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ATTACHMENT A <br />STATEMENT OF WORK <br />If selected by the System Agency to participate in the Breastfeeding Peer Dad <br />Program, Grantee shall submit to System Agency for review and approval a quarterly <br />activity report in a format designated by System Agency. The activity report shall <br />include goals and objectives, strategies, activities, timeline of events and performance <br />measures for implementing and evaluating the program. Grantee shall submit the <br />activity report to System Agency within 30 calendar days after the end of the each <br />quarter during the Contract term. <br />S. Implement special projects according to System Agency -approved plan related to nutrition <br />education, outreach or breastfeeding if project is requested by Grantee and approved by <br />System Agency. Funding for special projects is contingent upon availability and approval <br />in writing by System Agency of the Grantee's plan for the special project, <br />T. Implement lactation services for WIC program participants who have breastfeeding <br />problems that are beyond the scope of practice of Grantee's WIC staff and/or peer <br />counselors using International Board Certified Lactation Consultants (IBCLC) or the most <br />qualified equivalent. Lactation services may also include Local Agency staff training and <br />the provision of lactation equipment. System Agency will provide written approval of <br />Grantee's plan to use lactation funding. <br />U. Ensure adequate staff coverage and uninterrupted delivery of WIC services if any member <br />of Grantee's staff is approved in writing by System Agency to participate in the System <br />Agency's dietetic Internship program. This internship will consist of no less than 1,200 <br />hours of supervised learning experiences in a variety ofnutrition-related facilities. Grantee <br />is responsible for: <br />I . Designating a WIC Nutritionist, preferably a registered dietitian, to be the Community <br />Nutrition WIC Preceptor and oversce and evaluate intern's performance for the <br />Community Nutrition (CN)IWIC portion of the System Agency dietetic internship. <br />2. The Community Nutrition Preceptor to ensure that the dietetic interns meet all <br />requirements, standards and required supervised practice hours for the CN Supervised <br />Practice as outlined by the System Agency's WIC Program. <br />3. Ensuring that the intern is not used for regular WIC duties during the internship period. <br />4. Collecting pay -back monies from intem in the event that the intern does not fulfill <br />dietetic internship local agency contract requirements. Monies must be returned to <br />System Agency. <br />V. Stock System Agency provided manual pumps, single -user electric breast pumps and <br />multi-user electric breast pumps, collection kits, and purchase additional sized flanges. <br />Distribute the appropriate pumps, kits, and/or additional sized flanges to eligible WIC <br />participants. System Agency reserves the right to withhold payment if Grantee fails to <br />accurately complete and submit online breast pump receiving reports within three (3) <br />business days of receiving a System Agency breast pump delivery as documented in the <br />current WIC Local Agency policy and procedure manual. <br />System Agency Contract No. 2017-0497' &0J) I <br />v. 06.22.201.6 Page 3 <br />