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j : "°~"' ~ EXHIBIT ~. ~ Agreement Between Cuyahoga County Board of Health & ~ ~ THIS AGREEMENT MADE this_day of November 2009, by and between The Cuyahoga County Board of Health, (hereinafter Board), and (hereinafter Community), to fund public health emergency response and planning activities under the grant project entitled Public Health Emer ency Response Phase 1 and Phase 3. Community is a designated subcontractor authorized to perform duties under this program. A. TERMS AND PAYMENT. The contract is valid for the period August 10, 2009 through August 9, 2010. Community shall invoice the Board after meeting deliverables. The Board will pay Community the sum not to exceed Nine Thousand Dollars ($9,000.00) for the following Public Health Emergency Response Phase 1 activity: • Provide Board with a comprehensive up to date Strategic National Stockpile (SNS) plan, also known as the Mass DispensingNaccination plan, in an electronic format. The plans must be consistent with the planning guidance and template provide by the Board in ensure countywide integration and include the following key components: o Volunteer Management procedures o Point of Dispensing (POD) Tactical Communication o POD Site Access procedures o POD SNS Specific delivery location(s) o Activation procedures o Transportation/ POD Rally Point procedures (if applicable) o Security o Special Needs -Procedures for providing prophylaxis to homebound and other at-risk populations -including inventory of high density areas o POD Clinic Flow Map o Emergency Medical procedures o Public Information procedures o Exercise, Training and Evaluation The Board will pay Community the sum not to exceed Forty Thousand Dollars ($40,000.00) for the following Public Health Emergency Response Phase 3 activities: • Community to implement local SNS Point of Dispensing (POD) plan following the planning guidance and criteria provided by the Board and conduct at least one and no more than three public health H1N1 mass vaccination clinics at the request and direction of the Board. • The Board will pay Community the sum not to exceed Twenty Thousand Dollars ($20,000.00) for conducting the first public health POD and the sum not to exceed Ten Thousand Dollars ($10,000.00) thereafter for each subsequent activation. • Community will provide security, transportation and other expenses critical to conducting a public health POD. • Board will provide vaccine, vaccine supplies, POD clinic set-up model, vaccine information statements and necessary registration and screening forms. • Community may use funds for ancillary supplies, security, transportation and other expenses incurred by conducting a public health POD. • Within 30 days of conducting a public health POD, community will conduct an after action conference to document POD strengths and wealrnesses and provide Board with written plan for improvements. Community understands this funding is from the Ohio Department of Health and receiving funds for the services under this contract is contingent upon the Board receiving funds from the Ohio Department of Health. B. OTHER CONSIDERATIONS Approved Expenditure Documentation: Community shall invoice the Board upon execution of activity(ies). Supporting documentation includes a written improvement plan within 30 days of conducting each public health H1N1 POD activation. Community shall invoice the Board upon completion of comprehensive SNS POD plan. Supporting documentation includes written plan in an electronic format. Board will issue payment within 45 days after receipt of invoice from Community. POD H1N1 Activation and SNS Plan (Version Date 11/23/2009) Page 1 of 3