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Statement of Confidentiality

All recipients of this Request for Proposal (RFP) must treat it as confidential and must not disclose it to any party other than the recipients’ employees on a need to know basis, or other individuals authorized under a written Confidential Disclosure Agreement signed by the March of Dimes, Inc. (MOD) and the recipient. If the recipient does not agree with the above stated provisions, this RFP must be immediately returned.

March of Dimes, Inc. NC Preconception Health Campaign Western Region Subcontract Request for Proposals (RFP) PROPOSALS DEADLINE: MONDAY, SEPTEMBER 23, 2019 BY 5:00 p.m. EST March of Dimes, Inc. North Carolina Rocio C. Anderson 919-986-0017 RAnderson@marchofdimes.org

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I. MARCH OF DIMES NORTH CAROLINA Founded in 1938, the mission of the March of Dimes is to improve the health of babies by preventing birth defects, premature birth, and infant mortality. We do this by funding research to understand the problem and discover answers, helping moms have full-term pregnancies and healthy babies, and supporting families and comforting them when their baby needs help to survive and thrive. Premature birth is the leading cause of newborn death worldwide. Even babies born just a few weeks too soon can face serious health challenges and are at risk of lifelong disabilities. In 2003, the March of Dimes launched the Prematurity Campaign to address the crisis and help families have healthy, full-term babies. The campaign funds research to find the causes of premature birth, and to identify and test promising interventions; educates health care providers and women about risk-reduction strategies; advocates to expand access to health care coverage to improve maternity care and infant health outcomes; provides information and emotional support to families affected by prematurity; and generates concern and action around the problem. After a successful Folic Acid Campaign in North Carolina, March of Dimes developed and implemented the North Carolina Preconception Health Campaign to reduce infant mortality, birth defects, premature birth, and chronic health conditions in women, while also aiming to decrease unintended pregnancies. We understand that in order to achieve this we must improve women’s wellness, improve reproductive outcomes, and reduce health disparities. The March of Dimes, Inc. NC Preconception Health Campaign promotes folic acid consumption using trainings, education, media and the distribution of multivitamins to low-income women of childbearing age. In addition, the March of Dimes also educates providers and consumers on tobacco cessation for women, the importance of medical homes and early prenatal care, healthy weight for women and reproductive life planning. In addition to making sure women are healthy prior to conception, the March of Dimes, Inc. also provides a consumer training for pregnant women and their partners to combat the costly and unnecessary negative health consequences of early elective deliveries before the 39th week of pregnancy. II. 2019-2020 FISCAL YEAR AVAILABLE FUNDING FOR NC WESTERN REGION

SUBCONTRACT AND REQUIRED SCOPE OF WORK March of Dimes receives legislature appropriated funds from the Maternal and Child Health Block Grant to fund the Preconception Health Campaign in North Carolina. The total amount of $41,927.00 is designated to cover 1.0 FTE Regional Coordinator to conduct an educational campaign to educate women of childbearing age in Western North Carolina about the benefits of folic acid and preconception health. The applicant business address must be located in Western North Carolina and the employee assigned must reside within one of the counties listed below and implement this educational campaign in the following counties: Alexander, Alleghany, Ashe, Avery, Buncombe, Burke, Caldwell, Catawba, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Watauga, Yancey, Wilkes, Gaston, Lincoln and Cleveland.

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A. SCOPE OF WORK

1. The Subcontractor shall, for at least 190 public and private health care providers:

a. Coordinate and conduct approved trainings for 75 public and private health care providers using current and up to date evidence-based curricula on any of the following topics relevant to this project: folic acid, healthy weight for women of reproductive age, the importance of early prenatal care and medical homes for non-pregnant women, including those at risk for substance abuse, tobacco use and tobacco cessation resources, the importance of having a life plan that includes reproductive life planning, and/or cultural competency. These trainings will occur in office settings.

b. Coordinate and conduct at least two Area Health Education Center (AHEC)-

accredited webinars for public and private health care providers using current and up to date evidence-based curricula on any of the following topics relevant to this project: folic acid, healthy weight for women of reproductive age, the importance of early prenatal care and medical homes for non-pregnant women, including those at risk for substance abuse, tobacco use and tobacco cessation resources, the importance of having a life plan that includes reproductive life planning, and/or cultural competency. These trainings will occur online.

c. Reach an additional 105 public and private health care providers using current

and up to date evidence-based information on any of the following topics relevant to this project: folic acid, healthy weight for women of reproductive age, the importance of early prenatal care and medical homes for non-pregnant women, including those at risk for substance abuse, tobacco use and tobacco cessation resources, the importance of having a life plan that includes reproductive life planning, and/or cultural competency. These outreach activities will take place at presentations or exhibits at professional health care conferences and meetings.

d. Coordinate and participate in the March of Dimes educational forum that seeks to

educate at least 80 public and private health care providers using current and up to date evidence-based education on any of the following topics relevant to this project: folic acid, healthy weight for women of reproductive age, the importance of early prenatal care and medical homes for non-pregnant women, including those at risk for substance abuse, tobacco use and tobacco cessation resources, the importance of having a life plan that includes reproductive life planning, and/or cultural competency. The forum will be held within one of the perinatal regions.3

2. The Subcontractor shall provide education to at least 1,000 consumers to increase knowledge about the importance of entering pregnancy healthy as one important mechanism to reduce infant mortality and birth defects. In performance of the foregoing, Subcontractor will:

a. Train 10 community ambassadors (lay health educators) to train their peers about folic acid, healthy weight, or reproductive life planning. Each community ambassador will educate at least 30 peers (300 educated).

b. Coordinate and conduct trainings for 75 consumers via community-based and/or

youth service organizations using evidence based curricula. Education sessions relevant to this project include: folic acid, healthy weight for women of reproductive age, the importance of early prenatal care and medical homes for

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non-pregnant women, smoking cessation for men and women, the importance of having a life plan that includes reproductive life planning, and/or Healthy Before Pregnancy curriculum.

c. Expand and refine the Healthy Before Pregnancy curriculum and conduct

education sessions in at least 3 high school classrooms in North Carolina. Each presentation will reach approximately 15 students and provide the teacher with curriculum materials to continue teaching the material in subsequent semesters (45 educated).

d. Expand and refine the middle school curriculum, Healthy2: Now & Later, in at least

2 middle school classrooms in North Carolina. Each presentation will reach approximately 15 students and provide the teacher with curriculum materials to continue teaching the material in subsequent semesters (30 educated).

e. Provide preconception health or early elective delivery education for 7 local

community organizations or events such as wedding fairs, health fairs, and places of worship, worksites and community forums, educating an average of 50 individuals per event (350 educated).

3. Subcontractor shall provide technical assistance to all agencies that currently participate in the statewide multivitamin distribution program and request additional information and/or multivitamins. This shall include responding to questions, inquiries and all requests about ordering additional vitamins, providing trainings as per request and clarifying program guidelines as necessary.

4. Subcontractor shall share and distribute traditional and new media communications with individuals and communities of the Western Region of North Carolina to educate women and health care providers about preconception health and campaign resources. All pre-approved communications will be provided by March of Dimes.

5. Subcontractor shall provide preconception health leadership by participating in at least two local, regional or statewide coalition or advisory groups. Provide education and campaign overview to group members upon request.

6. Subcontractor will conduct evaluations of all health care provider educational sessions and pre and posttests from all participants of High School and Middle School trainings. All documents will be maintained secured and submitted to state campaign director

7. Subcontractor will ensure and maintain attendance registrars for health care provider trainings and community ambassador trainings. Registrars must be secured and submitted to state campaign director.

8. Subcontractor will submit monthly invoices and activity report to March of Dimes by the 10th day of the month for the preceding month’s services.

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III. ELIGIBILITY In order to be eligible to receive this March of Dimes NC Preconception Health Campaign subcontract, the applicant must be located and provide services in Western North Carolina. The applicant organization must be an incorporated public or private not-for-profit 501(c)(3) or government agency. You must have a minimum of one 1.0 FTE staff member(s) employed on this campaign. The March of Dimes does not award subcontracts to individuals. The March of Dimes does not fund billable health care provider services. The March of Dimes community grants also do not fund scientific research projects. All grantees must (i) certify that they are not presently listed on the Federal Excluded Party List, debarred or suspended from the award of any federal or state contracts, or excluded from participation in any governmental medical reimbursement programs; and must (ii) attest that they will comply with all laws and regulations (to include federal, state and local laws and regulations). Additionally, March of Dimes grantees may be screened to ensure that they are not debarred or suspended by the Federal Government and/or local State agencies. IV. APPLICATION TIMELINE AND FUNDING PERIOD Proposals due: 09/23/2019 Notification of awards: 09/27/2019 Grant period: 10/012019 – 05/31/2020 The March of Dimes NC Preconception Health Campaign is solely executed on yearly grant application and funding. Subcontracts, if any, are announced and awarded once during the current fiscal year. V. PROPOSAL EVALUATION CRITERIA

Each proposal will be evaluated based on the following criteria: Organization Criteria [10% of total evaluation]

Does the APPLICANT Organization have the appropriate and properly trained staff and internal capacity to execute the program as presented in the application? (5%)

Disbarment Status (SAM) (5%) General Proposal Criteria [35% of total score]

Evaluation of overall quality and completeness of the concept proposal. (10% of score) Are the project goals stated clearly? Are they concrete and specific enough to be

measurable? (10% of score) Evaluation of the potential health impact of the proposed project. (15% of score)

Plan of Work Criteria [35% of total score]

General rating of the project’s likelihood of success as defined by success criteria described in the application. (15% of score)

Are the goals, objectives, and primary tasks set forth feasible? (5% of score) Does the proposal provide sufficient time, according to the timetable, for the

accomplishment of project goals? Is too much time provided? (5% of score)

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Are generally accepted standards being followed and/or does the proposal indicate awareness of the factors contributing to success or failure? (5% of score)

Does the work plan and proposed methodology make sense? Is there a more logical or efficient manner of proceeding toward the accomplishment of stated project goals? (5% of score)

Personnel Criteria [10% of total score]

Does the proposal indicate the names, qualifications, and duties of all known personnel involved in a substantive way? (5% of score)

Does the plan use personnel whose background and qualifications are appropriate for the project? (5% of score)

Budget Criteria [10% of total score]

Do the budget line items seem typical and appropriate? (5% of score) Does the proposed budget seem adequate to execute successfully? Is it over budget? Does it reflect in-kind value? (5% of score)

VI. APPLICANT INSTRUCTIONS Interested applicant organizations must submit a proposal by the date listed above in the “IV. Application Timeline and Funding Period.” Late submissions will not be reviewed. Proposals must:

Adhere to the “Proposal Template” listed below

Be no longer than 15 double-spaced pages (excluding Appendices); proposals that exceed 15 pages will not be reviewed

Have a font size of 11 points or greater (Arial font style)

Have margins of at least 1 inch on all four sides Proposal Submission: Do NOT fax applications. Please follow the below instructions:

1. Email your proposal to RAnderson@marchofdimes.org by 5:00 pm EST on September 23, 2019. The electronic copy should be one complete file, either a PDF document (recommended) or a Microsoft Word document.

2. Mail one original proposal (with original signatures in appropriate places) and a completed W-9 form to the address below. The hard copy must be postmarked or FedEx by September 23, 2019 March of Dimes, Inc. North Carolina Rocio C. Anderson 6504 Falls of Neuse Rd. Suite 100 Raleigh, NC 27615

You will receive an email confirming that your application has been received. If you do not receive this email, please call Rocio Anderson at 919-986-0017 to verify that your application was received. Late applications will be rejected and not acknowledged.

All (EXCEPT LATE) APPLICATIONS will be reviewed by March of Dimes, Inc. and recommendations will be submitted to NC DHHS Contract Officer for approval. All applicants will be notified or acknowledged in writing of their application’s status by September 16,2019.

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All subcontract proposals must address the March of Dimes NC Preconception Health Campaign goals to reduce infant mortality, birth defects, premature birth, and chronic health conditions in women, while also aiming to decrease unintended pregnancies. Priority will be given to organizations that currently serve the target population and address the preconception health needs of women and men of childbearing years. VII. PROPOSAL TEMPLATE The full proposal template can be found in Appendix A. Applicants should answer all questions and include all components in submitted proposals. Submitted proposal with incomplete information will not be reviewed.

Project Overview (2 paragraphs)

Project Narrative (2 paragraphs)

Project Objectives/Activities/Evaluation Methods/Outcomes Template

Budget

Optional Supplemental Information

Completed W-9 Form

VIII. SUBCONTRACTOR REQUIREMENTS Upon receipt of notification of award, subcontractors must sign the March of Dimes, Inc. agreement. A sample agreement is included in the Appendix C. Applicants should review the agreement prior to submitting the proposal to ensure the terms and conditions can be achieved. March of Dimes subcontractors are required to report on the NC Preconception Health Campaign progress and results on a quarterly basis (dates will be provided by project director) through May 31, 2020. Subcontractors must also get written approval from the March of Dimes North Carolina for any changes in the project design or implementation, variance from the submitted budget, or changes in staff overseeing and implementing the project. SUBCONTRACTORS MUST NOT CONTRACT OUT ANY PART OF THE STATEMENT OF WORK TO ANY OTHER ENTITY.

Questions Regarding the Request for Proposals

If you have questions pertaining to this RFP, send an e-mail to Rocio Anderson at Randerson@marchofdimes.org prior to the due date. Please be sure to include a phone number, an email address and specify the section of the RFP in question. All questions must be sent in writing. Questions and answers may be forwarded to all participating vendors in order to avoid any unfair advantage. These guidelines for communications have been established to ensure a fair and equitable evaluation process for all respondents. Any attempt to bypass the above lines of communication may be perceived as establishing an unfair or biased process and could lead to your disqualification as a potential vendor.

Application Checklist Refer to the following checklist to ensure that your proposal is complete before submitting. Incomplete proposals will not be reviewed.

Project Overview (up to 2 paragraphs) o Completely filled out o Signed by appropriate person

Project Narrative o Addresses all items listed in that section o Includes at least one outcome objective that seeks to change knowledge, behavior or

birth outcome

Project Objectives/Activities/Evaluation Methods/Outcomes Template o Completely filled out o Proposal includes at least one outcome objective that seeks to change knowledge,

behavior or birth outcome

Budget (up to 2 pages) o Budget form is completely filled out and signed by appropriate person o Grant amount requested falls within the allowable range, and requested line items fall

within allowable cost items o Budget totals have been checked for accuracy o One-page written justification is included

Optional supplemental information (not included in overall 15 page maximum)

Application is no longer than 15 double-spaced pages (excluding a copy of most currently audited financial statement including Statement of Income and Expenditure and Balance Sheet for multi-year project proposals and optional supplemental information)

Font size is at least 11 points, using Arial font

Margins are at least 1 inch on all four sides

Appendix A: March of Dimes Proposal Application Template

Applicant Organization: __________________________________________________________ Address: ______________________________________________________________________ City: ___________________________ State:___________________________ Zip: _________ Project Title: ___________________________________________________________________ Contact Name : ________________________________________________________________ Phone: ________________________________ Fax: _________________________________ E-mail: ______________________________________________________________________ Institution Type (choose one): [ ] Clinic

[ ] Community-based Organization

[ ] Educational Institution

[ ] Health Department (State/Local)

[ ] Hospital

[ ] Other For-Profit Organization

[ ] Professional Association

[ ] Other

Have you previously received March of Dimes funding for the same project in the last 5 years? [

] Yes, please specify years_____________ [ ] No

Is this a proposal for a multi-year project? [ ] Yes, please specify # of years________ [ ] No Please provide a brief synopsis of your project (2 sentences are sufficient): ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Approximately how many unduplicated individuals will be served during the subcontract cycle? _________

Does this project target adolescents (17 and under)? [ ] Yes [ ] No Does this project aim to reduce disparities? [ ] Yes [ ] No Select the race/ethnicity of the majority of individuals expected to be served by this project (if applicable): RACE: [ ] White

[ ] Black or African American

[ ] American Indian or Alaska Native

[ ] Asian

[ ] Native Hawaiian or Other Pacific Islander

[ ] Other

ETHNICITY: [ ] Hispanic Please indicate what will be measured and reported on throughout the project: [ ] Change in knowledge [ ] Change in behavior [ ] Change in birth outcomes

[ ] Other

Is your agency willing to accept partial funding? [ ] Yes [ ] No If awarded, check should be made out to: ______________________________________ ________________________________ ___/___/___ ________________________ Signature - Primary Staff Person Date Type Name and Title

Project Narrative (pages)

Project goal: What is the goal of the project?

Target population: What is the target population? What needs of the target population are you addressing with this project? How will the project have an impact on these needs?

Project objectives: What are the measurable objective(s) the proposed project aims to achieve? Proposals are expected to include at least one objective that seeks to change knowledge, behavior or birth outcomes. Additional information about objectives and outcomes can be found in Appendix C.

Project activities: What activities will you undertake to achieve results?

Expected results: What do you expect to change as a result of this project?

Expected outcomes: What impact will this project have on the problem identified above?

Organizational capacity and staffing: Description of the organization’s capacity to carry out the project. Include agency’s mission, key staff, clientele, and experience working with the target population group. What will be the responsibilities of the staff members listed in the proposal?

Project timeline: Provide the timeline on which project activities and results are expected to occur.

Evaluation plan: How will you measure whether the project objective(s) was achieved? What data or information will be needed to measure this?

Evaluation tools: What tools will be used to measure whether objective(s) have been achieved? Include any evaluation tools that will be used (e.g. surveys, attendance sheets, summary health information)

Sustainability: Describe the plan for sustainability beyond the funding period through alternate sources of funding or a change in organizational systems or procedures that will sustain the project's impact.

Collaborating organizations: If applicable, list names and roles of collaborating organizations.

Sharing results and outcomes: In addition to the March of Dimes, with whom and how will project impact be shared?

Visibility: Describe the ways in which March of Dimes will be visible throughout the project period?

Project Objectives/Activities/Evaluation Methods/Outcomes Template. Proposals are expected to include at least one objective that seeks to change knowledge, behavior or birth outcomes. Additional information about objectives and outcomes can be found in Appendix C.

Description of Objective and Activities to Achieve Objectives

Person/ Agency

Responsible

Start/End Dates

Number of Individuals

Expected to be Served/

Reached/ Educated

Description of Expected Outcomes/Impact

OBJECTIVE # 1

MM/DD/YY MM/DD/YY

1. Activity

2. Activity

3. Activity

Describe the methods that will be used to evaluate the success of these activities and whether or not the objective will be achieved at the end of the project period. Include source of baseline data.

Description of Objective and Activities to Achieve Objectives

Person/ Agency

Responsible

Start/End Dates

Number of Individuals

Expected to be Served/

Reached/ Educated

Description of Expected Outcomes/Impact

OBJECTIVE # 2

MM/DD/YY MM/DD/YY

1. Activity

2. Activity

3. Activity

Describe the methods that will be used to evaluate the success of these activities and whether or not the objective will be achieved at the end of the project period. Include source of baseline data.

Description of Objective and Activities to Achieve Objectives

Person/ Agency

Responsible

Start/End Dates

Number of Individuals

Expected to be Served/

Reached/ Educated

Description of Expected Outcomes/Impact

OBJECTIVE # 3

MM/DD/YY MM/DD/YY

1. Activity

2. Activity

3. Activity

Describe the methods that will be used to evaluate the success of these activities and whether or not the objective will be achieved at the end of the project period. Include source of baseline data.

Budget Form and Written Justification. Complete the budget form and provide a one-page written budget justification to detail the items on the budget form. Please include the calculation(s) used to estimate costs. The attached budget form is not acceptable without a written budget justification. Allowable and non-allowable costs are described in Appendix D.

BUDGET

(see application guidelines for an explanation of allowable/not allowable expenses) 2019-2020

A. Salaries (include name, position, and FTE)

Sub-total A $0

B. Travel and Lodging

Sub-total B $0

C. Conferences and Health Fairs

Sub-total C $0

D. Other Expenses/Fees

Sub-total D $0

TOTAL COSTS (Sub-total A+B+C+D) $0

TOTAL AMOUNT REQUESTED $0

_____________________________ ___/___/___ ______________________________ Signature - Primary Staff Person Date Type Name and Title

Optional Supplemental Information. No page limit. Please submit additional information that supports your proposal. Additional items may include the following:

Letters of Support from collaborating organizations.

Evidence of Institutional Review Board (IRB) submission as deemed appropriate.

Other supporting materials relevant to the proposed project.

Appendix B: Primary and Secondary Purpose Categories Primary purpose category (select one):

Interconception education and healthcare

Preconception education and healthcare

Prenatal care services

Prenatal adjunct services

Prenatal education and social support

Professional education and training

Quality improvement

Other (please specify)

Secondary purpose category (select one):

Aspirin for preeclampsia

Becoming a Mom/Comenzando bien

Birth Spacing

Care coordination (case management, patient navigator, medical home, etc.)

Chronic disease management in pregnancy (hypertension, diabetes, obesity, etc.)

Coming of the Blessing

Early elective delivery prevention

Early entry into prenatal care

Education materials

Folic acid

Genetic services for pregnant women

Group prenatal care (CenteringPregnancy®)

Group Prenatal Care (March of Dimes Pilot Model)

Group prenatal care (other than CenteringPregnancy)

Home visiting

Interconception education

Maternal/Child Health (MCH) program enrollment (getting women into WIC, Medicaid, CHIP, etc.)

Post-polio activities

Preconception education

Prenatal education/incentive (Stork’s Nest®)

Prenatal education/incentive (models other than Stork’s Nest)

Preterm labor prevention

Project Alpha

Preterm birth recurrence prevention education (about 17P)

Preterm birth recurrence prevention education (other than 17P)

Risk reduction education/services (alcohol and drug use)

Risk reduction education/services (smoking cessation)

Appendix C:

SUBCONTRACT AGREEMENT

This Subcontract Agreement (the “Agreement”) is made by and between the North Carolina Office of the March of Dimes Inc. a New York State nonprofit corporation (“MOD” or “March of Dimes”) with offices located at 6504 Falls of Neuse Rd., Ste. 100, Raleigh, NC 27615, and Awarded Organization (“Subcontractor”) with offices located within Western, NC specified counties.

RECITALS 1. The March of Dimes is the recipient of funding under Contract Number XXXXX from the N.C. Department of

Health and Human Service, Division of Public Health. 2. The March of Dimes requires certain services as more fully described below, and Subcontractor has the

required expertise to perform the required services. 3. Subcontractor has agreed to provide the described services to the March of Dimes. 4. Funding for the described services is provided through the above–described contract. 5. For and in consideration of the mutual covenants contained herein and other good and valuable

consideration, the parties agree to the following terms and conditions.

TERMS AND CONDITIONS

1. Subject to Contract No. XXXXX (Grant). This Agreement is conditioned upon and subject to the terms of the grant (“Grant”) from the N.C. Department of Health and Human Services, Division of Public Health (“Funder”) to the March of Dimes Inc., an excerpt of which is attached hereto and incorporated hereto as Exhibit 1. This agreement is fully supported by the funds provided under the Grant.

Subcontractor understands and agrees that this Agreement is subject to the continued availability of funding under the Grant, and in the event of its expiration or termination, this Agreement shall automatically end without further liability between the parties, except that the obligations expressly designated to survive any expiration or termination of this Agreement shall remain in full force and effect in such event. Subcontractor will provide its full cooperation to MOD in connection with the satisfaction of responsibilities and compliance with obligations under the Grant. Additionally, Subcontractor agrees to abide by the terms and conditions of the Grant, as set forth under Exhibit 1. All references to Contractor and to the Contractor’s obligations under Exhibit 1 are to be construed as (i) references to Subcontractor and (ii) references to Subcontractor’s obligations to both the March of Dimes Foundation and to N.C. Department of Health and Human Services, Division of Public Health. Subcontractor agrees to abide by the Compliance and Certification, which is attached hereto as Exhibit 2, and incorporated herein.

2. Description of Services and Responsibilities. Subcontractor will provide the services in connection with Contract No. XXXXX as described under Exhibit 3 (“Services and Responsibilities”), attached hereto and incorporated herein.

3. Term of Agreement. This Agreement will start on September 3, 2019, and end on May 31, 2020, unless

earlier terminated.

4. Rate and Terms of Payments. The March of Dimes will pay to Subcontractor a fee for services not to exceed

$XXXX.00 in accordance with Exhibit 4 (“Budget and Schedule of Payment”), attached hereto and incorporated herein.

5. Subcontractor Obligations and Conduct of Services. Upon the terms and conditions contained hereunder

Subcontractor will perform its obligations and responsibilities as enumerated in Exhibits 1, 2, 3 and 4, and in a reasonable and responsible manner. It is understood that Subcontractor, in performance of any and all duties hereunder, has no authority to bind the March of Dimes to any agreements or undertakings. Subcontractor will, at mutually agreeable times and locations, engage in such discussions and meetings with designated March of Dimes staff as may be reasonably necessary to the satisfactory fulfillment of its obligations under this Agreement. The March of Dimes reserves the right to request revision to any and all services and/or materials developed by Subcontractor hereunder, and Subcontractor shall provide such revisions and modification to the March of Dimes within five (5) business days of receipt of such request.

6. Compliance, Disclosure Certification and Consents. Subcontractor shall comply with all federal, state and

local laws in connection with its activities hereunder.

Further, in addition to the terms of the “Privacy and Confidentiality” compliance and certification agreed to by Subcontractor under Exhibit 2, Paragraph 6 and bearing in mind the personal health information and any personally identifiable or other information that may be disclosed to Subcontractor or to which Subcontractor may have access to relative to its activities hereunder, Subcontractor expressly agrees, for itself, its employees, contractors and agents, to (i) use such information solely for the project activities/delivery of services described hereunder and to (ii) abide by and take all necessary steps to comply with all privacy and confidentiality laws, human subject protection regulations and other laws including the Health Insurance Portability and Accountability Act and the HITECH Act (collectively, “Privacy Laws”) as may be applicable to its activities hereunder, including without limitation the acquisition of such approvals and consents as may be required under those laws. Subcontractor will provide the March of Dimes with copies of approvals and consents upon request. Subcontractor expressly agrees to cooperate with the March of Dimes in all respects in connection with compliance with such Privacy Laws; cooperation to include without limitation the execution of such documents in connection therewith, including Business Associate Agreements and any and all other pass-thru and compliance agreements as may be reasonably requested by the March of Dimes. All such documents and agreements are hereby incorporated under this Agreement. Further, to the extent applicable, Subcontractor certifies for itself, and its respective employees, agents and contractors that is has acquired reasonable levels of knowledge and training in connection with the Privacy Laws, and that it will comply with any and all data security and breach notification requirements of those laws and regulations. In addition to the indemnification provided under Paragraph 19 below, Subcontractor hereby agrees to indemnify and hold harmless the March of Dimes and Funder from any and all claims, actions, lawsuits, damages, penalties, cost, expense and reasonable attorney fees arising from the acts or omissions of its own respective employees, contractors and agents in connection with compliance with laws and regulations applicable to the subject matter hereunder and its own breach of promises, representations and warranties in connection with the same. This provision shall survive any expiration or termination of this Agreement.

7. Intellectual Property, Publication Rights, Attribution and Trademark Approvals. Intellectual property

rights for works developed under the subcontract are subject to the terms and conditions for intellectual property under the Grant and as follows:

a. Reservation of Reproduction and Publication Rights. Ownership rights in and to any materials or other works (collectively, “Work(s)”) created under this Agreement are reserved to the Funder consistent with the Grant. MOD reserves for itself the right to exercise publication rights and privileges in connection with professional and/or academic papers or other writings it may develop in connection with the Project and related activities, findings and data, subject to the consent of Funder. Subcontractor may not publish or otherwise use the Work(s) created hereunder without the express written consent of Funder and MOD.

b. Attribution. Any and all “Work(s)” developed by the Subcontractor under this Agreement must bear an acknowledgment which states Funded by N.C. Department of Health and Human Services, Division of Public Health. Subcontractor will also provide the March of Dimes with a credit on those Work(s). Additionally, any and all academic and professional publications (journal articles, etc.), produced in connection with the Work(s) and or project related activities under this Agreement will as appropriate, be imprinted with a disclaimer which will advise the reader as follows: The contents and opinions expressed in this work are solely the responsibility of the authors and do not necessarily represent the official views of the N.C. Department of Health and Human Services, Division of Public Health and the March of Dimes Foundation.

c. Trademarks. A royalty free, non-exclusive, License is granted to Subcontractor to display the March of Dimes name, logo and tagline (collectively, “March of Dimes Marks”) on Work(s) created under this Agreement provided: (i) Subcontractor acknowledges March of Dimes' exclusive right, title and interest in and to March of Dimes Marks; (ii) Subcontractor agrees that in using the March of Dimes Marks on any works, it will be subject to March of Dimes standards, specifications and instructions including, but not limited to, March of Dimes corporate identity standards and periodic updating and review by health and education experts; (iii) Subcontractor must obtain prior written approval for all uses of March of Dimes Marks on any Work(s); (iv) U.S. federal trademark registration notice will be placed on March of Dimes Marks; and (v) Subcontractor agrees that it will not use the March of Dimes Marks in any way that would demean, defame, embarrass, diminish or cause any harm to the March of Dimes.

d. No Limitation on Academic and Non Commercial Use. In the event any terms of this of this Intellecutual Property provision conflict with the terms of the Grant, the terms of the Grant will prevail. However in no event will this Intellectual Property provision be construed to diminish, dilute, or otherwise limit the March of Dimes’ or Funder’s rights and interests in the academic and/or non commercial use of the intellectual property created under this Agreement, or otherwise limit the March of Dimes rights and interests in and to March of Dimes Marks.

e. Survival. The terms of this provision will survive any expiration or termination of this Agreement.

8. Confidentiality. Subcontractor shall keep confidential any and all information it shall acquire in connection with the March of Dimes’ business practices, programs, events, and sponsors, as well as business systems, data, information, procedures, or other information; and, Subcontractor shall take every reasonable precaution to safeguard any and all information and other property of the March of Dimes that is entrusted to Subcontractor; and will use same solely for the intended purposes of this Agreement, unless otherwise expressly agreed to by the parties under a separate writing. Upon request, or in the event of termination, Subcontractor shall promptly deliver to the March of Dimes any and all notes, transcripts, documents, or other materials received from the March of Dimes and/or originating under this Subcontract; including, without limitation, Subcontractor’s work product and/or deliverables prepared hereunder, whether complete or incomplete. Subcontractor shall indemnify the March of Dimes from any loss, damage or unauthorized use by Subcontractor or by others of March of Dimes information and/or property which may arise on account of Subcontractor’s breach of its promises under this provision. This provision shall survive any expiration or termination of the Agreement.

9. Independent Contractor. Nothing in this Subcontract shall be interpreted to place either party in a relationship of joint venturers or as agent for the other party; nor is either party an employer or employee of the other party. Subcontractor is an independent contractor and is not entitled to or covered by March of Dimes benefits, including without limitation, medical, dental, unemployment or pension benefits. The March of Dimes reports all fees to the Internal Revenue Service as required by the Internal Revenue Code and state law as applicable. The March of Dimes shall not withhold Federal or State income tax or Social Security tax from fees paid to Subcontractor. As an independent contractor, Subcontractor is responsible for all applicable taxes and other withholdings as required by law. Subcontractor is responsible for the payment of any and all applicable taxes, which may become due as a consequence of its activities hereunder. Subcontractor is subject to the administrative policies and procedures established by the March of Dimes for Subcontractors. This provision shall survive the term of this Subcontract.

10. Directive Advice. Subcontractor agrees to refrain from giving directive advice concerning abortion, as part

of a March of Dimes project.

11. Prohibitions. a. Supplanting/Co-Mingling of Funds. Funds provided under this Subcontract may not be co-

mingled/combined with other business dollars, and are to be used only for designated purposes as outlined under this agreement.

b. Political Activity/Lobbying. Funds provided under this Subcontract may not be used for political or lobbying activity.

12. Equipment. Equipment provided under the Grant and/or purchased with funds provided under this Subcontract will reside with the Subcontractor during the period of performance of this Agreement, however ownership rights and interests in and to such equipment will be retained by Funder (or as applicable, by the March of Dimes). Subcontractor agrees to maintain such equipment in good condition and working order, normal wear and tear excepted; and Subcontractor will maintain insurance coverage for said equipment. Upon the natural expiration or termination of this Agreement, Subcontractor will relinquish physical custody of all such equipment to March of Dimes or to Funder.

13. Severability. If any portion of this Subcontract is held to be void or unenforceable, such part shall be treated

as severable, and the remainder of this Subcontract shall be given full force and effect.

14. Disclosure and Recordkeeping. Subcontractor will disclose to the March of Dimes any and all activities, connections or obligations that may reasonably or potentially represent a conflict of interest relative to Subcontractor’s activities hereunder. Additionally, Subcontractor agrees to maintain identifiable records and files in connection with project activities/services provided under this Agreement, and shall retain such records and files for the government-mandated period of retention. Subcontractor understands and agrees that said records and files are subject to audit and inspection by the Funder, including without limitation governmental funding sources (or agents thereof) and/or regulatory agencies; and agrees to grant to the March of Dimes access to said files and records and the right to audit same upon receipt of reasonable notice. This provision shall survive any expiration or termination of this Agreement.

15. Assignment. This Subcontract is not assignable by either party without the prior written approval of both parties.

16. Time is of the Essence. Time is hereby expressly declared to be of the essence to this Agreement, and

each and every provision hereof is hereby made and declared to be a material, necessary and essential part of this Agreement.

17. Reservation of Rights. The March of Dimes reserves the right to enter into other contractual arrangements with other entities for similar or related services.

18. Headings. The captions utilized herein are for convenience and shall be construed to neither limit nor define

the provisions set forth under this Subcontract.

19. Indemnification. To the fullest extent permitted by law, the Subcontractor shall defend, indemnify and hold harmless the March of Dimes, its directors, officers, agents and employees and the N.C. Department of Health and Human Services Division of Public Health from and against any all actions, proceedings, claims, demands, damages, losses, penalties, fines, costs, and expenses of whatsoever kind or nature (including reasonable attorneys’ fees and expenses) arising out of or in any manner related to the services, operations (or products, as applicable) provided by or on behalf of Subcontractor hereunder, which are in any part caused by or contributed to, in any manner, by Subcontractor, its employees, contractors, or agents. This provision shall survive any expiration or termination of this agreement.

20. Insurance. Subcontractor shall maintain insurance against claims for injuries to persons or damages to

property which may arise from or in connection with the performance of the work hereunder by the Subcontractor, its agents, representatives, employees or subcontractors.

A. Minimum Limits of Insurance. Subcontractor shall maintain coverage with limits as follows:

(a) Workers’ Compensation for statutory limits in accordance with applicable law and Employers Liability limits of $1,000,000 per accident. (b) Comprehensive General Liability or Broad Form Comprehensive General Liability to cover claims which may arise from operations under this Subcontract.

The policy will include protection for the following hazards: (c) Premises and Operations (i) Independent Contractors Coverage (ii) Products & Completed Operations liability coverage to apply one year beyond completion and acceptance of the work specified by this Subcontract (iii) Personal Injury Liability (iv) Broad Form Property Damage (v) Contractual Liability The above policy shall be written with limits of at least $1,000,000 for Bodily Injury and Property Damage Liability for each occurrence, $1,000,000 aggregate. (d) Business Automobile Policy (Comprehensive Automobile Liability Insurance) provides coverage for all owned, non-owned and hired vehicles. Minimum limits shall be at least $1,000,000 each person each occurrence for Bodily Injury Liability and $500,000 each occurrence for Property Damage Liability. (e) Professional Liability, Errors and Omissions Insurance: Subcontractor shall obtain Professional Liability, Errors and Omissions Insurance. Subcontractor shall also require all professional personnel hired pursuant to this Agreement to obtain and maintain similar insurance with similar limits in connection with subcontracted work. All Professional Liability, Errors and Omissions Insurance shall be endorsed to provide Contractual Liability Coverage. Limit of Liability shall be at least $1,000,000 each occurrence.

B. Deductibles and Self-Insured Retention. Any deductibles or self-insured retention must be declared to and approved by the March of Dimes. Subcontractor deductible on professional liability shall be $10,000 or less.

C. Other Insurance Provisions. The policies are to contain, or be endorsed to contain, the following provisions: 1. General Liability.

a. The March of Dimes, its officers, officials and employees are to be named as additional insureds as respects: liability arising out of (i) activities performed by or on behalf of the Subcontractor; and (ii) products and completed operations of the Subcontractor; b. The Subcontractor’s insurance coverage shall be primary insurance as respects the March of Dimes, its officers, officials, and employees, but only with respect the acts or operations of the Subcontractor. Any insurance or self-insurance maintained by the March of Dimes, its officers, officials, employees or volunteers shall be in excess of the Subcontractor’s insurance and shall not contribute with it, but only with respect to acts or operations of the Subcontractor; c. The Subcontractor’s insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer’s liability; and d. The Subcontractor hereby waives any rights it may have against the March of Dimes on account of any loss or damage occasioned by the Subcontractor arising from any risk, and Subcontractor, on behalf of its insurance company insuring the March of Dimes against any such loss, waives any right of subrogation that it may have against the March of Dimes. 2. All Coverages. Proof of coverage for each insurance policy required by this clause shall be evidenced using the ACORD Form 25S with its standard statement regarding coverage not being suspended, voided, in limits except after thirty (30) days’ prior written notice to the March of Dimes. 3. Acceptability of Insurers. Insurance is to be placed with insurers with a Bests’ rating of no less than A:VII.

4. Verification of Coverage. Subcontractor shall furnish the March of Dimes with certificates of insurance. The certificates for each insurance policy are to be signed by a person authorized by that insurer to bind coverage on its behalf, and are to be received and approved by the March of Dimes before work commences. The March of Dimes reserves the right to require complete, certified copies of all required insurance policies, at any time.

21. Termination. In addition to the rights of termination set forth under Paragraph 1 (Subject to Contract No. 37056) above, each party hereto shall have the right to terminate this Agreement, with or without cause, upon thirty (30) days’ written notice to the other. In the event of such termination, the March of Dimes shall pay the Subcontractor its prorated compensation and actual expenses for work performed to and through the actual date of termination as well as any reasonable, out-of-pocket expenses incurred as a consequence of terminating this Subcontract.

22. Notices. All notices required hereunder shall be in writing and shall be deemed to have been duly given or made when delivered by hand, by facsimile transmission, a messenger service which provides a receipt, or registered United States mail with return receipt addressed as follows:

If to March of Dimes: Vice President of Maternal and Child Health March of Dimes Inc.

If to Subcontractor: Non-Profit Organization

Western, NC 23. Entire Agreement. This Agreement represents the entire agreement between March of Dimes and

Subcontractor and shall not be modified in any way except by written instrument executed by both parties. This Agreement has been negotiated by the parties in good faith. The parties represent and warrant to one another that each has, by counsel or otherwise actively participated in the finalization of this Agreement,

and in the event of a dispute concerning the interpretation of this Agreement, each party hereby waives the doctrine that an ambiguity should be interpreted against the party which has drafted this document. The parties hereto represent and warrant to the other that they are free and have full right and authority to enter into this Agreement and to perform all of their respective obligations hereunder and to contract all rights hereunder without violating the rights of any third party.

READ AND AGREED TO: FOR MARCH OF DIMES Inc./ (SUBCONTRACTOR’S NAME) N. CAROLINA MARKET OFFICE By: ___________________________ By: _____________________________ Name: _________________________ Name: ___________________________ Tax ID Number: ___________________ Date: ________________, 2019 Date: __________________, 2019 Exhibits (4) Exhibit 1 – Excerpt from Contract No. XXXXX Exhibit 2 – Compliance and Certification Exhibit 3 – Services and Responsibilities Exhibit 4 – Budget and Schedule of Payment

EXHIBIT 1

EXCERPT FROM CONTRACT No. XXXXX

EXHIBIT 2

COMPLIANCE AND CERTIFICATION

This Compliance and Certification is hereby incorporated to and under the grant, subcontract, cooperative agreement or other agreement (the “Agreement”) entered into by and between March of Dimes and the contractor, subcontractor, project partner, Subcontractor (the “Subcontractor”) for services or goods (the “project”). The Agreement is funded by Federal or State, or other funds awarded to the March of Dimes (the “Grant”) subject to governmental terms and conditions. Unless exempt or otherwise not applicable, Subcontractor agrees and certifies that it will comply with any all such terms, laws, statutes, regulations and any amendments thereto upon which the Grant is conditioned, and may otherwise be required by the Federal Government or any such other funding authority in connection with the project (or other) services or goods to be provided under the Agreement. 1. Applicable Circulars, Records Retention and Audit. The following Office of Management and Budget

(OMB) Circulars apply to the Grant: A-122 Cost Principles for Non-Profit Organizations. 2CRF Part 215 Uniform Administration Requirements for Grants and Grant with Institutions of Higher Education, Hospitals and Other Non-Profit Organizations. Subcontractor agrees to maintain identifiable records and files in connection with this Project, and shall retain such for the government mandated period of retention. Subcontractor understands and agrees that said records and files are subject to audit and inspection by appropriate government funding sources or agents thereof, and agrees to grant to the March of Dimes access to said files and records and the right to audit same upon receipt of reasonable notice. The parties will provide one another with reasonable levels of cooperation relative to compliance with applicable laws and regulations. This provision shall survive any expiration or termination of this Agreement.

2. EEO. Subcontractor agrees to comply with E.O. 11246, "Equal Employment Opportunity," as amended by

E.O. 11375, "Amending Executive Order 11246 Relating to Equal Employment Opportunity," and as supplemented by regulations at 41 CFR part 60, "Office of Federal Grant Compliance Programs, Equal Employment Opportunity, and Department of Labor."

3. Environmental Protection. As applicable, Subcontractor agrees to comply with the Clean Air Act, and the

Federal Water Pollution Control Act, as amended. Violations shall be reported to the Department of Health and Human Services (HHS) and the appropriate Regional Office of the Environmental Protection Agency.

4. Lobbying. Subcontractor certifies it is in compliance with the Byrd Anti-Lobbying Amendment and that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any Federal agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal grant, Grant or any other award covered by Subcontractor shall also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. Such disclosures will be forwarded to HRSA and any other federal agencies that may so require disclosure (45 CFR part 93). No part of appropriated funds from the Interior and Related Agencies Appropriations Act, FY 2003, for any activity or publication or distribution of literature that in any way tends to promote public support or opposition to any legislative proposal on which Congressional action in not complete shall be used.

5. Debarment and Suspension. Subcontractor certifies that it is not included on the General Services Administration's "Lists of Parties Excluded from Federal Procurement or Nonprocurement Programs" in accordance with E.O.s 12549 and 12689, "Debarment and Suspension." (See 45 CFR part 76.).

6. Privacy and Confidentiality. Contractor shall comply with all federal, state and local laws in connection

with the maintenance of privacy and confidentiality, and use, disclosure, security of health or other confidential information and data in connection with subjects (or other persons) participating in the project . This provision shall be construed to include without limitation, the Health Insurance Portability and Accountability Act of 1966 and its Privacy Rules as codified under 45 C.F.R. Parts 160 and 164 (collectively, the “HIPAA Regulations”), 45 C.F.R.46 (the “Protection of Human Subject Regulations”), all amendments thereto, and all other federal, state and local laws and regulations applicable to the subject matter hereunder, including without limitation the HITECH Act and the HIPAA Omnibus Rule. Consistent with the foregoing; Subcontractor shall obtain such authorizations and consents as may be appropriate to performance under the Agreement, and provide reasonable levels of cooperation to the March of Dimes Foundation and Funder in connection with compliance with said regulations.

7. Publication Rights and Attribution. Subcontractor is advised that the Federal Government reserves a

royalty-free, nonexclusive and irrevocable right to reproduce, publish, or otherwise use any Work(s) created under this Agreement for federal purposes, and authorize others to do so. 45 C.F.R. § 74.36 (a). The Federal Government may obtain, reproduce, publish or otherwise use the data first produced under an award (or Grant). Additionally, the Federal Government has the right to authorize others to receive, reproduce, publish or otherwise use such data for federal purposes. 45 C.F.R. § 74.36 (c). The Federal Government reserves the right to require attribution of federal funding on all Work(s) created under this Agreement, such language to be provided by March of Dimes and subject to federal approval. This provision shall survive any expiration or termination of this Agreement.

8. Rights in Technical Data. The Government may publish, reproduce, and use all technical data developed

under the Agreement in any manner, for any purpose, without limitation and may authorized others to do the same. The Government will not distribute any results from the Grant without discussions with the recipient of the Grant funds.

9. Patents – Small Business and Nonprofit Organizations. Subject to the provisions set forth in 37 CFR

401, 35 U.S.C. 203 and 35 U.S.C. 205, a recipient of Grant funds may retain the entire right, title, and interest throughout the world to each subject invention. With respect to any subject invention in which the recipient retains title, the Federal Government will have a nonexclusive, nontransferable, irrevocable, paid-up license to practice or have practiced for or on behalf of the United States the subject invention throughout the world.

10. Buy American Act for Assistance Programs, 43 CFR Part 12, Subpart E. Pursuant to Section 307 of the

Department of the Interior and Related Agencies Appropriations Act of 2000, Public Law 106-113, please be advised of the following: In the case of any equipment or product that may be authorized to be purchase

with financial assistance provided using funds made available in the Act, it is the sense of the Congress that entities receiving financial assistance should, in expending the assistance, purchase on American-made equipment and products.

11. Liability. Each party shall have complete responsibility for injury to its own employees and damage to its

own property occurring incidental to the conduct of the project. Each party shall be responsible for any injury to third parties or property damage caused by negligence of its own employee(s) acting within the scope of their employment and subject to such limitations as may be prescribed by applicable laws. The Government’s liability will be governed by the provisions of the Tort Claims Act. The Grantee shall be liable to reimburse the Government for any damage to Government property cause by negligence of its employees. In the case of educational institutions, students and other assistants receiving payment through the March of Dimes are assumed to be the Recipient’ employees for this purpose. This provision shall survive any expiration or termination of this Agreement.

12. Additional Compliance. Subcontractor shall comply with all such other federal, state and local statutes,

laws, rules and regulations as may be applicable. 13. Survival. Unless prohibited, or expressly restricted, the terms of this Compliance and Certification will

survive any expiration or termination of this Agreement.

EXHIBIT 3

SERVICES AND RESPONSIBILITIES

I. DESCRIPTION OF PROJECT/PROGRAM SERVICES Subcontractor will conduct an educational campaign to educate women of childbearing age in Western North Carolina about the benefits of folic acid and preconception health. Subcontractor will implement this educational campaign in the counties of Alexander, Alleghany, Ashe, Avery, Buncombe, Burke, Caldwell, Catawba, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Watauga, Yancey, Wilkes, Gaston, Lincoln and Cleveland. Activities will include: health education presentations in health care provider offices and other health care provider venues, recruiting, training and support of Community Ambassadors, presentations and exhibits at work sites, health fairs, wedding fairs and other community events, and training and technical assistance to agencies in the Western region that participate in the multivitamin distribution program.

II. RESPONSIBILITIES

A. SCOPE OF WORK 1. The Subcontractor shall, for at least 190 public and private health care providers:

a. Coordinate and conduct approved trainings for 75 public and private health care providers using current and up to date evidence-based curricula on any of the following topics relevant to this project: folic acid, healthy weight for women of reproductive age, the importance of early prenatal care and medical homes for non-pregnant women, including those at risk for substance abuse, tobacco use and tobacco cessation resources, the importance of having a life plan that includes reproductive life planning, and/or cultural competency. These trainings will occur in office settings.

b. Coordinate and conduct at least two Area Health Education Center (AHEC)-accredited webinars for public and private health care providers using current and up to date evidence-based curricula on any of the following topics relevant to this project: folic acid, healthy weight for women of reproductive age, the importance of early prenatal care and medical homes for non-pregnant women, including those at risk for substance abuse, tobacco use and tobacco cessation resources, the importance of having a life plan that includes reproductive life planning, and/or cultural competency. These trainings will occur online.

c. Reach an additional 105 public and private health care providers using current and up to date evidence-based information on any of the following topics relevant to this project: folic acid, healthy weight for women of reproductive age, the importance of early prenatal care and medical homes for non-pregnant women, including those at risk for substance abuse, tobacco use and tobacco cessation resources, the importance of having a life plan that includes reproductive life planning, and/or cultural competency. These outreach activities will take place at presentations or exhibits at professional health care conferences and meetings.

d. Coordinate and participate in the March of Dimes educational forum that seeks to

educate at least 80 public and private health care providers using current and up to date evidence-based education on any of the following topics relevant to this project:

e. folic acid, healthy weight for women of reproductive age, the importance of early prenatal care and medical homes for non-pregnant women, including those at risk for substance abuse, tobacco use and tobacco cessation resources, the importance of having a life plan that includes reproductive life planning, and/or cultural competency. The forum will be held within one of the perinatal regions.

2. The Subcontractor shall provide education to at least 1000 consumers to increase knowledge about the importance of entering pregnancy healthy as one important mechanism to reduce infant mortality and birth defects. In performance of the foregoing, Subcontractor will:

a. Train 6 community ambassadors (lay health educators) to train their peers about folic acid, early elective deliveries, healthy weight, or reproductive life planning. Each community ambassador will educate at least 30 peers (180 educated).

b. Coordinate and conduct trainings for xx consumers via community-based and/or youth service organizations using evidence based curricula. Education sessions relevant to this project include: folic acid, healthy weight for women of reproductive age, the importance of early prenatal care and medical homes for non-pregnant women, smoking cessation for men and women, the importance of having a life plan that includes reproductive life planning, and/or Healthy Before Pregnancy curriculum.

c. Expand and refine the Healthy Before Pregnancy curriculum and conduct education

sessions in at least 3 high school classrooms in North Carolina. Each presentation will reach approximately 15 students and provide the teacher with curriculum materials to continue teaching the material in subsequent semesters (45 educated).

d. Expand and refine the middle school curriculum, Healthy2: Now & Later, in at least 2

middle school classrooms in North Carolina. Each presentation will reach approximately 15 students and provide the teacher with curriculum materials to continue teaching the material in subsequent semesters (30 educated).

e. Provide preconception health or early elective delivery education for 7 local

community organizations or events such as wedding fairs, health fairs, and places of worship, worksites and community forums, educating an average of 50 individuals per event (350 educated).

3. Subcontractor will provide technical assistance to all agencies that currently participate in the statewide multivitamin distribution program that request additional information and/or multivitamins. This shall include responding to questions, inquiries and all requests about ordering additional vitamins, providing trainings as per request and clarifying program guidelines as necessary.

4. Subcontractor will share and distribute traditional and new media communications with the people of the Western region of North Carolina to educate women and health care providers about preconception health and campaign resources. All pre-approved communications will be provided by March of Dimes.

5. Subcontractor will provide preconception health by participating in at least two local, regional

or statewide coalition that addresses these topics. Provide education and campaign overview to coalition members upon request.

6. Subcontractor will conduct evaluations of group health care provider and school based curricula trainings and share with March of Dimes as requested.

7. Subcontractor will maintain attendance registrars for health care provider trainings and community ambassador trainings.

8. Subcontractor will maintain pre and posttests from all participants of High School and Middle

School trainings and submit it to state campaign director. 9. Subcontractor will submit monthly invoices and activity report to the March of Dimes by the

10th day of the month for the preceding month’s services.

B. MARCH OF DIMES RESPONSIBILITIES March of Dimes will provide the following services: Support for the work of the Western Campaign, including technical assistance from March of Dimes’ Program staff, and funding for the work. The March of Dimes contact for Subcontractor is: Rocio Anderson, Director, Health Education of MCH and NICU Innovation, March of Dimes, 6504 Falls of Neuse Rd., Ste. 100, Raleigh, NC 27615. 919-424-2149, RAnderson@marchofdimes.org. III. TIMELINE AND DELIVERABLES The timeline for Subcontractor’s delivery of services is TBD as mutually agreed upon in writing by the parties to this Agreement. All deliverables are to be completed during the term of this Agreement. All obligations shall be met by May 31, 2020.

IV. REPORTING Subcontractor will submit a work plan and quarterly reports that will provide a narrative of project related activities and summary of progress on the project (“Quarterly Report”). The Quarterly Report will be submitted to the March of Dimes in accordance with Exhibit 4, Section II (Schedule and Rate of Payment).

EXHIBIT 4

BUDGET AND SCHEDULE OF PAYMENT

I. BUDGET

Accounts Budget

Personnel and Benefits Western Regional Coordinator

Salary (1.00 FTE) =

Benefits at =

$

Travel and Lodging Travel for staff to provide education and trainings

$

Conferences and Meetings Professional Conference registration and exhibitor fees

$

Operating Expenses $

Total $

II. SCHEDULE AND RATE OF PAYMENT

A. Subcontractor shall be paid a total sum not to exceed $xxxx for the services described hereunder and consistent with the terms of the Budget, provided under this Exhibit 4 - Section I, above.

B. In the event of termination of this Subcontract or this Grant, Subcontractor shall be paid

as follows: Expenses that have been incurred or obligated as of the date of termination related to the budget and objectives under the N.C. Department of Health and Human Services, Division of Public Health Contract.

C. Subcontractor shall be reimbursed on a monthly basis for services rendered hereunder.

All reimbursement shall be pursuant to the budget identified under this Exhibit 4 – Section 1, above. Subcontractor shall submit detailed monthly invoices and reports to the March of Dimes by the 10th day of the month for the preceding month’s services/deliverables, unless otherwise directed hereunder. The final invoice is due June 1, 2020. Each payment shall be due and payable within thirty (30) days following MOD’s receipt of an invoice for the respective billing period and provided Quarterly Reports and the services/deliverables identified under the invoice are timely submitted and are to MOD’s reasonable satisfaction.

D. Subcontractor shall be reimbursed only for those expenses identified under the Budget

provided under this Exhibit 4 – Section I, above. Any and all reimbursement for said expenses is subject to Subcontractor’s provision of appropriate documentation for same and the terms of Paragraph C, above.

E. Unless otherwise specified herein, all invoices for payment shall be submitted by

Subcontractor to the MOD Contact: Rocio Anderson, Director, Health Education MCH and NICU Innovation, Electronically at RAnderson@marchofdimes.org or March of Dimes, 6504 Falls of Neuse Rd., Ste. 100, Raleigh, NC 27615. 919-424-2149.

III. ADDITIONAL SERVICES

Subcontractor must obtain the March of Dimes’ prior written consent for performance of any and all work, which extends beyond the scope of services described hereunder. Such additional work shall be construed to fall outside of the scope of work for this Project and is referred to as “Additional Work/Service.” In the event Additional Work/Service is requested by the March of Dimes or contemplated by Subcontractor, Subcontractor must provide the March of Dimes with a written description of the Additional Work/Service to be performed, quotations of charges/pricing and estimation of completion time for same (the “Quote”). The Quote shall be non-binding upon the March of Dimes and subject to the March of Dimes’ written approval of same prior to Subcontractor’s performance of the Additional Work/Service described thereunder and subject to such conditions and standards as established by the N.C. Department of Health and Human Services, Division of Public Health. In the event consent for Additional Work/Service is granted, such consent shall only be valid if reduced to a writing executed by and between authorized representatives of the parties hereto for specified and identifiable services to be performed by Subcontractor for a determinate price/charge.

Additional Information about Project Objectives and Outcomes Project objectives should be specific and measurable. For example:

One measurable objective of this project is to increase the percentage of pregnant women enrolled who have a prenatal visit in the first trimester of pregnancy from 40% (baseline) to 50% as measured by medical records review.

One measurable objective of this project is to decrease the percentage of preterm births among women enrolled in the project from 18% (baseline) to 16.5% as measured by medical records review.

Outcomes are benefits to clients from participation in the program, yet are often mistaken with program outputs or units of services such as the number of clients who went through a program. Outcomes for March of Dimes projects are usually in terms of changes in knowledge, behavior, or birth outcomes. To measure outcomes, baseline data is needed for comparison with data collected during and after project implementation. Below are sample objectives to give you ideas for content and wording about outcomes. Please notice the references to baseline data.

Knowledge Change - By MM/YY, 60% of program participants will demonstrate an increase in the perinatal knowledge test as measured by pre/post-tests. (Baseline will come from pre-test results.)

Intent to Change Behavior - By MM/YY, 80% of participants will agree to make at least one positive behavior change as a result of attending the prenatal classes as measured by client interviews. (Baseline will come from intake interviews.)

Behavior Change - By MM/YY, the number of women accessing adequate perinatal care (at least 13 prenatal visits beginning in the first trimester of pregnancy) at XYZ Health Center will increase from 125/year (baseline) to 150/year through the services of a Patient Navigator as measured by a review of client records.

Change in Birth Outcome - By MM/YY, decrease the percentage of preterm births among women enrolled in the project from 18% (baseline) to 16.5% as measured medical records review.

Appendix D: Allowable and Non-Allowable Costs Allowable Costs Include:

Salary - grant funds may be used to cover salaries for project-related employees, but cannot be used to pay salary costs for employees who are already employed full-time. Exceptions may be made in circumstances where a specified position is supported primarily by grant funds and the applicant can demonstrate that the requested funds would replace existing grant funds.

Materials and supplies (e.g. office supplies, health-related materials,) necessary to accomplish the specific objectives of the proposal that are usually "used up" in the course of the project. Incentives are items used to enable or ensure participants are able to take advantage of services provided by grantees, for example metro or bus cards to assist women in attending prenatal care appointments or educational sessions.

Travel that are reasonable and necessary for project implementation. March of Dimes funds may NOT be used to pay for first class travel.

Facilities - rental costs associated with using a physical location for an activity necessary to accomplish the specific objectives of the proposal are permitted.

Non-Allowable Costs Include:

Salary costs for staff who are already employed full-time by their organization (see exceptions under salary above)

Staff that are employed by the March of Dimes

Construction, alteration, maintenance of buildings or building space

Dues for organizational membership in professional societies

Tuition, conference fees, awards

Cash stipends for individuals

Child care services

Billable services provided by physicians or other providers

Permanent equipment (e.g. computers, video monitors, software printers, furniture) unless essential to project implementation and not available from other sources

Educational materials that do not meet the quality or evidence-based standards provided by March of Dimes

Nicotine patches

Indirect costs for grants under $25,000

Advertising materials and purchase of media time/space: Budget costs relating to these items may not be allowable depending on project specifics. Please consult with the State contact listed in this application regarding whether proposed items are allowable.