SIGNED FINAL 6-20-23_ Memorandum of Understanding CWCAC and Sauk County Health Department

Contract Status: 
Completed
Contract Type: 
Service
Contract Source: 
County
Contract Duration (months): 
11months
Responsible Department: 
Health
Vendor (Contractor): 
CWCAC
Contract Value: 
$0
Annual Cost: 
$0

Memorandum of Understanding (MOU)

Between

Central Wisconsin Community Action Council (CWCAC)

And

Sauk County Health Department (SCHD)

 

This is an agreement between Central Wisconsin Community Action Council, hereinafter referred to as CWCAC, and Sauk County Health Department, hereinafter referred to as SCHD.

 

  1. PURPOSE & SCOPE

 

The purpose of this MOU is to clearly identify the roles and responsibilities of each party as they relate to a formal partnership between CWCAC and SCHD.

The purpose of the VCO vaccine community outreach project is to conduct outreach services to address COVID-19 hesitancy, increase knowledge of the benefits of vaccines and to remove access barriers to vaccines.

Through this agreement, CWCAC and SCHD will coordinate and leverage expertise and resources to On-Site Covid Vaccination Clinics until May 31, 2024.

 

  1. ROLES AND Responsibilities under this MOU:

 

Under this agreement, CWCAC Representative will:

  1. Provide $50 KWIK TRIP GAS CARDS to a SCHD Representative for distribution to individuals receiving a COVID Vaccination at a SCHD on-site Vaccination Clinic.
  2. Provide enough $50 KWIK TRIP GAS CARDS to SCHD Representative based on anticipated vaccinations to be given per month at a SCHD on-site Vaccination Clinic.
  3. Provide additional $50 KWIK TRIP GAS CARDS to a SCHD Representative as needed.

 

Under this agreement, SCHD will:

 

  1. Provide the COVID-19 vaccination and all supplies necessary for direct administration of the COVID-19 vaccines.
  2. Administer the vaccination.
  3. Collect the following information and share via email with CWCAC Representative at the end of each calendar month: 
      1. First Name of individual receiving COVID-19 Vaccination
      2. What dose was given to the individual
      3. Date the dose was given to the individual
  4. Distribute $50 KWIK TRIP GAS CARDS to all individuals receiving a COVID-19 primary series dosage and/or updated Booster at a SCHD on-site Vaccination Clinic.
  5. Contact CWCAC Representative when supply of $50 KWIK TRIP GAS CARDS is running low.

 

  1. OTHER

 

The success of this MOU will be based on the continuing coordination between CWCAC and SCHD. Any additional initiatives, projects or extensions will be discussed and agreed upon within the context and operational policies of the two organizations.

In witness thereof, the parties listed have entered this agreement as of the dates set forth above:

 

 

__________________________                                            _____________________

Fred Hebert, Executive Director                                            Date

Central Wisconsin Community Action Council

 

__________________________                                            _______________________

Treemanisha Stewart, Director and Health Officer               Date

Sauk County Health Department

Review

Brian,

Treemanisha would like you to review this contract before I send to Brent for Signature.

Thank you.