in
Exhibit G of the Agreement; and,
AGREEMENT
NOW, THEREFORE, in consideration of the premises, covenants and agreements contained
herein and other good and valuable consideration, the receipt and sufficiency of which is hereby
acknowledged, the parties hereto agree as follows:
1. The Agreement is amended as follows:
a. Exhibit A. "Definitions", Section 8. "Financial Assistance Award" or "FAA" is
amended as follows: (deleted text is indicated by strikethrough, added text is bold and
underlined .)
"8. "Financial Assistance Award" or "FAA" means the description of financial
assistance set forth in Exhibit C, as such Financial Assistance Award may be
amended from time to time. References throughout this Agreement to "the
DC -2014---~ .. .--
IN WITNESS WHEREOF, the parties hereto have executed this Amendment as ofthe dates set
forth below their respective signatures.
APPROVED:
STATE OF OREGON ACTING BY AND THROUGH ITS OREGON HEALTH AUTHORITY (OHA)
By:
Name: Jayne Bailey
Title: Interim Deputy Public Health Director
Date:
DESCHUTES COUNTY ACTING BY AND THROUGH ITS DESCHUTES COUNTY HEALTH SERVICES
(LPHA)
By:
Name: Tammy Baney, Chair
Deschutes County Board of Commissioners
Title:
Date: ~• ~ I :H) I 'f
DEPARTMENT OF JUSTICE -APPROVED FOR LEGAL SUFFICIENCY
Amendment form group~approved by D. Kevin Carlson, Senior Assistant Attorney General. by
email on June 24,2014. A copy ofthe emailed approval is onjile at OCP.
OFFICE OF CONTRACTS & PROCUREMENT (OCP)
By:
Name: Phillip G. McCoy, OPBC, OCAC
Title: Contract Specialist
Date:
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 40F40 PAGES
142008-7 PGM.DOC -DESCHUTES COUNTY
Financial Assistance Award" means any and all descriptions of financial
assistance currently set forth or as may be added to Exhibit C. to reflect
increases or decreases in award amounts as they may occur during the
entire period of the Agreement."
b. Exhibit B "Program Element Descriptions" is amended as follows:
(1) Program Element #07: HIV Prevention Services is hereby superseded and
replaced in its entirety by Exhibit I "Program Element #07: HIV Prevention
Services" attached hereto and incorporated herein by this reference.
(2) Program Element #12: Public Health Emergency Preparedness Program
(PHEP) is hereby superseded and replaced in its entirety by Exhibit 2 "Program
Element #12: Public Health Emergency Preparedness Program (PHEP)"
attached hereto and incorporated herein by this reference.
(3) Program Element #41: Reproductive Health Program is hereby superseded
and replaced in its entirety by Exhibit 3 "Program Element #41: Reproductive
Health Program" attached hereto and incorporated herein by this reference.
(4) Program Element #44: School-Based Health Centers (SBHC) is hereby
superseded and replaced in its entirety by Exhibit 4 "Program Element #44:
School-Based Health Centers (SBHC)" attached hereto and incorporated herein
by this reference.
c. Exhibit C "Financial Assistance A ward and Revenue and Expenditure Reporting
Forms", Section I "Financial Assistance Award" only is amended to add the Financial
Assistance Award for the period July I, 2014 through June 30, 2015 as set forth in I
Attachment I attached hereto and incorporated by this reference. Attachment 1 must be
read in conjunction with Section 4 of Exhibit C, entitled "Explanation of Financial I
Assistance Award" of the Agreement.
d. Exhibit D "Special Terms and Conditions" is hereby superseded and replaced in its
entirety as set forth in Attachment 2 "Exhibit D, Special Terms and Conditions"
attached hereto and incorporated herein by this reference.
e. Exhibit G "Required Federal Terms and Conditions", Section 6. "HIPAA Compliance"
only is hereby deleted in its entirety and designated as "Reserved",
2. The current total award amount as of this Amendment is: $5,962,393.00.
3. LPHA represents and warrants to OHA that the representations and warranties of LPHA set
forth in Section 2 of Exhibit E of the Agreement are true and correct on the date hereof with the
same effect as ifmade on the date hereof
4. Capitalized words and phrases used but not defined herein shall have the meanings ascribed I
thereto in the Agreement.
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2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 2 OF40 PAGES
142008-7 PGM.OOC -DESCHUTES COUNTY
5. Except as amended hereby, all tenns and conditions of the Agreement remain in full force and
effect. The parties expressly agree to and ratify the Agreement as herein amended.
6. This Amendment may be executed in any number of counterparts, all of which when taken
together shall constitute one agreement binding on all parties, notwithstanding that all parties
are not signatories to the same counterpart. Each copy of this Amendment so executed shall
constitute an original.
7. This Amendment becomes effective on the date of the last signature below.
THE REMAINDER OF THIS PAGE IS INT/:,rlTlONALLY LEFT BLANK
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGEJ OF40 PAGES
142008-7 PGM.[)()C -DESCHUTES COUNTY
Exhibit 1 to Amendment #7 to Agreement #142008
Program Element #07: HIV Prevention Services
1. Description. Funds provided under this Agreement for this Program Element may only be
used, in accgrdance with and subject to the requirements and limitations set forth below, for the
following services and appropriate costs associated with the delivery of these services, which
are to be delivered in a manner satisfactory to OHA:
a. Confidential HIV CTRS, including rapid HIV testing;
b. Comprehensive Prevention with Positives services (see Section 2. "Definitions Specific
to HIV Services" of this Program Element). At a minimum, LPHAs must support
linkage to Partner Services and HIV care and treatment for people living with HIV
(PL WH). However, funds may be used to support any service that is listed in the
fdefinition of Comprehensive Prevention with Positives and approved by OHA during
the program planning process;
c. Other HIV prevention services with evidence of effectiveness to identified priority
populations in LPHA's service area; and
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Priority populations for service focus in Oregon are identified in the current HIV Prevention
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Comprehensive Plan. Funds awarded under this Agreement may only be expended on services
included in the LPHA's HIV Prevention Program Plan and Report Workbook that has been
approved by the OHA HIV Prevention Program, with a focused emphasis on services for the
priority populations identified in the Plan.
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2. Definitions Specific to mv Prevention Services. I,
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a. CDC means: Federal Centers for Disease Control and Prevention. I,b. Client Focused Counseling means: A counseling technique used in HIV Counseling,
Testing, and Referral Services that usually consists of (i) a personalized risk assessment r
counseling session that encourages the individual to identity, understand, and
I
~ acknowledge the behaviors and circumstances that put the individual at risk for HIV,
explores previous attempts to reduce risk, identifies successes and challenges in these
efforts and culminates, in most cases, in a commitment from the individual to adopt at
least one risk reduction behavior, and Oi) a second counseling session in which the I
counselor discusses the HIV test results, explores how the individual may have
implemented the risk reduction behavior the individual committed to in the first session,
identifies with the individual additional risk reduction behaviors he/she may also adopt,
and makes any appropriate referrals. When using HIV rapid testing technology, there
may be only one condensed client-focused counseling session.
c. Clinical Laboratory Improvement Amendments (CLIA) means: Federal legislation
that governs the licensing of laboratories. A CLlA certificate of waiver allows
laboratories to perform simple laboratory tests
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEAUH SERVICES PAGE5m'40PAGES
142008-7 PGM.OOC -DESCHUTES COUNTY
d. Community Review Panel (a/kla Program Review Panel) means: A panel comprised
of community members and established in accordance with CDC guidelines which are
available for review at hup:/lwww.cdc.govlodlpgolformslhiv.htm. which reviews and
approves for appropriateness the HIV prevention informational materials that are
distributed in the counties in which LPHA provides HIV prevention services. Review
panels may be convened by OHA or the LPHA.
e. Comprehensive Prevention with Positives means: Comprehensive Prevention with
Positives are services for PL WH that help prevent onward transmission to others.
These services include linkage, retention or re-engagement in care and treatment,
prevention services, or other medical and social services; risk screening; interventions
focusing on treatment adherence, risk reduction, or disclosure; interventions for HIV
discordant couples; referrals to screening for STDs, hepatitis or TB, ongoing HIV
Partner Services (not limited to newly diagnosed persons), and efforts to ensure HIV
positive pregnant women receive the necessary interventions to prevent mother-to-child
transmission.
f. Culturally Appropriate means: Characteristic of services provided to clients with
diverse values, ethnicities, sexual orientations, gender identities, beliefs and behaviors
that include, as necessary, the tailoring of delivery methods to meet client's social,
cultural and linguistic needs.
g. HIV Counseling, Testing, and Referral Services (CTRS) means: An HIV prevention
service, which includes client focused counseling, obtaining a blood or oral fluid
specimen on which to conduct an HIV test, and referral and linkage to other appropriate
services.
h. HIV Prevention Program Plan and Report Workbook means: The workbook that
describes HIV Counseling, Testing and Referral Services, Comprehensive Prevention
with Positives Services, and other HIV prevention services that LPHA intends to deliver
with funds provided under this Agreement for this Program Element. Each HIV
Prevention Program Plan and Report Workbook includes a specific engagement plan for
communities of color and also includes anti-stigma approaches and activities for
priority popUlations which are in alignment with the National HIV/AIDS Strategy.
i. HIV Partner Services means: A set of free services provided by LPHA to 1) inform
HIV -positive persons of their diagnosis and link them to care and treatment services; 2)
identify their sex and needle-sharing partners; and 3) notify partners of their potential
exposure and link them to testing and other services in a timely manner.
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j. Preliminary Positive means: A result from a Rapid HIV Test that indicates HIV
antibodies are in the blood of the person tested. A preliminary positive test result must
be followed up with a serum or oral fluid HIV test to determine if the individual is t
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actually infected with HIV. If rapid tests are used for both preliminary and confirmatory
testing, LPHA must confirm that the test kits must be produced by different
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manufacturers.
2013-2015INTERGOVERN.'~1ENTAI, AGREEMENT FOR THE FINANCING OF PllBLIC HEALTH SERVICES PAGE 6 OF 40 PAGES
142008-7 PGM.OOC -DESCHUTES COUNTY
k. Rapid HIV Test means: An FDA-approved HIV test that yields negative or preliminary
positive test results within a short time period (less than 30 minutes) after processing
specimen.
I. Sub-contractor means: A provider offering services pursuant to a subcontract of the
LPHA for the purposes of providing HIV Prevention services to a targeted population.
3. Procedural and Operational Requirements.
a. Staffing Requirements and Staff Qualifications for HIV CTRS. All individuals
providing HIV CTRS supported in whole or part with funds provided under this
Agreement must have received baseline training in the essentials of HIV prevention
which includes client focused counseling techniques, motivational interviewing skills,
HIV transmission basics, risk reduction messages, provision for making effective
referrals and linking people to care, and a general orientation to the priority populations
in Oregon. If staff is providing Rapid HIV Tests, appropriate training in methods and in
rapid HIV CTRS according to CDC HIV CTRS guidelines, in addition to the product
specific guidelines identified by the company(ies) that manufacture the HIV Rapid
Tests must be ensured. Staff that conduct rapid HIV tests must acquire a training
certification from the company(ies) that manufacture the specific rapid HIV tests which
are utilized during HIV CTRS sessions. In addition, contractors should plan on
participating in CTRS trainings after updates to the curricula have been made by the
CDC and as reasonably requested by the OHA HIV Prevention Program. To ensure
that the skills acquired during baseline training are employed during CTR services, the
OHA HIV Prevention Program reserves the right to shadow contractors during at least
one CTR session within a triennial review period. Baseline training (in person or web
based) will be available from the OHA.
b. Minimum Service Requirements for HIV CTRS.
i. All HIV CTRS supported in whole or in part with funds provided under this
Agreement must be delivered in accordance with LPHA's HIV Prevention Program
Plan and Report Workbook and must meet the following minimum requirements:
ii. HIV CTRS must be available on a voluntary and confidential basis within the
LPHA's service area. If a client requests anonymous HIV testing, staff should
explore the client's concerns, explain how client data are used and protected, and
provide information about obtaining an anonymous test (e.g., a home test kit).
iii. HIV CTRS must be provided in accordance with applicable Oregon and Federal
statutory and regulatory requirements, must be easily accessible, available, and
culturally appropriate. The identity of an individual receiving HIV CTRS must not
be released to anyone without the written consent of the individual, except when
otherwise required, or permitted, by Oregon or Federal statute or regulation.
iv. HIV CTRS must be available for priority populations, identified in the current
Oregon Jurisdictional HIV Prevention Plan available at:
healthoregon.orglhivprevention, regardless of an individual's ability to pay. LPHA
may impose fees for HIV CTRS but fees may not exceed the reasonable cost of the
2013-2015 INTERGOV[RNMENTAL AGR[EMENT FOR TH[ FINANCING OF PUBLIC HEALTH SERVICES PAGE 7 OF 40 PAGES
142008-7 PGM.I)()C -OESCH UTES COUNTY
service. LPHA may not deny HIV CTRS because of an individual's inability to pay
for the services. Revenues generated from HIV CTRS supported in whole or in part
with funds provided under this Agreement, and any donations received for HIV
CTRS, may only be used for HIV prevention services. LPHA must report all HIV
CTRS fee revenue and donations to the LPHA on the "Oregon Health Authority
Public Health Division Expenditure and Revenue Report" under Section B of
Exhibit C ofthis Agreement.
v. All individuals receiving HIV CTRS who are at increased risk for HIV infection
(e.g., priority populations) must have information offered to them regarding the
meaning of their test results, HIV transmission and prevention, and prevention and
testing services for related infections (e.g., hepatitis, sexually transmitted infections,
and tuberculosis) as appropriate. This information may be offered via client-focused
counseling or via educational materials.
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x. An OHA approved HIV Test Request and HIV Counseling, Testing, and Referral
Form (Form 44) must be completed for each HIV counseling and testing encounter I
that is supported in whole or in part with funds provided under this Agreement. The f
form may be obtained through the Oregon State Public Health Laboratory. t
vi. LPHAs will ensure that at least 95% of positive test results are delivered to clients
testing for HIV.
vii. HIV test results must be provided in a professional and supportive manner.
Individuals must be provided adequate opportunity to ask questions regarding HIV
test results.
viii. IfLPHA tests an individual for HIV and the test result is positive (either preliminary
or confirmatory), LPHA must:
(a.) Explain to the individual the meaning ofthe test results.
(b.) Encourage the individual to participate in Partner Services and facilitate entry
to this service.
(c.) Provide referral for medical evaluation and ensure linkage to care.
(d.) Provide the individual with information about and/or referral to other services
(e.g., mental health services, support groups and networks for PLWH) as
appropriate.
(e.) Maintain the strict confidentiality of both the receipt of the HIV test and the
H IV test result.
(f.) If the result is a Rapid HIV Test preliminary positive, offer the individual a
confirmatory HIV test or referral for confirmatory HIV testing. Confirmatory
testing may be conducted by a laboratory or by a rapid test from a different
manufacturer than the first rapid test which was administered.
ix. An LPHA utilizing Rapid HIV Tests must be enrolled in CLiA and have a
Certificate of Waiver.
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c. Other HIV Prevention Services and Structural Activities. All HIV prevention
services and structural activities supported in whole or in part with funds provided
under this Agreement must be delivered in accordance with LPHA's approved HIV
Prevention Program Plan and Report Workbook (this form may be obtained from the
state HIV Prevention Program) and must meet the following minimum requirements:
i. Program must be evidence-based and targeted to prioritized populations and sub
populations identified in the current Oregon Jurisdictional HIV Prevention Plan
available at healthoregon.orglhivprevention.
ii. Strategies endorsed by the CDC, such as Social Network Strategy recruitment into
CTRS or other evidence-based interventions may be implemented, subject to
approval of the LPHA's Program Plan and Report Workbook by the OHA HIV
Prevention Program and after completion of relevant training for staff.
iii. Structural activities, such as network building to meet the needs of a targeted
population group, work with related agencies to promote HIV risk reduction, etc.,
may be implemented, subject to approval of the LPHA's Program Plan and Report
Workbook by the OHA HIV Prevention Program.
iv. OHA HIV Prevention-approved evidence-based interventions must be implemented
with fidelity to the core elements of the intervention (a core element is a part of the
intervention that is crucial to satisfYing the intervention's goals and objectives).
d. All HIV Prevention Services. All LPHAs providing HIV prevention services
supported in whole or in part with funds provided under this Agreement must meet the
following requirements:
i. Monitoring activities related to capacity building efforts to support the provision of
HIV prevention services.
ii. Condoms must be available and distributed to populations engaging in high risk
behaviors, consistent with populations targeted by the LPHA in its HIV Prevention
Program Model Plan.
iii. Ifany part of the HIV prevention program of the LPHA is supported by federal HIV
prevention funds, all HIV educational materials must be reviewed and approved by
a local or statewide Program Review Panel in accordance with CDC guidelines.
iv. The LPHA must make available, to the general public, a minimum of one English
and one Spanish educational material (e.g., brochure, video) providing basic
information about how HIV is acquired and transmitted, when and where HIV
testing is available, and general information about HIV care services. Currently, the
"Know the Facts" brochure produced by the OHA HIV Prevention Program meets
this standard.
v. Contractors are required to conduct data submissions at least quarterly. If these
reporting timelines are not met, OHA HIV Prevention Program staff will work with
the contractor to establish and implement a corrective action plan.
20 13-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES
142008-7 PGM.DOC -DESCHUTES COUNTY
vi. Additionally, contractors provide Quarterly Fiscal Expenditure reports on the
amount and percentage of funds used for each HIV Prevention activity identified in
the agency's program plan using the appropriate tab of the "aHA HIV Prevention
Program Plan and Report Workbook." This report is due within 30 days after the
close of each calendar quarter.
vii. No financial assistance provided to LPHA for HIV Prevention Services may be used
to provide treatment and/or case management services.
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e. Conflicts. In the event of a conflict or inconsistency between the provisions of the HIV
Prevention Program Plan and Report Workbook and the other provisions of this
Program Element Description, the other provisions ofthis Program Element Description I
shall take precedence. If. Confidentiality. In addition to the requirements set forth in Section 6 of Exhibit E,
General Terms and Conditions, of this Agreement and above in this Program Element
Description, all providers of HI V Prevention Services supported in whole or in part with
funds provided under this Agreement must comply with the following confidentiality .I
~ req uirements: 1
i. All materials related to the delivery of HIV Prevention Services that contain names
of individuals receiving services or other identifying information must be kept in a
locked and secure area/cabinet, which allows access only to authorized personnel
Iand all computers and data programs that contain such information must have
restricted access. Providers of HIV Prevention Services must comply with all
applicable county, state and federal confidentiality requirements applicable to the
delivery of services. Each provider agency will designate an Overall Responsible I
Party (ORP) for confidentiality protection procedures. Iii. Breaches of confidentiality are serious and require immediate action. Breaches may
occur as the result of unauthorized access to paper records, electronic records,
including information transmitted electronically via fax, verbal communications,
audio or video recordings, electronic displays and electronic-generated reports.
Therefore, supervisory or administrative staff of a provider of HIV Prevention
Services must evaluate all known alleged breaches by its stafT, including volunteers
and subcontractor stafT, of the confidentiality requirements of this Program Element
Description and must document the process of resolution of breaches of
confidentiality. Potential breaches of confidentiality are those in which confidential
information was accessible to and may have been viewed by unauthorized persons.
Known alleged breaches of confidentiality are those in which the sharing of
confidential information with unauthorized persons was witnessed or documented.
All confirmed breaches of the confidentiality requirements ofthis Program Element
Description must result in appropriate sanctions in accordance with Provider policy r
and procedure and applicable law. Each provider of HIV Prevention Services must treport to the aHA the nature of confirmed breaches by its stafT, including
volunteers and subcontractors, of the confidentiality requirements of this Program t
Element Description within 14 days from the date of evaluation by the provider. I
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142008-7 PGM.DOC-DESCHUTES COUNTY
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iii. Providers of HIV Prevention Services must establish and comply with a written
policy and procedure regarding a breach of the confidentiality requirements of this
Program Element Description. Such policy must describe the consequences to the
employee, volunteer or subcontractor staff for a verified breach of the
confidentiality requirements of this Program Element Description.
4. Certain limitations on use of financial assistance awarded for DIV Preveution Services.
Funds awarded for HIV Prevention Services may only be used to support the following
activities during the period for which the funds are awarded:
a. Programs defined and described in the current Oregon Jurisdictional HIV Prevention -
Plan available at healthoregon.org/hivprevention.
b. Networking, collaborating, and building relationships with other agencies worKing with
the targeted populations. This may include attending meetings and giving presentations
at said agencies;
c. Other supporting activities such as advertising and promotion of activities;
d. Travel costs incurred conducting services;
e. Incentives for participation in services, as approved by OHA. Prior to the purchasing of
incentives, contractors must submit to OHA for approval documentation of cash or
incentive handling procedures, a justification for the purchase, and a description of how
incentives will be tracked;
f. Purchase and/or production of program materials;
g. Necessary office equipment and/or supplies to conduct activities, excluding furniture
unless approved by OHA;
h. Training and/or conferences for staff and/or supervisors that is relevant to the I
intervention and/or working with the target populations. This includes monitoring and
evaluation trainings; I
i. Paperwork, meetings, and preparation related to conducting programs;
j. Supervision, data collection and review, participation in planning and networking I
groups, and/or other related activities directly related to the delivery of HIV prevention
services included in the LPHA HIV Prevention Program Plan and Report Workbook,
which has been approved by the OHA.
5. Agency responsibility if subcontracting for delivery of services. An LPHA may use a
portion of HIV Prevention program funding to subcontract with another community
based agency for delivery of services with the following responsibilities:
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE II OF 40 PAGES
142008-7 PGM.DOC -DESCHUTES COUNTY
a. An LPHA that contracts for services using program funds will ensure the completion of
the "OHA HIV Prevention Program Plan and Report Workbook" both for its agency
and the subcontractor agency submitting both in a timely manner as requested by the
program.
b. LPHAs will ensure that the subcontractor's fiscal and monitoring data is submitted in a
timely manner.
c. In partnership with the state program, LPHA will identiry and participate in capacity
building and quality assurance activities applicable to the subcontractor.
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2013-2015 INTERGOVERNMElliTAL AGREEMENT FOR THE FllliANCING OF PUBLIC HEALTH SERVICES PAGE 12 OF 40 PAGES
142008-7 PGM.DOC -DESCHLITES COUNTY
Exhibit 2 to Amendment #7 to Agreement #142008
Program Element #12: Public Health Emergency Preparedness Program (PHEP)
1. Description. Funds provided under this Agreement to Local Public Health Authorities
(LPHA) for a Public Health Emergency Preparedness Program (PHEP) may only be used in
accordance with, and subject to, the requirements and limitations set forth below. The PHEP
shall address mitigation, preparedness, response and recovery phases for public health
emergencies through plan development and revision, exercise and response activities based on
the 15 CDC identified Public Health Preparedness Capabilities.
2. Definitions Specific to PHEP Programs.
a. Capability Performance Measure Analysis: An assessment of the difference between
prescribed CDC Capabilities organized by function and current local capabilities using
an evaluation tool developed by the Health Security Preparedness and Response
Program (HSPRP).
b. CDC: U.S. Department of Health and Human Services, Centers for Disease Control
and Prevention.
c. Community Hazard Risk Assessment: A community hazard risk assessment is a
process leading to a written document that presents findings used to assess and identify
community-specific public health hazards and vulnerabilities so that plans may be
developed to reduce or eliminate these threats. I
d. Electronic Surveillance System for Early Notification of Community based
Epidemics (ESSENCE): An automated, real-time syndromic surveillance system with
mapping and graphing capabilities that monitors emergency department visits across the I
state to identify emerging public health events.
e. Health Alert Network (HAN): A web-based, secure, redundant, electronic I
communication and collaboration system operated by OHA, available to all Oregon tpublic health officials, hospitals, labs and service providers. The data it contains is
maintained jointly by OHA and all LPHAs. This system provides continuous, hightspeed electronic access for Oregon public health officials and service providers to
public health information including the capacity for broadcasting information to Oregon
public health officials and service providers in an emergency 24 hours per day, 7 days
per week. The secure HAN has a call down engine that can be activated by state or
local Preparedness Health Alert Network administrators.
f. Health Security Preparedness and Response Program (HSPRP): A state level
program that is a joint effort with the Conference of Local Health Officials (CLHO) and
the tribes to develop plans and procedures to prepare Oregon to respond, mitigate, and
recover from public health emergencies.
2013-2015 INTERGOVERM1 ENTAL AGREEMENT FOR THE FINANCING OF Pl!BLIC HEALTH SERVICES PAGE 13 OF 40 PAGES
142008-7 PGM.DOC -DESCHUTES COUNTY
g. Investigative Guidelines: Oregon Disease Investigation Guidelines can be found at:
http://public.health.oregon.gov/diseasesconditionslcommunicab/ediseaselreportingcom
municab/ediseaselreportingguidelineslpageslindex.aspx
h. Medical Countermeasures: Vaccines, antiviral drugs, antibiotics, antitoxin, etc. in
support of treatment or prophylaxis to the identified population in accordance with
public health guidelines or recommendations. This includes the Strategic National
Stockpile (SNS), a CDC program developed to provide rapid delivery of
pharmaceuticals, medical supplies and equipment for an ill-defined threat in the early
hours of an event, a large shipment of specific items when a specific threat is known or
technical assistance to distribute SNS materiel. SNS program support includes the 12
hour Push Pack, vendor managed inventory (VM1), and Federal Medical Stations.
i. National Incident Management System (NIMS): The Federal Homeland Security
Administration's system for integrating effective practices in emergency preparedness
and response into a comprehensive national framework for incident management. The
NIMS enables emergency responders at all levels and in different disciplines to
effectively manage incidents no matter what the cause, size or complexity. More
information can be viewed at: http://www.fema.gov/emergencY/nims/index.shtm
j. Oregon Public Health Epidemiology User System (ORPHEUS): An application that
integrates information on reportable communicable diseases for state and local use.
Information can be found at:
http://public.health.oregon.gov/diseasesconditionslcommunicablediseasel/ocalhea/thde
partmentslpagesloutbreak. aspx
k. Public Information Officers (PIOs): The communications coordinators (officers) or
spokespersons for governmental organizations.
I. Public Health Emergency Preparedness (PHEP): local public health systems
designed to better prepare Oregon to respond, mitigate, and recover from public health
emergencies.
m. Reviews: The evaluation of an LPHA's Public Health Emergency Preparedness and
Response materials, products, plans, and activities conducted twice each year by state
and local preparedness staff using instruments developed by Oregon Health Authority
with collaboration and consultation with the Conference of Local Health Officials.
n. Receipt, Stage and Storage (RSS): The site where Strategic National Stockpile assets
are received staged and stored (RSS). To be an approved RSS, the warehouse must meet
minimum federal recommendations regarding security, climate control, size, lighting,
dock capacity, and access to warehouse resources.
o. Vaccine Adverse Events Reporting System (VAERS): A passive surveillance
program used to monitor vaccine safety in the United States. V AERS collects reports of
adverse events occurring after vaccination from public and private providers, parents,
patients, and vaccine manufacturers.
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 140F40PAGES
142008-7 PGM.DOC -DESCHUTES COUNTY
3. General Requirements. All of LPHA's PHEP services and activities supported in whole or in
part with funds provided under this Agreement and particularly as described in this Program
Element Description shall be delivered or conducted in accordance with the following
requirements and to the satisfaction of OHA:
a. Non-Supplantation. Funds provided under this Agreement for this Program Element
shall not be used to supplant state, local, other non-federal, or other federal funds.
b. Audit Requirements. In accordance with federal guidance, each entity receiving funds
shall, not less than once every two years, audit its expenditures of PHEP funding. Such
audits shall be conducted by an entity independent of the agency and in accordance with
the federal Office of Management and Budget Circular A-l33. Audit reports shall be
sent to the OHA, who will provide them to the CDC. Failure to conduct an audit or
expenditures made not in accordance with PHEP cooperative agreement guidance and
grants management policy may result in a requirement to repay funds to the federal
treasury or the withholding of funds.
c. Work Plan. LPHA shall implement its PHEP activities in accordance with its OHA Iapproved Work Plan using the example set forth in Attachment 2 to this Program IElement Description. Dependent upon extenuating circumstances, modifications to this
work plan may only be made with HSPRP agreement and approval. Work plans will be
reviewed on a semi-annual basis by the PHEP liaison.
Id. Public Health Preparedness Staffing. LPHA shall identify a Public Health
Preparedness Coordinator position acceptable to the OHA. The Public Health
Preparedness Coordinator will be the OHA's chief point of contact related to program
issues. The Public Health Preparedness Coordinator will ensure that all scheduled
preparedness coordination conference calls and statewide preparedness coordination
meetings and the LPHA PHEP Annual Review are attended by an LPHA representative.
LPHA must staff its PHEP Program at the appropriate level to implement its PHEP
activities in accordance with its approved Work Plan, depending on its level offunding,
as specified in the award of funds for this Program Element.
e. Use of Funds. Funds awarded to the LPHA under this Agreement for this Program
Element may only be used for activities related to the CDC Public Health Preparedness
Capabilities in accordance with an approved Budget using the template set forth as
Attachment I to this Program Element Description. Modifications to the budget
totaling $5,000 or more needs to go through the liaison and may only be made with
HSPRP approval.
f. Meeting Attendance and Participation. LPHA must attend HSPRP meetings and
participate in workgroups, as reasonably required by HSPRP as follows:
i. Attendance at PHEP grantee meetings.
ii. Training and/or conferences for staff and/or supervisors that is relevant to PHEP,
examples include PIO and ICS training.
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 15 OF 40 PAGES
142008-7 PGM.DOC -DESCHUTES COUNTY
iii. Paperwork, meetings, conference calls and preparation related to PHEP services and
activities.
iv. Participation in combined local/state PHEP workgroups for the development of
PHEP program materials and activities.
v. Participation in the regional or local HPP Coalition meetings.
g. Conflict between Documents. In the event of any conflict or inconsistency between the
provisions of the PHEP work plan or budget (as set forth in Attachments I and 2) and
the provisions of this Agreement or this Program Element Description, the provisions of
this Agreement or the provisions of this Program Element Description, as applicable,
shall control.
h. PHEP Program Reviews. PE 12 will be integrated into the Triennial! Biennial Review
Process of all of the PEs. LPHA shall submit its materials and tools for the Review, in
conjunction with the TrienniallBiennial Review process of all of the PEs. The review
will be biennial and completed in conjunction with the statewide WIC schedule
determined by the Office of Community Liaisons.
i. Budget and Expense Reporting. Using the budget and expense to budget Excel file
set forth in Attachment 1 and available through the liaison attached hereto and
incorporated herein by this reference, LPHA shall provide to OHA by August 31, of
each year, a budget using actual award amounts, detailing LPHA's expected costs to
operate its PHEP programs during the period of July I, through June 30 of each year.
LPHA shall submit to OHA by February IS of each year, the actual expense-to-budget
report for the period of July 1, through December 31. The LPHA shall provide to the
OHA by August 31 of each year, the actual expense-to-budget report for the period of
July 1, through June 30. The budget and expense to budget set forth in Attachment 1
shall be the only form used to satisfy this requirement. All equipment purchases of
$5,000 or more that use PHEP funds will be identified in this budget report under
Equipment.
4. Procedural and Operational Requirements.
a. Public Health Capability Performance Measure Analysis Introduction & Purpose:
During the next 4 years, local and tribal jurisdictions will work to demonstrate the
ability to perform a1l applicable CDC Public Health Preparedness Capabilities. To
determine 1) which capabilities the state as a whole should focus on, and 2) what
activities should be prioritized within each jurisdiction, counties and tribes will be asked
to complete a gap analysis based on the CDC capabilities. These analyses will build off
the following years work and will not have to be newly constructed each fiscal year.
b. Public Health Capability Performance Measure Analysis: LPHA shall complete a
Public Health Capability Performance Measure Analysis using the assessment tool
provided and approved by HSPRP by August 15 each year.
2013-20]5 INTERGOVERNMENTAL AGREEME!'IT FOR THE FINANCING OF PtiBLIC HEALTH SERVICES PAGE 16 OF 40 PAGES
142008-7 PGM.DOC -DESCHUTES COUNTY
I
c. Work Plan Description: Counties must develop a work plan for the budget period.
The work that LPHAs assign themselves in the work plan will be based on the gaps
identified in the Public Health Capability Performance Measure Analysis, using the
Public Health Consequences Analysis and improvement plans developed from after
action reports from real events or exercises to help prioritize which capabilities and
functions are most important to have fully developed in their jurisdiction. An example is
set forth in Attachment 2 to this Program Element Description.
d. Public Health Preparedness Program Work Plan: LPHA shall develop a Public
Health Preparedness Program work plan using the template set forth as Attachment 2 to
this Program Element Description focusing in the current year on activities to build or
sustain CDC Public Health Capabilities and associated functions. The work plan must
be completed and approved by OHA by September 15 each year. At a minimum LPHA
must build two capabilities in the work plan. Current capabilities shall be sustained.
e. Public Health Preparedness Program Work Plan Performance: LPHA shall
complete activities in their HSPRP approved PHEP work plans by June 30 each year. If
LPHA completes fewer than 75% of the planned activities in its local PHEP work plan
for two consecutive years, it may not be eligible to receive funding under this Program
Element in the next fiscal year.
f. Emergency Response Time.
i. LPHA shall establish and maintain a single telephone number whereby, physicians,
hospitals, other health care providers, and the public can phone to report public
health emergencies within the LPHA service area.
ii. The telephone number shall be operational 24 hours a day, 7 days a week, 365 days
a year and be an eleven digit telephone number available to callers from outside the
local emergency dispatch. LPHA may use their 911 system in this process, but the
eleven digit telephone number of the local 911 operators shall be listed in all
instances and be provided to switchboard operators so that callers from outside the
locality can contact LPHA through the local dispatch system.
iii. The LPHA telephone number described above shall be answered by a
knowledgeable person or by a recording that clearly states the above mentioned 2417
telephone number. LPHA shall list and maintain both the switchboard number and
the 2417 numbers on the HAN.
g. HAN. LPHA shall identify a local HAN Administrator. The local HAN Administrator
shall: 1
i. Ensure local HAN user and county role directory is maintained (add, modifY and
delete users; make sure users have the correct license).
ii. Act as a single point of contact for all LPHA HAN issues, user groups, and training.
iii. Serve as the LPHA authority on all HAN related access (excluding hospitals and
tribes).
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 170F40PAGES
142008-7 PGM.DOC -DESCHUTES COUNTY
iv. Coordinate with the State HAN Coordinator to ensure the roles are correctly
distributed within each county.
vii. Review their LPHA HAN users two times annually to ensure users are assigned
their appropriate roles and that appropriate users are deactivated.
viii. HAN-related Performance Measures:
Performance Measure 0.1: A HAN Administrator will be appointed for each
LPHA and this person's name and contact information will be provided to the
appropriate County Liaison and the State HAN Admin Coordinator.
Performance Measure 0.2: LPHA HAN Administrator will facilitate in the
development of HAN accounts for new LPHA users, and will document that LPHA
HAN user accounts are up to date at least twice annually.
Performance Measure 0.3: LPHA will upload AARs from incidents and exercises
within 60 days of their completion.
Performance Measure 0.4: LPHA will once annually confirm all plans and
appropriate procedures are submitted to the liaison.
h. Exercise Requirements. LPHA shall develop and conduct an exercise program that
tests LPHA's all-hazard emergency response plans, utilizing an After Action Report,
Improvement Plan, and Exercise Evaluation Guide. As further described below, the
program shall include exercises that involve LPHA's administration, the local
jurisdiction's emergency management and other emergency response partners. LPHA
shall annually submit to OHA for approval before December 15, an updated Training
and Exercise Plan. The Training and related exercise Plan shall meet the following
conditions:
I
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v. LPHA to participate in three annual statewide ESF-8 tactical communications
exercises. Deliverables associated with this exercise are as follows:
(I.) Test ofthe LPHA's 2417 contact with a response within 15 minutes.
(II.) Test of the LPHA's HAN system roles via alert confirmation for: Health
Officer, CD Coordinator(s), Preparedness Coordinator, PIO and LPHA County
HAN Administrator within one hour.
vi. Perform general administration for all local implementation of the HAN system in
their respective organizations.
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i. The Training and related Exercise Plan shall, at a minimum, outline the exercise
program priorities, CDC capabilities, and training and exercise schedule.
ii. The plan shall demonstrate continuous improvement and progress toward increased
capability of the LPHA to perform critical tasks while exercising to the gaps
2013-20IS INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 180F40PAGES
142008-7 PGM.DOC -DESCHUTES COlINTY
identified within their Gap Analysis process.
iii. The plan shall include priorities which address lessons learned from previous
exercises, as described in LPHA's existing After Action Reports (AARs) and
Improvement Plans (IPs).
iv. At a minimum, the plan shall identify at least two exercises per year and shall
identify a cycle of exercises that increase in complexity from year one to year three,
progressing from discussion based exercises (e.g. seminars, workshops, tabletop
exercises, games) to operations based exercises (e.g. drills, functional exercises and
full-scale exercises); exercises of similar complexity are permissible within any
given year ofthe plan.
v. LPHA shall work with emergency management to integrate exercises with the
county exercise schedule.
Performance Measure 0.5: At a minimum, LPHA shall, before June 30 each year,
develop and satisfactorily execute two public health preparedness exercises as
outlined in the LPHA's approved Training and Exercise Plan. LPHA shall submit to
OHA for approval an exercise scope, including goals, objectives, activities, list of
invited participants, and list of exercise design team members, for each of the
exercises at least 45 days before each exercise is scheduled to take place. LPHA
shall provide to the OHA an AAR documenting each exercise within 60 days of
conducting the exercise. Disease outbreaks or other public health emergencies
requiring a LPHA response may, upon OHA's approval, be used to satisfy exercise
requirements. NIMS compliant procedures for LPHA command and control shall be
used to manage the response to the communicable disease or public health
emergencies.
i. Training. LPHA shall be responsible for ensuring the following:
i. Staff responsible for public health emergency planning and response roles shall be
trained for their respective roles consistent with the Conference of Local Health
Officials Minimum Standards dated June 2008, including training on how to
discharge the LPHA statutory responsibility to take measures to control
communicable disease in accordance with applicable law. The Conference of Local
Health Officials Minimum Standards may be viewed at:
http://public.health.oregongov/ProviderPartnerResources/LocalHealthDepartment
ResourcesIPageslre{erence.aspx
ii. Identifying and training appropriate LPHA staff for response to bioterrorism,
chemical, radiation, communicable diseases, and general emergency response.
iii. All local HAN users complete HAN training necessary for their user license.
iv. LPHA shall maintain training records for all local public health staff with
emergency response roles.
2013-2015 INTERGOVERNMENTAL AGREEMENT .'OR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 190F 40 PAGES
142008-7 PGM.OOC -DESCHUTES COUNTY
Performance Measure 0.6: The LPHA training shall include an evaluation
component. LPHA is to be NIMS compliant. To determine NIMS compliance and
view the standards go to: http://www.fema.gov/emergencY/nims/
j. Planning: The LPHA shall maintain and execute emergency preparedness procedures/
plans as a component of its jurisdictional Emergency Operations Plan (see attachment 3
for a recommended list). All LPHA emergency procedures shall comply with the NIMS.
The emergency preparedness procedures shall address the 15 CDC capabilities and/or
hazards described in their Community Hazard Risk Assessment and revisions shall be
done according to the schedule included in each LPHA plan, or according to the local
emergency management agency schedule, but not less than once every five years after
completion as required in OAR 104-010-005. The governing body of the LPHA shall
maintain and update the other components and shall be adopted as local jurisdiction
rules apply.
k. Contingent Emergency Response Funding: Such funding is subject to restrictions
imposed by CDC at the time of the emergency and would provide funding under
circumstances when a delay in award would result in serious injury or other adverse
impact to the public.
Since the funding is contingent upon Congressional appropriations, whether contingent
emergency response funding awards can be made will depend upon the facts and
circumstances that exist at the time of the emergency; the particular appropriation from
which the awards would be made, including whether it contains limitations on its use;
authorities for implementation; or other relevant factors. No activities are specified for
this authorization at this time.
2013-2015 INTERGOVERr>MENTAL AGREEMENT FOR THE FIMr>CING OF PUBLIC HEALTH SERVICES PAGE 20 OF 40 PAGES
142008-7 PGM.DOC -DESCHUTES COUNTY
Brief description of activities, for example, This position has primary
for U COlI'lty public health preparedness activities.
Brief description of activities and responsibHties
Brief and responsiblities
Contract with L--' Company, for L(__~
Contract with L--' Company, for { } services.
Contract with L--' Company for, ( i services.
TOTAL INDIRECT CHARGES @_'!'io of Direct Expenses:
Date, Name and Phone Number of person who prepared budget.
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FI~A~C1NG OF PUBLIC HEALTH SERVICES
142008-7 PGM.DOC -DESCHUTES COliNTY
ATTACHMENT 1
TO PROGRAM ELEMENT #12
BUDGET TEMPLATE
Preparedness Program Annual cu'uyc,," , ..'c~~~f~>,,""i~i¥Jf'~~ll!~" ;.XF'.' "'.'h.
________________________________~~~~~~~~20
Total
PAGE 21 OF 40 PAGES
$0
$0
$0
$0
$0
$0
$0
Preparedness Program Expense to Budget (Example)
( , County
Period ofthe Report (July 1, 20_-December
PERSONNEL
Salary
Fringe Benefits
TRAVEL
In-State Travel:
Out-of-State Travel:
EQUIPMENT
SUPPLIES
CONTRACTUAL
OTHER
TOTAL DIRECT
TOTAL INDIRECT @ XX% of Direct Expenses (or describe method): /--_--=--+
TOTAL: $0 $0 $0
Date. name and phone number of person who prepared expense to budget report
Notes:
The budget total should reflect the total amount in the most recent Notice of Grant Award.
The budget in each category should reflect the total amount in that
category for that line item in your submitted budget.
2013-2015 I NTERGOVER"'ME"'TAL AGRHME"'T FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 22 OF40 PAGES
142008-7 PGM.DOC -DESCHlrrES COUNTY
Preparedness Program Expense to Budget (Example)
( ) County
Period of the Report (July 1, 20_ -June 30. 20-->
PERSONNEL
Salary
Fringe Benefits
TRAVEL
In-State Travel:
Out-of-State Travel:
EQUIPMENT
SUPPLIES
CONTRACTUAL
OTHER
TOTAL DIRECT
TOTAL INDlRECT@XX%ofDirectExpenses(ordescribe method):
TOTAL:
~=----'~E~x-pen--s-e'-------'
Budget to date Variance
$0
$0
SO
$0 $0
$0
$0
SO
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
1--__---=$_0-1-='-____"'+---____...;.$...;.0-\
$0 $0
Date, name and phone number of person who prepared expense to budget report
Notes:
The budget total should reflect the total amount in the most recent Notice of Grant Award.
The budget in each category should reflect the total amount in that
category for that line item in your submitted budget.
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20)3-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 23 OF 40 PAGES
142008-7 PGM.DOC -DESCHFfES COUNTY
Public Health Emergency Preparedness
Equipment Inventory Ust
To be completed for all major equipment or property acquired or furnished with Pub11c: Health Emer,ency Preparedness fut
year with a unit acquisition cost of $5.000 or more.
Equipment location:
Completed by:
Phone Number:
5eria1 # or identification " Purchased by
Item Description Number Pun:hase Price Federal Funds Acquisition Data
• in accordance wilh 45 CFR 7437 or 45 CFR 92.5
Please retum the completed form to your Regional liaison by ALlllI5t 31 of each Vltar.
I
Questions on this form can be directed to Jill Snyder at 971-613.0714 or yout Region liaison. I•
f
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t
t
2013-20t5INTERGOVERl'IMENTAL AGREEMENT FOR THE FI"'ANCING OF PUBLIC HEALTH SERVICES PAGE 240F40 PAGES
t 42008-7 PGM.DOC DESCH liTES COUNTY
ATTACHMENT 2
TO PROGRAM ELEMENT #12
Oregon Public Health Emergency Preparedness Work plan Instructions
JUNE 1,2014 JUNE 30, 2015
• Your liaison will set a date for submission ofa first draft to meet a final approval deadline of Sept. 15,
2014.
• Your approved work plan will be reviewed with your liaison at mid-year and end of year.
• Activities required under the 2014-15 PE-12 are prefilled in the work plan template. Although you may
not eliminate any specific requirements, you may adjust the language as necessary to fit your specific
planning efforts within the scope of the PE-12.
Suggested process for work plan development:
• TRAINING AND EDUCATION: In addition to prefilled requirements, list all preparedness
trainings, workshops conducted or attended by preparedness staff.
• EXERCISES: Conduct at least two exercises annually in accordance with your three year
training and exercise plan. For an exercise to qualify under this requirement the exercise a.) must
be part of a progressive strategy, b.) involve public health staff in the planning process, and c.)
involve more than one county public health staff and/or related partners.
• COMMUNITY OUTREACH: List any community outreach activities you plan to conduct to
improved community preparedness.
• PARTNER / STAKEHOLDER COLLABORATION: In addition to prefilled requirements, list
all meetings regularly attended and/or led by public health preparedness program staff.
• PLANNING: List all plans, procedures, updates, and revisions that need to be conducted this
year in accordance with your planning cycle.
Column Descriptions:
CAPABILITIES: Indicate the target capabilities addressed by this activity
SUSTAIN or BUILD: Indicate whether this activity sustains your current level of capability or builds
additional capacity. At least two capabilities must be built within each work plan year.
PLANNED ACTIVITY: Describe the planned activity. Where activity is pre-filled, please customize to
indicate your own county's specific activity. Ex: Conduct local call down drill.
PROJECTED OUTPUT: Use SMART goals to describe the activity outcome. Ex: 90% of health
department staffwill respond to drill within 60 minutes.
ACTUAL OUTCOMES: Describe what is actually achieved and/or the products created from this
activity. Ex: 80% ofhealth department staffresponded. Contact information was updated and processes
reviewed to improve future compliance.
TARGET DATE: Proposed date this activity will occur or be completed.
NOTES: For additional explanation.
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PlIBLIC HEALTH SERVICES PAGE 25 OF 40 PAGES
142008-7 PCM.DOC· DESCHllTESCOlINTY
capabilities Sustain
or Build
FISCAL/ADMINISTRATIVE
Planned ActNity
Projected
Output
Actual
Outcome
Target Pate Notes
'...
capabil~ies SUstain
or Build
TRAININGANO
Plj~~L
Projected
Outp.ut
Actual
Outcome
Target~te<, 1.:.~Otes :;
.·.....c·.
Capabillti~
....
S~in ....
or.lollel E
I.EX~Rg~.gS
Ig,:;'$Oi1f!d;Althdri
projected
<()UtPl.lt
Actual
,.()utc,pme
Pr()jected
Output
~~,I
Outcome
capabilities Sq$ta'ns .••.. :.• ,pAitTNER/Sl'Ai(EHQLDEIt
or Stlild( ..•. COltABO~TION
. •...•....•.•.. ·~ti'>. .. PJag.~ed·A~ity
Projected.
. Output
.' Actual
Outcome
......
capabilities Sus~in !:
orBuld.
Pl.ANNI~G
Planned Activity
projected
Output
Actual
Outcome
Target pate,!.
....•..
capabilities UNPLANNED ACTIVITY OR INCIDENT
...
Outcome Date of actNity or
incident Notes.
2013-20J5 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 26 Of' 40 PAGES
142008-7 PGM.DOC -Dr,sCHlITES COUNTY
County EOP
ESF-8
• Public Health
• Medical/EMS
• Mental Health
• Mass Fatality Management
ATTACHMENT 5
TO PROGRAM ELEMENT #12
RECOMMENDED PLANS
ESF-8, Health and Medical, is not an exclusively public
health responsibility. Public health should be deeply
involved in most if not all ofthe issues included therein,
however, and will likely act as the coordinating entity for
ESF-8. This is something that must be worked out
locally in coordination with local emergency
management and with EMS, mental health services,
health care providers and chief elected officials.
Public Health Specific Plans / Procedures
PHEP Base Plan (If not part of ESF-8)
• Direction and Control (how response is organized)
• Public Information, Emergency Risk Communication
• Communications (Tactical communications, information sharing)
• Resource Management Plan / Procedures
Public Health Operations
• Emergency Mass Dispensing / Vaccination and/or Distribution
• Isolation and quarantine (may be in epi procedures)
• Surveillance and outbreak investigation (how to ramp up; may be in epi procedures)
• Environmental Health
• Water and Food Safety, Sanitation and Air quality (depends on county)
Volunteer Management Plan / Procedures
Behavioral Health (addressed separately or integrated into plans/procedures)
Vulnerable Populations (addressed separately or integrated into plans/procedures)
Biodetection System Response (only for Jackson, Multnomah and Lane counties)
Continuity of Operations Plan
Supporting Documents
Public Health HV A / HRA
Mutual Aid Agreements
Vulnerable populations data
Adoption ordinance / documentation
Maintaining Preparedness
Training and Exercise Plan
Two exerci ses / year
Tribal Coordination (if applicable)
Required elements may be included
as part of Public Health
Preparedness Plans or EOP, as
stand-alone plans and procedures
or-in some cases-in other policy
or procedure documents. When
organizing these elements, priority
should be given to making them
2417 Contact Testing ! practical and usable.
HAN testing, staff assembly drills
Plan update schedule and documentation
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 27 OF 40 PAGES
142008-7 PGM.DOC -DESCHUTES COUNTY
Exhibit 3 to Amendment #7 to Agreement #142008
Program Element #41: Reproductive Health Program
1. General Description. Reproductive Health Services are the educational, clinical and social
services necessary to aid individuals to detennine freely the number and spacing of their
children. The purpose of the Reproductive Health Program is to assist people of reproductive
age to fonnulate and carry out a reproductive life plan by providing services in a manner
satisfactory to OHA including, but not limited to, a broad range of effective contraceptive
methods and reproductive health services on a voluntary and confidential basis.
2. Definitions Specific to the Reproductive Health Program.
a. Ahlers & Associates: Vendor for data processing contracted by the Oregon Health
Authority, Reproductive Health Program.
b. Client Visit Record (CVR): Data collection tool for reproductive health encounters
developed by HHS, Office of Population Affairs, Region X, Office of Family Planning,
available from the OHA, Reproductive Health Program.
c. Federal Poverty Level (FPL) Guidelines: The annually adjusted poverty income
guidelines prescribed by HHS which OHA provides to LPHA by April of each year to
detennine income eligibility for clients.
d. Federal Title X Program: The federal program authorized under Title X of the Public
Health Service Act to provide reproductive health services, supplies and education to
anyone seeking them. By law, priority is given to low-income clients.
e. Program Income: Additional revenue generated by the provision of reproductive health
services, such as client fees, donations, third party insurance and Medicaid
reimbursement.
f. Title X Program Guidelines: Program Requirements for Title X Funded Family
Planning Projects (fonnerly the Title X Program Guidelines for Project Grants for
Family Planning Services) revised in 2014 and published by the Office of Population
Affairs, Office of Public Health and Science, Office of Family Planning.
3. Procednral and Operational Requirements. All reproductive health services supported in
whole or in part with funds provided under this Agreement must be delivered in compliance
with the requirements of the Federal Title X Program as detailed in statutes and regulations,
including but not limited to 42 USC 300 et.seq., 42 CFR Part 50 subsection 301 et seq., and 42
CFR Part 59 et seq., the Program Requirements for Title X Funded Family Planning Projects,
the OPA Program Instructions, and the Oregon Health Authority, Reproductive Health Program
Manual.
a. Title X Program Guidelines. LPHA must comply with the revised Federal Title X
Program Requirements, and any subsequent program instructions issued by the Office
of Population Affairs, including the following: I
I
f20J3-2015INTERGOVERNMENTAL AGREEME;'I/T FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 28 OF 40 PAGES
142008-7 PGM.OOC -DESCHUTES COl';'I/TY
i. Operation of clinical sites that are open to the public on an established schedule and
have specified clinical personnel as well as ancillary staff who can provide
reproductive health services to the public.
Citation 42 CFR 59.5 (b)(3)
ii. Provide a broad range of contraceptive methods as defined in the Federal Title X
Requirements and as specified by the OHA Reproductive Health Program.
Citation 42 CFR 59.5 (a)(I)
~ -iii. Provide an education program which includes outreach to inform communities of
available services and benefits of reproductive health.
Citation 42 CFR 59.5 (b)(3)
iv. Assurance of confidentiality for all clients receiving reproductive health services,
including specific requirements for adolescents.
v. National Standards of care as defined by OPA Program Instruction 09-01 must be
cited in protocol and followed for the provision of reproductive health services.
vi. Medications will be administered and dispensed following the Oregon Board of
Pharmacy rules.
Citation OAR 855-043-0300 and OAR 855-043-0110 to 0120
vii. Provision of coordination and use of referral arrangements with other healthcare
services, local health and welfare departments, hospitals, voluntary agencies, and
health services projects supported by other federal programs.
I
I Citation 42 CFR 59.5 (b) (8)
b. Data Collection.
i. LPHA must collect and submit client data to OHA through Ahlers and Associates
using the clinic visit record (CVR) for each individual receiving any service
supported in whole or in part with OHA funds provided under this Agreement.
Citation 42 USC 701-709
ii. LPHA must collect and submit to the state OHA RH Program the DHHS Title X
Outreach and Enrollment Data Report detailing Affordable Care Act outreach and
enrollment activities.
4. Reporting Requirements. In addition to the reporting obligations set forth in Exhibit E
Section 8 of this Agreement, LPHA shall submit to OHA the following written reports:
a. Annual Plan for Reproductive Health Services covering the period of July 1 through
June 30 of the succeeding year. OHA will supply the due date, required format and
current service data for use in completing the plan.
Citation Title X Regulation 6.2
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 29 OF 40 PAGES
142008-7 PGM.I)OC -DESCHUTES COUNTY
b. Projected Budget for Family Planning Services covering the period of July I through
June 30 of the succeeding year. OHA will provide due date and required format.
Citation 45 CFR 92.20
c. Family Planning Program-Specific Revenue and Expenditure Report must be submitted
quarterly on the dates specified in Exhibit E Section 8 of this Agreement
5. Program Income.
a. Sliding Fee Scale. If any charges are imposed upon a client for the prOVISIon of
reproductive health services assisted by the State under this Program Element, such
charges: (I) will be pursuant to an OHA-approved sliding fee schedule of charges, (2)
will not be imposed with respect to services provided to low-income clients, and (3)
will be adjusted to reflect the income, resources, and family size of the client provided
the services, in accordance with 42 USC 701-709.
Citation 42 CFR 59.5 (a) (7) and (a) (8)
b. Fees. Any fees collected for reproductive health services shall be used only to support
the Reproductive Health Program.
Citation 45 CFR 74.21, 74.24,92.20,92.25
c. Disposition of Program Income Earned. OHA requires that LPHA maintain separate
fiscal accounts for program income collected from providing reproductive health
services. Program income collected under this Agreement subsection must be fully
expended by the termination date of this Agreement and only for the provision of the
services set forth in this Program Element Description, and may not be carried over into
subsequent years. See definition 2.e ofthis PE for definition of program income.
Citation 45 CFR 74.21, 74.24, 92.20, 92.25
d. Indirect Costs. LPHA may not use more than 10% of the funds awarded for family
planning services on indirect costs. For purposes of this Contract, indirect costs are
defined as costs incurred by an organization that are not readily identifiable but are
nevertheless necessary to the operation of the organization and the performance of its
programs." These costs include, but are not limited to, "costs of operating and
maintaining facilities, for administrative salaries, equipment, depreciation, etc." in
accordance with 42 USC 701-709.
Citation 42 USC 701-709
6. Subcontracting. If LPHA chooses to subcontract all components of family planning services,
assurances must be established and approved by OHA to ensure the requirements of this
Agreement are adhered to.
a. LPHA may sub-contract with another OHA Title X sub-recipient within the same
service area for the provision of Title X Family Planning services. LPHA shall monitor
client care and adherence to all program requirements as outlined in this contract.
LPHA shall participate in triennial reviews and must rectify any review findings.
Additional reviews, conducted by LPHA will be required as part of a sub-contract
agreement.
2013-2015 INTERGOVERNMENTAL t\GREEMEi'<T FOR THE FINAi'<CING OF PURLIC HEALTH SERVICES PAGE 30 m" 40 PAGES
142008-7 PGM.OOC -DESCHliTES COUi'<TV
b. LPHA may sub-contract with a non-Title X sub-recipient of OHA within the same
service area but must provide all necessary training to ensure that said sub-contractor is
fully knowledgeable of Title X program requirements. LPHA shall monitor client care
and adherence to all program requirements as outlined in this contract. LPHA shall
participate in triennial reviews and must rectifY any review findings. Additional
reviews, conducted by LPHA will be required as part of a sub-contract agreement.
2013-2015INTERGOVERN'VIENTAL AGREEMENT FOR THE FINANCING OF PlIBLIC HEALTH SERVICES PAGE310F40PAGES
142008-7 PGM.DOC -DESCHUTES COUNTY
Exhibit 4 to Amendment #7 to Agreement #142008
Program Element #44: School Based Health Centers (SBHC)
1. School-Based Health Center ("SBHC") Services
a. Definitions:
School-Based Health Center ("SBHC") has the meaning given the term in ORS
413.225.
b. Procedural and Operational Requirements.
i. The funds provided under this Agreement for SBHC Services shall only be used to
support activities related to planning, oversight, maintenance, administration,
operation, and delivery of services within one or more SBHC as required by OHA's
SBHC funding formula.
ii. All SBHC Services must be delivered in accordance with OAR 333-028-0220, a
copy of which or accessible on the Internet at:
[Copy and paste this link into your browser's address bar]
http://arcweb.sos.state.or.us/pages/rules/oars 300loar 3331333 028.html
The 2014 Standards for Certification for SBHC includes administrative, operations
and reporting guidance, and minimum standards and/or requirements in the areas of:
Certification Process, Sponsoring Agency/Facility, Operations/Staffing,
Laboratory/Diagnostic Services, Comprehensive Services, Data Collectionl
Reporting, and Billing. A copy of the Standards for Certification is available from
OHA or accessible on the Internet at:
[Copy and paste this link into your browser's address bar]
http://public.healthoregon.gov/HealthyPeopleFamilies/YouthiHealthSchoollSchool
BasedHealthCenterslDocumentslCerti{icationStandards2014.pdf
iii. LPHA must provide the oversight and technical assistance so that each SBHC in its
jurisdiction meets Certification Requirements as set forth in OAR 333-028-0220 ..
iv. LPHA shall assure to OHA that all certification documentation and subsequent
follow-up items are completed by the requested date(s) in accordance with the
OHA's certification review cycle as set forth in OAR 333-028-0230.
c. Reporting Obligations and Periodic Reporting Requirements. In addition to the
reporting requirements set forth in Section 8 of Exhibit E of this Agreement, LPHA
shall assure that all SBHC's in its county jurisdiction:
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 32 OF 40 PAGES
142008-7 PGM.DOC -DESCHUTES COUNTY
I
i. Submit client encounter data in a form acceptable to OHA and in accordance with
the 20 10 Standards for Certification at two times during the year, no later than
January 31 for the previous calendar year (July I -Dec 31) and no later than July
I Sth for the preceding service year (July 1 -June 30), and
ii. Submit annual SBHC Key Performance Measure (KPM) data in a form acceptable
to OHA and in accordance with the 2014 Standards for Certification no later than
October 1 st for the preceding service year (July 1 -June 30). The current list of
KPMs can be found at:
[Copy and paste this link into your browser's address bar]
http://public.healthoregon.gov/HealthyPeopleFamilieslYouthiHealthSchoollSchool
BasedHealthCenterslDocumentslKPMpdf
iii. Submit annual SBHC financial data via the Program's online Operational Profile in
the form acceptable to OHA no later than October I st for the preceding service year
(July I-June 30).
iv. Submit annual SBHC hours of operation and staffing via the Program's online
Operational Profile in the form acceptable to OHA no later than October 151 for the
current service year.
v. Submit completed annual patient satisfaction survey data no later than June I st.
vi. Complete the triennial School-Based Health Alliance SBHC Census Survey.
Current SBHC Census Survey timeline and details can be found at
http://www.sbh4all.orgl.
2. SBHC Planning Grants (for specific LPHAs in 2013-2015)
a. This section is applicable only to those LPHAs who have received a Planning Grant
from the Oregon Health Authority. Current and potential LPHAs will be notified if the
2013 Legislature approves and appropriates funds for SBHC Planning Grants or the
SBHC State Program Office has other available funds for SBHC development.
b. An SBHC planning grant awards one-time funds to assist the LPHA in developing a
strategic plan for implementing SBHC Services in the LPHA county jurisdiction. The
following terms and conditions apply if the Authority selects LPHA to receive a
planning grant:
i. Phase I (October 1,2013 -Juue 30, 2014) Strategic Planning
(A.) LPHA shall create and implement a collaborative strategic plan in
partnership with community agencies in order to develop, implement, and r
fmaintain SBHC Services to serve school-age children. This plan's target
must have the SBHC sites operational and ready for certification by Spring
201 S. SBHC certification standards are available from OHA or by using the
weblink provided in Section 1.a.ii above. I
I
2013-20151NTERGOVERNMEN1'AL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 33 OF 40 PAGES
142008-7 PGM.DOC -DESCHUTES COlINTY
(B.) LPHA shall participate in monthly technical assistance calls at times
mutually agreed to between OHA SBHC Program and LPHA Phase I
Planning LPHAs. In addition each SBHC site may have at least one
technical assistance visit by an OHA SBHC Program staff member.
(C.) By July 15, 2014, LPHA shall submit a final report and line item
expenditure report briefly describing its activities and progress to date on the
development of SBHC Services together with a copy of its strategic plan and
proposed implementation budget for Phase II.
ii. Phase II (July 1, 2014-June 30,2015) Strategic Planning
(A.) LPHA shall implement the approved Phase I SBHC strategic plan and have
the planned SBHC Services operational and ready for certification by Spring
2015. Sites must become certified by Spring 2015 to maintain current
funding and to receive SBHC awards in accordance with the approved
funding formula in effect and contingent on available funding. SBHC
certification standards are available at:
http://public. health. oregon.gov/HealthyPeopieF amilieslY outhlHealthSchool1
SchooiBasedHealthCentersiDocumentsiCertitlcationStandards20J4.pdf.
(B.) LPHA shall participate in monthly technical assistance calls at times
mutually agreed to between OHA SBHC Program and LPHA Phase II
Planning LPHAs. In addition, each SBHC site may have at least one
technical assistance visit by an OHA SBHC Program staffmember.
iii. Advance Phase (October 1, 2013-June 30, 2014 or July 1,2014 -June 30, 2015)
Strategic Planning
(A.) LPHA shall create and implement a collaborative strategic plan in
partnership with community agencies in order to develop, implement, and
maintain SBHC Services to serve school-age children. This plan's target
must have the SBHC sites operational and ready for certification by Spring
2014 or Spring 2015. SBHC certification standards are available at:
http.-//public.health.oregon.govIHealthyPeopleFamiliesIYouthlHealthSchool1
SchoolBasedHealthC enters/Documents/CertificationStandards20 J4. pdf.
(B.) LPHA shall participate in monthly technical assistance calls at times
mutually agreed to between the Authority SBHC Program and Advance
Phase Planning LPHAs. In addition, each SBHC site may have at least one
technical assistance visit by a Authority SBHC Program staff member.
(C.) LPHA must become certified in by Spring 2014 or Spring 2015 to maintain
current funding and to receive SBHC awards in accordance with the
approved funding formula in effect and contingent on available funding.
SBHC certification standards are available at:
2013-20I5INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 34 OF 40 PAGES
142008·7 PGM.DOC· DESCHUTES COUNTY
http://public.health.oregon.gov/HealthyPeopleFamilies/YouthiHealthSchooll
SchoolBasedHealthCenterslDocumentslCertificationStandards2014.pdf.
3. SBHC Mental Health Expansion Grants (December 1,2013 -June 30, 2015)
a. Funds provided under this Agreement shall be used to support mental health capacity
within the school-based health center system by:
i. adding menta) health staff or expanding current mental health staff hours, with the
ability to collect and report on mental health encounter visits and lor
ii. supporting mental health projects (as defined by grant proposal) within the school
based health center system.
b. LPHA shall provide services that are culturally and linguistically appropriate to their
target population.
c. LPHA shall track data related to mental health encounters as outlined in the SBHC
Certification standards. SBHC Certification standards are available at:
http://public.health.oregongov/HealthyPeopleFamilies/YouthiHealthSchoollSchoolBas
edHealthCentersIDocumentsICertificationStandards2014.pdf.
d. LPHA shall collect data as part of an evaluation for their support project In
collaboration with the SPO.
e. LPHA shall participate in monthly check-in meetings (via phone or email) with the SPO
and submit 2 mid-project reports and a final project report, due June 15, 2014,
December] 5,2014, and June 15,2015, respectively.
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 35 OF 40 PAGES
142008-7 PGM.DOC-DESCH liTES COIJNTY
Attachment 1 to Amendment #7 to Agreement #142008
Financial Assistance Award for the period July 1,2014 to June 30, 2015
I
State of Oregon Page 1 of2
Oregon Health Authority
Public Health Division
1) Grantee 2) Issue Date This Action
Name: Deschutes County Health Services June 18,2014 ORIGINAL
FY2015
Street: 2577 N. E Courtney 3) Award Period
City: Bend From July 1,2014 Through June 30, 2015
State: OR Zip Code: 97701
4) OHA Public Health Funds Approved
Previous Increasel Grant
Program Award (Decrease) Award
PE 01 State Support for Public Health 178,374
PE 03 TB Case Management 1,144
PE 07 HIV Prevention Services 29,886
H IV Prevention Block Grant Services
Ryan White Title II HIV I AIDS Services
PE 08 Ryan White--Case Management 77,894
PE 08 Ryan White--Support Services 25,730
PE 12 Public Health Emergency Preparedness
,PE 13 Tobacco Prevention &. Education 133,323
PE 15 Healthy Communities --Phase II 81,250
PE 40 Women, Infants and Children 620,940
FAMILY HEALTH SERVICES (a,b)
PE 40 WIC --PEER Counseling 44,100
FAMIL Y HEALTH SERVICES (cd)
PE 41 Reproductive Health Program 162,392
FAMIL Y HEAL TH SERVICES ( h )
5) FOOTNOTES:
a) July -September grant is $155,235 ; and includes $5,832 of minimum Nutrition Education: and
$7,955 for Breastfeeding Promotion.
b) October-June grant is $465,705 ; and includes $93,141 of minimum Nutrition Education amount
and $23,866 for Breastfeeding Promotion.
c) $11,025 is the July-September 2014 funding.
d) $33,075 is for the October 2014 through July 2015 period.
e) $268,613 is for July through September 2014. A10
f) $24,623 must be spent by 9/30114. Carry forward is not allowed. October-June is $73,870
g) $268,613 is for July through September 2014.
h) $120,736 is Title X funds for FY2015: $41,656 is Title V funds for FY2015.
j) Funds will not be shifted between categories or fund types. The same program may be funded
by more than one fund type, however, Federal funds may not be used as match for other
Federal funds ( such as Medicaid ).
6) Capital Outlay Requested in This Action:
Prior approval is required for Capital Outlay. Capital Outlay is defined as an expenditure for equip
ment with a purchase price in excess of $5,000 and a life expectancy greater than one year.
PROGRAM ITEM DESCRIPTION
I
I
PROG.
COST APPROV
PAGE 36 OF 40 PAGES2013-2015 I NTERGOVERNM ENTAL AGREEM ENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES
142008-7 PGM.OOC -DESCHUTES COUNTY
State of Oregon Page 2 of2
Oregon Health Authority
Public Health Division
1} Grantee I 2) Issue Date This Action
Name: Deschutes County Health Services • June 18, 2014 ORIGINAL
i FY2015
Street 2577 N. E. Courtney 3) Award Period
City: Bend From July 1,2014 Through June 30,2015
State: OR Zip Code: 97101
4} OHA Public Health Funds Approved
i Previous Increasel Grant
Program Award (Decrease) Award
PE 42 MCH/Child & Adolescent Health General Fund 11,323
FAMILY HEALTH SERVICES (i)
PE 42 MCH-TitieV Child & Adolescent Health 12,502
i FAMIL Y HEALTH SERVICES (i)
PE 42 MCH-TIlleV Flexible Funds 29,173
FAMILY HEALTH SERVICES ( i )
PE 42 MCH/Perinatal Health --General Fund 6,035
FAMILY HEALTH SERVICES (i)
PE 42 Babies First 18,078
FAMILY HEALTH SERVICES
PE 42 Oregon MothersCare 20,375
FAMILY HEALTH SERVICES
PE 43 Immunization Special Payments 38,902
FAMILY HEALTH SERVICES
PE 44 School Based Health Centers 325,000
FAMILY HEALTH SERVICES
PE 47 Linking Actions for Unmet Needs in Ch~d Health Project 268,613
FAMILY HEALTH SERVICES ( e)
PE 48 Teen Pregnency Prevention P.RE.P. 98,493
FAMILY HEALTH SERVICES ( f )
PE 50 Safe Drinking Water Program 93,862
2277 389
5} FOOTNOTES:
i
6) Capital Outlay Requested in This Action:
Prior approval is required for Capital Outlay_ Capital Outlay is defined as an expenditure for equip
ment with a purchase price in excess of $5,000 and a life expectancy greater than one year.
PROG.
PROGRAM ITEM DESCRIPTION COST APPROV
I
I
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PlIBLIC HEALTH SERVICES PAGE 37 OF 40 PAGES
142008-7 PGM.DOC -DESCHlITES COlJNTY
Attachment 2 to Amendment #7 to Agreement #142008
OREGON HEALTH AUTHORITY
2013-2015 INTERGOVERNMENTAL AGREEMENT
FOR THE FINANCING OF PUBLIC HEALTH SERVICES
EXHIBITD
SPECIAL TERMS AND CONDITIONS
1. Enforcement of the Oregon Indoor Clean Air Act. This section is for the purpose of
providing for the enforcement of laws by LPHA relating to smoking and enforcement of the
Oregon Indoor Clean Air Act (for the purposes of this section, the term "LPHA" will also refer
to local government entities e.g. certain Oregon counties that agree to engage in this activity.)
a. Authority. Pursuant to ORS 190.110, LPHA may agree to perform certain duties and
responsibilities related to enforcement of the Oregon Indoor Clean Air Act, 433.835
through 433.875 and 433.990(D) (hereafter "Act") as set forth below.
b. LPHA Responsibilities. LPHA shall assume the following enforcement functions:
(1) Maintain records of all complaints received using the complaint tracking system
provided by OHA's Tobacco Prevention and Education Program (TPEP).
(2) Comply with the requirements set forth in OAR 333-015-0070 to 333-015-0085
using OHA enforcement procedures.
(3) Respond to and investigate all complaints received concerning noncompliance
with the Act or rules adopted under the Act.
(4) Work with noncompliant sites to participate in the development of a remediation
plan for each site found to be out of compliance after an inspection by the
LPHA.
(5) Conduct a second inspection of all previously inspected sites to determine if I
remediation has been completed within the deadline specified in the remediation •
plan.
(6) Notity TPEP within five business days of a site's failure to complete
remediation, or a site's refusal to allow an inspection or refusal to participate in
development of a remediation plan. See Section 3.c. "OHA Responsibilities."
(7) For each non-compliant site, within five business days of the second inspection,
send the following to TPEP: intake form, copy of initial response letter,
remediation form, and all other documentation pertaining to the case.
(8) LPHA shall assume the costs of the enforcement activities described in this
section. In accordance with an approved Community-based work plan as
I
I
2013-2015 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 38oF40 PAGES
142008-7 PGM.DOC -DESCHUTES COUNTY
prescribed in OAR 333-010-0330(3)(b), LPHAs may use Ballot Measure 44
funds for these enforcement activities.
(9) If a local government has local laws or ordinances that prohibit smoking in any
areas listed in ORS 433.845, the local government is responsible to enforce
those laws or ordinances using local enforcement procedures. In this event, all
costs of enforcement will be the responsibility of the local government. Ballot
Measure 44 funds may apply; see Section 2.h. above.
c. OHA Responsibilities. OHA shall:
(1) Provide an electronic records maintenance system to be used in enforcement,
including forms used for intake tracking, complaints, and site visit/remediation
plan, and templates to be used for letters to workplaces and/or public places.
(2) Provide technical assistance to LPHAs.
(3) Upon notification of a failed remediation plan, a site's refusal to allow a site
visit, or a site's refusal to develop a remediation plan, review the documentation
submitted by the LPHA and issue citations to non-compliant sites as appropriate.
(4) If requested by a site, conduct contested case hearings in accordance with the
Administrative Procedures Act, ORS 183.411 to 183.470.
(5) Issue final orders for all such case hearings.
(6) Pursue, within the guidelines provided in the Act and OAR 333-015-0070
OAR 333-015-0085, cases of repeat offenders to assure compliance with the
Act.
2. HIPAA Compliance. The health care component of OHA is a Covered Entity and must
comply with the Health Insurance Portability and Accountability Act and the federal
regulations implementing the Act (collectively referred to as HIPAA). LPHA is a Business
Associate of the health care component of OHA and therefore must comply with OAR 943
014-0400 through OAR 943-014-0465 and the Business Associate requirements set forth in 45
CFR 164.502 and 164.504. LPHA's failure to comply with these requirements shall constitute
a default under this Agreement and such default shall not be subject to Exhibit F "Standard
Terms and Conditions", Section 1] "Limitation of Liabilities".
a. Consultation and Testing. If LPHA reasonably believes that the LPHA's or OHA's
data transactions system or other application of HIPAA privacy or security compliance
policy may result in a violation of HIPAA requirements, LPHA shall promptly consult
the OHA Information Security Office. LPHA or OHA may initiate a request for testing
of HIPAA transaction requirements, subject to available resources and the OHA testing
schedule.
2013-20]5 INTERGOVERNMENTAL AGREEMENT FOR THE FINANCING OF PtlBUC HEALTH SERVICES PAGE 390F40 PAGES
] 42008-7 PGM.DOC -DESCHUTES COUNTY
b. Data Transactions Systems. If LPHA intends to exchange electronic data transactions
with a health care component of OHA in connection with claims or encounter data,
eligibility or enrollment information, authorizations or other electronic transaction,
LPHA shall execute an Electronic Data Interchange (EDI) Trading Partner Agreement
with OHA and shall comply with OHA EDI Rules set forth in OAR 943-120-0110
through 943-120-0160.
THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK
2013-20lS1NTERGOVERN;\1ENTAL AGREEMENT f'OR THE FINANCING OF PUBLIC HEALTH SERVICES PAGE 40 Qf'40 PAGES
142008-7 PGM.DOC -DESCU LITES COUNTY
Nancy Mooney
From: Thomas Kuhn
Sent: Monday, June 30, 2014 9:22 AM
To: Nancy Mooney ISubject: RE: LPHA 142008-7 ready for approval for signature
f
Hi Nancy,
I
f
I affirm that I have read the OHA IGA #7 (July I, 2014 -June 30, 2015) in its entirety, that we can
accept/accomplish the required work and that signing this document is recommended. I've read the document
and approve the Statement of Work as it is set forth in this agreement. t
Note: Program Element 12 (Emergency Preparedness) is missing from this amendment and will be issued in a separate
amendment.
Sincerely, ITom Kuhn, M.S.Ed.
Deschutes County Health Services
Community Health Program Manager !
2577 NE Courtney Dr.
Bend, OR 97701
Ph:{541} 322-7410 I
thomask@deschutes.org
From: Nancy Mooney
Sent: Friday, June 27, 20149:21 AM
To: Thomas Kuhn
Subject: LPHA 142008-7 ready for approval for signature
Importance: High
Tom, I'm not sure who else may need to approve this amendment. Please let me know if I need to
send this to anyone else.
Please provide your affirmation that you have read this document in its entirety, that we can
accept/accomplish the Statement of Work and that signing this document is recommended.
Please note upon e-mailing your consent for signature that you're confirming you've read the
document and reviewed/approved the Statement of Work as it is set forth in the document.
Thank you,
Nancy Mooney
Contract Specialist
Phone: 541-322-7516
Fax: 541-322-7565
Deschutes County Health Services
2577 NE Courtney Drive
Bend, OR 97701
I
t
1
Nancy Mooney
From: MCCOY Phillip <phillip.mccoy@state.or.us>
Sent: Monday, June 30, 2014 6:36 AM
To: Nancy Mooney
Cc: PERKINS Meredith; Thomas Kuhn
Subject: RE: 2013/2015 LPHA 142008-7 --Question
PE 12 funding will be issued in a separate amendment.
'PMt&p tJ. ?1kff09, OPSC, OCAC
Contract Specialist
DHS/OHA Shared Services, Office of Contracts and Procurement
250 Winter Street NE
Salem, OR 97301
503-945-5868
Fax: 503-373-7365
Email: phillip.mccoy@state.or.us
Your customer feedback is always appreCiated. If you would like to comment about your experience, please take a
moment to contact my supervisor: Brenda Brown (503) 947-5284 or brenda.j.brown@state.or.us.
From: Nancy Mooney [mailto:Nancy.Mooney@deschutes.org]
Sent: Friday, June 27, 2014 11:33 AM
To: 'phillip.mccoy@state.or.us'
Cc: Connie THIES (connie.thies@state.or.us); Thomas Kuhn
Subject: 2013/2015 LPHA 142008-7--Question
Importance: High
Phil,
I have a question regarding Page 36. Program Element #12 does not have any funds attached in the
Grant Award column and I understand that for FY15 the award amount is to be $109,421. Please let
me know if this is coming in a separate amendment or if you would like to revise amendment #7.
Thank you,
Nancy Mooney
ContractlCredentialing Specialist
Deschutes County Health Services
2577 NE Courtney Drive
Bend, OR 97701
Phone: 541-322-7516
Fax: 541-322-7565
Business Hours:
Monday -Thursday gAM to 6PM
Friday 8AM to SPM
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Nancy Mooney
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From: Pamela Ferguson
Sent: Friday, June 27, 2014 2:08 PM
To: Nancy Mooney
Cc: Pamela Ferguson
Subject: RE: LPHA 142008-7 ready for approval for signature ,
FOR MATERNAL CHILD HEALTH PROGRAMS:
I affirm that I have read this document in its entirety, that we can accept/accomplish the Statement of Work and that
signing this document is recommended.
I also understand that bye-mailing my consent for signature that I am confirming that I have read the document and
reviewed/approved the Statement of Work as it is set forth in the document.
Thanks.
Pamela
Pamela Ferguson, RN, BSN, MHA
Interim Program Manager, Maternal Child Health
Clinical Supervisor, Nurse-Family Partnership & Maternal Case Mgt
Deschutes County Health Services
2577 NE Courtney Drive
Bend, OR 97701
541-322-7423 (office)
541-639-1434 (cell)
pamela.ferguson@deschutes.org
Our Mission: To promote and protect the health and safety of our community.
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e-mail message, Including an!} ali:achments, is For the sole use of the intended and 111":) con1:"1<1 contidenticll and privileged
infonnabon. /\n.lJ un"lIthori~ed review, lise, disclo:>ure, or distribution is pmhibited. IflJOU are not the mtended contact the
sender' b:1r<TI:1 e-mild and destw,'j nil C(JF"~S of the o,-iglnnl message. Thank :Jou r
From: Nancy Mooney
Sent: Friday, June 27, 2014 10:03 AM
To: Pamela Ferguson
Cc: Thomas Kuhn
Subject: LPHA 142008-7 ready for approval for signature
Importance: High
Pam, Please approve your part of this amendment.
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