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Visiting Nurses Association (VNA) - Lead & Healthy Homes Contract Copyright 2014 City of Dubuque Consent Items # 12. ITEM TITLE: Visiting Nurses Association (VNA)- Lead & Healthy Homes Contract SUMMARY: City Manager recommending approval of an agreement with the Dubuque Visiting Nurse Association for services related to the Housing and Urban Development(HUD) Lead Hazard Control and Healthy Homes Program. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Approve ATTACHMENTS: Description Type Lead & Healthy Homes Contract with VNA-MVM Memo City Manager Memo Staff Memo Staff Memo Subcontract, Lead Contract, Home Adwcate Supporting Documentation Description THE CITY OF Dubuque UBE I erica .i Masterpiece on the Mississippi 2007-2012-2013 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Iowa Department of Public Health Childhood Lead Poisoning and Healthy Homes Funding and Agreement with the Visiting Nurse Association DATE: March 29, 2016 Public Health Specialist Mary Rose Corrigan recommends City Council approval of an agreement with the Dubuque Visiting Nurse Association for services related to the Housing and Urban Development (HUD) Lead Hazard Control and Healthy Homes Program. The subcontracted funds will allow the Health and Housing & Community Development Departments to provide additional follow-up of families in the homes where lead and healthy homes work is occurring through contracted nursing and social work services related to the Home Advocate role provided by the Dubuque Visiting Nurse Association. Because the contract for the HUD Resiliency Grant will begin approximately July 1, 2016, the Home Advocate proposed in this agreement is temporary until an RFP can be issued for both projects. I concur with the recommendation and respectfully request Mayor and City Council approval. Micliael C. Van Milligen MCVM:jh Attachment cc: Barry Lindahl, City Attorney Cindy Steinhauser, Assistant City Manager Teri Goodmann, Assistant City Manager Mary Rose Corrigan, Public Health Specialist THE CITY OF Dubuque DUB E 1IIIIr Masterpiece on the Mississippi Qp .M2-WU TO: Mike Van Milligen, City Manager FROM: Mary Rose Corrigan, Public Health Specialist SUBJECT: Iowa Department of Public Health (IDPH) Childhood Lead Poisoning and Healthy Homes Funding and Agreement with the Visiting Nurse Association (VNA) DATE: March 29, 2016 INTRODUCTION This memorandum provides information regarding an agreement with the VNA for services related to the HUD Lead Hazard Control and Healthy Homes Program. BACKGROUND Since being funded by HUD for the Lead Based Paint grant, the City has had agreements with the Dubuque VNA for medical case management, blood lead testing, and outreach and education. The agreement has paid grant funds to VNA for these services related to the HUD Lead Hazard Control Grant. For the current HUD lead grant, we are expanding the VNA's scope of services to provide the Home Advocate for a six month period. This six month period will allow the city to determine how the Home Advocacy role and activities will be provided for the HUD Resiliency Grant, and whether they will be combined with the HUD Lead Hazard Control Grant. DISCUSSION The subcontracted funds will allowthe Health and Housing and Community Development Departments to provide additional follow-up of families in the homes where lead and healthy homes work is occurring through contracted nursing and social work services related to the Home Advocate role provided by the Dubuque Visiting Nurse Association. Because the contract for the HUD Resiliency Grant will begin approximately July 1, 2016, the Home Advocate proposed in this agreement is temporary until an RFP can be issued for both projects. BUDGETIMPACT The HUD Lead and Healthy Homes budget anticipated funding a maximum of $54,000 over the project period, through November 15, 2018. The VNA will be paid a maximum of $9,000 for this contract period. 1 RECOMMENDATION It is recommended that City Council Action authorize the City Manager to sign the attached agreement with the Dubuque Visiting Nurse Association on behalf of the City of Dubuque. CITY COUNCIL ACTION Authorize the City manager to sign the attached agreement. MRC/Ih cc Alvin Nash, Housing Services Manager Kim Glaser, Healthy Homes Program Manager 2 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 1 sc day of March, 2016. Whereas, the City has entered into a contract with the Department of Housing and Urban Development (HUD) for lead hazard reduction and Healthy Homes activities to improve the housing conditions for participating clients and property owners; and Whereas, the City of Dubuque, Iowa (City) is the Contract Administrator of the Contracts; 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 agreesthat it will provide the following services forthe 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. (3) Provide compensation to the VNA during the term of this Agreement not to exceed $9,000 for the performances of VNA's responsibilities as set forth herein. (4) Oversee and direct medical case management, healthy homes remediation, and educational/outreach activities through verbal and written direction. 1 .2. VNA's Responsibilities. VNA agrees to provide the following services for HH & CLPPP during the term of this Agreement for the agreed compensation: (1) Provide written reports on lead and healthy homes activities utilizing a form provided by the City. (2) Provide electronic documentation of medical case management, home advocacy, and related activities into City's lead and healthy homes database systems, HHLPSS, the Green and Healthy Homes Institute (GHHI) database ETO and of educational activities performed for each month by the 10th of the following month. (3) Provide for blood lead testing, medical case management, data management, and community education as referenced in the attached IDPH contract #5886LP03, dated July 1 , 2015-June 30, 2016. (4) Provide for Home Advocate activities as described in the attached Home Advocate job description. SECTION 2. CONTRACT POLICIES AND REQUIREMENTS. In providing the Work and Services, VNA agrees to comply with the requirements in the Contract, including the Special Conditions, and the General Conditions, to the extent applicable to the Work and Services 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. Attached hereto is a line item CLLLP/HH Performance Measure budget of specific costs to be reimbursed under this Subcontract or other cost basis for determining the amount of the Subcontract. The Healthy Homes activities will be invoiced to the City for VNA hourly rate. SECTION 6. INCORPORATION OF THE CONTRACT. VNA agrees that all of the provisions of the Contract, including audit requirements, are incorporated herein by this reference and VNA shall have all of the same requirements, obligations and conditions as Contractor with respect to VNA's Work and Services. SECTION 6. PERIOD OF PERFORMANCE. Unless terminated as provided herein, the Period of Performance for the Work and Services shall be from the 1 st day of March 2016, through the 31 st day of August 2016. SECTION 7. TERMINATION. Either party may terminate this Subcontract for any reason, with or without cause, upon ten (30) 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 with the same coverage which Contractor is required to maintain under Part 13 of the General Conditions. CITY OF DUBUQUE, IOWA VISITING NURSE ASSOCIATION By: By: Michael C. Van Milligen Stacey Killian City Manager Administrative Director City of Dubuque Insurance Requirements for Professional Services Insurance Schedule C 1. shall furnish a signed Certificate of Insurance to the City of Dubuque, Iowa for the coverage required in Exhibit I prior to commencing work and at the end of the project if the term of work is longer than 60 days. Providers presenting annual certificates shall present a Certificate at the end of each project with the final billing. Each Certificate shall be prepared on the most current ACORD form approved by the Iowa Department of Insurance or an equivalent. Each certificate shall include a statement under Description of Operations as to why issued. Eg: Project# or Lease of premises at or construction of 2. All policies of insurance required hereunder shall be with a carrier authorized to do business in Iowa and all carriers 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 contracting department of the City of Dubuque. 4. Failure to provide minimum coverage shall not be deemed a waiver of these requirements by the City of Dubuque. Failure to obtain or maintain the required insurance shall be considered a material breach of this agreement. S. Subcontractors and sub subcontractor performing work or service shall provide a Certificate of Insurance in accord with Exhibit 1. 6. All required endorsements to various policies shall be attached to Certificate of insurance. 7. Whenever a specific ISO form is listed,an equivalent form may be substituted subject to the provider identifying and listing in writing all deviations and exclusions that differ from the ISO form. 8. Provider shall be required to carry the minimum coverage/limits, or greater if required by law or other legal agreement, in Exhibit 1. 9. Whenever an ISO form is referenced the current edition of the form must be used. City of Dubuque Insurance Requirements for Professional Services Insurance Schedule C (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 a) Coverage shall be written on an occurrence, not claims made, form. All deviations from the standard ISO commercial general liability form CG 0001,or Business owners form BP 0002,shall be clearly identified. b) Include ISO endorsement form CG 25 04"Designated Location(s)General Aggregate Limit" or CG 25 03 "Designated Construction Project(s)General Aggregate Limit"as appropriate. c) Include endorsement indicating that coverage is primary and non-contributory. d) Include endorsement to preserve Governmental Immunity. (Sample attached). e) Include an endorsement that deletes any fellow employee exclusion. f) 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 2026. B) AUTOMOBILE LIABILITY $1,000,000(Combined Single Limit) C) WORKERS'COMPENSATION& EMPLOYERS LIABILITY Statutory benefits covering all employees injured on the job by accident or disease as prescribed by Iowa Code Chapter 85 as amended. Coverage A Statutory—State of Iowa Coverage B Employers Liability Each Accident $100,000 Each Employee-Disease $100,000 Policy Limit-Disease $500,000 Policy shall include an endorsement providing a waiver of subrogation to the City of Dubuque. Coverage B limits shall be greater if required by Umbrella Carrier. D) UMBRELLA LIABILITY $1,000,000 Umbrella liability coverage must beat least following form with the underlying policies included herein. E) PROFESSIONAL LIABILITY $1,000,000 Page 2 of 3 Schedule C, Professional Services April, 2013.Doc City of Dubuque Insurance Requirements for Professional Services Preservation of Governmental Immunities Endorsement 1. Nonwaiver of Governmental Immunity.The insurance carrier 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 insurance carrier 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 insurance carrier. 4. Non-Denial of Coverage.The insurance carrier shall not deny coverage under this policy and the insurance carrier 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 Preservation of Governmental Immunities Endorsement 1. Nonwaiver of Governmental Immunity. The insurance carrier 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 insurance carrier 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 insurance carrier. 4. Non-Denial of Coverage. The insurance carrier shall not deny coverage under this policy and the insurance carrier 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 Iowa Department of Public Health • IDPH Promoting and Protecting the Health of Iowans Gerd W. Clabaugh, MPA Terry E. Branstad Kim Reynolds Director Governor Lt. Governor CONTRACT#: 5886LP03 PROJECT PERIOD: July 1, 2015-June 30, 2016 PROJECT TITLE: Childhood Lead Poisoning Prevention CONTRACT PERIOD: July 1, 2015-June 30, 2016 Program FUNDING SOURCE OF IDPH: CONTRACT AMOUNT: $6454 FEDERAL: $0 STATE: $6454 STATE OF IOWA DEPT. OF ADMINISTRATIVE OTHER:$0 SERVICES VENDOR#: 00002128749 FEDERAL CATALOG#: NA CONTRACTOR Name and Address: Dubuque County Board of Health MATCH REQUIRED: YES❑ NO❑ NAF-1 720 Central Ave. Dubuque, IA 52002 FFATA REPORT REQUIRED YES❑ NO❑ CONTRACT ADMINISTRATOR: Name: Patrice Lambert Email: patrice.lambengdubuquecounty.us IOWA CODE CHAPTER 8F DESIGNATION: DESIGNATED AGENCY Name and Address: F-1This contract is covered by Iowa Code chapter 8F Dubuque County Health Department 13047 City View Drive ❑ This contract is NOT covered by Iowa Code chapter 8F Dubuque, IA 52002 ❑ At the time of execution, this contract is NOT covered Phone: 563-557-7396 by Iowa Code chapter 817, but if the Contractor executes Fax 563-587-3899 additional contracts with the Department, the aggregate of which exceed$ 500,000,the contract may be covered 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 General Conditions effective May 1, 2014 as posted on the Department's Web site under Funding Opportunities: www.idphstate.ia.us 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: By: By Ken Sharp,Director Dubuque County Board of Health Chair Division of ADPER&EH Lucas State Office Building, 321 E. 12th Street, Des Moines, IA 50319-0075 ■ 515-281-7689 ■ w Jdph.state.ia.us DEAF RELAY(Hearing or Speech Impaired) 711 or 1-800-735-2942 SPECIAL CONDITIONS FOR CONTRACT#5886LP03 ARTICLE I—IDENTIFICATION OF PARTIES Dubuque County Board of Health(hereinafter referred to as the CONTRACTOR)has demonstrated through application to the DEPARTMENT that it is prepared to provide the activities and authority outlined per Iowa Administrative Code(IAC)641 Chapter 72. The CONTRACTOR has designated Dubuque County Health Department(hereinafter referred to as the DESIGNATED AGENCY),to carry out the activities as required in IAC 641-72.2(3) and described in this contract. The address of the DESIGNATED AGENCY is: 13047 City View Drive,Dubuque, IA 52002 ARTICLE II—IDENTIFICATION OF AUTHORIZED STATE OFFICIAL: Ken Sharp,Director,Division of Acute Disease Prevention,Emergency Response,&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.officerAidyh.iowa.¢ov or 515-242- 5902. ARTICLE III—DESIGNATION OF AUTHORITY,CONTRACT ADMINISTRATOR,AND KEY PERSONNEL The CONTRACTOR,as listed on the contract face sheet,is responsible for financial and administrative matters of this contract. The CONTRACTOR has designated the Contract Administrator listed on the contract face sheet the authority to manage the contract,to assure compliance with all conditions,and to negotiate matters concerning this project. The Contract Administrator will receive key communications from the DEPARTMENT and will be responsible for keeping the CONTRACTOR and all authorized agencies informed. In addition to the CONTRACTOR and the Contract Administrator,additional individuals(s)as listed below shall be considered key personnel and may sign claims. Table A: Name Title Patrice Lambert Agency Director Patrice Lambert Program Administrator Bonnie Brime er Finance Manager Laura Hankes Data Entry Clerk Michelle Zurcher Nurse Rose Corrigan,Ben Pothoff, Certified Elevated Blood Lead(EBL)Inspector/Risk Assessor ARTICLE IV—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 IAC 641 Chapter 72. ARTICLE V-DEFINITIONS DEFINITIONS "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. "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. "Community partnership"means a collaborative relationship between entities to address healthy homes issues and lead poisoning prevention in the CLPPP service area. "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,documenting all case 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 Healthy Homes and Lead Poisoning Surveillance System(HI LPSS)database,and providing all HHLPSS reports required by this contract. "Developmental testing"means testing done by the local Early Access Program or Area Education Agency to determine whether a child is developmentally delayed. "Education and outreach"means seeking out and providing information regarding childhood lead poisoning and healthy homes 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 level greater than or equal to 20 micrograms per deciliter(µg/&)or at least two venous blood lead levels of 15 to 19 µg/&. `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 µg/&. "HHLPSS"means the Healthy Homes and Lead Poisoning Surveillance System web based case management program. "Healthy homes planning"means assessing housing issues other than lead in the community, developing a network of service providers that could assist with housing issues other than lead, and participating in a state or local healthy homes and lead poisoning prevention program advisory group or coalition. "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. "Laboratory"means a laboratory certified to perform either waived or non-waived blood lead analysis according to the federal Clinical Laboratory Improvement Act of 1988(CLIA). "Lead-based paint 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. `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 µg/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 healthy homes and 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 VII. "Referral"means to direct the family of a lead-poisoned to a service for the family or the child and to follow-up to assure that the family actually received the service. "Venous"means a blood sample taken from a vein in the arm for lead analysis. ARTICLE VI—DESCRIPTION OF WORK AND SERVICES The CONTRACTOR shall ensure that childhood lead poisoning prevention services are conducted as specified in this contract CLPPP SERVICE AREA The CLPPP service area is Dubuque County. PROGRAM SERVICES The CONTRACTOR shall ensure that the DESIGNATED AGENCY implements all of the program services as described below, and as necessary,within the CLPPP service area. The program services are medical case management(home nursing visits,referrals for nutrition counseling,and referrals for developmental testing),environmental case management inspections for lead-poisoned children, contacting property owners to determine if lead hazard remediation is completed,conducting inspections to determine if lead hazard remediation is complete,and performing clearance testing to assure that lead hazard remediation has been completed in a safe manner, and data management. The CONTRACTOR shall ensure that the DESIGNATED AGENCY develops written protocols to describe how each of these services will be provided. Templates provided by the DEPARTMENT may be used to develop these protocols. Reimbursable services also include the following activities; initial elevated blood lead(EBL)inspector/risk assessor certification,and refresher elevated blood lead(EBL)inspector/risk assessor certification. BLOOD LEAD TESTING The CONTRACTOR shall ensure that the DESIGNATED AGENCY: 1. Implements the CHILDHOOD LEAD POISONING PREVENTIONPROGRAM CASE MANAGEMENT PROTOCOLS(March 2015)within the CLPPP service area. 2. Conducts blood lead testing or ensures that medical providers conduct blood lead testing according to this plan. 3. Provides a written notice of the results of blood lead testing to the caregivers of all children tested by the DESIGNATED AGENCY. 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. 4. Provides 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 µg/dl,,regardless of who 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. This may be waived if the CLPPP collaborates with health care providers that provide this information to the parents. The CONTRACTOR shall ensure that the DESIGNATED AGENCY notifies the DEPARTMENT of such agreements in writing. DATA MANAGEMENT The CONTRACTOR shall ensure: 1. The DESIGNATED AGENCY conducts data management as specified in this contract. 2. All case management actions taken by the DESIGNATED AGENCY and CLPPP subcontractors are documented in the HHLPSS database. At a minimum, case management activities include contacts made with the family or medical provider,EBL inspections, lead hazard remediations,home nursing or outreach visits,nutrition evaluations, and developmental assessments 3. All reports specified in ARTICLE VII—REPORTS are provided by the deadlines given in this contract. 4. Blood lead data collected by the DESIGNATED AGENCY, medical providers, clinics and labs within your jurisdiction are reported to the DEPARTMENT. Blood lead data shall be reported to the DEPARTMENT on a weekly basis and according to the reporting guidelines (Appendix I). 5. The DEPARTMENT is notified immediately of HHLPSS database errors and missing records. 6. All requests for CLPPP data needed to support the local CLPPP and fulfill the requirements of this contract are submitted to the DEPARTMENT in a timely manner using the Lead Data Request form (Appendix 11). 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 section I of this Contract. The data will be stored in compliance with the standards of. CONTRACTOR shall comply with Department and State information technology standards. ➢ Data Backup Standard: Applicable to Entities which utilize data systems to process, store, transmit or monitor information. ➢ Data Stewardship Standard: Applicable to Entities which utilize data systems to process, store,transmit or monitor information. ➢ Interconnectivity Standard: Applicable to Entities which utilize data systems to process, store,transmit or monitor information. ➢ Laptop Data Protection Standard: Applicable to Entities which utilize laptops to process, store,transmit or monitor data. ➢ Removable Storage Encryption Standard: Applicable to Entities which utilize removable storage devices to process, store, transmit or monitor information. Current state information technology standards are accessible online at https://ocio.iowa.gov/standards. C. Confidentiality. CONTRACTOR shall maintain the confidentiality of all confidential records and data released pursuant to this Contract. CONTRACTOR shall not disclose any confidential information contained in these records or data, including but not limited to names and other identifying information of persons who are the subject of such records, either during the period of this Contract or hereafter. All identifiable and personal indicators shall be kept strictly confidential and shall not be used or released for any purpose. CONTRACTOR shall not use the information from the records or data to establish contact with the named person or his/her family without prior written approval from IDPH. 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 within CONTRACTOR 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. ➢ If the CONTRACTOR is associated with an Iowa regent institution,the CONTRACTOR agrees to comply with the conditions regarding publications and presentation contained in Section 8(b)`T"of the General Conditions for Contracts with State Universities, effective May 1, 2014. ➢ If CONTRACTOR is not associated with an Iowa 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. The DEPARTMENT agrees to: 1. Provide the CONTRACTOR with a timeframe for submitting data or reports requested through the Lead Data Request form. 2. Respond to CONTRACTOR requests for data needed to support the identification of children and properties associated with blood lead levels greater than or equal to 5 micrograms per deciliter in a reasonable timeframe. ENVIRONMENTAL CASE MANAGEMENT The CONTRACTOR shall ensure that the DESIGNATED AGENCY: 1. Maintains 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 or DESIGNATED AGENCY and the certified individuals shall comply with the provisions of Iowa Administrative Code 641-70.6(3). 2. Enrolls as a Medicaid provider for EBL inspection services,recovers reimbursement from Medicaid for EBL inspections,and uses the reimbursement as program income. 3. Conducts 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 µg/dL or at least two venous blood lead levels of 15 to 19µg/&. 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 µg/dL or three blood lead levels less than 15 µg/&. EBL inspections shall be conducted within the following times: A. Two venous blood lead levels of 15 to 19µg/dL–within 4 weeks after the report. ➢ Venous blood lead level of 20 to 44µg/dL–within 2 weeks after the report. ➢ Venous blood lead level of 45 to 69µg/dL–within 1 week after the report. ➢ Venous blood lead level greater than or equal to 70 µg/dL – within 2 days after the report. 4. Documents in BIII,PSS the reason why the DESIGNATED AGENCY was unable to complete any inspection required by this contract. 5. Contacts 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. 6. Contacts the current owners of all dwellings where lead hazards were identified,but lead hazard remediation has not been completed,at least once each year,until lead hazard remediation is completed. 7. Continues 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. 8. Does not close an address associated with a lead-poisoned child where lead hazards have been identified unless the lead hazard remediation has been completed or written permission has been obtained in advance from the DEPARTMENT to close the address even though lead hazard remediation has not been completed. 9. To the extent possible,assists families who have lead-poisoned children in locating resources for lead hazard remediation and/or alternative housing. 10. Conducts clearance testing according to Iowa Administrative Code Chapter 641 70,Lead Professional Certification,before verifying that lead hazard remediation has been completed in a home associated with a lead-poisoned child. The CONTRACTOR must adopt and enforce a local code that requires hazards to be repaired in the homes of elevated blood lead(EBL)children. A model code is available at Iowa Administrative Code 641Chapter 68. CONTRACTORS may adopt this model code by reference. Local regulations must be as protective as Iowa Administrative Code 641—Chapter 68. Local regulations that were previously adopted must be updated to reflect safe dust lead levels and other items that have changed since the local regulations were adopted. MEDICAL CASE MANAGEMENT The CONTRACTOR shall ensure that the DESIGNATED AGENCY: 1. Conducts medical case management as specified in this contract. 2. Is enrolled as a Medicaid provider for services that can be reimbursed by Medicaid,recovers reimbursement from Medicaid for medical case management services,and uses the reimbursement as program income. Follow-un blood lead testing The CONTRACTOR shall ensure that the DESIGNATED AGENCY: 1. Assures that providers in the CLPPP service area 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 DESIGNATED AGENCY may also provide this follow-up blood lead testing. A. Confirmatory venous blood lead testing ➢ Capillary blood lead level of 15 to 19 µg/dl,—within 4 weeks after the report. ➢ Capillary blood lead level of 20 to 44 µg/dl,—within 1 week after the report. ➢ Capillary blood lead level of 45 to 69 µg/dl,—within 48 hours after the report. ➢ Capillary blood lead level greater than or equal to 70 µg/dl,—immediately. B. 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 µg/dl, — within 3 months. After two levels less than 10 µg/dl, or three levels less than 15 µg/dl,, testing should follow the routine testing schedule for high-risk children. ➢ Venous blood lead level of 15 to 19µg/dl,—within 3 months. ➢ Venous blood lead level of 20 to 44µg/dl,—within 4 to 6 weeks. ➢ Venous blood lead level greater than or equal to 45 µg/dl,—immediately. C. Follow-up testing for a child who has been chelated ➢ At the end of chelation. ➢ Depending on the 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 ensure that the DESIGNATED AGENCY: 1. Assures that providers in the CLPPP conduct medical evaluations for children under the age of six years within the following timelines: A. Venous blood lead level of 20 to 44 µg/dl,—Refer within 48 hours after the report so that the service is received within 5 days. B. Venous blood lead level of 45 to 69µg/dl,—Refer within 24 hours after the report so that the service is received within 48 hours. C. Venous blood lead level greater than or equal to 70 µg/dl,—Refer for emergency medical evaluation. Home nursing or outreach visits The CONTRACTOR shall ensure that the DESIGNATED AGENCY provides home nursing or outreach visits for children under the age of six years according to the following timelines: 1. Venous blood lead level of 15 to 19 µg/dl,—within 4 weeks after the report. 2. Venous blood lead level of 20 to 44 µg/dl,—within 2 weeks after the report. 3. Venous blood lead level of 45 to 69µg/dl,—within 1 week after the report. 4. Venous blood lead level greater than or equal to 70 µg/dl, — within 2 days after the report. Ch el ati un The CONTRACTOR shall ensure that the DESIGNATED AGENCY 1. Assures that children with two venous blood lead levels greater than or equal to 45 µg/dl,receive chelation. Nutrition Evaluation The CONTRACTOR shall ensure that the DESIGNATED AGENCY: 1. Assures that children under the age of six years with a venous blood lead level greater than or equal to 15 µg/dl,receive a nutrition evaluation according to the following timelines: A. Venous blood lead level of 15 to 19 µg/dl,—Refer within 4 weeks after the report so that the service is received within 6 weeks. B. Venous blood lead level of 20 to 44 µg/dl,—Refer within 2 weeks after the report so that the service is received within 4 weeks. C. Venous blood lead level of 45 to 69 µg/dl,—Refer within 1 week after the report so that the service is received within 2 weeks. D. Venous blood lead level greater than or equal to 70 µg/dl,—Refer within 2 days after the report so that the service is received with 1 week. 2. Contacts the DEPARTMENT for assistance if access to a dietitian cannot be assured for children under the age of six years with a venous blood lead level greater than or equal to 15 µg/dl,. Developmental Assessment The CONTRACTOR shall ensure that the DESIGNATED AGENCY: 1. Assures that children under the age of six years with a venous blood lead level greater than or equal to 20 µg/dl,receive a developmental assessment according to the following timelines: A. Venous blood lead level of 20 to 44µg/dl,—Refer within 2 weeks after the report. B. Venous blood lead level of 45 to 69µg/dl,—Refer within 1 week after the report C. Venous blood lead level greater than or equal to 70 µg/dl,—Refer within 2 days after the report. Care Coordination The CONTRACTOR shall ensure that the DESIGNATED AGENCY provides care coordination or refers the family to the local child health contractor for this service. Medical Case Closure Guidelines Medical cases shall be closed only in the following circumstances: 1. A child has had two consecutive blood lead levels less than 10 µg/dl,or three consecutive blood lead levels less than 15 µg/dl,after the initial elevated blood lead level. 2. A child has had a capillary false positive blood lead level;that is a capillary or venous blood lead level less than 10 µg/dl,immediately after a single capillary blood lead level greater than or equal to 15 µg/dl,. 3. A child has reached the age of six years and has a blood lead level less than 20 µg/&. 4. A child has moved out of the CLPPP service area. The CONTRACTOR shall ensure that the DESIGNATED AGENCY immediately notifies IDPH. CHILDREN OVER THE AGE OF SIX YEARS The CONTRACTOR shall ensure that the DESIGNATED AGENCY contacts 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 µg/&. ARTICLE VII—REPORTS The CONTRACTOR shall ensure that the DESIGNATED AGENCY prepares and submits the following reports to the DEPARTMENT on forms and/or in the format approved by the DEPARTMENT: Report Number Date Due Claim Voucher 1 electronic Within 45 days of month of expenditure HHLPSS Documentation to 1 electronic Within 45 days of month of expenditure Support Expenditure Report Quarterly Narrative Report 4 reports submitted through Submit with October claim IowaGrants.gov Submit with January claim Submit with April claim Submit with July claim Claim vouchers and quarterly narrative reports shall be filed via IowaGrants.gov. HHLPSS documentation to support claim vouchers shall be uploaded to IowaGrants.gov Contract Document component. ARTICLE VIII—BUDGET 1. The total approved budget for this contract period is detailed in Exhibit 1. All services except for initial EBL inspector certification and EBL inspector refresher training will be reimbursed at unit cost rates specified in Exhibit 1,up to the contract award amount 2. Initial EBL inspector certification and EBL inspector refresher training will be reimbursed at actual cost,up to the maximum amount shown in Exhibit 1 for each item. The Department will not reimburse travel amounts in excess of limits established by Iowa Department of Administrative Services: Instate maximum allowable amounts for food is $8.00/breakfast; $12.00/lunch;and $23.00/dinner;lodging maximum of$83.00,plus taxes per night;and mileage maximum of$0.39 per mile. ARTICLE IX—PAYMENTS 1. Warrants will be made payable to the CONTRACTOR and mailed to the Contract Administrator at the DESIGNATED AGENCY address. Warrants may be sent to an alternate address if requested in writing from the CONTRACTOR. 2. Payments shall be made to the CONTRACTOR based on the claim vouchers submitted to the DEPARTMENT by the DESIGNATED AGENCY. 3. 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. ARTICLE X—ADDITIONAL CONDITIONS 1. Funds may not be spent for indirect costs, chelation or other medical treatment of lead poisoning, or lead hazard remediation. Funds may not be spent for blood lead analyses that could be reimbursed by Medicaid. 2. On January 1, 2016,April 1, 2016,and June 1, 2016,the DEPARTMENT may amend the contract to revert funds that are estimated to be unused to the DEPARTMENT and to reallocate the funds to contractors with demonstrated special needs for healthy homes and childhood lead poisoning prevention services. 3. Payments may be withheld if the DESIGNATED AGENCY or personnel employed by the DESIGNATED AGENCY are not in compliance with Iowa Administrative Code Chapter 641 70, Lead Professional Certification. 4. The CONTRACTOR and/or DESIGNATED AGENCY must check IowaGrants.gov correspondences at least once each week for lead poisoning prevention updates sent out by the DEPARTMENT. 5. 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 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. 6. The CONTRACTOR shall comply with Section 5 of the General Conditions for all subcontracts. 7. As a condition of the contract,the CONTRACTOR shall ensure that the DESIGNATED AGENCY provides linkage with the local board of health in each county where services are provided. The DESIGNATED AGENCY will ensure that the local board of health has been actively engaged in planning for and evaluation of services. It will also maintain effective linkages with the local board of health,including timely and effective communications and ongoing collaboration. 8. All work plan revisions must be approved by the DEPARTMENT prior to implementation. 9. Authorization-Each signatory to this contract or subsequent contract amendments represents and warrants to the other parties that: A. The signatory has the right,power, and authority to enter into this agreement and to bind the party represented by the signatory to this agreement. B. The party has the right,power,and authority to perform its obligations under the agreement; and C. The party has taken all requisite action(corporate,statutory,or otherwise)to approve execution, delivery, and performance of this agreement and this agreement constitutes a legal,valid,and binding obligation upon itself in accordance with its terms. APPENDIX I Mandatory Reporting of Blood Lead Level Results APPENDIX I Mandatory Reporting of Blood Lead Level Results Iowa Administrative Code Sec. 641-1.6(3) states that for blood lead testing, "...analytical results shall be reported to the 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 LeadCareII 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): htty://www.leadcare2.com/Product-Support/Reporting-Solutions Also included in the link are some instructions on using the software developed by Magellan, and the specifications for reporting for the State of Iowa. If you need additional help, 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 Lab Name State Provider Name and Zip Facility Name Race Ethnicity Sex (This information is required by the Lead Poisoning Prevention Program at the federal Centers for Disease Control.) Critical things to keep in mind: 1) Iowa Code requires weekly reporting of all blood lead tests. 2) You must inform us immediately via phone call at 1-800-972-2026 or by fax at 1-515- 281-4529 of any test results at 20 or above. (These more critical levels require that our staff or local public health staff follow up with the child's family and/or care provider in a timely manner.) 3) Reporting must be done electronically in a format specified by the Department. We currently accept three specified formats: HL7 (the standard reporting format used by healthcare information systems),the XML format produced by the LeadCareII 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 Iowa's Secure Mail system. What follows is a set of instructions on using this system. Sending Blood Lead Level Results via the State of Iowa's Secure Mail system You will be receiving a scheduled message on Monday of each week as a reminder to report your lead tests. The message will contain the image below and prompt you to click on a hyperlink to read the message. You have received a secure email from the State of Iowa. 1. When you click on the hyperlink, you will be taken to a login page where you will be required to create an new account—THIS IS A ONE-TIME PROCESS 2. You will be guided step-by-step through this process; CAREFULLY READ THE INSTRUCTIONS NOTE: for additional details on Iowa.gov SecureMail, see the user guide at: http://das.ite.iowa.aov/docs/infrastructure/External User Guide to Secure Email System.pdf 3. DOCUMENT AND SAVE YOUR SecureMail CREDENTIALS FOR FUTURE USE 4. Login to your Iowa.gov SecureMail account 5. Open the newly received SecureMail message with "IDPH Lead Reporting" in the subject line Reporters that use the LeadCare*H software to create a reporting file • just need to reply to the SecureMail message and • attach the reporting file to the reply by clicking on the `Attach' button near the top of the message window • click the `Send' button to send the message Reporters that use an Excel template for reporting: • Stop using all previous reporting templates and spreadsheets • When you access the SecureMail message, please open the attachment located at the bottom of the screen and save this to a location with which you are familiar (Desktop on your computer or afamiliar network location)—Ifyou 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 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 Appendix II Lead Data Request Form LEAD DATA REQUEST Date of request: Date required: CONTACT INFORMATION: Name: Program: e-mail: Phone number: SERVICE REQUEST: Service Type: Format of Data Purpose Access to Data Data Requested: Submit completed form to Rob Walker at: Robert.Walker@IDPH.lowa.gov THANK YOU: Your request will be processed in the order it was received. THE CFFY OF Dubuque DUB E *Uedcach 1111 Masterpiece on the Mississippi 2m7•2012-2013 CITY OF DUBUQUE Home Advocate for Visiting Nurse Association OVERVIEW This role requires an empathetic, dynamic, and organized em ployee(s)who have a passion for wo rking with people living in poverty. The Home Advocate collaborates with the City of Dubuque Housing and Community Development Department as well as Operation: New View Community Action Agency, and the Green & Healthy Homes Initiative (GHHI) Team, as well as other community-based organizations,to holistically address unhealthy homes both physically and socially. The Home Advocate is responsible for case management and community organizing. REQUIREMENTS The home advocate will be independent, a team player, and highly organized with a strong work ethic. Critical th i n king and creatively problem-solving, along with excellent oral,written, interpersonal and social service skills. This home advocate will present a mature, credible, and motivating presence. EDUCATION/EXPERIENCE • Bachelor's degree in a field related to social work and/or health • Experience working with people in poverty • Proficient in Word, Excel, PowerPoint, and Outlook • Proven ability to have a caseload of 10-15 clients and be responsible for othertasks simultaneously • Experience in community organizing • Flexible and collegial disposition and ability to work effectively with people with a range of backgrounds, experiences,and cultures DUTIES AND RESPONSIBILITIES Member of Green & Healthy Homes Team Works closelywith the Lead and Healthy Homes Team as well as community GHHI partners in every home, devising a plan on how to make each home green and healthy. • Accompany assessors during assessmentto complete family intake • Attend meetings with City staff and GHHI Resource Group to discuss status of homes/client • Advocate on an individual and policy level when the client is beingtreated unjustly • Continually suggest ways to improve process and partnerships • Educate team about being client-centered and the culture of poverty Case Manager • Responsible for knowing community resources • Connect clients with appropriate resources and services • Empower clients to gain knowledge about healthy homes maintenance practices • Track homes to assure they are going through the GHHI process in a timely manner Community Organizer • Continually create partnerships with different community organizations that will benefit clients • Coordinate workshops that address financial literacy,emotional health, physical health, and environmental health • Educate about Home Advocate position to funders,community leaders,and national leaders Volunteer Coordinator • Find and coordinate volunteers from various entities such as colleges,AmeriCorps, churches, etc. to assist clients and provide community education and outreach • Coordinate volunteer days Personal Growth and Development • Committed to continued professional growth and development • Read literature concerning the culture of poverty • Attend training classes by partnering organizations (e.g., Healthy Homes, Lead Abatement Program, etc.) • Mentor with local social work professionals and health care workers PHYSICAL DEMANDS The Home Advocate will be required to be flexible with work house with possible hours on weekends and evening hours. The Home Advocate must have reliable transportation during all work hours. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee is frequently required to use hands to handle or feel. The employee is required to stand and walk and must occasionally lift and/or move up to 20 pounds,as well as enter homes that are unhealthy and demonstrate tasks such as cleaning. Specific vision abilities required by this job include close vision.