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DSHS Health Service Regional Director or designee, as coordinator of regional services, <br />will assist DSHS staff in providing direction to Contractor. DSHS personnel may, from <br />time to time, provide technical assistance and training to Contractor. Contractor shall <br />cooperate with DSHS staff to attain the goals of policy application, coordinated services, <br />and quality assurance. <br />SECTION II. PERFORMANCE MEASURES: <br />The following performance measure(s) will be used to assess, in part, the Contractor's <br />effectiveness in providing the services described in this contract Attachment, without <br />waiving the enforceability of any of the other terms of the contract. <br />Contractor shall provide services to clients who receive services in the following <br />county(ies)larea: Lamar. <br />At least 25% of the total amount of this contract Attachment shall be for services <br />provided to Title V eligible individuals ages one (1) through twenty-one (21) by <br />Contractor. <br />SECTION III. SOLICITATION DOCUMENT: N/A <br />SECTION IV. RENEWALS: NIA. <br />SECTION V. PAYMENT METHOD: Fee-for-Service <br />SECTION VI. BILLING INSTRUCTIONS: <br />Contractor shall request payment using the State of Texas Purchase Voucher (Form B-13) <br />and acceptable supporting documentation for reimbursement of the required <br />services/deliverables. Vouchers and supporting documentation should be mailed or <br />submitted by fax or electronic mail to the addresseslnumberbe1ow. <br />Department of State Health Services <br />Claims Processing Unit <br />M.C. 1947 <br />1100 West 49~' Street <br />PO Box 149347 <br />Austin, Texas 78714-9347 <br />The fax number for submitting State of Texas Purchase Voucher (Form B-13) to the <br />Claims Processing Unit is (512) 458-7442. The email address is <br />invoicesna dshs.state.tx.us. <br />SECTION VII. BUDGET: <br />SOURCE OF FUNDS: CFDA # 93.994 and State <br />PROGRAM ATTACHMENT -Page 2 <br />