1996-112-RES WHEREAS, STATE OF TEXAS IS A FUNDING PARTNER WITH THE COUNTY OF LAMAR AND COP
RESOLUTION NO. 96-112
WHEREAS, the State of Texas is a funding partner with the County of Lamar and the
City of Paris for the Paris-Lamar County Health Department; and,
WHEREAS, the Contract for Public Health Services, TDH Document No. 75600227067
97, and the Contract Change Notices Nos. 01 and 02 to the same are the conduits through which
the state funds are received; and,
WHEREAS, it is appropriate that the forms of said Contract and Changes Notices,
attached hereto as Exhibits A, B, and C, respectively, be approved, and that the City Manager,
Michael E. Malone, be authorized to execute the same on behalf of the City of Paris, which is
the authorized contracting entity for the performing agency, the Paris-Lamar County Health
Department; NOW, THEREFORE,
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PARIS, that the
forms of the Contract for Public Health Services, TDH Document No. 75600022067 97, and
the Contract Change Notices Nos. 01 and 02, attached hereto as Exhibits A, B, and C,
respectively, be, and the same are hereby, approved; and,
BE IT FURTHER RESOLVED, that the City Manager, Michael E. Malone, be, and
he is hereby, authorized and directed to execute, on behalf of the City of Paris, which is the
authorized contracting entity for the performing agency, the Paris-Lamar County Health
Department, the Contract and Change Notices Nos. 01 and 02 to the same, under the terms and
conditions and in the forms shown in Exhibits A, B, and C, respectively, attached hereto.
PASSED AND ADOPTED this 14th day of October, 19
ATTEST:
~~;l.o~~~~~r...-,J
Mattie Cunningham, City Cler
TO FORM:
.\ .,
CONTRACT FOR PUBLIC HEALTH SERVICES
TDH DOCUMENT NO 7560022067 97
Contract Issued by: TEXAS DEPARTMENT OF HEALTH DM
(RECEIVING AGENCY) 1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
Legal Authority to Contract: Chapters 12 and 121, Health and Safety Code.
Venue: The provisions of this Contract shall be interpreted in accordance with Texas law. Venue for any court disputes shall be in
Travis County, Texas.
PERFORMING AGENCY NAME: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
MAILING ADDRESS: P. O. BOX 938 PARIS TX 75460-0938
(City, State, Zip)
STREET ADDRESS: 740 SOUTHWEST 6TH. PARIS TIC 75460-0000
(City, State, Zip)
NAME OF AUI'HORIZED
CONTRACTING ENTITY: CITY OF PARIS
(Ir different rrom PERFORMING AGENCY)
PAYEE DATA (If not the same as PERFORMING AGENCY or AUTHORIZED CONTRACTING ENmy; must be on file with the Texas State
Comptroller's Office.):
NAME:
ADDRESS:
State oCTexas Vendor Identification No. (14 digits) PAYEE AGENCY Fiscal
17560022067001 Year Ending Month: September
PAYEE BUSINESS INFORMATION FOR STATISTICAL REPORTING: Please check the categories that apply to your business.
- Small Business - A corporation, sole proprietorship, or other legal entity formed for the purpose oC making a profit which is independently
owned and operated and has Cewer than 100 employees or has less than $1,000,000 in annual gross receipts.
- Historically Underutilized Business (HUB) - A corporation, sole proprietorship, or joint venture Cormed for the purpose of making a profit
in which at least 51 % of all classes of the shares of stock or other equitable securities are owned by one or more persons who have been
historically undcrutilized (socially disadvantaged) because of their identification as members of cenain groups: Black American, Hispanic
American, Asian Pacific American, Native American. and Women. The HUB must be certified by General Services Commission or
another entity.
For Profit Organization
SUMMARY OF CONTRACT DOCUMENTATION:
COVER PAGE 1 - Receiving and Performing Agency Data GENERAL PROVISIONS
COVER PAGE 2 - Details of Attachment(s) ATIACHMENT(S)
COVER PAGE 3 - Authorized Signatures EXHIDrrS. IF APPLICABLE
Cover Page 1
EXHIBIT A
.'
DETAILS OF ATTACHMENTS
Attl TDH Term Financial Assistance Direct Total Amount
Amd Programl Begin End Source of Assistance (TDH Share)
No. m Amount
Funds.
01 BNS/CARDS 10/01/96 09/30/97 10.55793.268 0.00 0.00 0.00
TDH Document No.756OO22067 97 Totals $0,00 $0.00 $0.00
.Federal funds are indicated by a nwnber from the Catalog of Federal Domestic Assistance (CFDA), if applicable. REFER TO
BUDGET SECTION OF ANY ZERO AMOUNT ATIACHMENT FOR DETAILS.
Cover Page 2
EXECUTED IN DUPLlCATb JRIGINALS ON THE DATES SHO"'.,.
CITY OF PARIS
Authorized Contracting Entity (type above if different
from PERFORMING AGENCY) for and in behalf of:
PERFORMING AGENCY NAME:
PARIS-LAMAR COUNTY HEALTH
DEPARTMENT
By:
(Signature of person authorized to sign contracts)
MICHAEL E. MALONE, CITY MANAGER
(Name and Title)
Date:
RECOMMENDED:
By:
RECEIVING AGENCY NAME:
TEXAS DEPARTMENT OF HEALTH
Linda Farrow, Chief
Bureau of Financial Services
(Name and Title)
Date:
~ IIJ.J 1~
I f
, '
APPROVED AS TO FORM:
By: fi ~~ y- Y~1~
'Office of Ge ral Counsel
TDH Document No: 756002206797
Cover Page 3
GENERAL PROVISIONS FOR
TEXAS DEPARTMENT OF HEALTH CONTRACTS
PERFORMING AGENCY and RECEIVING AGENCY (the parties) agree to make and enter into this contract, to
faithfully perform the duties prescribed by this contract, and to uphold and abide by the terms and provisions of this
contract. PERFORMING AGENCY and RECEIVING AGENCY agree that this contract consists of receiving and
performing agency data, authorized signatures, general and/or special provisions, exhibit(s), if any, Attachment(s) with
detailed scope(s) of work and budget(s), as applicable, and Details of Attachment(s). This contract represents the complete
and entire understanding and agreement of the parties. No prior agreement or understanding, oral or otherwise, of the
parties or their agents will be valid or enforceable unless embodied in this contract.
The person or persons signing and executing this contract on behalf of PERFORMING AGENCY, or representing
themselves as signing and executing this contract on behalf of PERFORMING AGENCY, warrant and guarantee that
he, she, or they have been duly authorized by PERFORMING AGENCY to execute this contract on behalf of
PERFORMING AGENCY and to validly and legally bind PERFORMING AGENCY to all of its terms, perfonnances,
and provisions.
PERFORMING AGENCY assures compliance witll the following terms and conditions unless otherwise specified in the
Attachment(s) hereto:
ARTICLE 1. Scopp nf Wnrk
PERFORMING AGENCY will perform the work outlined in the Scope(s) of Work contained in the Attachment(s) hereto
which is/are referellCed in the Details of Attachments and hereby incorporated into this contract for all purposes as though
it were set out word-for-word in this document along with amendments which may be added by additional Attachment(s)
from time to time as set out in the Amendments Article.
Satisfactory perfonnance of this contract will be measured in part by (I) adherence to the contract; (2) results of CPA
or State Auditor reports; (3) timeliness, completeness, and accuracy of required reports, and (4) achievement of
performance measures.
ARTICLE 2. :I:erm
The lime period of this contract will be governed by the term(s) on the Attachment(s). No commitment of contract funds
is pennitted prior to the first day or subsequent to the last day of the term. The term may be extended or shortened by
amendment(s).
ARTICLE 3. Funning
This contract is contingent upon funding being available for the term of the Attachment(s) and PERFORMING AGENCY
will have no right of action against RECEIVING AGENCY in the event that RECEIVING AGENCY is unable to perform
its obligations under this contract as a result of the suspension. termination, withdrawal. or failure of funding to
RECEIVING AGENCY or lack of sufficient funding of RECEIVING AGENCY for any Attachment(s) to this contract.
If funds become unavailable, provisions of the Tennination Article will apply.
ARTICLE 4. Ampndmpnt<
No different or additional services, work, or products shall be authorized or performed except pursuant to an amendment
or modification of this contract that is executed in compliance with this Article. No waiver of any term, covenant, or
condition of this contract shall be valid unless executed in compliance with this Article. The PERFORMING AGENCY
shall not be entitled to payment for any services, work, or products which are not authorized by a properly executed
contract amendment or modification.
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1997 GENERAL PROVISIONS - Page 1
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This contract may bc modificd unilalcrally undcr dlC Icrms of dlC Sanctions Articlc. Odlcrwisc, dus contract may not
be amcndcd or modified unlcss such amendmcnt or modification is in writing and signed by individuals widl authority
to bind the parties.
ARTICLE S. Sp.vrr~hilit~
If any provision of this contract is construed to be illegal or invalid, dus will not affect dIe legality or validity of any of
its other provisions. The illegal or invalid provision will be deemed stricken and deleted to the same extent and effect
as if never incorporated herein, but all odlcr provisions will continue.
ARTICLE 6. Applir~hlr' .~w'" ~nrl Shmrbrrl~
This contract will be governed by the l:1ws of dIe Slate of Texas and enabling state/federal regulations, including federal
grant requirements applicable to funding sources. If PERFORMING AGENCY is a local governmental public health
entity, dus contract will also be govcmed by dIe Local Public Healdl Reorganization Act, Chapter 121, Health and Safety
Code.
Pj3RFORMING AGENCY agrees the Uniform Grant and Contract Marulgement Act (UGCMA), .Chapter 783, Texas
Government Code, and the Uniform Grant and Contract Management Standards (UGCMS) as amended by revised federal
circulars and incorporated in UGCMS by the Governor's Budget and Plarming Office, apply as terms and conditions of
this contract, and the Standards arc adopted by reference in their entirety. If a conflict arises between the provisions of
this contract, UGCMA and UGCMS, dlC provisions of UGCMA and UGCMS will prevail unless expressly stated
otherwise. A copy of the UGCMS manual and its refcrences will be provided to PERFORMING AGENCY by
RECEIVING AGENCY upon request.
PERFORMING AGENCY must obtain prior written approval from RECEIVING AGENCY for major project changes
which arc specified in the applicable Administrative Requirements and Cost Principles as set out in Article 10, below.
Copies of these docwnents will be provided to PERFORMING AGENCY by RECEIVING AGENCY upon request and
are incorporated by reference as a condition of this contract.
In accordance with 31 U.S.C. ~ l352 (~1352 of Public Law [P .L.] 101-l2l etTective Decembcr 22, 1989), PERFORMING
AGENCY is prohibited from using funds granted under dus contract for lobbying Congress or any agency in connection
with a particular contract. In addition, if at any time a contract excecds $100,000, thc law rcquires certification that none
of the funds provided by RECEIVING AGENCY to PERFORMING AGENCY have been used for payment to lobbyists.
Regardless of funding source, if a contract Attachment exceeds $100,000, PERFORMING AGENCY will provide to
RECEIVING AGENCY a certification of the names of any and all registercd lobbyists with whom PERFORMING
AGENCY has an agreement. This certification form is available upon request and must be forwarded to RECEIVING
AGENCY along with the names of any lobbyists, if applicable, within 90 days of receipt of the executed contract. .
PERFORMING AGENCY certifies by execution of dus contract that its payment of franchise taxes is current or, if
PERFORMING AGENCY is exempt from payment of franchise taxes, dlat it is not subject to the State of Texas franchise
tax. A false statement rcgarding franchise tax status will be treated as a material breach of this contract and may be
grounds for termination at the option of RECEIVING AGENCY. If franchise tax payments become delinquent during
the Attaelunent term, payments under dus contract will be held until PERFORMING AGENCY's delinquent franchise
tax is paid in full.
PERFORMING AGENCY agrees 10 comply with dIe requirements of dIe Immigration Reform and Control Act of 1986
and Immigration Act of 1990, 8 USC ~!lllOl, et scq., regarding employment verification and retention of verification
forms for any individual(s) lured on or after November 6. 1986, who will perform any labor or scrviccs under this
contract.
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1997 GENERAL PROVISIONS - Page 2
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"
ARTICLE 7. nph~rmpnt ~nrl ~1I'1:pcnsian
PERFORMING AGENCY funher certifies by execution of this contract that it is not ineligible for participation in federal
or state assistance programs under Executive Order 12549, Debannent and Suspension. PERFORMING AGENCY
certifies, by submission of this contract, that neither it nor its principals is presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal deparunent
or agency. Where the PERFORMING AGENCY is unable to certify to any of the statements in this certification,
PERFORMING AGENCY shall attach an explanation. PERFORMING AGENCY specifically asserts that it has not
knowingly failed to pay a single substantial debt or a number of outstanding debts to a federal or state agency and it is
not subject to an outstanding judgment in a suit against PERFORMING AGENCY for collection of the balance. A false
statement regarding PERFORMING AGENCY's status will be treated as a material breach of this contract and may be
grounds for tennination at the option of RECEIVING AGENCY.
ARTICLE 8. A!I:.!l:.llr!lnl"P'I:
PERFORMING AGENCY will establish safeguards to prohibit employees from using their positions for a purpose that
constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain.
To the extent such provisions are applicable to PERFORMING AGENCY, PERFORMING AGENCY agrees to fully
comply with the following: Title VI of the Civil Rights Act of 1964, 28 use ~1447, 42 USC ~~2000d to 2000d-4 (p.L.
88-352); ~504 of the Rehabilitation Act of 1973, 29 USC ~794 (p.L. 93-112); The Americans with Disabilities Act of
1990,29 USC ~706, 42 USC ~~121OI, et seq., 47 USC ~~152, 221, 225,611 (P.L. 101-336); and all amendments to
each, and all requirements imposed by the regulations issued pursuant to these acts, especially 45 CFR Part 80 (relating
to race, color and national origin), 45 CFR Part 84 (relating to handicap), 45 CFR Part 86 (relating to sex), and 45 CFR
Part 91 (relating to age).
Collectively, such requirements obligate RECEIVING AGENCY to provide services without discrimination on the basis
of race, color, national origin, age, sex, disability, or political or religious beliefs; PERFORMING AGENCY agrees that
in canying out the tenns of this contract, it will do so in a manner which will assist RECEMNG AGENCY to comply
with such obligations to the fullest extent of PERFORMING AGENCY's ability. PERFORMING AGENCY will use
its best efforts to make available employment opportunities for qualified disabled individuals.
PERFORMING AGENCY agrees to comply with the non-discriminatory requirements of Texas Labor Code, Chapter
21, which requires that certain employers not discriminate on the basis of race. color, disability, religion, sex, national
origin, or age.
PERFORMING AGENCY agrees to comply wiib ibe Pro-Children Act of 1994, 20 USC ~~6081 to 6084 (p .L. 103-227;
108 Stat 271 ~104) regarding the provision ofa smoke-free workplace and promoting the non-use of all tobacco products.
PERFORMING AGENCY will comply wiib envirorunental standards which may be prescribed pursuant to the following:
(a) institution of environmental quality control measures under the National Environmental Policy Act of 1969, 42 USC
~~4321 to 4332 (p.L. 91- 190) and "Protection and Enhancement of Envirorunental Quality ," Executive Order (EO) 11514;
(b) notification of violating facilities pursuant to "Providing for Administration of the Clean Air Act and the Federal Water
Pollution Control Act wiib Respect to Federal Contracts, Grants. or Loans," EO 11738; (c) confonnity of Federal actions
to Slate (Clear Air) Implementation Plans under ~176(c) ofibe Clean Air Act of 1955. as amended (42 U.S.C. ~~ 7401-
7642 ); and (d) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as
amended, 21 USC ~349, 42 USC ~~300f to 300j-9 (P.L. 93-523),
If applicable, PERFORMING AGENCY will comply with National Research Service Award Act of 1971, 42 USC
~289L-I, 20 USC ~~2080 - 6081 (P.L. 93-348 regarding ibe protection of human subjects involved in research,
development, and related activities supported by any applicable award of federal assistance.
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1997 GENERAL PROVISIONS - Page 3
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If applicable, PERFORMING AGENCY will comply wiUlthe Clinical Laboratory Improvement Amendments of 1988
(CLlA), 42 U.S.C. ~263a (P.L. 100-578) which establish federal requirements Cor the regulation and certification of
clinical laboratories .
If applicable, PERFORMING AGENCY will comply WiUI the OSHA Rcgulations on Bloodborne Pathogens, 56 Fed. Reg.
64175 (1991), 29 CFR 1919.030, which set safety standards Cor those workers and Cacilities who may handle bloodborne
pathogens .
PERFORMING AGENCY assures it will not transCer or assign its interest in this contract without the written consent
of the RECEIVING AGENCY.
ARTICLE 9. Stand:u:.ds..-Eor Fin:mrbl :mrl Progr:l.mm~ric...ManagcmCJ1t
PERFORMING AGENCY will devclop, implement, and maintain financial mamgement and control systems that meet
or exceed the requirements oC UGCMS. TIlose requirements include at a minimum:
1. Financial planning, including the development of budgets that adequately reflect all functions and resources
necessary to carry out authorized activities and the adequate determination of costs;
2. Financial mamgement systems including accurate, correct, and complete payroll, accounting, and fUlll11cial
reporting records; cost source documentation; effective internal and budgetary controls; detennination of
reasonableness, allowability, and allocability of costs; and timely and appropriate audits and resolution of any
fmdings; and,
3. Billing and collection policies, including a charge schedule, a system for discounting or adjusting charges based
on a person's income and family size, and a mechanism capable of billing and making reasonable efforts to
collect from patients and tl1ird parties.
In addition, PERFORMING AGENCY agrees to bill third party payors, at no cost to the client, for services provided
under the Attachment(s). These potential payors include, but arc not limited to, Medicaid, private insurance carriers,
other available federal, state, local and private funds, etc. PERFORMING AGENCY is required to become a Medicaid
provider for applicable program activities Cunded in the Attaclunent(s) hereto. and will maximize efforts to obtain payment
from Medicaid and all other available sources.
PERFORMING AGENCY, if designated a 50 1 (c)(3) organization as defined in Ule Internal Revenue Code or a for-profit
organization, and its governing board, shall bear full responsibility for the integrity of the fiscal and progranunatic
management of the organization. Such management shall include accountability for all Cunds and materials received from
the RECEIVING AGENCY; compliance with RECEIVING AGENCY rules, policies, and procedures, and applicable
federal and stalC laws and regulations; and correction of fiscal and program deficiencies identified through self-evaluation
and the RECEIVING AGENCY's monitoring processes. Ignorance of any contract provisions or other requirem~nts
conlained or referenced in the contract shall not constitute a dcfense or basis Cor waiving or appealing such provisions
or requiremelllS. Further, PERFORMING AGENCY's governing board shall ensure separation of powers, duties, and
functions of board members and staff.
ARTICLE 10. Al1ow:1hlr. rod.;: :'Inri Andi.l..Requil:cmcnt.s
Only those costs allowable under UGCMS and any revisions tllereto plus any applicable federal cost principles arc eligible
for reimbursement under this contract, Applicable cost principles, audit requirements and administrative requirements
are as follows:
Audit
App1il":'Ihlr rm:t Prinr:ipk.s. Rcqllirl"':mr.nts
Ad.mjnil:;.tr:lfiv~
R.cqllirl"':mr-nt'i.
A-87, State & Local Governments Circular A-128
UGCMS
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1997 GENERAL PROVISIONS - Page 4
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To be eligible for reimbursement under this contract, a cost must have been incurred and paid by PERFORMING
AGENCY within the applicable Attachment term prior to claiming reimbursement from RECEIVING AGENCY. Costs
encumbered by the last day of the applicable Attachmcnt term must be liquidated no later than 45 days after the end of
the applicable Attachment term.
Effective July I, 1996, each PERFORMING AGENCY/AUTHORIZED CONTRACTING ENTITY receiving $300,000
or more ih total federallstate financial assistance during its fiscal year shail arrange for a [mancial and compliance audit
of the PERFORMING AGENCY's/AUTHORlZED CONTRACTING ENTITY's fiscal year. The audit must be
conducted by an independent CPA and must be in accordance with the applicable OMB Circulars, Government Auditing
Standards, and UGCMS. For the purposes of this contract, the audit provisions of OMB Circular A-133 shail apply to
for-profit contracting entities. Procurement of audit services will comply with state procurement procedures, as well as
the provisions of UGCMS.
If PERFORMING AGENCY is receiving less that $300,000 in total federal/state [mancial assistance during their fiscal
year, RECEIVING AGENCY will provide PERFORMING AGENCY wriuen audit requirements.
OMB Circulars shall be applied with the following modifications: All references to "Federal Grantor Agency(ies)" shall
be expanded to read "Federal or State Grantor Agency(ies)," All references to "Federal Grant Funds" or "Federal
Assistance" shall be expanded to read "Federal and State Assistance;" "Federal Law" shall be expanded to read "Federal
or Slate Law;" and all references to "Federal Government" shall be expanded to read "Federal or State Government," as
applicable.
Within 30 days of receipt of the audit report, PERFORMING AGENCY/AUTHORIZED CONTRACTING ENTITY will
submit a copy to RECEIVING AGENCY's Internal Audit Division.
ARTICLE 11. Ovrrtimp rnmppnli:~tion
None of the funds provided by this contract will be used to pay overtime. PERFORMING AGENCY will be responsible
for any obligations of overtime pay due employees.
ARTICLE 12. Tprmo;;: :mrl t:nnrlitinno;;: of Paymrnt
For services satisfactorily performed pursuant to the Seope(s) of Work, PERFORMING AGENCY will receive
reimbursement for allowable costs. Reimbursements will not exceed the total of each Attachment(s) hereto and are
contingent on a signed contract.
Claims for reimbursement will be made on a State of Texas Purchase Voucher (TDH Form B-13). Vouchers for
reimbursement of actual expenses will be submitted monthly within 20 days following the end of the month covere4 by
the bill. A make-up claim may be submitted as a final close-out bill not later than 45 days following the end of the
applicable Attachment term(s). Advaoce payment may be requested in accordance with the applicable provisions of this
contract.
Payments made for approved claims or notice of denial of claims submitted against Attachment(s) to this contract will be
mailed not later than 60 days after receipt of monthly vouchers. Payment is considered made on the date posanarked.
Any reimbursements made by PERFORMING AGENCY to subcontractors will be made in accordance with Chapter
2251, Texas Government Code.
PERFORMING AGENCY may request, in writing, to be placed on Direct Deposit status. If this request is approved
by RECEIVING AGENCY, PERFORMING AGENCY will no longer receive copies of reimburscment vouchers.
Funding from this contract willoot be used to supplant state or local funds, but PERFORMING AGENCY will use such
funds to increase state or local funds currently available to PERFORMING AGENCY for a particular activity.
PERFORMING AGENCY further agrees to maintain its current level of support, if any,
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1997 GENERAL PROVISIONS - Page 5
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PERFORMING AGENCY will refund to RECEIVING AGENCY any funds PERFORMING AGENCY claims and
receives from RECEIVING AGENCY for the reimbursement of costs which arc determined by RECEIVING AGENCY
to be ineligible for reimbursement.
RECEMNG AGENCY will have the right to widlhold all or part of any futurc payments to PERFORMING AGENCY
to offset any reimbursement made to PERFORMING AGENCY for any ineligible expenditures not refunded to
RECEIVING AGENCY by PERFORMING AGENCY. Repayment may be taken from this contract Attachment or other
active contract Attachments with the same funding source between the panics in amounts necessary to fulfill
PERFORMING AGENCY repayment obligations.
Payment may be denied for noncompliance if rcquired financial reports arc not on file for prcvious quarters or for the
Cmal period, for failure to respond to financial compliance monitoring reports, for failure to submit independent audit
reports as required by applicable OMB Circulars, or if program requirements arc not met as specified in the Scope(s) of
Work.
ARTICLE 13, ~
PERFORMING AGENCY may request, in writing, a one time advance per Attachment with written justification and
the concurrence of RECEIVING AGENCY. Amount of advance will be determined by the amount and tenn of the
applicable Attachment(s). For each twelve (12) month Attaclunent, the amount of dle advance will not exceed one-sixth
(l/6th) of the total reimbursable amount. Advance will be requested on a State of Texas Purchase Voucher at the
beginning of the applicable Attachment period or at a single later time in the applicable Attachment period if circumstances
so warrant and the request is approved. Advance funds will be liquidated during thc applicable Attaclunent tenn so that,
after final monthly billing, PERFORMING AGENCY will not have advance funds on hand. Advance funds may be
drawn only to meet immediate cash needs for disbursement.
Amendments to applicable Attachment(s) may require upward or downward adjusbnent to the allowable advance until it
equates 1I6th of a twelve-month Attachment. In dle case of a downward adjusbnent, PERFORMING AGENCY and
RECEIVING AGENCY will agree on the amount of adjusbnent to dle advance. RECEIVING AGENCY retains the
option to reduce future claims by the required amount. In dle case of an upward adjusbnent and if PERFORMING
AGENCY needs additional funds to meet immediate operating expenses, PERFORMING AGENCY may submit to
RECENlNG AGENCY a written justification and State of Texas Purchase Voucher in the amount necessary to'eorrect
the ratio.
ARTICLE 14. ~gr"m Incnm.
PERFORMING AGENCY will develop a fce for service system and a schedule of fees for personal health services in
accordance with the provisions of Chapter 12, Sub-<:hapter D, Health and Safety Code, and the Texas Board of He,alth
rules covering Fees for Clinical Health Services, 25 TAC Section 1.91, and other applicable laws provided, however,
that a patient may not be denied a service due to inability to pay.
Bolh parties agree all revenues direcdy generated by an Attachment(s) supported activity or earned only as a result of the
Attacluncnt(s) during the tenn of dle Attachment(s) arc considered progranl income. 1bis income will be identified and
reponed quanerly and annually utilizing the report forms identified in the Financial Reports Article of these provisions.
PERFORMING AGENCY will retain dle program income and use one of the following alternatives:
1. Where the PERFORMING AGENCY is reimbursed by RECEIVING AGENCY under a cost reimbursement
method, the additive or deductive alternatives for program income may be used. Under dle additive method,
PERFORMING AGENCY will add the program income to dle funds already committed to the project by both
the RECENlNG AGENCY and PERFORMING AGENCY. PERFORMING AGENCY agrees program income
will be used to further the program objectives of the State/Federal statute under which the Scope of Work for
the Attachmcnt(s) was made and must be spent in the same project where it was generated. Program income
earned in a current budget period and not expended in that budget period may be carried forward to the next
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1997 GENERAL PROVISIONS. Page 6
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'.
budget period, but must be spent in the next budgct period, or dcductcd from program cxpendirores. TIlls policy
will apply unless specifically staled othcrwisc in thc Special Provisions of the applicable contracl Attaclunent(s).
Under the deductive method, the PERFORMING AGENCY will deduct the program income from the total
allowable costs to determine the net allowable costs.
2. Whcrc the PERFORMING AGENCY is reimburscd by RECEIVING AGENCY under a fixed price
arrangement, only the dcductive altcrnative for program income will be used. PERFORMING AGENCY
deducts the program income from the total allowable projcct costs to determine thc net allowable costs.
It is funher understood that RECEIVING AGENCY will base furorc funding levels, in parI, upon the PERFORMING
AGENCY's proficiency in identifying, billing, collecting, and reporting income, and in utilizing it for the purposes and
conditions of the applicablc Attacluncnt(s),
ARTICLE 15. F;"o"riol R.pods
Financial reports are requircd as provided in UGCMS and will be filcd by PERFORMING AGENCY regardless of
whether or nol expenses have been incurred. A Financial Staros Report, Slate of Texas Supplemental Form 269a
(TDH Form GC-4a), will be submitted within 30 days following the end of each of the first three quarters. A fmal
finaB:ial report, Slate of Texas Supplemental Form 269a (TDH Form GC-4a). will be submitted not later than 45 days
following !he end of Attaclunent term(s). If necessary, a Slate of Texas Purchase Voucher will be submitted if all costs
have nol been recovcred or a refund will be made of cxccss monies if costs incurred were less than funds received.
ARTICLE 16. Repnrtll: and Tn~pPf'tinno;:
PERFORMING AGENCY will submit financial. program. progress, and other reports as requested by RECEIVING
AGENCY in the format agreed to by the parties hercto.
RECEMNG AGENCY and, when federal fWJds are involved. any authorized representative(s) of the federal governmcnt
have the right, at all reasonable times, to inspect or otherwise evaluate the work (including clicnt or patient records)
performed or being performed hereunder and the premises in which it is being performed, including subcontractors.
PERFORMING AGENCY will participate in and provide reasonable access, facilities, and assistance to the
represcntatives. All inspections and evaluations will be performed in such a manncr as will not unduly delay the work.
PERFORMING AGENCY agrees that RECEIVING AGENCY and the federal government, or any of their duly
authorized representatives, will have access to any pertinent books, documents, papers, and client or palient records of
PERFORMING AGENCY for the purpose of making audit, examination, excerpts, and transcripts of transactions related
to contract Attaclunent(s). RECEIVING AGENCY will have the right to audit billings both before and after payment.
Payment under Attaclunent(s) will not foreclose the right of RECEIVING AGENCY to recover excessive or illegal
payments.
Any deficiencies identified by RECEIVING AGENCY upon examination of PERFORMING AGENCY's records will
be conveyed in writing to PERFORMING AGENCY. PERFORMING AGENCY's resolution of fmdings will also be
conveyed in writing to RECEIVING AGENCY within 30 days of receipt of RECEIVING AGENCY's fmdings. A
determination by RECEIVING AGENCY of either an inadequate or inappropriate resolution of the findings may result
in the withholding of funds, as provided in Terms and Conditions of Payment Article. Any such withholding of funds
will remain in effect until the fmdings are properly remedied as determined by RECEIVING AGENCY.
PERFORMING AGENCY will relain all such records for a period of thrce years from !he date of !he last expenditure
report submined under contract Attaclunent(s) or until resolution of all audit questions, whichever time period is longer.
ARTICLE 17. rUp"1 Rprned,
PERFORMING AGENCY, or any subcontractor, shall not transfcr an identifiable client record, including a patient
record, to ano!her entity or person without written consent from the client or patient, or someone authorized to act on his
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or her behalf; however, me RECEIVING AGENCY may require tlle PERFORMING AGENCY, or any subcontractor,
to transfer a client or patient record to anomer agency or to tlle RECEIVING AGENCY if me transfer is necessary to
protect eimer me confidentiality of the record or the health and welfare of the client or patient.
At me cnd of me Attaclunent lerm, all client or patient records arc mc propcrty of PERFORMING AGENCY.
RECEIVING AGENCY retains the rigIll to have access to the records or obtain copics for audit, examination, evaluation,
inspection. litigation, or other circumslanCCS that may arise.
If at any time during dIe Altachmenl term(s), PERFORMING AGENCY and/or RECEIVING AGENCY should decide
to terminalc tlle agreement, RECEIVING AGENCY may require me transfer of client or patient records upon wrinen
notice to PERFORMING AGENCY, either to another entity dlat agrees to continue me service or to RECEIVING
AGENCY.
Notwithstanding any other provision herein, if requested by RECEIVING AGENCY, me PERFORMING AGENCY shall
share all patient information with me RECEIVING AGENCY when me contract involves patient care by me
PERFORMING AGENCY. The PERFORMING AGENCY shall aucmplto obtain a release of medical information from
the client or patient or someone authorized to act on his or her behalf permitting the transfer of information outside the
PERFORMING AGENCY on forms supplied by the RECEIVING AGENCY. If the palient refuses to sign the release
of information form, the information will be shared widl dIe RECEIVING AGENCY devoid of all identifiers of a personal
nature, as specified by RECEIVING AGENCY. .
ARTICLE 18. C:onfir!rntblity
PERFORMING AGENCY will have a syslem in effect to protect client or patient records and all other documents
deemed confidential by law which arc maintained in connection with the activities funded under contract. Any disclosure
or transfer of confidential client or patient information by PERFORMING AGENCY, including information required by
me Reports and Inspections Article, will be in accordance with applicable law.
If providing direct c1ielll care, services, or programs, PERFORMING AGENCY agrees to implement workplace policies
based on the model guidelines adopled by RECEIVING AGENCY and to educate employees and clients concerning the
human inununodcficieocy virus (HIV) and its relatcd condilions including acquired immunodeficiency syndrome (AIDS)
in accordance with ~85 .113 of the Hcalth and Safcly Code.
ARTICLE 19. Equipmrnt "nr! Snppli.cs
Equipmclll is defll1Cd as tangible noncxpendable property wim an acquisition cost of over $1,000 and a useful life of more
than one year with tlle following exceptions: Fax Machines, Slereo Systems, Cameras, Video Recorder/Players,
Microcomputers, and Printers. TIlese exception items will still be considered equipment if their unit cost is over $~OO.
In accordance with Healdl & Safety Code, ~12.053, tide to all equipment and supplies purchased from funds provided
herein will be in the name of PERFORMING AGENCY duoughout dIe Attachment(s) term(s).
Unless initially lisled and approved in me Attaclunent(s), prior written approval from RECEIVING AGENCY is required
for any additions to or deletions of approved equipment purchases meeting the above equipment defmition. To receive
approval for data processing hardware and software, PERFORMING AGENCY must submit a detailed justification which
includes description of features, make and model, cost, etc.
PERFORMING AGENCY will maintain a property invcntory listing and submit an annual cumulative report (TDH Form
GC-II) to RECEIVING AGENCY no later man October 15th of each year. PERFORMING AGENCY will administer
a program of maintenance, repair, and protection of assets under dlis contract so as to assure their full availability and
usefulness. In tlle event PERFORMING AGENCY is indemnified, reimbursed, or otherwise compensated for any loss
of, destruction of, or damage to the assets provided under this contract, it will use the proceeds to repair or replace said
assets.
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1997 GENERAL PROVISIONS - Page 8
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PERFORMING AGENCY agrees that upon tennination of applicable Attachment(s), title to any remaining equipment
and supplies purchased from funds as hereinabove provided will be transfcrred to the RECEIVING AGENCY or any
other party designated by the RECEIVING AGENCY; provided. however, that RECEIVING AGENCY may, at its option
and to the extent allowed by law, transfer titlc to such property to the PERFORMING AGENCY.
In the event of bankruptcy, PERFORMING AGENCY agrces to sever RECEIVING AGENCY property, equipment, and
supplies in possession of PERFORMING AGENCY from thc bankruptcy.
ARTICLE 20. .~l1hl"nntr~l'ting
PERFORMING AGENCY may enter into agrcements with subcontractors unless restricted or otherwise prohibited in
specific AttaChment(s). Subcontracts, if any, entered into by PERFORMING AGENCY must be in writing, be executed
on an annual basis and include the following infonnation: 1) name and address of all panies, 2) well defined scope of
work, 3) measurable method and rate of payment, 4) clearly defmed and executable tennination clause, and 5) have
bcginning and ending dates coinciding with the dates of the applicable contract Attachment(s). PERFORMING AGENCY
must ensure that 1) subcontracts include any clauses required by State/Federal statutes, executive orders, and their
implementing regulations; and 2) subcontractors arc aware of requirements imposed upon them by State/Federal statutes
and regulations.
PERFORMING AGENCY will pass down audit requirements referenced in Article 10 to subcontractors where
appropriate and will maintain records sufficient to ensure that required audits have been completed in accordance with
applicable OMB circulars.
PERFORMING AGENCY agrees that it will be responsible to RECEIVING AGENCY for the performance of any
subcontractor. In addition. if PERFORMING AGENCY elects to enter into an agreement which subcontracts out a
substantial portion of PERFORMING AGENCY's Scope of Work, prior written approval must be obtained from
RECEIVING AGENCY.
ARTICLE 21. Copyrighh:1 Puhlil'~tinn,,=, :mrl Pntpnt~
PERFORMING AGENCY undemands and agrees that where activities supponed by the contract Attachments(s) produce
original books, manuals, films, or other original material, PERFORMING AGENCY may copyright such material subject
to the royalty-free, nonexclusive, and irrevocable license which is hereby retained by the federal government (if federal
funds have been used) andlor RECEIVING AGENCY, state government or any agency thereof to reproduce, publish or
otherwise use, and to authorize others to use for government purposes (a) the copyright in any work developed under a
grant, subgrant, or contract under a grant or subgrant. and (b) any rights of copyright to which a grantee, subgrantee or
a contractor purchases ownership with grant suppon. Use of the copyright for government purposes iD.cludes the right
to change the books, manuals, films, or other original material as necessary to use for governmental purposes.
PERFORMING AGENCY may publish at its expcnse the results of contract performance with prior RECEIVING
AGENCY review and approval. Any publication (written. visual. or sound) should include acknowledgment of the
suppon received from RECEIVING AGENCY and the appropriate federal agency, if applicable. At least three copies
of any such publication must be provided to RECEIVING AGENCY. RECEIVING AGENCY reserves the right to
require additional copies before or after the initial review.
PERFORMING AGENCY and any subcontractor. as appropriate, must comply with the standard patent rights clauses
in 37 CFR ~ 401.14 or FAR 52.227,11.
ARTICLE 22. Hold Hormless
To the extent authorized by law, PERFORMING AGENCY, as an independent contractor, agrees to hold RECEIVING
AGENCY andlor federal government hann1ess and to indemnify them from any and all liability, suits, claims, losses,
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1997 GENERAL PROVISIONS - Page 9
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damages and judgments, and shall pay all costs, fees and damages to dIe extent d,at such costs, fees and damages arise
from performance ,or non-performancc of PERFORMING AGENCY under this contract.
PERFORMING AGENCY, by acccplallce of funds provided duough contract Attachmcnt(s), agrces and ensures that
personnel paid from dlesc funds are duly licenscd and/or qualificd to pcrform the requircd serviccs.
ARTICLE 23. llnnding
PERFORMING AGENCY is required to carry a fidelity bond or insurance coverage equal to the amount of funding
provided under the contract Attachment(s) up to $100,000 that protects each employee of the PERFORMING AGENCY
handling funds under this contract, including person(s) audlOrizing payment of such funds. TIle fidelity bond or insurance
will provide for indemnification of losses occasioned by: (I) any fraudulent or dishonest act or acts committed by any
of PERFORMING AGENCY's employees either individually or in concert widl others. and/or, (2) failure of
PERFORMING AGENCY or any of its employees to perform faithfully hislher duties or to account properly for all
monies and property received by virtue of his/her position or employment.
ARTICLE 24. Hidnril"~lty "ncICDlt.il.iz.c.fl nll..in{'C;:~i:f";;
RECENlNG AGENCY must comply widl Texas Government Code, Chapter 2161, and I Texas Administrative Code
(fAC) ~~1I1.1I-1I1.24, whereby state agencies arc required to make a good faith effort to assist historically underutilized
businesses (HUBs) in receiving contract awards issued by the state to purchase "goods," which arc defined as "supplies,
materials, or equipment," services, or public works. PERFORMING AGENCY agrees to assist RECEIVING AGENCY
by complying with the same requirements.
A HUB is defmed in the Texas Government Code ~2161.001(2) as "...
(A) a corporation formed for the purpose of making a profit in which 51 percent or more of all classes of
the shares of stock or other equitable securities arc owned by one or more socially disadvantaged
persons who have a proportionate interest and actively participate in the corporation's control,
operation, and maru>gement;
(B) a sole proprietorship created for dIe purpose of making a profit that is completely owned, operated, and
controlled by a socially disadvantaged person;
(C) a partnership fonned for dle purpose of making a profit in which 51 percent or more of the assets and
interest in the partnership are owned by onc or more socially disadvantaged persons who have a
proportionate interest and actively participate in dlC partnership's control, opcration, and management;
(D) a joint vcnture in which each entity in the vcnture is a historically underutilized business, as determined
under anothcr paragraph of this subdivision; or
(E) a supplier contract between a historically undcrutilized busincss as determined under another parag~aph
of this subdivision and a prime contractor under which dle historically underutilized business is direcdy
involved in the manufacture or distribution of dIe goods or odlerwise warchouscs and ships the goods."
"Soeially disadvantaged pcrson" is defined in Texas Govcrnment Code ~2161.00I(3) as "...a pcrson who is socially
disadvantaged because of the person's identification as a member of a certain group, including Black Americans, Hispanic
Americans, women, Asian Pacific Americans and Native Americans. and who has suffered the effects of discriminatory
practices or other similar insidious eirculllSlaIlccs over which the person has no control."
PERFORMING AGENCY agrecs to:
I) make a,good faith cffottto subeontract with HUBs during the performancc of its contract Attachment(s) with thc
RECEIVING AGENCY and will report HUB subcontract activity on a quarterly basis for each contract
Attachment less than $100,000; and
2) comply with dIe requircments for good faith cfforts found at I TAC ~~ 111.11-111.114 as a condition of rcceiving
the contract award and for continuation of each contract Attachment when eithcr exceeds $100,000. In addition,
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1997 GENERAL PROVISIONS - Page 10
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PERFORMING AGENCY will report HUB subcontract activity on a quarterly basis for each contract
Attachment. If PERFORMING AGENCY complied with this requirement during the competitive procurement
process for the contract Attachment, no further action is necessary prior to the execution of this
contract/amendment. If PERFORMING AGENCY has not complied with this requirement because there was
no competitive procurcment process, PERFORMING AGENCY must comply with the good faith effort process
found at 1 TAC ~~111.1I-111.114 prior to contract execution.
PERFORMING AGENCY is responsible for being familiar with the T AC requirements and noncompliance with these
requirements will be grounds for termination. Copies of the applicable section of T AC are available upon request.
ARTICLE 25. S!lnrfinnc:
PERFORMING AGENCY agrees and understands that sanctions may be imposed by RECEIVING AGENCY both for
programmatic and fmancial noncompliance. RECEIVING AGENCY at its own discretion may impose one or more
sanctions for each item of noncompliance and will determine sanctions on a case-by-case basis. Both parties agree that
a stale or federal starote, rule, regulation, or federal guideline will prevail over the provisions of this ARTICLE unless
the starote, rule, regulation, or guideline can be read together with the provision(s) of this ARTICLE to give effect to
both. RECEIVING AGENCY may:
1) terminate all or a part of the contract. Termination is the permanent withdrawal of the PERFORMING
AGENCY's authority to obligate previously awarded funds before that authority would otherwise
expire, or the voluntary relinquishment by the PERFORMING AGENCY to obligate previously
awarded funds. PERFORMING AGENCY costs resulting from obligations incurred by the
PERFORMING AGENCY after termination of an award are not allowable unless expressly authorized
by the notice of termination.
2) suspend all or part of the contract. Suspension is the temporary withdrawal of the PERFORMING
AGENCY's authority to obligate funds pending compliance by the PERFORMING AGENCY or its
subcontractor(s) or pending a decision to terminate or modify the contract. PERFORMING AGENCY
costs resulting from obligations incurred by the PERFORMING AGENCY during a suspension are not
allowable unless expressly authorized by the notice of suspension.
3) temporarily or permanently withhold cash payments, Withholding of cash payment means that the
RECEIVING AGENCY retains funds claimed by the PERFORMING AGENCY in order to recover
payments already made for undocumented, disputed. inaccurate, or erroneous claims; obtain refunds
for overpayment for any reason; or obtain compliance,
4) deny contract renewal or furore contract awards to a PERFORMING AGENCY for a certain period
of time not to exceed five years.
5) delay contract execution, with the PERFORMING AGENCY while other proposed sanctions are
pending resolution.
6) amend all or a part of the contract as a result of the noncompliance.
7) place the PERFORMING AGENCY on probation. Probation means that the PERFORMING
AGENCY will be placed on accelerated monitoring for a period not to exceed six months at which
time items of noncompliance must be resolved or substantial improvement shown by the
PERFORMING AGENCY.
8) conduct accelerated monitoring of the PERFORMING AGENCY. Accelerated monitoring means
more frequent or more extensive monitoring will be performed by RECEIVING AGENCY than would
routinely be accomplished.
9) require the PERFORMING AGENCY to obtain technical or management assistance.
10) disallow claims by rejecting costs or fees claimed for payment or reimbursement by PERFORMING
AGENCY,
11) establish additional prior approvals for expendirore of funds by the PERFORMING AGENCY.
12) require additional, more detailed, tinancial and/or programmatic reports to be submitted by
PERFORMING AGENCY,
13) demand repayment from the PERFORMING AGENCY.
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1997 GENERAL PROVISIONS - Page 11
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14) reduce the eonlIaet fwxling amount for failure to achieve or maintain the proposed level of service, to
expend funds appropriately and at a rate which will make full uSe of the award, or to provide services
as set out i'1 the contract.
IS) take any othcr action which is dcemed appropriate.
RECEMNG AGENCY will formally notify the PERFORMING AGENCY in writing when a sanction is imposed with
the exception of accelerated monitoring, which may be W1aI1I1ounccd. PERFORMING AGENCY is required to file, within
15 days of receipt of notice, a written response to dIe RECEiVING AGENCY's program/division that sent the notice,
acknowledging receipt of such notice and how dIe PERFORMING AGENCY will correct the nO!lcompliance.
RECEiVING AGENCY may immediately tenninate or suspend all or part of dIe contract, temporarily or pennanendy
withhold cash paymelllS, deny contract renewal or future conlIaet awards. delay contract execution, or amend all or a part
of the contract in an emergency by delivering a written notice to a PERFORMING AGENCY by any method stating the
reason for the emergency action. The emergency may be a result of dIe PERFORMING AGENCY's noncompliance
having a direct adverse impact on dIe public or client healdl or safety, failure to achieve a perfonnance measure, being
reimbursed for expenditures which arc not in accordance widl applicable federal or state laws and regulations or the
provisions of the contract, or expending funds inappropriately.
PERFORMING AGENCY may request a review of the imposition of the following sanctions: termination of all or part
of the contract, suspension of all or part of dIe contract, pennancnt withholding of cash payments, denial of contract
renewal or future contract awards, and contract amcndment as a result of thc noncompliance. PERFORMING AGENCY
must make the request for review in writing to RECEIVING AGENCY widlin fifteen (15) days from the date of
notification.
ARTICLE 26. Tprmin~tinn
In addition to other provisions herein allowing tennination, dus contract shall terminate upon full perfonnance of all
requirements contained herein, unless extended in writing, or prior to completion of the contract term, all or a part of
this contract may be terminated for any of dIe following reasons:
I) Termination in the Best Interest of the State. TIus contract may be terminated by RECEIVING
AGENCY at any time when, in dIe sole determination of RECEIVING AGENCY, tennination is in
the best interests of the State of Texas.
2) Termination by Agreement. TIus contract may be tenninated, in whole or in part, when both parties
mutually agree d,at continuation of the contract would not achieve the objectives and goals of the
contract and d,at continuation would not be mutually beneficial.
3) Termination for Cause. RECEIVING AGENCY reservcs dIe right to tenninate this contract, in whole
or in part, upon the following conditions:
(a) TIle PERFORMING AGENCY makes an assigruncnt for the benefit of its creditors, or admits
in writing its inability to pay its debts generally as they become due, or consents to the
appoinnnent of a receiver, trustee, or liquidator of dIe PERFORMING AGENCY or of all
or any part of its property; if judgment for dIe payment of money in excess of $50,000.00
(which is not covered by insurance) is rendered by any court or governmental body against
the PERFORMING AGENCY, and dIe PERFORMING AGENCY does not discharge the
judgment or provide for its discharge in accordance widl its terms, or procure a stay of
execution thercof within 30 days from the date of entry thereof, and within the 30-day period
or a longer period during which execution of the judgment shall have been stayed, appeal
therefrom and causc dIe execution dlcrcof to be stayed during such appeal while providing
such reserves dlerefore as may be required under generally accepted accounting principles;
or a writ or warrant of attac1uncnt or any similar process shall be issued by any court against
all or any material portion of dIe property of dIe PERFORMING AGENCY, and such writ
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1997 GENERAL PROVISIONS - Page 12
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or warrant of attachment or any similar process is not released or bonded within 30 days after
its entry; or
(b) A court of competent jurisdiction finds that the PERFORMING AGENCY has failed to
adhere to any laws. ordinances, rules. regulations or orders of any public authority having
jurisdiction: or
(c) The PERFORMING AGENCY fails to communicate with the RECEIVING AGENCY as
required by the contract; or
(d) The PERFORMING AGENCY breaches a standard of confidentiality with respect to the
services provided under this contract; or
(e) The RECEIVING AGENCY makes a written determination that the PERFORMING
AGENCY has failed to substantially perform under this agreement, which determination
specifies the events resulting in the state's determination that the PERFORMING AGENCY
has failed to substantially perform under this agreement; or
(f) Either party makes a written determination that ct,e other party has conunitted a material
breach of any term(s) of this contract; or
(g) The RECEIVING AGENCY determines that the PERFORMING AGENCY is without the
personnel or resources to perform under the contract; or
(11) A receiver, conservator, liquidator, or trustee of the PERFORMING AGENCY, or any of
its property is appointed by order or decree of any court or agency or supervisory authority
having jurisdiction; or an order for relief is entered against the PERFORMING AGENCY,
under the Federal Bankruptcy Code; or the PERFORMING AGENCY is adjudicated bankrupt
or insolvent; or any portion of the property of the PERFORMING AGENCY is sequestered
by court order and the order remains in effect for more than 30 days after such party obtains
knowledge thereof; or a petition is filed against the PERFORMING AGENCY under any
state, reorganization, arrangement, insolvency, readjusonent of debt, dissolution, liquidation,
or receivership law of any jurisdiction. whether now or hereafter in effect, and such petition
is not dismissed within 30 days; or
(i) The PERFORMING AGENCY files a case under the Federal Bankruptcy Code or is seeking
relief under any provision of any bankruptcy, reorganization, arrangement, insolvency,
readjustment of debt, dissolution, receivership or liquidation law of any jurisdiction, whether
now or hereafter in effect, or consents to the filing of any case or petition against it under any
such law; or
0) The PERFORMING AGENCY fails to comply with any of the terms, conditions or
provisions of the agreement, in any manner whatsoever.
Written notice will be provided at least 30 days prior to the intended date of termination unless an emergency exists.
If either party gives notice of its intent to terminate all or a part of this contract, RECEIVING AGENCY ,and
PERFORMING AGENCY will try to resolve any issues related to the anticipated termination in good faith during the
notice period. Upon termination of all or a part of this contract. RECEIVING AGENCY and PERFORMING AGENCY
will be discharged from any further obligation created under the applicable terms of this contract except for the equitable
settlemcntofthe respective :!Ccrued interests or obligations incurred prior to termination. Termination does not, however,
constitute a waiver of any remedies for breach of this contract. In addition. the obligations of the PERFORMING
AGENCY to retain records and maintain confidentiality of information shall survive this contract.
ARTICLE 27. P....nnnpl
All personnel funded by Attacbment(s) to this contract are employees of PERFORMING AGENCY which will be
responsible for their direction and control and liable for any of their acts or omissions.
PERFORMING AGENCY will have in place legally sufficient Due Process Hearing Procedures for all of its employees
filling state budgeted positions.
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1997 GENERAL PROVISIONS - Page 13
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PERFORMING AGENCY will have full authority to employ, promote, suspend, demote, discharge, and transfer widtin
its organization any and all stalC budgelCd personnel funded by Attacluncnt(s) to dlis COOlract provided, however, that any
demotion, suspension, or discharge of such state budgelCd employecs will be in accordance with the Due Process Hearing
Procedures as set out above. TIle only distinction between state budgetcd and local paid employees is that employees on
state budgeted positions receive state benefits and arc subject to certain duties, obligations. and restrictions as stlte
employees as contained in state law. One such restriction, as contained in the State Appropriations Act, is that no
employee paid on a stalC budgelCd position may receive a salary supplement from any sourCe unless specifically authorized
in the Appropriations Act or other Slate law. TIus prohibition includes, but is not limited to, the payment to such
employee of a so-called "flat rate. car allowance or travel allowance. Any such travel or per diem to these employees
must be on a reimbursement basis. supported by appropriate records, and may not exceed dIe reimbursement for mileage
and/or per diem allowed under the Appropriations Act and current state travel regulations. This restriction will apply
whether travel funds arc provided in Attaclunent(s) under dtis contract or from any other source.
PERFORMING AGENCY will utilize RECEIVING AGENCY's polieies and procedures for hiring and promoting
individuals into state budgeted positions funded by dtis contract. Qualifications of any individuals filling these positions
will be subject to approval of RECEIVING AGENCY's Bureau of Personnel Management. The purpose of the approval
is to ensure that individuals occupying dlese positions meet minimum educational and experience requirements.
PERFORMING AGENCY will maintain required records and submit documents necessary to process personnel, payroll,
leave and time records, and travel claims on state budgeted positions. PERFORMING AGENCY will be furnished by
RECEIVING AGENCY state warrants for salary compensation or travel reimbursement for issuance to employees on
state budgeted positions.
An independent audit is not required as a condition of this contract if dIe Attaclunent provides assistance through
assigrunent of state budgeted positions and no funds arc budgeted for local costs.
PERFORMING AGENCY may be reimbursed for local personnel costs or other categories of expense used to fulfill the
scope of work of applicable Anachmcnt(s) in lieu of being furnishcd state payroll warrants after a state budgeted position
becomes vacant. Reimbursement will not exceed the balance of funds on the state budgeted position after all benefits,
obligations, and/or other entitlements are met. PERFORMING AGENCY's Director, or other person(s) authorized
elsewhere in this contract, may submit a request for conversion. RECEIVING AGENCY will transmit formal approval
and a revised budget to PERFORMING AGENCY to complete dIe conversion if dIe request is granted.
PERFORMING AGENCY agrees to defend and indemnify RECEIVING AGENCY for any and all claims and/or
judgments taken against any employees, state or local, or against dIe RECEIVING AGENCY, arising out of any claims
or cause of action against any such employees, except to the extent that employees on state budgeted positions may be
indemnified and the state may be liable for certain acts pursuant to Chapter 104 of the Civil Practice and Remedies Code
of Texas and any other applicable law. The PERFORMING AGENCY agrees to indemnify and hold hann1ess.the
RECEIVING AGENCY for any and all claims and/or judgments taken against RECEIVING AGENCY by employees
of the PERFORMING AGENCY dlat arc funded by the AttacluneOl(s) to dlis contract.
ARTICLE 28. Funding P~rticip~tinn Rl'qWt:C.ll1CI1t
PERFORMING AGENCY agrees funds provided through this contract will not be used for matching purposes in securing
other funding unless otherwise directed or approved by RECEIVING AGENCY.
ARTICLE 29. !\nrviv:tl nf Trrmllll
Tennination or expiration of dtis eomract for any reason shall not release eiuler party from any liabilities or obligations
set forth in this contract tllat (i) Ule parties have expressly agreed shall survive any such termination or expiration, or (ii)
remain to be performed or by dleir nature would be intended to be applicable following any such termination or
expiration.
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ARTICLE 30. Nn W~ivpr nf Snvprpign 'mmllnit~
TIlE PARTIES EXPRESSLY AGREE THAT NO PROVISION OF THIS CONTRACT IS IN ANY WAY INTENDED
TO CONSTITUTE A WAIVER BY RECEIVING AGENCY OR THE STATE OF TEXAS OF ANY IMMUNITIES
FROM SUIT OR FROM LIABILITY TIlAT RECEIVING AGENCY OR THE STATE OF TEXAS MAY HAVE BY
OPERATION OF LAW.
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1997 GENERAL PROVISIONS - Page 15
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DOCUMENT NO. 756002206797
ATTACHMENT NO. 01
PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: BUREAU OF NUTRITION SERVICES
TERM: October 01, 1996 THRU: September 30, 1997
SECTION 1. SCOPE OF WORK:
The PERFORMING AGENCY will provide supplemental food vouchers, nutrition education and
immunizations as an adjunct to good health care at no cost to low income pregnant and postpartum
women, infants, and children identified to be at nutritional risk. In meeting this goal the
PERFORMING AGENCY will:
A. Perform professional, administrative, and clerical services necessary to provide special
supplemental food vouchers and nutrition education to qualified women, infants, and
children in a specified geographic area. Services will be performed according to the terms
and specifications of the RECEIVING AGENCY and/or the United States Department of
Agriculture (USDA). Regulations, instructions, policies, and/or directives will be issued
to the PERFORMING AGENCY as they are formulated and appear in the State WIC
Policy and Procedures Manual, which is hereby incorporated by reference and made a part
hereof.
The RECEIVING AGENCY Program will notify the PERFORMING AGENCY, by letter,
of the authorized geographic service area(s). These geographic area(s) may be subject to
change upon written notice by the RECEIVING AGENCY Program and approval by the
PERFORMING AGENCY.
B. Assist in the collection and evaluation of data which will identify medical benefits of this
nutrition intervention program and furnish fmancial, dietary, medical, nutrition education,
and any other special reports in a timely manner as required by the RECEIVING
AGENCY Program's written policies for the compilation of such data.
C. Determine eligibility of applicants, register participants, collect data, conduct
measurements, provide nutrition education, and maintain records as required by the
RECEIVING AGENCY Program's written policies.
D. Make available appropriate health services to participants up to the income level specified
in the RECEIVING AGENCY'S Program policies and inform applicants of the health
services that are available. When health services are provided through referral, the
PERFORMING AGENCY must have a plan for continued efforts to make health services
ATTACHMENT - Page 1
. '
available to participants at the clinic or through written agreements with health care
providers.
E. Issue prenumbered food vouchers furnished by the RECEIVING AGENCY to qualified
participants who will use such vouchers to obtain specified food items from participating
vendors; maintain complete accountability and security of all food vouchers received from
the RECEIVING AGENCY; and be held financially responsible for all unaccounted for
food vouchers and/or those issued to ineligible participants. The PERFORMING
AGENCY will also be held fmancially accountable for unauthorized infant formulas issued
to participants.
F. Review the immunization record of WIC Program applicants/participants and provide
immunizations as needed using staff funded under this Attachment in accordance with the
WIC Policy and Procedure Manual provided by the RECEIVING .AGENCY to the
PERFORMING AGENCY or as otherwise approved in writing by the RECEMNG
AGENCY Program.
The PERFORMING AGENCY will comply with all applicable laws, regulations, standards, and
guidelines established at Federal, State and Local levels as these rules now appear or may be
amended during the period of this Attachment. These include but are not limited to:
1. Child Nutrition Act of 1966, as amended (42 USC 1786)
2. Public Laws 99-500 and 99-591
3. Child Nutrition Act and WIC Reauthorization Act of 1989, Public Law 101-147
4. Uniform Federal Assistance Regulations 7 CFR Parts 3015 and 3016
5. Applicable Federal Regulations located in 7 CFR Part 246
6. State WIC Policy and Procedures Manual
SECTION n. SPECIAL PROVISIONS:
General Provisions, ASSURANCES Article, is hereby amended to include the following:
The PERFORMING AGENCY hereby agrees that it will comply with Title VI of the Civil Rights
Act of 1964 (42 USC 2000d et.seq.), Title IX of the Education Amendments of 1972 (20 USC
1681 et.seq.), Section 504 of the Rehabilitation Act of 1973 (29 USC 794), Age Discrimination
Act of 1975 (42 USC 6101 et.seq.); all provisions required by implementing the regulations of
the Department of Agriculture; Department of Justice Enforcement Guidelines, 28 CFR Parts 50.3
& 42; and Food & Nutrition Service (FNS) directives and guidelines, to the effect that, no person
will, on the grounds of race, color, national origin, sex, age, or disability, be excluded from
participation under any program or activity for which the PERFORMING AGENCY receives
federal fmancial assistance from FNS; and hereby gives assurance that it will immediately take
measures necessary to effectuate this Attachment.
ATTACHMENT - Page 2
By accepting this assurance, the PERFORMING AGENCY agrees to compile data, maintain
records and submit reports, as required, to permit effective enforcement of the nondiscrimination
laws and permit authorized USDA personnel during normal working hours to review such
records, books, and accounts as needed to ascertain compliance with the nondiscrimination laws.
If there are any violations of this assurance, the Department of Agriculture, Food and Nutrition
Service, will have the right to seek judicial enforcement of this assurance. This assurance is
binding on the PERFORMING AGENCY, its successors, transferees, and assignees, as long as
they receive assistance or retain possession of any assistance from the Department of Agriculture.
The person or persons whose signatures appear on the COVER PAGES of this Attachment are
authorized to sign this assurance on behalf of the PERFORMING AGENCY.
General Provisions, STANDARDS FOR FINANCIAL MANAGEMENT Article, Number 1.,
regarding internal budgeting and Number 3., regarding billing, collection, and fee schedules are
not applicable.
General Provisions, ADVANCE PAYMENTS Article, is not applicable to this Attachment.
However, the PERFORMING AGENCY will be allowed the option of receiving a two-month
cash advance in accordance with WIC Program Policies and Procedures.
General Provisions, OVERTIME COMPENSATION Article, is not applicable.
General Provisions, TERMS & CONDITIONS OF PAYMENT Article, is hereby modified to
include the following paragraphs:
The participant caseload quantity will be assigned by the RECEMNG AGENCY Program by
giving written notice to the PERFORMING AGENCY and may be subject to change from time
to time upon written notice to the PERFORMING AGENCY from the RECEIVING AGENCY
Program. The PERFORMING AGENCY assumes liability for all food costs resulting from the
PERFORMING AGENCY exceeding assigned caseload maximum. The number of individuals
served in excess of assigned caseload are not to be included in the calculation of earned
administrative funds as described below.
The RECEIVING AGENCY will reimburse the PERFORMING AGENCY for administrative
costs which include participant referral, vendor evaluation, nutrition education, general
administrative support, start-up costs, outreach, applicant screening, and food voucher issuance.
Administrative costs will be reimbursed based on actual costs, but not to exceed the "maximum
reimbursement" set out below, based upon the sum of the participants who actually receive food
vouchers each month plus infants who do not receive any food vouchers whose breastfeeding
mothers were participants, to the extent that the total so derived does not exceed the
PERFORMING AGENCY'S total assigned caseload within any given month. Surplus funds (the
amount by which maximum reimbursements exceed actual cost) can be accumulated and carried
ATTACHMENT - Page 3
forward within the Attaclunent term. The time period during which surplus may be recovered will
be determined by the RECEIVING AGENCY.
PARTICIPANTS SERVED PER MONTH MAXIMUM REIMBURSEMENT:
Federal FY97, the period covered by this Attaclunent, represents the first year of a new funding
formula for the Texas WIC Program. As such, a grandfathering of the full effects of the formula
will be implemented this and the next several contract periods. During the term of the
Attaclunent, the PERFORMING AGENCY will earn administrative funds at the rate of $.l2....61
for each participant served as defined above for the first 16.058 clients served. All additional
participants served will be at the new funding rate of $~.
Special Initiative "Inununizations" funding is incorporated into the rate per participant shown
above until the PERFORMING AGENCY reaches a cumulative number of immunizations
administered for the Attaclunent period totaling U2Q and serves a total number of WIC
participants equal to that served in the FY96 contract period. At that point, all additional
immunizations administered by staff funded under this Attaclunent to WIC participants/applicants
and their siblings will earn administrative funds at the rate of $5.00 per immunization as reported
to the RECEIVING AGENCY via Encounter Forms or the Automation System to be implemented
by the RECEMNG AGENCY during the term of this Attaclunent.
The PERFORMING AGENCY agrees that:
(1) Not less than 20% of total administrative costs will be separately identified and
documented as expenditures directly related to nutrition education. Nutrition education
expenditures must be supported by documentation of participant attendance or non-
attendance.
(2) The RECEIVING AGENCY will reimburse the PERFORMING AGENCY for
administrative expenses at a rate not greater than five times the amount of properly
documented expenditures for nutrition education, but not more than is earned based on
actual participation not to exceed the PERFORMING AGENCY'S assigned participant
caseload.
(3) The RECEIVING AGENCY will limit (CAP) the PERFORMING AGENCY'S indirect
costs to the lesser of the rate approved by the RECEMNG AGENCY'S Fiscal Division
or twenty (20) percent applied to the PERFORMING AGENCY'S total direct salaries
plus benefits reimbursed by the RECEIVING AGENCY. However, approval must be
obtained from the RECEIVING AGENCY'S Fiscal Division before the recovery of any
indirect costs will be permitted with the exception of indirect costs recoveries using
amounts contained in the Uniform Grants and Contracts Management Standards (UGCMS)
for which approval can be granted by the WIC Program office.
ATTACHMENT - Page 4
'.
(4) The RECEIVING AGENCY will identify annually to the PERFORMING AGENCY an
amount of funds that must be spent for breastfeeding promotion. The breastfeeding
allocation of funds to the PERFORMING AGENCY will be based on the PERFORMING
AGENCY'S proportional share of the statewide combined total of pregnant and
breastfeeding participants as reported to the RECEMNG AGENCY.
(5) The RECEMNG AGENCY also reserves the right to withhold a proportionate amount
of earned administrative funds when evidence exists that nutrition education and/or
breastfeeding promotion is not being provided by the PERFORMING AGENCY, or the
PERFORMING AGENCY is not complying with the provisions of USDA and/or the
RECEMNG AGENCY directives.
(6) The RECEIVING AGENCY reserves the right to utilize a competitive offering for the
award of any future contracts at the end of the term of this Attachment.
(7) The RECEIVING AGENCY may amend or terminate this Attachment if funds available
become reduced, depleted, or unavailable during the term of the Attachment to the extent
that the WlC Program is unable to provide administrative funding at the rate(s) shown
above. The RECEMNG AGENCY will provide written notification to the
PERFORMING AGENCY of such fact.
(8) The RECEMNG AGENCY reserves the right to grant exceptions to the above funding
formula(s) to serve the best interest of the Texas WlC Program.
The PERFORMING AGENCY agrees to break out separately on the face of the claim for
reimbursement (State of Texas Purchase Voucher, TDH Form B-13) the costs associated with
nutrition education, breastfeeding, and other administrative costs.
General Provisions, PROGRAM INCOME, paragraph one, is not applicable to this Attachment.
General Provisions, FINANCIAL REPORTS Article, second paragraph, second sentence, is
replaced with the following:
A final report, Financial Status Report, Federal Form 269 (TDH Form GC-3), will be submitted
no later than December 31, 1997.
General Provisions. REPORTS AND INSPECTIONS Article, paragraph one is hereby modified
to include the following wording:
The PERFORMING AGENCY will submit an Immunization Encounter Form and Immunization
Dose Forms on a weekly basis. However, the Encounter Form may be replaced with an
automated immunization system during the term of this Attachment. In such event, the
PERFORMING AGENCY will comply with instructions from the RECEMNG AGENCY to
ATTACHMENT - Page 5
transmit immunization activity by diskette or via modem at intervals specified by the
RECEIVING AGENCY.
General Provisions, EQUIPMENT AND SUPPLIES Article, is amended by adding the following:
The PERFORMING AGENCY agrees to accept responsibility and financial liability for all
equipment and supplies purchased with the RECEIVING AGENCY funds, whether purchased
locally by the PERFORMING AGENCY, or by the RECEIVING AGENCY and transferred to
the care and custody of the PERFORMING AGENCY. The PERFORMING AGENCY further
agrees to conduct an annual physical inventory of all equipment purchased by the RECEMNG
AGENCY, and submit it at a time to be specified by the RECEIVING AGENCY. The
RECEIVING AGENCY reserves the right to recover the cost of equipment or supplies purchased
by the RECEIVING AGENCY and placed in the custody of the PERFORMING AGENCY if such
articles are lost, stolen, or otherwise unlocated.
SECTION ill BUDGET:
All categories of cost billed to the RECEIVING AGENCY and allocation of such costs must be
in accordance with the "Plan to Allocate Direct Costs" (pADC), submitted by the PERFORMING
AGENCY and approved by the RECEMNG AGENCY. A listing of the categories contained
in the negotiated P ADC are shown in Exhibit A of this Attachment.
ATTACHMENT - Page 6
. .'
. Project #62
Paris-Lamar County Health Department
Paris, Texas
FY97 Plan To Allocate Direct Costs
Approved Categories
Personnel Costs
Personnel Benefits
Travel Costs
Equipment Purchase
Outreach
Co=unications and Utilities
Printing and Reproduction
Office Supplies
Postage and Shipping
Expendable Medical Supplies
Other Expenses:
A. Nutrition Education Materials
B. Continuing Education
C. Equipment Repair
D. Liability Insurance
E. Annual Dues
F. Equipment Purchase
G. Computer Software
Contract Audit Services
Indirect Costs
Exhibit A
. . ~ . ~.
C_fTF!CATTON REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS. GRANTS, LOANS ANO COOPERATIVE AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief
that:
(1) No federal appropriated funds have been paid or will be paid, by
or on behalf of the undersigned, to any person for influencing or
attempting to influence an officer or an employee of any agency,
a member of congress, an officer or employee of congress. or an
employee of a member of congress in connectian with the awarding
of any federal contract, the making of any federal grant, the
making of any federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment,
ar madification of any federal contract, grant, loan, or
cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid
or will be paid to any person for influencing or attempting to
influence an officer or employee of any agency, a member of
congress, an officer or employee of congress, or an employee of a
member af congress in connection with this federal contract,
grant. loan, or cooperative agreement, the undersigned shall
camplete and submit Standard Form-lll, "Disclosure Form to Report
Lobbying, II in accordance with its instructions.
'.
(3) The undersigned shall require that the language of this
certification be included in the award dacuments far all
subawards at all tiers (including subcontracts, sub grants , and
contracts under grants, laans and cooperative agreements) and
that all subrecipients: shall certify and disclose accordingly.
This certification is a material representation of fact upan which reliance
was placed when this transaction was made or entered into. Submissian of
this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, Title 31, U.S. Code. Any person who
fails to file the required certification shall be subject to a civil
penalty of not less than S10.000 and nat more than S100,000 for each such
failure.
Y_.2f-1C
Date
~& cJl) ;JC).1J0 7 17 - () I
Application or Contract Number
AJ^/5 - ~l1lnl1r a. ;4'J;//i
Name and Ad ress OT Organizat1on
LJ.-~
I
, r~. ~.:
.....
"
~
TEXAS DEPARTMENT OF HEALTH
1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
STATE OF TEXAS
COUNTY OF TRAVIS
TDH Document No.7560022067 97
CONTRACT CHANGE NOTICE NO. III
The Texas Depanment of Health, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in writing with
PARIS-LAMAR COUNTY HEALTH DEPARTMENT hereinafter referred to as PERFORMING AGENCY. The parties thereto now
desire to amend such contract attachment(s) as follows:
SUMMARY OF TRANSACTION:
ATT. NO. 02: PRIMARY HEALTH CARE PROGRAM/COPC
All terms and conditions not hereby amended remain in full force and effect.
EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN.
CITY OF PARIS
Authorized Contracting Entity (type above if different
from PERFORMING AGENCY) for and in behalf of:
PERFORMING AGENCY:
RECEIVING AGENCY:
PARIS-LAMAR COUNTY HEALTH DEPARTMENT
By'
;./
(Signature of person authorized to sign contracts)
ture of person authorized to sign contracts)
MICHAEL E. MALONE, CITY MANAGER
(Name and Title)
Linda Farrow, Chief
Bureau of Financial Services
(Name and Title)
Date:
Date:
Q-6-'1"
RECOMMENDED:
APPROVED AS TO FORM:
k'h. AUG 3 0 ell
By:. 'tJb~.I! f)~ ~fi;-
Office o(General Counse
By:
OM GMO . Rev. 12195
G AGENCY Director. if different
authorized to sign contract)
EXHIBIT B
Cover Page 1
"
,J ETA I L S 0 FAT T A C H 1d E N T S
All/ TDH Term Financial Assistance Direct Total Amount
Amd Program! Begin End Source of Assistance (TDH Share)
No. m Amount
Funds"
01 BNSICARDS 10101/96 09/30/97 10.557 93.268 0.00 0.00 0.00
02 PRIMARY 09/01/96 08/31/97 State 211,415.00 0.00 211,415.00
TDH Document No.7560022067 97 Totals $211,415.00 $0.00 $211,415.00
Change No. 01
"Federal funds are indicated by a number from the Catalog of Federal Domestic Assistance (CFDA), if applicable. REFER TO
BUDGET SECTION OF ANY ZERO AMOUNT ATIACHMENT FOR DETAILS.
Cover Page 2
DOCUMENT NO. 7560022067-97
ATTACHMENT NO. 02
PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: PRIMARY HEALTH CARE PROGRAM/COPC
TERM: September 01, 1996
11IRU: August 31, 1997
SECTION I. SCOPE OF WORK
PERFORMING AGENCY will deliver comprehensive health care services to eligible low-income
individuals as authorized under the Health and Safety Code, Chapter 31, "Texas Primary Health
Care Services Act". Services delivered under this Attachment will be in compliance with
PERFORMING AGENCY'S application as approved by RECEIVING AGENCY Program, the
1995 edition, with revisions as they occur, of RECEIVING AGENCY'S Primary Health Care
(PHC) Handbook, the Request for Proposal (RFP), and the Primary Health Care Program Rules,
25 TAC, Chapter 39. The above referenced documents are adopted by reference as part of this
Attachment.
PERFORMING AGENCY agrees to comply with the Health and Safety Code, Chapter 31,
"Texas Primary Health Care Services Act".
PERFORMING AGENCY will submit a Program Services Report quarterly on a form that has
been furnished by RECEIVING AGENCY Program by the thirtieth (30th) of the month following
a quarter. A fInal Program Services Report will be submitted no later than sixty (60) days after
the end of the Attachment term. The RECEMNG AGENCY's Program requires comprehensive
reports which allow the Program to assess the volume and quality of services being provided.
The PERFORMING AGENCY must report on:
. screening, referral and PHC eligibility services (pHC-200)
. client intake - new and recertifIed clients (PHC-200)
. number of PHC eligible clients receiving medical services (pHC-200)
. clients served by quarter (pHC-200)
. cost and type of services provided (pHC-200)
. client demographic data (PHC-300) (annual)
The PERFORMING AGENCY must report quality measures on the:
A TT ACHMENT - Page 1
. Clinical Process = Outcome Measures report (pHC-301)
. Client Satisfaction Survey (PHC-302)
PERFORMING AGENCY will use the required eligibility system as described in the PHC
Handbook and use TESS (Texas Eligibility Screening System) as the initial step. During the fiscal
year, if TIES (Texas Integrated Enrollment System) is adopted by the RECEIVING AGENCY
Program, then PERFORMING AGENCY will use the new enrollment/eligibility system.
PERFORMING AGENCY will make reasonable efforts to investigate and apply for all other
sources of third party funding available to or identified by the patient before submitting claims for
allowable costs to RECEIVING AGENCY Program.
PERFORMING AGENCY agrees that, when each client is enrolled, the client will be assigned
to a specific primary care provider for preventive and episodic care to foster continuity of and
efficiency of care.
PERFORMING AGENCY will provide an estimated .8QQ clients with services/units of service in
or benefiting the county(ies)/area defined as: Lamar.
SECTION n. SPECIAL PROVISIONS
Breach of the General Provisions, REPORTS AND INSPECTIONS Article, CI1ENT RECORDS
Article and SUBCONTRACTING Article by PERFORMING AGENCY will be immediate
grounds for termination. Fully executed contracts between PERFORMING AGENCY and
subcontractors will be implemented and kept on file at the PERFORMING AGENCY.
PERFORMING AGENCY will provide RECEIVING AGENCY with necessary accessibility to
all pertinent records including subcontracts and client records.
ATTACHMENT - Page 2
.'
,
SECTION m. BUDGET:
PERSONNEL
FRINGE BENEFITS
TRAVEL
EQUIPMENT
SUPPLIES
CONTRACTUAL
OTHER
$129,681.00
29,827.00
3,000.00
0.00
16,907.00
32,000.00
0.00
TOTAL
$211,415.00
Total reimbursements will not exceed $ 211,415.00.
Financial status reports are due the 30th of December, 30th of March, 30th of June, and the 15th
of October.
. ,,"
ATTACHMENT - Page 3
. ~~.
t TTFICATION RESAROING LOBBYING
CERTIFICATION FOR CONTRACTS. GrtANTS. LOANS AND COOPERATIVE AGrtEEMENTS
The undersigned c~rtifies, to the best of his or her knowledge and belief
that:
(1) No federal appropriated funds have been paid or will be paid, by
or on behalf of the undersigned, to any person for influencing or
attempting to influence an officer or an ~loyee of any agency,
a member of congress, an officer or employee of congress, or an
employee of a member of congress in connection with the awarding
of any federa 1 contract, the mak i ng of any federa 1 grant, the
making of any federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewa I, amendment,
or modification of any federal contract, grant, loan, or
cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid
or will be paid to any person for influencing or attempting to
influence an officer or employee of any agency, a member of
congress, an officer or employee of congress, or an employee of a
member of congress in connection with this federal contract,
grant, loan, or cooperative agreement, the undersigned shall
complete and submit Standard Form-Ill, "Disclosure Form to Report
Lobbying," in accordance with its instructions.
(3) The undersi gned sha 11 requ ire that the 1 anguage of thi s
certifi cati on be i nc 1 uded in the award documents for a 11
subawards at all tiers (including subcontracts, sub grants , and
contracts under grants, loans and cooperati ve agreements) and
that all subrecipients sha'l1 certify and disclose accordingly.
This certification is a mat~rial representation of fact upon which reliance
was placed when this transaction was made or entered into. Submission of
this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, Title 31, U.S. Code. Any person who
fails to file the required certification shall be subject to a civil
penalty of not less than SlO,OOO and not more than S100,000 for each su~i
failure~
~ - r-.<o -7/.
Sig~ature Date
ANTHONY BETHEL, ADMINISTRATOR
Name OT Au~norizea InQlvlduai
r-Sf,(JO'J..-:)..(Jbl ,,,/-o?-
App lcatlon or Contract Numoer
PARIS-LAMAR CO. HEALTH DEPT. 740 S.W. 6TH, PARIS, TEXAS 75460
Name ana Address OT Organlzation
..... '-'..
~
TEXAS DEPARTMENT OF HEALTH
1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
STATE OF TEXAS
COUNTY OF TRAVIS
TDH Document No. 7560022067 97
CONTRACT CHANGE NOTICE NO. llZ
The Texas Department of Health, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in writing with
PARIS-LAMAR COUNTY HEALTH DEPARTMENT hereinafter referred to as PERFORMING AGENCY. The panies thereto now
desire to amend such contract attachment(s) as follows:
SUMMARY OF TRANSACTION:
ATI. NO. 03: ORASNACCINE
All terms and conditions not hereby amended remain in full force and effect.
EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN.
CITY OF PARIS
Authorized Contracting Entity (type above if different
from PERFORMING AGENCY) for and in behalf of:
PERFORMING AGENCY:
RECEIVING AGENCY:
PARIS-LAMAR COUNTY HEALTII DEPARTMENT
TEXAS DEPARTMENT OF HEALTII
(Signature of person authorized to sign contracts)
By:
MICHAEL E. MALONE, CITY MANAGER
(Name and Title)
Linda Farrow, Chief
Bureau of Financial Services
(Name and Title)
Date:
Date:
q - ( 3- '1 '"
(PERFO ING AGENCY Director, if different
from rson authorized to sign contract)
APPROVED AS TO FORM:
.>.J~VeJit;;; ~ 111l!8
By:
RECOMMENDED:
By:
Office of General Counsel
DM GMD - Rev. 12195
EXHIBIT C
Cover Page 1
DETAILS OF ATTACHMENTS
Att! TDH Term Financial Assistance Direct Total Amount
Amd Program! Begin End Assistance (TDH Share)
No. m Source of Amount
Funds'
01 BNS/CARDS 10/01/96 09130/97 10.55793.268 0.00 0.00 0.00
02 PRIMARY 09/01/96 08/31/97 State 211.415.00 0.00 211,415.00
03 ORAS/V AC 09/01/96 08/31/97 State 93.991 104,628.00 94,014.00 198,642.00
TDH Document No.7560022067 97 Totals $316,043.00 $94,014.00 $410,057.00
Change No. 02
'Federal funds are indicated by a number from the Catalog of Federal Domestic Assistance (CFDA), if applicable. REFER TO
BUDGET SECTION OF ANY ZERO AMOUNT ATIACHMENT FOR DETAILS.
Cover Page 2
DOCUMENT NO. 7560022067-97
ATTACHMENT NO. 03
PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
RECEMNG AGENCY PROGRAM: OFFICE OF REGIONAL ADMINISTRATIVE
SERVICES
TERM: September 01, 1996
THRU: August 31, 1997
SECTION 1. SCOPE OF WORK:
ESSENTIAL PUBLIC HEALTH SERVICES
PERFORMING AGENCY will use direct assistance and/or fInancial assistance, as specifIed in
Section III, Budget, from RECEIVING AGENCY to deliver one or more of the following ten
essential public health services:
1. Monitor health status to identify community health problems.
2. Diagnose and investigate health problems and health hazards in the community.
3. Inform, educate, and empower people about health status.
4. Mobilize community partnerships to identify and solve health problems.
5. Develop policies and plans that support individual and community health efforts.
6. Enforce laws and regulations that protect health and ensure safety.
7. Link people to needed personal health services and assure the provision of health
care when otherwise unavailable.
8. Assure a competent public health and personal health care workforce.
9. Evaluate effectiveness, accessibility, and quality of personal and population-based
health services.
10. Research for new insights and innovative solutions to health problems.
Two types of support are provided under this program: (1) direct assistance in the form of State-
paid positions and/or vaccines and/or (2) fmancial assistance from General Revenue funds and the
Preventive Health and Health Services Block Grant.
STATE-PAID POSITIONS
PERFORMING AGENCIES receiving direct assistance funding for State-paid positions are
required to submit to the appropriate Public Health Regional Director the following items by
ATTACHMENT - Page 1
"
December 1, 1996: a current job description, an organizational chart depicting the position,
identification of the position's direct supervisor, a current performance evaluation, and a statement
of health outcomes toward which the position's activities are directed.
These positions report to and are directly supervised by PERFORMING AGENCY administrative
staff. Supervision authorization includes, but is not limited to, overseeing daily work assignments
and duties, staff development, evaluations, daily supervision, leave approval, promotions, and
disciplinary actions including termination of the employee.
FINANCIAL ASSISTANCE
PERFORMING AGENCIES receive 73.5 percent of their fmancial assistance from General
Revenue funds and 26.5 percent from the Preventive Health and Health Services Block Grant.
PERFORMING AGENCY is required to submit to the appropriate Public Health Regional
Director a report detailing how these funds are currently being used by December 1, 1996. This
report must identify activities and objectives toward which these funds are directed.
For FY 1998, while General Revenue funds will continue to be directed toward the delivery of
a broad range of essential public health services, the Preventive Health and Health Services Block
Grant funds will be designated for activities directed solely toward the prevention of heart disease
and cancer.
During FY 1997, PERFORMING AGENCY agrees to develop two written plans for service
delivery in FY 1998, one plan for the General Revenue support and one plan for the Preventive
Health and Health Services Block Grant support. These plans must include a statement of
outcome objectives, specific activities to be performed, and a budget that links these objectives
and activities to the prescribed percentages. Tlus plan must be submitted to the appropriate Public
Health Regional Director by February 1, 1997.
ASSESSMENT, NOTICES, AND TRAINING:
PERFORMING AGENCY will assess immunization levels in the clinical records of preschool age
children. Immunization records will be randomly selected and assessed using the Center for
Disease Control and Prevention (CDC) Clinic Assessment Software Application (CASA) available
from RECEIVING AGENCY, Immunization Division. Two assessments using the criteria
specified in attached Exhibit A must be completed during the term of this Attachment. One of
these assessments may be conducted in cooperation with RECEIVING AGENCY. Assessment
results must be reported to RECEMNG AGENCY Program, Director, Immunization Division,
not more than two weeks after the assessments are completed for inclusion in a quarterly summary
ATTACHMENT - Page 2
"
of immunization levels to be shared with local, state, and federal health agencies. The electronic
file (either a backup or transfer file) for each clinic assessment should contain the following
information:
..
Date of assessment
Name and address of assessment site (including county and TDH Region)
Contact name (preferably the name of individual that performed assessment)
Contact organization name
Site(s) covered by filing system
Description of files that were used for the assessment (e.g., card files, medical
records)
Criteria for excluding records (if any)
Estimated "active" client population, sampling interval and sample size
..
..
..
..
..
..
..
PERFORMING AGENCY will produce reminders of upcoming immunizations as well as recall
for children who are due or overdue for doses of vaccine. The notifications may be automated
or manual and may include mailed or telephone messages. Extra effort should be made to notify
parents or guardians of children at high-risk of failure to complete the series on schedule (e.g.
children who start their series late).
INVESTIGATIONS/CONTROL MEASURES
PERFORMING AGENCY will investigate all reported cases and suspected cases of invasive
Haemophilus influenzae disease in children < 5 years of age and all reported cases and suspected
cases of measles, rubella, pertussis, paralytic poliomyelitis, and diphtheria within 24 hours of
receipt of the initial case report. PERFORMING AGENCY will investigate all reported
suspected cases of mumps and tetanus within 48 hours of receipt of the initial case report.
PERFORMING AGENCY will complete all case investigation forms and provide complete
epidemiologic data on all reported cases of invasive Haemophilus influenzae disease in children
< 5 years of age, and all reported cases of measles, mumps, rubella, congenital rubella
syndrome, pertussis, diphtheria, and paralytic poliomyelitis to the RECEIVING AGENCY,
Immunization Division, within 30 days of the initial case report. PERFORMING AGENCY will
provide copies of investigation forms to the RECEIVING AGENCY program.
PERFORMING AGENCY will adhere to the Vaccine-Preventable Disease Surveillance Guidelines
provided by the RECEMNG AGENCY program. PERFORMING AGENCY will implement
the most current outbreak control procedures and measures as recommended and provided by the
RECEIVING AGENCY program.
ATTACHMENT - Page 3
"
REPORTING REQUIREMENTS
PERFORMING AGENCY agrees to provide RECEIVING AGENCY, Immunization Division,
by January 31st of each year, a report detailing storage measures and methods used to control
vaccine loss including methods to monitor and record daily vaccine storage temperatures. The
report will be submitted in a fonnat provided each year by RECEMNG AGENCY, Immunization
Division.
PERFORMING AGENCY agrees to provide RECEIVING AGENCY, Immunization Division,
monthly reports of vaccine utilization/loss, within ten days after the end of each month, on forms
provided by RECEMNG AGENCY (Fonns C5, C33, C33A). Computer generated fonns in the
same fonnat and containing the required infonnation are acceptable. PERFORMING AGENCY
further agrees to provide copies of each Biological Fonn (C-68) used to transfer vaccines to
another agency or private provider. Vaccine lot numbers must be included on all Biological
Forms used to transfer vaccines. Status reports of program activities must be submitted to the
RECEMNG AGENCY quarterly, using the most current "Immunization Program Performance
Indicators Report" fonnat. PERFORMING AGENCY will be evaluated on: the number of doses
administered, the number of DTP 4 administered to children who are two years old and younger
and immunization levels of two year old children.
PERFORMING AGENCY agrees to provide to RECEMNG AGENCY, Immunization Division,
weekly reports of all immunizations given, detailed by client demographic and dose infonnation.
The report will be submitted in a fonnat provided by RECEMNG AGENCY, Immunization
Division.
Status reports of program activities must be submitted to the RECEMNG AGENCY using the
most current "Immunization Program Perfonnance Indicators Report". Immunization data (doses
administered by age, schedule, and patient demographics) must be provided in a fonnat that may
be loaded directly into the electronic Immunization Tracking System (ImmTrac). Report fonnats
have been supplied to PERFORMING AGENCY. PERFORMING AGENCY will be evaluated
on both the number of doses administered and the number of DTP 4 administered to children who
are two years old or younger.
PERFORMING AGENCY agrees to comply with the following: Texas Immunization Laws,
Rules, and Regulations: 942.043 Texas Human Resources Code; 9938.001-38.002 Texas
Education Code; 9981.023, 161.001-161.006 Texas Health and Safety Code; 25 T.A.C. 9997.61-
97.77,97.101-97.102, and 42 U.S.C. 9247b as amended.
ATTACHMENT - Page 4
PERFORMING AGENCY agrees to implement the "Standards for Pediatric Immunization
Practices," as recommended by the National Vaccine Advisory Committee, approved by the
United States Public Health Service, and endorsed by the A.merican Academy of Pediatrics.
PERFORMING AGENCY agrees to provide immunization services outside usual clinic hours
(Sam to 5pm) or on week-ends at least once each month or as needed to insure barrier free access
to immunization clinics. PERFORMING AGENCY residency requirements are not applicable
under this Attachment. PERFORMING AGENCY cannot deny vaccinations to recipients because
they do not reside within PERFORMING AGENCY's jurisdiction.
PERFORMING AGENCY will provide an estimated 17.500 clients with services/units of service
in or benefiting the county(ies)/area defined as: Lamar.
SECTION II. SPECIAL PROVISIONS:
General Provisions, REPORTS AND INSPECTIONS Article, is amended to include the following
paragraph:
PERFORMING AGENCY agrees to submit an Annual Expenditure Report to the appropriate
Public Health Regional Director no later than sixty (60) days following the end of PERFORMING
AGENCY'S fiscal year in a format prescribed by RECEMNG AGENCY.
PERFORMING AGENCY agrees to maintain an accurate, up-to-date list of clinics and sites
where public sector (free or low cost) immunization services are offered in PERFORMING
AGENCY'S local area. PERFORMING AGENCY further agrees to update the clinic list monthly
and provide the updates to local area AFDC offices and to RECEIVING AGENCY Program's
Communication and Training Section to assist with client referral.
PERFORMING AGENCY agrees to assist in distributing state-supplied vaccines to "Texas Health
Steps" providers, Medicaid providers, physicians, and other providers and organizations within
PERFORMING AGENCY'S local area.
PERFORMING AGENCY agrees that fees will be collected in accordance with 25 TAC ~1.91.
and that no one may be denied immunization services because of inability to pay the fee. Fee
schedules will not be based on vaccine type, formulation, or dose in series.
PERFORMING AGENCY understands that travel funds are provided for use by persons assigned
to the immunization project. All out -of-state travel and travel for persons not assigned to the
immunization project (this Attachment) require prior approval by the RECEMNG AGENCY,
Immunization Division Director.
ATTACHMENT - Page 5
For Immunization activities performed under this Attachment, General Provisions, OVERTIME
COMPENSATION Article, is not applicable and PERFORMING AGENCY agrees to comply
with the following paragraphs:
PERFORMING AGENCY is authorized to pay employees who are not exempt under the
Fair Labor Standards Act (FLSA), 29 V.S.C. Section 20 et seq., for overtime or
compensatory time at the rate of time and one-half per FLSA.
PERFORMING AGENCY is authorized to pay employees who are exempt under FLSA
on a straight time basis for work performed on a holiday or for regular compensatory time
hours when the taking of regular compensatory time off would be disruptive to normal
business operations.
Authorization for payment under this provision is limited to work directly related to
immunization activities and has to be in accordance with the amount budgeted in this
contract Attachment.
PERFORMING AGENCY is responsible for documenting proper authorization or
approval for any work performed by exempt or non-exempt employees in excess of 40
hours in a workweek.
ATTACHMENT - Page 6
SECTION III. BUDGET:
DIRECT ASSISTANCE
Direct assistance involves the assignment of state funded positions or the provision of supplies
such as vaccines in lieu of cash.
PERSONNEL
TRAVEL
VACCINE
OTHER
$16,332.00
0.00
77,682.00
0.00
TOTAL
$94,014.00
If applicable, direct assistance for personnel is shown on the attached list of positions and
budgetary amounts which is an integral part of this Attachment. State salary warrants for net
earnings will be issued in accordance with state regulations.
Financial status reports (FSRs) are not required on direct assistance. Program income generated
from activities supported with direct assistance will be reported on FSRs required for fmancial
assistance provided through this Attachment, if applicable, or through other program
Attachments(s) benefitting from this assistance.
RECEMNG AGENCY direct assistance will not exceed $ 94,014.00.
ATTACHMENT - Page 7
FINANCIAL ASSISTANCE
Financial assistance involves payment of funds to Performing Agency for costs incurred in
carrying out approved activities.
PERSONNEL
FRINGE BENEFITS
TRAVEL
EQUIPMENT
SUPPLillS
CONTRACTUAL
OTHER
$83,700.00
20,928.00
0.00
0.00
0.00
0.00
0.00
TOTAL
$104,628.00
RECEMNG AGENCY [mancial assistance will not exceed $104,628.00.
TOTAL RECEIVING AGENCY assistance will not exceed $198,642.00.
Financial status reports are due the 30th of December, 30th of March, 30th of June, and the 15th
of October.
ATTACHMENT - Page 8
TElAS DEPARTMENT OF HEALTH
OPERATING BUDGET FOR YEAR ENDING
AS OF MAY 31, 1996
H21311/KI3D2B
CATE- DESCRIPTION OR TITLE
GO~Y
1 COMMUNITY SERV AIDE II
PARIS-LAMAR COUNTY HEALTH DEPT
PHR 04
AUGUST 31, 1997
PAGE 910
BUDGET NO. PAOOO
FUND END ITEM JOB PAY PAY EFFECTIVE MONTHLY
DESC. MONTH NO. CLASS GP STP DATE RATE
STATE AUG 010 550Z 04 05 SEP 96 1,361.00
BUDGETED AtolT
16,332.00
15,332.00 *
EXHIBIT A
Assessments for these facilities can be automated using the (CASA) import feature. The
following issues must be considered prior to an automated assessment:
"
Should be validated with at least one manual assessment.
Can only be used if complete immunization histories are entered into computer
database.
Methodology used for an automated assessment must be approved by RECEIVING
AGENCY meeting contract requirements.
Complete enumeration should be performed (i.e.. CASA sampling feature is not used)
"
"
"
Assessment Criteria #1
CASA Clinic/Provider Site Requirements
Dou of Assessment
Common RtYiew Dau of 01102196 for QUJdren 24 10 35 Monlhs of Age
Provider Type
NIIIIIl of CliDicJProvider SilO
Reviewer lDitials
Clty
F<rimoIP<l . Active" C1iClll Populalion and Sample Size for Children Born in 1993
CASA Client Information
FULL Last and Fim Name
Date ofBinh (BetWeen 01101193 and 12131/93)
Client Zipcode
Moved or Gooe Elsewhere
Nwnbcr of Visits (Medical Cbans Only)
Shot Type
Shot DalO
Assessment Criteria #2
CASA CliniclProvider Site Requirements
CASA Client Information
Dou of AssuSlMIIt
Common Review Dote ofOI/02I96for arildnn12 10 24 Monzhs of Age
Proviclcr Type
Name of Clinic/Proviclcr Site
Reviewer lDitials
City
Eslimated . Active' Client Population and Sample Size for Children 12 to IS
Months of Age as of 01102196
FUll Last and Fim Name
Date of Binh (Between 01101193 and 12131/93)
Client Zipcoclc
Moved or Gone Elsewhere
Nwnber of Visits (Medical Cbans Only)
Shot Type
Shot Date
. , ,
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS GRANTS LOANS AND COOPERATIVE AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief that:
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for intluencing or attempting to influence an officer or an
employee of any agency, a member of congress, an officer or employee of congress,
or an employee of a member of congress in connection with the awarding of any federal
contract, the making of any federal grant, the making of any federal loan, the entering
into of any cooperative agreement, and the extension, continuation, renewal,
amendment or modification of any federal contract, grant, loan, or copperative
agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence an officer or employee of any agency,
a member of congress, an officer or employee of congress, or an employee of a
member of congress in connection with this federal contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form-Ill, "Disclosure
Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the
award documents for all subawards at all tiers (including subcontracts, subgrants, and
contracts under grants, loans and cooperative agreements) and that all subrecipients
shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for making or
entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails
to file the required certification shall be subject to a civil penalty of not less that $10,000 and not more
than $100,000 for each such failure.
.
d-~____
Date
ANTHONY BETHEL, ADMINISTRATOR
Name of Authorized Individual
'IS (,00 '''J.. d- 061 q 1- 6 '3
Application or Contract Number
PARIS-LAMAR COUNTY HEALTH DEPARTMENT, 740 S.W. 6TH, PARIS, TEXAS 75460
Name and Address of Organization