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Iowa Lead Poison Fund Agrement_VNAMEMORANDUM August 26, 2002 TO:The Honorable Mayor and City Council Members FROM:Michael C. Van Milligen, City Manager SUBJECT:Iowa Department of Public Health (IDPH) Childhood Lead Poisoning Funding and Agreement with the Visiting Nurse Association (VNA) Public Health Specialist Mary Rose Corrigan recommends approval of a contract with the Iowa Department of Public Health for continued funding of the Childhood Lead Poisoning Prevention Program (CLPPP) and a renewed agreement with the Dubuque Visiting Nurse Association for services related to the CLPPP. I concur with the recommendation and respectfully request Mayor and City Council approval. ____________________ Michael C. Van Milligen MCVM/jh Attachment cc: Barry Lindahl, Corporation Counsel Cindy Steinhauser, Assistant City Manager Mary Rose Corrigan, RN, Public Health Specialist CITY OF DUBUQUE, IOWA MEMORANDUM August 13, 2002 TO: Michael C. Van Milligen, City Manager FROM: Mary Rose Corrigan, RN,Public Health Specialist SUBJECT: Iowa Department of Public Health (IDPH) Childhood Lead Poisoning Funding and Agreement with the Visiting Nurse Association (VNA) INTRODUCTION This memorandum provides information regarding a contract w'rth the Iowa Department of Public Health for continued funding of the Childhood Lead Poisoning Prevention Program (CLPPP) and a renewed agreement with the VNA for services related to the CLPPP. BACKGROUND In February 1994, the City Council approved a grant agreement authorizing the Health and Housing Services Departments to contract with the Iowa Department of Public Health 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, 2002. DISCUSSION Since that time, the Iowa Department of Public Health has applied for ongoing funds with the Centers for Disease Control and Prevention (CDC) to distribute to local childhood lead poisoning prevention programs. The funds are distributed throughout childhood lead poisoning prevention programs in the State based on numbers of children in a community and the incidence of lead poisoning. The funds will allow the Health and Housing Services Departments to provide additional follow-up of lead poisoned children through contracted nursing services provided by the Dubuque Visiting Nurse Association, training for employees, and monies to do outreach and education in targeted neighborhoods. The contract also includes program performance standards, which we currently strive to achieve through our existing protocols and outreach programs. In cooperation with the VNA and the IDPH, we have agreed to conduct environmental investigations on lead poisoned children residing in Dubuque County. We currently do data management on children in Dubuque County. The VNA provides medical case management for lead poisoned children in the County. BUDGET IMPACT The FY 03 budget anticipated funding of $22,882, and is shown in the lead activity of the Health Services Department. However, due to the Centers for Disease and Prevention (CDC) budget cuts, out contract has been reduced to $20,409.15. RECOMMENDATION It is recommended that the City Council authorize the Mayor to sign the attached resolution authorizing the City Manager to sign the contract with the Iowa Department of Public Health and the agreement with the Dubuque Visiting Nurse Association on behalf of the City of Dubuque. COUNCIL ACTION Approve the attached resolution authorizing the City Manager or his designee to sign the contract with the Iowa Department of Public Health and the agreement with the Dubuque Visiting Nurse Association. MRC/cj cc: David Harris, Housing Services Manager Kathaleen Lamb, Senior Housing Inspector Kathy Ripple, VNA, Administrative Director RESOLUTION NO. 437-02 A RESOLUTION AUTHORIZING THE CITY MANAGER OR HIS DESIGNEE TO SIGN A CONTRACT WITH THE IOWA DEPARTMENT OF PUBLIC HEALTH AND AN AGREEMENT WITH THE DUBUQUE VISITING NURSE ASSOCIATION. Whereas, the City of Dubuque has established such a local childhood lead poisoning prevention program; and Whereas, the Iowa Department of 15ublic Health has offered to provide financial support for activities relating to the local childhood lead poisoning prevention program in the City of Dubuque; and Whereas, the City of Dubuque will provide environmental and medical case management of identified lead poisoned children in addition to community outreach and education on the problem of childhood lead poisoning. Whereas, the City of Dubuque must provide medical case menagement for all lead poisoned children in the city, and provide community outreach and education; and Whereas, the City of Dubuque will enter into an agreement with the Dubuque Visiting Nurse Association to provide medical case management of lead poisoned children and conduct community outreach and education for the citizens of Dubuque. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF · DUBUQUE, IOWA: Section 1. That the City of Dubuque, Iowa hereby approves the attached contract between the Iowa Department of Public Health and the City of Dubuque, Iowa. Section 2. That the attached Memorandum of Understanding by and between the City of Dubuque, Iowa and the Dubuque Visiting Nurse Association is hereby approved. Section 3. That the City Manager or his designee is hereby authorized and directed to execute said contract and agreement on behalf of the City of Dubuque, Iowa. Passed, approved and adopted this 3rd day of Sept ember, 2002. Terrance M. Duggan, Mayor Attest: Jeanne Schneider City Clerk HL AGREEMENT BETWEEN THE CITY OF DUBUQUE, IOWA, AND THE VISITING NURSE ASSOCIATION FOR THE CHILDHOOD LEAD POISONING PREVENTION PROGRAM (CLPPP) Now on this 1st day of July 2002, it is agreed by and between the City of Dubuque, Iowa, (City) and the Dubuque Visiting Nurse Association (VNA) as follow: A. TERM. The term of this Agreement shall be from the 1st day of July 2002, through the 30th day of June 2003. B. CITY'S RESPONSIBILITIES. City agrees that it will provide the following services for the CLPPP: 1. Submit quarterly reports and other reporting requirements as requested to the Iowa Department of Public Health (IDPH) and the Centers for Disease Control and Prevention. (CDC). 2.Provide for environmental investigations and environmental case management for lead abatement\lead hazard reduction in housing units in the dty of Dubuque, Iowa, and Dubuque County. 3.Provide compensation to the VNA during the term of this Agreement not to exceed $14,000.00 for the performances of VNA's responsibilities as set forth herein. 4.Oversee and direct medical case management activities through verbal and written direction. C. VNA'S RESPONSIBILITIES. VNA agrees to provide the following services for CLPPP dudng the term of this Agreement for the agreed compensation: 1.Provide written quarterly reports on lead-related activities utilizing the Iowa Quarterly Report Narrative Outline. 2.Provide computer documentation of medical case management and related activities into City's lead database system, STELLAR. 3.Provide blood lead screening and medical case management for follow-up testing for children in the city of Dubuque following the recommendations of the IDPH and the City of Dubuque Health Services Department. 4.Assist City with providing public education, lead coalition development and activities, and outreach to the City of Dubuque residents about childhood lead poisoning. 5.Conduct-home visits as needed to families\residents in order to provide medical case management services. 6. Provide education and medical case management of children with confirmed blood lead levels greater than or equal to 15 pg\dL. Medical case management includes: · assurance that children are being screened~retested for lead and case managed according to Iowa Department of Public Health requirements; -assurance that children and parents receive nutritional counseling and educational materials; -educate parents and families about major sources of lead and how to prevent poisoning; · assistance in interpreting blood lead levels; -refer all children with confirmed blood lead levels greater to or equal to 20 pg\dL to Keystone Area Education Agency for appropriate developmental testing, evaluation and assessment; and -provide information about lead testing and follow-up, available services, and resources for lead- poisoned children. 7. Provide informetion about lead poisoning and available services to local pediatric health care providers. 8. Participate with City in securing additional funding for childhood lead poisoning prevention activities. 9. Provide menthly work activity reports and invoices to the City Health Services Department outlining services performed, by the 7th day of the month following the previous month. 10. Work towards achieving the program performance standards in conjunction with the City's CLPPP, as outlined in the City's IDPH contract, Exhibit III. D. INSURANCE. VNA agrees to provide insurance as sat forth in the attached Insurance Schedule. E. INDEMNIFICATION. City agrees to save, defend, indemnify and hold harmless VNA from and against any and all claims which may be made against VNA adsing out of this Agreement which are the result of the sole negligence of City, its officers, agents or employees. VNA agrees to defend, hold harmless and indemnify City from and against any and all claims which may be mede against City arising out of this Agreement which are the sole negligence of VNA, its officers, employees or agents. F. TERMINATION. Either party may terminate this Agreement by giving sixty (60) days written notice to the other party. CITY OF DUBUQUE, IOWA VISITING NURSE ASSOCIATION BY: ____________________ Michael C. Van Milligen City Manager BY: ___________________ Kathy Ripple Administrative Director 3 INSURANCE SCHEDULE 1. Any policy of insurance or certificate of insurance required hereunder shall be with a carder authorized to do business in Iowa and a carder that has received a rating of A or better in the current Best's Rating Guide. 2. The City of Dubuque shall be named as an additional insured in any insurance policy required by this Schedule, and any policy of insurance required hereunder shall provide for a thirty-day notice to the City of any matedal change or cancellation of the policy prior to its expiration date. 3. VNA shall have its insurance agent or company certify in writing that any policy of insurance required herein with an aggregate limit of liability has not been reduced by paid or reserved claims at the time of issuance of policy or certificate. 4. VNA shall fumish copies of the following policies to the City with limits not less than the following, or greater if required by law, and shall also furnish certificates of insurance from all independent contractors or subcontractors hired by VNA or any independent contractor or subcontractor hired by the independent contractor or subcontractor, which certificates shall provide evidence of coverage for the following with limits not less than the following, or greater if required by law: COMMERCIAL GENERAL LIABILITY: General Aggregate Limit $2,000,000 Products-Completed Operation Aggregate Limit $2,000,000 Personal and Advertising Injury Limit $1,000,000 Each Occurrence Limit $1,000,000 OR Combined Single Limit $2,000,000 Medical Payments 5,000 Coverage is to include: occurrence form, premises/operations/products/competed operations coverage, independent contractors' coverage, contractual liability, broad form property damage, personal injury (hazards A-C and delete employment exclusions), City of Dubuque named as an additional insured with 30 days' written notice of change or cancellation. PROFESSIONAL LIABILITY: VNA shall furnish a certificate of insurance showing professional liability limits with limits of not less than $1,000,000 during the term of the project. WORKMEN'S COMPENSATION: Coverage A: Statutory State of Iowa Coverage B: Employers' Liability $100,000 each accident $100,000 each employee and disease $100,000 policy limit and disease STATE OF IOWA THOMAS J. VILSACK GOVERNOR SALLY J. PEDERSON LT. GOVERNOR DEPARTMENT OF PUBLIC HEALTH STEPHEN C. GLEASON, D.O., DIRECTOR PROJECT TITLE: PROJECT PERIOD:July 1, 2000 to June 30, 2003 Childhood Lead Poisoning Prevention Prograra CONTRACT #: 5883LP06 CONTRACTOR:City of Dubuque Health Services Division 1300 Main City Hall Annex Dubuque, IA 52501 FUNDING SOURCE OE IDPH: FEDERAL $16058 78.68% STATE $1484.59 7.27% OTttLER $$2,866.56 14.05% TOTAL FEDERAL CATALOG #: 93.197 MAIL REPORTS TO: Childhood Lead Poisoning Prevention Program Bureau of Lead Poisoning Prevention Division of Health Protection and Environmental Health L~asDepartment of Public health State Office Building Des Moines, IA 50319-0075 CONTRACT AMOUNT: $20409.15 CONTRACT PEROD: July 1, 2002 to June 30, 2003 MATCH REQUIRED: Yes AMOUNT: $1484.59 PROJECT DIRECTOR: Mary Rose Corrigan PHONE #: 563-5894181 The contractor agrees to perform the work and to provide the services desert"bed in the Special conditions for the cons~deraUon stated hereto. The duties, rights, and obligations of the parties to this cuntmct shall be governed by the Contract Documents, which include the Special Conditions, General Conditions Request for Proposal and Application. The parties hereto have executed rids contract on the day and year last specified below. For and on behalf of the DEPARTMENT: By: Stephen C. Gleason, D.O. Director of Public Health By: For and on behalf of the CONTRACTOR~ Michael C. Van MilHgan City Manager Date Date Stephen Quirk, Director Division of Health Protection and Environmental Health LUCAS STATE OFFII:;E BUILDING / 321 E. 12TH ST. / DES MOINES, IOWA 50319-0075 DEAF RE[LAY (HEARING OR SPEECH IMPAIRED) 1-800-735-2942 / INTERNE[T: HTTP:I/IDPH.STATE.IA.US! GENERAL CONDITIONS 1. General a. Contractors and subrecip, ients of State, Federal, or private funds are required to comply with the applicable laws, rules, anal regulations governing those funds. Compliance is subject to verification. b. This integrated contract between the DEPARTMENT and the CONTRACTOR shall consist of the specifications, terms and conditions of the following Contract Documents: the DEPARTMENT's Request for Proposal (RFP), the CONTRACTOR's proposal, any written amendments made in accordance with the provisions herein, these General Conditions, and the Special Conditions. c. The CONTRACTOR shall perform all of the services and shall develop, produce and deliver to the DEPARTMENT or to the DEPARTMENT's designated eligible recipients all of the services described in the Contract Documents. In return, the DEPARTMENT shall make payment as hereinafter described. d. In the event of a conflict between or among the provisions of the Contract Documents, the governing langnage shallbe fromthe Contract Document listed firstinthe following list: (1) Special Conditions; (2) General Conditions; (3) Written amendment; (4) RFP; and (5) CONTRACTOR's propOsal. e. The CONTRACTOR shall provide the necessary facilities, materials, services, and qualified personnel to satisfactorily perform and/or provide all the services set forth in this contract. The contract budget shall be the basis for the CONTRACTOR's expenditure of the contract amount. 2. Definitions a. "State" means the State oftowa. b. "DEPARTMENT" means the Iowa Department of Public Health. c. "CONTRACTOR" means the organization or individual contracting with the DEPARTMENT. d. "Project Director" means the person who has been delegated authority in the Special Conditions to administer the project described in this contract. e. "Related party transaction" means a Contractual arrangement for the provision of services with an employee, consultant, or member of a governing body of the CONTRACTOR who has a family, business, or other tie to the service to be provided. 3. Invalidity If any provision of this contract is in conflict with any State or Federal law or shall be declared to be invalid by any state or federal court of record, such invalidity shall affect only such 2 portions as are declared invalid or in conflict with the law. Any remaining portion shall continue to be in effect. 4. Status of Contractor a. The CONTRACTOR shall at all times be deemed an independent contractor and not an employee of the State of Iowa. The CONTRACTOR shall be responsible for all its withholding taxes, social security, unemployment, worker's compensation and other taxes and shall hold the DEPARTMENT harmless for any claims for same. b. If the CONTRACTOR is a non-profit organization or affiliated with a government organization, the CONTRACTOR shall file all required state and federal reports to maintain such status. 5. Equal Opportnnity: Code of Fair Practices a. The CONTRACTOR shall not discriminate against any cmaployee or applicant for employment because of race, creed, color, religion, political affiliation, national origin, sex, age, or physical or mental disability. The CONTRACTOR shall ensure that applicants are fairly considered, and that employees are treated without regard to their race, creed, color, religion, political affiliation, national origin, sex, age, or physical or mental disability except where age or disability relates to a bona fide occupational qualification. Such action shall include, but need not be limited to: Employment, promotion, demotion or transfer, recruitment or recruitment advertising, layoffor termination, rotes of pay or other forms of compensation, and selection for training (including apprenticeship). b. The CONTRACTOR shall, in all solicitations or advertisements for employment placed by or on behalf of the CONTRACTOR, state that all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, political affiliation, national origin, sex, age, or physical or mental disability except where age or disability relates to a bona fide occupational qualification. c. The CONTRACTOR shall send to each labor union or representative of workers with which the CONTRACTOR has a collective bargaining agreement or other contract or understanding a notice advising the labor union or worker's representative of the CONTRACTOR's commitments under this section and shall post copies of the notice in conspicuous places available to employees and applicants for employment. d. The CONTRACTOR shall comply with all applicable federal and state civil fights and nondiscrimination laws, rules, and executive orders. The CONTRACTOR shall furnish all information and reports requested by the DEPARTMENT and shall permit access by the DEPARTMENT to payrolls and employment records for purposes of investigation to ascertain that the CONTRACTOR has so complied. e. In complying with all applicable federal and state civil rights and nondiscrimination laws and regulations, the CONTRACTOR shall ensure that no person will be excluded from participation, be denied benefits, or be otherwise subjected to discrimination on the grounds of race, creed, color, religion, political affiliation, national origin, sex, age, physical or mental disability, testing positive for human immunodeficiency vires, or sexual orientation. For the purpose of this contract, discriminatory distinctions include, but are not limited to: Denying a participant any service, benefit, or availability of a facility; or providing any service or benefit which is different in manner, income guidelines, place or time fi:om that provided to other participants under this contract. f. The CONTRACTOR, shall develop and implement an equal employment opportunity policy and an affirmative action plan for hiring or promoting members of protected classes. Clients and potential clients and employees and potential employees shall be made aware of the policy and the plan. The CONTRACTOR shall make its policy and plan available to the DEPARTMENT upon request. g. The CONTRACTOR shall ensure that all its facilities are accessible to handicapped individuals, or have written policies and procedures that outline how disabled individuals can gain access to the facility for services. The CONTRACTOR shall comply with all aspects of the federal American With Disabilities Act, Part I (relating to employment ) and Part II (relating to services ). h. The CONTRACTOR shall include the provisions of this section in every subcontract, unless specifically exempted by written approval fi:om the Director of the DEPARTMENT, so that such provisions shall be binding on each subcontractor. The CONTRACTOR shall take such action with respect to any subcontractor as the DEPARTMENT or the authorized representative thereof may direct as a means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event the CONTRACTOR becomes involved in or is threatened with litigation with a subcontractor as a result of such direction by the DEPARTMENT, the CONTRACTOR may request the DEPARTMENT to enter into such litigation to protect the interest of the State. i. This contract may be suspended or terminated, in whole or in part, in the event of the CONTRACTOR's noncompliance with this section 5 and the CONTRACTOR may be declared ineligible for further contracts with the DEPARTMENT. Additionally, the DEPARTMENT may take further action by imposing other sanctions or invoking other remedies as provided by the Iowa Civil Rights Act of 1965 or as otherwise provided by taw. 6. Accounts and Records a. The CONTRACTOR shall maintain accurate, current, and complete r~cords of the financial activity of this contract, including records which adequately identify the source and application of funds. Cash contributions made by the CONTRACTOR and third party in-kind (property or service) contributions shall be verifiable f~om the CONTRACTOR's records. These records must contain information pertaining to contract mount, obligations, unobligated balances, assets, liabilities, expenditures, income and third-party reimbursements. b. The CONTRACTOR shall maintain accounting records supported by such source documentation as cancelled checks, paid bills, payrolls, time and attendance records, contract award documents, etc. 4 c. The CONTRACTOR, in maintaining project expenditure accounts, records and reports, shall make any necessary adjustments to reflect refunds, credits, underpayments or overpayments, as well as any adjustments resulting from administrative or compliance reviews and audits. Such adjustments shall be set forth in the financial reports filed with the DEPARTMENT. d. The CONTRACTOR shall maintain a sufficient record keeping system to provide the necessary data for the purposes of planning, monitoring and evaluating their program. e. The CONTRACTOR shall retain all accounting and financial records, programmatic records, supporting docnments, statistical records and other records reasonably considered as pertinent to the contract, for a period of tkree (3) years starting on the day the CONTRACTOR submits its final expenditure report. If any litigation, claim, negotiation, audit or other action involving the records has been started before the expiration of 'the three (3) year per/od, the records must be retained until completion of the action and resolution of all issues which arise from it, or until the end of the regular three (3) year period, whichever is later. Client records which are non-medical must be maintained for a period of five (5) years. f. The CONTRACTOR shall retain all medical records indefinitely or until transfer or disposal is authorized by the DEPARTMENT. g. The CONTRACTOR shall maintain confidentiality for all records of the project in accordance with state and federal laws, roles, and regulations. 7. Equipment a. Definition of Equipment: Any item costing $500 or more and having an anticipated life of one year or more. Computer software is excluded from this definition. b. The CONTRACTOR may use its own definition of equipment provided that such defim'tion would at least include all equipmant described above. c. Title and Disposition: Title to equipment purchased in whole or in part with contract funds resides with the DEPARTMENT. Upon contract expiration or termination the DEPARTMENT reserves the right to transfer the equipment either to the State or to another contractor. Approval fi:om the DEPARTMENT must be received before disposing of any equipment duringthe contract period. d. Records: The CONTRACTOR shall maintain inventory control records, and maintenance procedures for all equipment purchased in whole or in part with DEPARTMENT funds or obtained from state surplus or the DEPARTMENT. Equipment records shall include: state tag number (or CONTRACTOR inventory number if no state tag has been assigned); description of the item; location; name of the contract purchased under; percent of DEPARTMENT participfition in project cost for the year in which the equipment was acquired; and, if available, vendor name, manufacturer's serial number, purchase price, date of acquisition, date of disposition, disposition price, and type of disposition. 5 e. Control System: A control system (including an annual physical inventory) shall be implemented to ensure adequate safeguards to prevent loss, damage, or theft of the equipment. Any loss, damage, or theft shall be investigated and fully documented. Where the CONTRACTOR is authorized to sell the equipment, sales procedures shall providc for competition to the extent practicable and result in the highest possible disposition price. 8. Procurement Standards and Subcontracting a. The CONTRACTOR shall use procurement procedures that comply with all applicable federal, state, and local laws and regulations. b. None of the activities or funds relating to this contract shall be subcontracted to another organization or individual without specific prior written approval by the DEPARTMENT except for subcontracts under $1,000. For purchase of service contracts, the term "activities" refers to services paid for as units of service. For cost reimbursement contracts, the term "activities" refers to services or programming described in the CONTRACTOR's approved goals and objectives. To obtain approval, the CONTRACTOR shall submit to the DEPARTMENT the proposed contract or written agreement between the parties. The proposed contract or agreement shall contain: (1) A list of the activities to be performed by the subcontractor. (2) The contract policies and requirements. (3) Provision for the DEPARTMENT, the CONTRACTOR, and any of their duly authorized representatives to have access, for the purpose of audit and 6xamination, to any documents, papers, and records of the subcontractor pertinent to the subcontract. (4) The mount of the subcontract. (5) A line item budget of specific costs to be reimbursed under the subcontract or agreement or other cost basis for determining the amount of the subcontract as appropriate. (6) A statement that all provisions of this contract are included in the subcontract including audit requirements. (7) Period of performance. (8) Any additional subcontract conditions. c. Any subcontract or other written agreement shall not affect the CONTRACTOR's overall responsibility and accountability to the DEPARTMENT for the overall direction of the project. 6 d. If during the course of the subcontract period the CONTRACTOR or subcontractor wishes to change or revise the subcontract, prior written approval from the DEPARTMENT is required. e. The CONTRACTOR shall maintain a contract administration system which ensures that subcontractors perform in accordance with the terms, conditions, and specifications of their contracts or purchase orders. f. The CONTRACTOR shall maintain written standards of conduct governing the performance of its employees engaged in the award and admistration of any subcontract. No employee, officer or agent of the CONTRACTOR or subcontractor shall participate in the selection or in the award or administration of a subcontract if a conflict of interest, real or apparent would be involved g. Targeted Small Business: The CONTRACTOR is expected to take documented steps to encourage participation from targeted small businesses for the purpose of subcontracting or supplying materials. 9. Program Income a. Program income means gross income earned by the CONTRACTOR from activities where part or all of the cost is borne as a direct cost towards meeting a cost sharing or a matching requirement of the contract. It includes, but is not limited to, income in the form of fees for services performed during the contract or subcontract period, proceeds from sale of tangible personal or real property or equipment, usage or rental fees, and patent or copyright royalties. b. Program income may be used for allowable costs of the project unless the Special Conditions of the contract specify otherwise. c. Refunds and Rebates: When prior year refunds or rebates result from the expenditure of DEPARTMENT provided funds, they shall be returned to the DEPARTMENT in the same proportion that the DEPARTMENT funds are to the project's total income or income related to any subcontract, as appropriate. d. Cash advances, whether permanent or in the form of working capital, must be maintained in interest bearing accounts. Interest earned by the CONTRACTOR on cash advances shall be allocated by the CONTRACTOR to the program for which the cash advance was received. All interest earned on cash advances, shall be remitted to the DEPARTMENT promptly or at least quarterly. Interest amounts up to $250 per contract period in the aggregate for all federal funded programs may be retained by the CONTRACTOR for administrative expenses only. e. Other Sources of Funding: The CONTRACTOR shall develop other sources of financial support for program activities. The CONTRACTOR shall: (1) Recover, to the maximum extent feasible, third-party revenues to which the CONTRACTOR is entitled as a result of services provided; 7 (2) Garner all other available £ederal, state, local and private funds; (3) Charge beneficiaries according to their ability to pay for the services provided, based on a sliding fee schedule. The sliding tee schedule shall be based on standardized guidelines provided by the DEPARTMENT. Variances from these guidelines must have prior written DEPARTMENT approval. Client billing and collection procedures shall be consistent with those established and provided by the DEPARTMENT. Services fimded partially or completely by the DEPARTMENT shall not be denied to a person because of the inability of the person or group to pay a fee for the service. Factors of individual/immediate family income and family size are to be used in developing the sliding fee schedule; and (4) Report~to the DEPARTMENT within five (5) working days, funding sources developed in addition to those shown in the application for funding. 10. Non-Supplantin~ Requirement Federal and State funds made available under this contract shall be used to supplement and increase the level o£ state, local and other non-federal funds that would in the absence of such federal and State funds be made available for the programs and activities for which funds are provided and will in no event take the place of state, local and other non-federal funds. 11. CONTRACTOR's Certification regardin~ Lobbvin~ The CONTRACTOR certifies that: a. No Federal appropriated funds have been paid or will be paid, by or on behalf of the CONTRACTOR, to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, tho malting of any Federal loan, the entering into of any cooperative agreement, or the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. b. If any fimds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with any Federal contract, grant, loan, or cooperative a~reement, the CONTRACTOR shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying" in accordance with its instructions. c. The CONTRACTOR shall require that the language oftbe Disclosure Form in section 1 l(b) be included in the award documents for all subawards at all levels (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certi~, and disclose accordingly. d. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code of Federal Regulations. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. 12. CONTRACTOR's Certification regarding Brokering The CONTRACTOR certifies that no person or selling agency has been employed or retained to solicit and secure this contract upon an agreement or understanding for commission, percentage, brokerage, or contingency excepting bona fide employees or selling agents maintained by the CONTRACTOR for the purpose of securing business. For breach or violation of this certification, the DEPARTMENT shall have the right to terminate this contract without liabil/ty, or in its discretion, to deduct from the contract price or to otherwise recover the full mount of such commission, percentage, brokerage, or contingency. 13. Publications, Copyrights and Rights in Data and Patents a. Publications: The CONTRACTOR shall not publish the results of contract activity without prior written approval by the DEPARTMENT. Such publication (written, visual, or audio) shall contain an acknowledgment of DEPARTMENT contract support. A copy of any such publication shall be furnished to the DEPARTMENT at no cost. b. Copwights and Rights in Data: Where activities supported by this contract produce an original computer program (including executable computer programs and supporting data in any form), writing, sound recording, pictorial reproduction, drawing or other graphical representation and work of similar nature, the DEPARTMENT reserves the right to its use, duplication, and disclosure, in whole or in part, in any manner for any purpose whatsoever. c. Patents: If any patentable invention is developed by an employee of the CONTRACTOR in the course of employment related to this contract, such invention shall be reported to the DEPARTMENT. The DEPARTMENT shall be entitled to a share, proportionate to DEPARTMENT funding, of rights to said invention, including title to and license rights under any patent application or patent which may be issued. 14. Release of Information and Confidentiality of Records a. Release of Contract Information: The CONTRACTOR agrees to provide to the DEPARTMENT or the public, upon request, all written program records including, but not limited to, client records, statistical information, board and other administrative records, and financial records, including budget, accounting activities, financial statements, and the annual audit in accordance with Code of Federal Regulations, Title 45. All such records shall be available except when access to the records is limited in accordance with state or federal confidentiality laws, roles or regulations. b. Confidentiality of Client Records: The CONTRACTOR's policies and procedures shall provide that records regarding the ideutity, diagnosis, prognosis, and services provided to any client in connection with the performance of the contract are maintained and disclosed only for the purposes and under the circumstances expressly authorized under state or federal confidentiality laws, rules or regulations. c. Security of Client Files and Data: The CONTRACTOR's employees shall be allowed access to records only as necessary for the performance of their duties related to the contract and in accordance with the policies and procedures of the custodian of the records. The CONTRACTOR shall maintain policies and procedures for safeguarding the confidentiality of such data, and may be liable civilly or criminally under state or federal confidentiality laws, roles or regulations for the negligent release of such information. d. Unauthorized Disclosure: The CONTRACTOR shall protect from unauthorized disclosure the names and other identifying information of persons receiving services pursuant to this contract, except for statistical information not identifying any client. The CONTRACTOR shall not use such identifying information for any purpose other than carrying out the CONTRACTOR's obligations under this contract. The CONTRACTOR shall promptly transmit to the DEPARTMENT all requests for disclosure of such identifying information to anyone other than the DEPARTMENT without prior written authorization from the DEPARTMENT. For purposes of this paragraph, the term "identify" shall include, but not be limited to, name, identifying number, )symbol, or other identifier particularly assigned to the individual. The CONTRACTOR shall maintain confidentiality for all records of the project in accordance with state and federal laws and regulations and in accordance with 42 CFR. 15. Conflict of Interest a. The provisions of Iowa Code Chapter 68B shall apply. In the event a conflict of interest is proven to the DEPARTMENT, the DEPARTMENT shall terminate the contract, and the CONTRACTOR shall be liable for any excess costs to the DEPARTMENT as a result of contract default. b. The CONTRACTOR shall establish safeguards to prevent employees, consultants, or members of governing bodies from using their positions for purposes that are, or give the appearance of being, motivated by the desire for private gain for themselves or others with whom they have family, business, or other ties. c. The CONTRACTOR shall report any related party transaction to the DEPARTMENT. Written approval from the DEPARTMENT shall be required prior to such transaction. 16. Private Consultation Employees of the CONTRACTOR whose salaries are paid by DEPARTMENT funds shall not engage in private consultation during the hoars that are paid for by DEPARTMENT funds. l0 17. Qualifications of Staff The CONTRACTOR shall be responsible for assuring that ail persons, whether they are employees, agents, subcontractors or anyone acting for or on behaif of the CONTRACTOR, are properly licensed, certified or accredited as required under applicable state law and the Iowa Administrative Code. The CONTRACTOR shall provide standards for service providers who are not otherwise licensed, certified or accredited under state law or the Iowa Administrative Code. 18. Insurance The CONTRACTOR shall procure and maintain such insurance as is required by applicable federai and state law and regulation. Such insurance should include, but not be limited to, the following: liabihty insurance, fidelity bonding of persons entrusted with handling of funds, workers compensation, unemploYment insurance and professionai liability. 19. Audit or Examination of Records a. Subrecipients of Federal funds are required to have an audit made in accordance with the provisions of OMB Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations. The DEPARTMENT may require, at any time and at its sole discretion, that recipients of state funds have an audit made. A copy of audit reports acquired and subject to OMB Circular A-133, State regulations or otherwise required, shall be forwarded to the DEPARTMENT upon receipt and at no charge. The CONTRACTOR may be required to comply with other prescribed compliance and review procedures. The CONTRACTOR shall be solely responsible for the cost of any required audit unless otherwise agreed in writing by the DEPARTMENT. When the DEPARTMENT has agreed in writing to pay for the required audit services, the DEPARTMENT reserves the right to refuse payment for audit services which do not meet Federal or State requirmnents. Audits are due within nine (9) months following the end of the period covered. b. The audit report shall contain supplementary schedules identifying by program the revenue, expenditures, and balances of each contract. c. Upon completion of the audit, a press release shall be published to announce the availability of the audit report for review by the public at the CONTRACTOR's office. The press release shail be provided to a local newspaper with a copy sent to the DEPARTMENT and a copy maintained in the CONTRACTOR's Office. d. One (1) copy of the audit report shail be submitted to the DEPARTMENT within thirty (30) working days of its issuance, unless specific exemption is granted in writing by the DEPARTMENT. The audit shall be scheduled so that an audit report will be received by the DEPARTMENT no later than nine (9) months following the end of the contract period. To be submitted with the audit is a copy of the separate letter to managemont addressing non-material findings, if provided by the auditor. e. If the contract award(s) from the State of Iowa total $150,000 or more, a pre-award survey by the State Auditor is required for private non-profit contractors. The cost of the pre- award survey and the annual audit shall be borne by the CONTRACTOR unless specifically waived in writing bythe DEPARTMENT. f. The CONTRACTOR agrees that the Auditor of the State or any authorized representative of the State, and whore Federal funds are involved, the Comptroller General of the United States or any other authorized representative of the United States Government, shall have access to, and the right to examine, audit, excerpt and transcribe any pertinent books, documents, paper, and records of the CONTRACTOR related to order, invoices, or payments of this contract. g. The CONTRACTOR agrees that the DEPARTMENT or its authorized representatives may have access to medical records and quality assurance materials for purposes of an independent audit of quality assurance and quality of care. h. All records and work papers resulting from this contract shall become the property of the DEPARTMENT. 20. Contract Performance a. Monitoring of Porformance (1) The CONTRACTOR agrees that the DEPARTMENT may conduct site visits to review contract compliance, assess management controls, assess the applicable services and activities, and provide technical assistance. The CONTRACTOR agrees to ensure the cooperation of the CONTRACTOR's employees and board members in such efforts. (2) Following each site visit, the DEPARTMENT shall submit a written report to the CONTRACTOR which identifies the findings of the site visit. A Corrective Action Plan with a timetable to address any deficiencies or problems noted in the site visit report may be requested. The Corrective Action Plan shall be submitted to the DEPARTMENT for approval within the timelines outlined in the written report. The CONTRACTOR agrees to carry out the plan after it is approved by the DEPARTMENT. Failure to do so may result in suspension or termination of the contract. b. Contract Performance Disputes (1) This contract is not subject to arbitration. Any performance issues shall be identified in writing and submitted to the appropriate Division Director of the Department. All disputes concerning performance of this contract shall be decided by the appropriate Division Director, who shall put the decision in writing and serve a copy to the CONTRACTOR and the DEPARTMENT's Director. (2) The Division Director's decision shall be final unless within fifteen (15) days from the date of service of such copy the CONTRACTOR files a contested case proceeding with the DEPARTMENT. 12 21. Availability of Funds The disbursement of funds under this contract is contingent upon the continued availability of federal, state, or private fimds to the DEPARTMENT. 22. Withholding of Support a. With ten (10) working days written notice, the DEPARTMENT may temporarily withhold payment of DEPARTMENT funds. The CONTRACTOR may be required to submit a corrective action plan for approval by the DEPARTMENT. Reasons for withholding payment of funds may include, but are not limited to: (1) Delinquency in submitting required reports. (2) Failure to show satisfactory progress in achieving the objectives of the project or failure to meet the terms and conditions of the contract. (3) Failure to provide adequate management of contract fimds or equipment. b. Temporary withholding of funds does not constitute just cause for the CONTRACTOR to interrupt services to clients. 23. Suspension a. When, as detenuined by the DEPARTMENT, a CONTRACTOR has materially failed to comply with the terms and conditions of the contract, the DEPARTMENT may suspend the contract, in whole Or in part, upon written notice. The notice of suspension shall state the reason(s) for the suspension, any corrective action required, and the effective date. b. A suspension shall be in effect until the CONTRACTOR has provided evidence satisfactory to the DEPARTMENT that corrective action has been or will be taken, or until the contract is terminated. c. Obligations incurred by the CONTRACTOR during the suspension period shall not be allowed unless expressly authorized in the notice of suspension. Necessary costs which the CONTRACTOR could not reasonably avoid during the suspension shall be allowed only if the CONTRACTOR had a prior obligation for those expenses. 24. Termination a. This contract may be terminated by the CONTRACTOR upon thirty (30) working days advance written notice only for the failure of the DEPARTMENT to comply with any term, condition, or provision of this contract, including but not limited to the failure to make timely payment for work performed on the project. In this event, the CONTRACTOR shall deliver to the DEPARTMENT written notice specifying the nature of the DEPARTMENT's default. The DEPARTMENT shall have the thirty-day notice period to correct the problem that resulted in the default notice. 13 b. This contract may be terminated effective immediately by either party when circumstances beyond the control of the DEPARTMENT or the CONTRACTOR make continuation of this contract impossible; c. This contract may be terminated solely by the DEPARTMENT for any of the following reasons: (1) Default by the CONTRACTOR. The failure of the CONTRACTOR to comply with any term, condition, or provision of this contract shall constitute a default by the CONTRACTOR. In this event, the DEPARTMENT shall deliver to the CONTRACTOR written notice specifying the nature of the CONTRACTOR's default. The DEPARTMENT's notice shall also include any penalties due for late or unsatisfactory performance. The DEPARTMENT may make termination of the contract effective immediately. If the notice of default sent by the DEPARTMENT does not indicate that the contract shall be terminated effective immediately, the CONTRACTOR shall have ten (10) days after receipt of such notice to correct the problem which resulted in the default notice and to submit payment for the fine imposed. The DEPARTMENT may thereafter issue a notice of immediate termination if the default is not corrected to the satisfaction of the DEPARTMENT or payment of the proposed fine is not received within the ten day period. (2) The convenience of the DEPARTMENT. The DEPARTMENT may terminate performance of work under this contract in whole or in part whenever, for any reason, the DEPARTMENT shall determine that such temination is in the best interest of the State. In this event, the DEPARTMENT shall issue a termination notice to the CONTRACTOR at least ten (10) days prior to the effective termination date. (3) Bankruptcy or Insolvency. In the event that the CONTRACTOR shall cease conducting business in the normal course, become insolvent, make a general assignment for the benefit of creditors, suffer or permit the appointment of a receiver for its business or its assets or shall avail itself of, or become subject to, any proceeding under the Federal Bankruptcy Act or any other statute of any state related to insolvency or the protection of the rights of ereditors, the DEPARTMENT may, at its option, terminate this contract upon written notice to the CONTRACTOR. The CONTRACTOR must inform the DEPARTMENT of its intention to file a petition in bankruptcy at least five days prior to filing such a petition. The CONTRACTOR's failure to comply with this pre-firing notice requirement shall be deemed a material, pre-petition incurable breach. In the event the DEPARTMENT elects to terminate the contract under this provision, the date of termination shall be deemed to be the date the DEPARTMENT mailed the written termination notice to the CONTRACTOR, unless otherwise specified. (4) Unavailability of Funds. The performance by the DEPARTMENT of any of its obligations under the contract shall be subject to and contingent upon the availability of Federal and State moneys lawfully applicable for such purposes. If the DEPARTMENT deems that moneys lawfully applicable to this contract shall not be available at any time during the contract term, the DEPARTMENT may issue a termination notice to the CONTRACTOR at least thirty (30) days prior to the effective date that funds to continue this contract will no longer be available. The obligations of the parties hereto shall end as of the date specified in the termination notice, and the contract will be considered canceled. (5) Conflict of interest. In the event that the CONTRACTOR is proven to have a conflict of interest, as defined in section 15 of this contract, the DEPARTMENT shall immediately terminate this contract. d. In the event of termination, the CONTRACTOR shall be reimbursed by the DEPARTMENT only for those allowable costs incurred or encumbered prior to the termination date, subject to the continued availability of fimds to the DEPARTMENT. The supplies and inventoriable items shall be returned or reimbursed to the DEPARTMENT. e. Should this contract terminate prior to the expiration date, the CONTRACTOR agrees to deliver such information and items which are due as of the date of termination, including partially completed plans, drawings, data, documents, surveys, maps, reports, models, etc. The CONTRACTOR also is responsible to ensure a smooth transition of services to clients, regardless of whether this contract terminates prior to or upon the expiration date of the contract. If the CONTRACTOR fails to ensure a smooth transition of services to clients, the DEPARTMENT may, at its sole discretion, place the CONTRACTOR on its list of contractors barred fxom entering into any contract with the DEPARTMENT and immediately terminate all other then existing contracts between the DEPARTMENT and the CONTRACTOR, pursuant to subsection 24(f). f. Should this contract be terminated under subsection 24(c)(1) ("Default by the CONTRACTOR") or subsection 24(c)(3) ('~Bankruptcy or Insolvencf! of the CONTRACTOR), or should the CONTRACTOR fail to ensure a smooth transition of services to clients as required by subsection 24(e), the DEPARTMENT may, at its sole discretion, place the CONTRACTOR on its list of contractors barred from entering into any contract with the DEPARTMENT. Such placement may be permanent or for an indefinite period of time with no possibility of reinstatement for a fixed period of time, at the sole discretion of the DEPARTMENT. The DEPARTMENT may also, at its sole discretion, immediately terminate all contracts between the DEPARTMENT and CONTRACTOR if the CONTRACTOR is placed on the barred list of contractors. g. The DEPARTMENT shall not be liable for unemployment compensation arising from the termination of this contract. h. The DEPARTMENT reserves all administrative, contractual and legal relfiedies which are available in the event that the CONTRACTOR violates or breaches the terms of this contract. i. Should the DEPARTMENT obtain a money judgment against the CONTRACTOR as a result of a default under this contract, the CONTRACTOR hereby consents to such judgment being set off from moneys owed the CONTRACTOR by the DEPARTMENT or any other agency of the State under any other contract. 25. Suspension and Debarment The CONTRACTOR certifies that it is not disbarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded fi'om participation in this contract by any federal department or agency. The CONTRACTOR further agrees to comply with the regulations implementing executive order 12549 regarding debarment and suspension. 26. Contested Cases Any CONTRACTOR who wishes to contest action taken by the DEPARTMENT pursuant to General Conditions 20, 22, 23, or 24 of the contract may do so within 15 days following receipt of notice from the DEPARTMENT. The appeal shall be conducted in accordance with Iowa Code section 17A. 12. 27. Changes of Key Personnel The CONTRACTOR's personnel specified by name and title in Article III of the Special Conditions are considered to be essential to the work or services being performed. If, for any reason, substitution or elimination of a specified individual becomes necessary, the CONTRACTOR shall provide written notification to the DEPARTMENT. Such written notification shall include the successor's name and title. The CONTRACTOR shall notify the DEPARTMENT in writing within five (5) working days of any change of key personnel. A copy of the resume for a director hired during the course of the contract shall also be sent to the DEPARTMENT within five (5) working days from the date of hire. 28. Assignment a. This contract shall not be assigned or transferred by the CONTRACTOR to any third party or parties without written approval in advance by the DEPARTMENT. The DEPARTMENT reserves the right to not contract with a new contractor. b. A written agreement with the CONTRACTOR to relinquish all fights to the project, and a written agreement with the new contractor to accept all the terms and conditions of the contract shall be submitted to and approved in writing by the DEPARTMENT prior to the date of transfer. 29. Changes in Location The DEPARTMENT shall be notified of any change in office or service location from that shown in the contract at least five (5) working days prior to such change. 30. Changes in Service Changes in the services to be provided by the CONTRACTOR as outlined in the contract require prior written approval by the DEPARTMENT. Discontinuation of any service may result in a decrease in the contract amount or termination of the contract. 16 31. Drug Free Workplace In order to comply with. the Drug Free Worlcplace Act of 1988 and 41 U.S. Code Annotated section 701, the CONTRACTOR is required to report any conviction of employees under a criminal drag statute for violations occurring on the CONTRACTOR's premises 'or off the CONTRACTOR's premises while conducting official business. A report of a conviction shall be made to the DEPARTMENT within five (5) working days after the conviction. 32. Certification Regarding Environmental Tobacco Smoke a. Public Law 103-227, also known as the Pro-Children Act of 1994 (Act), requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by Federal programs either directly or through State or local governments, by Federal grant, contract, loan, or loan guarantee. The law also applies to children's services that are provided in indoor facilities that are constructed, operated, or maintained with such federal funds. The law does not apply to children's services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment; service providers whose sole source of applicable Federal funds is Medicare or Medicaid; or facilities where WIC coupons are redeemed. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. b. The CONTRACTOR certifies that it will comply with the requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act. c. The CONTRACTOR agrees that it will require that the language of this certification be included in any subcontract or subaward that contains provisions for children's services and that all subrecipients shall certify accordingly. 33. Indemnification The CONTRACTOR and its successors and assignees agree to defend, indemnify and hold the DEPARTMENT, any Consultant/Consultant Affiliate, and the State of Iowa harmless from any and all liabilities, damages, settlements, judgments, costs and expenses (including reasonable attomgy fees of the Attorney General's Office, and the costs and expenses and attorney fees of other counsel required to defend the DEPARTMENT, any Consultant/Consultant Affiliate, or the State of Iowa) related to or arising from any of the following: a. Any violation of this contract. b Any negligent acts or omissions of the CONTRACTOR, its officers, employees, agents, board members, contractors or subcontractors, or any other person in connection with this project. 17 c. Claims for infringement of patents, trademarks, trade dress, trade secrets, or copyrights arising from the work of the project. d. The CONTRACTOR's performance or attempted performance of this contract. e. Any failure by the CONTRACTOR to comply with all federal, state, and local laws and regulations. f. Any failure by the CONTRACTOR to make all reports, payments, and withholdings required by federal and state law with respect to social security, employee income, and other taxes, fees, or costs required by the CONTRACTOR to conduct business in the State of Iowa. g. The death, bodily injury or damage to property of any enrollee, agent, employee, business invitee or.business visitor of the CONTRACTOR or any of its subcontractors. 34. Not a Joint Venture Nothing in this contract shall be construed as gearing or constituting the relationship of a parmership or joint venture between the parties hereto. Each party shall be deemed to be an independent contractor acting toward the mutual benefits expected to be derived herefrom. No party, unless othemdse specifically provided for herein, has the authority to enter into any contract or create an obligation or liability on behalf of, in the name of, or binding upon another party to this contract. 35. Joint Entity, If the CONTRACTOR is a joint entity, consisting of more than one individual, partnership, corporation or other business organization, all such entities shall be jointly and severally liable for carrying out the activities and obligations of this contract, and for any default of such activities and obligations. 36. Choice of Law and Forum The terms and provisions of this contract shall be construed in accordance with the laws of the State of Iowa. Any and all litigation or actions commenced in conuection with this contract shall be brought in Des Moines, Iowa, in the Iowa District Court in and for Polk County, Iowa. If, however, jurisdiction is not proper in the Polk County District Court, the action shall only be brought in the United States District Court for the Southern District of Iowa, Central Division, provided that jurisdiction is proper in that forum. This provision shall not be construed as waiving any immunity to suit or liability that may be available to the DEPARTMENT or the State of Iowa. 37. Waiver Except as specifically provided for in a written waiver signed by duly authorized representatives of the DEPARTMENT and the CONTRACTOR, failure by either party at any time to require performance by the other party or to claim a breach of any provision of the 18 contract shall not be construed as affecting any subsequent breach or the right to require performance with respect thereto or to claim a breach with respect thereto. 38. Miscelaneous a. Headings or Captions. The section and subsection headings or captions are for identification purposes only and do not limit or construe the contents of the sections and subsections. b. Suporsedes former Contracts. This contract supersedes all prior contracts between the DEPARTMENT and the CONTRACTOR for services and products provided in connection with this contract. c. Counterparts. The parties agree that this contract has been or may be executed in several countcn'parts, each of which shall be deemed an original and all such counterparts shall together constitute one and the same instrument. 1 SPECIAL CONDITIONS FOR CONTRACT # 5883LP06 ARTICLE I - IDENTIFICATION OF PARTIES. This contract is entered into by and between the Iowa Department of Public Health (herein identified as the DEPARTMENT) and the CONTRACTOR, as identified on the contract face sheet. ARTICLE II - IDENTIFICATION OF AUTHORIZED STATE OFFICIAL: The Director of Public Health is the Authorized State Official for this contract. Any changes in the terms, conditions, or amounts specified in tiffs contract must be approved by the Authorized State Official. Negotiations concerning this contract should be referred to: Stephen Quirk, phone 515/281-5784 ARTICLE HI -.DESIGNATION OF CONTRACT ADMINISTRATOR, KEY PERSONNEL, AND CONTRACT DOCUMENTS Refer to Exhibit I. ARTICLE - STATEMENT OF CONTRACT PURPOSE The purpose of this contract is to provide funds for the contractor to conduct childhood lead poisoning prevention activities as specified in Article V, Description of Work and Services. ARTICLE V - DESCRIPTION OF WORK AND SERVICES: The CONTRACTOR shall conduct chilcthood lead poisoning prevention services as specified in this article. DEFINITIONS "Annual surveillance extract" means the procedure in STELLAR that compiles the contractor's activities for the calendar year into a data file that is submitted to the department electronically by the deadlines given in Article VI. "Blood lead testing" means taking a capillary or venous sample of blood and sending it to a laboratory to determine the level of lead in the blood. "Capillary" means a blood sample taken from the finger or heel for lead analysis. "Care coordination" means the process of linking the service system to the recipient and/or family, and coordination of the various elements in order to achieve a successful outcome. 2 "CDC" means the Centers for Disease Control and Prevention. "Certified elevated blood lead (EBL) inspection agency" means an agency that has met the requirements of 641--70.5(135) and that has been certified by the department. "Certified elevated blood lead (EBL) inspector/risk assessor" means a person who has met the requirements of 641--70.5(135) for certification or interim certification and who has been certified by the department. "Chelation" means the administration of medication that binds lead so that it can be removed from the body. "Child health contractor" means an agency that has a contract with the Iowa Department of Public Health for the Title V Child Health program. "Childhood Lead Poisoning Prevention Program (CLPPP) service area" means the geographic area for which the CLPPP has agreed to provide CLPPP services. "CLPPP" means childhood lead poisoning prevention program. "Complete medical evaluation" means a history, physical examination, and testing for iron status as described in Chapter 7 of Preventing Lead Poisoning in Young Children, CDC, October 1991. "Data management" means all actions taken by the contractor to manage blood lead data and case management data. This includes, but is not limited to, entering blood lead test results for all individuals under the age of 16 years in the CLPPP service area who receive blood lead testing from the CLPPP or any other provider in the STELLAR database, documenting all ease management actions such as contact with the family or provider, EBL inspection, lead hazard remediation, home nursing or outreach visits, nutrition evaluations, and developmental assessments in the STELLAR database, and providing all STELLAR reports required by this contract. "Developmental testing" means testing done by the local Area Education Agency to determine whether a child is developmentally delayed. "Education and outreach" means seeking out and providing information regardLfig childhood lead poisoning to members of populations who are at high risk for lead poisoning and those who work for agencies that provide service to these high-risk populations; members of the general public, including homeowners, landlords, Realtors, and members of community organizations, and health professionals and para-professionals, including physicians, nurses, and laboratory technicians. "Elevated blood lead (EBL) Child" means any child who has had one venous blood lead levet greater than or equal to 20 micrograms per deciliter (ug/dL) or at least two venous blood lead levels of 15 to 19 Ixg/dL. "Elevated blood lead (EBL) inspection" means an inspection to determine the sources of lead exposure for an elevated blood lead (EBL) child and the provision within ten working days of a written report explaining the results of the investigation to the owner and occupant of the residential dwelling or child-occupied facility being inspected and to the parents of the elevated blood lead (EBL) child. "Elevated blood lead (EBL) inspection agency" means an agency that employs or contracts with individuals who perform elevated blood lead (EBL) inspections. Elevated blood lead (EBL) inspection agencies may also employ or contract with individuals who perform other lead-based paint activities. "Environmental case management" means providing elevated blood lead (EBL) inspections in all dwellings associated with an EBL child and assuring that lead hazards identified at these dwellings. "Follow-up blood lead testing" means blood lead testing that is conducted after a child has had at least one capillary or venous blood lead level greater than or equal to 10 ug/dL. "Home nursing or outreach visit" means a home visit conducted by a nurse or social worker to provide information to the caregiver of a lead-poisoned child regarding the health effects of lead poisoning, the importance of good housekeeping and nutrition, and the importance of follow-up blood lead testing and to assess the overall situation of the child and family to determine whether the child and/or family should be referred for additional services. "Lead-basedpaint hazard" means hazardous lead-based paint, a dust-lead hazard, or a soil-lead hazard as defined in 641 Chapter 70. "Lead hazard remediation" means the control of lead hazards identified in the EBL inspection through interim controls, renovation and remodeling, or lead abatement. "Local board of health" means a county, district, or city board of health. "Local coalition" means a group convened by the contractor to address the issue of childhood lead poisoning in the CLPPP service area. The local coalition should be composed of physicians, nurses, housing officials, parents, contractors, and representatives of neighborhoods where homes are being renovated. "Medical case management" means all services necessary to evaluate the health and development of a child with a blood lead level greater than or equal to 10 Ixg/dL and to treat any conditions identified in the evaluation. Medical case management includes, but it not limited to, follow-up blood lead testing, medical evaluation, home nursing or outreach visits, chelation, nutrition evaluation, developmental assessment, and care coordination. Nutrition evaluation means an evaluation conducted by a dietician to determine whether a child is receiving a well-balanced and age-appropriate diet, with particular attention to the child intake of Vitamin C, iron, and calcium. "Quarterly narrative report" means a report of the contractor's childhood lead poisoning prevention activities for the quarter that is developed according to guidelines provided by the department and is provided to the department by the deadlines given in Article VI. "Quarterly update for supervisory database" means an extract of the contractor's STELLAR database that is provided electronically to the department by the deadlines given in Article VI. "Referral" means to direct the family ora lead-poisoned to a service for the family or the child and to follow-up to assure that the family actually received the service. "STELLAR" means the Systematic Tracking of Elevated Lead Levels and Remediation database which is provided by CDC at no charge. "STELLAR Lab Batch" means the procedure in STELLAR that processes blood lead tests and sets dates for follow-up blood lead tests, opens medical cases, and opens environmental cases. STELLAR quarterly report means the procedure in STELLAR that compiles the contractor s activities for the quarter into a data file that is submitted to the department electronically by the deadlines given in Article VI. "Venous" means a blood sample taken from a vein'in the arm for lead analysis. CLPPP SERVICE AREA The CLPPP service area is Dubuque County. REQUIRED SERVICES The contractor is respormible for the following CLPPP services with the CLPPP service area: blood lead testing, data management, environmental case management, medical case management, education and outreach, and the local coalition within its service area. The contractor shall develop written protocols to describe how each of these sen,lees will be provided. The contractor may use templates provided by the department to develop these protocols. BLOOD LEAD TESTING The contractor shall assure that the State of Iowa Plan for Childhood Blood Lead Testing (January 2001) is implemented within the CLPPP service area. The contractor shall assure that medical providers conduct blood lead testing according to this plan. The contractor may also conduct blood lead testing. The contractor shall provide a written notice of the results of blood lead testing to the caregivers of all children tested by the contractor. · The written notice Shall include information regarding the meaning of the blood lead test result and the date when the child should be tested again. The contractor shall provide a written notice of the results of blood lead testing to the caregivers of all children in the CLPPP service area who have blood lead levels greater than or equal to 10 i~g/dL, regardless of whether the contractor, did the testing. The written notice shall include information regarding the meaning of the blood lead test result, actions that the parents can take to reduce the child's blood lead level, and the date when the child should be tested again. The goals for blood lead testing are: Increase the percentage of children in the CLPPP service area receiving at least one blood lead test between the ages of 12 and 35 months fi:om the current Iowa average of 36 percent to 45 percent by June 30, 2003. Increase the percentage of children in the CLPPP service area receiving at least one blood lead test before the age of six years from the current Iowa average of 48 percent to 60 percent by Jtme 30, 2003. If the contractor does not meet this goal, the contractor shall document in writing the reasons why the goal was not met and shall develop by June 30, 2003, a written plan with specific actions that the contractor has taken and will take to increase the rate of blood lead testing in the CLPPP service area. DATA MANAGEMENT The contractor shall conduct data management as specified in this contract. The contractor shall notify the department wJlhin 10 working days of assigning STELLAR data entry duties to a new staff'person. Contractor shall assure the department that new data entry staff has received appropriate training or work within the department to assure that new data entry staff receives appropriate training. The contractor shall install STELLAR on a computer network consisting of at least two computers that are linked to the same server. The contractor shall allow the department and other agencies providing medical and environmental case management of lead-poisoned children in the CLPPP service area to access the main STELLAR database via the soft-ware, PC Anywhere, or another software package approved in advance by the DEPARTMENT. The contractor shall enter the results of blood lead testing for all individuals under the age of 16 years in the CLPPP service area who receive blood lead testing fi:om the CLPPP or any other provider in the STELLAR database. The contractor shall document all case management actions taken by the contractor juch as contact with the family or provider, EBL inspection, lead hazard remediation, home nursing or outreach visits, nutrition evaluations, and developmental assessments in the STELLAR database and shall assure that all CLPPP subcontractors also document all case management actions that they taken in STELLAR. The contractor shall enter blood lead test results and case management actions into STELLAR on at least a weekly basis. The contractor shall run STELLAR Lab Batch at least every two weeks and shall forward case information to other agencies providing medical and environmental case management in the CLPPP service area at least every two weeks. The contractor shall provide all STELLAR reports by the deadlines given in this contract. ENVIRONMENTAL CASE MANAGEMENT The contractors shall maintain certification of individual inspectors as elevated blood lead (EBL) inspector/risk assessors and agency certification as an elevated blood lead level (EBL) inspection agency. The contractor shall be enrolled as a Medicaid provider for EBL inspection services and shall recover reimbursement fi:om Medicaid for EBL inspections. Costs for environmental case management that could be recovered from Medicaid reimbursement may not be billed to this grant. The contractor shall conduct elevated blood lead (EBL) inspections for any child under the age of six years who has had one venous blood lead level greater than or equal to 20 ug/dL or at least two venous blood lead levels of 15 to 19 ug/dL. EBL inspections shall be conducted for all addresses associated with the child and for all addresses that the child moves to after the case is initially reported until the child has had one blood lead level less than 10 ug/dL or three blood lead levels tess than 15 ug/dL. EBL inspections shall be conducted within the following times: · Two venous blood lead levels of 15 to 19 ug/dL - within 4 weeks after the report. · Venous blood lead level of 20 to 44 ug/dL - within 2 weeks after the report · Venous blood lead level of 45 to 69 ug/dL - within 1 week after the report · Venous blood lead level greater than or equal to 70 ug/dL - within 2 days after the report. 'The contractor shall document in STELLAR the reason why the contractor was unable to complete any inspection required by this contract. The contractor shall contact the occupants and/or owners of dwellings where lead hazards have been identified within 30 days of the initial inspection to check their progress towards making the dwelling lead-safe. The contractor shall follow up on all dwellings where lead hazards were identified, but lead hazard remediation has not been completed, at least once ever/six months until lead hazard remediation is completed. The contractor shall continue to follow up on all of these dwellings until lead hazard remediation is completed, regardless of whether the dwellings are owner-occupied or rental and regardless of changes in ownership. The contractor shall not close an address associated with a lead-poisoned child where lead hazards have been identified unless the lead hazard remediation has been completed unless permission is obtained in advance fi:om the DEPARTMENT. The contractor shall, to the extent possible, assist families who have lead-poisoned children in locating resources for lead hazard remediation and/or alternative housing. 7 The goals for environmental case management are: Complete environmental investigations for at least 99% of children having a single venous blood lead level greater than or equal to 20 Ixg/dL or two venous blood lead levels from 15- 19 ug/dL and for at least 90% of homes associated with these children according to the required time lines. Ensure that the most serious lead hazards are remediated with/n 30 days of the initial investigation in at least 80% of homes where lead hazards are identified. Ensure that less serious lead hazards are remediated Within one year of the initial investigation in at least 60% of homes where lead hazards are identified. MEDICAL CASE MANAGEMENT The contractor shall conduct medical case management as specified in this contract. The contractor shall be enrolled as a Medicaid provider for services that can be reimbursed by Medicaid. Costs for medical case management that could be recovered from Medicaid reimbursement may not be billed to this grant. Follow-up blood lead testing The contractor shall assure that providers in the CLPPP service that conduct blood lead testing provide follow-up blood lead testing for children under the age of six years within the timelines listed below. The contractor may provide this follow-up blood lead testing. Confirmatory venous blood lead testing · Capillary blood lead level of 15 to 19 ug/dL - wilhin 4 weeks after the report. Capillary blood lead level of 20 to 44 ug/dL - within 1 week after the report Capillary blood lead level of 45 to 69 ug/dL- within 48 hours after the report Capillary blood lead level greater than or equal to 70 ug/dL - immediately. Follow-up testing after an elevated blood lead level for a child who has not been chelated · Capillary or venous blood lead level of 10 to 14 ug/dL - within 3 months. After two levels less than 10 Ixg/dL or three levels less than 15 ug/dL, testing should follow the routine testing schedule for high-risk children. · Venous blood lead level of 15 to 19 ug/dL - within 3 months. Venous blood lead level of 20 to 44 ug/dL - within 4 to 6 weeks. Venous blood lead level greater than or equal to 45 ug/dL - immediately Follow-up testing for a child who has been chelated · At the end of chelation. Depending on tha blood lead level, 7 to 21 days after the end of chelation. The results of this test will determine the need for additional chelation and the schedule for additional blood lead testing. Medical evaluations The contractor shall assure that providers in the CLPPP provide conduct medical evaluations for children under the age of six years within the following timelines: · Venous blood lead level of 20 to44 ug/dL - Refer w/thin 48 hours after the report so that the service is received within 5 days. · Venous blood lead level of 45 to 69 ug/dL - Refer within 24 hours after the report so that the service is received within 48 hours. · Venous blood lead level greater than or equal to 70 ug/dL - Refer for emergency medical evaluation. Home nursing or outreach visits The contractor shall provide home nursing or outreach visits for children under the age of six years according to the following timelines: · Venous blood lead level of 15 to 19 ug/dL - w/thin 4 weeks after the report. · Venous blood lead level of 20 to 44 ug/dL- within 2 weeks after the report · Venous blood lead level of 45 to 69 ug/dL - w/thin 1 week after the report · Venous blood lead level greater than or equal to 70 ug/dL - within 2 days after the report. Chelation The contractor shall assure that children with two venous blood lead levels greater than or equal to 45 ug/dL receive chelation. Nutrition evaluation The contractor shall assure that children under the age of six years with a venous blood lead level greater than or equal to 15 ug/dL receive a nutrition evaluation according to the following timelines: · Venous blood lead level of 15 to 19 ug/dL - within 4 weeks after the report. · Venous blood lead level of 20 to 44 ug/dL - within 2 ~veeks after the report · Venous blood lead level of 45 to 69 ug/dL- within 1 week after the report Venous blood lead level greater than or equal to 70 ug/dL- within 2 days after the report. · The contractor shall contact the DEPARTMENT for assistance if access to a dietician cannot be assured for children under the age of six years w/th a venous blood lead level greater than or equal to 15 ug/dL. Developmental assessment The contractor shall assure that children under the age of six years with a venous blood lead level greater than or equal to 20 ug/dL receive a developmental assessment according to the following timelines: · Venous blood lead level of 20 to 44 ug/dL - Refer within 2 weeks after the report. · Venous blood lead level of 45 to 69 ug/dL- Refer witlfin 1 week after the report · Venous blood lead level greater than or equal to 70 ug/dL - Refer within 2 days after the report. Care coordination The contractor shall provide care coordination or refer the family to the local child health contractor for this service. Medical Case Closure Gnidelines Medical cases shall be closed only in the following circumstances: 1. A child has had two consecutive blood lead levels less than 10 ug/dL or three consecutive blood lead levels less than 15 ug/dL after the irdtial elevated blood lead level. A child has had a capillary false positive blood lead level; that is, a capillary or venous blood lead level less than 10 ug/dL immediately after a single capillary blood lead level greater than or equal to 15 ug/dL. A child has reached the age of six years and has a blood lead level less than 20 ug/dL. A child has moved out of the CLPPP service area. The contractor shall immediately notify the appropriate local CLPPP agency in the area to which the child has moved and provide copies of all environmental and medical case management records to the appropriate local CLPPP agency. Goals for Medical Case Management The goals for medical case management are: Follow-up blood lead testing Ensure that at least 95% of children with capillary blood lead levels greater than or equal to 15 ug/dL receive confirmatory venous blood lead measurements. Ensure that at least 50% of children with blood lead levels of 10-14 ug/dL receive follow-up testing at an average interval of 100 days. Ensure that at least 80% of children with venous blood lead levels of 15 to 19 ug/dL receive blood lead testing at an average interval of 100 days. Ensure that at least 95% of children with venous blood lead levels greater than or equal to 20 ug/dL receive blood lead testing at an average interval of 50 days. Other medical case management services Ensure that at least 95% of children with confinmed blood lead levels greater than or equal to 15 ug/dL receive ahome nursing or outreach visit. 10 Ensure that at least 95% of children with confirmed blood lead levels greater than or equal to 15 ~tg/dL receive a nutrition evaluation. Ensure that 100% of children with venous blood lead levels greater than or equal to 20 [tg/dL receive a complete medical evaluation from a physician. Refer 100% of children with confirmed blood lead levels greater than or equal to 20 gg/dL to the local Area Education Agency for the appropriate developmental testing. Ensure that at least 95% of children with confrrmed blood lead levels greater than or equal to 20 gg/dL receive the appropriate developmental testing, evaluation, and assessment from their local Area Education Agency. Ensure that 100% of children with .two venous blood lead levels greater than or equal to 45 [tg/dL receive appropriate chelation treatment. Overall outcomes Ensure that no more than 5% of children initially identified with blood lead levels of 10-14 gg/dL eventually have venous blood lead levels greater than or equal to 20 [tg/dL Ensure that no more than 10% of children initially identified with venous blood lead levels of 15-19 [tg/dL eventually have venous blood lead levels greater than or equal to 20 [tg/dL Ensure that at least 50% of children under the age of 3 years with venous blood lead levels greater than of equal to 20 gg/dL have their blood lead levels drop to less than 20 [tg/dL during their first nine months of case management. CHILDREN OVER THE AGE OF SIX YEARS The contractor shall contact the department for specific case management guidelines for a child over the age of six years who has a venous blood lead level greater than or equal to 20 gg/dL. EDUCATION AND OUTREACH The contractor shall provide education and outreach regarding childhood poisoning in the CLPPP service area. LOCAL COALITION The contractor shall establish a local coalition for the CLPPP service area. The coalition may be a subgroup/work group of a larger umbrella coalition. However, participation in an umbrella coalition does not meet this requirement unless a specific subgroup has been formed to deal with lead poisoning prevention in the community. The coalition shall include citizens who are not part of agency (Health, Housing, Human Services, etc.) staff that participate in the CLPPP. Article VI - Reports The CONTRACTOR shall prepare and submit the following reports to the department: Report Number of Copies Date Due Claim Voucher 4 By the 10th of each month Expenditure Report 3 By the l0th of each month Quarterly Narrative Report 1 Electronic 10-25-2002 1-25-2003 4-25-2003 7-25-2003 Preliminary STELLAR Quarterly Report 1 Electronc 10-15-2002 1-15-2003 4-15-2003 7-15-2003 Final STELLAR Quarterly Report 1 Electronic 10-25-2002 1-25-2003 4-25-2003 7-25-2003 Annual Surveillance Extract 1 Electronic 4-1-2003 Quarterly Updates for 1 Electronic 10-25 -2002 Supervisory Database 1-25-2003 4-25-2003 7-25-2003 The contractor shall ensure that all subcontractors' enter all reqtfired case management data in STELLAR so that required reports are complete and accurate. The contractor shall require each subcontractor to provide a quarterly narrative report to the contractor so that the contractor may include this information in the quarterly narrative report that the contractor provides to the department. Article VII - Budget The total approved budget for this contract period is detailed in Exhibit II. Article VIII - Payments: The DEPARTMENT agrees to reimburse the CONTRACTOR for budgeted and approved expenditures that have been incurred or encumbered during the contract period in a sum not to exceed the contract mount. The CONTRACTOR shall submit the required number of signed vouchers, expenditure reports, and progress reports to the DEPARTMENT on forms approved by the DEPARTMENT. All requests for payment shall be submitted within 45 days of the reporting period in which the costs were incurred or encumbered. A penalty of 5% of the requested payment may be assessed if the required reports are not received in the DEPARTMENT by the established due date. Article IX - Modification of General Conditions None. Article X - Additional Conditions 1. The contract period is the period dui'ing which the current award is available to cover approved project expenses. Continuing funding after this contract period will be available for additional contract periods through the end of the project period, subject to satisfactory contractor performance and the availability of funding. 2. No funds may be spent for indirect costs. 3. Expenditures may exceed the apprOved mount for a specific line item by no more than 10% or $200, whichever is greater, without prior approval, provided that total contract reimbursement shall not exceed contract totals as shown on Exhibit I Transfers between line items that would cause expenditures for one or more specific line items to exceed the approved amount for a line item by more than 10% or $200, whichever is greater, must be approved in advance. 4. Funds must be made available to reimburse subcontractor expenses no later than 30 days after the contract is signed. 5. The contractor shall ensure that all subcontractors follow the provisions of this contract. 6. The contractor must check Intemet e-mail at least once each week for lead poisoning prevention updates sent out by the DEPARTMENT. 7. Costs for medical case management, such as home nursing visits, care coordination, and nutrition evaluation that could be recovered from Medicaid reimbursement may not be billed to this grant. 8. Program income, such as Medicaid reimbursement and fees for conducting inspections, must be returned to the lead program and used to enhance lead program efforts. 9. XRF analyzers that were originally purchased, in part or in whole, with Iowa Department of Public Health grant funds, are to be shared with other elevated blood lead (EBL) inspector/risk assessors that have a contract w/th 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. 10. The CONTRACTOR shall assure linkage with the local board of health in each county where services are provided as a condition of the contract. The CONTRACTOR will assure that the local board(s) of health have been actively engaged in the planning for and evaluation of services, as well as maintaining effective linkage with the local board of health including timely and effective communications and ongoing collaboration. 11. Fund may not be spent for chelation or other medical treatment of lead poisoning. 12. Funds may not be spent for lead hazard remediation. 14 Exhibit I Contract #5883 Michael C. Van Milligan has been designated by the CONTRACTOR to act as the Contract Administrator. This individual is respossible for financial and administrative matters of this contract. Negotiations regarding this contract should be referred to: Mary Rose Corrigan, telephone 563-589-4181. The following individual(s) shall be considered key personnel: Name Title Mary Rose Corrigan Kathaleen Lamb Integrated documents of this contract include: 1. Request for Proposal (RFP) 2. Approved application. 3. Approved budget. 4. Contract face sheet and any subsequent amendments. 5. General conditions effective 1-14-1999. 6. Special conditions effective 7-1-2002. On behalf of the CONTRACTOR, I am responsible for the identified key personnel. I have read the integrated documents listed above and agree to fulfill the requirements and conditions stipulated in this contract. By: ___________________ Michael C. Van Milligan City Manager Date:______________ AGREEMENT BETWEEN THE CITY OF DUBUQUE, IOWA, AND THE VISITING NURSE ASSOCIATION FOR THE CHILDHOOD LEAD POISONING PREVENTION PROGRAM (CLPPP) Now on this 1st day of July 2002, it is agreed by and between the City of Dubuque, Iowa, (City) and the Dubuque Visiting Nurse Association (VNA) as follow: TERM. The term of this Agreement shall be from the 1st day of July 2002, through the 30th day of June 2003. CITY'S RESPONSIBILITIES. City agrees that it will provide the following services for the CLPPP: 1. Submit quarterly reports and other reporting requirements as requested to the Iowa Department of Public Health (IDPH) and the Centers for Disease Control and Prevention. (CDC). Provide for environmental investigations and environmental case management for lead abatement\lead hazard reduction in housing units in the city of Dubuque, Iowa, and Dubuque County. Provide compensation to the VNA during the term of this Agreement not to exceed $14,000.00 for the performances of VNA's responsibilities as set forth herein. Oversee and direct medical case management activities through verbal and written direction. VNA'S RESPONSIBILITIES. VNA agrees to provide the following services for CLPPP during the term of this Agreement for the agreed compensation: Provide written quarterly reports on lead-related activities utilizing the Iowa Quarterly Report Narrative Outline. Provide computer documentation of medical case management and related activities into City's lead database system, STELLAR. Provide blood lead screening and medical case management for follow-up testing for children in the city of Dubuque following the recommendations of the IDPH and the City of Dubuque Health Services Department. Assist City with providing public education, lead coalition development and activities, and outreach to the City of Dubuque residents about childhood lead poisoning. Conduct home visits as needed to families\residents in order to provide medical case management services. 1 Provide education and medical case management of children with confirmed blood lead levels greater than or equal to 15 I~g\dL. Medical case management includes: · assurance that children are being screened\retested for lead and case managed according to Iowa Department of Public Health requirements; assurance that children and parents receive nutritional counseling and educational materials; educate parents and families about major sources of lead and how to prevent poisoning; assistance in interpreting blood lead levels; refer all children with confirmed blood lead levels greater to or equal to 20 pg\dL to Keystone Area Education Agency for appropriate developmental testing, evaluation and assessment; and provide information about lead testing and follow-up, available services, and resources for lead- poisoned children. Provide information about lead poisoning and available services to local pediatric health care providers. = Participate with City in secudng additional funding for childhood lead poisoning prevention activities. Provide monthly work activity reports and invoices to the City Health Services Department outlining services performed, by the 7th day of the month following the previous month. 10. Work towards achieving the program performance standards in conjunction with the City's CLPPP, as outlined in the City's IDPH contract, Exhibit III. D. INSURANCE. VNA agrees to provide insurance as set forth in the attached Insurance Schedule. E. INDEMNIFICATION. City agrees to save, defend, indemnify and hold harmless VNA from and against any and all claims which may be made against VNA arising out of this Agreement which are the result of the sole negligence of City, its officers, agents or employees. VNA agrees to defend, hold harmless and indemnify City from and against any and all claims which may be made against City arising out of this Agreement which are the sole negligence of VNA, its officers, employees or agents. F. TERMINATION. Either party may terminate this Agreement by giving sixty (60) days written notice to the other party. CITY OF DUBUQUE, IOWA BY: Michael C. Van Miltigen City Manager VISITING NURSE ASSOCIATION BY: Kathy Ripple Administrative Director INSURANCE SCHEDULE 1. Any policy of insurance or certificate of insurance required hereunder shall be with a carrier authorized to do business in Iowa and a carrier that has received a rating orA or better in the current Best's Rating Guide. 2. The City of Dubuque shall be named as an additional insured in any insurance policy required by this Schedule, and any policy of insurance required hereunder shall provide for a thirty-day notice to the City of any matedal change or cancellation of the policy pdor to its expiration date. 3. VNA shall have its insurance agent or company certify in wdting that any policy of insurance required herein with an aggregate limit of liability has not been reduced by paid or reserved claims at the time of issuance of policy or certificate. 4. VNA shall fumish copies of the following policies to the City with limits not less than the following, or greater if required by law, and shall also furnish certificates of insurance from all independent contractors or subcontractors hired by VNA or any independent contractor or subcontractor hired by the independent contractor or subcontractor, which certificates shall provide evidence of coverage for the following with limits not less than the following, or greater if required by law: COMMERCIAL GENERAL LIABILITY: General Aggregate Limit Products-Completed Operation Aggregate Limit Personal and Advertising Injury Limit Each Occurrence Limit OR Combined Single Limit Medical Payments $2,000,000 $2,000,000 SI,000,000 SI,000,000 $2,000,000 5,000 Coverage is to include: occurrence form, premises/operations/products/competed operations coverage, independent contractors' coverage, contractual liability, broad form property damage, personal injury (hazards A-C and delete employment exclusions), City of Dubuque named as an additional insured with 30 days' written notice of change or cancellation. PROFESSIONAL LIABILITY: VNA shall furnish a certificate of insurance showing professional liability limits with limits of not tess than $1,000,000 during the term of the project. WORKMEN'S COMPENSATION: Coverage A: Statutory State of Iowa Coverage B: Employers' Liability $100,000 each accident $100,000 each employee and disease $100,000 policy limit and disease