HomeMy WebLinkAboutAgreement A-24-494 Second Amend. to Agt. with Care Coordination Systems.pdf Agreement No. 24-494
1 AMENDMENT NO. #2 TO SERVICE AGREEMENT
2 This Amendment No. 2 to Service Agreement ("Amendment No.2") is dated
3 September 10, 2024 and is between Care Coordination Systems LLC, a Domestic Limited
4 Liability Company ("Contractor"), and the County of Fresno, a political subdivision of the State of
5 California ("County").
6 Recitals
7 A. On May 17, 2022, the County and the Contractor entered Agreement with Care
8 Coordination Systems, LLC: Community Health Record Integrated Data Sharing Platform, which
9 is County agreement number 22-214 ("Agreement"), for use of the Care Coordination Systems
10 integrated data sharing platform and software training.
11 B. On March 28, 2023 the County and Contractor entered into Amendment No. 1, Which is
12 County agreement number 23-127, to increase the total number of user licenses of the
13 Agreement, and add services including custom data collection forms, data mapping, reports,
14 and trainings.
15 C. WHEREAS, County requires the improvements of the Care Coordination Systems
16 platform consistent with American Disabilities Act (ADA) provided by Contractor; and
17 D. WHEREAS, County requires 211 resource integration provided by the Contractor; and
18 E. WHEREAS, County requires integration of bidirectional exchange of client information
19 between the County's Community Information Exchange (CIE) software and Care Coordination
20 Systems provided by Contractor; and
21 F. WHEREAS, the total cost to plan, build, implement, maintain, and monitor these
22 additions is One Hundred and Forty Thousand Dollars and 00/100 (140,000.00); and
23 G. WHEREAS, the parties desire to amend the Agreement regarding changes as stated
24 below and restate the Agreement in its entirety.
25 H. The County and the Contractor now desire to further amend the Agreement to include
26 ADA improvements, 211 resource integration, and CIE integration services as identified in
27 Exhibit A-1, attached hereto and by this reference incorporated herein; and
28
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1 I. The County and the Contractor now desire to amend the Agreement to increase the total
2 compensation of the Agreement to account for these additions to the Agreement.
3 The parties therefore agree as follows:
4 1. That the Specifications Section of the Community Health Record Software License
5 Agreement as previously amended located on Page Twenty (20) starting with "Community
6 Health Record" and ending with the word "Agreements" is deleted in its entirety and replaced
7 with the following:
8 "Community Health Record: license for a 5-year term, including up to 164 Licensed Users,
9 including invoicing and agency payout, medication reconciliation, patient activation measure
10 screening, real time advanced reporting, benchmarks, data visualization dashboards,
11 HealthBridge.care integration maintenance, user support, and standard system upgrades. In
12 no event shall services performed under this and all Agreements be in excess of One Million
13 Three Hundred and Nine Thousand Two Hundred and Fifty Dollars and No/100
14 ($1,309,250.00) during the initial term of these Agreements."
15 2. That all references in the Agreement to "Exhibit A" shall be changed to read "Exhibit A-V
16 and "Exhibit A" as previously amended located at pages sixty-three through sixty-four (63-64) is
17 deleted in its entirety and replaced with Exhibit A-1. Exhibit A-1 is attached and incorporated by
18 this reference.
19 3. When both parties have signed this Amendment No. 2, the Agreement, Amendment No.
20 1, and this Amendment No. 2 together constitute the Agreement.
21 4. The Contractor represents and warrants to the County that:
22 a. The Contractor is duly authorized and empowered to sign and perform its obligations
23 under this Amendment.
24 b. The individual signing this Amendment on behalf of the Contractor is duly authorized
25 to do so and his or her signature on this Amendment legally binds the Contractor to
26 the terms of this Amendment.
27 5. The parties agree that this Amendment may be executed by electronic signature as
28 provided in this section.
2
1 a. An "electronic signature" means any symbol or process intended by an individual
2 signing this Amendment to represent their signature, including but not limited to (1) a
3 digital signature; (2) a faxed version of an original handwritten signature; or (3) an
4 electronically scanned and transmitted (for example by PDF document) version of an
5 original handwritten signature.
6 b. Each electronic signature affixed or attached to this Amendment (1) is deemed
7 equivalent to a valid original handwritten signature of the person signing this
8 Amendment for all purposes, including but not limited to evidentiary proof in any
9 administrative or judicial proceeding, and (2) has the same force and effect as the
10 valid original handwritten signature of that person.
11 c. The provisions of this section satisfy the requirements of Civil Code section 1633.5,
12 subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part
13 2, Title 2.5, beginning with section 1633.1).
14 d. Each party using a digital signature represents that it has undertaken and satisfied
15 the requirements of Government Code section 16.5, subdivision (a), paragraphs (1)
16 through (5), and agrees that each other party may rely upon that representation.
17 e. This Amendment is not conditioned upon the parties conducting the transactions
18 under it by electronic means and either party may sign this Amendment with an
19 original handwritten signature.
20 6. This Amendment may be signed in counterparts, each of which is an original, and all of
21 which together constitute this Amendment.
22 7. The Agreement as amended by this Amendment No. 2 is ratified and continued. All
23 provisions of the Agreement and not amended by this Amendment No. 2 remain in full force and
24 effect.
25 [SIGNATURE PAGE FOLLOWS]
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Docusign Envelope ID:AFD6B1F9-5961-40E1-9090-D1731C062532
1 The parties are signing this Amendment No. 2 on the date stated in the introductory
2 clause.
3
Care Coordination Systems, LLC COUNTY OF FRESNO
4
Docu Signed by:
5 f4 RAMA& + 5
6 Ro ert arnach, CEO Nathan Magsig, Chairman of the Board of
Supervisors of the County of Fresno
7 75 East Market Street
Akron, OH 44308 Attest:
8 Bernice E. Seidel
Clerk of the Board of Supervisors
9 County of Fresno, State of California
10
By:
11 Deputy
12 For accounting use only:
13 Org No.: 56201558, 56201019
Account No.:7295
14 Fund No.:0001
Subclass No.:10000
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Fresno County Exhibit A-1
Products and Pricing
Term 5/17/2022-5/17/27
Service Descrip0an Annual Cost-5year Vear1 Year2 Year1 Year/ VearS Total
contract terms sN-2-5116/23 Sl1]/23d11fi120 511]/TA2.125 511T/25116126 5/1]126-511}/2]
min emt CCS
lend via HeallhBntlg........-Massaging,s
Community Health Record on hx leChmral-ppon,b p secumycomphanceautldaslantlartl g45000 845,000 Wool) $45,000 $45000 545000 5225,000
Platform g. -d-maimenanm, restore,one hegoemsfaDaara sysbm opgreaes
Desktop/polal-annual,In a 5year contract,10 desktop user Ilce-are mdutled vnth the CHR
platform,Addthmal user Ilcenaes per contract term,p-Isd et bme IN Medizatim to nevi 11-bb
nary tlaN,inclutles Ter2 user auppad Multiple care motleH may be usetl vdN each
seat Alva by. user Iicmce is required br Ne uaorto be enabled lath Pathways antl HeaIIM1
User Licenses iHomes(aranyotherpladorms)mncunently.User kcenaes above the platform alloMent may be atltled $100.500 $1151500 5115,500 $115,500 $115,500 $115500 $571,500
and removetl an nu snecessary Eedmatetl atl%atld0onel uaere @ET50 for e[INaldlfi0
re wIN Ne 10 I-lunclutletl uaere above.
Public Facing H-Iffilridge.care Ammmunityres.urces and refenal aemre p-br Public antl HUB diem use
HeallhBritlge.eare -altithe ucein the CHR by the wre cmmin8"mduded Mh APIs for tmrd party systems Public
Integrated with the CHR and HUB deems may seek local refenal sources and serve rmuesb to Ne 3m party agencies Pubkc end
HUB clients may mainNin secure user l.gms for them referrals and communications with Ne agenorea
and enabled for Tel,- HUB/ACH Clients have added benefit as their community care coortlinetor is alsorecervmg the inbrmdim
Coordinator and Personal andpathways are sacking outcomes as agencea and.Lent perform Commonly resource lreknga are
Health Recortl loaded by HUB staff and maintained by agenclea through their agency login%v they also track and $59,000-ONE-TIME
p .referrals firer contract
Addlllodnally,HeaithBatlgel%IDtCd-wM the Community HedN R...m platform p-MgaecuntyI payment In
information.repMmg,aubgen-t-of pathways for HUB died.,antl l-grated resources far caremth 5year contract, $59,000 $10,000 $10,000 $10.000 $10,000 $89,000
oordinators to select antl send refer-b.agenclea Rvd.-Tad Coordinate-d-Coach, 510,-annual after first
Personal Health Recortl,and the-HealthBndge 20 features bang released In eddy 2022 y08f
mmuniry Engagement sretegyfor Head6nagecare- unity
Ic nehw MM1reruns antl
- - ntl webinars to begin using $10,000-ONE-TIME
Advisory S,rvlce8 rm enefil commluconlry se acel Hganizalmne mare-.1 nex ruevenue oPPortunaies 1pryour PMvnent in first wnl2ul 810,000 510,000
muniry b year
Pathways C.mmumty HUB lnsktute Ab-diem usage fees-PCHI regwrea every reasonable.1
usage fee for the access t.the-dal and taming matmda Annul,1,000 ad.ckents-5500,2,500
PCHI CIieM Usage Fees Iva clients-$1,250,5,000-active ckents,Ask about dM1ar chant ranges $1250 $1250 $1250 $1250 $1250 Sll
.nc liaBM-Annual.Five-veer term,N e ical
dhways wnh ynnr app-,1 MeaimenncRe.Iewrere gmCkly.la DvaN
re wHainator may mmpbte the meaicabon assessmem wim me f�ient one
n r wrer(s)a rend D e
License a M.h_Hc n $e000 $6,000 $6,000 $6,000 $6,000 $s000 $30,000
Inbrpereonal di l.s of belning earns d--Dlly health workers ID the CHR platform features
and best practices for eaective sup-lob,care assurance quality Improvement,mbnndim gdhenng
and.AeMabllity Choice of vinual.,,b-person tco,for all software-M Me HUB Supnasore
and Community HealthW.rkere moat eland entire trainingseasion Stlays IN290minute wluel
wna,3 d-IN in-person training vaM access to m-one lessons in Leammg Management Sy
(LME)lb,1 year as well C community HUB spmiflc guides workbooks,wdem,warkfiaw pra�esses and
best pradces.Course wtll end,_Pathways Community HUB mods training Mat focuses oD HUe.
vas Pracdceln Md Commonly HealthRecord(CHRlvnth real-$fe case study eramples separate
Supemsor training pr.ndetl far�ee to those attending Activation Training SUp--.,break-ounce q
Software Activation includesm_bec.ominabrs,best practices formgning documents and mbn,t.ng caseloads va
Trainin repoNng rod Addtimal supp.d week aaer trammg vnllindudet boor open office boor sessions br $210,000 S21o,000
D mrtlin-dupe,.,and HUB staff toaskbr-h..guidance and/or problem se a coned
sea.Act...n training to be held n.darker Nan 2 wedre-bb kve launch into the fled Pnang
$1,500 per suMdce -5C.h-@$30,000p--Pbxble-..Mingddt.--t-
Team of CCS data expels-coach HUB athfl m all repMmg fedoras Rael-time reporting udrzed for
enchmarks,bh.11enges abd.verall pr.gram perf.nnance Create b_d"ed reports and dasbb.erds
all fonder requlrementa Specisllzetlrepoding views and drilltlown dasbb.aMsfor mdmdusls,
andb-41-hoursesal.nspmtlaunch INHUB lst b-bbvAll ba free lath
Reporting Training for Staff puaGoase ofarep.rung bundle and moat take place before Activadon Training end shoultl be done in $1,500
tangent with TA support when creating pdiciea and precedurea Price for 3 sessions-$1,500,Addib.nal
sins-$5001-
Learnbcreate su ded.bihty through invoicing training CCSvall trim HUB-Mhrob tleagnabon
inclutling mvorang access:bed practices in pokey a procedures,agency Idling a Iss and repMmg
Create bbe-bntling watelall to ID EdbAeall fundere and ensure mmmundy based--bon
Invoicing Training for Stall work is su-M bla.Access to gwdea end wtlmavaN ongorng hoe aupp.d hfiretBmmths Training $1,500
Price$1,500,atltlitional support 1 hour'.$500
1 Apply accessibility awn to Commonly Hea11M1 Recom®(DHR)'3 PCHI wuAeowlo itlenlify usability
ers br CHW antl$upemsor users
ADA Improvements aDe iopment teem to uvrk vnlh m M.d part bbdDID.-CHR eodebaseto-Me Americans $20.000 $10.0. $10,000 tn 00
of%abll and web conte di-(ADA) nt Arresdbility 6ubeline%(WCA6)dantlerds
3 APPty M.awns ana maintenance
iu cecl Reswme D.-,worknow ana trMsmisemn m resmree ado
211 Resource Integration nnedbon vntM1 iCamlmpull resource seta lnbrmaeon into GHR 330,000 00
Build aummaeon In CHR b Dobfy Hu te
o 4.Maintain Ccnnedon in D-Hion,npd-as neeaeae.
1 Establish acmcenaus I-hamework for sharing elan[data
2 Establish business rule requirements br when.kenldad,may be exchanged
3 Develop Apphcason Program dteddca(AP,)l0 support consent antl pnvay fmmewodes
CIE Integration
Implement tlda valddim wrappw end user into -lb support Inbound data fiow(s)horn evbmal $60.000 $5000 $5,000 $10D00
omplate bblreHlonal exchange df-diem Inbrmdlon between CHR antl mmmundy
rm n x de(CIE) n,
so
6 tMe-D API-ld-bdon,making updabs as needed,to operate bMire-1 exchange
Sub-T-I: 5449,}50 $1]},}50 $25},}50 $222,}50 5[92.T50 $1,300,750
Ongoing Services(as needed)
Data Mapping Proled Mawgerb Compleleddla mapping dfFCDPH data Selas MOCO-hd sWCWre(16 hoursx$250Nr) $4,00000
Customize CCS data Pro/ed Nil Customize CCS dad.11 bbkrmaindudmg Chant Pmfib,Inidal6 Fdlmv-up drab-,Event Tracker(4
collection Forms boon x5250IM1r) $1,00000
Dale Mapping S Form P- Managerbwpk wdM1 FresnoCmnry DepadmenldPubllc HeallM1bcmdinde tlda mapping antl fMnvalitlwon(2 hours
Validation $25omr) $`�D�
Custom Reports 1-d forcustom repels bacetl on tlda wileckondaing,tlirect implemmUlion ana bestprzcbces(2 M1oursx$250Ihr)
$500 00
Arse ant
Design Cuslom Rep,ne Repod Developerto easing msbm repbul d neeaea(8 hours x$250Ihr) $200000
Confirmre dv Ild..b through directImplementation,best practices,and Cmdinatim vnM Fresno County Depadment of Pubkc
Report Vai lion Health(2 hours x$250Ihr) $50000
Sub-Total: $01500.00
Agreement Total: $1,30%250
A-1
Fresno County Exhibit A-1
Products and Pricing
Term 5/17/2022-5/17/27
Service Oescriptlons
S.M. Dascripgoa Stantlartl Coats Annual Cost 5 year coated tams
5 year<onbact terms
veYear.rm,L en.grelm community resources rtaral na H«
Its Rec.m a.s.m ,Tier2.sI.Pl.nwm«colaem Mt h.. secunrycom Il 111.1 pl.ncoamn tlar stmtl 00J
h.senp,emntlartl man......ackup/r«mre.s $M $as 000
data uemsmma tlsrys.m upl,ad.
«fur licenses-Annual,10e—plp—user I--
rLmeneea Ouserli userlmens«arerirelu,letl wnM1 I.—
Al
use
Aa a21122.no $0
IueL wM me CHR platform, ( r 1—m p—b—D
a ME—
re w rtMaeple tine bn—,nbarMuseewnne«nlaenss A w u>a cenae amd ET50
r uceneae es lore ser d.i«m>l can y.Ucerticenses above tM pledmm alovnemm ybe LaL ma removL g1,z E1o6500
wally,as necessary Eenmmeem l>a aeenional usere®fg5o.ratotal of tea uaere web tba 10 incluaea.sare above. $1500 L�easm Poyea wrNect
unity,«aortas antl re.rml secure vor.l M pubec antl HUB diem.e enernal m m.......CHR byma care wairem,innmm.U,APx mr
anOcam ,parrysa.ms P mmaysxkl«al referral a.ars«am aenarepoasmtotbe$,11t y1 gene«P
«a me agenn«H umry wrebc.—a.is lAl � Ne iaOrmm a.
anal Xeelln Rerore Amumly..U.laisengsaera uploatletl by HUB staff-d manbmea by ag«ies MmuObtltenagenry log $5g,000.0NE-TIME
«erg outcomesas agent«xa diem perWm CBremitlge isimepm.tl wnM1 roe Community HeabM1 R«ortl planorm pr.wtlinp yunryainbrmaeoa,apomn0,ne paymaminfiret contrail ynl,$"—annual ana,brat year $%,000OreTime;E10,000 annuallywnM1 yourSyearcammn
on a paNwnys 1w HUB�enV em Inmgread re«murces M tare cooMinerore.-1-1 ene serve remrrem m egenass R.qul,ae for TelrCaaLlnaonTelr
M1,P.—Al Heath R—Bb antl tb.new H.aNM1Bnd0.20 fda—baina bal in wady 20-
.eery Health Revere web munMr«Dorcas remrml wa Heanhanaee care(non-vublm.nrg websnel a muniry
Itnx g rel egretL �mry HUBmnream ne me referral prDcessmrcara c^oNnamrs w entstra.gy�upplyiea byusayw ma
remD�m,
.,mmawa rea.nng m.mvla aDt.memaa yve,>auon.mire re..al Panw,aya ana,eamm memta ma atDaea DDp avnemr e�gmymnDvmw. IwInaL lnya.,cxR Plarc.mr $g
- nua, epmmrm.we-naaL twtren>ro,omwmg,Bremae-f—.9wamrmllaaermme>m.appreprlam Pay.fm the.nwmea tea aiwts .liree wlnaL lnexR
al Mel1lfinwnmweretmns mnlemg Paverewo-anm^nam—nnam,aeon lm.mr.9 vmr>mi,>i.n m P.ram.wemwang.erep.m g>npm copal $1B,,CHR
g ee r aron' „u y;nrew—m wxns year D.mranl
Acces>your sooH ene ctlnlcel ene Tall Vl Inmrme iw eem vi Ion vela wrLvmmee Te01wu essnOwms.Pre«aatlw qualryem woesafor eownlwe,
eau gate auallzatlon ten<rw e>hbwm>ror m bmeat
yourmemsu«mmwirorpr«ticea
b,key my perfmmence lnelcatar> Ill Al in me5 ymrwm«t InclWetl
only Engapem nagas mergage yW,w umry,co umryem mgovem nimegrae
p byatep 9wa nog—d,IAdP,rare
vreory Servmee etl loop re.rrelsmryoueimeav«P,mo p .,mbrmM—harem cemmunity serve organ eons anatl p r«anu.Opp—.—W-,l— ltya� 11B—one..a $10o00
st.PCHI1—bmm,lels In 1M CHR(.alt Form,P,g Form,21 PoNw—PCHI ramming El 2M1AI,HUB SmP
albulkuploLaHUBPaya wafiw mearfw HUBSme,cHw>,era y>zomo^n.,l-1g 1pret—2BI--m ,PCHI uan«e Mai«ml>am lP"b—Hp-'C,nt�-r Pbab.,aua corerenmlr H.m Rawra albogg onebree mawea
nwadda0 10
swam zg Anrvtlr.n P.a orm.w.ry¢ere vwnn tear,^syaa�o�r�or aemlorel syea,e.mwlonroonlremwntren.
PC eg..I Uawa IF --II-xmu-ssa z500 Hv.Ill..-si2111,oo—d—,naiaba�oaneea �ee«reewmaaa«emnre m.aa ana laamrm mamma: Eaema.a mtaaa zsoo U,.I.ym, $1,2m
w hmn.gere vela yan,a ee MLiw
alt a re<.o�amaw air almxe�a lmm�eiatar«m mean m r�s)a� .ea.,Pamwave—pl mmamtauDn,«Dntu�L
DE—
ae meaiw e.«ame, an,wet m-$s,uoliDre
ana. rec.M'snD.axnwts,eveneele ro lee rare teem Fa.,min Lang Swore Better wllL.ree.n wnl preweere ene %5p0a
rmacism.Mare pal epw p su.—Y
PAM Lima. All— .(PAM)-licensepe,ek.ble«reareaol_parymr,In ee,m.p«year Screemrg ParhaO«a ga,500
EI
bI
e�Nl lmaceemomny IntllvMuesMmenass to HUBS are sa fox coon- —alve Wepw e�Ed.to ah..a llw —..11 a..C—.b.IW HUB..nOea st Sg 000
$12,502
$17Bm
yr ry M --a,
em Rec«a Dd.—b.,mclme tM launcM1 of me CHR pl—ana Lev plans am b.dgl.,coal g De al 211 am CIE $1$,000 Inclmee
Sally D—ril w M Annual coat-5 year cdal tams
5 ea onbact teens
mryH
m(I-B tin
umry HU,wp.%scsgutmes,—kbwksuvi me Pahweys.....ay HUBtmma tralnir.P.
umry Heelm R«.re(CHRI win e55liearase slutlyraevam>eao Sepa.te5upwrismtralningepmWaee kr Rcemtlrae m-$1s,000;Mmlmum-E30,o0o torn CHW trelnew,Fapea6
Software Attivagon Tmining a n>PBbm,ynbre1—balning lncluee>ma,wging morelnamrs,bell praceces%,>IgmnO awumenm a a meam"g case-a rep"Nng wa cco $160000
eee any,Ea reM.rae npmws.m ma HUB sin ro a.m,rebeshere abl m.blem
haIl ni«tban 2week.heron lw.la.ocb imoths Sae.Pn a III,—p.,atmneaa 6COnOm®Eao.000 Pa,
a expene--HU.sail Dn all reponng.aures R M1allerges ana Dverell vr.g am pea0rmanco c
er regmremerds svana�l�zea epD enxews sea Lrnlldmm Lashboartle mnnewtlas.age es,parmere ana boarCbda a tla,d HUB
manalmm ke plow bemre Arnvmm Training antl mnOemwM g1,500;Cnlnclme Fresw Cunryem HUe personnel forgreeter
Reporting Tmining for Stag $TI-50olMurnwMncreahrg pd c«eem yr«eauresllPnce lDr$seuiDns�St�Soo�Aaammals«sio yin sboula beamein wwyv $1,500
blllty mrougnlmoiclig Valnlig.ceS will Vein HUB smnwnn ale essigwfiw lwluelig lnvaclig aces>,beater«tice g8pr.cLures,
wy billing cycles ene rep.Nng Cream breieL mneTig wemaell roinwrPorem ell tuneers ene em.,community bssee werelreeon work is
Invoicing Training far Stag vaeas win rig g suppdMnret6m m, b g ce$1.-,Lemon. pp rtt pour$500 suamine0le acres 9 $1500.Ca,.—FresreHUB car«nreltorgrearereyromy $1,W0
Ind-Pa H-adeg..aare rea....a,publlo faring lm.aa-.Zt4a.nrehA N.-Ill. abglaterea teem a^^.ems tar roar a Es0,o00 mrmnfo00dierim,aaamorw I.-
t. annwlly moose Lis ayDu wam1 area pmml am exmnaetl
HealthBridge 2.0 .o,elnatore am Cal Csest.re.11ln.greme wlin Heal�en ge�searcn ene all eovumOnmllmaretea tnee p nn ana execnea 1 Dl.nt ch.. Annual t, cowtlinamr..ures To be l—b-In.1 N22
nt>nb> abw-$6n,bb preyma Aeemwaa.wmin.M p p-n .al,gggaiwm-$e6—t•
care TmnaRon lnta—HUons c naXlon eaxnas.Evieence-best em nlgnlymxwwleegee n mlreLmissiom(z 50%.)ene
Transition coaches rvatlw Onam-da.bah,vela omennaeonal reeeiness essessmem,col epepe,atlm and vmn gaabc.bm and le. rig be>t omen Mmmlle@c padw Qom kmamNom«aa—MA
ws.— emo terw g envom webmare.
Cam Transnlon lnta—HUon naltlon eom uppon eTlnemaw coat roeWeve lie
Organzational Readiness eve en ers wCom aW eetlrg>p reraitlaa C.ecn cenaAeetea rig Velnin erere.ulrM
Assessment wio be<we.t>1L vmrlmivaual orgmgzetlw xMOML e011reaoverr2 mantle meswLee key—bme wl be whatlrrpu
ree.wa 6alag ear M>plml reaeml>aw ram>wMle lmprewng patlmxamanlvea.n em ream eDnt«t M�rnalla®«av Iw,ar=yn mr�m.m.hon
.n«el�«g m9allo�es r�ame>a.»e»mmxpd«mwm,m.tlw a.vaarm a.m wail e.c,.np o-ammg>eaawaa
E.B6 Tren>mDn c.atnwmm.m>are .m,a wnmm m,zs vawe wetM>
Illmn9 men
ruenirysae Nways seems t— -weak A mc1SM^I
CHW Tmining/CDC 2109 ,men tweeke bmP« mdmestre Human Healm segm.ta p all a ea Dnb p aces in me field Aettw is enableamamnsersn0m ma Only@w>pet en win rorinlwmeeon on>pecla CDC zlos Prking
Ad lDonal User Lkansea luewre ennuel,uwrlroensssem nerz>uppon rorinlnalve evelualon Lem vela up m$evauemre per lnm.nve lwluess repatlrg mceasro eaauea.n repmtlng $5.000
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