Contract - 07-25-2023 - 12922 - Contract Department of Health Group A Water Systems AS-12922 Motion Items 4.
BOCC Agenda
Meeting Date: 07/25/2023
Contract 21-070 (8)with the Department of Health
Submitted For: Carole Harrison Submitted By: Wheeldon Jennifer
Department: Health/Human Services
Information
Subject and Summary Statement
This contract with the Washington State Department of Health is a multi-year, multi-program contract
which contains key sources of public health funding accompanied by 'Statements of Work (SOW)' and
specific deliverables (tasks). An initial contract is received at the beginning of the multi-year agreement
with amendments that arrive every 4-6 weeks which may change funding sources or tasks.
The purpose of this revision is to modify statement of work for Group A water systems, to reconcile
Foundational Public Health Services (FPHS) funding based on actual spending for the period
7/1/22-6/30/23, and to add the new FPHS allocation for 7/1/23-6/30-24.
Total Con-Con 4,205,878.0 +181,000.0 4,386,878.0 1/1/22-12/31/2
SOW Name Source of Change in
(MCHBG, PHEPR, (Fed or Current $ (+$100, Total $$ Funding Period
etc.) State) -$100, etc.)
FPHS STATE 1,589,00 -1,258,0001 331,00 7/1/22-6/30/2
FPHS STATE A +1,439,00 1,439,00 7/1/23-6/30/2
GROUP A WATER STATE 1 7,50A 7,500 1/1/22-12/31/23
Will Staff Attend - NAME OF STAFF
Gena James will attend.
Department Recommendation
It is the recommendation of the Cowlitz County Health & Human Services Department that the Cowlitz
County Board of Commissioners move to approve Contract Amendment 21-070 (8) with the
Department of Health.
Attachments
Amendment 21-070 (8)
SOW- FPHS 2022
SOW- FPHS 2023
SOW - Group A
Contract Summary
Summary- FPHS- 21-24 allocations
21-070 (7) Fully signed
AS-12922 Motion Items 4.
BOCC Agenda
Meeting Date: 07/25/2023
Contract 21-070 (8)with the Department of Health
Submitted For: Carole Harrison Submitted By: Wheeldon Jennifer
Department: Health/Human Services
Information
Subject and Summary Statement
This contract with the Washington State Department of Health is a multi-year, multi-program contract
which contains key sources of public health funding accompanied by'Statements of Work (SOW)' and
specific deliverables (tasks). An initial contract is received at the beginning of the multi-year agreement
with amendments that arrive every 4-6 weeks which may change funding sources or tasks.
The purpose of this revision is to modify statement of work for Group A water systems, to reconcile
Foundational Public Health Services (FPHS)funding based on actual spending for the period
7/1/22-6/30/23, and to add the new FPHS allocation for 7/1/23-6/30-24. _
'Total Con-Con 4,205,878.00 +181,000.0 4,386,878.00 1/1/22-12/31/2
SOW Name Source of Change in y
(MCHBG, PHEPR, (Fed or Current$ (+$100, Total $$ Funding Period
etc.) State) -$100, etc.) y
IFPHS 1STATE 1,589,00 -1,258,000 331,00 7/1/22-6/30/2
IFPHS ,STATE +1,439,00 1,439,000 7/1/23-6/30/2
GROUP A WATER ISTATE 7,500 7,500 1/1/22-12/31/2
Will Staff Attend - NAME OF STAFF
Gena James will attend.
Department Recommendation
It is the recommendation of the Cowlitz County Health & Human Services Department that the Cowlitz
County Board of Commissioners move to approve Contract Amendment 21-070 (8) with the
Department of Health.GG
Approved: 2 J 23
BOARD OF COUN Y COMMISSIONERS
NTY, WASHINGT N
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Richard R Dahl, Chairman o�GOt11VTr
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A Mortensen, Co issio er m COUNTY
Al 0 MASIiNri�W
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Dennis P Weber, Commissioners � ca`
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Attachments
Amendment 21-070 (8)
SOW- FPHS 2022
SOW - FPHS 2023
SOW- Group A
Contract Summary
Summary- FPHS- 21-24 allocations
21-070 (7) Fully signed
21-070 DOH ConCon (6)signed
21-070 (5) Fully signed
21-070 (4) Fully signed
21-070 (3) Fully signed
21-070 (2) Fully signed
21-070 (1) Fully signed
Original Signed Contract
Form Review
Inbox Reviewed By Date
Jamie Hopps Jamie Hopps 07/11/2023 04:49 PM
Gena James Gena James 07/12/2023 10:11 AM
Form Started By:Wheeldon Jennifer Started On:07/11/2023 10:53 AM
Final Approval Date:07/14/2023
COWLITZ COUNTY HEALTH& HUMAN SERVICES
2022-2024 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH31008 AMENDMENT NUMBER: 8
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as
"DOH", and COWLITZ COUNTY HEALTH &HUMAN SERVICES, a Local Health Jurisdiction,hereinafter referred to
as "LHJ",pursuant to the Modifications/Waivers clause, and to make necessary changes within the scope of this contract
and any subsequent amendments thereto.
IT IS MUTUALLY AGREED: That the contract is hereby amended as follows:
I. Exhibit A Statements of Work, includes the following statements of work, which are incorporated by this reference
and located on the DOH Finance SharePoint site in the Upload Center at the following URL:
ItIWE1/swieafwa.s s/dol3-ofsfuiidingt:esources/sitepgges4iome.asnx'?=e1;9a94G88da2d94d3ea80ac7fbc32e4d7c
® Adds Statements of Work for the following programs:
Foundational Public Health Services(FPHS) -Effective July 1, 2023
® Amends Statements of Work for the following programs:
Foundational Public Health Services(FPHS) - Effective July 1, 2022
Office of Drinking Water Group A Program - Effective January 1, 2022.
❑ Deletes Statements of Work for the following programs:
2. Exhibit B-8 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-7 Allocations as
follows:
® Increase of 18$ 1,000 for a revised maximum consideration of$4,386,878.
❑ Decrease of for a revised maximum consideration of
❑ No change in the maximum consideration of
Exhibit B Allocations are attached only for informational purposes.
Unless designated otherwise herein,the effective date of this amendment is the date of execution.
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force
and effect.
IN WITNESS WHEREOF, the undersigned has affixed his/her signature in execution thereof.
COWLITZ COUNTY HEALTH&HUMAN SERVICES STATE OF WASHINGTON
DEPARTMENT OF HEALTH
Signatiir . Signature:
V�
Date: I Date:
LZS12'�
APPROVED AS TO FORM ONLY
Assistant Attorney General
Page 1 of 1
EXHIBIT B-8
Cowlitz County Health&Human Services Department ALLOCATIONS Contract Number: CLH31008
Contract Term:2022-2024 Date: June 1,2023
Indirect Rate as of January 1,2022:Direct Allocation of Costs
DOH Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend# List#* Code** Start Date End Date Start Date End Date Amount SubTotal
Total
FFY22 PHEP BP4 LHJ Funding NU90TP922043 Amd4 93.069 333.93.06 07/01/22 06/30/23 07/01/22 06/30/23 $79,074 $79,074 $158,148
FFY21 PHEP BP3 LHJ Funding NU90TP922043 Amd 2 93.069 333-93.06 01/01/22 06/30/22 07/01/21 06/30/22 $79,074 $79,074
COVID19 Vaccines R4 NH231P922619 Amd 3 93.268 333.93.26 01/01/22 06/30/24 07/01/20 06/30/24 ($460,864) $0 $0
COVID19 Vaccines R4 NH231P922619 Amd 1 93.268 333.93.26 01/01/22 06/30/24 07/01/20 06/30/24 $460,864
FFY19 ELC COVID Ed LHJ Allocation NU50CK000515 Amd 2 93.323 333.93.32 01/01/22 10/18/22 05/19/20 10/18/22 $191,632 $191,632 S191,632
FFY20 ELC EDE LHJ Allocation NTJ50CK000515 Amd 2 93.323 333.93.32 01/01/22 12/31/22 01/15/21 07/31/24 $1,658,052 S1,658,052 $1,658,052
FFY22 MCHBG LHJ Contracts B04MC45251 Amd 1 93.994 333-93-99 01/01/22 09/30/22 10/01/21 09/30/22 $78,754 $78,754 $78,754
GFS-Group B(FO-SW) Amd 6 N/A 334.04.90 01/01/23 06/30/23 07/01/22 06/30/23 $25,878 S25,878 $51,755
GFS-Group B(FO-SW) Amd 1 N/A 334,04.90 01/01/22 06/30/22 07/01/21 06/30/22 $25,877 $25,877
SFY23 FPHS-LHJ-GFS Amd 8 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 ($1,258,000) S331,000 $331,000
SFY23 FPHS-LHJ-GFS Amd 5 N/A 336,04.25 07/01/22 06/30/23 07/01/21 06/30/23 $150,000
SFY23 FPHS-LHJ-GFS Amd 4,5 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 $1,439,000
FPHS-LHJ-Proviso(YR2) Amd 4 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 (S867,000) $0 $471,037
FPHS-LHJ-Proviso(YR2) Amd I N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 S867,000
FPHS-LHJ-Proviso(YR1) Amd 5 N/A -336,04.25 01/01/22 06/30/22 07/01/21 06/30/23 ($395,963) $471,037
FPHS-LHJ-Proviso(YRI) Amd 1 N/A 336.04.25 01/01/22 06/30/22 07/01/21 06/30/23 $867,000
FPHS-Local Health Jurisdiction Amd 8 N/A 336.04.25 07/01/23 06/30/24 07/01/23 06/30/25 $1,439,000 S1,439,000 $1,439,000
YR 25 SRF-Local Asst(15%)(FO-S W)SS Amd 7 N/A 346.26.64 01/01/23 12/31/23 01/01/23 12/31/23 $2,250 $2,250 $5,500
YR24 SRF-Local Asst(15%)(FO-SW)SS Amd 1 N/A 346.26.64 01/01/22 12/31/22 07/01/21 06/30/23 $3,250 $3,250
YR 25 SRF-Local Asst(15%)(FO-SW)TA Amd 7 N/A 346.26.66 01/01/23 12/31/23 01/01/23 12/31/23 $1,000 $1,000 $2,000
YR24 SRF-Local Asst(15%)(FO-SW)TA Amd I N/A 346.26.66 01/01/22 12/31/22 07/01/21 06/30/23 S1,000 S1,000
TOTAL S4,386,878 $4,386,878
Total consideration: S4,205,878 GRAND TOTAL $4,386,878
$181,000
GRAND TOTAL $4,386,878 Total Fed $2,086,586
Total State $2,300,292
*Catalog of Federal Domestic Assistance
"Federal revenue codes begin with"333". State revenue codes begin with"334",
Pagel of]
Exhibit A
Statement of Work
Contract Term: 2022-2024
DOH Program Name or Title: Foundational Public Health Services FPHS - Local Health Jurisdiction Name: Cowlitz County Health&Human Services
Effective July 1,2022 Department
Contract Number: CLH31008
SOW Type: Revision Revision#(for this SOW) 2 Funding Source Federal Compliance Type of Payment
❑ Federal<Select One> (check if applicable) ❑ Reimbursement
Period of Performance: July 1,2022 through June 30, 2023 ® State ❑ FFATA(Transparency Act) ® Periodic Distribution
❑ Other ❑ Research&Development
Statement of Work Purpose: Per RCW 43.70.512,Foundational Public Health Services(FPHS)funds are for the governmental public health system: local health jurisdictions,
Department of Health, state Board of Health, sovereign tribal nations and Indian health programs. These funds are to build the system's capacity and increase the availability of
FPHS services statewide.
Revision Purpose: The purpose of this revision is to reduce the allocation of SFY23 funds by$1,258,000 to reflect unspent dollars which where reallocated to other LHJs. Task
#1 is being reduced by$565,305 task#2 by$60,000 and task#3 by$30,000,task#4 by$150,000, task#5 by$34,000, task#6 by$50,695 and task#7 by$368,000.
Master Assistance BARS Allocation
LHJ Funding Period Chan e
Index Listing Revenue Current g Total
DOH Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation Decrease(—) Allocation
SFY23 FPHS-LHJ-GFS 99202112 N/A 336.04.25 07/01/22 06/30/23 1,589,000 -1,258,000 331,000
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
TOTALS 1,589,000 -1258,000 331,000
Task Activity Deliverables/Outcomes Due Date/Time Frame Payment Information
# and/or Amount
FPHS funds to each LHJ—See below in Program Specific See below in Program Specific See below in Program 9803.0
1 Specific Requirements-
Requirements—Activity Special Instructions for details Requirements-Deliverables Deliverables �237'h95
Assessment funds to each LHJ—See below in Pro ram am Specific See below in Pro ram Specific See below in Program $69;099
2 Requirements—Activity Special Instructions for details Requirements-Deliverables Specific Requirements- $0
Deliverables
Assessment funds to each LHJ—CHA/CHIP—See below in Program See below in Program Specific See below in Program $30,999
3 Specific Requirements-
Specific Requirements—Activity Special Instructions for details Requirements-Deliverables Deliverables $�
Exhibit A, Statement of Work Page 1 of 6 Contract Number CLH31008—Amendment 8
Task Activity Deliverables/Outcomes Due Date/Time Frame Payment Information
# and/or Amount
Assessment—Shared Epidemiology—See below in Program Specific See below in Program Specific See below in Program $150-000
4 Requirements—Activity Special Instructions for details Requirements-Deliverables Specific Requirements- $0
Deliverables
CD—Hepatitis C—See below in Pro ram am Specific Requirements— See below in Pro rg am Specific See below in Program $34,000
5 Activity Special Instructions for details Requirements-Deliverables Specific Requirements- $0
Deliverables
6 CD—Case Investigation Capacity—See below in Pro ram am Specific See below in Program Specific See below in Program `''"
Requirements—Activity Special Instructions for details Requirements-Deliverables Specific Requirements-
q y p q Deliverables 493.3fJ5
Lifecourse—Infrastructure&Workforce Capacity—See below in See below in Program
7 Program S ecific Requirements—Activi See below in Program Specific 7 �3(38,00
g p q tySpecial Instructions for Requirements-Deliverables Specific Requirements- $�
details Deliverables
DOH Program and Fiscal Contact Information for all ConCon SOWs can be found on the DOH Finance SharePoint site.Questions related to this SOW,or any other
finance-related inquiry,may be sent to financena,doh.wa.gov.
FPHS staff from DOH and the Washington State Association of Local Public Health Officials(WSALPHO)will coordinate and communicate together to build and assure
common systemwide approaches per FPHS Steering Committee direction and the FPHS framework intent.
• For LHJ questions about the use of funds:
o Chris Goodwin, FPHS Policy Advisor,WSALPHO—cgoodwinkwsac.org,564-200-3166
o Brianna Steere,FPHS Policy Advisor,WSALPHO—bsteerega wsac.org, 564-200-3171
• For other questions:
o Marie Flake,FPHS Lead, DOH—marie.flake a,doh.wa.gov,360-951-7566
Program Specific Requirements
The Steering Committee is engaged in a long-term,multi-biennial,phased,building-block approach to full funding and implementation of of FPHS statewide that includes:
• Full funding of FPHS with adequate,dedicated, stable funding that keeps pace with inflation and demand for services
■ Full implementation of FPHS that includes system transformation and modernization to deliver services in the most equitable,effective,and efficient manner possible
for the funds available
Foundational Public Health Services Definitions and related information can be found here: www.doh.wa.gov/fphs or FPHS I Powered by Box.
Stable funding and an iterative decision-making process—The FPHS Steering Committee is the decision making body for FPHS. The Steering Committee provides oversight
including determination of goals,priorities, budget request, funding allocation and accountability metrics. The Steering Committee relies on FPHS Subject Matter Expert
(SME)Workgroups and other FPHS workgroups to ensure a collaborative,systemwide, decision making process. The Steering Committee use an iterative approach to
decision making. This means that additional tasks and/or funds may be added to a local health jurisdiction's(LHJ)FPHS Statement of Work(SOW)as funding decisions are
made.
Annual Allocations—The legislature appropriates FPHS funding on an annual basis and the FPHS Steering Committee allocates funds annually through the FPHS Concurrence
Process for the State Fiscal Year(SFY):July-June. FPHS funds can be applied retroactively to expenditures within the SFY for which they were allocated even if the
expenditure occurred before the Steering Committee made the allocation decision or the agency contract was signed.
Exhibit A, Statement of Work Page 2 of 6 Contract Number CLH31008—Amendment 8
SFYs are named for the year in which they end. The state biennium is named for the year in which it begins and ends.
• SFY22 (July 1,2021 —June 30,2022);half of annual FPHS allocation disbursed July 1,2021 and January 1,2022
• SFY23 (July 1,2022—June 30,2023);half of annual FPHS allocation disbursed July 1,2022 and January 1,2023
• SFY 22 &23 comprise the 2021 —2023 Biennium(21-23)
The Legislature appropriates FPHS funding amounts for each fiscal year of the biennium. This means that funds must be spent within that fiscal year and cannot be carried
forward. Any funds not spent by June 30"each year must be returned to the State Treasury. Funding allocations reset and begin again at the start of the next fiscal year
(July 1).
The Consolidated Contract(ConCon) is based on the calendar year and renewed every 3 years.FPHS statements of work may include reference information such as
allocations, fund disbursement schedules, deliverable due dates, etc.that fall outside of the current 3-year contract period if they are part of the same state fiscal year. The
purpose for including this information in the ConCon is to provide a)historical information from the previous ConCon cycle; and/or b)prospective information about future
ConCon cycle, if they are part of the same SFY.
Disbursement of FPHS funds to LHJs—Unlike other ConCon grants,FPHS bill-back to DOH is NOT required. Half of the annual FPHS funds allocated by the Steering
Committee to each LHJ are disbursed, each July and January. The July payments to LHJs and access to FPHS allocation for all other parts of the governmental public health
system occur upon completion of the FPHS Annual Assessment.
Spending of FPHS funds—The FPHS funds are for assuring FPHS services are available, and as reflected in the SOW. Each agency is responsible for deciding how to spend
their funds within the parameters established by the FPHS Steering Committee and the SOW contract. Assurance includes providing the FPHS as part of your jurisdiction's
program operations,contracting with another governmental public health system partner to provide the service, or receiving the service through a new service delivery model
such as cross jurisdictional sharing or regional staff.
Deliverables—FPHS funds are to be used to increase the availability of FPHS services statewide. The FPHS accountability process measures how funds are sent,along with
changes in system capacity through the FPHS Annual Assessment, system performance indicators,and other data. Each part of the governmental public health system that
receives FPHS funds must complete:
1. Routine reporting of spending and spending projections. Process and reporting template are provided by the FPHS Steering Committee via FPHS Support Staff.
Unspent or projected unspent funds may be reallocated by the Steering Committee to other FPHS activities in order to fully utilize funds within the state fiscal year
timeframe to deliver services to Washington communities. Any FPHS funds unspent at the end of the state fiscal year(ending June 30)revert to the state treasury.
Because LHJs receive funds up front,prospectively, any unspent funds and must be returned to DOH by end of July of each year for DOH to return to the Office of
Financial Management.
2. FPHS Annual Assessment is due each July to report on the previous state fiscal year.Process and reporting template are provided by the FPHS Steering Committee
via FPHS Support Staff. System results are published in the annual FPHS Investment Report available at www.doh.wa..gov/fphs.
BARS Revenue Code: 336.04.25
BARS Expenditure Coding—provided for your reference
562.xx BARS Expenditure Codes for FPHS activities: see below
10 FPHS Epidemiologgy& Surveillance
11 FPHS Community Health Assessment
12 FPHS Emergency Preparedness&Response
13 FPHS Communication
Exhibit A, Statement of Work Page 3 of 6 Contract Number CLH31008—Amendment 8
14 FPHS.Policy Development
15 FPHS Community Partnership Development
16 FPHS Business Competencies
17 FPHS Technology
20 FPHS CD Data&Planning
21 FPHS Promote Immunizations
23 FPHS Disease Investi anon—Tuberculosis(TB)
24 FPHS Disease Investigation—Hepatitis C
25 FPHS Disease Investigation—Syphilis,Gonorrhea&HIV
26 FPHS Disease Investigation—STD(other)
27 FPHS Disease Investigation—VPD
28 FPHS Disease Investigation—Enteric
29 FPHS Disease Investigation—General CD
40 FPHS EPH Data&Planning
41 FPHS Food
42 FPHS Recreational Water
43 FPHS Drinking Water Quality
44 FPHS On-site Wastewater
45 FPHS Solid&Hazardous Waste
46 FPHS Schools
47 FPHS Temporary Worker Housing_
48 FPHS Transient Accommodations
49 FPHS Smoking in Public Places
50 FPHS Other EPH Outbreak Investigations
51 FPHS Zoonotics(includes vectors
52 FPHS Radiation
53 FPHS Land Use Planning
60 FPHS MCH Data&Planning
70 FPHS Chronic Disease,Injury&Violence Prevention Data&Plannin
80 FPHS Access/Linkage with Medical,Oral and Behavioral Health Care Services Data&Planning
90 FPHS Vital Records
91 FPHS Laboratory—Centralized PHSKC Only)
92 FPHS Laboratory
There are two different BARS Revenue Codes for"state flexible funds"to be tracked separately and reported separately on your annual BARS report. These two BARS
Revenue Codes and definitions from the State Auditor's Office(SAO's)are listed below along with a link to the BARS Manual. 336.04.25 is the new BARS Revenue
Code to use for the Foundational Public Health Services(FPHS)funds included in this statement of work.
336.04.24—County Public Health Assistance
Use this account for the state distribution authorized by the 2013 2ESSB 5034, section 710. The local health jurisdictions are required to provide reports regarding
expenditures to the legislature from this revenue source.
336.04.25—Foundational Public Health Services
Use this account for the funding designated for the local health jurisdictions to provide a set of core services that government is responsible for in all communities in
the WA state. This set of core services provides the foundation to support the work of the broader public health system and community partners. At this time the
Exhibit A, Statement of Work Page 4 of 6 Contract Number CLH31008—Amendment 8
funding from this account is for delivering ANY or all of the FPHS communicable disease services(listed above)and can also be used for the FPHS capabilities that
support FPHS communicable disease services as defined in the most current version of FPHS Definitions.
Public Health Budgeting,Accounting and Reporting System(BARS)Resources: www.doh.wa.gov/lhjfunding
Special References(i.e.,RCWs,WACs,etc.):
Link to RCW 43.70.512—RCW 43.70.512:Public health_system-Foundational public health services—Intent.(wa.gov)
Link to RCW 43.70.515—RCW 43.70.515: Foundational public health services—Funding.,fwa.m 1]
Activity Special Instructions:
1. FPHS funds to each LHJ
These funds are allocated tQeach Local Health Jurisdiction to assure FPHS are available in their own jurisdiction. In coordination with the FPHS Steering Committee and
Subject Matter Expert(SME) Workgroups,these funds may be used to provide any of the activities described in the most current version of FPHS definitions for
foundational programs and foundational capabilities. Each LHJ is empowered to prioritize where and how to use these funds to maximize equitable, effective and
efficient delivery of FPHS to every community in Washington.
Even if FPHS services are provided by another agency through a contract,new service delivery model, or centralized service delivery model(such as the State Public
Health Lab),all agencies that receive FPHS funds are responsible for reporting progress on the availability and implementation within their jurisdiction using the FPHS
Annual Assessment.
These funds are not intended for fee-based services such as selected environmental public health services, licensing of healthcare facilities, screening of newborn babies
for congenital disorders, etc. As state funding for FPHS increases, other funds sources(local revenue,grants,federal block grants) should be directed to the
implementation of additional important services and local/state priorities as determined by each agency/jurisdiction.
Use BARS expenditure codes from the list above that most closely align with expenditure made.
Pandemic Response—These FPHS funds are to be used as directed and allocated by the FPHS Steering Committee to deliver FPHS services. As the global
COVID-19 pandemic and the public health response to it continues to wane,these FPHS funds can be braided with and used to supplement other short-term
pandemic response funding as needed for FPHS activities during this period of performance through 6/30/23. Responding to pandemics, epidemics and public
health emergencies are foundational services of the governmental public health system.
2. Assessment funds to each LHJ—(FPHS definition G.2)
These funds are allocated to each Local Health Jurisdiction to assure FPHS are available in their own jurisdiction-Support LHJ assessment capacity with flexible funds to
meet locally identified needs. BARS expenditure codes: 562.10 or 11.
3. Assessment funds to each LHJ—CHA/CHIP(FPHS definitions G.3)
These funds are allocated to each LHJ to assure FPHS are available in their own jurisdiction-
Support any CHA/CHIP activity or service(e.g., data analysis,focus groups,report writing,process facilitation)and may be used to contract with other agencies for staff
time or services. Use BARS expenditure codes: 562.11.
4. Assessment—Shared Epidemiology—General(Assessment/Surveillance,CHA/CHIP)(FPHS definitions G.1,2)
These funds are to select LHJs to assure FPHS are available in or for multiple jurisdictions—Increase assessment and epidemiology capacity via regional/shared
epidemiologist model to meet locally identified needs. Use BARS expenditure codes: 5 62.10 or 11.
5. CD—Hepatitis C(FPHS definitions C.4.o-p)
Exhibit A, Statement of Work Page 5 of 6 Contract Number CLH31008—Amendment 8
These funds are to select LHJs to assure FPHS are available in their own jurisdictions—Address Hepatitis C cases per guidance developed by the statewide FPHS
Communicable Disease Workgroup, including,but not limited to: shared priorities, standardized surveillance,minimum standards of practice,common metrics and
staffing models. Use BARS expenditure codes: 562.24.
The priorities for the 2021-2023 biennium(July 2021 —June 2023):
• Washington Disease Reporting System(WDRS),enter acute cases into WDRS.
• Investigation—focus on acute cases: people aged 35 or younger,newly diagnosed,pregnant women,people seen in the ED/inpatient,Black,Indigenous and People
of Color or other historically marginalized population and incorporate Hepatitis B work.
6. CD—Case investigation Capacity(FPHS definitions C.2,C.4)
These funds are to select LHJs to assure FPHS are available in their own jurisdictions-Support LHJ communicable disease capacity to conduct case investigation and
follow up to reduce gaps and meet locally identified needs that address notifiable conditions responsibilities. Use BARS expenditure codes: 562.23-29.
7. Lifecourse—Infrastructure&Workforce Capacity(FPHS definitions D,E,F)
These funds are to each LHJ to assure FPHS are available in their own jurisdictions-Infrastructure and workforce investments to each LHJ to meet fundamental needs in
three areas: Maternal/Child/Family Health;Access/Linkage with Medical,Oral and Behavioral Health Services; and Chronic Disease, Injury and Violence Prevention.
Use BARS expenditure codes: 562.60 or 70 or 80.
Exhibit A, Statement of Work Page 6 of 6 Contract Number CLH31008—Amendment 8
Exhibit A
Statement of Work
Contract Term: 2022-2024
DOH Program Name or Title: Foundational Public Health Services(FPHS)- Local Health Jurisdiction Name: Cowlitz County Health&Human Services
Effective July 1,2023 Department
Contract Number: CLH31008
SOW Type: Original Revision #(for this SOW) Funding Source Federal Compliance Type of Payment
❑ Federal<Select One> (check if applicable) ❑ Reimbursement
Period of Performance: July 1,2023 through June 30,2024 ® State ❑ FFATA(Transparency Act) ® Periodic Distribution
❑ Other ❑Research&Development
Statement of Work Purpose: Per RCW 43.70.512,Foundational Public Health Services(FPHS)funds are for the governmental public health system: local health jurisdictions,
Department of Health, state Board of Health, sovereign tribal nations and Indian health programs. These funds are to build the system's capacity and increase the availability of
FPHS services statewide.
Revision Purpose: N/A
Master Assistance BARS Allocation
LHJ Funding Period Chan e
Index Listing Revenue Current g Total
DOH Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation Increase(+) Allocation
FPHS-LOCAL HEALTH JURISDICTION 99200840 N/A 336.04.25 07/01/23 06/30/24 0 1,439,000 1,439,000
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
TOTALS 0 1 1,439,000 1 1,439,000
Task Payment
# Activity Deliverables/Outcomes Due Date/Time Frame Information and/or
Amount
I FPHS funds to each LHJ—See below in Program Specific See below in Program Specific See below in Pro-rg am Specific $803 000
Requirements—Activity Special Instructions for details Requirements-Deliverables Requirements-Deliverables '
2 Assessment Reinforcing Capacity—See below in Program Specific See below in Program Specific See below in Pro rg am Specific $60,000
Requirements—Activity Special Instructions for details Requirements-Deliverables Requirements-Deliverables
3 Assessment—CHA/CHIP—See below in Program Specific See below in Program Specific See below in Program Specific $30,000
Requirements—Activity Special Instructions for details Requirements-Deliverables Requirements-Deliverables
4 Lifecourse—Infrastructure&Workforce Capacity—See below in See below in Program Specific See below in Program Specific $368,000
Program Specific Requirements—Activity Special Instructions for details Requirements-Deliverables Requirements-Deliverables
Exhibit A, Statement of Work Page 1 of 5 Contract Number CLH31008-Amendment 8
Task Payment
# Activity Deliverables/Outcomes Due Date/Time Frame Information and/or
Amount
5 CD—Hepatitis C—See below in Program Specific Requirements— See below in Program Specific See below in Program Specific $34,000
Activity Special Instructions for details Requirements-Deliverables Requirements-Deliverables
6 CD—Case Investigation Capacity—See below in Program Specific See below in Program Specific See below in Program Specific S144,000
Requirements—Activity Special Instructions for details Requirements-Deliverables Requirements-Deliverables
DOH Program and Fiscal Contact Information for all ConCon SOWs can be found on the DOH Finance SharePoint site.Questions related to this SOW, or any other
finance-related inquiry,may be sent to finance u;doh.wa.gov.
FPHS staff from DOH and the Washington State Association of Local Public Health Officials(WSALPHO)will coordinate and communicate together to build and assure common
systemwide approaches per FPHS Steering Committee direction and the FPHS framework intent.
• For LHJ questions about the use of funds:
o Chris Goodwin, FPHS Policy Advisor,WSALPHO—cgoodwingwsac.org, 564-200-3166
o Brianna Steere,FPHS Policy Advisor,WSALPHO—bsteere(kwsac.org, 564-200-3171
The intent of FPHS funding is outlined in RCW 43.70.512.
Foundational Public Health Services Definitions and related information can be found here: www.doh.wa.gov/fphs.
Stable funding and an iterative decision-making process—The FPHS Steering Committee's roles and responsibilities are outlined in the FPHS Committee&Workg�oup
Charter The Steering Committee is the decision making body for FPHS and operates under a consensus-based decision making model, outlined here. The Steering Committee use
an iterative approach to decision making meaning additional tasks and/or funds may be added to a local health jurisdiction's(LHJ)FPHS Statement of Work(SOW)as funding
decisions are made.
Spending of FPHS funds—FPHS funds do not require pre-approval or pre-authorization to spend. FPHS funds are to assure FPHS services are available in each jurisdiction based
on the FPHS Definitions(link)and as reflected in the SOW.Assurance includes providing FPHS as part of your jurisdiction's program operations,contracting with another
governmental public health system partner to provide the service,or receiving the service through a new service delivery model such as cross jurisdictional sharing or regional
staff. FPHS funds are eligible starting at the beginning of each state fiscal year(July 1)regardless of when funds are received by the LHJ, even if the expenditure
occurred before the LHJ's contract was signed.
These funds are not intended for fee-based services such as select environmental public health services. As state funding for FPHS increases, other funds sources(local revenue,
grants, federal block grants)should be directed to the implementation of additional important services and local/state priorities as determined by each agency/jurisdiction.
Annual Allocations—The legislature appropriates FPHS funding on an annual basis and the FPHS Steering Committee allocates funds annually through the FPHS Concurrence
Process for the State Fiscal Year(SFY):July-June.
The Legislature appropriates FPHS funding amounts for each fiscal year of the biennium. This means that funds must be spent within that fiscal year and cannot be carried
forward. Any funds not spent by June 30'h each year must be returned to the State Treasury. Funding allocations reset and begin again at the start of the next fiscal year(July 1).
This Statement of Work is for the period of July 1,2023-June 30, 2024 and may be included in multiple Consolidated Contracts(ConCons)which are based on the calendar year
and renewed every three years.
Exhibit A, Statement of Work Page 2 of 5 Contract Number CLH31008-Amendment 8
Disbursement of FPHS funds to LHJs—Unlike other ConCon grants,FPHS bill-back to DOH is NOT required. Half of the annual FPHS funds allocated by the Steering
Committee to each LHJ are disbursed each July and January. The July payments to LHJs and access to FPHS allocation for all other parts of the governmental public health
system occur upon completion of the FPHS Annual Assessment.
Deliverables—FPHS funds are to be used to assure FPHS services statewide. The FPHS accountability process measures how funds are spent,along with changes in system
capacity through the FPHS Annual Assessment,system perfonnance indicators,and other data. DOH, SBOH and local health jurisdictions have agreed to complete:
1. Reporting of spending and spending projections. Process timelines and reporting template are provided by the FPHS Steering Committee via FPHS Support Staff.
2. FPHS Annual Assessment is due each July to report on the previous state fiscal year. Process and reporting template are provided by the FPHS Steering Committee via
FPHS Support Staff. System results are published in the annual FPHS Investment Report available at www.doh.wa.gov/fphs,
BARS Revenue Code: 336.04.25
BARS Expenditure Coding—provided for your reference.
562.xx BAILS Expenditure Codes for FPHS activities: see below
10 FPHS Epidemiology&Surveillance
11 FPHS Community Health Assessment
12 FPHS Emergency Preparedness&Response
13 FPHS Communication
14 FPHS Policy Development
15 FPHS Community Partnership Development
16 FPHS Business Competencies
17 FPHS Technology
20 FPHS CD Data&Planning
21 FPHS Promote Immunizations
23 FPHS Disease Investigation—Tuberculosis(TB)
24 FPHS Disease Investigation—Hepatitis C
25 FPHS Disease Investigation—Syphilis,Gonorrhea&HIV
26 FPHS Disease Investigation—STD other
27 FPHS Disease Investigation—VPD
28 FPHS Disease Investigation—Enteric
29 FPHS Disease Investigation—General CD
40 FPHS EPH Data&Planning
41 FPHS Food
42 FPHS Recreational Water
43 FPHS Drinking Water Quality
44 FPHS On-site Wastewater
45 FPHS Solid&Hazardous Waste
46 FPHS Schools
47 FPHS Temporary Worker Housing
48 FPHS Transient Accommodations
49 FPHS Smoking in Public Places
50 FPHS Other EPH Outbreak Investigations
Exhibit A, Statement of Work Page 3 of 5 Contract Number CLH31008-Amendment 8
51 FPHS Zoonotics includes vectors
52 FPHS Radiation
53 FPHS Land Use Planning
60 FPHS MCH Data&Planning
70 FPHS Chronic Disease, 1pjury&Violence Prevention Data&Planning
80 FPHS Access/Linkage with Medical,Oral and Behavioral Health Care Services Data&Planning
90 FPHS Vital Records
91 FPHS Laboratory_—Centralized(PHSKC Only)
92 F'PFIS Laboratory
Special References(i.e.,RCWs,WACs,etc.):
FPHS Intent-RCW 43.70.512
FPHS Funding—RCW 43.70.515
FPHS Committee&Work roup Charter
FPHS Steering Committee Consensus Decision Making Model
Activity Special Instructions:
Investments to Each LHJ:
1. FPHS Funds to Each LHJ
These funds are allocated to be used to provide any programs and services within all of the FPHS Definitions.Each LHJ is empowered to prioritize where and how to use
these funds to maximize equitable,effective and efficient delivery of FPHS to every community in Washington.
Use BARS expenditure codes from the list above that most closely align with expenditure made.
Targeted Investments to Each LHJ:
2. Assessment Reinforcing Capacity(FPHS definition G.2)
Support LHJ assessment capacity with flexible funds to meet locally identified needs.BARS expenditure codes: 562.10 or l l
3. Assessment—CHA/CHIP (FPHS definitions G.3)
Support any CHA/CHIP activity or service(e.g., data analysis, focus groups,report writing,process facilitation) and may be used to contract with other agencies for staff
time or services. Use BARS expenditure codes: 562.11
4. Lifecourse—Infrastructure&Workforce Capacity(FPHS definitions D,E,F)
Infrastructure and workforce investments to each LHJ to meet fundamental needs in three areas: Maternal/Child/Family Health; Access/Linkage with Medical,Oral and
Behavioral Health Services; and Chronic Disease,Injury and Violence Prevention. Use BARS expenditure codes: 562.60 or 70 or 80.
Tar eted Investments to Select LHJs—Assurin FPHS Available in awn Jurisdiction:
5. CD—Hepatitis C(FPHS definitions C.4.o-p)
Address Hepatitis C cases per guidance developed by the FPHS CD SME Workgroup and ❑OH's Hepatitis C Prioritization document with particular emphasis on lab
surveillance and investigation of acute cases. Use BARS expenditure codes: 562.24.
Exhibit A, Statement of Work Page 4 of 5 Contract Number CLH31008-Amendment 8
6. CD—Case Investigation Capacity(FPHS definitions C.2,C.4)
Support LHJ communicable disease capacity to conduct case investigation and follow up to reduce gaps and meet locally identified needs that address notifiable
conditions responsibilities. Use BARS expenditure codes: 562.23-29.
Exhibit A, Statement of Work Page 5 of 5 Contract Number CLH31008-Amendment 8
Exhibit A
Statement of Work
Contract Term: 2022-2024
DOH Program Name or Title: Office of Drinking Water Group A Program- Local Health Jurisdiction Name: Cowlitz County Health&Human Services
Effective January 1, 2022. Department
Contract Number: CLH31008
SOW Type: Revision Revision#(for this SOW) 2 Funding Source Federal Compliance Type of Payment
® Federal Contractor (check if applicable) ❑ Reimbursement
Period of Performance: January 1,2022 through December 31,2023 ❑ State ® FFATA(Transparency Act) ® Fixed Price
❑ Other ❑ Research&Development
Statement of Work Purpose: The purpose of this statement of work is to provide funding to the LHJ for conducting sanitary surveys and providing technical assistance to small
community and non-community Group A water systems
Revision Purpose: The purpose of this revision is to identify Data Sharing Information.
Master Assistance BARS Allocation
LHJ Funding Period Chan e
Index Listing Revenue Current g Total
DOH Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation None Allocation
YR 24 SRF-LOCAL ASST 15%)(FO-SW) SS 24239224 N/A 346.26.64 01/01/22 12/31/22 2,500 0 2,500
YR 24 SRF-LOCAL ASST 15%)(FO-SW)TA 24239224 N/A 346.26.66 01/01/22 12/31/22 1,000 0 1,000
YR 25 SRF-LOCAL ASST 1501.)(FO-SW) SS 24239225 N/A 346.26.64 01/01/23 12/31/23 3,000 0 3,000
YR 25 SRF-LOCAL ASST 15%)(FO-SW)TA 24239225 N/A 346.26.66 01/01/23 12/31/23 1,000 0 1,000
0 0 0
0 0 0
TOTALS 7,500 0 7,500
Task Due
# Activity Deliverables/Outcomes Date/Time Payment Information and/or Amount
Frame
1 Trained LHJ staff will conduct sanitary Provide Final* Sanitary Survey Final Sanitary Upon ODW acceptance of the Final Sanitary Survey Report,the
surveys of small community and non- Reports to ODW Regional Office. Survey LHJ shall be paid$250 for each sanitary survey of a non-
community Group A water systems Complete Sanitary Survey Reports Reports must community system with three or fewer connections.
identified by the DOH Office of Drinking shall include: be received
Water(ODW)Regional Office. 1. Cover letter identifying by the ODW Upon ODW acceptance of the Final Sanitary Survey Report,the
significant deficiencies, Regional LHJ shall be paid$500 for each sanitary survey of a non-
See Special Instructions for task activity. significant findings, Office within community system with four or more connections and each
observations,recommendations, 30 calendar community system.
and referrals for further ODW days of
The purpose of this statement of work is to follow-up. conducting Payment is inclusive of all associated costs such as travel,
provide funding to the LHJ for conducting 2. Completed Small Water System the sanitary lodging,per diem.
sanitary surveys and providing technical checklist. survey.
Payment is authorized upon receipt and acceptance of the Final
Exhibit A, Statement of Work Pagel of 4 Contract Number CLH31008-Amendment 8
Task Due
# Activity Deliverables/Outcomes Date/Time Payment Information and/or Amount
Frame
assistance to small community and non- 3. Updated Water Facilities Sanitary Survey Report within the 30-day deadline.
community Group A water systems. Inventory(WFI).
4. Photos of water system with text Late or incomplete reports may not be accepted for payment.
identifying features
5. Any other supporting
documents.
*Final Reports reviewed and
accepted by the ODW Regional
Office.
2 Trained LHJ staff will conduct Special Provide completed SPI Report and Completed Upon acceptance of the completed SPI Report,the LHJ shall be
Purpose Investigations(SPI)of small any supporting documents and SPI Reports paid$800 for each SPI.
community and non-community Group A photos to ODW Regional Office. must be
water systems identified by the ODW received by Payment is inclusive of all associated costs such as travel,
Regional Office. the ODW lodging,per diem.
Regional
See Special Instructions for task activity. Office within Payment is authorized upon receipt and acceptance of
2 working completed SPI Report within the 2-working day deadline.
days of the
service Late or incomplete reports may not be accepted for payment.
request.
3 Trained LHJ staff will provide direct Provide completed TA Report and Completed Upon acceptance of the completed TA Report,the LHJ shall be
technical assistance(TA)to small any supporting documents and TA Report paid for each technical assistance activity as follows:
community and non-community Group A photos to ODW Regional Office. must be . Up to 3 hours of work: $250
water systems identified by the ODW received by . 3-6 hours of work: $500
Regional Office. the ODW e More than 6 hours of work: $750
Regional
See Special Instructions for task activity. Office within Payment is inclusive of all associated costs such as consulting
30 calendar fee,travel, lodging,per diem.
days of
providing Payment is authorized upon receipt and acceptance of
technical completed TA Report within the 30-day deadline.
assistance.
Late or incomplete reports may not be accepted for payment.
4 LHJ staff performing the activities under For training attended in person,prior Annually For training attended in person,LHJ shall be paid mileage,per
tasks 1,2 and 3 attend periodic required to attending the training, submit an diem, lodging, and registration costs as approved on the pre-
survey training as directed by DOH. "Authorization for Travel (Non- authorization form in accordance with the current rates listed on
Employee)"DOH Form 710-013 to the OFM Website hqp://www.ofm.wa.gov/resources/travel.aV
See Special Instructions for task activity. the ODW Program Contact for
approval(to ensure enough funds are
available).
Exhibit A, Statement of Work Page 2 of 4 Contract Number CLH31008-Amendment 8
DOH Program and Fiscal Contact Information for all ConCon SOWs can be found on the DOH Finance SharePoint site.Questions related to this SOW, or any other
finance-related inquiry,may be sent to financena doh.wa. ov.
Federal_Funding Accountability and Transparency Act(FFATA)(Applies to federal grant awards.)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Unique Entity Identifier(UEI)generated by SAM.gov.
Information about the LHJ and this statement of work will be made available on USASpending_Qgov by DOH as required by P.L. 109-282.
Program Specific Requirements
Data Sharing
The Once of Drinking Water will share water system information and files with the local health jurisdiction to support the work identified in this statement of work. To request
water system data please contact the regional office with the name of the water system, water system ID#, specific information being requested and any timeline requirements. If
allowable,please give administrative staff 3 to S business days to provide records.
Program Manual,Handbook,Policy References: Field Guide(DOH Publication 331-486).
Special References:
Chapter 246-290 WAC is the set of rules that regulate Group A water systems. By this statement of work, ODW contracts with the LHJ to conduct sanitary surveys(and SPIs and
provide technical assistance)for small community and non-community water systems with groundwater sources. ODW retains responsibility for conducting sanitary surveys(and
SPIs and provide technical assistance)for small community and non-community water systems with surface water sources,large water systems,and systems with complex
treatment.
LHJ staff assigned to perform activities under tasks 1, 2, and 3 must be trained and approved by ODW prior to performing work. See special instructions under Task 4,below.
Special Billing Requirements
The LHJ shall submit quarterly invoices within 30 days following the end of the quarter in which work was completed, noting on the invoice the quarter and year being billed for.
Payment cannot exceed a maximum accumulative fee of$5,500 for Task 1,and$2,000 for Task 2,Task 3 and Task 4 combined during the contracting period,to be paid at the
rates specified in the Payment Method/Amount section above.
When invoicing for Task 1,submit the list of WS Name, ID#,Amount Billed,Survey Date and Letter Date for which you are requesting payment.
When invoicing for Task 2-3, submit the list of WS Name,ID#,TA Date and description of TA work performed, and Amount Billed.
When invoicing for Task 4,submit receipts and the signed pre-authorization form for non-employee travel to the ODW Program Contact below and a signed A19-IA Invoice
Voucher to DOH Grants Management,billing to BARS Revenue Code 346.26.66 under Technical Assistance(TA).
Special Instructions
Task 1
Trained LHJ staff will evaluate the water system for physical and operational deficiencies and prepare a Final Sanitary Survey Report which has been accepted by ODW. Detailed
guidance is provided in the Field Guide for Sanitary Surveys, Special Purpose Investigations and Technical Assistance(Field Guide).The sanitary survey will include an
evaluation of the following eight elements: source;treatment; distribution system; finished water storage;pumps, pump facilities and controls; monitoring, reporting and data
verification; system management and operation;and certified operator compliance. If a system is more complex than anticipated or other significant issues arise,the LHJ may
request ODW assistance.
• No more than 4 surveys of non-community systems with three or fewer connections be completed between January 1, 2022 and December 31,2022.
Exhibit A, Statement of Work Page 3 of 4 Contract Number CLH31008-Amendment 8
• No more than 3 surveys of non-community systems with four or more connections and all community systems to be completed between January 1,2022 and
December 31,2022.
• No more than 4 surveys of non-community systems with three or fewer connections be completed between January 1,2023 and December 31,2023.
• No more than 4 surveys of non-community systems with four or more connections and all community systems to be completed between January 1,2023 and
December 31,2023.
The process for assignment of surveys to the LHJ,notification of the water system, and ODW follow-up with unresponsive water systems; and other roles and responsibilities of
the LHJ are described in the Field Guide.
Task 2
Trained LHJ staff will perform Special Purpose Investigations(SPIs)as assigned by ODW. SPIs are inspections to determine the cause of positive coliform samples or the cause of
other emergency conditions. SPIs may also include sanitary surveys of newly discovered Group A water systems. Additional detail about conducting SPIs is described in the Field
Guide.The ODW Regional Office must authorize in advance any SPI conducted by LHJ staff.
Task 3
Trained LHJ staff will conduct Technical Assistance as assigned by ODW. Technical Assistance includes assisting water system personnel in completing work or verifying work
has been addressed as required,requested,or advised by the ODW to meet applicable drinking water regulations. Examples of technical assistance activities are described in the
Field Guide.The ODW Regional Office must authorize in advance any technical assistance provided by the LHJ to a water system.
Task 4
LHJ staff assigned to perform activities under tasks 1,2, and 3 must be trained and approved by ODW prior to performing work.
If required trainings,workshops or meetings are not available,not scheduled, or if the LHJ staff person is unable to attend these activities prior to conducting assigned tasks,the
LHJ staff person may,with ODW approval,substitute other training activities to be determined by ODW. Such substitute activities may include one-on-one training with ODW
staff,co-surveys with ODW staff,or other activities as arranged and pre-approved by ODW.LHJ staff may not perform the activities under tasks 1,2,and 3 without completing
the training that has been arranged and approved by ODW.
Exhibit A, Statement of Work Page 4 of 4 Contract Number CL1431008-Amendment 8
:T,_"Ir, Cowlitz County
Health&Human Services Consolidated Contract Overview: 2022-24
� � -- HnHlllly PCOp(0-He;i llll%Co Rlllll�lIIIICS
Under1 15, local health boards an• health officers are considered extensions of • • Board of Health
and Washington State Department of Health. Local health departments are responsible for supporting the preservation of life and
health of •• jurisdiction. •• • includes:
INFORM THE PUBLIC MITIGATE 11 PREVENT TAKE MEASURES EDUCATE
about the causes,nature, the spread of dangerous and to promote overall public and enforce state
and prevention of infectious diseases and health and maintain public 0 public health
diseases and disabilities. nuisances that are detrimental health and sanitation. statutes, rules,
to public health. and regulations.
Group A
What's a consolidated Water(<1%)
contractor • • 0I Maternal Child
Rather than sending individual contracts to / Health(3%)
localdepartments, • •
DepartmentState of •cates funding
through a consolidated contract, also called ~
Emergency
• • Preparedness
(6%)
• • of
departments.work agreement that provides funding to local
health
Group B
Instead of • on • Water(2%)
general . and fees, local
departments use Con-Con funding to support
Foundational
mandated foundational public health services Public Health
• other functions. Services(88%)
-- -- 2022 2023 ------- - — — 2024 — —_---
Public Health Services
Fulfill core public health services,
including communicable disease,
environmental health,and chronic $471,037 00$331,00 $$1,439,000
disease prevention and education
source of rands:State
Maternal Child Health
InWork with families,schools,and
childcare facilities to support children
&youth w/special healthcare needs, $78,764
make referrals for diagnostic-
treatment funds from the state-
Source of funds:Federal
Emergency Preparedness
Fund one,full-time Emergency
Preparedness and Response
Coordinator-Works closely with local, $79,074 $79,074
state,regional partners,incl-Cowlitz
County DEM,schools,and hospital
Source or funds:Federal
Group B Water
Regulate Group B public water systems
(WAC 246-291&local ordinances)toe $25,878
ensure safe and reliable drinking watr, $25.877
Group B public water systems serve
less than 25 people/day-There are
99 Group B systems in the County
Source of funds:State
Group A Water
Perform sanitary surveys&provide
technical assistance to ensure safe& $3 500 q 000
reliable drinking water in Group A public
water systems-Group A public water r�
systems serve 25 or more people/day-
There are 67 Group A systems in the
County- Source of funds:State
i ♦ This includes everything up to Amendment 8
I
A� Cowlitz County
Health &Human Services FPHS Funding: 2021-24
-` Hcal(liy Peopin H-tthy Coniniunilizs
Source of funds:State
wkere does tkis money come from?
In RCW 43.70.512, the WA state legislature
defines a statewide set of core public health services, called foundationalpublic
health services (FPHS) which the governmental public .. .le for providing Washington State. The
governmental public health system includes the state departmentboard of health, local health jurisdictions,
programssovereign tribal nations, and these services are made up of foundational capabilities.
services are unique, provided only or primarily by government.
How are decisions made about this f undin9?
The Cowlitz County Board of County Commissioners makes high-level funding decisions and relies on Cowlitz County Health &
Human Services(CCHHS)to administer the funds.
July
2021 to June 2024
July 2021 to July 2022 to July 2023 to
June 2022 June 2023 June 2024
State Consolidated Contract: Dept. of Health =12-month 12-month 12-month
n Allocation Allocation
0 $ 1,589,000 $ 1,439,000
EXPENDITURES
Communicable Disease
Prevention and control of communicable diseases and other notifiable Actual Spent Actual Spent Allocation
conditions.This includes infection prevention activities with care $203,980 $88,305 $178,000
facilities,schools and businesses.
Environmental Health
Environmental public health issues and health impacts related to food Actual Spent Actual Spent Allocation
safety, recreational water safety,drinking water,and liquid and solid $824 $123,948 $0
waste.
CHA/CHIP/Epi
Collecting and analyzing data to guide decision making.Conducting Actual Spent Actual Spent Allocation
comprehensive community health assessments and Using the $0 $0 $90,000
information collected to help identify local health priorities.
Lifecourse
Maternal/Child/Family Health;Access/Linkage with Medical,Oral and Actual Spent Actual Spent Allocation
Behavioral Health Care Services;and Chronic Disease,Injury and $0 $0 $368,000
Violence Prevention
Cross Cutting Capabilities
These funds are allocated to be used to provide any programs and EActual Spent Actual Spent Allocationt
services within the FPHS Definitions including those listed above, 66,233 $118,747 $803,000
Each LHJ prioritizes where and how to use these funds.
Total S ent Actual Spent Actual Spent
p $471,037 $331,000 TBD
Total Returned to WA State $395,963 =$1,258,000 TBD
.• Longview,
COWLITZ COUNTY HEALTH& HUMAN SERVICES
2022-2024 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH31008 AMENDMENT NUMBER: 7
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as
"DOH", and COWLITZ COUNTY HEALTH &HUMAN SERVICES, a Local Health Jurisdiction, hereinafter referred to
as"LHJ",pursuant to the Modifications/Waivers clause,and to make necessary changes within the scope of this contract
and any subsequent amendments thereto.
IT IS MUTUALLY AGREED: That the contract is hereby amended as follows:
1. Exhibit A Statements of Work, includes the following statements of work, which are incorporated by this reference
and located on the DOH Finance SharePoint site in the Upload Center at the following URL:
littps://statepAyo.sliarepoiait.cottvsites/doli-ofsf tiidingresources/sitepaos4iome.aWx'.=e 1_9a946$8da2d94d3ea8Uac 7tl)c32e4d7c
❑ Adds Statements of Work for the following programs:
® Amends Statements of Work for the following programs:
Office of Drinking Water Group A Program -Effective January 1, 2022
❑ Deletes Statements of Work for the following programs:
2. Exhibit B-7 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-6 Allocations as
follows:
® Increase of$3,250 for a revised maximum consideration of$4,20:5,878.
❑ Decrease of for a revised maximum consideration of
❑ No change in the maximum consideration of
Exhibit B Allocations are attached only for informational purposes.
Unless designated otherwise herein,the effective date of this amendment is the date of execution.
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force
and effect.
IN WITNESS WHEREOF, the undersigned has affixed his/her signature in execution thereof.
COWLITZ COUNTY HEALTH&HUMAN SERVICES STATE OF WASHINGTON
DEPARTMENT OF HEALTH
Signature: Signature:
ffawy'p W 4 Aw,mL Hew�Fre a
Date: Date:
Jun 1,2023 Jun 1,2023
APPROVED AS TO FORM ONLY
Assistant Attorney General
Page 1 of 1
EXHIBIT B-7
Cowlitz County Health&Human Services Department ALLOCATIONS Contract Number: CLH31008
Contract Term:2022-2024 Date: February 1,2023
Indirect Rate as of January 1,2022:Direct Allocation of Costs
DOH Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend# List#* Code** Start Date End Date Start Date End Date Amount SubTotal Total
FFY22 PHEP BP4 LHJ Funding NU90TP922043 Amd 4 93,069 333.93.06 07/01/22 06/30/23 07/01/22 06/30/23 $79,074 $79,074 $158,148
FFY21 PHEP BP3 LHJ Funding NU90TP922043 Amd 2 93,069 333.93.06 01/01/22 06/30/22 07/01/21 06/30/22 $79,074 S79,074
COV1D19 Vaccines R4 NH231P922619 Amd 3 93.268 333.93.26 01/01/22 06/30/24 07/01/20 06/30/24 ($460,864) $0 $0
COV1D19 Vaccines R4 NH231P922619 Amd 1 93,268 333.93.26 01/01/22 06/30/24 07/01/20 06/30/24 $460,864
FFY19 ELC COVID Ed LHJ Allocation NU50CK000515 Amd 2 93.323 333.93.32 01/01/22 10/18/22 05/19/20 10/18/22 $191,632 $191,632 S191,632
FFY20 ELC EDE LI-U Allocation NU50CK000515 Amd 2 93.323 333.93.32 01/01/22 12/31/22 01/15/21 07/31/24 $1,658,052 $1,659,052 $1,658,052
FFY22 MCHBG LHJ Contracts B04MC45251 Amd 1 93.994 333.93.99 01/01/22 09/30/22 10/01/21 09/30/22 $78,754 $78,754 S78,754
GFS-Group B(FO-SW) Amd 6 N/A 334.04.90 01/01/23 06/30/23 07/01/22 06/30/23 $25,878 $25,878 $51,755
GFS-Group B(FO-SW) Amd 1 N/A 334.04,90 01/01/22 06/30/22 07/01/21 06/30/22 $25,877 $25,877
SFY23 FPHS-LHJ-GFS Amd 5 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 $150,000 S1,589,000 $1,589,000
SFY23 FPHS-LHJ-GFS Amd 4,5 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 $1,439,000
FPHS-LHJ-Proviso(YR2) Amd 4 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 ($867,000) $0 $471,037
FP14S-LHJ-Proviso(YR2) Amd 1 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 $867,000
FPHS-LHJ-Proviso(YR1) Amd 5 N/A 336.04.25 01/01/22 06/30/22 07/01/21 06/30/23 ($395,963) $471,037
FPHS-LHJ-Proviso(YR I) Amd 1 N/A 336.04.25 01/01/22 06/30/22 07/01/21 06/30/23 $867,000
YR 25 SRF-Local Asst(15%)(FO-SW)SS Amd 7 N/A 346.26.64 01/01/23 12/31/23 01/0l/23 12/31/23 $3,000 $3,000 $5,500
YR24 SRF-Local Asst(15%)(FO-SW)SS Amd 7 N/A 346.26.64 01/01/22 12/31/22 07/01/21 06/30/23 ($750) $2,500
YR24 SRF-Local Asst(15%)(FO-SW)SS Amd.1 N/A 346.26.64 01/01/22 12/31/22 07/01/21 06/30/23 $3,250
YR 25 SRF-Local Asst(15%)(FO-SW)TA Amd 7 N/A 346.26.66 01/01/23 12/31/23 01/01/23 12/31/23 S1,000 $1,000 $2,000
YR24 SRF-Local Asst(15%)(FO-SW)TA Amd 1 N/A 346,26.66 01/01/22 12/31/22 07/01/21 06/30/23 $1,000 $1,000
TOTAL $4,205,878 $4,205,878
Total consideration: $4,202,628 GRAND TOTAL $4,205,878
$3,250
GRAND TOTAL $4,205,878 Total Fed $2,086,586
Total State $2,119,292
*Catalog of Federal Domestic Assistance
**Federal revenue codes begin with"333". State revenue codes begin with"334".
Pagel of]
COWLITZ COUNTY HEALTH & HUMAN SERVICES
2022-2024 CONSOLIDATED CONTRACT
1 CONTRACT NUMBER: CLH31008 AMENDMENT NUMBER: 6
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as
"DOH", and COWLITZ COUNTY HEALTH&HUMAN SERVICES,a Local Health Jurisdiction,hereinafter referred to
as"LHJ",pursuant to the Modifications/Waivers clause, and to make necessary changes within the scope of this contract
and any subsequent amendments thereto.
IT IS MUTUALLY AGREED: That the contract is hereby amended as follows:
1. Exhibit A Statements of Work, includes the following statements of work, which are incorporated by this reference
and located on the DOH Finance SharePoint site in the Upload Center at the following URL:
htt s://state five shy r ❑int.cotnlsite:/doh-of%fimdin resou cs/•it &� horne.a x?=el:%94688dtt2d94d3ea80ac7Fbc32e4d7c
❑ Adds Statements of Work for the following programs:
® Amends Statements of Work for the following programs:
Office of Drinking Water Group B Programs -Effective January 1,2022
❑ Deletes Statements of Work for the following programs:
2. Exhibit B-6 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-5 Allocations as
follows:
® Increase of$25,878 for a revised maximum consideration of 2$4, 02,628.
❑ Decrease of for a revised maximum consideration of
❑ No change in the maximum consideration of
Exhibit B Allocations are attached only for informational purposes.
Unless designated otherwise herein,the effective date of this amendment is the date of execution.
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force
and effect.
IN WITNESS WHEREOF,the undersigned has affixed his/her signature in execution thereof.
COWLITZ COUNTY HEALTH &HUMAN SERVICES STATE OF WASHINGTON
DEPARTMENT OF HEALTH
Signature: Signature:
J72NN%f,?WeAy- frNer!
Date: Date:
Feb 1,2023 Feb 1,2023
APPROVED AS TO FORM ONLY
Assistant Attorney General
Page 1 of 1
EXHIBIT B-6
Cowlitz County Health&Human Services Department ALLOCATIONS Contract Number: CLH31008
Contract Term:2022-2024 Date: December 1,2022
Indirect Rate as of January 1,2022:Direct Allocation of Costs
DOH Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend# List#* Code** Start Date End Date Start Date End Date Amount SubTotal Total
FFY22 PHEP BP4 LHJ Funding NU90TP922043 Amd 4 93.069 333.93.06 07/01/22 06/30/23 07/01/22 06/30/23 $79,074 $79,074 $158,148
FFY21 PHEP BP3 LHJ Funding NU90TP922043 Amd 2 93.069 333.93.06 01/01/22 06/30/22 07/01/21 06/30/22 $79,074 $79,074
COVID19 Vaccines R4 NH231P922619 Amd 3 93.268 333.93.26 01/01/22 06/30/24 07/01/20 06/30/24 ($460,864) $0 $0
COVID19 Vaccines R4 NH231P922619 Amd 1 93.268 333.93.26 01/01/22 06/30/24 07/01/20 06/30/24 $460,864
FFY19 ELC COVID Ed LHJ Allocation NU50CK000515 Amd2 93,323 333.93.32 01/01/22 10/18/22 05/19/20 10/18/22 $191,632 $191,632 $191,632
FFY20 ELC EDE LHJ Allocation NU50CK000515 Amd2 93.323 333.93.32 01/01/22 12/31/22 01/15/21 07/31/24 $1,658,052 $1,658,052 $1,658,052
FFY22 MCHBG LHJ Contracts B04MC45251 Amd 1 93.994 333.93.99 01/01/22 09/30/22 10/01/21 09/30/22 $78,754 $78,754 $78,754
GFS-Group B(FO-SW) Amd 6 N/A 334.04.90 01/01/23 06/30/23 07/01/22 06/30/23 $25,878 S25,878 $51,755
GFS-Group B(FO-SW) Amd 1 N/A 334.04.90 01/01/22 06/30/22 07/01/21 06/30/22 $25,877 $25,877
SFY23FPHS-LHJ-GFS Amd5 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 $150,000 $1,589,000 $1,589,000
SFY23 FPHS-LHJ-GFS Amd 4,5 N/A 336,04.25 07/01/22 06/30/23 07/01/21 06/30/23 $1,439,000
FPHS-LHJ-Proviso(YR2) Amd 4 N/A 336,04.25 07/01/22 06/30/23 07/01/21 06/30/23 ($867,000) $0 $471,037
FPHS-LHJ-Proviso(YR2) Amd 1 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 $867,000
FPHS-LHJ-Proviso(YRI) Amd 5 N/A 336.04.25 01/01/22 06/30/22 07/01/21 06/30/23 ($395,963) S471,037
FPHS-LHJ-Proviso(YRI) Amd 1 N/A 336.04.25 01/01/22 06/30/22 07/01/21 06/30/23 $867,000
YR24 SRF-Local Asst(15%)(FO-SW)SS Amd 1 N/A 346.26.64 01/01/22 12/31/22 07/01/21 06/30/23 $3,250 $3,250 $3,250
YR24 SRF-Local Asst(15%)(FO-SW)TA Amd 1 N/A 346.26.66 01/01/22 12/31/22 07/01/21 06/30/23 $1,000 S1,000 S1,000
TOTAL $4,202,628 $4,202,628
Total consideration: $4,176,750 GRAND TOTAL $49202,628
$25,878
GRAND TOTAL $4,202,628 Total Fed $2,086,586
Total State $2,116,042
*Catalog of Fcderal Domestic Assistance
"Federal revenue codes begin with"333". State revenue codes begin with"334"-
Page 1 of 1
COWLITZ COUNTY HEALTH & HUMAN SERVICES
2022-2024 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH31008 AMENDMENT NUMBER: 5
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as
"DOH", and COWLITZ COUNTY HEALTH&HUMAN SERVICES, a Local Health Jurisdiction, hereinafter referred to
as"LHJ",pursuant to the Modifications/Waivers clause,and to make necessary changes within the scope of this contract
and any subsequent amendments thereto.
IT IS MUTUALLY AGREED: That the contract is hereby amended as follows:
1. Exhibit A Statements of Work,includes the following statements of work, which are incorporated by this reference
and located on the DOH Finance SharePoint site in the Upload Center at the following URL:
https:/Lstat4x.)fiva.sharepoint.conilsitesL(loh-tifsfurscl ng���Uurc,;W te�esllivme,aspx?=e!:9a94688da2[194d3ea8oac7tbc32e4d7c
❑ Adds Statements of Work for the following programs:
® Amends Statements of Work for the following programs:
Executive Office of Resiliency and Health Security-PHEP -Effective July 1, 2022
Foundational Public Health Services (FPHS) -Effective January 1,2022
Foundational Public Health Services(FPHS) -Effective July 1,2022
❑ Deletes Statements of Work for the following programs:
2. Exhibit B-5 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-4 Allocations as
follows:
❑ Increase of for a revised maximum consideration of
® Decrease of 24��for a revised maximum consideration of K176,750.
❑ No change in the maximum consideration of
Exhibit B Allocations are attached only for infonnational purposes.
Unless designated otherwise herein,the effective date of this amendment is the date of execution.
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force
and effect.
IN WITNESS WHEREOF,the undersigned has affixed his/her signature in execution thereof.
COWLITZ COUNTY HEALTH &HUMAN SERVICES STATE OF WASHINGTON
DEPARTMENT OF HEALTH
Signature: Signature:
�ehhir Webe-
Date: Date:
Nov 22,2022 Nov 29,2022
APPROVED AS TO FORM ONLY
Assistant Attorney General
Page 1 of 1
EXHIBIT B-5
Cowlitz County Health&Human Services Department ALLOCATIONS Contract Number: CLH31008
Contract Term:2022-2024 Date: October 1,2022
Indirect Rate as of January 1,2022:Direct Allocation of Costs
DOH Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend# List#* Code** Start Date End Date Start Date End Date Amount SubTotal Total
FFY22 PHEP BP4 LHJ Funding NU90TP922043 Amd 4 93.069 333.93.06 07/01/22 06/30/23 07/01/22 06/30/23 $79,074 $79,074 $158,148
FFY21 PHEP BP3 LHJ Funding NU90TP922043 Amd 2 93.069 333.93.06 01/01/22 06/30/22 07/01/21 06/30/22 $79,074 $79,074
COVLD19 Vaccines R4 NH23IP922619 Amd 3 93,268 333.93.26 01/01/22 06/30/24 07/01/20 06/30/24 ($460,864) $0 $0
COVID19 Vaccines R4 NH23IP922619 Amd 1 91268 333.93.26 01/01/22 06/30/24 07/01/20 06/30/24 $460,864
FFY19 ELC COVID Ed LHJ Allocation NU50CK000515 Amd 2 93323 333.93.32 01/01/22 10/18/22 05/19/20 10/18/22 $191,632 $191,632 $191,632
FFY20 ELC EDE LHJ Allocation NU50CK000515 Amd 2 93.323 333.93.32 01/01/22 12/31/22 01/15/21 07/31/24 $1,658,052 $1,658,052 $1,658,052
FFY22 MCHBG LHJ Contracts B04MC45251 Amd 1 93.994 333.93.99 01/01/22 09/30/22 10/01/21 09/30/22 $78,754 $78,754 $78,754
GFS-Group B(FO-SW) Amd 1 N/A 334.04.90 01/01/22 06/30/22 07/01/21 06/30/22 S25,877 $25,877 $25,877
SFY23 FPHS-LHJ-GFS Amd 5 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 S150,000 $1,589,000 $1,589,000
SFY23 FPHS-LHJ-GFS Amd 4,5 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 S1,439,000
FPHS-LHJ-Proviso(YR2) Amd 4 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 (S867,000) $0 S471,037
FPHS-LHJ-Proviso(YR2) Amd 1 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 S867,000
FPHS-LHJ-Proviso(YRI) Amd 5 N/A 336.04.25 01/01/22 06/30/22 07/01/21 06/30/23 ($395,963) $471,037
FPHS-LHJ-Proviso(YRI) Amd 1 N/A 336.04.25 01/01/22 06/30/22 07/01/21 06/30/23 $867,000
YR24 SRF-Local Asst(15%)(FO-S W)SS Amd I N/A 346.26.64 01/01/22 12/31/22 07/01/2) 06/30/23 $3,250 S3,250 S3,250
YR24 SRF-Local Asst(15%)(FO-SW)TA Amd 1 N/A 346.26.66 01/01/22 12/31/22 07/01/2) 06/30/23 $1,000 $1,000 $1,000
TOTAL $4,176,750 $4,176,750
Total consideration: $4,422,713 GRAND TOTAL $4,176,750
($245,963)
GRAND TOTAL $4,176,750 Total Fed $2,086,586
Total State S2,090,164
*Catalog of Federal Domestic Assistance
"Federal revenue codes begin with"333". State revenue codes begin with"334".
Page] of 1
COWLITZ COUNTY HEALTH& HUMAN SERVICES
2022-2024 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH31008 AMENDMENT NUMBER: 4
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as
"DOH", and COWLITZ COUNTY HEALTH&HUMAN SERVICES,a Local Health Jurisdiction, hereinafter referred to
as"LHJ",pursuant to the Modifications/Waivers clause, and to make necessary changes within the scope of this contract
and any subsequent amendments thereto.
IT IS MUTUALLY AGREED: That the contract is hereby amended as follows:
1. Exhibit A Statements of Work, includes the following statements of work, which are incorporated by this reference
and located on the DOH Finance SharePoint site in the Upload Center at the following URL:
https:llstateofwx.sharepUint comisit�slcfph t�kyfundingresotEi�eslsite,�ge5fhnn�c,aspx:y=cl:9o94688da2d94d3ea&Dac7tbc32e4d7c
® Adds Statements of Work for the following programs:
Executive Office of Resiliency&Health Security-PHEP-Effective July 1,2022
Foundational Public Health Services -Effective July 1,2022
® Amends Statements of Work for the following programs:
Foundational Public Health Services (FPHS) -Effective January 1, 2022
❑ Deletes Statements of Work for the following programs:
2. Exhibit B-4 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-3 Allocations as
follows:
® Increase of$651,074 for a revised maximum consideration of$4,422,713.
❑ Decrease of for a revised maximum consideration of
❑ No change in the maximum consideration of
Exhibit B Allocations are attached only for informational purposes.
Unless designated otherwise herein,the effective date of this amendment is the date of execution.
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force
and effect.
IN WITNESS WHEREOF,the undersigned has affixed his/her signature in execution thereof.
COWLITZ COUNTY HEALTH &HUMAN SERVICES STATE OF WASHINGTON
DEPARTMENT OF HEALTH
Signature: Signature:
gft!mh$tItcrn�duYm+rkre
Date: Date:
Sep 30,2022 Oct 3,2022
APPROVED AS TO FORM ONLY
Assistant Attorney General
Pagel of 1
EXHIBIT B4
Cowlitz County Health&Human Services Department ALLOCATIONS Contract Number: CLH31008
Contract Term:2022-2024 Date: August 1,2022
Indirect Rate as of January 1,2022:Direct Allocation of Costs
DOA Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend# List#* Code** Start Date End Date Start Date End Date Amount SubTotal Total
FFY22 PHEP BP4 LHJ Funding NU90TP922043 Amd 4 93.069 333.93.06 07/01/22 06/30/23 07/01/22 06/30/23 $79,074 $79,074 $158,148
FFY21 PHEP BP3 LHJ Funding NU90TP922043 Amd 2 93.069 333.93 06 01/01/22 06/30/22 07/01/21 06/30/22 $79,074 $79,074
COVID19 Vaccines R4 NH231P922619 Amd 3 93.268 333.93.26 01/01/22 06/30/24 07/01/20 06/30/24 ($460,864) $0 $0
COVID19 Vaccines R4 NH23IP922619 Amd 1 93:268 333.93.26 01/01/22 06/30/24 07/01/20 06/30/24 $460,864
FFY19 ELC COVID Ed LHJ Allocation NU50CK000515 Amd 2 93.323 333.93.32 01/01/22 10/18/22 05/19/20 10/18/22 $191,632 $191,632 $191,632
FFY20 ELC EDE LHJ Allocation NU50CK000515 Amd 2 93.323 333.93.32 01/01/22 12/31/22 01/15/21 07/31/24 S1,658,052 $1,658,052 S1,658,052
FFY22 MCHBG LHJ Contracts B04MC45251 Amd 1 93.994 333.93,99 01/01/22 09/30/22 10/01/21 09/30/22 $78,754 $78,754 S78,754
GFS-Group B(FO-SW) Amd 1 N/A 334.04.90 01/01/22 06/30/22 07/01/21 06/30/22 $25,877 $25,877 $25,877
FPHS-LHJ-Proviso(YR2) Amd 4 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 $1,439,000 S1,439,000 $2,306,000
FPHS-LHJ-Proviso(YR2) Amd 4 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 ($867,000) $0
FPHS-LHJ-Proviso(YR2) Amd 1 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 S867,000
FPHS-LHJ-Proviso(YR1) Amd 1 N/A 336.04.25 01/01/22 06/30/22 07/01/21 06/30/23 S867,000 S867,000
YR24 SRF-Local Asst(15%)(FO-SW)SS Amd 1 N/A 346.26.64 01/01/22 12/31/22 07/01/21 06/30/23 $3,250 $3,250 $3,250
YR24 SRF-LocalAsst(15%)(FO-SW)TA Amd 1 N/A 346.26.66 01/01/22 12/31/22 07/01/21 06/30/23 $1,000 $1,000 $1,000
TOTAL S4,422,713 $49422,713
Total consideration: $3,771,639 GRAND TOTAL $4,422,713
$651,074
GRAND TOTAL $4,422,713 Total Fed $2,0869586
Total State $2,336,127
*Catalog of Federal Domestic Assistance
**Federal revenue codes begin with"333". State revenue codes begin with"334".
Pagel of 1
COWLITZ COUNTY HEALTH & HUMAN SERVICES
2022-2024 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH31008 AMENDMENT NUMBER: 3
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as
"DOH", and COWLITZ COUNTY HEALTH&HUMAN SERVICES, a Local Health Jurisdiction, hereinafter referred to
as"LHJ",pursuant to the Modifications/Waivers clause, and to make necessary changes within the scope of this contract
and any subsequent amendments thereto.
IT IS MUTUALLY AGREED: That the contract is hereby amended as follows:
1. Exhibit A Statements of Work, includes the following statements of work, which are incorporated by this reference
and located on the DOH Finance SharePoint site in the Upload Center at the following URL:
lilt)s://stateo4Wa.share oint.coiii,lsites/doh-ofsftuufin rresout-ces/site a es/tionic.as x?=el:9a94698da2d94d3ea8Oac7fbc32e4d7c
❑ Adds Statements of Work for the following programs:
® Amends Statements of Work for the following programs:
f DCHS-ELC COVID-19 Response-Effective January 1,2022
I ® Deletes Statements of Work for the following programs:
Office of Immunization COVID-19 Vaccine-Effective January 1,2022
2. Exhibit B-3 Allocations,attached and incorporated by this reference,amends and replaces Exhibit B-2 Allocations as
follows:
[t. Increase of for a revised maximum consideration of
® Decrease of G$4 0,864 for a revised maximum consideration of 3 7S , 71,639.
❑ No change in the maximum consideration of
Exhibit B Allocations are attached only for informational purposes.
Unless designated otherwise herein,the effective date of this amendment is the date of execution.
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force
and effect.
IN WITNESS WHEREOF,the undersigned has affixed his/her signature in execution thereof.
COWLITZ COUNTY HEALTH&HUMAN SERVICES STATE OF WASHINGTON
DEPARTMENT OF HEALTH
Signature: Signature:
✓ &ky �-„Gueber dar a 1#inntrr
Date: Date:
May 24,2022 May 24,2022
APPROVED AS TO FORM ONLY
Assistant Attorney General
Page 1 of 1
EXHIBIT B-3
Cowlitz County Health&Human Services Department ALLOCATIONS Contract Number: CLH31008
Contract Term:2022-2024 Date: April 1,2022
Indirect Rate as of January 1,2022:Direct Allocation of Costs
DOH Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend# List#* Code** Start Date End Date Start Date End Date Amount SubTotal Total
FFY21 PHEP BP3 LHJ Funding NU90TP922043 Amd 2 93.069 333.93.06 01/01/22 06/30/22 07/01/21 06/30/22 $79,074 $79,074 $79,074
COVID19 Vaccines R4 NH231P922619 Amd 4 93.268 333.93.26 01/01/22 06/30/24 07/01/20 06/30/24 ($460,864) $0 $0
COVID19 Vaccines R4 NH23IP922619 Amd 1 93.268 333.93.26 01/01/22 06/30/24 07/01/20 06/30/24 $460,864
FFY19 ELC COVID Ed LHJ Allocation NU50CK000515 Amd 2 93.323 333.93.32 01/01/22 10/18/22 05/19/20 10/18/22 $191,632 $191,632 $191,632
FFY20 ELC EDE LHJ Allocation NU50CK000515 Amd 2 93.323 333.93.32 01/01/22 12/31/22 01/15/21 07/31/24 $1,658,052 $1,658,052 $1,658,052
FFY22 MCHBG LHJ Contracts B0445251 Amd 1 93.994 333.93.99 01/01/22 09/30/22 10/01/21 (19/30/22 $78,754 $78,754 $78,754
GFS-Group B(FO-SW) Amd 1 N/A 334.04.90 01/01/22 06/30/22 07/01/21 06/30/22 $25,877 $25,877 $25,877
FPHS-LHJ-Proviso(YR2) Amd 1 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 $867,000 $867,000 $1,734,000
FPHS-LHJ-Proviso(YRI) Amd 1 N/A 336.04.25 01/01/22 06/30/22 07/01/21 06/30/23 $867,000 $867,000
YR24 SRF-Local Asst(15%)(FO-SW)SS Amd 1 N/A 346.26.64 01/01/22 12/31/22 07/01/21 06/30/23 $3,250 $3,250 $3,250
YR24 SRF-Local Asst(15%)(FO-SW)TA Amd 1 N/A 346.26,66 01/01/22 12/31/22 07/01/21 06/30/23 $1,000 $1,000 S1,000
TOTAL $3,771,639 $3,771,639
Total consideration: $4,232,503 GRAND TOTAL S3,771,639
($460,864)
GRAND TOTAL $3,771,639 Total Fed $2,007,512
Total State $1,764,127
*Catalog of Federal Domestic Assistance
**Federal revenue codes begin with"333". State revenue codes begin with"334".
Page] of 1
COWLITZ COUNTY HEALTH & HUMAN SERVICES
2022-2024 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH31008 AMENDMENT NUMBER: 2
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as
"DOH", and COWLITZ COUNTY HEALTH &HUMAN SERVICES,a Local Health Jurisdiction, hereinafter referred to
as"LHJ",pursuant to the Modifications/Waivers clause,and to make necessary changes within the scope of this contract
and any subsequent amendments thereto.
IT IS MUTUALLY AGREED: That the contract is hereby amended as follows:
1. Exhibit A Statements of Work, includes the following statements of work, which are incorporated by this reference
and located on the DOH Finance SharePoint site in the Upload Center at the following URL:
https:llstateof'wa.sharenoint:comisitesldUft-nfstiinclin resnurcetilsiten eslhumc.aspx;�=e1:9,a94688da2dg4d3ea8Oac7fhe32c4d7c
® Adds Statements of Work for the following programs:
DCHS-ELC COVID-19 Response-Effective January 1,2022
Emergency Preparedness,Resilience&Response-PHEP-Effective January 1,2022
❑ Amends Statements of Work for the following programs:
❑ Deletes Statements of Work for the following programs:
2. Exhibit B-2 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-1 Allocations as
follows:
® Increase of$1 928,758 for a revised maximum consideration of$4,232,503.
❑ Decrease of for a revised maximum consideration of
❑ No change in the maximum consideration of
Exhibit B Allocations are attached only for informational purposes.
Unless designated otherwise herein,the effective date of this amendment is the date of execution.
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force
and effect.
IN WITNESS WHEREOF,the undersigned has affixed his/her signature in execution thereof.
COWLITZ COUNTY HEALTH & HUMAN SERVICES STATE OF WASHINGTON
DEPARTMENT OF HEALTH
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Dennis P Weber(Apr 5,202217:26 PDT) LinvSda blrv'w:+..���, •�iyi,n 1.Sp••.�nl�d::��� ..:�s JJ 1'••3
Date Date
APPROVED AS TO FORM ONLY
Assistant Attorney General
Page 1 of 1
EXHIBIT B-2
Cowlitz County Health&Human Services Department ALLOCATIONS Contract Number: CLH31008
Contract Term:2022-2024 Date: February 1,2022
Indirect Rate as of January 1,2022:Direct Allocation of Costs
DOH Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend# List#* Code** Start Date End Date Start Date End Date Amount SubTotal
Total
FFY21 PHEP BP3 LHJ Funding NU90TP922043 Amd 2 93.069 333.93.06 01/01/22 06/30/22 07/01/21 06/30/22 $79,074 $79,074 $79,074
COVIDI9 Vaccines R4 NH231P922619 Amd 1 93.268 333.93.26 01/01/22 06/30/24 07/01/20 06/30/24 $460,864 $460,864 $460,964
FFY19 ELC COV1D Ed LHJ Allocation NU50CK000515 Amd 2 93.323 333.93.32 01/01/22 10/18/22 05/19/20 10/18/22 $191,632 S191,632 $191,632
FFY20 ELC EDE LHJ Allocation NU50CK000515 Amd 2 93.323 333.93.32 01/01/22 12/31/22 01/15/21 07/31/24 $1,658,052 $1,658,052 S1,658,052
FFY22 MCHBG LHJ Contracts B0445251 Amd 1 93.994 333.93.99 01/01/22 09/30/22 10/01/21 09/30/22 $78,754 $78,754 $78,754
GFS-Group B(FO-SW) Amd l N/A 334.04.90 01/01/22 06/30/22 07/01/21 06/30/22 $25,877 $25,877 $25,877
FPHS-LHJ-Proviso(YR2) Amd 1 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 $867,000 $867,000 $1,734,000
FPHS-LHJ-Proviso(YR1) Amd 1 N/A 336.04.25 01/01/22 06/30/22 07/01/21 06/30/23 S867,000 $867,000
YR24 SRF-Local Asst(15%)(FO-SW)SS Amd 1 N/A 346.26.64 01/01/22 12/31/22 07/01/21 06/30/23 $3,250 $3,250 $3,250
YR24 SRF-Local Asst(15%)(FO-SW)TA Amd 1 N/A 346.26.66 01/01/22 12/31/22 07/01/21 06/30/23 $1,000 $1,000 $1,000
TOTAL $4,232,503 $4,232,503
Total consideration: $2,303,745 GRAND TOTAL $4,232,503
$1,928,758
GRAND TOTAL $4,232,503 Total Fed $2,468,376
Total State S1,764,127
*Catalog of Federal Domestic Assistance
**Federal revenue codes begin with"333". State revenue codes begin with"334".
Page] of 1
COWLITZ COUNTY HEALTH & HUMAN SERVICES
2022-2024 CONSOLIDATED CONTRACT
CONTRACT NUMBER: CLH31008 AMENDMENT NUMBER: 1
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as"DOH", and
COWLITZ COUNTY HEALTH&HUMAN SERVICES,a Local Health Jurisdiction,hereinafter referred to as"LHJ",pursuant to
the Modifications/Waivers clause,and to make necessary changes within the scope of this contract and any subsequent amendments
thereto.
IT IS MUTUALLY AGREED: That the contract is hereby amended as follows:
1. Exhibit A Statements of Work,located on the DOH Finance SharePoint site in the Upload Center at the following URL:
.htto://stateofiva.sliar paint.cem/sites�4oh-ofsfundiitgresnurces/sitepaVs/hank.aspx'-c1:9a94698da2d94d3ea8Oac7tbc32c4d7c,
and incorporated by this reference, are amended as follows:
® Adds Statements of Work for the following programs:
• COVID-19 Mass Vaccination-FEMA-Effective January 1,2022
• Foundational Public Health Services(FPHS)-Effective January 1, 2022
• Maternal&Child Health Block Grant-Effective January 1,2022
• Office of Drinking Water Group A Program-Effective January 1,2022
• Office of Drinking Water Group B Program-Effective January 1,2022
• Office of Immunization COVID-19 Vaccine-Effective January 1,2022
❑ Amends Statements of Work for the following programs:
❑ Deletes Statements of Work for the following programs:
2. Exhibit B-1 Allocations,attached and incorporated by this reference, amends and replaces Exhibit B-0 Allocations as follows:
® Increase of$2,303.745 for a revised maximum consideration of 2 3$t 03,745.
❑ Decrease of for a revised maximum consideration of
❑ No change in the maximum consideration of
Exhibit B Allocations are attached only for informational purposes.
Unless designated otherwise herein,the effective date of this amendment is the date of execution.
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force and effect.
IN WITNESS WHEREOF,the undersigned has affixed his/her signature in execution thereof.
COWLITZ COUNTY HEALTH &HUMAN SERVICES STATE OF WASHINGTON
DEPARTMENT OF HEALTH
Dennis P_Weber(Feb S,2022 12:29 PST) Ou.-iv 4i nrnulson_Cun i i,u.i%S pru.d is[[Fe9 6.202:I L 77 P f i
Date Date
APPROVED AS TO FORM ONLY
Assistant Attorney General
Page 1 of 1
EXHIBIT B-1
Cowlitz County Health&Human Services Department ALLOCATIONS Contract Number: CLH31008
Contract Term:2022-2024 Date: January 1,2022
Indirect Rate as of January 1,2022:Direct Allocation of Costs
DOH Use Only
BARS Statement of Work Cbart of Accounts Funding Chart of
Federal Award Assist Revenue LHJ Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend# List#* Code** Start Date End Date Start Date End Date Amount SubTotal Total
COVIDI9 Vaccines R4 NH231P922619 Amd 1 93.268 333.93.26 01/01/22 06/30/24 07/01/20 06/30/24 $460,864 $460,864 $460,864
FFY22 MCHBG LHJ Contracts B0445251 Amd 1 93.994 333.93.99 01/01/22 09/30/22 10/01/21 09/30/22 $78,754 $78,754 S78,754
GFS-Group B(FO-SW) Amd 1 N/A 334.04.90 01/01/22 06/30/22 07/01/21 06/30/22 $25,877 $25,877 S25,877
FPHS-LHJ-Proviso(YR2) Amd 1 N/A 336.04.25 07/01/22 06/30/23 07/01/21 06/30/23 $867,000 $867,000 $1,734,000
FPHS-LHJ-Proviso(YR 1) Amd 1 N/A 336.04,25 01/01/22 06/30/22 07/01/21 06/30/23 $867,000 $867,000
YR24 SRF-Local Asst(15%)(FO-SW)SS Amd 1 N/A 346.26.64 01/01/22 12/31/22 07/01/21 06/30/23 $3,250 S3,250 $3,250
YR24 SRF-Local Asst(15%)(FO-SW)TA Amd1 N/A 346.26.66 01/01/22 12/31/22 07/01/21 06/30/23 $1,000 $1,000 $1,000
TOTAL $2,303,745 $2,303,745
Total consideration: $0 GRAND TOTAL S2,303,745
$2,303,745
GRAND TOTAL $2,303,745 Total Fed S539,618
Total State $1,764,127
*Catalog of Federal Domestic Assistance
"Federal revenue codes begin with"333 State revenue codes begin with'334".
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