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DOCUMENT NO. 7560022067A-2005 <br />ATTACHVIENT NO. 01 <br />PURCHASE ORDER NO. 038765000 <br />PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT <br />RECEIVING AGENCY PROGRAM: ASSOCIATE COMMISSIONER FOR FAMILY <br />HEALTH <br />TERM: September 01, 2004 THRU: August 31, 2005 <br />SECTION I. SCOPE OF WORK: <br />PERFORMING AGENCY shall provide or assure the provision of prenatal, preventive, and <br />primary child health, dysplasia, and dental services (for children and adolescents) for Title V <br />eligible clients. PERFORMING AGENCY shall provide services approved in the <br />PERFORMING AGENCY'S application or shall have an established referral relationship with a <br />qualified provider of each approved service, which it does not provide. <br />PERFORMING AGENCY shall comply with all applicable federal and state laws, rules, <br />regulations, standards and guidelines in effect on the beginning date of this contract Attachment <br />unless amended, including but not limited to: <br />• Fees for Clinical Health Services, 25 TAC § 1.91 (Local Health Departments only). <br />The following documents are incorporated by reference and made a part of this contract <br />Attachment. These include: <br />r <br />~ RECENING AGENCY Title V FY2005 Competitive Request For Proposal (RFP); <br />• PERFORMING AGENCY'S FY2005 Component II, Attachment A application and any <br />revisions; <br />• Title V Policy and Procedures Manual, revised for FY2005; and <br />• RECEIVING AGENCY'S Texas Department of Health (TDH) Standards for Public <br />Health Clinic Services, revised January 31, 2004. Within thirty (30) days of receipt of an amended standard(s) or guideline(s), PERFORMING <br />AGENCY shall inform RECEIVING AGENCY Program, in writing, if it shall not continue <br />performance under this Attachment in compliance with the amended standard(s) or guideline(s). <br />RECEIVING AGENCY may terminate the Attachment immediately or within a reasonable <br />period of time as determined by RECEIVING AGENCY. <br />RECEIVING AGENCY'S Public Health Regional Director or designee, as coordinator of <br />regional services, will assist RECEIVING AGENCY staff in providing direction to <br />ATTACHVIENT - Page 1 <br />