HomeMy WebLinkAbout2020-551-E Health-NC DHHS Form 544 agreement AddendumDivision of Public Health
Agreement Addendum
FY 20-21
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_____________________________________________ ____________________________________
Health Director Signature (use blue ink) Date
Local Health Department to complete:
(If follow-up information is needed by DPH) LHD program contact name:
Phone number with area code:
Email address:
Signature on this page signifies you have read and accepted all pages of this document. Revised July 2019
Orange County Health Department
Epidemiology Section /
Communicable Disease Branch
Local Health Department Legal Name DPH Section / Branch Name
544 IPC Regional Teams
John Peebles 919-546-1670
john.peebles@dhhs.nc.gov
Activity Number and Description DPH Program Contact
(name, phone number, and email)
07/01/2020 – 12/15/2020
Service Period DPH Program Signature Date
(only required for a negotiable agreement addendum)
08/01/2020 – 12/30/2020
Payment Period
Original Agreement Addendum
Agreement Addendum Revision #
I. Background:
The primary mission of the Communicable Disease Branch (CDB) is to reduce morbidity and mortality
resulting from communicable diseases that are a significant threat to the public through detection,
investigation, testing, treatment, tracking, control, education, and care activities to improve the health of
people in North Carolina. Infection prevention and control is an important component of these efforts as
it offers the opportunity to reduce the morbidity and mortality of communicable diseases, and to prevent
some infections entirely. Strong infection prevention knowledge, preparedness, and practices are key to
protecting the health and safety of North Carolina’s most vulnerable residents during this pandemic.
The “Coronavirus Aid, Relief, and Economic Security Act” or the “CARES Act” of 2020 established the
$150 billion Coronavirus Relief Fund. U.S. Treasury has made payments from the Fund to States and
eligible units of local government; the District of Columbia and U.S. Territories (the Commonwealth of
Puerto Rico, the United States Virgin Islands, Guam, American Samoa, and the Commonwealth of the
Northern Mariana Islands); and Tribal governments (collectively “governments”).
The CARES Act requires that the payments from the Coronavirus Relief Fund only be used to cover
expenses that:
• are necessary expenditures incurred due to the public health emergency with respect to the
Coronavirus Disease 2019 (COVID–19);
• were not accounted for in the budget most recently approved as of March 27, 2020 (the date of
enactment of the CARES Act) for the State or government; and
• were incurred during the period that begins on March 1, 2020 and ends on December 30, 2020.
nbontrager@orangecountync.gov
919-245-2407
Natalie Bontrager
DocuSign Envelope ID: 243DF0DA-4637-4259-B8AD-6D5E166FA19E
8/24/2020
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Revised July 2019
The North Carolina General Assembly passed Session Law 2020-4 (H1043) to fulfill their constitutional
duty to appropriate all funds, including federal CARES Act funds appropriated or otherwise made
available under the COVID-19 Recovery Legislation, and to direct the use of those funds in a manner
that is consistent with the authorizing federal legislation and that responsibly provides for the public
health and economic well-being of the State. Through this legislation, the Coronavirus Relief Fund was
established.
II. Purpose:
In a high-risk setting like a COVID-19 outbreak, Long Term Care Facilities (LTCFs) must have very
strong infection prevention policies and procedures to prevent the spread of disease. This initiative will
create Regional Prevention Support Teams (RPSTs) in each of North Carolina’s 10 public health regions
to provide on-site infection prevention and control training and consultation to all types of LTCFs. The
goal of the RPSTs is to reduce the introduction of disease through on-site training and consultation with
facility staff in the use of evidence-based infection control procedures consistent with applicable CDC,
CMS and HHS guidance. This initiative is particularly important for residential facilities that do not
typically have health care professionals on staff.
RPSTs will be based in each of the 10 public health regions with operational and fiscal responsibilities
managed by one lead local public health department in each region, and will be supported by
NC DHHS/DPH project management and program oversight. The lead health department will be
identified collaboratively between NC DHHS/DPH and the public health regions. Each RPST will have
a prevention coordinator and additional training staff based upon the number of Nursing Home and
Adult Care Home beds in each region. Training for the RPSTs will be provided by the Division of
Public Health in collaboration with the University of North Carolina’s Statewide Program for Infection
Control and Epidemiology (UNC SPICE).
III. Scope of Work and Deliverables:
The Local Health Department shall:
1. Reach and engage the following priority populations: Work with administration of long-term care
facilities, including skilled nursing facilities, assisted living facilities, independent living facilities
and adult care homes, proactively for prevention, early detection and infection prevention strategies
for COVID-19 response.
2. Establish and Maintain a Regional Prevention Support Team (RPST):
a. On behalf of its region, the Local Health Department will maintain a Regional Prevention
Support Team (RPST) based on the budgetary guidance. Each RPST will have a Regional
Prevention Coordinator and additional prevention trainers, the number of which will be based
upon the number of Nursing Home and Adult Care Home beds in each region. Training for the
RPSTs will be provided by the Communicable Disease Branch (CDB) in collaboration with
UNC SPICE.
b. RPSTs will collaborate with UNC SPICE to develop an Infection Prevention and Control
curriculum to deliver to LTCFs tailored to the level of medical knowledge of employees in each
type of facility.
c. RPSTs, in collaboration with CDB, will develop communications protocols to ensure close
coordination and deconfliction with Healthcare Coalition Outbreak Strike Teams in their regions.
3. Maintain a Regional Leadership Team within the established public health regions:
a. The Local Health Department, in its role as lead health department in its region, will assemble a
Regional Leadership Team consisting of representatives from a majority of its region’s local
DocuSign Envelope ID: 243DF0DA-4637-4259-B8AD-6D5E166FA19E
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Revised July 2019
health departments. The Regional Leadership Team should meet on a quarterly basis, either in
person or via conference calls. The RPST’s Regional Prevention Coordinator will provide
monthly reports to this leadership team and each local health director in the region. The
Regional Prevention Coordinator will work with the Regional Leadership Teams to develop and
execute an annual action plan and to build networked partnerships.
b. Programmatic oversight: CDB will provide programmatic oversight of the RPSTs in
coordination with each lead local health department.
4. Participate in CDB sponsored meetings coordinated by the CDB Program Manager.
5. Evaluate Regional progress by tracking LTCF outbreak data.
IV. Performance Measures/Reporting Requirements:
1. Reporting Requirements for Deliverables and Performance Measures:
The Local Health Department provides documentation to the DPH RPS Program Manager of
regional activities, using the RPST report template (to be provided by CDB in October 2020),
according to the following schedule:
Interim Progress Report Period Report Submission Deadline
July 2020 – September 2020 October 23, 2020
October 2020 – December 2020 January 22, 2021
2. Regional Prevention Support Team Performance Measures:
a. Recruiting and hiring the RPST Coordinator and trainers by September 30, 2020.
b. Completing RPST UNC SPICE training by October 30, 2020.
c. Coordinating an RPST communications protocol with Healthcare Coalition Outbreak Strike
Teams by November 30, 2020.
d. RPST completing initial introductions and formal program briefings to all LTCFs in its region no
later than December 7, 2020.
V. Performance Monitoring and Quality Assurance:
1. The DPH RPS Program Manager, based in the Communicable Disease Branch, will assess the Local
Health Department’s performance through tracking progress toward completion of the Scope of
Work deliverables above and through review of the RPST reports submitted.
2. The DPH RPS Program Manager will conduct conference calls with the RPST and the Local Health
Department to provide guidance and technical assistance as needed.
VI. Funding Guidelines or Restrictions:
1. Requirements for pass-through entities: In compliance with 2 CFR §200.331 – Requirements for
pass-through entities, the Division of Public Health provides Federal Award Reporting Supplements
to the Local Health Department receiving federally funded Agreement Addenda.
a. Definition: A Supplement discloses the required elements of a single federal award. Supplements
address elements of federal funding sources only; state funding elements will not be included in
the Supplement. Agreement Addenda (AAs) funded by more than one federal award will receive
a disclosure Supplement for each federal award.
b. Frequency: Supplements will be generated as the Division of Public Health receives information
for federal grants. Supplements will be issued to the Local Health Department throughout the
DocuSign Envelope ID: 243DF0DA-4637-4259-B8AD-6D5E166FA19E
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Revised July 2019
state fiscal year. For federally funded AAs, Supplements will accompany the original AA. If
AAs are revised and if the revision affects federal funds, the AA Revisions will include
Supplements. Supplements can also be sent to the Local Health Department even if no change is
needed to the AA. In those instances, the Supplements will be sent to provide newly received
federal grant information for funds already allocated in the existing AA.
2. The following is a nonexclusive list of costs that would not be eligible expenditures:
a. Administrative costs. Neither indirect costs nor allocated overhead are allowable costs. All
salary expenses for permanent employees must be direct expensed.
b. Lobbying. Federally funded lobbying, either directly or indirectly (i.e., “grassroots” lobbying), is
prohibited by law.
c. Expenses for the State share of Medicaid.
d. Damages covered by insurance.
e. Payroll or benefits expenses for employees whose work duties are not substantially dedicated to
mitigating or responding to the COVID-19 public health emergency.
f. Expenses that have been or will be reimbursed under any federal program.
g. Reimbursement to donors for donated items or services.
h. Workforce bonuses other than hazard pay or overtime.
i. Severance pay.
j. Legal settlements.
k. Elective abortion or on research in which a human embryo is destroyed, discarded, or knowingly
subjected to risk of injury or death.
i. The prohibition on payment for abortions does not apply to an abortion if the pregnancy is
the result of an act of rape or incest; or in the case where a woman suffers from a physical
disorder, physical injury, or physical illness, including a life-endangering physical condition
caused by or arising from the pregnancy itself, that would, as certified by a physician, place
the woman in danger of death unless an abortion is performed.
ii. Furthermore, no government which receives payments from the Coronavirus Relief Fund
may discriminate against a health care entity on the basis that the entity does not provide, pay
for, provide coverage of, or refer for abortions.
3. The final drawdown of funds request must be submitted in the Aid-to-Counties database no
later than 12/15/2020.
DocuSign Envelope ID: 243DF0DA-4637-4259-B8AD-6D5E166FA19E
Federal Award Reporting Requirements for Pass-Through Agencies, 2 CFR § 200.331 DPH 8-18-20
FY21 Activity: 544 IPC Regional Teams Supplement 1
Supplement reason: ☒ In AA+BE or AA+BE Rev –OR– ☐ –
CFDA #: 21.019 Federal awd date: 03/27/20 Is award R&D? no FAIN: H.R. 748 – 116th Congress
(2019-2020)
Total amount
of fed awd: $ 3,585,391,176
CFDA
name: Coronavirus Relief Fund
Fed award project
description:
Coronavirus Aid, Relief, and Economic Security Act, Coronavirus Relief Funds
(to States)
Fed awarding
agency: U.S. Treasury Federal award
indirect cost rate:
NC DHHS limited to:
Subawardee limited to:
0%
0%
Subrecipient Subrecipient
DUNS
Fed funds for
This Supplement
Total of All Fed Funds
for This Activity Subrecipient Subrecipient
DUNS
Fed funds for
This Supplement
Total of All Fed Funds
for This Activity
Alamance 965194483 = = Jackson 019728518 = =
Albemarle 130537822 85,260 85,260 Johnston 097599104 = =
Alexander 030495105 = = Jones 095116935 = =
Anson 847163029 = = Lee 067439703 = =
Appalachian 780131541 142,100 142,100 Lenoir 042789748 = =
Beaufort 091567776 = = Lincoln 086869336 = =
Bladen 084171628 = = Macon 070626825 85,260 85,260
Brunswick 091571349 = = Madison 831052873 = =
Buncombe 879203560 = = MTW 087204173 = =
Burke 883321205 = = Mecklenburg 074498353 = =
Cabarrus 143408289 227,360 227,360 Montgomery 025384603 = =
Caldwell 948113402 = = Moore 050988146 = =
Carteret 058735804 = = Nash 050425677 = =
Caswell 077846053 = = New Hanover 040029563 = =
Catawba 083677138 = = Northampton 097594477 = =
Chatham 131356607 = = Onslow 172663270 = =
Cherokee 130705072 = = Orange 139209659 198,940 198,940
Clay 145058231 = = Pamlico 097600456 = =
Cleveland 879924850 = = Pender 100955413 = =
Columbus 040040016 = = Person 091563718 = =
Craven 091564294 = = Pitt 080889694 113,680 113,680
Cumberland 123914376 113,680 113,680 Polk 079067930 = =
Dare 082358631 = = Randolph 027873132 = =
Davidson 077839744 = = Richmond 070621339 = =
Davie 076526651 = = Robeson 082367871 = =
Duplin 095124798 113,680 113,680 Rockingham 077847143 = =
Durham 088564075 = = Rowan 074494014 = =
Edgecombe 093125375 = = Sampson 825573975 = =
Foothills 782359004 170,520 170,520 Scotland 091564146 = =
Forsyth 105316439 = = Stanly 131060829 = =
Franklin 084168632 = = Stokes 085442705 = =
Gaston 071062186 = = Surry 077821858 = =
Graham 020952383 = = Swain 146437553 = =
Granville-Vance 063347626 170,520 170,520 Toe River 113345201 = =
Greene 091564591 = = Transylvania 030494215 = =
Guilford 071563613 = = Union 079051637 = =
Halifax 014305957 = = Wake 019625961 = =
Harnett 091565986 = = Warren 030239953 = =
Haywood 070620232 = = Wayne 040036170 = =
Henderson 085021470 = = Wilkes 067439950 = =
Hoke 091563643 = = Wilson 075585695 = =
Hyde 832526243 = = Yadkin 089910624 = =
Iredell 074504507 = =
DocuSign Envelope ID: 243DF0DA-4637-4259-B8AD-6D5E166FA19E
DPH-Aid-To-Counties For Fiscal Year: 20/21 Budgetary Estimate Number: O
Activity 544 AA 1175 Proposed New
4023 Total Total
HN
Service Period 07/01-12/15 2.oU> · 202.0
Payment Period 08/01-12/30
01 Alamance 0 0 0
D1 Albemarle • 0 85,260 85,260 85,260
02 Alexander 0 0 0
04Anson 0 0 0
D2 Appalachian • 0 142,100 142,100 142,100
07 Beaufort 0 0 0
09 Bladen 0 0 0
10 Brunswick 0 0 0
11 Buncombe 0 0 0
12 Burke 0 0 0
13 Cabarrus • 0 227,360 227,360 227,360
14 Caldwell 0 0 0
16 Carteret 0 0 0
17 Caswell 0 0 0
18 Catawba 0 0 0
19 Chatham 0 0 0
20 Cherokee 0 0 0
22 Clay 0 0 0
23 Cleveland 0 0 0
24 Columbus 0 0 0
25 Craven 0 0 0
26 Cumberland •0 113,680 113,680 113,680
28 Dare 0 0 0
29 Davidson 0 0 0
30 Davie 0 0 0
31 Duplin • 0 113,680 113,680 113,680
32 Durham 0 0 0
33 Edgecombe 0 0 0
D7 Foothills •0 170,520 170,520 170,520
34 Forsyth 0 0 0
35 Franklin 0 0 0
36 Gaston 0 0 0
38 Graham 0 0 0
D3 Gran-Vance •0 170,520 170,520 170,520
40 Greene 0 0 0
41 Guilford 0 0 0
42 Halifax 0 0 0
43 Harnett 0 0 0
44 Haywood 0 0 0
45 Henderson 0 0 0
46 Hertford 0 0 0
47 Hoke 0 0 0
48 Hyde 0 0 0
49 Iredell 0 0 0
50 Jackson 0 0 0
DocuSign Envelope ID: 243DF0DA-4637-4259-B8AD-6D5E166FA19E
8/19/2020
08/19/2020
08/20/2020
DocuSign Envelope ID: 243DF0DA-4637-4259-B8AD-6D5E166FA19E