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Iowa Department of Health and Human Services (HHS) Childhood Lead Poisoning and Healthy Homes Funding and Agreement with the Visiting Nurse Association (VNA) and the Dubuque County Board of HealthCity of Dubuque City Council Meeting Consent Items # 010. Copyrighted January 16, 2024 ITEM TITLE: Iowa Department of Health and Human Services (HHS) Childhood Lead Poisoning and Healthy Homes Funding and Agreement with the Visiting Nurse Association (VNA) and the Dubuque County Board of Health SUMMARY: City Manager recommending City Council approval for the City Manager sign the attached subcontract with the Dubuque County Board of Health, and the agreement with the Dubuque Visiting Nurse Association on behalf of the City of Dubuque. SUGGESTED Suggested Disposition: Receive and File; Approve DISPOSITION: ATTACHMENTS: Description MVM Memo Type City Manager Memo Memo to MVM I HHS CLPP & HH Agreement w/VNA & Staff Memo DBQ Co & Board of Health Iowa Health and Human Services CLPP Contract 5883 L P03 Iowa Health and Human Services CLPP Contract 5883LP03 Amend #1 Lead subcontract with VNA for the HH & CLPP Unity Point VNA Certificate of Insurance Lead subcontract with County Board of Health Supporting Documentation Supporting Documentation Supporting Documentation Supporting Documentation Supporting Documentation THE CITY OF Dubuque DUB TEE1. All -America City Masterpiece on the Mississippi � pp zoo�•*o 13 zoi720zoi9 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Iowa Department of Health and Human Services (HHS) Childhood Lead Poisoning and Healthy Homes Funding and Agreement with the Visiting Nurse Association (VNA) and the Dubuque County Board of Health DATE: January 9, 2024 Public Health Director Mary Rose Corrigan is recommending City Council approval for the City Manager to sign the attached subcontract with the Dubuque County Board of Health, and the agreement with the Dubuque Visiting Nurse Association on behalf of the City of Dubuque. The FY24 budget anticipated funding of $8,808. The contract amount increased to $10,000, from the $8,008 in FY23. The sub -agreement with the VNA will be paid utilizing funds from the IDPH grant. I concur with the recommendation and respectfully request Mayor and City Council approval. Micliael C. Van Milligen MCVM:sv Attachment CC' Crenna Brumwell, City Attorney Cori Burbach, Assistant City Manager Mary Rose Corrigan, Public Health Director THE CITYF DUijB- El Masterpiece on the Mississippi TO: Michael C. Van Milligen, City Manager FROM: Mary Rose Corrigan, Public Health Director Dubuque AII•Anedea M �,awvuav[: iru3.r 1IIII®r 2007-2012.2013 2017*2019 SUBJECT: Iowa Department of Health and Human Services (HHS) Childhood Lead Poisoning and Healthy Homes Funding and Agreement with the Visiting Nurse Association (VNA) and the Dubuque County Board of Health DATE: January 8, 2024 INTRODUCTION This memorandum provides information regarding a contract with the Dubuque County Board of Health and the Iowa Department of Health and Human Service (HHS) for continued funding of the Childhood Lead Poisoning Prevention Program (CLPPP), a renewed agreement with the VNA for services related to the CLPPP and Healthy Homes Program. BACKGROUND Since 1994, the City Council has approved grant agreements authorizing the Health Services Department to contract with the Iowa Department of Health and Human Services via subcontract with the Dubuque County Health Department for environmental follow-up and medical case management for children with lead poisoning according to the Iowa Department of Public Health guidelines. The original funding contract has been renewed annually. The latest contract ended June 30, 2023. DISCUSSION The Iowa HHS contracts with local Boards of Health for distribution of their funds. This allows local Boards of Health to monitor public health funding, avoid duplication of services and assure community health needs are addressed (see attached contract). The County Health Department subcontracted funds will allow the Health Services and Housing and Community Development Departments to provide additional follow-up of lead poisoned children through contracted nursing services provided by the Dubuque Visiting Nurse Association, education for employees, and monies to do outreach and education in targeted neighborhoods regarding lead poisoning and healthy homes activities. The contract also includes program performance standards, which we currently strive to achieve through our existing protocols and outreach programs. The grant funds will be reimbursed based on the specific activities outlined in the budget. BUDGETIMPACT The FY24 budget anticipated funding of $8,808. The contract amount increased to $10,000, from the $8,008 in FY23. The sub -agreement with the VNA will be paid utilizing funds from the IDPH grant. RECOMMENDATION It is recommended that the City Manager sign the attached subcontract with the Dubuque County Board of Health, and the agreement with the Dubuque Visiting Nurse Association on behalf of the City of Dubuque. uIOW14 it Public Health IL IM/11AsoraR Kim Reynolds GOVERNOR Adam Gregg LT. GOVERNOR Kelly Garcia DIRECTOR CONTRACT #: 5883LP03 PROJECT TITLE: FY24-26 Childhood Lead Poisoning Prevention Program CONTRACTOR LEGAL NAME AND ADDRESS: PROJECT PERIOD: Dubuque County Board of Health July 1, 2023 — June 30, 2026 720 Central Ave. Dubuque, IA 52001-7079 STATE OF IOWA DEPT. OF ADMINISTRATIVE CONTRACT PERIOD: SERVICES VENDOR M 00002128749 July 1, 2023 -- June 30, 2024 Warrant/payment mailing address TOTAL CONTRACT AMOUNT: $10,000.00 (if different from legal address): FUNDING SOURCE: FEDERAL: $0 STATE: $10,000.00 OTHER:$0 Interagency State: $0 Interagency Federal: $0 Private/Fees/Other:$0 Federal Subreciplent Addendum Needed? NO IOWA CODE CHAPTER 8F DESIGNATION: This contract is NOT covered by Iowa Code chapter 8F The Contractor agrees to perform the work and to provide the services described in the Special conditions for the consideration stated herein. The duties, rights and obligations of the parties to this contract shall be governed by the Contract Documents, which include the Special Conditions, General Conditions, Request for Proposal and Application. The Contractor has reviewed and agrees to the Iowa Department of Public Health General Conditions Effective July 1, 2019 as posted on the Agency's website under Funding Opportunities or as available by contacting Kevin Officer, (515) 724-3139. The Contractor specifies no changes have been made to the Special Conditions or General Conditions. The parties hereto have executed this contract on the day and year last specified below. For and on behalf of the Agency: For and on behalf of the Contractor: Digitally signed by Ken Sharp e n a rp Date 2023.07.14 By: 07:28:54-05'00' By:_g Ken Sharp, Operations Deputy Insert Date (required if not a digital signature): 1 IZ i Special Conditions for Contract # 5883LP03 Article I- Identification of Parties: This contract is entered into by and between Iowa Health and Human Services, Division of Public Health (hereinafter referred to as Agency or Iowa HHS) and the Contractor, as identified on the contract face sheet. Article II - Designation of Authorized State Official: Ken Sharp, Operations Deputy, Division of Public Health, is the Authorized State Official for this contract. Any changes in the terms, conditions, or amounts specified in this contract must be approved by the Authorized State Official. Negotiations concerning this contract should be referred to Kevin Officer, Community Health Consultant, at kevin.officer@idph.iowa.gov or 515- 724-3139. Article III - Designation of Contract Designation of Project Director: Samantha Kloft has been designated by the Contractor to act as the Contract Administrator. This individual is responsible for financial and administrative matters of this contract. IowaGrants.gov. The Agency utilizes an electronic grant management system (lowaGrants.gov) for all contract activities. It is the Contractor's sole responsibility to ensure appropriate individual(s) have registered within IowaGrants. The Contractor acknowledges that all assigned individuals to the Grant Tracking site have full rights (add, modify, and delete) for all Grant Tracking site components including contractual forms such as work plans, personnel, budgets, and reporting forms, and claims submission. The Contract Administrator designates Mary Rose Corrigan as the Grantee Contact in IowaGrants (www.lowaGrants.gov) who shall regulate and assign access of appropriate individuals to this grant site. 1. The Contractor, as listed on the Contract Face Sheet, is responsible for financial and administrative matters of this Contract. 2. The Project Director, as designated by the Contractor and listed in Article IV — Key Personnel for Project Implementation, has the authority to manage the contract and the legal responsibility to assure compliance with all contract conditions. Negotiations concerning this contract should be referred to the Project Director. 3. The Project Director will receive key communications from the Agency and will be responsible for keeping the Contractor and all Authorized Agencies informed of any relevant contract issues. 4. It is the Contractor's sole responsibility to ensure appropriate individual(s) have registered within IowaGrants. The Contractor acknowledges that all assigned individuals to the Grant Tracking site have full rights (add, modify, and delete) for all Grant Tracking site components including contractual forms such as work plans, personnel, budgets, and reporting forms, and claims submission. The Contractor designates Mary Rose Corrigan as the Grantee Contact in IowaGrants (www.lowaGrants.gov) who shall regulate and assign access of appropriate individuals to this grant site. Article IV — Key Personnel: The following individual(s) shall be considered key personnel for purposes of this contract: Aqencv Personnel Name Title Email Address Mindy Uhle Bureau Chief melinda.uhle id h.iowa. ov Kevin Officer Program Contract Manager kevin.officer(o)idph.iowa.gov Janet Lobsin er Pro ram Contact 'anet.lobsin er id h.iowa. ov Key Contractor Personnel Name Title Email Address Mary Rose Corrigan Project Director mcorri a cit ofd u bug ue.or Mary Rose Corrigan Program Coordinator meorriga@cityofdubuque.org Angela Ventris Finance Manager aventris cit ofdubu ue.or Mary Rose Corrigan HHLPSS Data Manager mcorri a cit ofdubu ue.or Kelly Davis Certified EBL Inspector/Risk Assessor kdavis@cityofdubuque.org The Contractor shall notify the Agency in writing within ten (10) working days of any change of Key Personnel identified in this section. Article V - Statement of Contract Purpose: The purpose of this contract is to provide funds for the Contractor to ensure that childhood lead poisoning prevention activities are conducted as specified in this contract and in compliance with Iowa Administrative Code (IAC) 641— Chapter 72. The Agency is actively working to strengthen our capacity to address health inequities in Iowa. Health equity is defined as the attainment of the highest possible level of health for all people by achieving the environmental, social, economic and other conditions in which all people have the opportunity to attain their highest possible level of health. This contract promotes health equity by enabling local public health agencies to carry out childhood lead poisoning prevention activities for high -risk geographic areas and at -risk populations for lead exposure. Article VI - Description of Work and Services: CLPPP SERVICE AREA The CLPPP service area is Dubuque County DESIGNATED AGENCY Dubuque County Health Department 1225 Seippel Rd Dubuque, IA 52002 563-557-7396 CLPPP Activities and Services In compliance with the Agency -approved work plan within IowaGrants, the Contractor shall: A. Blood Lead Testing 1. Ensure that all children under the age of six years receive blood lead testing according to the CLPPP protocols, especially children between the ages of 12 months and 35 months. 2. Ensure medical providers, Title V Child Health, WIC, Community Empowerment, and other programs within their jurisdiction conduct initial and follow-up blood lead testing according to CLPPP protocols. 3. Ensure parents, guardians, and caregivers are informed of the results of blood lead testing of all children tested within their jurisdiction. B. Medical Case Management 1. Coordinate medical case management services and activities within the jurisdiction, as prescribed according to CLPPP protocols, with medical providers, Title V Child Health, WIC, Community Empowerment, and other child health programs that may be involved in the management of lead - poisoned children. 2. Document all clinical case management activities occurring within the jurisdiction in the Healthy Homes & Lead Poisoning Surveillance System (HHLPSS) for children with blood lead levels greater than or equal to 10 micrograms per deciliter (lag/dL). C. Environmental Case Management 1. Coordinate environmental case management activities and services within the jurisdiction. 2. Ensure Elevated Blood Lead (EBL) inspections occur in dwellings associated with an EBL child. Ensure EBL inspections are conducted by an Iowa certified EBL inspector/risk assessor. 3. Ensure follow-up inspections are conducted to verify if lead -based paint hazards identified during an EBL inspection have been remediated. 4. Enrollment as a Medicaid provider or have an agreement with an agency that is a Medicaid provider so that EBL inspection services can be recovered under Medicaid as reimbursement and used as program income. 5. Adoption of local lead hazard codes or regulations within the jurisdiction requiring hazards to be repaired in the homes of EBL children. A model code is available at Iowa Administrative Code 641—Chapter 68. Applicants may adopt this model code by reference. Local regulations must be as protective as Iowa Administrative Code 641—Chapter 68. 6. Document all environmental case management activities occurring within the jurisdiction in HHLPSS. D. Data Management 1. Ensure that all case management actions for children with blood lead levels greater than or equal to 10 lag/dL occurring within the jurisdiction, such as contact with the family or provider, EBL inspections, lead hazard remediations, home nursing or outreach visits, nutrition evaluations, and developmental assessments, be recorded weekly in the HHLPSS database according CLPPP protocols. 2. Ensure all reports specified in ARTICLE VIII — REPORTS are provided by the deadlines given in this contract. 3. Facilitate the reporting of blood lead samples analyzed by medical providers, hospitals, clinical labs, and other health care facilities. Iowa Administrative Code 641-1.6 requires all blood lead results less than 20 micrograms per deciliter (lag/dL) be reported to the Agency on a weekly basis, and results equal to or greater than 20 pg/dL be reported immediately via phone or fax. 4. Ensure that all requests for CLPPP data needed to support the local CLPPP and fulfill the requirements of this contract be submitted to the Agency in a timely manner using the Lead Data Request form in Appendix II. 5. Assist the Agency in ensuring all patient and address records in HHLPSS are complete and accurate. 6. Notify the Agency of HHLPSS database errors and missing records immediately. 7. Ensure that all records and data are managed according to the following: a. Data Use. All records and data collected through and/or provided by this contract shall be used only for purposes as set forth in the contract. The Contractor shall not use or permit others to use the records and data in any way except for the purposes outlined in this contract. b. Data Storage. All records and data received pursuant to this contract shall be stored in a secure locked area with access restricted to project personnel for purposes only as set forth in Article VII of this Contract. Contractor shall comply with Agency and State information technology standards. I. Data Backup Standard: Applicable to Entities which utilize data systems to process, store, transmit or monitor information. ii. Data Stewardship Standard: Applicable to Entities which utilize data systems to process, store, transmit or monitor information. iii. Interconnectivity Standard: Applicable to Entities which utilize data systems to process, store, transmit or monitor information. iv. Laptop Data Protection Standard: Applicable to Entities which utilize laptops to process, store, transmit or monitor data. v. Removable Storage Encryption Standard: Applicable to Entities which utilize removable storage devices to process, store, transmit or monitor information. Current state information technology standards are accessible online at https://ocio.iowa.gov/standards. c. Confidentiality. The Contractor may, if approved through an Iowa HHS Childhood Lead Program Work Plan, release information to personnel identified within a grant application or this Contract for the purposes of medical and environmental case management to complete the work and services of this Contract (See September 23, 2015 Letter of Clarification to all FY16 Childhood Lead Poisoning Prevention Program Contractors). In all cases, confidential data shall only be accessed by the minimum number of people necessary to complete required and approved work and services. With the exception of the above, the Contractor shall maintain the confidentiality of all confidential records and data collected and/or released pursuant to this Contract. Contractor shall not disclose any confidential information contained in these records or data, including but not limited to names and other identifying information of persons who are the subject of such records, either during the period of this Contract or hereafter. All identifiable and personal indicators shall be kept strictly confidential and shall not be used or released for any purpose, except as authorized by this Contract. Contractor shall immediately report to Iowa HHS any unauthorized disclosure of confidential information. Such disclosure shall be grounds for immediate termination of this Contract. d. Ownership. Records and data provided by Iowa HHS to Contractor, and any files created by linking these data files, pursuant to this Contract shall remain the property of the Agency at all times. e. Re-release. Contractor may not re-release data provided by this contract without expressed written permission from Iowa HHS , except as authorized by this Contract. Data provided by this contract is for use solely by the Contractor and only for the purposes outlined in this contract. f. Aggregate Data Publication. The Contractor agrees to provide a copy of all proposed publications to Iowa HHS at least thirty (30) days in advance of the proposed dissemination date. The publication shall not be published in any format without the prior written consent of Iowa HHS. Any publication of aggregate data shall comply with the Iowa HHS Disclosure of Confidential Public Health Information Records. or Data Policy. g. Data Linkage. Contractor may not link the data provided by this contract to any other dataset without express written permission from Iowa HHS E. Education/Outreach 1. The Contractor shall develop and implement an educational, outreach, and training program that provides information about childhood lead poisoning to members of the community, including parents, medical providers, property owners, and community policy makers within their jurisdiction. 2. Organize an annual meeting or training session with partners, stakeholders, and programs (e.g., early childhood education programs, social services, school systems, public housing agencies, etc.) that provide services or housing to children. Meetings should engage partners in strategizing, planning, developing, and implementing lead- related activities and services within their jurisdiction. 3. Assure medical providers, hospitals, and other child health programs, educate parents and guardians on a child's blood lead test results and provide information on how-to eliminate or minimize future lead exposures. 4. Develop community partnerships to address childhood lead poisoning prevention within the jurisdiction you are applying. 5. Conduct education and outreach campaigns to raise public awareness about lead -related issues. 6. Connect parents and guardians of lead -exposed children to services that can provide assistance in addressing lead -related issues. F. Training 1. The Contractor shall send at least one individual to attend a CLPPP regional meeting. Travel expenses are the responsibility of the successful applicant. The Agency will reimburse travel expenses up to the limits established by the Iowa Department of Administrative Services and outlined in Article X. G. Reporting The Contractor shall provide Quarterly Progress Reports to Iowa HHS on the IowaGrants.gov web site. The quarterly progress report shall include data and details about CLPPP program activities and services provided within the CLPPP service area in the quarter in which claims are being submitted for reimbursement. Quarterly progress reports must be submitted by: October 31; January 31; April 30; and July 31. 2. The Contractor shall submit quarterly claims to Iowa HHS in IowaGrants.gov. Quarterly claims must be submitted by: October 31; January 31; April 30; and July 31. H. Program Maintenance 1. The Contractor shall submit a plan of action to the Agency prior to discontinuing the program. The plan must describe how the program will be continued on a maintenance basis during this transition period. Article VII — Performance Measure Reimbursement under the contract will be based upon successful implementation of the contractors workplan activities outlined for meeting the requirements and deliverables outlined in the budget section, in addition to: 1. Timely submission of quarterly claims and quarterly reports. 2. Quarterly progress reports must describe the level of efforts towards meeting each deliverable outlined in the budget section. a. The narrative description in the quarterly progress report must describe the contractor's efforts to meet the performance measures/goals outlined for each deliverable, along with barriers encountered. b. The Agency may request additional information from the Contractor to satisfy documented efforts through progress report negotiation or other means as appropriate. 3. All deliverables must meet Agency approval prior to payment of the reimbursement. Failure to provide deliverables meeting Agency satisfaction may result in non-payment of a corresponding deliverable. The Contractor shall submit any documentation required for the performance measure into the progress reports component of the grant site within IowaGrants.gov. Article VIII — Reports: The Contractor shall complete and submit the following reports in the grant site located in IowaGrants. Report Title Form Frequency/Type Date Due Quarterly Progress Report (Submitted Quarterly Quarterly throughout through grant site.) the Contract Period (October 31, January 31, April 30, and Jul 31 Quarterly Performance Measure Quarterly Quarterly throughout Data Report (Prepared by Iowa the Contract Period NHS and uploaded to grant (October 31, January 31, site.) Aril 30, and Jul 31 Quarterly Case Management Report Quarterly Quarterly throughout (Prepared by Iowa HHS and uploaded the Contract Period to grant site.) October 31, January 31, April 30, and Jul 31 Quarterly Claim and Support Quarterly Quarterly throughout Documentation Report (if the Contract Period applicable) (October 31, January 31, April 30, and Jul 31 Deliverable -based Reimbursement Reimbursement under this contract will be deliverable -based. These amounts are all inclusive and no other costs or expenses will be provided. Deliverable Performance Measures/Goals Due Dates Fixed (description) Cost A. Documented efforts Al. Increase the number and percentage Quarterly 20% of to increase blood lead of children in the CLPPP service area through allocated testing, if population between the ages of 12 and 35 months out the funds/4 available. who had a blood lead test. Contract Period A2. Increase the percentage of children in (October 31, the CLPPP service area before the age of January 31, 6 who receive a blood lead test. April 30, and Jul 31 B. Documented efforts B3. Ensure that at least 95% of children Quarterly 25% of to ensure follow up with capillary blood lead levels greater through allocated blood lead testing for than or equal to 20 lag/dL receive out the funds/4 elevated blood lead confirmatory venous blood lead tests Contract levels. within the scheduled time frame Period according to CLPPP protocols.* (October 31, January 31, B4. Ensure that at least 75% of children April 30, and with capillary blood lead levels greater July 31) than or equal to 10 leg/dL receive confirmatory venous blood lead tests within the scheduled time frame according to CLPPP protocols.* B5. Ensure that at least 75% of children confirmed with a blood lead level between 10-14 lag/dL receive follow-up testing at an interval of 12 weeks/84 days.* C. Documented efforts C6. Ensure that at least 95% of children Quarterly 30% of to ensure referral and confirmed with an initial case making through allocated delivery of services for blood lead level greater than or equal to out the funds/4 elevated blood lead 15 lag/dL receive a home nursing or Contract levels. outreach visit within the scheduled time Period frame according to CLPPP protocols.* (October 31, January 31, C7. Ensure that at least 95% of children April 30, and confirmed with an initial case making July 31) blood lead level greater than or equal to 15 lag/dL receive a nutrition evaluation within the scheduled time frame according to CLPPP protocols.* C8. Ensure that 100% of children with an initial case making venous blood lead level greater than or equal to 20 pg/dL receive a complete medical evaluation from a physician.* C9. Refer 100% of children with confirmed blood lead levels greater than or equal to 15 lag/dL to the local Area Education Agency for the appropriate developmental testing, evaluation, and assessment.* C10. Ensure that at least 95% of children confirmed with an initial case making blood lead level greater than or equal to 20 lag/dL receive the appropriate developmental testing, evaluation, and assessment from their local Area Education Agency.* D. Documented D11. Complete environmental Quarterly 20% of efforts to ensure investigations for 100% of homes through allocated environmental follow associated with children having venous out the funds/4 up services for blood lead levels greater than or equal to Contract elevated blood lead 20 lag/dL or persistent blood lead levels Period levels. from 15-19 lag/dL within the scheduled (October 31, time frame.* January 31, April 30, and D12. Contact at least 95% of the July 31) occupants and/or owners of dwellings where lead hazards have been identified within 30 days of the initial investigation to check their progress towards making the dwelling lead -safe.* E. Documented E13. Give presentations about childhood quarterly 5% of efforts of community lead poisoning prevention to each of the througho allocated outreach and following groups at least once during the utthe funds/4 education related to contract period: Contract childhood lead A. Members of targeted high Period poisoning. risk populations and those (October 31, who work for agencies that January 31, April 30, and provide service to these July 31) high risk populations. B. Members of the general public, including homeowners, landlords, Realtors, and members of community organizations. C. Health professionals and para- professionals, including physicians, nurses, and laboratory technicians. Total Fixed Cost: $ (100% of allocated funds *For deliverables marked with an "*" the contractor will receive the fixed cost payment for the corresponding period in the event there is no eligible population for the stated deliverable requirement. Article X - Payments: 1. Submission of Claims for contract period: The Contractor shall complete and submit a claim quarterly for activities and services occurring during that period of time. The claim shall be submitted in the grant site located in IowaGrants by: October 31; January 31; April 30; and July 31, each year of the contract period. The Agency shall verify the Contractor's performance of the provision of Services/Deliverables and timeliness of claims before making payment. The Agency may elect not to pay claims that are considered untimely. 2. End of State Fiscal Year Claims Submission: Notwithstanding the time frames above, and absent: i. longer timeframes established in federal law or ii. the express written consent of the Agency, the Contractor shall submit all claims to the Agency by August 10th for all services performed in the preceding state fiscal year (the State fiscal year ends June 30). The Agency will not automatically pay end of state fiscal year claims that are considered untimely. If the Contractor seeks payment for end of state fiscal year claim(s) submitted after August 10th, the Contractor may submit the late claim(s), as well as a justification for the untimely submission. The justification and request for payment must be submitted within the Correspondence component of this grant site. The Agency may reimburse the claim if funding is available after the end of the fiscal year. If funding is not available after the fiscal year, the claim may be submitted to the State Appeal Board in accordance with instructions for consideration. Instructions for this process may be found at: http://www.dom.state.ia.uslappeals/general claims.html. 3. The Agency shall pay all approved invoices/claims in arrears. The Agency may pay in less than sixty (60) days, but an election to pay in less than sixty (60) days shall not act as an implied waiver of Iowa law. 4. Final payment may be withheld until all contractually required reports have been received and accepted by the Agency. At the end of the contract period, unobligated contract amount funds shall revert to the Agency. 5. Warrants (payments) for services provided under this contract will be made payable to the Contractor and mailed to the Contractor at the Contractor Legal Address as listed on the contract face page. a. If the Contractor authorizes payments under this contract to be mailed to an address other than the Contractor Legal Address, the Contractor shall provide that address to the Agency in the Alternate Mailing Address portion of the Business Organization Form — Contact Information section of the grant site form found in IowaGrants. b. This address will be inserted in the 'Warrant/payment mailing address (if different from legal address)' Feld on the contract face page. 6. All funding payable to the Contractor must be received by the County Treasurer Office [Iowa Code 331.552(1)] and credited to the general fund of the county [Iowa Code 331.427(1)]. If the Agency is made aware the funding payable to the Contractor is deposited into an account other than County Treasury, all current and future contractual funds issued by the Agency (regardless of contractual program) will be delivered to the Contractor only via Electronic Fund Transfer (EFT) or by mailing the warrant to the Contractor if the EFT option has not been activated by the Contractor. Article XI — Additional Conditions The Contractor shall ensure all IowaGrant Grant Tracking site component information is accurate and current. This is inclusive of personnel, work plans, and budget forms. Requests by the Contractor for access to update the Grant Tracking site components shall be submitted through correspondence to the Iowa HHS Program Contract Manager. If an update is approved by the Agency, an amendment to the contract may be required. 2. All work plan revisions must be approved by the Agency prior to implementation. Requests for work plan revisions must be received by the Agency through the correspondence component within the Grant Tracking site on or before May 31, 2024. 3. XRF analyzers that were originally purchased, in part or in whole, with Iowa HHS Division of Public Health grant funds, and are to be shared with other elevated blood lead (EBL) inspector/risk assessors that have a contract with the Childhood Lead Poisoning Prevention program. This sharing is to be at no cost other than their travel to pick up and deliver the machine. Programs are strongly encouraged to also share the XRF analyzers with government and private, non-profit housing agencies that employ appropriately certified inspector/risk assessors. Any fees received for sharing the machine with government and private, non-profit housing agencies are considered program income that shall be returned to the lead program and used to enhance lead program efforts. 4. As a condition of the contract, the Contractor shall assure linkage with the local board of health in each county where services are provided. The Contractor will assure that the local board of health has been actively engaged in planning for, and evaluation of, services. It will also maintain timely and effective communications and ongoing collaboration with the local board of health in each county where services are provided. 5. Funds may not be spent for: a. indirect costs, b. chelation or other medical treatment of lead poisoning, c. lead hazard remediation, d. blood lead analyses that could be reimbursed by Medicaid, e. environmental inspections (EBL inspections, clearance inspections) that could be reimbursed by HUD, Medicaid, or any other program that reimburses for these services. APPENDIX I Mandatory Reporting of Blood Lead Level Results APPENDIX I Mandatory Reporting of Blood Lead Level Results Iowa Administrative Code Sec. 641-1.6(3) states that for blood lead testing, "...analytical results shall be reported to the Agency at least weekly in an electronic format specified by the Agency." We suggest you use the Lead Care Reporting Software available through Magellan, the company which manufactures the LeadCare II machine. Here is a link to download the Lead Care Reporting software (if clicking on the link doesn't work, just copy and paste into your browser): http•//www leadcare2 com/Product-SupporURei)orting-Solutions Also included in the link are some instructions on using the software developed by Magellan, and the specifications for reporting for the State of Iowa. If you need additional help, Iowa HHS can connect you with other LeadCare II user locations. Here are the pieces of information that are required for each result reported: Name Date of Sample Date of Birth Sample Type (Capillary or Venous) Street Address or PO Box City Provider Name State Facility Name (draw location) Zip Lab Name Race Ethnicity Sex (This information is required by the Lead Poisoning Prevention Program at the federal Centers for Disease Control.) Critical things to keep in mind: Iowa Code requires weekly reporting of all blood lead tests. 2. You must inform us immediately via phone call at 1-800-972-2026 or by fax at 1-515- 281-4529 of any test results at 20 or above. (These more critical levels require that our staff or local public health staff follow up with the child's family and/or care provider in a timely manner.) 3. Reporting must be done electronically in a format specified by the Agency. We currently accept three specified formats: HL7 (the standard reporting format used by healthcare information systems), the XML format produced by the LeadCare® II Software manufactured by Magellan, Inc., and the Excel spreadsheet attached to your weekly reminder. 4. Reporting must be done via a secure email channel using the State of Iowa's Secure Mail system. What follows is a set of instructions on using this system. Sending Blood Lead Level Results via the State of Iowa's Secure Mail system You will be receiving a scheduled message on Monday of each week as a reminder to report your lead tests. The message will contain the image below and prompt you to click on a hyperlink to read the message. You have received a secure email from the State of Iowa. 1. When you click on the hyperlink, you will be taken to a login page where you will be required to create an new account — THIS IS A ONE-TIME PROCESS 2. You will be guided step-by-step through this process; CAREFULLY READ THE INSTRUCTIONS NOTE: for additional details on lowa.gov SecureMail, see the user guide at: http://das.ite.iowa..qov/docs/infrastructure/External User Guide to Secur e Email Svst em.ndf 3. DOCUMENT AND SAVE YOUR SecureMail CREDENTIALS FOR FUTURE USE 4. Login to your lowa.gov SecureMail account 5. Open the MOST CURRENTLY received message with "Iowa HHS Lead Reporting" in the subject line Reporters that use the LeadCareO II software to create a reporting file • just need to reply to the SecureMail message and attach the reporting file to the reply by clicking on the'Attach' button near the top of the message window • click the 'Send' button to send the message Reporters that use an Excel template for reporting: • Stop using all previous reporting templates and spreadsheets • When you access the SecureMail message, please open the attachment located at the bottom of the screen and save this to a location with which you are familiar (Desktop on your computer or a familiar network location) — If you are a laboratory that currently submits an Excel template you should have received an example of this template in a previous email from Iowa HHS • Open the NEW TEMPLATE and enter your lead reporting information • Save the template • Attach the newly saved file to the reply by clicking on the 'Attach' button near the top of the message window • Click the 'Send' button to send the message Appendix II Lead Data Request Form LEACH DATA REQUEST Late of request: 1777= Date required: ��4�*a1i+�$rh+^k+Fw}��iF+9*♦iAF�f♦4lp+#d i+dr F �. �.s a...w Mid^++F+Fy CONTACT INFORMATION: Name Program: e-mail: Phone number: SERVICE REQUEST: Service Type: Format of Data Purpose Access to Data Data Requested: ���+��+��+�ha.+�«�++��e�+rt�+�+�_ate+a�►�++�.,r�+��»�•r��+a�a�+i AVAILABILITY: THANK YOU: Your request will be processed in the order it was received. Public Health IOWA HHS Kim Reynolds GOVERNOR Adam Gregg LT. GOVERNOR Kelly Garcia DIRECTOR CONTRACT #: 5883LP03 AMENDMENT #: 1 CONTRACTOR: Dubuque County Board of Health PROJECT TITLE: FY24 Childhood Lead Poisoning Prevention Program For the FY24 CLPPP contract, Section D7 is amended as follows: 7. Ensure that all records and data are used only for purposes as set forth in the contract. The Contractor shall not use or permit others to use the records and data in any way except for the purposes outlined in this Contract. Contractor may not re-release data provided by this contract without expressed written permission from Iowa HHS in the form of an amendment to this Contract, except as authorized by this Contract. Data provided by this contract is for use solely by the Contractor and only for the purposes outlined in this contract. The contract is further amended to add a sub -section 8, which should read: 8. The Contractor may, if approved through an Iowa HHS Childhood Lead Program Work Plan, release information to personnel within the Contractor's agency working under other contracts with Iowa HHS for the purposes of medical and environmental case management to complete the work and services of this Contract (641 IAC 1.17(3)(f) and 641 IAC 175.10(2)(e). Confidential information shall maintain its confidential status and not be re-released by these staff. In all cases, confidential data shall only be accessed by the minimum number of people necessary to complete required and approved work and services. The FY24 CLPPP contract is also amended to include the following language under Article XI. Budget — Deliverables -Based Reimbursement: The Contractor shall receive written approval from the Agency prior to spending the final three (3) percent of all funds awarded. All other conditions and terms of the contract remain in effect. The contractor specifies no additional changes have been made to the Special Conditions or General Conditions. The parties hereto have executed this contract amendment on the day and year last specified below. For and on behalf of the Department: By: Digitally signed by Ken Ken Sharp Date: 2023.10.03 10:02:04-05'00' Ken Sharp, Operations Deputy Public Health Division For and on behalf of the Contractor: By: Dlgiially signed by Allie White DN: c,-Allie White. o Dubuque Cl-, A I I i e Wh ito eu=il-,1, ebounty Public Health, m D.ba ie.white@dubugk H-1lh, go =US Date: 2023.08.30 12:02:30-05'00' Insert Date (required if not a digital signature): SUBCONTRACT BY AND BETWEEN THE CITY OF DUBUQUE, IOWA, AND THE DUBUQUE VISITING NURSE ASSOCIATION FOR THE HEALTHY HOMES AND CHILDHOOD LEAD POISONING PREVENTION PROGRAM This Subcontract by and between the City of Dubuque, Iowa and The Visiting Nurse Association is dated for reference purposes the 151 day of July 2023. WHEREAS, Dubuque County, Iowa (Contractor) has entered into Contract 5883LP03 with the Iowa Department of Health and Human Services (the Department) for the Healthy Homes (HH) and Childhood Lead Poisoning Prevention Program (CLPPP) (the Contract), a copy of which is attached hereto, pursuant to which Contractor will provide the work and services described in the Contract in accordance with the Special Conditions therein, and the General Conditions, a copy of which is attached hereto; and WHEREAS, the City of Dubuque, Iowa (City) is the Contract Administrator of the Contract between Contractor and the Department; and WHEREAS, it is necessary for City to subcontract for certain work and services; and WHEREAS, City now desires to enter into this Subcontract with the Visiting Nurse Association (VNA) to provide the work and services described herein upon the terms and conditions set forth herein. NOW, THEREFORE, IT IS AGREED BY AND BETWEEN CITY AND VNA AS FOLLOWS: SECTION 1. WORK AND SERVICES. City and VNA agree to provide the following work and services (the Work and Services): 1.1. City's Responsibilities. City agrees that it will provide the following Work and Services for the HH & CLPPP: (1) Submit reports/vouchers and other reporting requirements as required by the Iowa Department of Health and Human Services (IHHS), the Centers for Disease Control and Prevention (CDC), and the Department of Housing and Urban Development (HUD). (2) Provide for environmental investigations and environmental case management for lead abatement\lead hazard reduction and healthy homes interventions in housing units in the city of Dubuque, Iowa, and Dubuque County as referenced in the Contract. (3) Provide compensation to the VNA during the term of this Subcontract not to exceed Ten Thousand Dollars ($10,000.00) for the performances of VNA's responsibilities as set forth herein. (4) Oversee and direct medical case management and educational/outreach activities through verbal and written direction. 1.2. VNA's Responsibilities. VNA agrees to provide the following Work and Services for Healthy Homes (HH) & Childhood Lead Poisoning Prevention (CLPPP) during theterm of this Subcontract for the agreed compensation: (1) Provide written quarterly reports and billing on lead and healthy homes activities utilizing the Iowa Quarterly Report Narrative Outline and the billing form approved by City. (2) Provide electronic documentation of medical case management and related activities into City's lead and healthy homes database systems, Healthy Homes and Lead Poisoning Surveillance System (HHLPSS), and of educational activities performed for each month by the 1 V1 of the following month. (3) Provide for blood lead testing, medical case management, data management, and community education outreach as referenced in the attached Contract, dated July 1, 2023-June 30, 2024, using a form agreed to by City and VNA. (4) Enroll as a Medicaid provider so that elevated blood level (EBL) inspection services provided by City can be recovered under Medicaid as reimbursement and used as program income reimbursed to City. (5) Support City's efforts to be a viable, livable, and equitable community, and to advance equity and inclusion. City will provide opportunities to demonstrate this support by inviting the Executive Director of VNA and any employees working on services covered by this Subcontract to participate professional development opportunities and supporting activities such as: a. The opportunity to be active and engaged participants in Inclusive Dubuque peer learning opportunities and strategic efforts; b. The opportunity to attend intercultural and equity workshops offered by City, including workshops that focus on developing an intercultural team with a strategic plan for advancing equity and inclusion within VNA and through VNA's work; and Assistance in creating status reports that demonstrate the ways in which VNA's efforts are advancing equity and inclusion and access to the City's equity toolkit. SECTION 2. CONTRACT POLICIES AND REQUIREMENTS. In providing the Work and Services, VNA agrees to comply with the requirements in the Contract, including the Special Conditions, and the General Conditions, to the extent applicable to the Work and Services. SECTION 3. ACCESS TO BOOKS AND RECORDS. VNA agreed to provide access, upon reasonable notice, for the purpose of audit and examination, to its documents, papers, and records, to the extent such documents, papers, and records are related to the Work and Services, to the Department, Contractor, City, or any of their duly authorized representatives. SECTION 4. COSTS TO BE REIMBURSED. Cost reimbursed will be based on performance measures and outcomes as outlined in the Contract using a form agreed to by City and VNA. SECTION 5. INCORPORATION OF THE CONTRACT. VNA agrees that all of the provisions of the Contract, including audit requirements, are incorporated herein by this reference and VNA shall have all of the same requirements, obligations and conditions as Contractor with respect to VNA's Work and Services. SECTION B. PERIOD OF PERFORMANCE. Unless terminated as provided herein, the Period of Performance for the Work and Services shall be from the 1st day of July 2023, through the 30th day of June 2024. SECTION 7. TERMINATION. Either party may terminate this Subcontract for any reason, with or without cause, upon ten (10) days written notice delivered to the other party. In the event of termination, City shall compensate VNA for its Work and Services rendered through the date of termination. SECTION S INDEMNIFICATION. (1) VNA agrees to defend, indemnify, and hold the Department, City and Contractor, and their officers, and employees harmless from and against any and all claims of any kind arising out of or related to VNA's negligence in the performance of the Work and Services pursuant to this Subcontract. (2) City agrees to defend, indemnify, and hold VNA and its officers, and employees harmless from and against any and all claims of any kind arising out of or related to City's negligence in the performance of the Work and Services pursuant to this Subcontract. SECTION 9. INSURANCE. VNA shall at its expense maintain insurance in compliance with City Insurance Schedule J, attached as Exhibit A. CITY OF DUBUQUE, IOWA By: Lt 1� Michael C. Van Millig6fi City Manager VISIT TING ASSOCIATION Stacey Ki I a n Ad inistrAtive Director EXHIBIT A INSURANCE SCHEDULE J (Schedule J Professional Services Jan-2023) 1. Visiting Nurse shall furnish a signed certificate of insurance to the City of Dubuque, Iowa for the coverage required in Exhibit I prior to commencing work and at the end of the project if the term of work is longer than 60 days. Contractors presenting annual certificates shall present a certificate at the end of each project with the final billing. Each certificate shall be prepared on the most current ACORD form approved by the Iowa Department of Insurance or an equivalent approved by the Director of Finance and Budget. Each certificate shall include a statement under Description of Operations as to why the certificate was issued. Eg: Project # or Project Location at or construction of 2. All policies of insurance required hereunder shall be with an insurer authorized to do business in Iowa and all insurers shall have a rating of A or better in the current A.M. Best's Rating Guide. 3. Each certificate shall be furnished to the Finance Department of the City of Dubuque. 4. Failure to provide coverage required by this Insurance Schedule shall not be deemed a waiver of these requirements by the City of Dubuque. Failure to obtain or maintain the required insurance shall be considered a material breach of this agreement. 5. Contractors shall require all subconsultants and sub-subconsultants to obtain and maintain during the performance of work insurance for the coverages described in this Insurance Schedule and shall obtain certificates of insurances from all such subconsultants and sub-subconsultants. Contractors agree that they shall be liable for the failure of a subconsultant and sub- subconsultant to obtain and maintain such coverages. The City may request a copy of such certificates from the Contractor. 6. All required endorsements shall be attached to the certificate. The certificate is due before the contract/agreement can be approved. 7. Whenever a specific ISO form is listed, required the current edition of the form must be used, or an equivalent form may be substituted if approved by the Director of Finance and Budget and subject to the contractor identifying and listing in writing all deviations and exclusions from the ISO form. & Contractors shall be required to carry the minimum coverage/limits, or greater if required by law or other legal agreement, in Exhibit I. If the contractor's limits of liability are higher than the required minimum limits then the provider's limits shall be this agreement's required limits. 9. Contractor shall be responsible for deductibles and self -insured retention for payment of all policy premiums and other cost associated with the insurance policies required below. 10. All certificates of insurance must include agents name, phone number, and email address. 11. The City of Dubuque reserves the right to require complete, certified copies of all required insurance policies, including endorsements, required by this Schedule at any time. U. The City of Dubuque reserves the right to modify these requirements, including limits, based on changes in the risk or other special circumstances during the term of the agreement, subject to mutual agreement of the parties. INSURANCE SCHEDULE J (continued) A) COMMERCIAL GENERAL LIABILITY General Aggregate Limit $2,000,000 Products -Completed Operations Aggregate Limit $1,000,000 Personal and Advertising Injury Limit $1,000,000 Each Occurrence $1,000,000 Fire Damage Limit (any one occurrence) $50,000 Medical Payments $5,000 1) Coverage shall be written on an occurrence, not claims made, form. The general liability coverage shall be written in accord with ISO form CG 00 01 or business owners form BP 00 02. All deviations from the standard ISO commercial general liability form CG 00 01, or business owners form BP 00 02, shall be clearly identified. 2) Include endorsement indicating that coverage is primary and non-contributory. 3) Include Preservation of Governmental Immunities Endorsement. (Sample attached). 4) Include additional insured endorsement for: The City of Dubuque, including all its elected and appointed officials, all its employees and volunteers, all its boards, commissions and/or authorities and their board members, employees, and volunteers. Use ISO form CG 20 26. 5) Policy shall include Waiver of Right to Recover from Others endorsement. 6) Policy shall include cancellation and material change endorsement providing thirty (30) days advance written notice of cancellation, non -renewal, reduction in insurance coverage and/or limits and ten (10) days written notice of non-payment of premium shall be sent to: City of Dubuque Finance Department, 50 West 131h Street Dubuque, Iowa 52001. B) AUTOMOBILE LIABILITY Combined Single Limit $1,000,000 Coverage shall include all owned, non -owned, and hired vehicles. If the Contractor's business does not own any vehicles, coverage is required on non - owned and hired vehicles. 1) Policy shall include Waiver of Right to Recover from Others endorsement. c) WORKERS' COMPENSATION & EMPLOYERS LIABILITY Statutory Benefits covering all employees injured on the job by accident or disease as prescribed by Iowa Code Chapter 85. Coverage Statutory —State of Iowa Coverage B Employers Liability Each Accident $100,000 Each Employee -Disease $100,000 Policy Limit -Disease $500,000 Policy shall include Waiver of Right to Recover from Others endorsement. Coverage B limits shall be greater if required by the umbrella/excess insurer. M.q If, by Iowa Code Section 85.1A, the Contractor is not required to purchase Workers' Compensation Insurance, the Contractor shall have a copy of the State's Nonelection of Workers' Compensation or Employers' Liability Coverage form on file with the Iowa Workers' Compensation Insurance Commissioner, as required by Iowa Code Section 87.22. Completed form must be attached. D) UMBRELLAIEXCESS LIABILITY $1,000,000 The General Liability, Automobile Liability and Workers Compensation Insurance requirements may be satisfied with a combination of primary and Umbrella or Excess Liability Insurance. If the Umbrella or Excess Insurance policy does not follow the form of the primary policies, it shall include the same endorsements as required of the primary policies including but not limited to Waiver of Subrogation and Primary and Non- contributory in favor of the City. E) PROFESSIONAL LIABILITY $2,000,000 If the required policy provides claims -made coverage: 1) The Retroactive Date must be shown and must be before the date of the agreement 2) Insurance must be maintained and evidence of insurance must be provided for at least five (5) years after completion of the work or services. 3) If coverage is canceled or non -renewed and not replaced with another claims - made policy form with a Retroactive Date prior to the date of the agreement, the contractor must provide "extended reporting" coverage for a minimum of five (5) years after completion of the work or services. F) CYBER LIABILITYIBREACH $1,000,000 x Yes _ No Coverage for First and Third Party liability including but not limited to lost data and restoration, loss of income and cyber breach of information. Please be aware that naming the City of Dubuque as an additional insured as is required by this Insurance Schedule may result in the waiver of the City's governmental immunities provided in Iowa Code sec. 670.4. If you would like to preserve those immunities, please use this endorsement or an equivalent form. PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT 1. Nonwaiver of Governmental Immunity. The insurer expressly agrees and states that the purchase of this policy and the including of the City of Dubuque, Iowa as an Additional Insured does not waive any of the defenses of governmental immunity available to the City of Dubuque, Iowa under Code of Iowa Section 670.4 as it is now exists and as it may be amended from time to time. 2. Claims Coverage. The insurer further agrees that this policy of insurance shall cover only those claims not subject to the defense of governmental immunity under the Code of Iowa Section 670.4 as it now exists and as it may be amended from time to time. Those claims not subject to Code of Iowa Section 670.4 shall be covered by the terms and conditions of this insurance policy. 3. Assertion of Government Immunity. The City of Dubuque, Iowa shall be responsible for asserting any defense of governmental immunity, and may do so at any time and shall do so upon the timely written request of the insurer. 4. Non -Denial of Coverage. The insurer shall not deny coverage under this policy and the insurer shall not deny any of the rights and benefits accruing to the City of Dubuque, Iowa under this policy for reasons of governmental immunity unless and until a court of competent jurisdiction has ruled in favor of the defense(s) of governmental immunity asserted by the City of Dubuque, Iowa. No Other Change in Policy. The above preservation of governmental immunities shall not otherwise change or alter the coverage available under the policy. SPECIMEN (DEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES) / A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 9/26/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER TrueNorth Companies, L.C. 500 1 st St SE Cedar Rapids IA 52401 CONTACT NAME: RM Home Office PHONE FAX AIC No Ext : 319-366-2723 A/C No): 877-810-6374 ADDRESS: certs@truenorthcompani'es.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Unit Point Health Self -Insured Program INSURED IOWAHEA-01 Iowa Health System, dba UnityPoint Health 1776 West Lakes Parkway, Suite 400 INSURERB: Liberty Insurance Corporation 42404 INsuRERc: Liberty Mutual Fire Insurance Company 23035 INSURERD: Underwriters at Lloyd's, London Illinois 15792 West Des Moines, IA 50266-8239 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1030703850 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X CLAIMS-MADE1:1 OCCUR Y SELF INSURED 6/1/2022 6/1/2024 EACH OCCURRENCE $ 1,000,000 DAMAGE TO PREMISESa oNcur ence)$ ('a MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- JECT ❑ LOC OTHER: GENERAL AGGREGATE $3,000,000 X PRODUCTS - COMP/OP AGG $ $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY AS7-641-445274-053 6/1/2023 6/1/2024 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ D UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE B0146HCUSA2300367 6/1/2023 6/1/2024 EACH OCCURRENCE $ 10,000,000 X AGGREGATE $ 10,000,000 DED X RETENTION $ in nnn nnn $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A EW2-64N-445274-023 6/1/2023 6/1/2024 X STATUTE ERH $500,000 SIR E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Dubuque 50 W 13th Street AUTHORIZED REPRESENTATIVE Dubuque IA 52001 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD / A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 8/31/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER TrueNorth Companies, L.C. 500 1 st St SE Cedar Rapids IA 52401 CONTACT NAME: PHONE FAX AIC No Ext : 319-366-2723 A/C No): 319-862-0612 ADDRESS: certs@truenorthcompani'es.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Underwriters at Lloyd's, London Illinois 15792 INSURED IOWAHEA-01 Iowa Health System, dba UnityPoint Health 1776 West Lakes Parkway, Suite 400 INSURER B : INSURERC: INSURER D West Des Moines, IA 50266-8239 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 1899515313 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE1:1 OCCUR DAMAGE TO PREMISES( a oRENTED cur ence)$ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO - POLICY ❑ LOC PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY L $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Cyber Liability N N W2EFDD230301 6/1/2023 6/1/2024 Aggregate 10,000,000 Each Claim 10,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Dubuque 50 W 13th Street AUTHORIZED REPRESENTATIVE Dubuque IA 52001 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD / A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 8/31/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER TrueNorth Companies, L.C. 500 1 st St SE Cedar Rapids IA 52401 CONTACT NAME: RM Home Office PHONE FAX AIC No Ext : 319-366-2723 A/C No): 877-810-6374 ADDRESS: certs@truenorthcompani'es.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Unit Point Health Self -Insured Program INSURED IOWAHEA-01 Iowa Health System, dba UnityPoint Health 1776 West Lakes Parkway, Suite 400 INSURERB: Liberty Insurance Corporation 42404 INsuRERc: Liberty Mutual Fire Insurance Company 23035 INSURERD: Underwriters at Lloyd's, London Illinois 15792 West Des Moines, IA 50266-8239 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:435283452 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y SELF INSURED 6/1/2022 6/1/2024 EACH OCCURRENCE $ 1,000,000 Fv� CLAIMS -MADE OCCUR DAMAGE TO PREMISES('a a oNcur ence)$ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY ❑ PRO- JECT ❑ LOC X PRODUCTS - COMP/OP AGG $ 3,000,000 $ OTHER: B AUTOMOBILE LIABILITY Y Y AS7-641-445274-053 6/1/2023 6/1/2024 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY D UMBRELLA LIAB X OCCUR B0146HCUSA2300367 6/1/2023 6/1/2024 EACH OCCURRENCE $ 10,000,000 X AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION $ in nnn nnn $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N Y EW2-64N-445274-013 6/1/2023 6/1/2024 X STATUTE ERH SIR $750,000 ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ NIA E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Professional Liability SELF INSURED 6/1/2022 6/1/2024 Each Incident 1,000,000 Aggregate Limit 3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is named as additional insured applies with regards to General Liability and Auto Liability per written contract. Governmental Immunities endorsement applies. Waiver of Subrogation applies with regards to General Liability, Auto Liability and Workers Compensation. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Dubuque ACCORDANCE WITH THE POLICY PROVISIONS. Leisure Services Department AUTHORIZED REPRESENTATIVE 50 W 13th St Dubuque IA 52001 '4 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SUBCONTRACT FOR HEALTHY HOMES AND CHILDHOOD LEAD POISONING PREVENTION SERVICES BETWEEN DUBUQUE COUNTY BOARD OF HEALTH AND THE CITY OF DUBUQUE WHEREAS, the Dubuque County Board of Health (County Board), as Contractor, has entered into an Agreement (the Agreement) wit the Iowa Department of Health and Human Services to perform childhood lead poisoning prevention services as set forth in the Agreement (Contract # 5883LP03), a copy of which is attached hereto; and WHEREAS, County Board desires to enter into a subcontract with the City of Dubuque (City) to perform the services required by the Agreement and City desires to provide such services through its Health Services Department. NOW, THERFORE, IT IS AGREED BY AND BETWEEN THE PARTIES AS FOLLOWS: 1. City shall perform all of the services required of the Contractor in the Agreement. 2. County Board shall pay City for its services in the same manner as County Board as Contractor will be paid for its services under the Agreement. Signed and dated the 22 day of .2023. Allie White Michael C. Van Milligen Dubuque County Board of Health City Manager