HomeMy WebLinkAboutWashington State Department of Health Amendment # 09 MASON COUNTY PUBLIC HEALTH
2018-2020 CONSOLIDATED CONTRACT MC Contract#19-070
CONTRACT NUMBER: CLH18253 AMENDMENT NUMBER: 9
PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as
"DOH",and MASON COUNTY PUBLIC HEALTH hereinafter referred to as"LHJ",pursuant to the
MQdifications/Waivers clause,and to make necessary changes within the scope of this contract and any subsequent
amendments thereto.
IT IS MUTUALLY AGREED: That the contract is hereby amended as follows:
1. 'Exhibit A Statements of Work,attached and incorporated by this reference,are amended as follows:
® Adds Statements of Work for the following programs:
• Office of Immunization&Child Profile-Perinatal Hepatitis B-Effective July 1,2019
• OICP-Promotion of hnmunizations to Improve Vaccination Rates-Effective July 1,2019
• OSS LMP Implementation-Effective July 1,2019
• Recreational Shellfish Activities- Effective July 1,2019
ER Amends Statements of Work for the following programs: RECEIVED
AUG 1 Z 2019
❑ Deletes Statements of Work for the following programs:
Department of Health
2. Exhibit B-9 Allocations,attached and incorporated by this reference,amends and A MMeift"-7 ocaftlls as
follows:
® Increase of 569,600 for a revised maximum consideration of S805,771.
❑ Decrease of for a revised maximum consideration of
❑ No change in the maximum consideration of
Exhibit B Allocations are attached only for informational purposes.
3. Exhibit C-8 Schedule of Federal Awards,attached and incorporated by this reference,amends and replaces
Exhibit C-7.
Unless designated otherwise herein,the effective date of this amendment is the date of execution.
ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force
and effect.
IN WITNESS WHEREOF,the undersigned has affixed his/her signature in execution thereof.
MASON COUNTY PUBLIC HEALTH STATE OF WASHINGTON
DEPARTMENT OF HEALTH
Date Date
APPROVED AS TO FORM ONLY
Assistant Attorney General
Page I of 11
AMENDMENT#8
2018-2020 CONSOLIDATED CONTRACT
EXHIBIT A
STATEMENTS OF WORK
TABLE OF CONTENTS
DOH Program Name or Title: NEP SSI Onsite Sewage Management-Effective January 1,2018...................................................................................................3
DOH Program Name or Title: Prescription Drug Overdose Prevention for States Supplement-Effective January 1,2018...........................................................26
Exhibit A,Statements of Work Page 2 of 29 Contract Number CLH18253-8
Revised as of March 15,2019
AMENDMENT#8
Exhibit A
Statement of Work-
Contract Term: 2018-20207
DOH Program Name or Title: Prescription Drug Overdose Prevention for States Local Health Jurisdiction Name: Mason County Public Health
Supplement-Effective January 1,2018 '
;:7 — t Contract Number: CLHIS253
SOW Type: Revision Revision#(for this SOW) 3 Funding Source Federal Compliance Type of Payment
Z Federal Subrecipient (check if applicable) ®Reimbursement
Period of Performance: January 1,2018 through September 30.2019 ❑State ®FFATA(Transparency Act) ❑Fixed Price
❑Other ❑Research&Development
Statement of Work Purpose: Under the Centers for Disease Control and Prevention(CDC)Prescription Drug Overdose Prevention for States grant(5 NU17CE002734)an
Opioid Overdose Prevention position will be funded.This position will be staffed by a public health nurse and other public health professional to conduct the work described
below.Positions will provide community and prescriber technical assistance and education to help prevent overdoses,and to improve clinical care for patients taking opioids for
chronic pain and those with opioid use disorder.
Mason County Public Health(MCPH)will 1)follow up with nonfatal overdose patients,provide training for overdose reversal,and refer nonfatal overdose patients to treatment
and other services;2)if the overdose involved a prescription opioid,follow up with the prescriber regarding the nonfatal overdose;3)when available,obtain a list of patients'
prescriptions from the Prescription Drug Monitoring Program(PDMP),and follow up with provider(s)to discuss opioid prescribing and provide education;4)on a monthly basis
provide DOH with opioid overdose reports which include the number of nonfatal overdose patients in Mason County and the number of patients served by the public health
consultant;5)perform public outreach,education and trainings to improve community awareness around opioid use and opioid overdose;and 6)attend monthly meetings with
DOH and provide updates on activities.
Revision Purpose: The purpose of this revision is to add additional funding and tasks 3-6.
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue index (LHJ Use Only) Consideration Consideration
Code Code increase(+)
Start Date End Date
FFY17 PRESCRIPTION DRUG OD-SUPP 93.136 333.93.13 77520271 01/01/18 08/31/18 63,027 0 63,027
FFYIS PRESCRIPTION DRUG OD-SUPP 93.136 333,93.13 77520280 09/01/18 1 08/31/19 75,000 35,000 110,000
TOTALS 1 138,027 35,000 1 173,027
Task Task/Activity/Description *May Support PHAB Deliverables/Outcomes Due Date/Time Frame Payment information
Number Standards/Measures and/or Amount
1. Follow up with overdose patients in Provide monthly reports to DOH MCPH will submit monthly Monthly invoices for
Mason County to connect them to which includes number of fatal and written progress reports of actual cost reimbursement
evidence based substance abuse nonfatal overdoses and number of ongoing activities January I, will be submitted to
treatment and other needed services. persons contacted. 2018—August 31,201 S. DOH.
Increase outreach to persons with
substance use disorder(SUD)to Report technical assistance Final report to be submitted
provided dates,location, I by Sept mber 30,20IS.
Exhibit A,Statements of Work Page 26 of 29 Contract Number CLH18253-8
Revised as of March 15,2019
AMENDMENT#8
Task Task/Activity/Description 'May Support PHHAB' Deliverables/Outcomes Due Date/Time Frame Payment Information
Number Standards/Measures and/or Amount
navigate services such as evidence participants-TA consultation)If Total of all invoices will
based treatment and recovery support. materials are prepared,please (See Special Instructions not exceed$63,027
share. below.) through August 31,2018.
In the case of suspected opioid
overdose: At least one(1)community forum Final invoice must be
Notify the person's prescribers listed in will be held where opioid addiction received by
the PMP and person's primary care and treatment is discussed. September 15,2018.
provider,if known,of the overdose
event. Provide updates on ongoing (See Special.Billing
activities related to opioid Requirements below.)
Provide technical assistance,training, overdose prevention and linkages
consultation and resources regarding to treatment at monthly meetings
opioid prescribing guidelines and opioid with DOH.
use disorder.
Will report on these efforts and
Provide public outreach,education,and discussions at meetings with DOH.
training to community around opioids
and opioid use disorder.
Increase prevention activities such as
naloxone education to include law
enforcement,discuss overdose response
and prevention efforts by the sheriffs
office,tribal police,etc.
2. Continuation.of activities above for new Continuation of deliverables/ MCPH will submit monthly Monthly invoices for
funding year.Increase staff assigned to outcomes listed above. written progress reports of actual cost reimbursement
24 hours a week. ongoing activities through will be submitted to
August 31,2019. DOH.
Final report to be submitted Total of all invoices for
by September 30,2019, this funding period will
not exceed$75,000
(See Special Instructions
below.) Final invoice must be
received by
September 15,2019.
(See Special Billing
Requirements below.)
Exhibit A,Statements of Work Page 27 of 29 Contract Number CLHI8253-8
Revised as of March 15,2019
............
AMENDMENT#8
Task Task/Activity/Description *May Support PHAB Deliverables/Outcomes Due Date/Time Frame Payment Information
Number Standards/Measures and/or Amount
increase travel and outreach training. Increase outreach training to jar! MCPH ivill submit monthly Monthly invoices for
population(4x Injonth) and Mobile written progress reports of actual cost reimbursement
Outreach population f2xliveek of ongoittg activities through will be submitted to DOH.
j6ur(4)sites]number of`persons August 31,2019.
Hill vary at all locations. MCPH Total of all invoices for
will share outcomes challenges Final report to be submitted this funding period will
and successes. by September 30. 2019. not cwceed$35.000.
4. Professional dcmelopment trainingjur One(1)or two(2)JWCPH staff will
staff. attend the KV Drug Abuse and (See Special Instructions Final invoice must be
Heroin Summit in Atlanta, GA. below.) received by
Goal of training for staff. September 15,2019.
To stay abreast of latest and
up-to-date research and methods, (See Special Billing
in n battling the Gpioid epidemic Requirements bcdovif)
and obtain practical strategies that
can be shared with community and
stakeholders to utilize in their
Community Opinid Response Plan.
5 Community-wide cultural competency I-laid a trauma training for
and sensitivity training for service criminal justice professionals.
providers and community members who Time and location will be
ore in contact with opioid drug users. dependent on trainer availabilitY.
Outcome of training:
To increase awareness and
comprehension of effects of'trauma
io help develop and implement
stralegiesfor trautna-injbrmed
policies.
A survey following the training will
he used to gain feedback.
Outreach supplies, educational Provide a PDF or other copy of
materials and Centers for Disease material and who, where, haw ads
Control and Prevention(CDC)Rx ivere placed, Outcome of ads,
Awareness campaign. CDC materials clicks, views,feedback MCPH will
for pharmacy distribution,paid be utilizing CDC*s RX Awareness
Campaign for radio spots, social
media andpharmaci,
Exhibit A,Statements of Work Page 28 of 29 Contract Number CLH 18253-8
Revised as of March 15,2019
AMENDMENT O
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
http://www.phaboard.ore/wn-content/up loads/PHAB-Standards-and-Measures-Version-1.0.odf
Program Specific Requirements/Narrative
Special Requirements
Federal Fundinz Accountability and Transparency Act(FFATA)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Data Universal Numbering System(DUNS®)number.
Information about the LHJ and this statement of work will be made available on USASRending.gov by DOH as required by P.L. 109-282.
Staffing Requirements:
Added time for specialist to perform community outreach
Restrictions on Funds(what funds can be used for which activities,not direct payments,etc):
This grant cannot be used for purchase of food/drinks,lobbying,for purchase of naloxone or for distribution of sterile needles or syringes.
Special Billing Requirements:
DOH will provide an A 19-1 A invoice voucher form that must be used for monthly billing.
Special Instructions
Monthly written progress reports via email and conference calls with DOH program contacts.
DOH Program Contacts:
Jennifer Alvisurez Rachel Meade
Program Manager Opioid Overdose Prevention Specialist
Injury and Violence Prevention Injury and Violence Prevention
Office of Community Health Systems Phone: 360-236-2846
Washington State Department of Health rachel.meade(411doh.wa.gov
P.O.Box 47855,Olympia,WA 98504-7855
Phone:360-236-2845 Fax:360-236-2830
i cnnifcr.alvisure7f&..doh.wa.gov
Exhibit A,Statements of Work Page 29 of 29 Contract Number CLH18253-8
Revised as of March 15,2019
AMENDMENT#8
Exhibit A
Statement of Work
Contract Term: 2018-20207
DOH Program Name or Title: NEP SSI Onsite Sewage Management- Local Health Jurisdiction Name: Mason County Public Health
Effective JanuM 1,2018
LP01 W _ Le l,P('2-J Contract Number: CLI418253
SOW Type: Revision Revision#(for this SOW) 2 Funding Source Federal Compliance Type of Payment
®Federal Subrecipient (check if applicable) Reimbursement
Period of Performance: January 1,2018 through June 30,2019 ❑ State ®FFATA(Transparency Act) ❑Fixed Price
❑Other ❑Research&Development
Statement of Work Purpose: The purpose of this statement of work is for Mason County Public Health(MCPH)to protect public health by minimizing the public's effects of
onsite septic systems(OSS)on surface water,assure effective treatment and disposal of sewage on a long-term basis,minimize potential for public exposure to sewage,uphold
and comply with design,installation,and management requirements for OSS to accommodate effective treatment and disposal of sewage on a long term basis,and enhance
protection of environmentally sensitive areas within the Oakland Bay and Hammersley Inlet shellfish growing areas.Mason County Public Health(MCPH)will employ
previously successful tools used by the health department such as following up on unsatisfactory service events and complaints,creating as-builts to complete records,completing
parcel surveys,offering monitary operation and maintenance(O&M)incentives,notifying OSS owners of an overdue O&M status and educating the public about O&M and water
quality.MCPH will identify and correct non-point source pollution sources by conducting a monitoring program for optical brighteners.MCPH will also prioritize for the
emergency closure growing area of Hammersley Inlet to implement OSS regulation and increase O&M compliance.MCPH will develop,enhance,and review risk-based protocols
to support the work. Mason County Public Health(MCPH)will work with the Washington Department of Health(DOH)to develop and implement a risk based on-site sewage
system evaluation program within the Hammersley Inlet area. The program will employ previously successful tools used by the health department such as file review,parcel
evaluations,sampling(fecal coliform and optical brightener),dye studies,notifying homeowners of overdue O&M evaluations, offering O&M incentives,and educating the public
about O&M and water quality. Mason County Public Health will focus primarily on the Hammersley Inlet shoreline and upland area.Outreach and education activities will also
occur in the Oakland Bay watershed including Uncle John's Creek which feeds Oakland Bay's Chapman Cove.
NOTE:This statement of work(SOW)carries forward incomplete tasks and unspent funds from the 2015-2017 consolidated contract SOW.Total spending between the
two SOWS may not exceed the total award amount of$202,407.There are multiple funding sources for this award.See Special Instructions for spending requirements
from each funding source.
NOTE 2:Dates that precede January 1,2018 are for reference only.
Revision Purpose: The purpose of this revision is to extend the period of performance and funding from March 31,2019 to June 30,2019 for project continuation;add and revise
deliverable due dates,payment information and budget table for the additional project reporting(quarterly and FEATS)extension;revise Task 6.1 to attend the AEC which aligns
with the new project timeline;and update the DOH program contact information.
Chart of Accounts Program Name or Title CFDA# EARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration None Consideration
Code Code Start Date End Date
NEP 5-6 ONSITE SEWAGE MANAGEMENT 66.123 333.66.12 261Al2AS 01/01/18 06/30/19 85.330 0 85,330
PS SSI 1-5 OSS TASK 4 66.1.23 333.66.12 261K1209 01/01/18 06/30/19 86,541 0 86,541
TOTALS 171 871 0 171 871
Exhibit A,Statements of Work Page 3 of 29 Contract Number CLH18253-8
Revised as of March 15,2019
AMENDMENT#8
GOALS&MEASURABLE OBJECTIVES
This simply summarizes key deliverables and measures called out in the tasks below. This table is a component of the FEATS report.
Description(e.g.,"shellfish beds reopened") Units Targets
e. ."acres" ("number")
Complete Task 0.3 Evaluation Plan Evaluation Plan 1
Complete Task 1.1 Project Factsheet Project Factsheet I
Change the status of 19 parcel closures from Closed to Open in the growing area of Hammersley Inlet Growing parcel Open L9
Area
QAPP QAPP I
Optical Brightener Policy&Procedure Plan I
Risk Based On-Site Sewage System Evaluation Policy&Procedure Plan I
Updated OSS Dye Testing Policy&Procedure Plan I
Fecal coliform monitoring plan Plan I
Number of Hammersley Inlet fecal coliform samples collected Samples 600
Number of Hammersley Inlet Optical Brighteners(OB)pads analyzed by Mason.County Public Health OB pads analyzed(MCPH) 600
(MCPH)
Number of Hammersley Inlet Optical Brighteners(OB)pads analyzed by Ozark Underground Laboratory OB pads analyzed(OUL) 60
(OUL)
Number of sanitary surveys conducted in Hammersley Inlet Sanitary Surveys Up to 1.0 200
Investigative fecal coliform monitoring Samples Up to 30
Risk based Iist of parcels for field evaluation in Hammersley Inlet List 1
Risk based list of parcels requiring OSS dye studies. List 1
Number of dye tests conducted in Hammersley Inlet Dye Tests 100%of parcels
identified to be dye
tested
Number or percentage of OSS failures found that have been fixed OSS Failures repaired or in repair 100%
process
Number of OSS Rebates distributed Rebates 100
Oakland Bay Day EDDM for DOH approval Mailer I
Number of Oakland Bay Day Mailers went in 2018 EDDMs sent Up to 12,000
Number of Oakland Bay Day Mailers went in 2019 EDDMs sent Up to 12,000
Oakland Bay overdue O&M educational mailings Mailings Up to 80
Mailer for community meeting for DOH approval. Mailer 1
Final Project Report Report 1
Exhibit A,Statements of Work Page 4 of 29 Contract Number CLH 18253-8
Revised as of March 15,2019
AMENDMENT O
'May Support PHA.B Payment
Task Number Task,/Activity/Description Standards/Measures Deliverables/Outcomes Due Date/Time Frame Information
and/or Amount
NEP ONSITE SEWAGE MANAGEMENT ROUNDS 5-6—CFDA 66.123
THESE FUNDS MUST BE SPENT FIRST.
Costs for activities charged to this grant will not exceed$74,426. All A19-1 A invoice vouchers for these expenditures will be billed to NEP 5-6 ONSITE SEWAGE
MANAGEMENT(Master Index Code 261Al2A5). FEATS,MBE/WBE,and any other reporting for activities conducted under Cooperative Agreement#00J88801 and will
reference this agreement number. See Special Instructions for applicable federal Terms and Conditions for this agreement.
NEP SHELLFISH STRATEGIC INITIATIVE ONSITE SEWAGE MANAGEMENT—CFDA 66.123
THESE FUNDS CAN ONLY BE SPENT AFTER ALL NEP OSS ROUNDS 5-6 FUNDS ARE SPENT,
Costs for activities charged to this grant will not exceed$99,878. All A19-1A invoice vouchers for these expenditures will.be billed to PS SSI 1-5 TASK 4(Master Index Code
26I K1204).FEATS,MBE/WBE,and any other reporting for activities conducted under Cooperative Agreement#OOJ 18001 and will reference this agreement number.See
Special.Instructions for applicable federal Terms and Conditions for this agreement.
TASK 0. PROJECT DEVELOPMENT
This task must be completed before initiating any other work under this subaward.Work completed prior to the completion of Task 0 will be ineligible for reimbursement under
this subaward.
0.1 Project Spatial Data and Project Spatial Data and September 15,2017 Reimbursement
Climate Change Climate Assessment up to$0 based on
Assessment actual costs.
In the tasks below This was included as
subrecipients will create a informational only for contract
detailed project outline and negotiations,not intended to
timeline to describe project stay in contract.
expectations and outcomes.
The detailed project plan
will also identify how the
objectives of the project
will be evaluated,
including quantifiable
performance measures and
targets.DOH will review
project to see if actions
may have climate change F
intersections.If there is a
strong climate change
interconnections,DOH
will work with the
subreci ient on how the
Exhibit A,Statements of Work Page 5 of 29 Contract Number CLI318253-8
Revised as of March 15,2019
AMENDMENT#8
project may be developed
to be climate resilient.
DOH will work with the
subrecipient on the plan
and establish mutual
expectations.
Subrecipients should
provide relevant spatial
data for their project,and
this should be identified in
the detailed project plan.
Subrecipients should
consult with technical staff
and spatial analysts where
appropriate to determine
the spatial data,associated
metadata,and data storage
location that are relevant
for the project.All
subrecipients should
submit project coordinates
(latitude,longitude)in
decimal degrees.
0.2 Quality Assurance QAPP Within 60 days of award
Project Plan(QAPP)
Development MCPH will work with Kitsap
Subrecipient will submit a Public Health.District,Rood
Quality Assurance Project Canal Coordinating Council,
Plan(QAPP)or QAPP Island County Public Health,
waiver using and Department of Ecology
Environmental Protection (ECY)to develop an approved
Agency's(EPA's)National QAPP.
Estuary Program(NEP)
guidance for QAPPs.If a
QAPP is required,
subrecipients will work
with the Washington State
Department of Ecology's
QA Officer to develop and
approve the QAPP.Work
related to collecting
environmental data may
not begin until the QAPP
or waivers are completed
and approved.See EPA
Exhibit A,Statements of Work Page 6 of 29 Contract Number CLH I S253-8
Revised as of March 15,2019
AMENDMENT#8
Programmatic Condition
#5 in this agreement for
more information.
0.3 Evaluation Plan Complete a short one-page Within 30 days of award
document.Use it to plan the
process your program will use
to gather information or collect
data. Following the project,it
will be used to assist in
describing what the outcome
results tell you about the impact
and success of your program
activities.
TASK 1.PROJECT MANAGEMENT AND REPORTING
This task describes the data collection and reporting requirements associated with this subaward.Maintenance of project records,submittal of payment vouchers,fiscal forms,
and progress reports;compliance with applicable procurement,contracting and interlocal agreement requirements;application for,receipt of,and compliance with all required
permits,licenses,easements,or property rights necessary for the project and submittal of required performance items. Carry out project in accordance with any completion dates
outlined in the agreement.Refer to and comply with all underlying federal terms and conditions.
1.1 Project Factsheet Project Fact Sheet August 30,2017 Reimbursement
Create a project factsheet up to S4;603
(using included template) S12,843 based on
and submit it in MS Word actual costs.
with the first quarterly
ro;ress report.
1.2 Bi-monthly(ConCon Bi-monthly invoice and project Due annually:
invoices are due every 60 summaries.
days)Invoicing and June 15
Progress Summary FEATS will serve as project August 15
The subrecipient will email summary for performance October 1 (FEATS)
bi-monthly progress periods that fall on or near December 15
summary and invoicing FEATS due dates.See FEATS March 15(FEATS)
related to project tasks and schedule in Task 1.2.1.
deliverables to the contract
manager.The summary Annual Performance Periods
period is synced to inform
the Grant Program's EPA First Period:
reporting schedule; January I—February
therefore it is critical that
the Project Sponsor submit Second Period:
these summaries to the March—April(FEATS)
Grant Program according
to the following schedule. Third Period:
Progress Summaries shall May—June 30
include,at a minimum:
Exhibit A,Statements of Work Page 7 of 29 Contract Number CLH 18253-8
Revised as of March 15,2019
AMENDMENT#8
• A description of the Fourth Period:
work completed in the July I—August
last performance
period,including total Fifth Period:
spending by the September—October(FEATS)
project sponsor and
any partners and any Sixth Period:
completed November—December
deliverables.
• The status and
completion date for
the project activities
and near-term
deliverables.
• Description of any
problem or
circumstances
affecting the
completion date,scope
of work,or costs.
• Evidence that all the
reporting requirements
have been
satisfactorily
completed(see
below).
1.2.1 Financial and Ecosystem Semi-annual FEATS reports April 1
Accounting Tracking October 1
System(FEATS) FEATS will serve as project
Complete semi-annual summary for performance And upon contract completion
FEATS progress reports,as periods that fall on or near
well as a final FEATS FEATS due dates.See FEATS
report.The final FEATS schedule in Task 1.2.1.
report,reflecting the final
project billing,will be
provided during project
closeout,after the end of
the grant,and will describe
the entire project,
highlighting project
outcomes and discussing
lessons learned.See EPA
Programmatic Condition
Exhibit A,Statements of Work Page 8 of 29 Contract Number CLH18253-8
Revised as of March 15,2019
AMENDMENT#8
I.2.2 Puget Sound Partnership 1. Implementation Status I: March 31-April 28,2017
Required Near-Term November 1-30,2017
Actions(NTA)Reporting May 1-31,2018
NTA owners are required November 2018
to report on the following: Pon pf-j 1
• Implementation status
of their actions on a
semiannual basis Spring 2019
• Financial status of their Upon projectINTA
actions on an annual completion or
basis
2. Financial Status 2.:June 30-August 15,2017
June 29-August 13,2018
Upon project/NTA
completion er-4rros; 84
1.2.3 Women/Minority-Owned MBE/WBE Reporting October 15 annually
Business(MBE/WBE)
Reports And upon project completion
MBE/WBE reporting is
required annually.This
federal reporting is
required for assistance
agreements where there are
funds budgeted for
procuring construction,
equipment,services and
supplies,including funds
budgeted for direct
procurement by the
recipient or procurement
under subawards or loans
in the"Other"category
that exceed the threshold
amount of$150,000,
including amendments
and/or modifications.
1.3 Final Project Report Final Report and updated Fact Upon project completion
A final report will be Sheet
written by the project
owners that describes the
methods,results,lessons
learned and
recommendations for
future work. The final
report will evaluate the
Exhibit A,Statements of Work Page 9 of 29 Contract Number CLH 18253-8
Revised as of March 15,2019
AMENDMENT#8
success of achieving the
performance measures
identified in the detailed
project plan.Included with
the final project report will
be an updated Project Pact
Sheet(see 1.1).
TASK 2. POLICY DEVELOPMENT AND REVIEW
MCPH will develop a policy and procedure that will be used in the implementation of a sampling plan to include the analysis of optical brighteners.In addition,MCPH will
develops and implements a risk based analysis of all OSS along the shoreline of Hammersley Inlet to assure the systems are functioning properly and not impacting surface
water.Policies and procedures,using existing practices in Mason and other counties,will be developed.
2.1 OB Policy&Procedure a)QAPP or QAPP addendum a-b)Within 60 days of award Reimbursement
MCPH will evaluate, and updates clue widliin 30 days up to"$2,433
develop,and complete a b)Policy and procedure for OB of amendinews based on actual
policy and procedure for sampling reviewed by DOH costs.
OB sampling,analysis,and
regulatory implication.
MCPH will provide a copy
to DOH for review and
approval.
2.2 Risk Based OSS Development of a risk based Final procedure to DOH by
Evaluation Procedure OSS evaluation procedure September 30,2017.
MCPH,in cooperation reviewed by DOH.
with DOH,will develop a
risk based OSS evaluation
procedure.The procedure
will assess the risk of
individual OSS and the
potential for impact to
surface water.The
procedure will assign high,
medium,and low tiers with
the intent of implementing
field-based OSS
evaluations and dye studies
based on the assigned tier.
2.3 OSS Dye Study Protocol a)Evaluation of the current a-b)Final procedure to DOH by
&Procedure OSS dye study protocols and October 31,2017
Reevaluation procedures,in cooperation with
MCPH,in cooperation DOH
with DOH,will evaluate
the county's current OSS b)Update current OSS dye
dye study protocols and study protocols and procedures
procedures.Protocols will
Exhibit A,Statements of Work Page 10 of 29 Contract Number CLI418253-8
Revised as of March 15,2019
AMENDMENT#8
be updated,as necessary,
based on current conditions
and evaluation techniques.
TASK 3. SHORELINE MONITORING AND"HOT SPOT"IDENTIFICATION
Hammersley Inlet is a shallow,narrow tidal channel connecting Oakland Bay with the main body of southern Puget Sound.The inlet is approximately 6.5 miles in length and
0.13 mile wide.The entire watershed is approximately 36.5 square miles,most of which is along the southern shoreline. There are approximately 175 small creeks,drainages,
culverts,and seeps exist along the shorelines of the Inlet. This study will target a minimum of 50 drainages with historically elevated bacteria levels or located near significant
upland development.
MCPH will use the policies and procedures developed in Task 2 to conduct a pilot project to monitor for optical brighteners(OB)and fecal coliform(FC). Optical brighteners
are fluorescent dyes found in most laundry detergents.Since adsorption is critical in the performance of on-site sewage systems(OSS),the presence of OB in surface water may
indicate ineffective OSS treatment. Monitoring for OB will help differentiate the source of elevated fecal coliform bacteria levels currently and previously identified in upland
drainages.
MCPH will work with DOH to develop the sampling plan. General direction of the sampling will include drainage and discharge analysis during both the"wet"and"dry'
seasons of the study period. The period of October through April will be considered the"wet"season while May through September will be considered the"dry"season. OB
cotton pads will be installed at each site during portions of the evaluation period. Sites will be evaluated for a four week period during both"wet"and"dry"seasons. During
these evaluation periods,cotton pads will be replaced each week. Flow measurements and FC samples will be collected when the cotton pads are replaced. Additional.FC and
OB sampling may be used to investigate and segment drainages with positive OB detections or elevated FC concentrations.Sampling and analysis activities will be performed
according the plans and policies developed for the study.
MCPH will analyze OB pads under a long wavelength ultraviolet(365 nm)light in-house and verify the results of approximately 10%of the samples at Ozark Underground
Laboratory. Fecal coliform sampies will be analyzed at a certified laboratory outside Mason County. All results will be provided to DOH.
3.1 OB&Fecal Conform a)OB and FC monitoring plan May 31,2019 Reimbursement
Sampling approved by DOH up to 7
MCPH will conduct fresh 549,806 based on
water monitoring at a b)Number and results of OB actual costs.
minimum of 50 drainages cotton sample pads(up to 600)
to Hammersley Inlet to analyzed by MCPH
identify the presence of
optical brighteners(OB). c) Number and results of OB
Sampling at each drainage cotton sample pads analyzed by
will occur one time during Ozark Underground Laboratory
the predefined"wet"and (up to 60 for QA/QC)
"dry"seasons.All OB pads
will be analyzed in-house d)Number and results of fecal
according to developed and coliform monitoring samples.
approved procedures.Ten (Up to 600 samples collected
percent of the pads will be by MCPH)
analyzed by Ozark
Underground Laboratory e)Number of drainages
for QA/QC. evaluated along the shorelines
Simultaneously,the of Hammersley Inlet. (A
selected drainages will be minimum of 50 drainages
monitored for fecal evaluated.)
coliform bacteria.Fecal
coliform samples will be
Exhibit A,Statements of Work Page 11 of 29 Contract Number CLH18253-8
Revised as of March 15,2019
AMENDMENT#8
analyzed by a certified
laboratory.MCPH will
develop a sampling plan in
cooperation with DOH.
TASK 4: RISK BASED EVALUATION OF ON-SITE SEWAGE SYSTEMS(OSS)
According to a 2016 shoreline survey completed by DOH,there are approximately 350 developed parcels along the Hammersley inlet shorelines using OSS for wastewater
treatment and dispersal. Land use is a mix of residential,timber,and agricultural lands with residential development along the fresh and marine water shorelines.Ninety-eight
percent of these sites were single family use sites with 60%considered to be full time residential sites. Fifty-eight percent of the OSS used gravity distribution for dispersal of
effluent and 43%of the systems were greater than 30 years old.To identify impacts from OSS into shellfish growing areas MCPH will complete an.OSS risk based evaluation
along Hammersley Inlet.
4.1 OSS Record Search a) In-house record search a) Ongoing. Reimbursement
MCPH will complete an and data evaluation for a up to 94,0 9
OSS record search for all minimum of 350 First record search due S63.527 based on
systems along the shoreline parcels October 31,2017. actual costs.
Hammersley Inlet shoreline.
A risk based analysis will be b) Development of a risk b) September 30,2018
completed using the data based list of parcels for
collected and summarized to field evaluation
prioritize field based
analysis.This will be a
working document that will
be continually revised and
updated.
4.2 OSS Field Evaluations a)Number of field parcel a) Field evaluation of 100
MCPH will complete"wet" surveys.Conduct a minimum of parcels by April 2018
season field evaluations 200 field parcel surveys in the
using the procedures work area.
identified in the OSS field
evaluation portion of the b)Development of a risk based b) Field evaluation of 100
performance plan outline in list of parcels requiring OSS parcels by April 2019
Task 2. dye studies.
c)Summarize number and c) See Task 1.
results Deliverables/Outcomes
and other progress indicators
utilizing DOH Pollution
Identification and Correction
Implementation Reporting form
quarterly. Attach reports to
each FEATS report. The final
quarterly report will have the
cumulative total for the entire
project period.
Exhibit A,Statements of Work Page 12 of 29 Contract Number CLH 18253-8
Revised as of March 15,2019
AMENDMENT#8
4.3 OSS Dye Testing a) Number of OSS dye tests a) OSS dye test of 30-581/o
MCPH will complete dye completed. A target of parcels by 4pHEAlfoy 2018
tests of the OSS of concern 100%of OSS identified
identified in Task 4.2 using in the risk analysis will be OSS dye test of 100%of
approved dye testing dye tested. parcels -4tw4-Mgv^ 2019
methodologies.
b) Number of OSS b) 4 May 2019
deficiencies/failures
identified
c) Summarize number and c) See Task 1.
results
Deliverables/Outcomes
and other progress
indicators utilizing DOH
Pollution Identification
and Correction
Implementation Reporting
form quarterly. Attach
reports to each FEATS
report. The final
quarterly report will have
the cumulative total for
the entire project period.
4.4 OR Positive"Hot Spot" a) Completed record a) Record search and field
OSS Follow up searches for developed evaluations completed for
MCPH will follow up on parcels new OB postive first"wet"season by June
positive OB and fecal drainages within 30 days 2018
coliform results identified in of positive sampling
Task 3 by completing OSS results.
record searches for those b) Completed risk based b) Record search and field
parcels in the vicinity of the field evaluations of evaluations completed for
implicated drainages.Risk developed parcels near second"wet"season by
based field evaluation and OB positive drainages May 2019
dye tests shall be completed within 15 days of record
according to the search
risk-based c) Completed risk based c) OSS dye studies completd
OSS evluation procedure OSS dye studies of by May 2019
outlined in Task 2. developed parcels near
OB positive drainages.
d) Up to 30 investigative FC d) May 2019
samples and results.
Exhibit A,Statements of Work Page 13 of 29 Contract Number CLH18253-8
Revised as of March 15,2019
AMENDMENT#8
TASK 5. STUDY EDUCATION AND OUTREACH
As a member of Mason ECO Net,MCPH will help plan and participate in Oakland Bay Day.Oakland Bay Day is hosted by Mason ECO Net to educate the community about
water quality.Mason County will have an educati.onaI booth educating attendees about OSS maintenance and regulation and water quality.MCPH will provide twelve thousand
(12,000)every door direct mailings(EDDM)to the residents and landowners in the Oakland Bay MRA to encourage attendance.
MCPH will educate the shoreline OSS owners within the Hammersley Inlet emergency closure area with an out of date O&M status about their maintenance status and ways to
move into compliance.These informational mailings will occur four(4)times throughout the project.The number of mailings will depend on the number of shoreline OSS out of
compliance at the time of the mailing.
One hundred(100)rebates will be offered first come,first served to incentivize OSS maintenance.A$200 rebate will be offered for O&M or pumping.A second$200 rebate
will be offered for the installation of risers or an effluent filter.MCPH will prioritize the rebates first to the OSS owners in the Hammersley Inlet and then to the general MRA
where appropriate.Within each priority area MCPH will offer rebates to OSS with no O&M or out-of-date O&M.
MCPH will inform all residents and landowners in the Hammersley Inlet study area,via direct mailing,of the project described in Tasks 2-3 before work starts. The mailing will
inform owners of the pending project,the importance of OSS operation and maintenance,and the time,date,and location of the scheduled community-based meeting.At project
completion.findings will be available for landowner review.
5.1 Oakland Bay Days a) Copy of the direct mailing. a) May 30,2018 Reimbursement
MCPH will coordinate and Draft mailer materials May 30,2019 up to$35,462
participate in Oakland Bay will be sent to DOH staff based on actual
Day 2018 and 2019 by for review costs.
providing water quality
and onsite information at b) Number of mailings 10,000 b) June 30,2018
an educational booth. mailings for 2018
MCPH will send 12,000 c) Number of mailings. c) June 30,2019
EDDM mailings to inform 10,000 mailings for 2019
and invite residents and
landowners of the Oakland d) Coordinate and participate d) July 2018
Bay MRA to Oakland Bay in Oakland Bay Day 444y June 2019
Day to help increase
attendance and to track the e) Number of Oakland Bay e) Upon project completion
effectiveness of EDDM for Day 2018 and 2019
educational events. attendees who heard
about the event through
the mailings.MCPH will
report outcomes in
FEATS.
5.2 Oakland Bay OSS O&M Mailings up to eighty(80) a)October 2017
Educational Mailings shoreline and upland OSS
MCPH will inform all owners within Oakland Bay b)April 2018
shorelines OSS owners with out of date operation and
within the Oakland Bay maintenance compliance. c)October 2018
Shellfish Growing Area d)April 2019.
with out of date OSS of
O&M status and next steps
for O&M compliance and
Exhibit A,Statements of Work Page 14 of 29 Contract Number CLH 18253-8
Revised as of March 15,2019
AMENDMENT#8
rebate information.There
will be four(4)mailings.
5.3 OSS Rebates a)Provide up to one hundred a)April 30,2019
Incentives will be offered (100)rebates
to OSS owners within the
Oakland Bay and
Hammersley shellfish
growing areas in the form
of rebates.Applicants will
be required to submit their
paid invoices with the
proper paperwork to
receive the rebate. A$200
rebate will be offered for
either maintenance or
pumping.A second$200
rebate will be offered to
install risers and or effluent
filter.if a homeowner self-
installs risers or an effluent
filter,MCPH will conduct
a site visit to inspect the
construction.Each
interested household will
be eligible for both rebates
with die maximum amount
of$400 per household.
MCPH will-offer rebates
exclusively to Hammersley
Inlet OSS owners until
April 2018. After April
2018,the rebates offered
are first come,first served.
Within each priority area
MCPH will offer rebates to
OSS with no O&M and out
of date O&M,MCPH will
offer incentives to
individuals as well as
targeted areas.
Exhibit A,Statements of Work Page IS of 29 Contract Number CLH I S253-8
Revised as of March 15,2019
AMENDMENT#8
5.4 Hammersley Inlet Study
Education&Outreach
5A.1 MCPH will inform all a)Copy of the mailing. Draft a-b)September 2017
Hammersley Inlet mailer materials will be sent to
shoreline residents and DOH staff for review.
landowners in the study
area,via direct mailing,of b)Date and number of mailings
the project before work sent(up to 400).
starts. The mailing will
inform owners of the
pending project,the
importance of OSS
operation and maintenance,
and the time,date,and
location of the scheduled
community-based meeting.
At project completion,
findings will be available
for landowner review.
5.4.2 MCPH will hold one a)Report showing agenda, a) November 2017
community-based meeting time,date,location and
to inform the shoreline estimated number of attendees.
OSS owners,and other
interested parties,of the
upcoming project.
TASK 6.BROADER IMPACTS AND COMMUNICATION
MCPH will attend a knowledge exchange event relevant to the project topic(conference,forum,stakeholder workshop). The
subrecipient will submit high-quality project photos or video clips of the project(process,progress,etc.).MCPH will ensure anyone in the photo or video has signed a release in
case photos or videos are used for future publications.
6.1 Submit high-quality project a) Photos a) Upon completion of project Reimbursement
photos or videos. up to 0$7,800
b) MCPH will b) November based on actual
cttveet�trt< i+rc�try�rrrrF i costs.
L1CPH + &mA stye, Fe
iri11 attend a knowledge attend the Washington XhT 2019
exchange event relevant to State Environmental
the project topic. Health Association
(WSEHIIJ annual
Education Coo erence
eieio 0&DOM we►f fep
Exhibit A,Statements of Work Page 16 of 29 Contract Number CLH18253-8
Revised as of March 15,2019
AMENDMENT#8
�Seter�er.�-S►�►�s+irrrr-i+t
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
http:,'/www.12haboard.orzln-content/u210ads[PH A B-Standards-and-Measures-Version-1.O.pdf
BUDGET
Category Amount
Personnel/Salaries S P-,7.3 4 is f 1,22 t
Fringe Benefits Sd i,633 S41,103
Travel 4052.040
Equipment (federal definition) $0
Supplies $750
Contracts $20,500
Lab Services
Subawards $0
Name and amount ea.
Other
• Rebates $22,197
• Postage
• EDDM Mailings
Total Direct Charges $157,814
Indirect Charges $14,057
(federally approved rate)
TOTAL $171,871
Program Specific Reg uirements/Narratiye
Special Requirements
Federal Funding Accountability and Transparency Act(FFATA)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Data Universal Numbering System(DUNS®)number.
Information about the LHJ and this statement of work will be made available on USASpending.gov by DOH as required by P.L. 109-282.
Exhibit A,Statements of Work Page 17 of 29 Contract Number CLH18253-8
Revised as of March 15,2019
AMENDMENT#8
Program Manual,Handbook,Policy References
Mason County's On-site Sewage System Management Plan,December 5,2007
Special References(RCWs,WACs,etc.)
WAC 246-272A,RCW 70.118A,Puget Sound Action Agenda,Interim PIC Program Protocols
Federal funds from the Environmental Protection Agency(EPA)National Estuary Program(NEP)Account must be used to implement elements and activities o f the local on-site
sewage management plans that do not conflict with and are consistent with the goals,strategies,objectives,and actions of the Puget Sound Action Agenda.
Monitoring Visits(frequency,type)
The DOH program contact may conduct at least one(1)monitoring visit during the life of this project.The type,duration,and timing of visit will be determined and scheduled in
cooperation with the subawardee.The DOH Fiscal Monitoring Unit may conduct at least one(1)fiscal monitoring visit during the life of this project.
Special Instructions
"Unexpended funds,tasks,and deliverables in this statement of work that are not completed by December 31,2017 will be reauthorized for work in 2018 in anew statement of
work under the new consolidated contract term beginning January 1,2018.. Total spending between the 2015-2017 and 2018-2020 SOWs may not exceed$202,427(award total)."
Progress reports are due to DOH via email to megan.schell(c1doh.wa.gov and nichole.sinurtons aidoh.lva.sfov on
the following dates:March 1,2018,September 1,2018,and upon contract completion.Minority and Women-Owned business Reporting is due to kristy.warner@doh.wa.lov and
cc: megan.schellCcc?,doh.wa.gov and nichnie.simmorxvra,.doh.wa..Qov on the following dates:October 1.5 annually,
and upon contract completion.
All environmental data must be entered by the LHJ into EPA's Storage and Retrieval data system(STORET)at kitty://www.cya.gov/STORET.The semi-annual report format and
data reporting requirements will be provided by DOH and may be modified throughout the contract period via email announcement.
"Note:Deliverables and due dates after December 31,2017 are included in this statement of work for informational purposes only and will be included in a new
statement of work under the new consolidated contract term beginning January 1,2018..
Program Specific Reg uirem ents/Na rrative
The following provisions are the pass-thru requirements of all U.S.EPA-DOH subawards funded under cooperative agreement PCOIJ18001-0.
Administrative Conditions
1. General Terms and Conditions-Effective March 29,2016
The subrecipient agrees to comply with the current EPA general terms and conditions available at: https://www.epa.goy/grants/epa-general-terms-and-conditions-effective-
march-29-2016-or-later.These terms and conditions are in addition to the assurances and certifications made as part of the award and terms,conditions or restrictions cited
below.
The EPA repository for the general terms and conditions by year can be found at: https://www.cpa.gov/grantsihrant-terms-and-conditions#general
2. General Terms and Conditions-Consultant Cap-Additional Information
In addition to the General Terms and Conditions#6"Consultant Cap",as of January 1,2016,the limit is$614.48 per day$76.81 per hour.
NOTE:For future years'limits,the subrecipient may find the annual salary for Level IV of the Executive Schedule on the following Internet site: http://w'vw.o)m.P-ov/oca.
Select"Salary and Wages",and select"Rates of Pay for the Executive Schedule".The annual salary is divided by 2087 hours to determine the maximum hourly rate,which is
then multiplied by 8 to determine the maximum daily rate.
Exhibit A,Statements of Work Page 18 of 29 Contract Number CLH 18253-8
Revised as of March 15,2019
AMENDMENT#8
3. General Terms and Conditions—Cybersecurity
The subrecipient agrees to comply with the current EPA general terms and conditions"Cybersecurity".
The terms and conditions can be found on the EPA Grants Terms and Conditions Website.
For STATE:httt)s://www.et)a.2ov/firants/state-izrant-cvbersecuri ,-condition
For TRIBE:https//www.et)a.�,ov/grants/tribal-tyrant-c b�ersecurity-condition
For Other Recipients:http://www2.epa.gov/sites/production/files/2015-07/documentstcybersecurity--mntconditionforotherr ecipients.pdf,
4. General Terms and Conditions-Indirect Costs for States and Tribal
The cost principles of 2 CFR 200 Subpart E are applicable,as appropriate,to this subaward.
In addition to the General Terms and Conditions"Indirect Cost Rate Agreements",if the subrecipient does not have a previously established indirect cost rate,it agrees to
prepare and submit its indirect cost rate proposal in accordance with 2 CFR 200 Appendix VII.
For State Agencies
The subrecipient must send its proposal to its cognizant federal agency within six(6)months after the close of the governmental unit's fiscal year.If EPA is the cognizant
federal agency,the state subrecipient must send its indirect cost rate proposal within six(6)months after the close of the governmental unit's fiscal year to:
Regular Mail
Financial Analysis and Rate Negotiation Service Center Office of Acquisition Management
U.S.Environmental Protection Agency
1200 Pennsylvania Avenue,NW,MC 3802R
Washington,DC 20460
Mail Courier(e.e.FedEx,UPS,etc.)
Financial Analysis and Rate Negotiation Service Center Office of Acquisition Management
US Environmental Protection Agency
1300 Pennsylvania Avenue,NW,6th floor
Bid and Proposal Room Number 61107
Washington,DC 20004
For Indian Tribe
If the subrecipient does not have a previously established indirect cost rate,the subrecipient must submit their indirect cost rate proposals to:
National Business Center
Indirect Cost Services
U.S.Department of the Interior
2180 Harvard Street,Suite 430
Sacramento,CA 95815-3317
The subrecipient agrees to comply with the audit requirements in accordance with 2 CFR 200 Subpart F.
5. Utilization of Small,Minority and Women's Business Enterprises(MBE/WBE)
General Compliance,40 CFR,Part 33
The subrecipient agrees to comply with the requirements of EPA's Disadvantaged Business Enterprise(DBE)Program for procurement activities under assistance agreements,
contained in 40 CFR,Part 33.
MBE/WBE Reporting,40 CFR,Part 33,Subpart E
MBE/WBE reporting is required in annual reports.Reporting is required for assistance agreements where there are funds budgeted for procuring construction,equipment,
services and supplies,including funds budgeted for direct procurement by the subrecipient or procurement under subawards or loans in the"Other"category that exceed the
threshold amount of$150,000.,including amendments and/or modifications.
Exhibit A,Statements of Work Page 19 of 29 Contract Number CLH 1.8253-8
Revised as of March 15,2019
AMENDMENT#8
Based on EPA's review of the planned budget,this award meets the conditions above and is subject to the Disadvantaged Business Enterprise(DBE)Program reporting
requirements.However,if subrecipient believes this award does not meet these conditions,the subrecipient must provide a justification and budget detail within 21 days of the
award date clearly demonstrating that,based on the planned budget,this award is not subject to the DBE reporting requirements to the Region 10 DBE Coordinator.
The subrecipient agrees to complete and submit a"MBE/WBE Utilization Under Federal Grants,Cooperative Agreements and Interagency Agreements"report(EPA Form
5700-52A)on an annual basis.All procurement actions are reportable,not just that portion which exceeds$150,000.
When completing the annual report,subrecipients are instructed to check the box titled"annual'in section 113 of the form.For the final report,subrecipients are instructed to
check the box indicated for the"last report"of the project in section 1 B of the form.Annual reports are due by October 3011'of each year.Final reports are due by October 30U'
or 90 days after the end of the project period,whichever comes first.
The reporting requirement is based on total procurements.Subrecipients with expended and/or budgeted funds for procurement are required to report annually whether the
planned procurements take place during the reporting period or not.If no budgeted procurements take place during the reporting period,the subrecipient should check the box
in section 5B when completing the form.
The current EPA Form 5700-52A can be found at the EPA Office of Small Business Program's Home Page at http'Iwww.ena.uov/osbn/dbereportine.htm.
This provision represents an approved deviation from the MBE/WBE reporting requirements as described in 40 CFR,Part 33,Section 33.502;however,the other requirements
outlined in 40 CFR Part 33 remain in effect,including the Good Faith.Effort requirements as described in 40 CFR Part 33 Subpart C,and Fair Share Objectives negotiation as
described in 40 CFR Part 33 Subpart D and explained below.
Six Good Faith Efforts,40 CFR,Part 33,Subpart C
Pursuant to 40 CFR,Section 33.301,the subrecipient agrees to make the following good faith efforts whenever procuring construction,equipment,services and supplies under
an EPA financial assistance agreement,and to require that sub-subrecipients,loan subrecipients,and prime contractors also comply.Records documenting compliance with
the six good faith efforts shall be retained:
(a) Ensure DBEs are made aware of contracting opportunities to the fullest extent practicable through outreach and recruitment activities.For Indian Tribal,State and Local
and Government subrecipients,this will include placing DBEs on solicitation lists and soliciting them whenever they are potential sources.
(b) Make information on forthcoming opportunities available to DBEs and arrange time frames for contracts and establish delivery schedules,where the requirements permit,
in a way that encourages and facilitates participation by DBEs in the competitive process.This includes,whenever possible,posting solicitations for bids or proposals for
a minimum of 30 calendar days before the bid or proposal closing date.
(c) Consider in the contracting process whether firms competing for large contracts could subcontract with DBEs.For Indian Tribal,State and local Government
subrecipients,this will include dividing total requirements when economically feasible into smaller tasks or quantities to permit maximum participation by DBEs in the
competitive process.
(d) Encourage contracting with a consortium of DBEs when a contract is too large for one of these firms to handle individually.
(e) Use the services and assistance of the SBA and the Minority Business Development Agency of the Department of Commerce.
(fl If the prime contractor awards subcontracts,require the prime contractor to take the steps in paragraphs(a)through(e)of this section.
Contract Administration Provisions,40 CFR,Section 33.302
The subrecipient agrees to comply with the contract administration provisions of 40 CFR,Section 33302.
Bidders List,40 CFR,Section 33.501(b)and(c)
Subrecipients of a Continuing Environmental Program Grant or other annual reporting grant,agree to create and maintain a bidders list.Subrecipients of an EPA financial
assistance agreement to capitalize a revolving loan fund also agree to require entities receiving identified loans to create and maintain a bidders list if the subrecipient of the
loan is subject to,or chooses to follow,competitive bidding requirements.Please see 40 CFR,Section 33.501 (b)and(c)for specific requirements and exemptions.
Exhibit A,Statements of Work Page 20 of 29 Contract Number CLHI8253-8
Revised as of March 15,2019
AMENDMENT#8
Fair Share Objectives,40 CFR,Part 33,Subpart D
(1) For Grant Awards$250,000 or Less
This assistance agreement is a Technical Assistance Grant(TAG);or the award amount is$250,000 or less;or the total dollar amount of all of the subrecipient's
financial assistance agreements from EPA ui the current Federal fiscal year is$250,000 or less.Therefore,the subrecipient of this assistance agreement is exempt
from the fair share objective requirements of 40 CFR,Part 33, Subpart D,and is not required to negotiate fair share objectives/goals for the utilization of MBE/WBEs
in its procurements.
(2) For Subrecipients Accepting Goals
A subrecipient must negotiate with the appropriate EPA award official,or his/her designee,fair share objectives for MBE and WBE participation in procurement
under the financial assistance agreements.
In accordance with 40 CFR, Section 33.411 some subrecipients may be exempt from the fair share objectives requirements as described in 40 CFR,Part 33,Subpart
D.Subrecipients should work with their DBE coordinator,if they think their organization may qualify for an exemption.
Accepting the Fair Share Objectives/Goals of Another Subrecipient
The dollar amount of this assistance agreement,or the total dollar amount of all of the subrecipient's financial assistance agreements in the current federal fiscal year
from EPA is$250,000,or more.The subrecipient accepts the applicable MBE/WBE fair share objectives/goals negotiated with EPA.The Region 10 fair share
objectives/goals can be found:lit!n://w,,vw.epa.gov/osbp/pdfclrl Ofairsilareg_oals,l)df,
By signing this financial assistance agreement,the subrecipient is accepting the fair share objectives/goals and attests to the fact that it is purchasing the same or
similar construction,supplies,services and equipment,in the same or similar relevant geographic buying market.
Negotiating Fair Share Objectives/Goals,40 CFR,Section 33.404
The subrecipient has the option to negotiate its own MBE/WBE fair share objectives/goals. If the subrecipient wishes to negotiate its own MBE/WBE fair share
objectives/goals,the subrecipient agrees to submit proposed MBE/WBE objectives/goals based on an availability analysis,or disparity study,of qualified MBEs and
WBEs in their relevant geographic buying market for construction,services,supplies and equipment.
The submission of proposed fair share goals with the supporting analysis or disparity study means that the subrecipient is not accepting the fair share
objectives/goals of another subrecipient.The subrecipient agrees to submit proposed fair share objectives/goals,together with the supporting availability analysis or
disparity study,to the Regional MBE/WBE Coordinator within 120 days of its acceptance of the financial assistance award. EPA will respond to the proposed fair
share objective/goals within 30 days of receiving the submission.If proposed fair share objective/goals are not received within the 1.20 day time frame,the
subrecipient may not expendits EPA funds for procurements until the proposed fair share objective/goals are submitted.
(3) For Subrecivients with Established Goals
The subrecipient must negotiate with the appropriate EPA award official,or his/her designee,fair share objectives for MBE and WBE participation in procurement
under the financial assistance agreements.
In accordance with 40 CFR,Section 33.411 some subrecipients may be exempt from the fair share objectives requirements described in 40 CFR,Part 33,Subpart D.
Subrecipients should work with their DBE coordinator,if they think their organization may qualify for an exemption.
Current Fair Share Objective/Goal
The dollar amount of this assistance agreement or the total dollar amount of all of the subrecipient's financial assistance agreements in the current federal fiscal year
from EPA is$250,000,or more.The Region 10 fair share objectives/goals can be found: http://www.epa. og v/osbp/pdfs/`rl0fairshare ooals.pd£
Negotiating Fair Share Objectives/Goals
In accordance with 40 CFR,Part 33,Subpart D,established goals/objectives remain in effect for three fiscal years unless there are significant changes to the data
supporting the fair share objectives.The subrecipient is required to follow requirements as outlined in 40 CFR Part 33,Subpart D when renegotiating the fair share
objectives/goals.
Exhibit A,Statements of Work Page 21 of 29 Contract Number CLH18253-8
Revised as of March 15,2019
AMENDMENT#8
(4) For DWSRF,CWSRF and BROWNFIELDS RLF Subrecivients ONLY
Objective/Goals of Loan Subrecipients
As a subrecipient of an EPA financial assistance agreement to capitalize revolving loan funds,the subrecipient agrees to either apply its own fair share objectives
negotiated with EPA to identified loans using a substantially similar relevant geographic market,or negotiate separate fair share objectives with its identified loan
subrecipients.These separate objectives/goals must be based on demonstrable evidence of the availability of MBEs and WBEs in accordance with 40 CFR,Part 33,
Subpart D.
The subrecipient agrees that if procurements will occur over more than one year,the subrecipient may choose to apply the fair share objective in place either for the
year in which the identified loan is awarded or for the year in which the procurement action occurs.The subrecipient must specify this choice in the financial
assistance agreement,or incorporate it by reference therein.
(5) RIO DBE Coordinator and Where to Send Report
Andrea Bennett at(206)553-1789 or email.Bcnnett.Andrea rAepa.gov. The coordinator can answer any MBEIWBE reporting questions you may have.MBE/WBE
reports should be sent to the EPA Region 10,Grants and Interagency Agreements Unit, 1200 Sixth Avenue,Suite 900,OMP-173,Seattle,WA 98101 or FAX to
(206)553-4957.
ProLrammatic Conditions
1. Semi-Annual Performance Reports
The subrecipient shall submit performance reports every six(6)months during the life of the project.Reports are due 30 calendar days after the end of each reporting period.
Reports shall be submitted to the DOH Contract Manager and may be provided electronically.
In accordance with 2 CFR 200.328,as appropriate,the subrecipient agrees to submit performance reports that include brief information on each of the following areas:
(a) A comparison of actual accomplishments to the outputs/outcomes established in the assistance agreement work plan for the period;
(b) The reasons why established goals were not met,if appropriate;
(c) Additional pertinent information including,when appropriate,analysis and explanation of cost overruns or high unit costs.
In addition to the semi-annual performance reports,the subrecipient shall immediately notify the DOH Contract Manager of developments that have a significant impact on the
award-supported activities. As appropriate,the subrecipient agrees to inform the DOH Contract Manager as soon as problems, delays or adverse conditions become known
which will materially impair the ability to meet the outputs/outcomes specified in the assistance agreement work plan. This notification shall include a statement of the action
taken or contemplated,and any assistance needed to resolve the situation.
The subrecipient will submit performance reports through EPA's Puget Sound Financial and Ecosystem Accounting Tracking System(FEATS).Reports are due at least 30
calendar days after the end of each reporting period.Earlier,but not later due dates may be mutually agreed upon by the Contract Manager and subrecipient in the award
document.The reporting periods shall end March 31 st and September 30th of each calendar year.Reports shall be submitted to the DOH Contract Manager on the FEATS
form provided by the Contract Manager and shall be submitted by electronic mail.The subrecipient agrees to submit performance reports that include brief information on
each of the following areas:
(a) A comparison of actual accomplishments to the outputs/outcomes established in the assistance agreement work plan for the period;
(b) The reasons for slippages if established outputs/outcomes were not met;
(c) Additional pertinent information,including when appropriate,analysis and information of cost overruns or high unit costs.
2. Final Performance Report
The subrecipient shall submit a final performance report through FEATS,which is due 90 calendar days after the expiration or termination of the award.The report shall be
submitted to the DOH Contract Manager and must be provided electronically.The report shall generally contain the same information as in the periodic reports,but should
cover the entire project period.After completion of the project,the DOH Contract Manager may waive the requirement for a final performance report if the DOH Contract
Manager deems such a report is inappropriate or unnecessary.
Exhibit A,Statements of Work Page 22 of 29 Contract Number CLHi8253-8
Revised as of March 15,2019
AMENDMENT#8
3. Program Income-Addition
If program income is generated,the subrecipient is required to account for program income related to this project,Program income earned during the project period shall be
retained by the subrecipient and shall be added to funds committed to the project by EPA and the subrecipient,and shall be used to further eligible project objectives.
4. Recognition of EPA Funding
Reports,documents,signage,videos,or other media,developed as part of projects funded by this assistance agreement shall contain the following statement:
"This project has been funded wholly or in part by the United States Environmental Protection Agency under assistance agreement(number)to(subrecipient).The contents of
this document do not necessarily reflect the views and policies of the Environmental Protection Agency,nor does mention of trade names or commercial products constitute
endorsement or recommendation for use."
5. Quality Assurance Requirements(2 CFR 1500.11)(if applicable)
Acceptable Quality Assurance documentation must be submitted within 30 days of the acceptance of this agreement or another date as negotiated with the DOH
Contract Manager and NEP Quality Assurance Coordinator.No work involving direct measurements or data generation,environmental modeling,compilation of data
from literature or electronic media,and data supporting the design,construction,and operation of environmental technology shall be initiated under this project until the EPA
Project Officer,in concert with the EPA Quality Assurance Manager,has approved the quality assurance document.
Instructions to Submit Quality Assurance Documents for Review
Please refer to The Department of Ecology's website at:httti:;lwtivw.ccy.wa.gov/pro rag msieaplaaldocs/NEPQAPPiindex.html for guidance and templates. Submit the
Acceptable Quality Assurance documentation to Tom Gries at tprl461 ta�ecv,wa.gov(NFP Quality Assurance Coordinator)for review with a cc:to megan_schelloadoh.wa.tov
and 'and nichole.sirnrnons�'zi),clr)h.u-a.zov(DOTI NEP Contract Managers).
Additional information on these requirements can be found at the EPA Office of Grants and Debarment website: http:/!www.epa.gov/ogdf,gmts/assurance.htm.
6. Peer Review
The results of this project may affect management decisions relating to Puget Sound.Prior to finalizing any significant technical products the Principal Investigator(PI)of this
project must solicit advice,review and feedback from a technical review or advisory group consisting of relevant subject matter specialists.A record of comments and a brief
description of how respective comments are addressed by the PI will be provided to the Project Monitor prior to releasing any final reports or products resulting from the
funded study.
7. Competency of Organizations Generating and/or Using Environmental Measurement Data
In accordance with.Agency Policy Directive Number FEM-201.2-02,Policy to Assure the Competency of Organizations Generating Environmental Measurement Data under
Agency-Funded Assistance Agreements,subrecipient shall maintain competency for the duration of the project period of this agreement and this will be documented during
the annual reporting process.A copy of the Policy is available online at hLp://Nvww.cpa.l ov/fem/lab comp.htm or a copy may also be requested by contacting the DOH
Contract Manager for this award.
Federal Assistance Anreement Funds Up To$200,000
Subrecipient agrees that if the total federal funding obligated on this award exceeds$200,000(resulting from subsequent amendments to this agreement)and will involve the
use or generation of environmental data it will(unless it has otherwise done so)demonstrate competency prior to carrying out any activities involving the generation or use of
environmental data under this agreement.
Federal Assistance Agreement Funds Exceed or Expect to Exceed$200,000
Subrecipient agrees,by entering into this agreement,that it has demonstrated competency prior to award,or alternatively,where a pre-award demonstration of competency is
not practicable.Subrecipient agrees to submit documentation and demonstrate competency prior to carrying out any activities under the award involving the generation or use
of environmental data.
Shellfish Strategic Initiative Quality Assurance Coordinator Contact: Tom Gries at t rgr1461 ecy.wa.gov
Exhibit A,Statements of Work Page 23 of 29 Contract Number CLH18253-8
Revised as of March 15,2019
AMENDMENT#8
8. STORET Requirement
Subrecipients are required to institute standardized reporting requirements into their work plans and include such costs in their budgets.All water quality data generated in
accordance with an EPA approved Quality Assurance Project Plan as a result of this assistance agreement,either directly or by subaward,will be required to be transmitted
into the Agency's Storage and Retrieval(STORET)data warehouse using either WQX or WQX web.Water quality data appropriate for STORET include physical,chemical,
and biological sample results for water,sediment and fish tissue.The data include toxicity data,microbiological data,and the metrics and indices generated from biological
and habitat data.The Water Quality Exchange(WQX)is the water data schema associated with the EPA, State and Tribal Exchange Network.Using the WQX schema
partners map their database structure to the WQX/STORET structure.WQX web is a web based tool to convert data into the STORET format for smaller data generators that
are not direct partners on the Exchange Network.More information about WQX,WQX web,and the STORET warehouse,including tutorials,can be found at
17itn:!'r www.epa,aovistoret/wgxl
If activities submitted as match for this federal assistance agreement involve the generation of water quality data,the resulting information must be publicly accessible(in
STORET or some other database).Subrecipients are encouraged to develop a cross walk between any non-STORET database utilized for the storage of water quality data
associated with match activities and EPA's Water Quality Exchange(WQX).
9. Riparian Buffers
Riparian buffer restoration projects in agricultural areas shall be consistent with the interim riparian buffer recommendations provided to EPA and the Natural Resource
Conservation.Service by National Marine Fisheries Service letters of January 30,2013. (stamp received date-February 4,2013)and April 9,2013(stamp received date—
April 16,2013),or the October 28,2013 guidance.Grantees shall confirm in writing projects'consistency with the recommendations referenced above.When developing
project proposals,grantees also should consider the extent to which proposals include appropriate riparian buffers or otherwise address pollution sources on other water
courses on the properties in the project area to support water quality and salmon recovery.Deviations can only be obtained through an exception approved by EPA.In order
for EPA to evaluate a request for an exception,the grantee must submit the scientific rationale demonstrating adequacy of buffers for supporting water quality and salmon
recovery.The request must summarize tribal input on the scientific rationale or other relevant issues.The scientific rationale could be developed from sources such as site-
specific assessment data,salmon recovery plans,Total Maximum Daily Loads(TMDLs)and the state nonpoint plan.EPA will confer with the National Oceanic and
Atmospheric Administration(NOAA)and the Washington Department of Ecology and provide the opportunity for affected tribes to consult with EPA before making a final
decision on a deviation request.
10. International Travel(Including Canada)
All International Travel must be approved by the Office of International and Tribal Affairs(OITA)BEFORE travel occurs.Even a brief trip to a foreign country,for example
to attend a conference,requires OITA approval.Please contact your DOH Contract Manager as soon as possible if travel is planned out of the country, including Canada
and/or Mexico,so that they can obtain appropriate approvals from EPA Headquarters.If you have questions,please contact your DOH Contract Manager listed in this award
document.
11. Geospatial Data Standards
All geospatial data created must be consistent with Federal Geographic Data Committee(FGDC)endorsed standards.Information on these standards may be found at
wwkv.fucic.aoy
12. ULO Stretch Goal
Subrecipients should manage their programs and subaward funding in ways that reduce the length of time that federal funds obligated and committed to subaward projects are
"unspent"federal funds,not yet drawn down through disbursements.
EPA encourages the reduction of these unliquidated obligations(ULOs)by applying the following programmatic term and condition to these assistance agreements
Assistance agreement subrecipients are to apply these"stretch"goals throughout the life of the assistance agreement and to confer with your DOH Contract Manager
whenever instances arise that make attainment of these stretch goals unlikely.
A stretch goal for utilization of funds is established.All funds should be spent by 2 years.
Exhibit A,Statements of Work Page 24 of 29 Contract Number CLH 18253-8
Revised as of March 15,2019
AMENDMENT
Stretch Goal
Funds Awarded in FY 2016
(October, 1,2016-September 30,2017)
Should all Be Drawn Down by March 2019
DOH Program Contact
Conlracl Manager: �lefwkio?&Megan Schell,Office of Environmental Health,PO Box 47824,Olympia.WA 98504-7824;360.236,E 3307,
mekan,srhell(jidoh.wy wiv
Fiscal Lead. AlicholeSimmons, Office of Environmental Ileallh, PO Box 47824, Olympia, WA 98504-7824. 360.236.3208:nichole.simmotwadoh.wa-go:
Exhibit A,Statements of Work Page 25 of 29 Contract Number CLH 18253-8
Revised as of March 15,2019