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KPHD Amendment_Standard Form.docx
AMENDMENT TO AGREEMENT 2174
This Amendment (“Amendment”) to Kitsap Public Health District Contract 2174 for FEMA
MASS VAX (the “Contract”), is entered into between the City of Bremerton (“Subcontractor”) and
the Kitsap Public Health District (“District”).
RECITALS
WHEREAS, on February 29, 2020, the Governor of Washington State executed a
Proclamation of Emergency relating to the COVID-19 outbreak, which remains in effect;
WHEREAS, on March 11, 2020, the World Health Organization declared the rapidly
spreading COVID-19 a pandemic;
WHEREAS, on March 13, 2020, the President of the Unites States issued a Proclamation
declaring COVID-19 a nation emergency, which remains in effect;
WHEREAS, the Parties entered into the Contract effective May 27, 2021; and
WHEREAS, President Biden has announced an extension of 100 percent federal
reimbursement for eligible COVID-19 emergency response costs through December 31, 2021; and
NOW, THEREFORE, THE PARTIES AGREE AS FOLLOWS:
I.Amendment of Contract Section 1 Period of Performance. The period of performance
of this Agreement shall begin January 21, 2021 (“effective date”) and be completed no later than
December 31, 2021, unless terminated sooner or extended as provided for herein.
II.Amendment of Contract Section 6 Federal Source of Funds. The funding source for
this Agreement is Federal and is a subcontract through the Washington State Department of
Health and the District. The Assistance Listing number is 97.036 and the BARS code is
333.97.03.
III.Amendment of Contract Attachment B. Updated LHJ Mass Vaccination Funding
Guide. (Updated October 2021.)
IV.Other Provisions Unchanged. The other provisions of the Contract, remain
unchanged.
V.Effective Date. This Amendment is effective upon signature of both parties.
VI.Authorization. Each party signing below warrants to the other party that they have the
full power and authority to execute this Amendment on behalf of the party for whom they
sign.
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IN WITNESS WHEREOF, the Parties have subscribed their names hereto.
Dated this _____ day of ______, 2021.
KITSAP PUBLIC
HEALTH DISTRICT
Keith Grellner
Administrator
Dated this ______ day of ______, 2021.
CITY OF BREMERTON
Greg Wheeler
Mayor
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Dec.1st Dec.1st
An overview of Washington
State Department of
Health Mass Vaccination
Funding for Local Public
Health Jurisdictions
Mass
Vaccination
Funding
2020
Mass
Vaccination
Funding
2020
OCTOBER 2021
JUNE 2021
October 2021 UPDATE
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To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing
customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov.
For more information or additional copies of this report:
Washington State Department of Health
Office of Financial Services
111 Israel Road SE
Tumwater, WA 98501
Report Author
Amy Ferris, Chief Financial Officer
Washington State Department of Health
Amy.Ferris@doh.wa.gov
360-236-4503 | www.doh.wa.gov
Version Date: 10-8-2021
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Contents
Executive Summary: Mass Vaccination Funding is Built on a Collaborative Model ....................... 1
Funding Considerations .................................................................................................................. 2
Funding Considerations (cont.) ....................................................................................................... 3
Reimbursement Considerations ..................................................................................................... 3
Equipment, Supplies, and Commodities ......................................................................................... 4
Terms & Definitions ........................................................................................................................ 5
Mass Vaccination Funding Process for LHJs ................................................................................... 6
Reporting & Documentation ........................................................................................................... 7
Frequently Asked Questions (FAQs) ............................................................................................... 8
FAQs (cont.)..................................................................................................................................... 9
FAQs (cont.)................................................................................................................................... 10
FAQs (cont.)................................................................................................................................... 11
FAQs (cont.)................................................................................................................................... 12
FAQs (cont.)................................................................................................................................... 13
Support & Contacts ....................................................................................................................... 14
Appendices .................................................................................................................................... 16
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Mass Vaccination Funding
An overview of Washington State Department of Health
Mass Vaccination Funding for Local Public Health Jurisdictions
UPDATE: OCTOBER 2021
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WASHINGTON STATE DEPARTMENT OF HEALTH
Mass Vaccination Funding – October 2021 | 1
Executive Summary: Mass Vaccination
Funding is Built on a Collaborative Model
May 5, 2021
The Washington State Department of Health (DOH) continues to support the national COVID-19
Response plan by working with federal, state, local, and tribal partners to assist, augment, and
expedite vaccinations in the state of Washington. Through funding from the Federal Emergency
Management Agency (FEMA), the DOH will expedite 100% reimbursement for eligible mass
vaccination projects as appropriate and consistent with approved and allowable activities
associated with this project. This expedited funding, with an initial period of performance from
January 21, 2021 through December 31, 2021, will support the State of Washington with
emergency protective measures to store, handle, transport, distribute, and administer the
COVID-19 vaccine. In response to the COVID-19 crisis, the DOH will utilize contracts to establish
mass vaccination distribution across Washington. We continue to work with federal, state,
local, and tribal partners to ensure a coordinated approach to equitable vaccine distribution
efforts through reimbursement of associated and allowable costs.
A key feature of this COVID-19 Mass Vaccination Funding is the alignment with the Healthy
Washington Roadmap to Recovery, which uses a regional approach for its phased recovery
plan. These regions are largely based on the Emergency Medical Services (EMS) regions, formed
along the local availability of medical services, capabilities, and proximity of individual access.
The coordinated approach, as supported by the FEMA-funded Expedited Project funding, is
designed to leverage Incident Management resources for supporting effective mass vaccination
operations. Local Health Jurisdictions (LHJs) must therefore coordinate the planning and
implementation of mass vaccination clinics with a regional Incident Management Team (IMT) or
Incident Management Organization (IMO). Coordination between federal, state, regional, and
local entities is critical to an effective response to this pandemic.
The DOH remains strongly committed to ensuring every person who wants a vaccine can get
one. The DOH is leading the implementation of the vaccine distribution effort, which is state
supported, regionally coordinated, and locally synchronized. We support local public health
efforts through the administration of this funding to ensure an equitable and effective response
to the COVID-19 pandemic. By working together, we take heart knowing that we can beat this
virus, and create a safer, brighter future for people across our great state.
Thank you all for your support through this response. I’m honored to work amongst such
dedication to our state’s public health.
Amy Ferris, CFO
Washington State Department of Health
Office of Financial Services
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WASHINGTON STATE DEPARTMENT OF HEALTH
Mass Vaccination Funding – October 2021 | 2
Funding Considerations
• The Local Health Jurisdiction (LHJ) is acting as a contractor for these funds under the
Department of Health (DOH). County/City Governments and other healthcare partners,
acting as subcontractors to the LHJ, are required to coordinate mass vaccination
activities with their local Unified Command group in order to be potentially eligible for
these funds. The Healthy Washington - Roadmap to Recovery describes how
Washington will use a regional approach to implement a phased recovery plan. The DOH
and IMT/IMO will work with LHJs within their Roadmap Regions to coordinate the
appropriate allocation of resources. More information about the Roadmap can be found
at: https://www.governor.wa.gov/sites/default/files/HealthyWashington.pdf
• Eligible costs from the timeframe of January 21, 2021 – December 31, 2021 include
facility rentals/leases; medical and support staff for planning, management, support,
and operations; as well as wrap-around services for staff (i.e., meals, travel, lodging).
Regular and overtime pay, exempt and non-exempt, associated with this project is
allowable for all staff working under this COVID-19 mass vaccination project and must
be billed as a direct charge; timesheets are required and must be available upon request
by DOH. Indirect rates are not applicable to these funds. Examples of eligible items
include but are not limited to facility infection control measures, personal protective
equipment (PPE), storage equipment, coolers, freezers, temperature monitoring
devices, portable vaccine storage units for transportation, supplies such as emergency
medical supplies (for emergency medical care needs that may arise in the administration
of the vaccine), containers for medical waste, as well as proper storage as needed for
canisters of liquid nitrogen or dry ice. Equipment over $5,000 a piece must be pre-
approved by the IMT/IMO and should be first leased before purchasing. Any
questionable or identified expenses will require a narrative on the purchase rationale
and will be subject approval from the Incident Management Team (IMT) / Incident
Management Organization (IMO) prior to reimbursement.
• Timely, accurate monthly invoicing of costs by LHJs to the DOH is essential. The DOH will
use this information to substantiate costs to the Federal Emergency Management
Agency (FEMA), monitor funding utilization, and project future need in order to request
potential extensions and/or additional funding as appropriate. LHJs will be reimbursed
by the DOH for approved costs on a monthly basis; LHJs will not be provided a fund
allocation. LHJs will be solely responsible for reimbursing all subcontractor costs for all
approved expenses prior to requesting reimbursement from the DOH. Documentation
by LHJ and subcontractors (i.e., timesheets, reports, purchased materials, etc.) must be
available upon request by DOH to substantiate costs.
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WASHINGTON STATE DEPARTMENT OF HEALTH
Mass Vaccination Funding – October 2021 | 3
Funding Considerations (cont.)
• Recent FEMA guidance requires collection of demographic data to include race,
ethnicity, disability status; and also information on primary language, sexual orientation
or gender identity. The DOH is presently exploring mechanisms by which this data
collection can be effectively supported and will be communicated to you through your
IMT/IMO. DOH may ask for narrative contributions to this effort for the work that is
being done by LHJs and sub-contractors to carry out the Mass Vaccination activities in
an equitable fashion.
• As stated in FEMA guidance given in FEMA Policy 104-21-0003, Version 2 issued on
September 8, 2021, and reaffirmed in a FEMA memorandum on September 20, 2021,
Under the direction of the Biden Administration, FEMA is funding 100% of eligible costs
associated with COVID-19 response efforts through December 31, 2021, which includes
funding for COVID-19 booster shots. A key provision of this Federal Emergency
Management Agency (FEMA) Public Assistance Program is cost assistance for eligible
emergency protective measures conducted in response to COVID-19 during an officially
declared public emergency. Eligible expenses related to mass vaccination efforts
incurred by participating local health jurisdictions occurring within this timeframe may
be submitted to the DOH for reimbursement. LHJs should continue working with the
Incident Management Teams or Incident Management Organizations on mass
vaccination efforts and related expenses as needed. You can find the latest HHS Public
Health Emergency Declaration at
https://www.phe.gov/emergency/news/healthactions/phe/Pages/default.aspx
• Updates will continue to be provided as new information becomes available. For the
most recent updates and resources regarding COVID-19 on our DOH website at
https://www.doh.wa.gov/emergencies/COVID19
Reimbursement Considerations
• Duplication of billing is prohibited. If ANY entity is billing ANY third party to pay for ANY
vaccination services or supplies, it disqualifies them from participating and billing their
costs to their LHJ. Allowable bills related to this mass vaccination response effort should
only be submitted to the DOH for reimbursement.
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WASHINGTON STATE DEPARTMENT OF HEALTH
Mass Vaccination Funding – October 2021 | 4
• LHJs are responsible for billing and reporting for expenses related to this funding source.
Authority to make financial agreements to support local vaccination efforts rests with
the LHJs. All billing from subcontractors must be submitted to the LHJ first. The Regional
IMT/IMO will coordinate with LHJs to ensure expenses are directly aligned with mass
vaccination efforts.
• Cost Summary Workbooks and any narratives will first be submitted by the LHJ to their
associated IMT/IMO. The IMT/IMO will review the invoice and provide assistance to the
LHJ as needed with any required edits or narratives, then notifies LHJ the invoice is
ready to submit. During the review, the IMT/IMO will complete the following steps:
o Ensure all billing recorded on the Cost Summary Spreadsheet supports costs
associated with activities related to county or regional mass vaccination efforts.
o Ensure all appropriate supporting documentation aligns with billing.
o Notify the LHJ that the billing is ready to be submitted to the DOH for processing.
Equipment, Supplies, and Commodities
• FEMA policies dictate our ability to reimburse for Equipment owned by the Jurisdiction
utilized in the Mass Vaccination Effort. In 2019, FEMA published the latest FEMA
Equipment Reimbursement Rate sheet, which outlines reimbursement per hour or by
mile for equipment owned by the jurisdiction. This does not include rental equipment or
capital equipment that does not appear on the FEMA reimbursement rate sheet.
• The Equipment Summary Tab on the Cost Summary Workbook captures the following
information:
o The daily use of all contractor-owned equipment (LHJ or Subcontractor) used for
eligible mass vaccination efforts (activities), date/hours of use, locations of use,
and tasks performed with equipment.
o For each piece of LHJ or Contractor equipment utilized, include make, model,
horsepower, capacity in a separate narrative, or choose the most appropriate
FEMA Equipment Rate Code and associated FEMA Cost Code assigned to that
piece of Equipment.
o Applicable equipment rates charged (local rates or FEMA cost code), including
supporting documentation on how equipment rates were developed, what costs
were included in the rates, how your organization adopts the rates, for
implementation, and when were the current rates adopted will be required on
project closeout if your jurisdiction utilizes this reimbursement opportunity.
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Mass Vaccination Funding – October 2021 | 5
Terms & Definitions
TERM DEFINITION
Documentation Documentation requirements include all items that are generally required for contracted services.
Documentation due on a monthly basis includes the Cost Summary Workbook, A19, and any needed narratives.
Documentation due at closeout includes timesheets, situation reports, site operation reports, weekly vaccine
administration per site reports, IIS reports, and other reporting related to mass vaccination efforts. These items
must be available upon request by the DOH to substantiate project costs. Please assume any documentation
typically required by FEMA will also be required for this effort for closeout at the end of this process.
Duplication of
Billing
Duplication of billing refers to submitting costs for the mass vaccination mission to more than one entity
(including federal, state, local, or private pay/insurance). Duplication of billing is disallowed. Allowable cost
reimbursement related to this mass vaccination response effort should only be submitted to the DOH for
reimbursement, and to no other entity.
Eligible Costs Eligible costs from the timeframe of January 21, 2021 – December 31, 2021 include facility rentals; medical and
support staff for planning, management, support, and operations; as well as wrap-around services for staff (i.e.,
meals, travel, lodging). Regular and overtime pay, exempt and non-exempt, associated with this project is
allowable for all staff working under this COVID-19 mass vaccination project and must be billed as a direct
charge; timesheets are required and must be available upon request by DOH. Indirect rates are not applicable
to these funds. Examples of eligible items include but are not limited to facility infection control measures,
personal protective equipment (PPE), storage equipment, coolers, freezers, temperature monitoring devices,
portable vaccine storage units for transportation, supplies such as emergency medical supplies (for emergency
medical care needs that may arise in the administration of the vaccine), containers for medical waste, as well as
proper storage as needed for canisters of liquid nitrogen or dry ice.
Funding
Timeframe
The timeframe of this expedited funding, with an initial period of performance, is January 21, 2021 through
December 31, 2021.
Healthy
Washington
Roadmap to
Recovery
The Healthy Washington - Roadmap to Recovery describes how Washington will use a regional approach to
implement a phased recovery plan. The Roadmap can be found at this website:
https://www.governor.wa.gov/sites/default/files/HealthyWashington.pdf
IMT/IMO
Coordination
LHJs must coordinate planning and implementation of mass vaccination clinics with a regional IMT/IMO as
approved by DOH. Requests for Regional IMT/IMO should be submitted through the normal process via
WebEOC. For LHJs wishing to use an existing Unified Command as their regional IMT/IMO, please contact Tim
McClung at doh-osc@doh.wa.gov to determine eligibility.
Indirect Rates Indirect rates on this project are defined as “overhead” paid for via an established percentage rate, as
approved in your indirect cost plan. Indirect rates are NOT allowed to be submitted for reimbursement to the
DOH under this funding source. Overhead costs in support of this project are allowable as a direct charge only.
Mass
Vaccination
Clinic
Mass vaccination clinics are defined as mass vaccination efforts outside of the usual healthcare delivery
methods. Examples of mass vaccination clinics include mobile clinics, pop-up clinics, non-clinical facility clinics
(i.e., fairgrounds, arenas, etc.). LHJs determine based on their own criteria if a clinic is outside of the usual
healthcare delivery method
Time Sheets Timesheets are required documentation for all activities related to mass vaccination efforts. Staff time in/out
must be recorded, as well as a brief description of activities performed in support of the mass vaccination
efforts. A general description of activities is acceptable for those working at the vaccine site; more
detailed/specific description is required for those not working at the vaccine site.
Work Time LHJs can submit regular time, overtime, exempt, and non-exempt work time for positions working directly on
mass vaccination activities, or directly supporting mass vaccination activities.
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WASHINGTON STATE DEPARTMENT OF HEALTH
Mass Vaccination Funding – October 2021 | 6
Mass Vaccination Funding Process for LHJs
1. LHJ plans & conducts Local/Regional Mass Vacc Clinics, paying subcontractors and
maintaining documentation
2. LHJ submits Cost Summary Workbook and any narratives to IMT/IMO for review
3. IMT/IMO reviews Cost Summary Workbook and narratives for reimbursement eligibility
4. IMT/IMO helps LHJ with any required edits or narratives, then notifies LHJ bill is ready to
submit
5. LHJ submits to DOH a separate A19, Cost Summary Workbook & any narratives to
LHJInvoice@doh.wa.gov: “RUSH – Mass Vaccination – Month of service”
LHJ plans & conducts Local/Regional Mass Vacc Clinics,
paying subcontractors and maintaining documentation
LHJ submits Cost Summary Workbook and any narratives
to IMT/IMO for review
IMT/IMO reviews Cost Summary Workbook and narratives
for reimbursement eligibility
IMT/IMO helps LHJ with any required edits or narratives,
then notifies LHJ bill is ready to submit
LHJ submits separate A19, Cost Summary Workbook & any
narratives to lhjinvoice@doh.wa.gov: “RUSH –Mass
Vaccination –Month of service”
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Reporting & Documentation
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Mass Vaccination Funding – October 2021 | 8
Frequently Asked Questions (FAQs)
Q: What’s the timeframe for this funding?
A: January 21, 2021 – December 31, 2021. The DOH may request from FEMA an
extended project time period as needed, but there is no assurance of future funds beyond the
current end date.
Q: Is this funding considered part of the Consolidated Contract?
A. Yes, this funding is part of the Consolidated Contract.
Q: Can I access these funds if I am not part of an IMT/IMO with delegation of authority from
DOH?
A: No. This federal funding requires an approved IMT/IMO with delegation of authority
from the DOH, as outlined in the DOH FEMA project. The IMT/IMO needs to be a separately
recognized entity from the LHJ for fiscal oversight and resource coordination purposes.
Q: How does our LHJ request to join a Regional IMT/IMO?
A: Please work within your Unified Command structure (County Emergency
Management Division) to submit a request through WebEOC for joining a Regional
IMT/IMO. An approval established through this process demonstrates that the LHJ is
participating in the DOH-approved plan.
Q: How does our LHJ go about creating a Regional IMT/IMO?
A: Please work with your County Emergency Management division to submit a request
through WebEOC to create a Regional IMT/IMO. All regional or area IMTs/IMOs must be
approved by DOH Incident Command, and by that approval, be granted the delegation of
authority to coordinate mass vaccination activities in the region. For more information, please
contact Tim McClung at doh-osc@doh.wa.gov.
Q: I have concerns about joining a Regional IMT/IMO? Who can I talk with?
A. Please reach out to:
Heidi Kuykendall, FEMA Program Manager
Heidi.kuykendall@doh.wa.gov or 360-236-4537
Q: What type of documentation do I need to submit for this funding?
A. You should plan to submit all documentation that is regularly expected with FEMA
reimbursement and contracted services and follow the DOH guidance on entering all mass
vaccination data into IIS. Documentation due on a monthly basis includes the Cost Summary
Workbook, A-19, and any needed narratives. Documentation that will be due at or before close-
out of this funding includes contracts/agreements, invoices, manual timekeeping sheets (is
applicable), monthly cost summary spreadsheets, narratives to support larger or unusual
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Mass Vaccination Funding – October 2021 | 9
FAQs (cont.)
purchases, proof of payment records, situation and site operation reports, system of record
reports, and any other reporting related to mass vaccination efforts. Other documentation that
is good to keep would include pictures of on-site vaccination activities (without compromising
patient privacy).
Q: Help! We need more assistance/resources with our mass vaccination efforts, beyond what
is currently available in our county. What do we do?
A: Your IMT/IMO is there to support your mass vaccination efforts. Please reach out to
your IMT/IMO for assistance in assessing your needs and finding solutions.
Q: What is the IMT/IMO looking for when they review our billing?
A: The IMT/IMO is checking that costs associated with the mass vaccination efforts are
reasonable and eligible. The IMT/IMO will also be monitoring regional mass vaccination
activities and seeking opportunities to share resources within the region or with neighboring
regions. The IMT/IMO may provide a general narrative of activities that occur outside of the
traditional mass vaccination site.
Q: How long might it take for the IMT/IMO to review our billing?
A: The IMT/IMO process is designed to give timely feedback to LHJs if potentially
ineligible costs are included in submission to the IMT/IMO. Regular coordination and
communication between LHJs and the IMT/IMO is essential to the effective execution of mass
vaccination efforts. LHJs should compile projected and incurred costs and share this
information with their IMT/IMO so they are aware of potential opportunities for support or an
immediate need for more resources that are not able to be locally sourced.
Q: How long might it take for DOH to reimburse our expenses once the DOH receives the
LHJ’s billing and documentation?
A: After submission and approval of correctly filled out documentation, the anticipated
turnaround for reimbursements to LHJs from the DOH in most cases should be approximately
one to two weeks.
Q: Can we bill Medicare, Medicaid, or other insurance for mass vaccination clinics that we’re
submitting to DOH for reimbursement under this funding?
A: No. Duplication of billing refers to submitting costs for services to more than one
entity. Duplication of billing is disallowed. Allowable cost reimbursements related to this
response effort should only be submitted to the DOH for reimbursement, and to no other
entity. FEMA specifically sites duplication of billing as criterion for ineligibility for participation
in this program.
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FAQs (cont.)
Q: Is regular work time for hours spent on mass vaccination efforts reimbursable?
A: Yes. Regular and overtime work associated with this project is reimbursable. LHJs can
submit regular time, overtime, exempt, and non-exempt work time for positions working
directly on mass vaccination efforts or directly supporting mass vaccination activities.
Wraparound services for staff such as meals, travel, and lodging is also allowable under this
funding. Exception for allowability of regular time, if any LHJ is considering sub-contracting
with a state level entity (state university, state agency), please consult with Amy Ferris before
finalizing those agreements.
Q: What are some examples of things that can be submitted for reimbursement?
A:
o FEMA cannot fund, to provide incentives for community members when
receiving a vaccination. Costs for incentives falls outside the scope and intent of
Medical Care Policy and other FEMA PA Policies. Although, other funding sources
may be allowable per the Consolidated Contract statement of work
o Personnel expenses for work performed for mass vaccination site, including
regular and overtime pay, exempt and non-exempt
o Wrap-around services for staff such as meals, travel, and lodging
o Facility rentals/leases
o Medical professionals/pharmacists preparing doses in support of the LHJ-
authorized mass vaccination site
o Transporting vaccine from prep area to mass vaccination sites
o Supplies, equipment, PPE, and IT specifically supporting the mass vaccine sites
o Personnel in the mass vaccination clinic administering the vaccine
o Meeting with personnel specifically to prepare for mass vaccination clinics
o Unified Command costs per personnel; direct costs of
conducting/coordinating/supporting mass vaccination administration activities
o Public Works or other personnel doing site preps and making sure traveled right
of ways at mass vaccination sites are safe and continue to be accessible
o Coordination of resources (human and supplies) and planning of next operation
period personnel specifically to mass vaccination activities
o Mobile units going out from main locations and conducting small scale mass
vaccination activities to ensure equity and accessibility issues do not hamper
people getting vaccines
o Site security personnel or contracts supporting mass vaccination sites
o Facility infection control measures
o Personal protective equipment (PPE)
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o Storage equipment, coolers, freezers
FAQs (cont.)
o Temperature monitoring devices
o Portable vaccine storage units for transportation
o Supplies such as emergency medical supplies (for emergency medical care needs
that may arise in the administration of the vaccine)
o Containers for / disposal of medical waste
o Proper storage as needed for canisters of liquid nitrogen or dry ice
o Contracts with medical providers or sub-contractors to help Unified
Command/LHJs accomplish the mass vaccination plan that has been filed with
the DOH and that medical providers are fully cooperating and coordinating
under the LHJ plan.
Q. What are examples of expenses that may be disallowed under this funding?
A. The DOH appreciates efforts to accomplish mass vaccination events across
Washington. Some costs, however, may be ineligible for reimbursement. Examples of
disallowed expenses include costs for activities outside of the scope of work, costs exceeding
the amount that FEMA considers reasonable and necessary, or equipment expenses that
exceed $5,000 apiece (refer to appendix). Vaccinations provided in a traditional healthcare
setting are not allowable (i.e., doctor’s office, in-patient hospital setting). Remember that
narratives are required for any unusual purchases.
Q: Can hospitals or other healthcare providers submit for reimbursement for their own mass
vaccination clinics under this funding?
A: Not directly, only by contracting with a LHJ and as part of a LHJ Mass Vaccination
plan. Only LHJs are authorized to submit for reimbursement under this DOH funding
agreement. All reimbursement requests associated with this funding must be tied to mass
vaccination activities under the coordination and authority of the LHJ. All subcontractors must
have agreements in place and understandings that they are participating and cooperating with
the LHJ to carry out their Mass Vaccination Plan as provided to DOH. Any variations of this
process are not covered under this funding. Other jurisdictions could seek potential funding
through the Washington State Public Assistance Program.
Q: Can we subcontract with hospitals or other healthcare providers to implement our mass
vaccination plan?
A: Yes, as long as your hospital or other healthcare provider is working as a
subcontractor as reflected on your plan to support mass vaccination efforts, this would be
allowable. Healthcare partners that are providing wrap around services and NOT directly
administering vaccines can be treated like a contractor with backup invoices as substantiation.
Healthcare partners that have potentially eligible vaccine administration service costs need to
attest to being fully compliant with the FEMA Medical Care Policy, not billing any third parties,
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and will be required to fill out the same Cost Summary Workbook as the LHJs are for FEMA
reimbursement through this DOH FEMA Mass Vaccination Project. The costs for this
FAQs (cont.)
will be reflected as a contract cost line item on the LHJs Cost Summary Workbook and the
healthcare partner will fully fill out a separate workbook submitted with the LHJs A-19 and Cost
Summary Workbook as backup.
Q: Do I need to use the A-19 form to submit billing for this funding?
A: Yes. LHJs will submit expenses associated with this project to their IMT/IMO with the
A-19 form and billing documentation for processing.
Q: How do we develop or get examples of contractual agreements that could be used for
subcontracts for mass vaccination activities?
A: Your IMT/IMO is there to support these efforts. Please reach out to your IMT/IMO for
assistance in developing contractual agreements for subcontracted services.
Q: What’s the BARS code I need to bill for this funding?
A: The revenue code is 333.97.03 Mass Vaccination Reimbursement. As with all DOH
funding, LHJs are responsible to select the expenditure code related to the specific expense.
Q: Will we get reimbursed for mass vaccination clinics we conducted after January 21, 2021,
but before we were directed by DOH to collaborate with the IMT/IMO?
A: Potentially. Please connect with your IMT/IMO for review of those expenses. Costs
will be evaluated for potential reimbursement on a case by case basis.
Q: Can LHJs or Sub-contractors be reimbursed for vaccine incentives through the DOH FEMA
Mass Vaccination Project?
A: Unfortunately, no. FEMA funds cannot be used to provide incentives for community
members when receiving a vaccination. Costs for incentives falls outside the scope and intent
of the FEMA Medical Care Policy and other FEMA Public Assistance policies.
Q: What is the relationship between DOH and LHJs for this project?
A: DOH is acting as a Sub-recipient to the State of Washington Military Department
Public Assistance Program as the Recipient with FEMA. LHJs have been contracted to carry out
the Mass Vaccination Project Activities through an amendment of the Consolidated Contract.
LHJs can sub-contract with other entities as necessary to carry out the Mass Vaccination project
activities, but they need to follow any requirements that the LHJ outlines in their Mass
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Vaccination Plan and other guidance given to them by DOH as project needs are more fully
outlined and as additional guidance is received from FEMA Public Assistance.
FAQs (cont.)
Q: Beyond the administration of the funding, what are the DOH responsibilities associated
with this project?
A. As shared in the Leader’s Intent for this project, the overall purpose of the DOH is to
lead the implementation of the vaccine distribution effort, which is state supported, regionally
coordinated, and locally synchronized. The DOH issues prioritization guidance based on
recommendations from the Center for Disease Control and Prevention (CDC), including
determination of the phases of eligibility (i.e., which populations will be eligible for vaccination
at specified periods of time relative to dose availability). In addition, the DOH enrolls providers
as vaccinators, determines allocation of doses among providers in consultation with local public
health agencies, transmits provider orders to the CDC for processing, and supports the
statewide Immunization Information System for requiring reporting of COVID-19 vaccine doses
administered by the facility. The DOH is also responsible to bridge the gap in local and regional
capacity to meet vaccination goals through alternative solutions such as state-run/sponsored
mass vaccination clinics, utilization of the National Guard, or coordination of other state
resources as needed.
For operational guidance on mass vaccination operational issues (non-finance), please contact
the regional IMT/IMO, who will then coordinate with the DOH Incident Management Team
Operations Section Chief, Tim McClung at doh-osc@doh.wa.gov.
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Support & Contacts
• For general questions and support:
Jennifer Love-Tillotson, Finance Liaison
Jennifer.Love-Tillotson@doh.wa.gov
(360) 236-3927
• For questions related to Mass-Vaccination Funding:
Patrick Plumb, FEMA Reimbursement Management Analyst
Patrick.Plumb@doh.wa.gov
360-236-4291
• For questions related to BARS and Accounting
Toni Smith, BARS Coding, Director Accounting & Budget
Toni.Smith@doh.wa.gov
(360) 236-4535
• For questions related to the ConCon:
Brenda Henrikson, Consolidated Contract Coordinator
Brenda.Henrikson@doh.wa.gov
(360) 236-3933
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Appendices
Statement of Work for Mass Vaccination Clinics – Single IMTs
Statement of Work for Mass Vaccination Clinics – Regional IMTs
Monthly Cost Summary Spreadsheet
FEMA Medical Policy
DOH Equipment Reimbursement Guidance
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