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Healthy Homes and Childhood Lead Poisoning Prevention Program Contracts/Subcontracts Copyrighted August 5, 2019 City of Dubuque Consent Items # 21. ITEM TITLE: Healthy Homes and Childhood Lead Poisoning Prevention Program ContracUSubcontracts SUM MARY: City Manager recommending approval of a contract with the Dubuque County Board of Health and the lowa Department of Public Health for continued funding of the Childhood Lead Poisoning Prevention Program, and a renewed agreement with the Dubuque Visiting Nurse Association for services related to the Childhood Lead Poisoning Prevention Program and Healthy Homes Program. SUGGESTED DISPOSITION: Suggested Disposition: Receiveand File;Approve ATTACHMENTS: Description Type IDPH Childhood Lead Poisoning and Healthy Homes City Manager Memo Funding and Agreement-MVM Memo Staff Memo Staff Memo Subcontractw/ DBQ Co BOH Supporting Documentation Subcontractw/VNA Supporting Documentation Insurance Schedule G Supporting Documentation Contract Supporting Documentation Dubuque THE CITY OF � uI�AaMca cih DuB E � � I � � I Maste iece on the Mississi i Zoo�•zoiz•zois YP pp zoi�*zoi9 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: lowa Department of Public Health (IDPH) Childhood Lead Poisoning and Healthy Homes Funding and Agreement with the Visiting Nurse Association (VNA) and the Dubuque County Board of Health DATE: July 31, 2019 Public Health Specialist Mary Rose Corrigan recommends City Council approval of a contract with the Dubuque County Board of Health and the lowa Department of Public Health for continued funding of the Childhood Lead Poisoning Prevention Program, and a renewed agreement with the Dubuque Visiting Nurse Association for services related to the Childhood Lead Poisoning Prevention Program and Healthy Homes Program. The contract is for $8,802, the same as the FY19 award. I concur with the recommendation and respectfully request Mayor and City Council approval. v Mic ael C. Van Milligen MCVM:jh Attachment cc: Crenna Brumwell, City Attorney Teri Goodmann, Assistant City Manager Cori Burbach, Assistant City Manager Mary Rose Corrigan, Public Health Specialist Dubuque THE CTTY OF � AIFA�aerica Ciq DuB E ; �� � �, Maste iece on the Mississi i zoo�.zo�Z=zo�3 rP PP 2017*2019 TO: Mike Van Milligen, City Manager FROM: Mary Rose Corrigan, Public Health Specialist SUBJECT: lowa Department of Public Health (IDPH) Childhood Lead Poisoning and Healthy Homes Funding and Agreement with the Visiting Nurse Association (VNA) and the Dubuque County Board of Health DATE: July 29, 2019 INTRODUCTION This memorandum provides information regarding a contract with the Dubuque County Board of Health and the lowa Department of Public Health (IDPH) for continued funding of the Childhood Lead Poisoning Prevention Program (CLPPP), a renewed agreement with the VNA for services related to the CLPPP and Healthy Homes Program. BACKGROUND In February 1994, the City Council approved a grant agreement authorizing the Health and Housing Services Departments to contract with the lowa Department of Public Health for environmental follow-up and medical case management for children with lead poisoning according to the lowa Department of Public Health guidelines. The original funding contract has been renewed annually. The latest contract ended June 30, 2019. DISCUSSION The lowa Department of Public Health contracts with local Boards of Health for distribution of their funds. This allows local Boards of Health to monitor public health funding, avoid duplication of services and assure community health needs are addressed (see attached contract). The subcontracted funds will allowthe 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, education for employees, and monies to do outreach and education in targeted neighborhoods regarding lead poisoning and healthy homes activities. The contract also includes program performance standards, which we currently strive to achieve through our existing protocols and outreach programs. The grant funds will be reimbursed based on the specific activities outlined in the budget. BUDGETIMPACT The FY20 budget anticipated funding of$8,802. The contract is for $8,802, the same as the FY19 award. The sub-agreement with the VNA will be paid utilizing funds from the IDPH grant. RECOMMENDATION It is recommended that the City Manager sign the attached subcontract with the Dubuque County Board of Health, and the agreement with the Dubuque Visiting Nurse Association on behalf of the City of Dubuque. MRC/Ih cc: Alexis Steger, Housing Services Manager Sharon Gaul, Lead and Healthy Homes Program Manager 2 SUBCONTRACT FOR HEALTHY HOMES AND CHILDHOOD LEAD POISONING PREVENTION SERVICES BETWEEN DUBUQUE COUNTY BOARD OF HEALTH AND THE CITY OF DUBUQUE WHEREAS, the Dubuque County Board of Health (County Board), as Contractor, has entered into an Agreement (the Agreement) wit the Iowa Department of Public Health to perform childhood lead poisoning prevention services as set forth in the Agreement (Contract # 5888LP03), a copy of which is attached hereto; and WHEREAS, County Board desires to enter into a subcontract with the City of Dubuque (City) to perform the services required by the Agreement and City desires to provide such services through its Health Services Department. NOW, THERFORE, IT IS AGREED BY AND BETWEEN THE PARTIES AS FOLLOWS: 1. City shall perform all of the services required of the Contractor in the Agreement. 2. County Board shall pay City for its services in the same manner as County Board as Contractor will be paid for its services under the Agreement. Signed and dated the 9 day of Patrice L •ert Dubuque County Board of Health Micha'eI C. Van Milligen City Manager SUBCONTRACT BETWEEN THE CITY OF DUBUQUE, IOWA, AND THE DUBUQUE VISITING NURSE ASSOCIATION FOR THE HEALTHY HOMES AND CHILDHOOD LEAD POISONING PREVENTION PROGRAM This Subcontract between the City of Dubuque, Iowa and The Visiting Nurse Association is dated for reference purposes the 1st day of July, 2019. Whereas, Dubuque County, Iowa (Contractor) has entered into Contract 5888LP03 with the Iowa Department of Public Health for Public Health (the Department) for the Healthy Homes (HH) and Childhood Lead Poisoning Prevention Program (CLPPP) (the Contract), a copy of which is attached hereto, pursuant to which Contractor will provide the work and services described in the Contract in accordance with the Special Conditions therein, and the General Conditions, a copy of which is attached hereto; and Whereas, the City of Dubuque, Iowa (City) is the Contract Administrator of the Contracts between Contractor and Department; and Whereas, it is necessary for City to subcontract for certain work and services; and Whereas, City now desires to enter into this Subcontract with the Visiting Nurse Association (VNA) to provide the work and services described herein upon the terms and conditions set forth herein. NOW, THEREFORE, IT IS AGREED BY AND BETWEEN CITY AND VNA AS FOLLOWS: SECTION 1. WORK AND SERVICES. City and VNA agree to provide the following work and services (the Work and Services): 1.1. City's Responsibilities. City agrees that it will provide the following services for the HH & CLPPP: (1) Submit reports/vouchers and other reporting requirements as required by the Iowa Department of Public Health (IDPH), the Centers for Disease Control and Prevention (CDC), and the Department of Housing and Urban Development (HUD). (2) Provide for environmental investigations and environmental case management for lead abatement\lead hazard reduction and healthy homes interventions in housing units in the city of Dubuque, Iowa, and Dubuque County as referenced in the attached IDPH contract #5888LP03, dated July 1, 2019 -June 30, 2020. (3) Provide compensation to the VNA during the term of this Agreement not to exceed $7,000.00 for the performances of VNA's responsibilities as set forth herein. (4) Oversee and direct medical case management and educational/outreach activities through verbal and written direction. 1.2. VNA's Responsibilities. VNA agrees to provide the following services for Healthy Homes (HH) & Childhood Lead Poisoning Prevention (CLPPP) during the term of this Agreement for the agreed compensation: Provide written quarterly reports and billing on lead and healthy homes activities utilizing the Iowa Quarterly Report Narrative Outline and the billing form approved by the City. Provide electronic documentation of medical case management and related activities into City's lead and healthy homes database systems, Healthy Homes and Lead Poisoning Surveillance System (HHLPSS), and of educational activities performed for each month by the 10th of the following month. Provide for blood lead testing, medical case management, data management, and community education outreach as referenced in the attached IDPH contract #5888LP03, dated July 1, 2019 -June 30, 2020 using a form agreed to by the City and VNA. Enrollment as a Medicaid provider so that elevated blood level (EBL) inspection services provided by the City can be recovered under Medicaid as reimbursement and used as program income reimbursed to the City. VNA shall support the City's efforts to be a viable, livable, and equitable community, and to advance equity and inclusion. City will provide opportunities to demonstrate this support by inviting the Executive Director of the VNA and any employees working on services covered by this agreement to participate professional development opportunities and supporting activities such as: a. The opportunity to be active and engaged participants in Inclusive Dubuque peer learning opportunities and strategic efforts; b. The opportunity to attend intercultural and equity workshops offered by the City, including workshops that focus on developing an intercultural team with a strategic plan for advancing equity and inclusion within the VNA and through the VNA's work; c. Assistance in creating status reports that demonstrate the ways in which the VNA's efforts are advancing equity and inclusion; and Access to the City's equity toolkit. SECTION 2. CONTRACT POLICIES AND REQUIREMENTS. In providing the Work and Services, VNA agrees to comply with the requirements in the County Contract, including the Special Conditions, and the General Conditions, to the extent applicable to the Work and Services described in Section 1. SECTION 3. ACCESS TO BOOKS AND RECORDS. VNA to provide access, upon reasonable notice, for the purpose of audit and examination, to its documents, papers, and records, to the extent such documents, papers, and records are related to the Work and Services, to the. Department, Contractor, City, or any of their duly authorized representatives. SECTION 4. COSTS TO BE REIMBURSED. Cost reimbursed will be based on performance measures and outcomes as outlined in the attached IDPH contract #5887LP03, dated July 1, 2019 -June 30, 2020 using a form agreed to by the City and VNA. The Healthy Homes activities will be invoiced to the City for VNA staff time plus benefits at 32% through the completion of the HUD Lead Hazard Control grant. SECTION 5. INCORPORATION OF THE CONTRACT. VNA agrees that all of the provisions of the County Contract, including audit requirements, are incorporated herein by this reference and VNA shall have all of the same requirements, obligations and conditions as Contractor with respect to VNA's Work and Services. SECTION 6. PERIOD OF PERFORMANCE. Unless terminated as provided herein, the Period of Performance for the Work and Services shall be from the the 1st day of July 2019, through the 30th day of June 2020. SECTION 7. TERMINATION. Either party may terminate this Subcontract for any reason, with or without cause, upon ten (10) days written notice to the other party. In the event of termination, City shall compensate VNA for its Work and Services rendered through the date of termination. SECTION 8 INDEMNIFICATION. (1) VNA agrees to defend, indemnify, and hold Department, City and Contractor, and their officers, and employees harmless from and against any and all claims of any kind arising out of or related to VNA's negligence in the performance of the Work and Services pursuant to this Subcontract. (2) City agrees to defend, indemnify, and hold VNA and its officers, and employees harmless from and against any and all claims of any kind arising out of or related to City's negligence in the performance of the Work and Services pursuant to this Subcontract. SECTION 9. INSURANCE. VNA shall at its expense maintain insurance in compliance with City Insurance Schedule G, attached as Exhibit A. CITY OF DUBUQUE, IOWA By: Mic ael C. Van Milligen City Manager VISITING NURSE ASSOCIATION //, , By:�� Stace'ttTIlia, Administrat' e Director City of Dubuque Insurance Requirements for Vendors (Suppliers, Service Providers) INSURANCE SCHEDULE G shall furnish a signed certificate of insurance to the City of Dubuque, Iowa for the coverage required in Exhibit I prior to the contract commencement. Each certificate shall be prepared on the most current ACORD form approved by the Iowa Insurance Division or an equivalent. Each certificate shall include a statement under Description of Operations as to why the certificate was issued. Eg: Project # or purchase agreement 2. All policies of insurance required hereunder shall be with an insurer authorized to do business in Iowa and all insurers shall have a rating of A or better in the current A.M. Best's Rating Guide. 3. Each certificate shall be furnished to the Finance Department of the City of Dubuque. 4. The vendor shall be required to carry the minimum coverage/limits, or greater if required by law or other legal agreement, in Exhibit I. Failure to provide the required minimum coverage shall not be deemed a waiver of such requirements by the City of Dubuque. 5. Failure to obtain or maintain the required insurance shall be considered a material breach of this agreement. 6. All required endorsements shall be attached to certificate. 7. Whenever a specific ISO form is referenced the current edition of the form must be used unless an equivalent form is approved by the Director of Finance and Budget. The vendor must identify or list in writing all deviations and exclusions from the ISO form. 8. If vendor's limits of liability are higher than the required minimum limits then the vendor's limits shall be this agreement's required limits. 9. Vendor shall require all subcontractors and sub -subcontractors to obtain and maintain during the performance of work insurance for the coverages described in this Insurance Schedule and shall obtain certificates of insurance from all such subcontractors and sub -subcontractors. Vendor agrees that it shall be liable for the failure of a subcontractor and sub -subcontractor to obtain and maintain such coverage. The City may request a copy of such certificates from the Vendor. 10. Vendor shall be responsible for deductibles and self-insured retention. Page 1 of 4 Schedule G Vendors May 2019 City of Dubuque Insurance Requirements for Vendors (Suppliers, Service Providers) INSURANCE SCHEDULE G (continued) EXHIBIT I A) COMMERCIAL GENERAL LIABILITY General Aggregate Limit $2,000,000 Products -Completed Operations Aggregate Limit $1,000,000 Personal and Advertising Injury Limit $1,000,000 Each Occurrence $1,000,000 Fire Damage Limit (any one occurrence) $50,000 Medical Payments $5,000 1) Coverage shall be written on an occurrence, not claims made, form. The general liability coverage shall be written in accord with ISO form CG 00 01 or business owners form BP 00 02. All deviations from the standard ISO commercial general liability form CG 00 01, or Business owners form BP 00 02, shall be clearly identified. 2) Include ISO endorsement form CG 25 04 "Designated Location(s) General Aggregate Limit." 3) Include endorsement indicating that coverage is primary and non-contributory. 4) Include Preservation of Governmental Immunities Endorsement (Sample attached). 5) Include additional insured endorsement for: The City of Dubuque, including all its elected and appointed officials, all its employees and volunteers, all its boards, commissions and/or authorities and their board members, employees and volunteers. Use ISO form CG 20 10 (Ongoing operations) or its equivalent. 6) Policy shall include Waiver of Right to Recover from Others endorsement. 7) If vendor utilizes Trikkes or Segways in the conduct of business, include an endorsement reflecting that these vehicles are not excluded from Commercial General Liability coverage. 8) Policy shall include Waiver of Right to Recover from Others endorsement. B) WORKERS' COMPENSATION & EMPLOYERS LIABILITY Statutory Benefits covering all employees injured on the job by accident or disease as prescribed by Iowa Code Chapter 85. Coverage A Coverage B Statutory—State of Iowa Employers Liability Each Accident $100,000 Each Employee -Disease $100,000 Policy Limit -Disease $500,000 Policy shall include Waiver of Right to Recover from Others endorsement. Coverage B limits shall be greater if required by the umbrella/excess insurer. OR Nonelection of Workers' Compensation or Employers' Liability Coverage under Iowa Code sec. 87.22. Completed form must be attached. Page 2 of 4 Schedule G Vendors May 2019 City of Dubuque Insurance Requirements for Vendors (Suppliers, Service Providers) INSURANCE SCHEDULE G (continued) C) POLLUTION LIABILITY Coverage required: _ yes _ no Pollution liability coverage shall be required if the lessee, contracting party, or permittee has any pollution exposure for abatement of hazardous or contaminated materials including, but not limited to, petroleum products, the removal of lead, asbestos, or PCBs. Pollution product and completed operations coverage shall also be covered. Each Occurrence $2,000,000 Policy Aggregate $4,000,000 1) Policy to include job site and transportation coverage. 2) Include additional insured for: The City of Dubuque, including all its elected and appointed officials, all its employees and volunteers, all its boards, commissions and/or authorities and their board members, employees and volunteers. Use ISO form CG 20 10. (Ongoing operations) or its equivalent and CG 20 37(competed operations). 3) Include Preservation of Governmental Immunities Endorsement. 4) Provide evidence of coverage for 5 years after completion of project. D) PROFESSIONAL LIABILITY $1,000,000 Coverage required: _ yes no Provide evidence of coverage for 5 years after completion of project. E) CYBER LIABILITY $1,000,000 Coverage required: _ yes _ no Coverage for First and Third Party liability including but not limited to lost data and restoration, loss of income and cyber breach of information. F) UMBRELLA/EXCESS $1,000,000 yes _ no Umbrella liability coverage must be at least following form with the underlying policies included herein (General Liability, Automobile, Workers Compensation). Page 3 of 4 Schedule G Vendors May 2019 City of Dubuque Insurance Requirements for Vendors (Suppliers, Service Providers) PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT 1. Nonwaiver of Governmental Immunity. The insurer expressly agrees and states that the purchase of this policy and the including of the City of Dubuque, Iowa as an Additional Insured does not waive any of the defenses of governmental immunity available to the City of Dubuque, Iowa under Code of Iowa Section 670.4 as it is now exists and as it may be amended from time to time. 2. Claims Coverage. The insurer further agrees that this policy of insurance shall cover only those claims not subject to the defense of governmental immunity under the Code of Iowa Section 670.4 as it now exists and as it may be amended from time to time. Those claims not subject to Code of Iowa Section 670.4 shall be covered by the terms and conditions of this insurance policy. 3. Assertion of Government Immunity. The City of Dubuque, Iowa shall be responsible for asserting any defense of governmental immunity, and may do so at any time and shall do so upon the timely written request of the insurer. 4. Non -Denial of Coverage. The insurer shall not deny coverage under this policy and the insurer shall not deny any of the rights and benefits accruing to the City of Dubuque, Iowa under this policy for reasons of governmental immunity unless and until a court of competent jurisdiction has ruled in favor of the defense(s) of governmental immunity asserted by the City of Dubuque, Iowa. No Other Change in Policy. The above preservation of governmental immunities shall not otherwise change or alter the coverage available under the policy. SPECIMEN (DEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES) Page 4 of 4 Schedule G Vendors May 2019 Attachment 1: PROGRAM ADMINISTRATION A. Client Files 1. VNA shall review files regularly and shall assist in ensuring appropriate information and documentation is contained in each. 2. The completed/closed out files shall be located in a designated office of the City and will remain the property of the City. B. Home Advocacy Services will address individual homeowners' and residents' needs by providing education, awareness, tools and resources needed to live in an urban watershed. Services to assess general resilience needs and challenges faced by residents and businesses in the Bee Branch watershed and one-on-one interaction with residents to complete a comprehensive assessment at the household level which may include some of all of the following: 1. Meet with City or designated committee to assist in the development of standards and guidelines. 2. Compose needed forms, handbooks, etc., for program implementation. 3. Promote advertisement for applications and assist with community engagement for participation 4. Accompany inspectors, when possible to complete family intake 5. Attend collaboration meetings with City and inspection staff inputting ideas to improve process and efficiency in the program. 6. Facilitate a client -centered approach and advocate on an individual and policy level when a client is being treated unjustly. 7. Community organizing, including facilitating a community partner resource group that may include Operation New View Community Action Agency, Green and Healthy Homes Initiative (GHHI) team, NICC, Iowa Workforce Development, Crescent Community Health Center and others as program needs arise. 8. Individual/Family case management with a focus on the social indicators of health. 9. Assistance with education and referrals to increase understanding of what it means to live in a watershed, and what resources and services are available to support development, employment, education, health and neighborhood revitalization. 10. Utilize a variety of community resources and empower residents to maintain their homes in a resilient manner. Responsible for knowing community resources and referral systems 11. Recruit and coordinate volunteers from various entities such as colleges, AmeriCorps, churches, etc, for volunteer opportunities, to assist clients and provide community engagement, education and outreach. 12. Track client appropriate use of resources and services 13. Coordinate and communicate with medical case managers 14. Provide ongoing monitoring of home repairs and interventions in order to evaluate outcomes. 15. Coordinate workshops and learning methods that address financial literacy, emotional health, physical health, and environmental health 16. Provide information about the Home advocate service to funders, community-based organizations, and community and national leaders The outline captures the general scope of services, but some areas may have more detailed requirements implied, but not listed. The City may request assistance from VNA that is not specifically designated. lowa Department of Public Health • I DPH Protecting and Improving the Health of lowans Kim Reynolds Adam Gregg Gerd W. Clabaugh, MPA Governor Lt. Governor Director CONTRACT #: 5880LP03 PROJECT TITLE: FY20 Childhood Lead Poisoning Prevention Program CONTRACTOR LEGAL NAME AND ADDRESS: PROJECT PERIOD: July 1, 2019— June 30, 2020 Dubuque County Board of Health 720 Central Ave. Dubuque, lA 52001-7079 STATE OF IOWA DEPT. OF ADMINISTRATIVE CONTRACT PERIOD: July 1, 2019 —June 30, 2020 SERVICES VENDOR#: 00002128749 WarranUpayment mailing address TOTAL CONTRACT AMOUNT: $8,808.00 (if different from legal address): FUNDING SOURCE: FEDERAL: $0 STATE: $0 OTHER:$0 Interagency State: $0 Interagency Federal: $0 Private/Fees/Othe r:$0 Federal Subrecipient Addendum Needed? NO IOWA CODE CHAPTER 8F DESIGNATION: This contract is NOT covered by lowa Code chapter 8F The Contractor agrees to perform the work and to provide the services described in the Special conditions for the consideration stated herein. The duties, rights and obligations of the parties to this contract shall be governed by the Contract Documents, which include the Special Conditions, General Conditions, Request for Proposal and Application. The Contractor has reviewed and agrees to the lowa Department of Public Health General Conditions Effective Julv 1, 2019 as posted on the DepartmenYs website under Funding Opportunities or as available by contacting Kevin Officer at 515-242-5902. The contractor specifies no changes have been made to the Special Conditions or General Conditions. The parties hereto have executed this contract on the day and year last specified below. For and on behalf of the Department: For and on behalf of the Contractor: oigrczuy signeo oy snarp,Ken oigvzuy signeo oy vxnce By 5h8fp, K211 -0 oo3�,s���s�������, By Patrice Lambert ����'gos�„sos,g Ken Sharp, Director Insert Date (required if not a digital signature): Division of ADPER& EH Lucas State Office Building, 321 E. 12th Street, Des Moines, IA 50319-0075 � 515-281-7689 �www.idph.iowa.gov DEAF RELAY(Hearing or Speech Impaired)711 or 1-800-735-2942 1 Special Conditions for Contract # 5880LP03 Article I- Identification of Parties: This contract is entered into by and between the lowa Department of Public Health (hereinafter referred to as Department) and the Contractor, as identified on the contract face sheet. Article II - Designation of Authorized State Official: Ken Sharp, Director, Division of Acute Disease Prevention, Emergency Response, and Environmental Health is the Authorized State Official for this contract. Any changes in the terms, conditions, or amounts specified in this contract must be approved by the Authorized State Official. Negotiations concerning this contract should be referred to Kevin Officer, Community Health Consultant, at kevin.officer(c�idph.iowa.qov or 515-242-5902 Article III - Designation of Contract Designation of Project Director: 1 . The Contractor, as listed on the Contract Face Sheet, is responsible for financial and administrative matters of this Contract. 2. The Project Director, as designated by the Contractor and listed in Article IV — Key Personnel for Project Implementation, has the authority to manage the contract and the legal responsibility to assure compliance with all contract conditions. Negotiations concerning this contract should be referred to the Project Director. 3. The Project Director will receive key communications from the DEPARTMENT and will be responsible for keeping the Contractor and all Authorized Agencies informed of any relevant contract issues. 4. It is the Contractor's sole responsibility to ensure appropriate individual(s) have registered within IowaGrants. The Contractor acknowledges that all assigned individuals to the Grant Tracking site have full rights (add, modify, and delete) for all Grant Tracking components including contractual forms, reporting forms, and claims submission. The Contractor designates Bonnie Brimeyer as the Grantee Contact in IowaGrants (www.lowaGrants.qov) who shall regulate and assign access of appropriate individuals to this grant site. 2 Article IV — Key Personnel: The following individual(s) shall be considered key personnel for purposes of this contract: De artment Personnel Name Title Email Address Carmily Stone Bureau Chief carmilv.stone(c�idph.iowa.qov Kevin Officer Program Contract kevin.officer(c�idph.iowa.qov Manager Ke Contractor Personnel Name Title Email Address Patrice Lambert Project Director patrice.lambert@dubuquecounty.us Sharon Gaul Program Coordinator sgaul@cityofdubuque.org Mary Rose Corrigan Finance Manager mcorriga@cityofdubuque.org Mary Rose Corrigan Data Manager mcorriga@cityofdubuque.org Tim Link, Maddy Haverland Certified EBL tlink@cityofdubuque.org, Inspector/Risk Assessor Mhaverla@cityofdubuque.org The Contractor shall notify the department in writing within ten (10) working days of any change of Key Personnel identified in this section. Article V - Statement of Contract Purpose: The purpose of this contract is to provide funds for the Contractor to ensure that childhood lead poisoning prevention activities are conducted as specified in this contract and in compliance with lowa Administrative Code (IAC) 641— Chapter 72. Article VI - Description of Work and Services: CLPPP SERVICE AREA The CLPPP service area is Dubuque County DESIGNATED AGENCY Dubuque County Health Department 13047 City View Drive Dubuque, IA 52002 3 CLPPP Activities and Services In compliance with the Department-approved work plan within IowaGrants, the Contractor shall: A. Blood Lead Testing 1 . Ensure that all children under the age of six years receive blood lead testing according to the Childhood Lead Poisoning Prevention Program (CLPPP) protocols. 2. Ensure medical providers, Title V Child Health, WIC, Community Empowerment, and other programs within their jurisdiction conduct initial and follow-up blood lead testing according to CLPPP protocols. 3. Ensure parents, guardians, and caregivers are informed of the results of blood lead testing of all children tested within their jurisdiction. B. Medical Case Management 1 . Coordinate medical case management services and activities within the jurisdiction, as prescribed according to CLPPP protocols, with medical providers, Title V Child Health, WIC, Community Empowerment, and other child health programs that may be involved in the management of lead- poisoned children. 2. Document all clinical case management activities occurring within the jurisdiction in the Healthy Homes & Lead Poisoning Surveillance System (HHLPSS) for children with blood lead levels greater than or equal to 10 micrograms per deciliter (�ag/dL). C. Environmental Case Management 1 . Coordinate environmental case management activities and services within the jurisdiction. 2. Ensure elevated blood lead (EBL) inspections occur in dwellings associated with an EBL child. Ensure EBL inspections are conducted by an lowa certified EBL inspector/risk assessor. 3. Ensure follow-up inspections are conducted to verify if lead-based paint hazards identified during an EBL inspection have been remediated. 4. Enrollment as a Medicaid provider or have an agreement with an agency that is a Medicaid provider so that elevated blood lead (EBL) inspection services can be recovered under Medicaid as reimbursement and used as program income. 5. Adoption of local lead hazard codes or regulations within the jurisdiction requiring hazards to be repaired in the homes of EBL children. A model code is available at lowa Administrative Code 641—Chapter 68. Applicants may adopt this model code by reference. Local regulations must be as protective as lowa Administrative Code 641—Chapter 68. 6. Documentation of all environmental case management activities occurring within the jurisdiction in HHLPSS. D. Data Management 1 . Ensure that all case management actions for children with blood lead levels greater than or equal to 10 �ag/dL occurring within the jurisdiction, such as contact with the family or provider, EBL inspections, lead 4 hazard remediations, home nursing or outreach visits, nutrition evaluations, and developmental assessments, be recorded weekly in the HHLPSS database according CLPPP protocols. 2. Ensure all reports specified in ARTICLE VIII — REPORTS are provided by the deadlines given in this contract. 3. Facilitate the reporting of blood lead samples analyzed by medical providers, hospitals, clinical labs, and other health care facilities. lowa Administrative Code 641-1 .6 requires all Blood lead results less than 20 micrograms per deciliter (�ag/dL) be reported to the Department on a weekly basis, and results equal to or greater than 20 �ag/dL be reported daily. 4. All requests for CLPPP data needed to support the local CLPPP and fulfill the requirements of this contract be submitted to the Department in a timely manner using the Lead Data Request form in Appendix II. 5. Assist the Department in ensuring all patient and address records in HHLPSS are complete and accurate. 6. Notify the Department of HHLPSS database errors and missing records immediately. 7. Records and data are managed according to the following: a. Data Use. All records and data provided by this contract shall be used only for purposes as set forth in the contract. The Contractor shall not use or permit others to use the records and data in any way except for the purposes outlined in this contract. b. Data Storage. All records and data received pursuant to this contract shall be stored in a secure locked area with access restricted to project personnel for purposes only as set forth in Article VII of this Contract. Contractor shall comply with Department and State information technology standards. i. Data Backup Standard: Applicable to Entities which utilize data systems to process, store, transmit or monitor information. ii. Data Stewardship Standard: Applicable to Entities which utilize data systems to process, store, transmit or monitor information. iii. Interconnectivity Standard: Applicable to Entities which utilize data systems to process, store, transmit or monitor information. iv. Laptop Data Protection Standard: Applicable to Entities which utilize laptops to process, store, transmit or monitor data. v. Removable Storage Encryption Standard: Applicable to Entities which utilize removable storage devices to process, store, transmit or monitor information. Current state information technology standards are accessible online at https://ocio.iowa.qov/standards. c. Confidentiality. Contractor shall maintain the confidentiality of all confidential records and data released pursuant to this Contract. Contractor shall not disclose any confidential 5 information contained in these records or data, including but not limited to names and other identifying information of persons who are the subject of such records, either during the period of this Contract or hereafter. All identifiable and personal indicators shall be kept strictly confidential and shall not be used or released for any purpose. Contractor shall immediately report to IDPH any unauthorized disclosure of confidential information. Such disclosure shall be grounds for immediate termination of this Contract. d. Ownership. Records and data provided by IDPH to Contractor, and any files related by linking these data files, pursuant to this Contract shall remain the property of the IDPH at all times. e. Re-release. Contractor may not re-release data provided by this contract without expressed written permission from IDPH. Data provided by this contract is for use solely by the Contractor and only for the purposes outlined in this contract. f. Aggregate Data Publication. The Contractor agrees to provide a copy of all proposed publications to IDPH at least thirty (30) days in advance of the proposed dissemination date. The publication shall not be published in any format without the prior written consent of IDPH. Any publication of aggregate data shall comply with IDPH confidentiality guidelines, including IDPH Policy for Release of Confidential Public Health Records. i. If the Contractor is associated with an lowa regent institution, the Contractor agrees to comply with the conditions regarding publications and presentations contained in Section 8(b) "i" of the General Conditions for Contracts with State Universities, effective August 17, 2017. ii. If Contractor is not associated with an lowa regent institution, Contractor agrees to provide a copy of the proposed publication to IDPH at least thirty (30) days in advance of the proposed dissemination date. The publication shall not be published in any format without the prior written consent of IDPH. g. Data Linkage. Contractor may not link the data provided by this contract to any other dataset without express written permission from IDPH. E. Education/Outreach 1 . The Contractor shall develop and implement an education, outreach, and training program that provides information about childhood lead poisoning to members of the community, including parents, medical providers, property owners, and community policy makers within their jurisdiction. 2. Organize an annual meeting or training session with partners, stakeholders, and programs (e.g., early childhood education programs, 6 social services, school systems, public housing agencies, etc.) that provide services or housing to children. Meetings should engage partners in strategizing, planning, developing, and implementing lead- related activities and services within their jurisdiction. 3. Assure medical providers, hospitals, and other child health programs educate parents and guardians on a child's blood lead test results and provide information on how-to eliminate or minimize future lead exposures. 4. Develop community partnerships to address childhood lead poisoning prevention within the jurisdiction you are applying. 5. Conduct education and outreach campaigns to raise public awareness about lead-related issues. 6. Connect parents and guardians of lead-exposed children to services that can provide assistance in addressing lead-related issues. F. Training 1 . The Contractor shall send at least one individual to attend a CLPPP regional meeting. Travel expenses are the responsibility of the successful applicant. The Department will reimburse travel expenses up to the limits established by lowa Department of Administrative Services and outlined in Article X. G. Reporting 1 . The Contractor shall provide Quarterly Progress Reports to IDPH on the IowaGrants.gov web site. The quarterly progress report shall include data and details about CLPPP program activities and services provided within the CLPPP service area in the quarter in which claims are being submitted for reimbursement. Quarterly progress reports must be submitted by: October 30, 2019, January 31 , 2020, April 30, 2020, and July 31 , 2020. 2. The Contractor shall submit quarterly claims to IDPH in IowaGrants.gov. Quarterly claims must be submitted by: October 30, 2019, January 31 , 2020, April 30, 2020, and July 31 , 2020. H. Program Maintenance 1 . The Contractor shall submit a plan of action to the department prior to discontinuing the program. The plan must describe how the program will be continued on a maintenance basis during this transition period. Article VII — Performance Measure Reimbursement under the contract will be based upon: 1 . Timely submission of quarterly claims and quarterly reports. 2. Quarterly progress reports must describe the level of efforts towards meeting each deliverable outlined in the budget section. a. The narrative description in the quarterly progress report must describe the contractor's efforts to meet the performance measures/goals outlined foreach deliverable, along with barriers encountered. 7 b. The Department may request additional information from the Contractor to satisfy documented efforts through progress report negotiation or other means as appropriate. 3. All deliverables must meet Department approval prior to payment of the reimbursement. Failure to provide deliverables meeting Department satisfaction may result in non-payment of a corresponding deliverable. If needed, call your contract administrator for assistance in writing a performance measure. The Contractor shall submit any documentation required for the performance measure into the progress reports component of the grant site within IowaGrants.gov. Article VIII — Reports: The Contractor shall complete and submit the following reports in the grant site located in IowaGrants. Report Title Form Frequency/Type Date Due Quarterly Progress Report (submitted Quarterly October 30, 2019, through grantsite.) January 31 , 2020, April 30, 2020, July 31 , 2020 Quarterly Performance Measure Quarterly October 30, 2019, D8t8 RepOPt (Prepared by IDPH and January 31 , 2020, uploaded to grant site.) Apl'll 30, 2020, July 31 , 2020 Quarterly Case Management Report Quarterly October 30, 2019, (Prepared by IDPH and uploaded to grant January 31 , 2020, site.) April 30, 2020, July 31 , 2020 Quarterly Claim and Support Quarterly October 30, 2019, Documentation Report (if January 31 , 2020, applicable) April 30, 2020, July 31 , 2020 Article IX - Budget: Deliverable-based Reimbursement Reimbursement under this contract will be deliverable-based. These amounts are all inclusive and no other costs or expenses will be provided. 8 Deliverable Performance Measures/Goals Due Dates Fixed (description) Cost A. Documented A1. Increase the number of children in the CLPPP Quarterly 20% of efforts to increase service area between the ages of 12 and 35 months (Q1, Q2, allocated blood lead testing, if who had a blood lead test. Q3, Q4) funds/4 population available. A2. Increase the percentage of children in the CLPPP service area before the age of 6 who receive a blood lead test. B. Documented B3. Ensure that at least 95% of children with Quarterly 25% of efforts to ensure capillary blood lead levels greater than or equal to (Q1, Q2, allocated follow up blood lead 20 �ag/dL receive confirmatory venous blood lead Q3, Q4) funds/4 testing for elevated tests within the scheduled time frame according to blood lead levels. CLPPP protocols. B4. Ensure that at least 75% of children with capillary blood lead levels greater than or equal to 10 �ag/dL receive confirmatory venous blood lead tests within the scheduled time frame according to CLPPP protocols. B5. Ensure that at least 75% of children confirmed with an initial case making blood lead level between 10-14 �ag/dL receive follow-up testing at an interval of 12 weeks/84 days. 9 Deliverable Performance Measures/Goals Due Dates Fixed (description) Cost C. Documented C6. Ensure that at least 95% of children confirmed Quarterly 30% of efforts to ensure with an initial case making blood lead level greater (Q1, Q2, allocated referral and than or equal to 15 �ag/dL receive a home nursing or Q3, Q4) funds/4 delivery of services outreach visit within the scheduled time frame for elevated blood according to CLPPP protocols. lead levels. C7. Ensure that at least 95% of children confirmed with an initial case making blood lead level greater than or equal to 15 �ag/dL receive a nutrition evaluation within the scheduled time frame according to CLPPP protocols. C8. Ensure that 100% of children with an initial case making venous blood lead level greater than or equal to 20 �ag/dL receive a complete medical evaluation from a physician. C9. Refer 100% of children with confirmed blood lead levels greater than or equal to 15 �ag/dL to the local Area Education Agency for the appropriate developmental testing, evaluation, and assessment. C10. Ensure that at least 95% of children confirmed with an initial case making blood lead level greater than or equal to 20 �ag/dL receive the appropriate developmental testing, evaluation, and assessment from their local Area Education Agency. D. Documented D11. Complete environmental investigations for Quarterly 20% of efforts to ensure 100% of homes associated with children having (Q1, Q2, allocated environmental venous blood lead levels greater than or equal to 20 Q3, Q4) funds/4 follow up services 1�9�dL or persistent blood lead levels from 15-19 for elevated blood 1�9�dL within scheduled time frame. lead levels. D12. Contact at least 95% of the occupants and/or owners of dwellings where lead hazards have been identified within 30 days of the initial investigation to check their progress towards making the dwelling lead-safe. D13. Follow up on 100% of investigations completed in previous years at least once every 12 months (annually) until lead hazard remediation has been completed. 10 Deliverable Performance Measures/Goals Due Dates Fixed (description) Cost E. Documented E14. Give presentations about childhood lead Quarterly 5% of efforts of poisoning prevention to each ofthe following groups (Q1, Q2, allocated community at least once during the contract period: Q3, Q4) funds/4 outreach and A. Members of targeted high risk education related populations and those who work for to childhood lead agencies that provide service to these poisoning. high risk populations. B. Members of the general public, including homeowners, landlords, Realtors, and members of community organizations. C. Health professionals and para- professionals, including physicians, nurses, and laboratory technicians. Total Fixed Cost: $ (100% of al located funds) The Contractor shall receive written approval from the Department prior to spending the final three (3) percent of all funds awarded. Article X - Payments: 1 . Submission of Claims for contract period: The Contractor shall complete and submit a claim quarterly for activities and services occurring during that period of time. The claim shall be submitted in the grant site located in IowaGrants by: October 30, 2019, January 31 , 2020, April 30, 2020, and July 31 , 2020. The Department shall verify the Contractor's performance of the provision of Services/Deliverables and timeliness of claims before making payment. The Department may elect not to pay claims that are considered untimely. 2. End of State Fiscal Year Claims Submission: Notwithstanding the timeframes above, and absent: i. longer timeframes established in federal law or ii. the express written consent of the Department, the Contractor shall submit all claims to the Department by August 10th for all services performed in the preceding state fiscal year (the State fiscal year ends June 30). The Department will not automatically pay end of state fiscal year claims that are considered untimely. If the Contractor seeks payment for end of state fiscal year claim(s) submitted after August 10th, the Contractor may submit the late claim(s), as well as a justification for the untimely submission. The justification and request for payment must be submitted within the Correspondence component of this grant site. The Department may reimburse the claim if funding is available after the end of the 11 fiscal year. If funding is not available after the fiscal year, the claim may be submitted to State Appeal Board in accordance with instructions for consideration. Instructions for this process may be found at: http://www.dom.state.ia.us/appeals/qeneral claims.html. 3. The Department shall pay all approved invoices/claims in arrears. The Department may pay in less than sixty (60) days, but an election to pay in less than sixty (60) days shall not act as an implied waiver of lowa law. 4. Final payment may be withheld until all contractually required reports have been received and accepted by the Department. At the end of the contract period, unobligated contract amount funds shall revert to the Department. 5. Warrants (payments) for services provided under this contract will be made payable to the Contractor and mailed to the Contractor at the Contractor Legal Address as listed on the contract face page. a. If the Contractor authorizes payments under this contract to be mailed to an address other than the Contractor Legal Address, the Contractor shall provide that address to the Department in the Alternate Mailing Address portion of the Business Organization Form — Contact Information section of the grant site form found in IowaGrants. b. This address will be inserted in the 'Warrant/payment mailing address (ifdifferent from legal address)' field on the contract face page. 6. All funding payable to the Contractor must be received by the County Treasurer Office [lowa Code 331 .552(1)] and credited to the general fund of the county [lowa Code 331 .427(1)]. If the Department is made aware the funding payable to the Contractor is deposited into an account other than County Treasury, all current and future contractual funds issued by the Department (regardless of contractual program) will be delivered to the Contractor only via Electronic Fund Transfer (EFT) or by mailing the warrant to the Contractor if the EFT option has not been activated by the Contractor. 12 Article XI — Additional Conditions 1 . All work plan revisions must be approved by the Department prior to implementation. Requests for work plan revisions must be received by the department on or before May 31 , 2020. 2. XRF analyzers that were originally purchased, in part or in whole, with lowa Department of Public Health grant funds, are to be shared with other elevated blood lead (EBL) inspector/risk assessors that have a contract with the Childhood Lead Poisoning Prevention program. This sharing is to be at no cost other than their travel to pick up and deliver the machine. Programs are strongly encouraged to also share the XRF analyzers with government and private, non-profit housing agencies that employ appropriately certified inspector/risk assessors. Any fees received for sharing the machine with government and private, non-profit housing agencies are considered program income that shall be returned to the lead program and used to enhance lead program efforts. 3. As a condition of the contract, the Contractor shall assure linkage with the local board of health in each county where services are provided. The Contractor will assure that the local board of health has been actively engaged in planning for, and evaluation of, services. It will also maintain timely and effective communications and ongoing collaboration with the local board of health in each county where services are provided. 4. Funds may not be spent for: a. indirect costs, b. chelation or other medical treatment of lead poisoning, c. lead hazard remediation, d. blood lead analyses that could be reimbursed by Medicaid, e. environmental inspections (EBL inspections, clearance inspections) that could be reimbursed by HUD or any other program that reimburses for these services. 13 APPENDIX I Mandatory Reporting of Blood Lead Level Results 14 APPENDIX I Mandatory Reporting of Blood Lead Level Results lowa Administrative Code Sec. 641-1.6(3) states that for blood lead testing, "...analytical results shall be reported to the department at least weekly in an electronic format specified by the department." We suggest you use the Lead Care Reporting Software available through Magellan, the company which manufactures the LeadCare II machine. Here is a link to download the Lead Care Reporting software (if clicking on the link doesn't work, just copy and paste into your browser): http://www.leadcare2.com/Product-Support/Reportinq-Solutions Also included in the link are some instructions on using the software developed by Magellan, and the specifications for reporting for the State of lowa. If you need additional help, IDPH can connect you with other LeadCare II user locations. Here are the pieces of information that are required for each result reported: Name Date of Sample Date of Birth Sample Type (Capillary or Venous) Street Address or PO Box Numerical Result City Provider Name State Facility Name (draw location) Zip Lab Name Race Ethnicity Sex (This information is required by the Lead Poisoning Prevention Program at the federal Centers forDisease Control.) Critical things to keep in mind: 1 . lowa Code requires weekly reporting of all blood lead tests. 2. You must inform us immediately via phone call at 1-800-972-2026 or by fax at 1-515- 281-4529 of any test results at 20 or above. (These more critical levels require that our staff or local public health staff follow up with the child's family and/or care provider in a timely manner.) 3. Reporting must be done electronically in a format specified by the Department. We currently accept three specified formats: HL7 (the standard reporting format used by healthcare information systems), the XML format produced by the LeadCarell Software manufactured by Magellan, Inc., and the Excel spreadsheet attached to your weekly reminder. 4. Reporting must be done via a secure e-mail channel using the State of lowa's Secure Mail system. What follows is a set of instructions on using this system. 15 Sending Blood Lead Level Results via the State of lowa's Secure Mail system You will be receiving a scheduled message on Monday of each week as a reminder to report your lead tests. The message will contain the image below and prompt you to click on a hyperlink to read the message. You have received a secure email from the State of lowa. 1 . When you click on the hyperlink, you will be taken to a login page where you will be required to create an new account — THIS IS A ONE-TIME PROCESS 2. You will be guided step-by-step through this process; CAREFULLY READ THE INSTRUCTIONS NOTE: for additional details on lowa.gov SecureMail, see the user guide at:_ http://das.ite.iowa.qov/docs/infrastructure/External User Guide to Secure Email Svst em.pdf 3. DOCUMENT AND SAVE YOUR SecureMail CREDENTIALS FOR FUTURE USE 4. Login to your lowa.gov SecureMail account 5. Open the MOST CURRENTLY received message with "IDPH Lead Reporting" inthe subject line Reporters that use the LeadCare011 soflware to create a reporting �le • just need to reply to the SecureMail message and attach the reporting file to the reply by clicking on the 'Attach' button near the top of the message window • click the 'Send' button to send the message Reporters that use an Excel template for reporting: • Stop usinq all previous reportina templates and spreadsheets • When you access the SecureMail message, please open the attachment located at the bottom of the screen and save this to a location with which you are familiar (Desktop on your computer or a familiar network location) — If you are a laboratory that currently submits an Excel template you should have received an example of this template in a previous email from IDPH. • Open the NEW TEMPLATE and enter your lead reporting information • Save the template • Attach the newly saved file to the reply by clicking on the 'Attach' button near the top of the message window • Click the 'Send' button to send the message 16 Appendix II Lead Data Request Form �� LEAD DATA REQUEST oareo� ���uc 0 oarerea���w�. 0 ...... .. .. . ..... . ..... . ..... .......... . ... .. . ... .. CONTACTINFORMATION: Name wogrem'. PM1onenumber: •.�.�. �.�. r .�.�. � .�.« a .�.�. u�.� .�.�. � .�.r. � .�.r. SERV ICE REpUEST: Service TyFe: Pormat of Dala Pwpo6e Access �o Datd Data Repues�etl� a.�.�. �.�. � .�.�. � .�.�. � .�.�. �.a.� .�.�. � .�.�. � .�.a. Submi\ complMed fo�m ta Rob Walke� a\: Rob¢rt.Walke��IDPH.Iawa.gov THANK VOU- V011! IBQI125I WIII bB P(OCB662010IbB 0(U2(II Wd6 (BCBIVPO. 18