Program Specific Requirements. 3.9.4.1. The initial clinical assessment and establishment of a new patient relationship, including any determination of diagnosis and/or medical necessity, may be delivered through synchronous video interaction.
Program Specific Requirements. The outcome of this performance-based grant is safe, affordable, and stable housing for the clients of the HOPWA Program. LHJ shall provide the following inputs: • Staff who provide services described in this Statement of Work (SOW)
Program Specific Requirements. 1 . A year of high school algebra and geometry with a letter grade of “C” or better.
Program Specific Requirements. Tasks in this statement of work may not be subcontracted without prior written approval from the Office of Immunization. Exhibit A Statement of Work Contract Term: 2022-2024 DOH Program Name or Title: Youth Cannabis & Commercial Tobacco Prevention Program - Effective July 1, 2022 Local Health Jurisdiction Name: Kitsap Public Health District Contract Number: CLH31014 SOW Type: Original Revision # (for this SOW) Funding Source Federal Subrecipient State Other Federal Compliance (check if applicable) FFATA (Transparency Act) Research & Development Type of Payment Reimbursement Fixed Price Period of Performance: July 1, 2022 through December 31, 2022 Statement of Work Purpose: The purpose of this statement of work is to provide funding for cannabis & commercial tobacco (including vaping products) prevention and control activities as a regional contractor for the Youth Cannabis and Commerical Tobacco Prevention Program through four sources of funding: SFY23 Dedicated Cannabis Account, SFY23 Tobacco Prevention, SFY23 Youth Tobacco Vapor Products, and FFY22 Tobacco-Vap Prevention Component 1. Note: Commercial tobacco includes any product that contains tobacco and/or nicotine, such as cigarettes, cigars, electronic cigarettes, hookah, pipes, smokeless tobacco, heated tobacco, and other oral nicotine products. Commercial tobacco does not include FDA-approved nicotine replacement therapies. ** PLEASE NOTE: Due dates and allocations are for purposes of reflecting the total annual allocation and reporting for FFY22 and SFY23. Revision Purpose: N/A DOH Chart of Accounts Master Index Title Master Index Code Assistance Listing Number BARS Revenue Code LHJ Funding Period Start Date End Date Current Allocation Allocation Change Increase (+) Total Allocation SFY23 YOUTH TOBACCO VAPOR PRODUCTS 77410893 N/A 334.04.93 07/01/22 12/31/22 0 38,402 38,402 FFY22 TOBACCO-VAPE PREV COMP 1 77410212 93.387 333.93.38 04/29/22 12/31/22 0 24,482 24,482 SFY23 TOBACCO PREVENTION PROVISO 77410823 N/A 334.04.93 07/01/22 12/31/22 0 190,000 190,000 TOTALS 0 500,393 500,393 Task # Activity Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount 1 DEVELOP NETWORK ANNUAL WORK PLAN Contractor will submit a work plan for 2022-2023 utilizing the template provided by YCCTPP that addresses the four goals of the program and includes: • Performance-based objectives that will be defined by the contractor and YCCTPP contract manager. • Activities that utilize program strategies (defined...
Program Specific Requirements. For MI Codes 77410893, 77410823 & 77420823 To be in compliance with grant requirements, contractor will:
Program Specific Requirements. General Representations. The Grantee represents and warrants to, and agrees with XXXX, as of the date hereof as follows:
Program Specific Requirements. None- As the instructor, I am recommending that this student receive college credit per this agreement. ( ) Student’s Name (Please Print) Home Telephone Number [ ] Xxxxx-Xxxxxx Community High School Address [ ] Xxxx Xxxxx High School [ [ ] ] Crystal Lake Central High School Crystal Lake South High School [ ] Harvard Community High School City State Zip [ [ ] ] Xxxxxxx Community High School Johnsburg High School Graduation Year Birthdate / / [ ] Marengo Community High School [ ] XxXxxxx East High School DIRECTIONS: Make 2 Copies. Check Box for Appropriate Individual. Distribute to Appropriate Individual. [ ] Student Copy [ ] High School Copy Mail original to: Credentials Evaluation Office (A258H) XxXxxxx County College 0000 XX Xxxxxxx 00 Xxxxxxx Xxxx, XX 00000 [ ] XxXxxxx West High School [ ] Prairie Ridge High School
Program Specific Requirements. This section is for program specific information not included elsewhere. In SOWs where more than one project is listed, each requirement must be identified by MI Code. Exhibit A Statement of Work Contract Term: 2022-2024 DOH Program Name or Title: OI-Promotion of Immunizations to Improve Vaccination Rates - Effective July 1, 2022 Local Health Jurisdiction Name: Snohomish Health District Contract Number: CLH31027 SOW Type: Original Revision # (for this SOW) Funding Source Federal Subrecipient State Other Federal Compliance (check if applicable) FFATA (Transparency Act) Research & Development Type of Payment Reimbursement Fixed Price Period of Performance: July 1, 2022 through June 30, 2023 Statement of Work Purpose: The purpose of this statement of work is to contract with local health to conduct activities to improve immunization coverage rates. Revision Purpose: N/A DOH Chart of Accounts Master Index Title Master Index Code Assistance Listing Number BARS Revenue Code LHJ Funding Period Start Date End Date Current Allocation Allocation Change Increase (+) Total Allocation TOTALS 0 45,150 45,150 Task # Activity Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount
Program Specific Requirements. All work will be performed in accordance with the revised and approved project plans to be submitted to DOH. Restrictions on Funds (what funds can be used for which activities, not direct payments, etc) CDC Funding Regulations and Policies xxxxx://xxx.xxx.xxx/grants/documents/General-Terms-and-Conditions-Non-Research-Awards.pdf Monitoring Visits (frequency, type) The DOH program contact may conduct monitoring visits 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 fiscal monitoring site visits during the life of this project Special Billing Requirements:
Program Specific Requirements. All work will be performed in accordance with the revised and approved project plans to be submitted to DOH. Restrictions on Funds (what funds can be used for which activities, not direct payments, etc) CDC Funding Regulations and Policies xxxxx://xxx.xxx.xxx/grants/documents/General-Terms-and-Conditions-Non-Research-Awards.pdf Monitoring Visits (frequency, type) The DOH program contact may conduct monitoring visits 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 fiscal monitoring site visits during the life of this project Special Billing Requirements Payment: Upon approval of deliverables and receipt of an invoice voucher, DOH will reimburse for actual allowable costs incurred. Billings for services on a monthly fraction of the budget will not be accepted or approved.
