1998-132-RES WHEREAS, STATE OF TEXAS IS A FUNDING PARTNER WITH THE COUNTY OF LAMAR
RESOLUTION NO. 98-132
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, tl1e Contract for Public Health Services, TDH Document No. 7560022067
99 and Contract Change Notice No. 01 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 Change Notice, attached
hereto as Exhibits A and B, 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. 756002206799, and the
Contract Change Notice No. 01, attached hereto as Exhibits A and B, respectively, be, and the
same are hereby, approved; and,
BE IT ~1JRTHER 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 Notice to the same, under the terms and conditions and in
the forms shown in Exhibits A and B, respectively, attached hereto.
PASSED AND ADOPTED this 14th day of September, 1998.
Charles H. Neeley, Mayor
ATTEST:
Mattie Cunningham, City Clerk
APPROVED AS TO FORM:
:;w!);t~
Scott P. Foster, City Attorney
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TDH DOCUMENT NO. 756002206799
CONTRACT FOR PUBLIC HEALTH SERVICES
Contract Issued by:
(RECEIVING AGENCY)
TEXAS DEPARTMENT OF HEALTH
1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
DM
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 TX 75460-0000
(City, State, Zip)
NAME OF AUTHORIZED
CONTRACTING ENTITY:
I (If different from PERFORMING AGENCY)
I
PAYEE DATA (If not the same as PERFORMING AGENCY or AUTHORIZED CONTRACTING ENTITY; must be on file with the Texas State
Comptroller's Office.):
NAME:
ADDRESS:
State of Texas Vendor Identification No. (14 digits)
17560022067001
PAYEE AGENCY Fiscal
Year Ending Month:, September
PAYEE BUSINESS INFORMATION FOR STATISTICAL REPORTING: Please check the categories that apply to your business.
Small Business - A corporati~n, sole proprietorship, or other legal entity formed for the purpose of making a profit which is independently
owned and operated and has fewer 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 formed 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 underutilized (socially disadvantaged) because of their identification as members of certain 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
COVER PAGE 2 - Details of Attachment(s)
COVER PAGE 3. Authorized Signatures
GENERAL PROVISIONS
ATTACHMENT(S)
EXHmITS, IF APPLICABLE
~ ~ XHIBfT A
Cover Page 1
."
DETAILS OF ATTACHMENTS
Aul TDH Term Financial Assistance Direct Total Amount
Amd Program! End Source of Assistance (TDH Share)
No. 10 Begin Amount
Funds'" ,
01 ORAS/V AC 09/01/98 08/31/99 State 93.991 121,404.00 0.00 121,404.00
02 PHR4&5/EPSDT 09/01/98 02/28/99 State 93.778 5,749.00 0.00 5,749.00
03 BCH/CASE 09/01/98 02/28/99 State 26,187.00 0.00 26,187.00
04 COPC/PRIMARY 09/01/98 08/31/99 State 211,415.00 0.00 211,415.00
TDH Document No.7560022067 99 Totals $364,755.00 $0.00 $364,755.00
"'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 ATTACHMENT FOR DETAILS.
~
Cover Page 2
EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN.
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: September 14. 1998
RECOMMENDED:
By:
RECEIVING AGENCY NAME:
TEXAS DEPARTMENT OF HEALTH
Douglas C. ilson, Director
Grants Manal!ement Division
(Name and Title)
Dare: 1j~
I
TDH Document No: 756002206799
Cover Page 3
,.
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I
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Any alteration to this document constitutes a ~ounter-Q((er and must be approved in writing by the Texas Department of Health.
GENERAL PROVISIONS FOR
TEXAS DEPARTMENT OF HEALTa GRANT CONTRACTS
ARTICLE 1. rream~
PERFORMING AGENCY and RECEMNG AGENCY (the parties) hereby agree to make and enter into this grant
contract (contract), to faithfully perform the duties prescribed by this contract and to uphold and abide by its terms
and provisions. This contract consists of RECEIVING and PERFORMING AGENCY identifying data, Details of
Attachment(s), authorized signatures, General Provisions, and Attachment(s) with detailed Scope(s) of Work,
Special Provisions, budget(s), and exhibit(s) as applicable. 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,
performances, and provisions.
PERFORMING AGENCY assures compliance with this contract, including these General Provisions unless
otherwise specified in the Attachment(s) to this document:
ARTICLE 2. Term
The time period of this contract shall be governed by the term(s) of the Attachment(s). No commitment of contract
funds is permitted 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. Funding
This contract is contingent upon the availability of funding for each Attachment for the term of the Attachment.
PERFORMING AGENCY will have no right of action against the State of Texas or RECEIVING AGENCY in the
event that RECEIVING AGENCY is unable to fulfill its obligations under this contract as a result of lack of
sufficient funding of RECEIVING AGENCY for any Attachment(s) to this contract. If funds become unavailable,
provisions of the Termination Article will apply.
ARTICLE 4. Amendments
This contract may only be amended if the amendment is in writing and signed by individuals with authority to bind
all parties.
PERFORMING AGENCY ~hall not perform and RECEIVING AGENCY shall not pay for the performance of
different or additional services, work, or products except pursuant to an amendment of this contract that is executed
in compliance with this Article. RECEIVING AGENCY may not waive any term, covenant, or condition of this
contract unless by amendment executed in compliance with this Article.
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ARTICLE 5. Severabili~
If any provision of this contract is construed to be illegal or invalid, the illegal or invalid provision will be deemed
stricken and deleted to the same extent and effect as if never incorporated, but all other provisions will continue.
ARTICLE 6. ApplicabkLaws and Standard$
This contract shall be interpreted under and in accordance with the laws of the State of Texas and enabling state
rules. Where applicable, federal statutes and regulations, including federal grant requir~ments applicable to funding
sources, will apply to this contract. '
The Uniform Grant and Contract Management Act (UGCMA), Texas Government Code, Chapter 783, Vernon's
Texas Codes Annotated (VTCA), and the Uniform Grant Management Standards (UGMS) as amended by revised
federal circulars and incorporated in UGMS by the Governor's Budget and Planning Office, apply as terms and
conditions of this contract and are adopted by reference in their entirety. If a conflict arises between the provisions
of this contract and the provisions of UGCMA and UGMS, the provisions of UGCMA and UGMS will prevail
unless expressly stated otherwise.
RECEIVING AGENCY must give prior approval for changes to contract Attachment(s) as specified by UGMS in
"Part III-State Uniform Requirements for Grants and Cooperative Agreement, Subpart C-Post-Award
Requirements, item _JD-Changes" and applicable federal Office ofManageme~t and Budget (OMB) circulars.
RECEIVING AGENCY will provide copies of applicable OMB circulars and UGMS to PERFORMING AGENCY
upon request. These documents are incorporated by reference as a condition of this contract.
PERFORMING AGENCY may not use funds granted under this contract to lobby Congress or any agency in
connection with a specific grant or contract (31 USC ~1352 and UGMS). If at any time this contract exceeds
. $100,000, regardless of funding, the PERFORMING AGENCY shall certify to RECEIVING AGENCY within 90
days of receipt of the executed contract that none of the funds provided by RECEIVING AGENCY have been used
for payment to lobbyists and the names of any and all registered lobbyists with whom PERFORMING AGENCY
has an agreement. RECEIVING AGENCY will supply the certification form to PERFORMING AGENCY upon
request.
ARTICLE 7.}Hbarment and Suspension
PERFORMING AGENCY certifies by execution of this contract to the following:
~ it is not ineligible for participation in federal or state assistance programs under Executive Order
12549, Debarment and Suspension;
~ neither it nor its principals are presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from participation in this transaction by any federal department
or agency;
~ 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 of a debt.
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Where the PERFORMING AGENCY is unable to certify to any of the statements in this Article, PERFqRMING
AGENCY shall attach an explanation.
PERFORMING AGENCY shall not contract with a subrecipient nor procure goods or services from a
subcontractor, at any tier, which is debarred or suspended or is otherwise excluded from or ineligible for
participation in federal assistance programs under Executive Order 12549.
ARTICLE 8. Assurances
PERFORMING AGENCY shall 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, 42 USC ~~2000d et seq. (P.L. 88-352), which prohibits
discrimination on the basis of race, color or national origin;
~ Title IX of the Education Amendments of 1972, as amended, 20 USC ~~1681-1683, and 1685-1686,
which prohibits discrimination on the basis of sex;
~ Section 504 of the Rehabilitation Act of 1973,29 USC ~794(a), which prohibits discrimination on
the basis of disabilities and the Americans with Disabilities Act of 1990, 42 USC ~~ 12101 et seq.;
~ The Age Discrimination Act of 1974, as amended, 42 USC ~~6101-6107, which prohibits
discrimination on the basis of age;
~ The Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to
nondiscrimination on the basis of drug abuse;
~ The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act
of 1970 (P.L. 91-616), as amended, relating to the nondiscrimination on the basis of alcohol abuse
or alcoholism;
~ Public Health Service Act of 1912, ~~523 and 527, 42 USC ~290 dd-2, as amended, relating to
confidentiality of alcohol and drug abuse patient records;
~ Title VIII of the Civil Rights Act of 1968, 42 USC ~3601 et seq., as amended, relating to
nondiscrimination in the sale, rental or financing of housing; and,
~ The requir~ments of any other nondiscrimination statute(s).
.
Collectively, such requirements obligate RECEIVING AGENCY to provide services without discrimination on the
basis of race, color, national origin, age, sex, or disability. PERFORMING AGENCY agrees that in carrying out
the terms of this contract, it will do so in a manner which will assist RECEIVING AGENCY to comply with such
obligations to the fullest extent of PERFORMING AGENCY's ability.
PERFORMING AGENCY agrees to comply with all or part of the following, as applicable:
A. Texas Labor Code, Chapter 21, VTCA, which requires that certain employers not discriminate on the
basis of race, 'color, disability, religion, sex, national origin, or age.
B. Immigration Refonn and Control Act of 1986, 8 USC ~~ 1324a et seq. as amended, regarding
employment verification and retention of verification forms for any individual(s) hired on or after
November 6, 1986, who will perform any labor or services under this contract.
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C. Pro-Children Act of 1994,20 USC ~~6081-6084, regarding the provision of a smoke-free workplace and
promoting the non-use of all tobacco products.
D. The National Research Service Award Act of 1971, as amended, 42 USC ~~288 et seq. and 6601 (P.L.
93-348 and P.L. 103-43) regarding the protection of human subjects involved in research, development,
and related activities supported by any applicable award of federal assistance.
E. The Clinical Laboratory Improvement Amendments of 1988, 42 USC ~263a, which establish federal
requirements for the regulation and certification of clinical laboratories.
F. The Occupational Safety and Health Administration Regulations on Bl09d Borne Pathogens, 56 Fed.
Reg. 64175 (1991),29 CFR ~ 1910.1030, which set safety standards for thos~ workers and facilities who
may handle blood borne pathogens. '
G. Laboratory Animal Welfare Act of 1966,7 USC ~~2131 et seq. (P.L. 89-544), as amended, pertaining
to the care, handling, and treatment of warm-blooded animals held for research, teaching, or othe'r
activities supported by this award of assistance.
H. Article 9102, Texas Revised Civil Statutes (TRCS), as amended, pertaining to standards which
eliminate architectural barriers for persons with disabilities.
I. Health and Safety Code ~ 165.004 (V emon' s Supp. 1998), relating to the promotion of breast-feeding
by providing information that encourages breast-feeding to program participants who are pregnant
women or mothers with infants. Promotional material may be requested from RECEIVING AGENCY
by calling (512) 406-0744. .
J. Environmental standards pursuant to the following:
(1) Institution of environmental quality control measures under the National Environmental Policy Act
of 1969, 42 USC ~~43~1-4347 (P.L. 91-90) and Executive 'Order 11514 "Protection and
Enhancement of Environmental Quality."
(2) Notification of violating facilities pursuant to Executive Order 11738 "Providing
for Administration of the Clean Air Act and the Federal Water Pollution Control Act with Respect
to Federal Contracts, Grants, or Loans."
(3) Protection of wetlands pursuant to Executive Order 11990.
(4) Evaluation of flood hazards in floodplains in accordance with Executive Order 11988.
(5) Assurance of project consistency with the approved State Management program developed under
the Coastal Zone Management Act of 1972, 16 USC 1451 et seq.
(6) Conformity of federal actions to state clean air implementation plans under the
Clean Air Act of 1955, as amended, 42 USC ~~7401 et seq.
(7) Protection of underground sources of drinking water under the Safe Drinking Water Act of 1974,
as amended, 42 USC ~~300f-300j (P.L. 93-523).
(8) Protection of endangered species under the Endangered Species Act of 1973, as amended (P.L. 93-
205).
K. The Hatch Political Activity Act, 5 USC ~7321-29, which limits the political activity of employees
whose principal employment activities are funded in whole or in part with federal funds.
L. The Federal Fair Labor Standards Act and the Intergovernmental Personnel Act of 1970, as applicable,
concerning minimum wage and maximum hours.
M. General Appropriations Act, Regular Session, 75th Legislature, 1997, Article IX, ~33 "Limitation on
Grants to Units of Local Government." For the purpose of ~33, "unit of local government" shall mean
a council of governments, a regional planning commission, or a similar regional planning agency created
under Chapter 391, Local Government Code; a Local Workforce Development Board; or an MHMR
community center.
N. Texas Government Code, Chapter 573, Vernon's 1994, relating to nepotism.
O. Texas Government Code, Chapter 552, Vernon's 1994, relating to open records and public information.
P. Texas Government Code, Chapter 551, Vernon's 1994, relating to open meetings.
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Q. Texas Government Code, Chapter 415, and all rules adopted by the Texas Commission on Law
Enforcement Officer Standards and Education pursuant to Chapter 415, Texas Government Code relating
to regulated law enforcement agencies.
'.
PERFORMING AGENCY will insure that the facilities under its ownership, lease or supervision which shall be
utilized in the accomplishment of the project are not listed on the Environmental Protection Agency's (EPA) list
of Violating Facilities and that it will notify the Federal grantor agency of the receipt of any communication from
the Director of the EP A Office of Federal Activities indicating that a facility to be used in the project is under'
consideration for listing by the EPA (Executive Order 11738).
PERFORMING AGENCY will comply with the flood insurance purchase requirements of 102(a) of the Flood
Disaster Protection Act of 1973 (P.L. 93-234). Section 102 (a) requires the purchase of flood insurance in
communities where the insurance is available as a condition for the receipt of any Federal financial assistance for
construction or acquisition proposed for use in any area that has been identified by the Secretary of the Department
of Housing and Urban Development as an area having special flood hazards.
PERFORMING AGENCY agrees to comply with the requirements of the Texas Workers' Compensation Act,
Labor Code, Chapters 401-406, VTCA, and rules promulgated thereunder found at 28 Texas Administrative Code
(TAC), Chapter 41, et seq., which cover compensation for employees' injuries.
When incorporated into a contract, standard assurances contained in the application package, if any, become terms
or conditions for receipt of RECEIVING AGENCY funds. PERFORMING AGENCY and its subrecipients shall
maintain an appropriate contract administration system to insure that all terms, conditions, and specifications are
met.
PERFORMING AGENCY will comply with all federal tax laws and is solely responsible for filing all required state
and federal tax forms.
PERFORMING AGENCY shall comply with all applicable requirements offederal and state laws, executive
orders, regulations and policies governing the activity described in Attachment(s), and with the applicable standard
conditions or assurances prescribed by UGMS in "Part III-State Uniform'Requirements for Grants and Cooperative
Agreement, Subpart B -Pre-Award Requirements, _' 14-State Assurances."
PERFORMING AGENCY assures it shall not transfer, assign or sell its interest in this contract, or in any equipment
purchased with funds from this contract, without the written consent of RECEIVING AGENCY.
ARTICLE 9. Year-2000 Certification
PERFORMING AGENCY certifies that any supplied or supported hardware, software, firmware and micro code
products used individually or together as a system to comply with RECEIVING AGENCY contract requirements
will be year-2000-compliant on or before the date such hardware, software, firmware and systems are to be
impacted. Year-2000-compliant means that such product operates "accurately" in the manner in which it was
intended as it relates to date related operations when given a "valid date" containing century, year, month, and day.
F or purposes of this Article,' "accurately" is defined to include the following: 1) calculations using dates must
execute using a four-digit year; 2) functionality-on-line, batch including entry, inquiry, maintenance and updates
must support four-digit year processing; 3) interfaces and reports must support four-digit year processing; 4)
successful translation into year-2000 with the correct system date (e.g., 1/1/2000) without human intervention; 5)
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processing with a four-digit year after transition to any beyond the year-2000 without human intervention; 6)
providing correct results in forward and backward date calculation spanning century boundaries; 7) a leap year must
be calculated correctly; and 8) processing correct results in forward and backward date calculation spanning century
boundaries must be provided, including the conversion of previous years currently stored as two digits.
"Valid date" contains a two-digit month, a two-digit day and a four-digit year.
PERFORMING AGENCY and its subrecipient(s) as licensee(s) must obtain a war.ranty from any licensor from
which it obtains software that any software licensed prior to, during, or after calendar year-2000, that includes or
shall include, at no added cost to PERFORMING AGENCY or its subrecipient(s), deSign and performance so that
PERFORMING AGENCY and its subrecipient(s) shall not experience software abnormally ending and/or invalid
and/or incorrect results from the software in the operation of the business of the PERFORMING AGENCY or its
subrecipient(s) as it pertains to RECEIVING AGENCY. The software design to ensure year-2000 compatibility
shall include date data century recognition, calculations that accommodate same century and multi-century
formulas and date values, and date data interface values that reflect the century. If PERFORMING AGENCY
purchases specific products to perform as a system, then the warranty shall apply to those listed products as a
system. The remedies available to the PERFORMING AGENCY under the warranty shall include repair or
replacement of any supplied product, in addition to and notwithstanding any commercial warranty or warranties.
Nothing in this warranty shall be considered to limit any rights or remedies that PERFORMING AGENCY may
otherwise have with respect to defects other than year-2000 performance.
RECEIVING AGENCY will not hold PERFORMING AGENCY responsible if the information coming to
PERFORMING AGENCY's product/software from RECEIVING AGENCY is inaccurate or corrupt.
ARTICLE 10. Certification Rel:ardin~ License. Certificate. or Permit
RECEIVING AGENCY may pay PERFORMING AGENCY only for personnel who are duly licensed and/or
qualified to p,erform required services.
PERFORMING AGENCY certifies that no owner, operator, or administrator of the PERFORMING AGENCY has
had a license, certificate, or permit revoked by any of the Texas state agencies listed below (~163 of Article IX of
the General Appropriations Act, 75th Legislature):
. Adjutant General's Department
. Board of Private Investigators and Private Security Agencies
. Interagency Council on Early Childhood Intervention
. Texas Alcoholic Beverage Commission
. Texas Cancer Council "
. Texas Children's Trust Fund of Texas Council
. Texas Commission for the Deaf and Hard of Hearing
. Texas Commission on Alcohol and Drug Abuse
. Texas Commission on Jail Standards
. Texas Commission on Law Enforcement Officers Standards & Education
. Texas Commission on Fire Protection
. Texas Council on Sex Offender Treatment
. Texas Criminal Justice Policy Council
. Texas Department of Criminal Justice
. Texas Department of Human Services
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. Texas Department of Mental Health & Mental Retardation
. Texas Department of Protective and Regulatory Services
. Texas Department of Public Safety
. Texas Department of Health
. Texas Health & Human Services Commission
. Texas National Guard Armory Board
. Texas Polygraph Examiners Board
. Texas Rehabilitation Commission
. Texas Youth Commission
ARTICLE 11. Standards for Financial and ProgrammatkManagement
PERFORMING AGENCY shall develop, implemen~ and maintain financial management and control systems that
meet or exceed the requirements of UGMS as detailed in RECEIVING AGENCY's Financial Administrative
Procedures Manual. Those requirements shall include at a minimum:
A. 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;
B. Financial management systems including accurate, correct, and complete payroll, accounting, and
financial reporting records; cost source documentation; effective internal and budgetary controls;
determination of reasonableness, allowableness, and allocability of costs; and timely and appropriate
audits and resolution of any findings; and,
C. 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 third parties.
In addition, PERFORMING AGENCY shall bill third party payers, at no cost to the client, for services provided
under the Attachment( s). These potential payers include, but are not limited to, Medicaid, private insurance carriers,
and other available federal, state, local, and private funds. PERFORMING AGENCY shall become a Medicaid
provider for eligible activities funded in the Attachment(s) and will maximize efforts to obtain payment from
Medicaid and all other available sources.
PERFORMING AGENCY and its governing body shall bear full responsibility for the integrity of the fiscal and
programmatic management. Such responsibility shall include: accountability for all funds and materials received
from RECEIVING AGENCY; compliance with RECEIVING AGENCY rules, policies, procedures, and applicable
federal and state laws and regulations; and correction of fiscal and program deficiencies identified through self.
evaluation and RECEIVING AGENCY's monitoring processes. Ignorance of any contract provisions or other
requirements contained or referenced in this contract shall not constitute a defense or basis for waiving or appealing
such provisions or requirements.
,
ARTICLE 12. Allowable Costs and Audit Requirements
Only those costs allowable under UGMS and any revisions thereto plus any applicable federal cost principles are
eligible for reimbursement under this contract. Applicable cost principles, audit requirements, and administrative
requirements are as follows:
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Applicable Cost Principles. Audit Requirements.
Administrative
Requirements.
OMB Circular A-87, State & OMB Circular A-I33
Local Governments
UGMS
. OMB Circulars shall be applied with the modifications prescribed by UGMS.
PERFORMING AGENCY must have incurred a cost within the applicable Attachfllent term to be eligible for
reimbursement under this contract. PERFORMING AGENCY must incur cost(s) prior to requesting reimbursement
under this contract. No later than 90 days after the end of the applicable Attachment term, RECEIVING AGENCY
must receive vouchers from PERFORMING AGENCY for costs encumbered by the last day of the applicable
Attachment term. Reimbursement requests submitted and postmarked more than 90 days following the end ofthe
applicable Attachment term mayor may not be reimbursed, at the discretion of RECEIVING AGENCY.
PERFORMING AGENCY or the AUTHORIZED CONTRACTING ENTITY shall arrange for a financial and
compliance audit (Single Audit) if required by OMB Circular A-133 and/or UGMS. The audit shall be of
PERFORMING AGENCY's or the AUTHORIZED CONTRACTING ENTITY's fiscal year. The audit must be
conducted by an independent certifieo public accountant and in accordance with applicable OMB Circulars,
Government Auditing Standards, and UGMS. PERFORMING AGENCY shall procure audit services in compliance
with state procurement procedures, as well as with the provisions ofUGMS.
If PERFORMING AGENCY is not required to have a Single Audit, a limited scope audit may be required.
RECEIVING AGENCY will provide PERFORMING AGENCY with written audit requirements if a limited scope
audit is required.
. Within 30 days of receipt of the audit reports required by this section, PERFORMING AGENCY/ AUTHORIZED
CONTRACTING ENTITY shall submit a copy to RECEIVING AGENCY's Internal Audit Division.
ARTICLE 13. Overtime Compensation
PERFORMING AGENCY shall not use any of the funds provided by the Attachment(s) hereto to pay the premium
portion of overtime. PERFORMING AGENCY shall be responsible for any obligations of premium overtime pay
due employees. Premium overtime pay is defined as any compensation paid to an individual in addition to the
normal rate of pay for hours worked in excess of normal working hours.
ARTICLE 14. Terms and Conditions of Payment
" i .
For services satisfactorily performed pursuant to this contract, RECEIVING AGENCY will reimburse
PERFORMING AGENCY for allowable costs. Reimbursements are contingent on a signed contract and will not
exceed the total of each Attachment(s). The PERFORMING AGENCY is entitled to payment only ifthe service,
work, and/or product has been satisfactorily performed and authorized in accordance with this contract.
PERFORMING AGENCY must submit requests for reimbursement on a State of Texas Purchase Voucher (TDH
. Form B-13) or any other form designated by RECEIVING AGENCY. PERFORMING AGENCY shall submit
vouchers for reimbursement monthly within 30 days following the end of the month covered by the bill.
PERFORMING AGENCY shall submit a reimbursement request as a final close out bill not later than 90 days
following the end of the applicable Attachment term(s). Reimbursement requests submitted and postmarked more
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than 90 days following the end of the applicable Attachment term may not be paid, at the discretion of RECEIVING
AGENCY.
PERFORMING AGENCY shall disburse program income, rebates, refunds, contract settlements, audit recoveries
and interest earned on such funds before requesting additional cash payments from RECEIVING AGENCY.
As of September 1, 1998, PERFORMING AGENCY is required to be placed on Direct Deposit status in accordance
with Texas Government Code, 9403.016(c), VTCA. PERFORMING AGENCY will no longer receive copies of'
vouchers.
Funding from this contract may not be used to supplant state or local funds, but PERFORMING AGENCY shall
use the funds from this contract to increase state or local funds currently available for a particular activity.
PERFORMING AGENCY shall maintain its current level of support, if possible.
RECEIVING AGENCY shall determine whether costs submitted by PERFORMING AGENCY are allowable and
reimbursable. If RECEIVING AGENCY has paid funds to PERFORMING AGENCY for unallowable or ineligible
costs, PERFORMING AGENCY shall return the funds to RECEIVING AGENCY within 30 days of notice.
RECEIVING AGENCY may withhold all or part of any payments to PERFORMING AGENCY to offset
reimbursement for any ineligible expenditures that PERFORMING AGENCY has not refunded to RECEIVING
AGENCY. RECEIVING AGENCY may take repayment from funds available under any contract Attachment,
active or expired, with the same funding source in amounts necessary to fulfill PERFORMING AGENCY
repayment obligations.
ARTICLE 15. !dvance Payments
PERFORMING AGENCY may request a one-time advance for each Attachment only to meet immediate need for
cash disbursement. PERFORMING AGENCY must make the request on State of Texas Purchase Voucher,
accompanied by written justification and supporting documentation as specified in RECEIVING AGENCY's
Financial Administrative Procedures Manual. RECEIVING AGENCY may approve the advance request for each
Attachment. PERFORMING AGENCY must request the advance on a State of Texas Purchase Voucher at the
beginning of the applicable Attachment period or at a later time in the applicable Attachment period if
circumstances so warrant.
RECEIVING AGENCY will determine the amount ofthe advance, if any, by the amount and term of the applicable
Attachment(s). For each Attachment, the amount ofthe advance shall not exceed an amount equal to the amount
of the Attachment divided by the number of months covered by the Attachment multiplied by two (2). Advance
funds will be expended during the applicable Attachment term so that, "after the final monthly billing,
PERFORMING AGENCY will not have advance funds on hand.
If the Attachment is amended to increase or decrease the total amount, RECEIVING AGENCY may make an
upward or downward adjustment to the allowable advance in accordance with the above formula. If PERFORMING
AGENCY is requesting an upward adjustment, PERFORMING AGENCY must submit a written justification and
State of Texas Purchase Voucher in the amount necessary to correct the ratio. If the adjustment is downward,
RECEIVING AGENCY will determine the amount of adjustment to the advance and the method of repayment.
(LGS)
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ARTICLE 16. Program Income
PERFORMING AGENCY may, but if a local health department shall, develop a fee for service system and a
schedule of fees for personal health services in accordance with the provisions of Chapter 12, Subchapter 0, Health
and Safety Code, VTCA; the Texas Board of Health rules covering Fees for Clinical Health Services, 25 TAC
~ 1.91; and other applicable laws. No patient may be denied a service due to inability to pay.
All revenues directly generated by an Attachment( s) supported activity or earned only as a result of the
Attachment(s) during the term of the Attachment(s) are considered program income. I PERFORMING AGENCY
shall identify and report this income utilizing the forms specified in the Financial Reports Article of these
. .
provIsions.
PERFORMING AGENCY will utilize one of the following methods for applying program income:
1. Additive method - add the program income to the funds already committed to the project by both
parties. Program income will be used by the PERFORMING AGENCY to further the program
objectives of the state/federal statute under which the Attachment(s) was/were made, and it shall
be spent on the same project in which it was generated.
2. Deductive method - deduct the program income from the total allowable costs to determine the net
allowable costs.
RECEIVING AGENCY may base future funding levels, in part, upon the PERFORMING AGENCY's proficiency
in identifying, billing, collecting, and reporting program income, and in utilizing it for the purposes and conditions
of the applicable Attachment(s).
ARTICLE 17. Financial Reports
Financial reports are required as provided in UGMS, and PERFORMING AGENCY shall file them regardless of
whether expenses have been incurred.
PERFORMING AGENCY shall submit a Financial Status Report, State of Texas Supplemental Form 269a (TDH
Form GC-4a) within 30 days following the end of each ofthe first three quarters. PERFORMING AGENCY shall
submit a final financial report on State of Texas Supplemental Form 269a (TDH Form GC-4a), not later than 90
days following the end of the Attachment term(s). PERFORMING AGENCY shall submit a State of Texas
Purchase Voucher if all costs have not been recovered, or PERFORMING AGENCY shall refund excess monies
if costs incurred were less than funds received. PERFORMING AGENCY shall file a State of Texas Purchase
Voucher if all costs have not beenrecovered~ Failure to timely file may result in RECEIVING AGENCY
disallowing payment. PERFORMING AGENCY shall refund excess monies if costs incurred were less than funds
received.
ARTICLE 18. Reports and Inspections
PERFORMING AGENCY shall submit the financial, program, and progress reports required by RECEIVING
AGENCY in the format agreed to by the parties. PERFORMING AGENCY shall provide RECEIVING AGENCY
other reports RECEIVING AGENCY determines to be necessary to accomplish the objectives of this contract. If
PERFORMING AGENCY is legally prohibited from providing such reports, it shall immediately notify
RECEIVING AGENCY.
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,I
RECEIVING AGENCY and, when federal funds are involved, any authorized representative(s) of the federal
government have the right, at all reasonable times, to inspect or otherwise evaluate the work (including,reviews
of client or patient records and discussions with staff) performed by PERFORMING AGENCY and its
subrecipient(s), if any, and the premises on which the work is being performed. PERFORMING AGENCY and its
subrecipient(s) shall participate in inspections and provide reasonable access, facilities, and assistance to the
representatives. All inspections and evaluations will be performed in such a manner as will not unduly interfere
with the work.
PERFORMING AGENCY and its subrecipient(s), if any, shall give RECEIVING AGENCY, the federal
governmen~and the Texas State Auditor, or any of their duly authorized representatives, access to any pertinent
books, documents, papers, and client or patient records, if any, for the purpose of making audit, examination,
excerpts, and transcripts of transactions related to contract Attachment(s). RECEIVING AGENCY will have the
right to audit billings both before and after payment. Payment under Attachment(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 findings will
also be conveyed in writing to RECEIVING AGENCY within 30 days of receipt of RECEIVING AGENCY's
findings. A RECEIVING AGENCY determination of either an inadequate or inappropriate resolution of the
findings may result in sanctions which will remain in effect until RECEIVING AGENCY determines the
deficiencies are properly remedied.
PERFORMING AGENCY will retain all records for a period of three years from the date of the last expenditure
report submitted under contract Attachment(s) or until all audit questions are resolved, whichever time period is
longer.
ARTICLE 19. Client Records
Notwithstanding any other provision herein, if requested by RECEIVING AGENCY, the PERFORMING
AGENCY shall share all patient information with RECEIVING AGENCY when the contract involves patient care
by the PERFORMING AGENCY.
RECEIVING AGENCY may require the PERFORMING AGENCY, or any subrecipient, to transfer a client or
patient record to another agency or to RECEIVING AGENCY if the tral1sfer is necessary to protect either the
confidentiality of the record or the health and welfare of the client or patient.
In the event of termination, RECEIVING AGENCY may require the transfer of client or patient records as
authorized by law upon written notice to PERFORMING AGENCY, either to another entity that agrees to continue
the service or to RECEIVING AGENCY.
At the end of the Attachment term, PERFORMING AGENCY shall give RECEIVING AGENCY access to the
records or provide copies for audit, examination, evaluation, inspection, litigation, or other circumstances that may
arise, to the extent authorized by law.
PERFORMING AGENCY, or. any subrecipien~ shall not otherwise transfer an identifiable client record, including
a patient record, to another entity or person without written consent from the client or patient, or someone
authorized to act on his or her behalf on a form provided by RECEIVING AGENCY or as otherwise authorized
by law, including the Texas Medical Practice Act, Article 449Sb, TRCS.
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ARTICLE 20. Contid~ntialitJ
PERFORMING AGENCY shall have a system in effect to protect client or patient records and all other documents
deemed confidential by law which are maintained in connection with the activities funded under this contract.
PERFORMING AGENCY may not disclose or transfer confidential client or patient information, including
information required by the Reports and Inspections Article, except in accordance with applicable law.
If providing direct client care, services, or programs, PERFORMING AGENCY snaIl implement RECEIVING
AGENCY's workplace policies based on the model guidelines, and PERFORMIN:G AGENCY shall educate
employees and clients concerning the human immunodeficiency virus (illV) and its related conditions, including
acquired immunodeficiency syndrome (AIDS), in accordance with the Health and Safety Code, ~~85.l12-114,
VTCA. '
ARTICLE 21. Equipment and Supplies
In accordance with Health & Safety Code, 912.053, VTCA, title to all equipment and supplies purchased from
funds from this contract will be in the name of PERFORMING AGENCY throughout the Attachment(s) term(s)
or until the Attachment is terminated.
Equipment is defined as tangible nonexpendable property with an acquisition cost of more than $1,000 and a useful
life of more than one year, with the following exceptions: fax machines, stereo systems, cameras, video
recorder/players, microcomputers, medical equipmen~ laboratory equipmen~ and printers. If the unit cost of these
exception items is more than $500, they will still be considered equipmen~ must be approved for purchase, and are
considered capital assets for inventory purposes. Medical and laboratory equipment in this category is defined as
microscopes, oscilloscopes, centrifuges, balances, and incubators. Medical and laboratory equipment not included
in these five categories is not considered a capital asset unless the unit value is more than $1,000. Supplies which
. may be necessary to carry out the contract include medical supplies, drugs, janitorial supplies, office supplies,
patient educational supplies, software less than $500, plus any equipment with a purchase price including freight
not to exceed $1,000 per item, except those defined as "equipment."
Unless initially listed and approved in the Attachment(s), prior written approval from RECEIVING AGENCY is
required for any changes to approved equipment purchases meeting the above equipment definition. To receive
approval to purchase data processing hardware and software or enhancements, PERFORMING AGENCY must
submit a detailed justification which includes description of features, make and model, and cost, etc.
PERFORMING AGENCY shall maintain a property inventory and submit an annual cumulative report (TDH Form
GC-Il) to RECEIVING AGENCY no later than October 15th of each year. PERFORMING AGENCY shall
administer a program of maintenance, repair, and protection'of-assets under this contract so as to assure their full
availability and usefulness. In the 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 shall use the
proceeds to repair or replace said assets.
Upon termination or expiration of applicable Attachment(s), title to any remaining equipment and supplies
purchased from funds under this contract reverts to RECEIVING AGENCY. Title may be transferred to any other
. party designated by RECEIVING AGENCY. RECEIVING AGENCY may, at its option and to the extent allowed
by law, transfer the reversionary interest to such property to the PERFORMING AGENCY.
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cC
ARTICLE 22. Contracts with Subrecipients
PERFORMING AGENCY may enter into contracts with subrecipients unless restricted or otherwise prohibited in
specific Attachmen~s). PERFORMING AGENCY is responsible to RECEIVING AGENCY for the performance
of any subrecipient.
Contracts with subrecipients shall be in writing and must include the following:
. name and address of all parties;
. a detailed description of the services to be provided;
. measurable method and rate of payment and total amount of the contract;
. clearly defined and executable termination clause;
. beginning and ending dates which coincide with the dates of the applicable contract Attachment( s)
or cover a term within the beginning and ending dates of the applicable contract Attachment(s);
. access to inspect the work and the premises on which any of the work is performed, in accordance
with the Reports and Inspections Article contained in this contract; and
. all clauses required by state/federal statutes, executive orders, and their implementing regulations.
PERFORMING AGENCY agrees that all contracts with subrecipients containing a categorical budget shall include
audit requirements referenced in the Allowable Costs and Audit Requirements Article of this contract, as
appropriate.
Prior to entering into an agreement equaling $25,000 or 25% of an Attachment, whichever is greater,
PERFORMING AGENCY shall obtain written approval from RECEIVING AGENCY.
PERFORMING AGENCY shall ensure that:
. all subrecipients are fully aware of the requirements imposed upon them by state/federal statutes
and regulations;
. all subrecipients comply with all financial management requirements as defined by RECEIVING
AGENCY and ,the applicable OMB circulars;
. subrecipients complete required audits;
. an adequate tracking system is maintained to ensure timely receipt of any subrecipient's required
audit reports and the resolution of any findings and questioned costs cited by these reports.
ARTICLE 23. Contracts for Procurement
PERFORMING AGENCY may enter into contracts for procurement unless restricted or otherwise prohibited in
specific Attachment(s). PERFORMING AGENCY agrees that it shall be responsible to RECEIVING AGENCY
for the performance of any subcontracted activity.
Contracts for procurement shall be in writing and must contain the following provisions:
. Administrative, contractual, or legal remedies in instances where contractors violate or breach
contract terms, and provide for such sanctions and penalties as may be appropriate. (Contracts
other than small purchases.)
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1999 GENERAL PROVISIONS Page 13
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I Termination for cause and for convenience by the PERFORMING AGENCY including the
manner by which it will be effected and the basis for settlement. (All contracts in excess of
$10,000.)
I Compliance with the Copeland "Anti-Kickback" Act (18 USC ~874) as supplemented in
Department of Labor regulations (29 CFR Part 3). (All contracts and subgrants for construction
or repair.)
I Compliance with ~~103 and 107 of the Contract Work Hours and Safety Standards Act (40
USC ~~327-330) as supplemented by Department of Labor r~gulations (29 CFR Part 5).
(Construction contracts awarded by grantees and subgrantees in ex~ess of$2,000, and in excess
of $2,500 for other contracts which involve the employment of mechanics or laborers.)
I Notice of awarding agency requirements and regulations pertaining to reporting.
I Notice of awarding agency requirements and regulations pertaining to patent rights with respect
to any discovery or invention which arises or is developed in the course of or under such
contract.
I Awarding agency requirements and regulations pertaining to copyrights and rights in data.
I Access by the grantee, the subgrantee, the federal grantor agency, the Comptroller General of
the United States, the State of Texas or any of their duly authorized representatives to any
books, documents, papers, and records of the contractor which are directly pertinent to that
specific contract for the purpose of making audit, examination, excerpts, and transcriptions.
I Retention of all required records for three years after grantees or subgrantees make final
payments and all other pending matters are closed.
I Compliance with all applicable standards, orders, or requirements issued under ~306 of the
Clean Air Act (42 USC ~1857(h)), 9508 of the Clean Water Act (33 USC 91368), Executive
Order 11738, and Environmental Protection Agency regulations (40 CFR Part 1 5). (Contracts,
subcontracts, and subgrants of amounts in excess of $1 00,000.)
I Mandatory standards and policies relating to efficiency which are contained in the state energy
plan issued in compliance with the Energy Policy and Conservation Act (Pub. L. 94-163).
ARTICLE 24. Copyri~hts. Publications. and Patents
Texas Health and Safety Code 912.020(a), VTCA, authorizes RECEIVING AGENCY to apply for, register, secure,
hold, and protect a patent, copyright, trademark or other evidence of protection or exclusivity issued in or for
intellectual property. All work performed that results in the production of original books, manuals, films, or other
original material is the exclusive property of RECEIVING AGENCY. All right, title, and interest in and to said
property shall vest in RECEIVING AGENCY upon creation. All work performed shall be deemed to be a "work
made for hire" and made in the course of the services rendered pursuant to this contract. To the extent that title to
any such work may not, by operation oflaw, vest in RECEIVING AGENCY or such work may not be considered
a work made for hire, all rights, title and interest ,therein' are hereby irrevocably assigned to RECEIVING
AGENCY. RECEIVING AGENCY shall have the right to obtain and to hold in its own name any and all patents,
copyrights, trademarks, service marks, certification marks, collective marks, registrations, or such other protection
as may be appropriate to the subject matter, and any extensions and renewals thereof. PERFORMING AGENCY
shall ensure all rights, titles, and interest in and to the property are secured to RECEIVING AGENCY from
PERFORMING AGENCY and its subrecipients. PERFORMING AGENCY agrees to give RECEIVING AGENCY
and agrees to require its subrecipients to give RECEIVING AGENCY, or any person designated by RECEIVING
. AGENCY, all assistance required to perfect the rights defined in this Article, without any charge or expense beyond
those amounts payable to PERFORMING AGENCY for the services rendered under the contract.
(LGS)
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. r
If federal funds are used to finance activities supported by the contract Attachment(s) that result in the production
of original books, manuals, films, or other original material, the federal awarding agency reserves a roy~lty-free,
nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use, for
federal government purposes (1) the copyright in any work developed under a grant, subgrant, or contract under
a grant or subgrant; and (2) any rights of copyright to which a PERFORMING AGENCY or its subrecipient
purchases ownership with grant support. PERFORMING AGENCY shall place an acknowledgment of federal
awarding agency grant support and a disclaimer, as appropriate, on any publication written or published with such
support and, if feasible, on any publication reporting the results of or describing a grant-supported activity. An .
acknowledgment shall be to the effect that "This publication was made possible by grant number
from m~oeral awarding aiency)" or "The project described was supported by grant number from
(federal awardin~ a~ency)" and "Its contents are solely the responsibility of the authors and do not necessarily
represent the official views of the (~)."
In the event the terms of a federal grant award the copyright to the PERFORMING AGENCY, RECEIVING
AGENCY reserves a royalty-free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use,
and to authorize others to use, for RECEIVING AGENCY and state government purposes (1) the copyright in any
work developed under a grant, subgrant, or contract under a grant or subgrant; and (2) any rights of copyright to
which a grantee, subgrantee or a contractor purchases ownership with grant support.
PERFORMING AGENCY may publish the results of the contract performance at its expense with prior
RECEIVING AGENCY review and approval. If RECEIVING AGENCY owns the copyright, any publication
should include"~ Texas Department of Health, 1100 West 49th Street, Austin, Texas, (the year of publication),
All Rights Reserved." If the PERFORMING AGENCY is the copyright holder, any publication shall include
acknowledgment of the support received from RECEIVING AGENCY. At least six 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 subrecipient, as appropriate, must comply with the standard patent rights
clauses in 37 Code of Federal Regulations ~401.l4 or Federal Acquisition Regulations 52.227.11.
ARTICLE 25. Bonding
PERFORMING AGENCY is required to carry a fidelity bond, insurance coverage or self-insurance equal to the
amount of funding provided under the contract Attachment(s) up to $1 OQ,OOO that covers each employee of the
PERFORMING AGENCY handling funds under this contract, including person(s) authorizing payment of such
funds. The fidelity bond, insurance, or self-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 with 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 hislher
position or employment.
ARTICLE 26. Historically Underutilized Businesses
RECEIVING AGENCY shall comply with Texas Government Code, Chapter 2161, VTCA, and I TAC ~~111.11-
111.24 whereby state agencies are 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 are defined as "supplies,
materials, or equipment," services, or public works.
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1999 GENERAL PROVISIONS Page 15
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If PERFORMING AGENCY subcontracts a portion of this contract, PERFORMING AGENCY agrees to make a
good faith effort to subcontract with HUBs during the performance of its contract Attachment(s) with RECEIVING
AGENCY and will report HUB subcontract activity on a quarterly basis to RECEIVING AGENCY.
PERFORMING AGENCY and its subrecipient(s), if any, are encouraged to use minority banks (a bank which is
owned at least 50 percent by minority group members).
ARTICLE 27. Sanctions
RECEIVING AGENCY may impose sanctions for any breach of contract. PERFORMtNG AGENCY will be
monitored both for programmatic and financial compliance. RECEIVING AGENCY may, at its own discretion,
impose one or more sanctions for each item of noncompliance and will determine sanctions on a case-by-case basis.
A state or federal statute, rule, regulation, or federal guideline will prevail over the provisions of this Article unless
the statute, rule, regulation, or guideline can be read together with the provision( s) of this Article to give effect to
both.
RECEIVING AGENCY may:
A. 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'th~ PERFORMING AGENCY
after termination of an award are not allowable unless expressly authorized by the notice of termination.
Termination does not include: (1) withdrawal of funds awarded on the basis of the grantee's
underestimate of the unobligated balance in a prior period; (2) withdrawal of the unobligated balance as
of the expiration of a grant; (3) refusal to extend a grant or award additional funds, to make a competing
or noncompeting continuation, renewal, extension, or supplemental award; or (4) voiding of a grant upon
determination that the award was obtained fraudulently, or was otherwise illegal or invalid from
inception;
B. suspend all or part of the contract. Suspension is, depending on the context, either (1) the temporary
withdrawal of the PERFORMING AGENCY's authority to obligate funds pending corrective action by
the PERFORMING AGENCY or its subrecipient(s) or pending a decision to terminate or amend the
contract, or (2) an action taken by a suspending official in accordance with agency regulations
implementing Executive Order 12549 to immediately exclude a person from participating in grant
transactions for a period, pending completion of an investigation and such legal or debarment
proceedings as may ensue. 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;
C. disallow (deny both use of funds and matching credit for) all or part of the activities or action not in
compliance;
D. temporarily withhold cash payments. Temporarily withholding cash payments means the temporary
withholding of advances or reimbursements to PERFORMING AGENCY or its subrecipient(s) for
proper charges or obligations incurred, pending resolution of issues of noncompliance with grant
conditions or indebtedness to the United States or to the State of Texas;
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1999 GENERAL PROVISIONS Page 16
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. .
, ,
E. permanently withhold cash payments. Permanently withholding of cash payment means that
RECEIVING AGENCY retains funds billed by the PERFORMING AGENCY or its subrecipient(s) for
a) unallowable, undocumented, disputed, inaccurate, improper, or erroneous claims; b) failure to comply
with grant award conditions; or c) indebtedness to the United States or to the State of Texas;
F. deny contract renewal or future contract awards to a PERFORMING AGENCY for a certain period of
time not to exceed five years;
G. delay contract execution with the PERFORMING AGENCY while other proposed sanctions are pending
resolution;
H. 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;
I. 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;
1. require the PERFORMING AGENCY to obtain technical or managerial assistance;
K. disallow requests for reimbursement by disapproving costs or fees submitted for payment or
reimbursement by PERFORMING AGENCY;
L. establish additional prior approvals for expenditure of funds by the PERFORMING AGENCY;
M. require additional, more detailed, financial and/or programmatic reports to be submitted by
PERFORMING AGENCY;
N. demand repayment from the PERFORMING AGENCY;
O. reduce the contract funding 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 in the -contract; and
P. impose other remedies provided by law.
RECEIVING AGENCY will formally notify the PERFORMING AGENCY in writing when a sanction is imposed
(with the exception of accelerated monitoring, which may be unannounced), stating the nature of the sanction(s),
the reasons for imposing them, the corrective actions which must be taken before they will be removed and the time
allowed for completing the corrective actions, and the method, if any, of requesting reconsideration of the sanctions
imposed. PERFORMING AGENCY is required to file, within 15 days of receipt of notice, a written response to
RECEIVING AGENCY's program/division that sent the notice, acknowledging receipt of such notice and stating
how the PERFORMING AGENCY will correct the noncompliance or demonstrating that the findings on which
the sanctions are based are either invalid or do not warrant the sanction( s).
In an emergency, RECEIVING AGENCY may immediately terminate or suspend all or part of the contract,
temporarily or permanently withhold cash payments, deny contract renewal or future contract awards, or delay
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1999 GENERAL PROVISIONS Page 17
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contract execution by delivering written notice to a PERFORMING AGENCY, by any verifiable method, stating "
the reason for the emergency action.
An "emergency" is defined as the following:
. PERFORMING AGENCY is noncompliant and the noncompliance has a direct adverse impact on
the public or client health or safety. The direct adverse impact may be programmatic or financial,
impacting health or safety by failing to provide services, providing i~adequate services, providing
unnecessary services, or utilizing resources so that the public or clients do not receive the benefits
contemplated by the contract scope of work or performance measure~; ,
. PERFORMING AGENCY fails to achieve a performance measure;
. PERFORMING AGENCY is reimbursed or requesting reimbursement for expenditures which are
not in accordance with applicable federal or state laws and regulations or the provisions of the
contract; or
. PERFORMING AGENCY is expending funds inappropriately.
Whether PERFORMING AGENCY'S conduct or inaction is an emergency shall be determined by RECEIVING
AGENCY on a case-by-case basis and shall be based upon the egregious nature of the noncompliance or conduct.
ARTICLE 28. Sanction Review
The 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 the contract, permanent withholding of cash payments, and
denial of contract renewal or future contract awards.
PERFORMING AGENCY must make the request for review in writing to RECEIVING AGENCY within fifteen
(15) days from the date of notification by providing written notice of the dispute to the person who signed the
notification.
PERFORMING AGENCY's notice shall contain the following: (i) a copy ofthe letter from RECEIVING AGENCY
notifying PERFORMING AGENCY of the sanction; (ii) a specific description of each act that is the basis for the
dispute; (Hi) the grounds upon which PERFORMING AGENCY bases the complaint; (iv) an identification of the
issue or issues to be resolved; (v) a precise statement of the relevant facts; (vi) any documentation in support of
PERFORMING AGENCY's position; and (vii) a statement and authorities in support of PERFORMING
AGENCY's position.
Evidence that PERFORMING AGENCY properly notified the RECEIVING AGENCY consists of any of the
following documents: (i) signature on delivery card; (ii) confirmation of a facsimile to correct telephone number;
or (iii) signed acknowledgment of delivery.
RECEIVING AGENCY's representative will schedule a meeting or a conference call to attempt to resolve the
issues in dispute. If the dispute is resolved, any resolution will be in writing and will be signed by all parties. If the
dispute is not resolved, RECEIVING AGENCY's representative will notify the PERFORMING AGENCY in
writing. RECEIVING AGENCY will appoint a reviewer(s), who will review the information, who may permit or
. require additional information and who may grant, deny, or modify all relief requested in the written notice of
dispute. The reviewer( s)' s decision will be in writing and will contain a discussion of the reason for the decision
and the remedial action, if any. The reviewer(s) will send copies of the decision to all parties by any verifiable
(LaS)
1999 GENERAL PROVISIONS Page 18
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means. The decision of the reviewer(s) is final and is the final action of RECEIVING AGENCY for purposes of
further proceedings.
A state statute or rule or a federal statute, regulation or guideline will prevail over the provisions of this Article
unless the statute, rule, regulation or guideline can be read together with the provision or provisions of this Article
to give effect to both.
ARTICLE 29. l'ermination
Each Attachment shall terminate upon the expiration date of the Attachment unless extended by written amendment
in accordance with the Amendments Article. Prior to completion of the contract term, all or a part of this contract
may be terminated with or without cause as set out below.
A. Termination without cause.
(I) Either party may terminate this contract with at least 90 days prior written notice to the other
party .
(2) The parties may terminate this contract by mutual agreement.
(3) Either party may terminate this contract with at least 30 days prior written notice to the other party
in the event state and/or federal funding for this contract is terminated, limited, suspended, or
withdrawn.
(4) RECEIVING AGENCY may terminate this contract when, in the sole determination of
RECEIVING AGENCY, termination is in the best interest of the State of Texas.
B. Termination for cause.
(1) Either party may terminate for material breach of contract with at least 30 days written notice to
the other party.
(2) RECEIVING AGENCY may terminate this contract, in whole or in part, for breach of contract or
for risky conduct by giving at least 30 days written notice, to PERFORMING AGENCY. "Risky
conduct" may include one or more of the following:
(a) 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;
(b) PERFORMING AGENCY fails to communicate with RECEIVING AGENCY or fails to
allow its employees or those of its subrecipients to communicate with RECEIVING
AGENCY as necessary to the performance of the contract;
(c) PERFORMING AGENCY breaches a standard of confidentiality with respect to the
services provided under this contract;
(LGS)
1999 GENERAL PROVISIONS Page 19
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. .
(d) RECEIVING AGENCY determines that the PERFORMING AGENCY is without the
personnel or resources to perform under the contract;
(e) RECEIVING AGENCY detennines that PERFORMING AGENCY, its agent or another
representative offered or gave a gratuity (e.g., an entertainment or gift) to an official or
employee of RECEIVING AGENCY for the purpose of obtaining a contract or favorable
treatment;
,
(f) PERFORMING AGENCY's management system does not m~et the UGMS management
standards; or .
(g) PERFORMING AGENCY appears to be financially unstable. Indicators of financia]
instability may include one or more of the following:
(i) PERFORMING AGENCY fails to make payments;
(ii) PERFORMING AGENCY makes an assignment for the benefit of its creditors;
(iii) PERFORMING AGENCY admits in writing its inability to pay its debts generally
as they become due; or
(iv) If judgment for the payment of money in excess 0[$50,000 (which is not covered
by insurance) is rendered by any court or governmental body against
PERFORMING AGENCY, and PERFORMING AGENCY does not (a) discharge
the judgment or (b) provide for its discharge in accordance with its tenns, or ( c)
procure a stay of execution 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 cause the execution
thereof to be stayed during such appeal while providing such reserves therefore
as may be required under general accepted accounting principles.
C. Emergency tennination. RECEIVING AGENCY may terminate the contract immediately upon notice
to PERFORMING AGENCY in an emergency by any verifiable means. "Emergency" is defined in the
Sanctions Article.
Either party may deliver written notice of intent to tenninate by any verifiable method. If either party gives notice
of its intent to tenninate all or a part of this contract, RECEIVING AGENCY and PERFORMING AGENCY will
try to resolve any issues related to the anticipated tennination in good faith during the notice period. Upon
tennination of all or 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
settlement of the respective accrued interests or obligations incurred prior to tennination. Tennination 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 infonnation shall survive this contract.
. ARTICLE 30. lJreach of Contract
Any remedies set out in this contract are in addition to rights and remedies for breach of contract provided by law.
(LGS)
1999 GENERAL PROVISIONS Page 20
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I I;
ARTICLE 31. Void Contract
RECEIVING AGENCY may hold a contract void upon its determination that the contract award was obtained
fraudulently or was otherwise illegal or invalid from its inception.
ARTICLE 32. Local HWth..Department Personnel,
All local health department personnel funded by Attachment(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.
PERFORMING AGENCY will have full authority to employ, promote, suspend, demote, discharge, and transfer
within its organization any and all state budgeted personnel funded by Attachment(s) to this contract provided,
however, that any demotion, suspension, or discharge of such state budgeted employees will be in accordance with
the due process hearing procedures as set out above. The only distinction between state budgeted and local paid
employees is that employees on state budgeted positions receive state benefits and are subject to certain duties,
obligations, and restrictions as state employees as contained in state law. One such restriction, as contained in the
State Appropriations Act, is that no employee paid on a state budgeted position may receive a salary supplement
from any source unless specifically authorized in the Appropriations Act or other state law. This prohibition
includes the payment to such employee of a so-called "flat rate" car allowance or travel allowance. Any travel or
per diem allowance to these employees must be on a reimbursement basis, supported by appropriate records, and
may not exceed the reimbursement for mileage and/or per diem allowed under the Appropriations Act and current
state travel regulations. This restriction will apply whether travel funds are provideq in Attachment(s) under this.
contract or from any other source.
PERFORMING AGENCY will utilize RECEIVING AGENCY's policies and procedures for hiring and promoting
individuals into state budgeted positions funded by this contract. Qualifications of any individuals filling these
positions will be subject to approval of RECEIVING AGENCY's Bureau of Human Resources. The purpose of the
approval is to ensure that ind,ividuals occupying these 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 costs on state budgeted positions. RECEIVING AGENCY will furnish
documentation regarding salary compensation or travel reimbursement for employees on state budgeted positions.
An independent audit is not required as a condition of this contract if the'Attachment provides assistance through
assignment of state budgeted positions and no funds are 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 Attachment( s) in lieu of being furnished 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, ooligations, 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 the conversion if the
request is granted.
(LGS)
1999 GENERAL PROVISIONS Page 21
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ARTICLE 33. yundine Participation Requirement
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 34. Conflict ofInterest
PERFORMING AGENCY does not have nor shall it knowingly acquire any inter~st that would conflict in any
manner with the performance of its obligations under this contract. Potential conflicts of interest include an existing
business or personal relationship between PERFORMING AGENCY, its principal, or any affiliate or subrecipient
with RECEIVING AGENCY, its officers or employees, or any other entity or person involved in any way in any
project that is the subject of this contract.
ARTICLE 35. SUn'ival of Terms
Termination or expiration of this contract for any reason shall not release either party from any liabilities or
obligations set forth in this contract that (a) the parties have expressly agreed shall survive any such termination
or expiration, or (b) remain to be performed or by their nature would be intended to be applicable following any
such termination or expiration.
ARTICLE 36. No Waiver of Sovereien Immunity
, '
THE P ARTIES EXPRESSLY AGREE THAT NO PROVISION OF THIS CONTRACT IS IN ANY WAY
INTENDED TO CONSTITUTE A WAIVER OF ANY IMMUNITIES FROM SUIT OR FROM LIABILITY
THAT THE PARTIES OR THE STATE OF TEXAS MAY HAVE BY OPERATION OF LAW.
ARTICLE 37. Certifications
The governing body of each party has authorized this contract. RECEIVING AGENCY is paying for the
performance of governmental functions and services from current revenues available to RECEIVING AGENCY.
The payment is in an amount that fairly compensates PERFORMING AGENCY for the services or functions
performed under the contract.
(LOS)
1999 GENERAL PROVISIONS Page 22
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DOCUMENT NO. 7560022067-99
ATTACHMENT NO. 01
PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: OFFICE OF REGIONAL ADMIN. SERVICES
TERM: September 01, 1998
THRU: August 31, 1999
SECTION I. SCOPE OF WORK:
ESSENTIAL PUBLIC HEALTH SERVICES
PERFORMING AGENCY shall use direct assistance and/or [mancial assistance, as specified in
SECTION m., BUDGET, from RECEIVING AGENCY to deliver one or more of the following
essential public health services as specified in PERFORMING AGENCY'S FY 99 Service
Delivery Plan, which is adopted by reference:
. Monitor health status to identify community health problems;
. Diagnose and investigate health problems and health hazards in the community;
. Inform, educate, and empower clients about health status;
. Mobilize community partnerships to identify and solve health problems;
. Develop policies and plans that support individual and community health efforts; .
. Enforce laws, rules, regulations, and ordinances, where applicable, that protect
health and ensure safety;
. Link clients to needed personal health services and assure the provision of health
care whe,n otherwise unavailable;
. Assure a competent public health and personal health care work force;
. Evaluate effectiveness, accessibility, and quality of personal and population-based
health services; and .
. 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 (2) [mancial assistance from General Revenue funds and the Preventive
Health and Health Services Block Grant.
, STATE-PAID POSITIONS
State-paid positions under this contract Attachment shall perform activities as specified in
PERFORMING AGENCY'S FY 99 Service Delivery Plan. Activities shall be specific to one of
the ten essential public health services or cardiovascular and cancer activities.
ATTACHMENT - Page 1
These positions report to and are directly supervised by PERFORMING AGENCY administr~tive
staff. Supervision authorization includes 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 AGENCY shall direct 73.5% of the General Revenue funds toward the delivery
of a broad range of essential public health services and 26.5 % of the Preventive Health and Health
Services Block Grant funds for activities designed to reduce the incidence of cancer and
cardiovascular disease.
PERFORMANCE MEASURES (ORAS)
The following performance measure(s) will be used to assess, in part, PERFORMING
AGENCY'S effectiveness in providing the services described in this contract Attachment, without
waiving the enforceability of any of the other terms of the contract.
PERFORMING AGENCY shall submit quarterly progress reports which describe
accomplishments, challenges, barriers, impact and progress toward achieving the work plan goals
and objectives contained in PERFORMING AGENCY'S FY 99 Service Delivery Plan. These
reports shall include the progress and activities of the employees in state-paid positions under
the II 000" budget.
IMMUNIZATION
PERFORMING AGENCY will implement the "Standards for Pediatric Immunization Practices, ""
February 1996, recommended by the National Vaccine Advisory Committee, approved by the
United States Public Health Service, and endorsed by the American Academy of Pediatrics.
PERFORMING AGENCY shall formulate and implement a comprehensive immunization policy
for all employees according to the most current Advisory Committee on Immunization Practices
(ACIP) statement: "Immunization of Health-Care Workers. II
PERFORMING AGENCY will attend and participate in at least one seminar or training session
addressing the immunization requirements for children and students enrolled in Texas public and
, private schools and licensed child-care facilities.
PERFORMING AGENCY shall investigate all suspected cases of invasive Haemophilus
influenzae disease in children less than 5 years of age and all suspected cases of measles, rubella,
pertussis, paralytic poliomyelitis, and diphtheria within 24 hours of receipt of the initial case
report. PERFORMING AGENCY shall investigate all suspected cases of mumps and tetanus
within 48 hours of receipt of the initial case report.
ATTACHMENT - Page 2
PERFORMING AGENCY shall complete all case investigation forms and provide co~plete
epidemiologic data on all reported cases of invasive Haemophilus influenzae disease in children
less than 5 years of age, and all reported cases of measles, mumps, rubella, congenital rubella
syndrome, pertussis, diphtheria, and paralytic poliomyelitis to RECEIVING AGENCY
Immunization Division within 30 days of the initial case report. PERFORMING AGENCY shall
provide copies of investigation forms to RECEIVING AGENCY Immunization Division.
PERFORMING AGENCY shall adhere to the Vaccine-Preventable Disease Surveillance
Guidelines provided by RECEIVING AGENCY Immunization Division and shall implement the
most current outbreak control procedures and measures as recommended in those guidelines.
PERFORMING AGENCY shall implement an immunization reminder and recall system to notify
parents or guardians of children when immunizations are due. The notifications may be
automated or manual and may include mailed or telephone contacts. Extra efforts shall be made
to notify parents or guardians of children at high-risk of failure to complete the vaccines on
schedule (e.g., children who start their vaccines late).
PERFORMING AGENCY shall provide immunization services outside usual clinic hours (which
are 8:00 a.m. to 5:00 p.m., Monday through Friday) 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 contract Attachment. PERFORMING AGENCY shall
not deny vaccinations to recipients because they do not reside within PERFORMING AGENCY'S
jurisdiction.
PERFORMING AGENCY will 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 will update the clinic list monthly and provide the updates .,
to local area Temporary Aid to Needy Families (TANF) offices and to the Immunization
Communication and Training Program of RECEIVING AGENCY.
No fee may be charged for vaccines provided by RECEIVING AGENCY Immunization Division.
All vaccines obtained from RECEIVING AGENCY Immunization Division shall be used solely
for purposes of this contract Attachment and shall not be sold to agencies or individuals.
PERFORMING AGENCY shall not collect vaccine administration fees from Medicaid recipients.
Vaccine administration fees collected from non-Medicaid patients shall be kept within guidelines
, established by RECEIVING AGENCY. No one may be denied immunization services in public
clinics because of inability to pay the administration fee. Fee schedules shall not be based on
vaccine type, formulation, or dose in series. A copy of PERFORMING AGENCY'S fee schedule
shall be submitted to RECEMNG AGENCY Immunization Division by the first day of the fifth
month of this contract Attachment term.
ATTACHMENT - Page 3
",
All equipment and vaccine used by PERFORMING AGENCY which are provide~ by
RECEMNG AGENCY Immunization Division shall be accounted for the same as other public
property. RECEMNG AGENCY Immunization Division may investigate equipment or vaccine
loss, destruction, spoilage, or other waste and may then require PERFORMING AGENCY to
replace or reimburse RECEIVING AGENCY Immunization Division for them.
PERFORMING AGENCY shall record vaccine lot numbers on all vaccine storage records and
in individual clinic immunization records to ensure a vaccine audit trail. PERFORMING
AGENCY shall provide RECEMNG AGENCY Immunization Division with a copy of any local
agency audit of immunization program funds and vaccines.
PERFORMING AGENCY shall submit a report to RECEIVING AGENCY Immunization
Division for the previous calendar year that details storage measures and methods used to control
vaccine loss, including methods to monitor and record daily vaccine storage temperatures. The
report shall be submitted by the first day of the fifth month of this contract Attachment term in
a format provided by RECEIVING AGENCY Immunization Division.
PERFORMING AGENCY will 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 shall provide the parent, managing conservator, or guardian of each
patient with a form, developed by RECEIVING AGENCY Immunization Division in compliance
with 25 TAC, Chapter 100. This form will allow the parent, managing conservator, or guardian
to authorize participation in the Immunization Tracking System (ImmTrac). When this form is
signed and returned to PERFORMING AGENCY, PERFORMING AGENCY shall comply with
the requirements of 25 TAC, Chapter 100 and provide an immunization history to RECEIVING ,.
AGENCY Immunization Division.
PERFORMING AGENCY shall provide RECEIVING AGENCY Immunization Division weekly
data transfers of all vaccines administered, detailed by client name, demographics, and dose
information. The data shall be submitted in a format provided by RECEIVING AGENCY
Immunization Division for inclusion in the state's immunization registry ~mmTrac).
PERFORMING AGENCY shall comply with all applicable federal, state, and local laws, rules
and regulations as these now appear or may be amended during the term of this contract
'Attachment, and standards and guidelines in effect on ,the beginning date of this contract
Attachment. These include:
. Texas Human Resources Code ~42.043, VTCA;
. Texas Education Code ~~38.001-38.002, VTCA;
. Health and Safety Code ~~81.023 and 161.001-161.009, VTCA;
. 25 TAC ~~97.61-97.77 and 97.101-97.102;
ATTACHMENT - Page 4
,"
. 25 TAC, Chapter 100;
. 42 USC ~~247b and 300 aa-25;
. Omnibus Budget Reconciliation Act of ~993, 26 USC ~4980B; and
. Client Services Standards for Public Health and Community Clinics, revised
June 1997.
PERFORMANCE MEASURES (Immunization)
The following performance measure(s) will be used, in part, to assess PERFORMING
AGENCY'S effectiveness in providing the services described in this contract Attachment, without
waiving the enforceability of any of the terms of the contract.
PERFORMING AGENCY shall provide an estimated 2,215 doses of vaccine to clients
who live or receive services in the following county(ies)/area defined as: Lamar.
PERFORMING AGENCY shall provide RECEIVING AGENCY Immunization Division
monthly reports of doses administered by vaccines and age group and vaccine
utilization/loss. Reports shall be submitted by the fifteenth day of each month for the
previous calendar month, on forms provided by RECEIVING AGENCY Immunization
Division (forms C5, C33, C33A). If automated reports are used by PERFORMING
AGENCY, the report shall be similar to and include the same information as theC5, C33,
C33A forms. PERFORMING AGENCY shall provide copies of each Biological Transfer
Form (C-68) used to transfer vaccines to another agency or private provider. Vaccine lot .
numbers shall be included on all Biological Transfer Forms used to transfer vaccines.
PERFORMING AGENCY shall endeavor to achieve and maintain the following vaccine
coverage levels:
. 90% for diphtheria and tetanus toxoids and pertussis vaccine (DTP), diphtheria and
tetanu~ toxoids and acellular pertussis vaccine (DTaP), diphtheria and tetanus
toxoids (DT), polio, measles/mumps/rubella (MMR), and Haemophilus influenzae
type b conjugate (HibCV) vaccines in preschool age children; and
. 80 % for hepatitis B.
PERFORMING AGENCY will implement and participate in RECEIVING AGENCY'S
Perinatal Hepatitis B Prevention Program following program protocol and providing
program services when HBsAg-positive pregnant women are identified in their service
area.
PERFORMING AGENCY will assist licensed child care facilities and registered family
homes in achieving and maintaining 90% immunization levels.
ATTACHMENT - Page 5
PERFORMING AGENCY will assist accredited public and private schools in achieving
and maintaining 95 % immunization levels. .
PERFORMING AGENCY shall assess the clinical records of preschool-age children to
determine immunization levels. PERFORMING AGENCY shall use the Assessment
Feedback Initiative Exchange (AFIX) methodology to assess immunization records using
the Centers for Disease Control and Prevention (CDC) Clinic Assessment Software
Application (CAS A) available from RECEIVING AGENCY Immunization Division.
PERFORMING AGENCY shall complete two (2) on-site assessments of all its facilities
and one (1) assessment on at least five (5) Texas Vaccines for Children (TVFC) private
providers within their jurisdiction during the term of this contract Attachment, using the
criteria specified in the attached Exhibit "A." One of these assessments may be conducted
in cooperation with RECEIVING AGENCY Immunization Division. Assessment results
shall be reported to RECEIVING AGENCY Immunization Division not more than two
weeks after the assessments are completed. An electronic file (either a backup or transfer
file) for each clinic assessment shall contain the following information:
.
Date of assessment
Name and address of assessment site (including county and RECEIVING
AGENCY'S public health region)
Contact name (preferably the name of individual from site who can be contacted
regarding assessment)
E-mail address
Telephone number
Fax number
Name of organization
Site(s) c~vered by filing system (WIC, hospitals, private providers, etc.)
Description of files that were used for the assessment (e.g., card files, medical
records, ICES, data base)
Agenci,es that participated in assessment .
Type of active reminder and recall system.(e.g., automatic, manual)
.,., ~
.
.
.
.
.
.
.
.
.
.
SECTION II. SPECIAL PROVISIONS
General Provisions, REPORTS AND INSPECTIONS Article, is amended to include the following
paragraph:
PERFORMING AGENCY shall submit quarterly reports and an Annual Expenditures Report to
the appropriate Public Health Regional Director in the format specified by RECEIVING
AGENCY Program within thirty (30) days following the end of each quarter and sixty (60) days
following the end of PERFORMING AGENCY'S fiscal year.
ATTACHMENT - Page 6
For immunization activities performed under this contract Attachment, General Provisions,
OVERTIME COMPENSATION Article, is not applicable, and PERFORMING AGENCY'shall
comply with the following paragraphs:
PERFORMING AGENCY is authorized to pay employees who are not exempt under the
Fair Labor Standards Act (FLSA), 29 USC, Chapter 8, ~201 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.
PERFORMING AGENCY shall document proper authorization or approval for any work
performed by exempt or non-exempt employees in excess of 40 hours in a workweek.
.-
A TT ACHMENT - Page 7
" l
SECTION III., BUDGET:
PERSONNEL
FRINGE BENEFITS
TRAVEL
EQUIPMENT
SUPPLIES
CONTRACTUAL
OTHER
$100,476.00
20,928.00
0.00
0.00
0.00
0.00
0.00
TOTAL
$121,404.00
Total reimbursements will not exceed $ 121,404.00.
Financial status reports are due the 30th of December, 30th of March, 30th of June, and the 15th of
October.
.'
EXHIBIT A
Assessments for these facilities can be automated using ~e (CASA) import feature. The
following issues must be considered prior to an automated 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 as meeting contract requirements.
*
Complete enumeration should be performed (i.e., CASA sampling feature is not used).
Assessment Criteria # 1
CASA Assessment Site Requirements
CASA Client Information
Provider Review Date
Common Review Date: Same as Provider Review Date
Provider Type
Name of Assessed Site
Reviewer Initials
Address
City, Zip Code
County Code
FULL Last and First Name
Date of Birth (12-23 and 24-35 months of age from date of
assessment)
Moved or Gone Elsewhere
Number of Medical Visits (Medical Charts Only)
Shot Type
Shot Date
Gender
SS Number
.'
Assessment Criteria #2
CASA Assessment Site Requirements
CASA Client Information
Provider Review Date
Common Review Date: Same as Date of Assessment
Provider Type
Name of Assessed Site
Reviewer Initials
Address
City, Zip Code
County Code
FULL Last and First Name
Date of Birth (12-23 and 24-35 months of age from date of
assessment)
Moved or Gone Elsewhere
Number of Medical Visits (Medical Charts Only)
Shot Type
Shot Date
Gender
SS Number
Rev. 5/98
CERIlEJCATION REGARDING LQ&Jilltill
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 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 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-111, "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 than $10,000 and not more than $100,000 for each
such failure.
r2/1- ~ '(
Date.
Y BETHEL, ADMINISTRATOR
Print Name of Authorized Individual
756002206799-0l
Application or Contract Number
,EARlS.:L.AMAR COUNTY HEALTH DEPAETMEm
Organization Name
p. O. BOX 938
EARlS, rX 75460-0938
I'
DOCUMENT NO. 7560022067-99
ATTACHMENT NO. 02
PERFORMING AGENCY : PARIS-LAMAR COUNTY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: PUBLIC HEALTH REGION 4&5
TERM: September 01, 1998
THRU: February 28, 1999
SECTION 1. SCOPE OF WORK:
PERFORMING AGENCY shall conduct one or both of the following Texas Health Steps/EPSDT
(THS/EPSDT) activities to assist RECEIVING AGENCY in meeting the federally-mandated 80%
medical screening participation goal for THS/EPSDT Medicaid eligibles. PERFORMING
AGENCY shall:
1. Conduct THS/EPSDT outreach activities in order to increase the awareness of
THS/EPSDT medical! dental screenings.
For the purposes of this contract Attachment, THS/EPSDT client outreach is defined as
efforts, strategies, plans, events, organized activities, and courses of action taken to
advertise, educate, or in some way increase participation in utilizing THS/EPSDT
preventive health care services. Some of the activities approved in the past include health
fairs, group presentations in various locations (WIC clinics, DHS offices), home visits,
telephone outreach, and mail-outs.
Outreach shall ~nclude offering client support services which shall respond to requests "
from: a client for assistance, a health care provider on behalf of a client, and Texas
Department of Human Services (TD HS) or another agency on behalf of a client. Action
on all requests for THS/EPSDT information or services by the client, or on behalf of the
client, shall be completed within ten (10) working days from the date of the request.
These services shall include the following activities:
a. Assistance with scheduling of appointments for THS/EPSDT medical and/or dental
check-ups in an area that is convenient and acceptable to the client;
b. Assistance with scheduling medical transportation when requested by the
THS/EPSDT Medicaid client;
c. Responding to client requests for THS/EPSDT assistance/information;
d. Developing outreach methods for informing THS/EPSDT Medicaid eligible clients
regarding the THS/EPSDT Program through personal contacts, mail-outs, group
A TT ACHMENT - Page 1
..
meetings and other venues that involve innovative approaches in a variety of
settings;
e. Telephone coverage at a designated number in each sector, answered by an
THS/EPSDT knowledgeable person who shall assist clients in utilizing
THS/EPSDT services that shall facilitate medical and/or dental check-ups,
diagnosis, and treatment;
f. Participation in education/information sessions that describe and promote the
concept and services of THS/EPSDT;
g. Provision of information to THS/EPSDT Medicaid clients about where
THS/EPSDT services, support services, and medical transportation Services can
be obtained;
h. Conducting intensive outreach with those targeted groups of clients identified by
RECEIVING AGENCY and outlined in RECEIVING AGENCY'S Request for
Proposal (RFP) and PERFORMING AGENCY'S Application. .
2. PERFORMING AGENCY shall operate and manage a centralized telephone answering
system that is toll free and shall respond promptly to incoming THS/EPSDT inquiries from
the Medicaid eligible clients who reside in PERFORMING AGENCY'S service area
described below.
Activities shall consist of the following:
a. Implementation and maintenance of a toll free phone system that is user-friendly,.'
community~based, accessible, culturally relevant, and provides information,
referral, and assistance to THS/EPSDT clients.
b.. All calls shall be toll free through a dedicated THS/EPSDT 1-800 number or a
dedicated THS/EPSDT local telephone number.
c. The dedicated telephone system shall have adequate lines and staff to answer 90%
of all incoming calls promptly (within two [2] minutes), which is the same goal
that has been set for the medical transportation program's toll free system. No
calls will be "answered" exclusively by a tape recorded message during normal
working hours, except in unusual circumstances. The medical transportation
number'shall not be given by a recorded message. The THS/EPSDT telephone
outreach system shall have the capability of directly linking the client requesting
services to the medical transportation service, PERFORMING AGENCY, or other
outreach contractors via the call transfer or call forwarding system. This will
eliminate the need for a second client initiated call.
ATTACHMENT - Page 2
'l
"
d. Telephone equipment shall be adequate so that equipment failure will only.be a
direct result of circumstances beyond the control of staff.
e. The regional toll free telephone system shall have staff available to answer calls
from 8:00 a.m. until 5:00 p.m. during the regular Monday-Friday work week.
f. There shall be an adequate number of bilingual staff as determined by the
population served.
g. The THS/EPSDT centralized telephone system staff shall have access to the
THS/EPSDT automated system. The staff shall receive training in this system that
will be conducted by the staff of RECEIVING AGENCY.
h. The telephone staff shall ask the calling client if they need assistance with
scheduling medical, dental, or transportation appointments. If assistance is
required, then the answering operator shall be able to provide the client with the
assistance requested.
I. The THS/EPSDT telephone outreach operators shall forward all provider-initiated
complaints to the designated RECEIVING AGENCY regional staff. In addition,
a report of provider-initiated requests for client assistance shall be submitted to
RECEIVING AGENCY'S provider relation staff in a format provided by
RECEIVING AGENCY within 24 hours of each call.
PERFORMING AGENCY shall provide to RECEMNG AGENCY both statistical and narrative
reports delineating the THS/EPSDT telephone outreach activities. These reports shall be
submitted no later than the fifth (5th) working day of each' month for the previous month's ""
THS/EPSDT telephone outreach activities. Once the automated system designed by RECEMNG
AGENCY is fully functional, PERFORMING AGENCY will not be required to submit statistical
reports. However, specific reports, as designated by RECEIVING AGENCY, shall be required.
RECEIVING AGENCY requires, at minimum, a monthly meeting with the relevant staff of
PERFORMING AGENCY for the purpose of monitoring adherence to this contract Attachment.
RECEMNG AGENCY shall submit, in writing, a report of findings to the person(s) identified
by PERFORMING AGENCY.
PERFORMING AGENCY shall utilize RECEIVING AGENCY'S automated system for tracing
THS/EPSDT activitieS for eligible clients. PERFORMING AGENCY shall also provide to
RECEIVING AGENCY both statistical and narrative reports delineating various THS/EPSDT
outreach activities. PERFORMING AGENCY shall provide RECEMNG AGENCY reports by
the fifth (5th) working day of each month for the previous month's THS/EPSDT outreach
activities in the format provided br ~CEIVING AGENCY Program.
ATTACHMENT - Page 3
RECEIVING AGENCY Program shall provide to PERFORMING AGENCY the following:
1. Listing of the THS/EPSDT Medicaid eligible clients in the service area. This will include
updated lists of those clients who are new or recertified Medicaid eligibles, those who are
overdue for their THS/EPSDT medical check-ups, and those who are due for a medical
check-up (screen).
2. Listing of active THS/EPSDT Medicaid medical and dental providers in each service area.
Listings of newly enrolled providers will be distributed periodically.
3. Written materials for clients and staff.
4. Training for PERFORMING AGENCY staff involved in the THS/EPSDT program,
including Medicaid information and other information as needed.
PERFORMING AGENCY agrees to comply with Medicaid law, Title XIX of the Social Security
Act, 42 USC ~1396, et seq., as amended; 42 CFR ~~441.50-441.62; THS/EPSDT program rules,
25 TAC Chapter 33; the Client Services Standards for Public Health and Community Clinics,
revised June 1997; and, the Texas State Plan for Medical Assistance. The Texas State Plan for
Medical Assistance is subject to revision during the contract Attachment term. RECEIVING
AGENCY shall notify PERFORMING AGENCY of the revisions; PERFORMING AGENCY
will have thirty (30) days from receipt of the notice to concur or terminate this contract
Attachment.
PERFORMING AGENCY agrees that all activities shall be performed in accordance with
RECEIVING AGENCY'S RFP and PERFORMING AGENCY'S application, workplan, and
revisions, if any, as agreed to and approved by RECEIVING AGENCY Program. These <.:
documents are hereby adopted by reference and made a part of this contract Attachment.
PERFORMING AGENCY shall provide outreach and/or 1-800 telephone services to clients who
live or receive services in the service area described in PERFORMING AGENCY'S application.
PERFQRMbNCE MEASURES
The following performance measure(s) will be used to assess, in part, PERFORMING
AGENCY'S effectiveness in providing the services described in this contract Attachment, without
, waiving the enforceability of any of the other terms of the contract.
PERFORMING AGENCY shall meet the Minimum Performance Standards, as applicable, listed
in Exhibit A. These' are called Minimum Performance Standards because PERFORMING
AGENCY shall comply with all other applicable contractual standards, provisions, and
requirements. A PERFORMING AGENCY providing client outreach services shall comply with
ATTACHMENT - Page 4
,.
t,1
Minimum Performance Standards numbers 1, 2, 3, 5, 6, 7 and 8 (if entering CARES data on
computer), or 9 (if only completing CARES forms).
A PERFORMING AGENCY providing 1-800 telephone service shall comply with Minimum
Performance Standards numbers 4, 5, 7, and 8 (if entering CARES data on computer), or 9 (if
only completing CARES forms).
SECTION II. SPECIAL PROVISIONS:
PERFORMING AGENCY shall maintain a permanent base of operations that will house the
outreach workers.
PERFORMING AGENCY shall respect the client's choice of THS/EPSDT service providers.
PERFORMING AGENCY shall obtain prior written approval of all client-informing materials
from RECEIVING AGENCY before distributing these materials.
PERFORMING AGENCY will use THS/EPSDT funds included in this contract Attachment for
activities described in Section I. above. PERFORMING AGENCY shall not use these funds for
the provision of other THS/EPSDT services, nor divert these funds for use in any other
THS/EPSDT program in which PERFORMING AGENCY is involved.
General Provisions, ASSURANCES Article, paragraph ten, is revised to read as follows:
PERFORMING AGENCY assures it may not transfer or assign its interest in this contract
Attachment.
General Provisions, REPORTS AND INSPECTIONS Article, paragraph three, is revised to read
as follows:
RECEIVING AGENCY, the Texas State Auditor, and the federal government, or any of
their duly authorized representatives, shall have access to any pertinent books, documents,
papers, electronic data, and client or patient records of PERFORMING AGENCY for the
purpose of making audit, examination, excerpts, and transcripts of transactions related to
contract Attachment(s). RECEMNG AGENCY will have the right to audit billings both
before and after payment. Payment under contract Attachment(s) shall not foreclose the
right of RECEIVING AGENCY to recover excessive or illegal payments.
General Provisions, REPORTS AND INSPECTIONS Article, paragraph five, is replaced with
the following:
Due to pending litigation involving RECEIVING AGENCY'S THS/EPSDT Program
(Frew vs McKinney), PERFORMING AGENCY is required to retain all records related
A TT ACHMENT - Page 5
"
to services funded by this contract Attachment until RECEIVING AGENCY notifies
PERFORMING AGENCY that retention of these records is no longer required.
PERFORMING AGENCY shall acquire and utilize at least the minimum requirements for the
THS/EPSDT outreach software/hardware. The THS/EPSDT outreach software was developed
by RECEMNG AGENCY to comply with settlement terms of the above-referenced lawsuit, and
is an asset of RECEMNG AGENCY. RECEMNG AGENCY will not provide source code to
PERFORMING AGENCY. PERFORMING AGENCY shall use the software for its intended
purpose upon the condition that the software shall not be modified,: decompiled, transferred,
assigned, sold, or distributed in any manner by PERFORMING AGENCY.
PERFORMING AGENCY shall obtain RECEIVING AGENCY Central Office Program staff
approval prior to developing any software to be used with RECEMNG AGENCY software. The .
copyright to any such software shall belong to RECEIVING AGENCY.
In addition to the General Provisions CONFIDENTIALITY Article, PERFORMING AGENCY
shall adhere to RECEMNG AGENCY requirements for confidentiality ofTHS/EPSDT Medicaid
client information in accordance with the 1998 Texas Medicaid Provider Procedures Manual and
42 CFR ~~431.301-431.307. PERFORMING AGENCY shall ensure compliance with all federal .
and state laws and regulations related to access, safeguards, and disclosure of confidential client
information subject to any changes in law that may occur. State and federal law prohibits
disclosure of any information including, but not limited to, names and addresses concerning
Medicaid applicants or recipients for purposes not directly connected with administration of the
Medicaid program.
PERFORMING AGENCY shall adopt security procedures to protect the confidentiality of
information to assure that unauthorized persons cannot retrieve the information by computer, "
remote terminal, or otherwise.
PERFORMING AGENCY shall store any printed reports ,or other materials containing
confidential information in a physically secure location protected from access by unauthorized
persons .
PERFORMING AGENCY shall protect THS/EPSDT outreach software against intrusion by
unauthorized users, including providing protective virus screening software.
, PERFORMING AGENCY shall notify RECEIVING AGENCY immediately upon detecting any
security violation of any provisions contained herein.
As Medicaid managed care is implemented within PERFORMING AGENCY'S service area, the
Scope of Work described in Section I above is subject to renegotiation. PERFORMING
AGENCY shall coordinate activities with managed care providers within PERFORMING
AGENCY'S service area described in Section I above.
ATTACHMENT - Page 6
SECTION III. BUDGET:
PERSONNEL
FRINGE BENEFITS
TRAVEL
EQUIPMENT
SUPPLIES
CONTRACTUAL
OTHER
$3,839.00
960.00
360.00
0.00
270.00
0.00
320.00
TOTAL
$5,749.00
Total reimbursements will not exceed $ 5,749.00.
Financial status reports are due the 30th of December, and the 15th of April.
"'L~
A TT ACHMENT - Page 7
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r.
DOCUMENT NO. 7560022067 -99
ATTACHMENT NO. 03
PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
RECEMNG AGENCY PROGRAM: BUREAU OF CHILDREN'S HEALTH
TERM: September 01, 1998
THRU: February 28, 1999
SECTION 1. SCOPE OF WORK:
PERFORMING AGENCY shall provide comprehensive case management services to individuals
who are under the age of twenty-one (21) and meet the RECEIVING AGENCY'S eligibility
requirements.
PERFORMING AGENCY shall comply with all applicable laws and regulations established at
federal and state levels as these regulations now appear or may be amended during the period of
the award and with standards and guidelines in effect on the beginning date of this Attachment.
These include:
.
RECEIVING AGENCY'S FY '99 Continuation Case Management Request for Proposal;
PERFORMING AGENCY'S FY '99 Continuation Application and any revisions;
Applicable sections of the RECEIVING AGENCY'S Quality Assurance Targeted Case
Management (PWI), Children with Special Health Care Needs (CSHCN) Case
Management, and CSHCN Speciality Services On-Site Evaluation Report;
RECEIVING AGENCY'S Quality On-Site Evaluation Report (Core Tool); and
Instructions for Use of Evaluation Tools.
...,~
.
.
.
.
~ERFORMANCE MEASURES:
The following performance measures will be used to assess, in part, PERFORMING AGENCY'S
effectiveness in providing the services described in this contract Attachment without waiving the
enforceability of any of the other terms of the contract:
100% of eligible children shall be current with scheduled Texas Health Steps services or informed
of and referred to Texas Health Steps services.
50 % of children enrolled in case management services shall have a medical provider for
preventive and primary care.
PERFORMING AGENCY shall provide a list of active clients to RECEIVING AGENCY,
Regional Director of Social Work Services, within 30 days of the end of each quarter.
ATTACHMENT - Page 1
..... '. ~~
PERFORMING AGENCY shall submit quarterly progress reports to RECEIVING AGENCY
Program within 30 days of the end of each quarter which document the accomplishments, impact,
and progress in achieving the work plan goals and objectives contained in PERFORMING
AGENCY'S response to the BUREAU OF CHILDREN'S HEALTH FY99 RFP. The quarterly
progress report will be in the format specified by RECEMNG AGENCY. Reports shall
document PERFORMING AGENCY'S progress in meeting the above performance measures.
PERFORMING AGENCY shall provide services to clients who live or receive services in the
following county(ies)/area: Lamar.
SECTION II. SPECIAL PROVISIONS:
In addition to the site visits authorized by the Reports and Inspections Article of the General
Provisions, PERFORMING AGENCY shall allow RECEIVING AGENCY to conduct on-site
quality assurance reviews as deemed necessary by RECEIVING AGENCY. Unsatisfactory
review findings may result in implementation of General Provisions, SANCTIONS Article.
PERFORMING AGENCY shall notify RECEIVING AGENCY immediately in the event of any
significant change affecting PERFORMING AGENCY'S identity, ownership or control, name,
governing board membership, vendor identification, medical or program director, or address.
Failure to disclose the required information or inaccurate disclosure by PERFORMING AGENCY
may be treated as a material breach of this contract and may be grounds for termination.
ATTACHMENT - Page 2
"', , I
SECTION III. BUDGET:
PERSONNEL
FRINGE BENEFITS
TRAVEL
EQUIPMENT
SUPPLIES
CONTRACTUAL
OTHER
$19,105.00
4,776.00
1,640.00
0.00
256.00
0.00
410.00
TOTAL
$26,187.00
Total reimbursements will not exceed $ 26,187.00.
Financial status reports are due the 30th of December, and the 15th of April.
.,
. A TT ACHMENT - Page 3
DOCUMENT NO. 7560022067-99
ATTACHMENT NO. 04
PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: BUREAU OF COMMUNITY ORIENTED PRIMARY
CARE
TERM: September 01, 1998
THRU: August 31, 1999
SECTION I. SCOPE OF WORK
PERFORMING AGENCY shall 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 shall be in compliance with
PERFORMING AGENCY'S application as approved by RECEIVING AGENCY Program, the
Request for Proposal (RFP) dated March 4, 1998, the Primary Health Care Program Rules, 25
TAC, Chapter 39, and RECEIVING AGENCY'S Primary Health Care (PHC) Handbook, with
amendments current as of the effective date of the contract. PERFORMING AGENCY shall
comply with changes in income guidelines as determined by RECEIVING AGENCY. The above-
referenced documents are adopted by reference as part of this Attachment.
PERFORMING AGENCY shall comply with the Health and Safety Code, Chapter 31, Texas
Primary Health Care Services Act.
PERFORMING AGENCY shall provide services in accordance with the Client Services Standards
for Public Health and Community Clinics, revised June 1997 . PERFORMING AGENCY is also
responsible for requesting and complying with the service-specific standards/guidelines set by
RECEIVING AGENCY'S programs for the particular client services provided.
PERFO~ANCE~MEASURES
The following performance measures will be used to assess in part the PERFORMING
AGENCY'S effectiveness in providing the services described in this Attachment, without waiving
the enforceability of any of the other terms of the contract.
, PERFORMING AGENCY shall report on:
. screening, referral and PHC eligibility services (PRe-200)
. client intake - hew and recertified clients (PHC-200)
. number of PHC eligible clients receiving medical services (PHC-200)
. clients served by quarter (PRC-200)
. cost and type of services provided (PHC-200)
ATTACHMENT - Page 1
. client demographic data (PHC-300) (annual)
PERFORMING AGENCY shall report quality measures on the:
. Clinical Process = Outcome Measures report (pHC-301)
. Client Satisfaction Survey (PHC-302) (annual)
PERFORMING AGENCY shall use the required eligibility system as described in the PHC
Handbook and use TESS (Texas Eligibility Screening System) as the initial step.
PERFORMING AGENCY shall 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.
When each client is enrolled, the client shall be assigned to a specific primary care provider for
preventive, episodic and chronic care to foster continuity and efficiency of care.
PERFORMING AGENCY shall provide services to 12QQ clients who live or who receive
services in the following county(ies)/area: Lamar.
SECTION II. SPECIAL PROVISIONS
General Provisions, REPORTS AND INSPECTIONS Article, is revised to include the following:
PERFORMING AGENCY shall submit a Program Services Report on or before the
following dates: January 1, April 1 , July 1 and October 1. A final Program Services
Report shall be submitted on or before November 1. RECEIVING AGENCY Program
requires compreheIisive reports which allow the Program to assess the volume and quality
of services being provided.
ATTACHMENT - Page 2
SECTION III. BUDGET:
PERSONNEL
FRINGE BENEFITS
TRAVEL
EQUIPMENT
SUPPLIES
CONTRACTUAL
OTHER
$125,641.00
27,641.00
1,500.00
0.00
14,633.00
32,000.00
10,000.00
TOTAL
$211,415.00
Total reimbursements will not exceed $ 211,415.00.
Financial status reports ar.e due the 30th of December, 30th of March, 30th of June, and the 15th
of October.
ATTACHMENT - Page 3
I:
TEXAS DEPARTMENT OF HEALTH
1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
STATE OF TEXAS
COUNTY OF TRA VIS
..
TDH Document No. 7560022067 99
CONTRACT CHANGE NOTICE NO. Ql
The Texas Department of Health, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in writing with
PARIS-L6MAA 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. 05: BCNS - WIC CARD PARTICIPATION
All terms and conditions not hereby amended remain in full force and effect.
EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN.
Authorized Contracting Entity (type above if different
from PERFORMING AGENCY) for and in behalf of:
PERFORMING AGENCY:
RECEIVING AGENCY:
PARIS-LAMAR COUNTY HEALTH DEPARTMENT
(Signature of person authorized to sign contracts)
TE~SDEPAR1MENT~~
By: ~~
erson authorized to sign contracts)
By:
MICHAEL E.MALONE', CITY MANAGER
(Name and Title)
Douglas C. Wilson, Director
Grants Mana~ement Division
i Title)
Date: ~
Date: September 14, 1998
RECOMMENDED:
OM GMD . Rev. 3/98
'l;
r. Vt1PrHT n
.. r\r. i 151 1~j
Cover Page 1
DETAILS OF ATTACHMENTS
Aul TDH Term Financial Assistance Direct Total Amount
Amd Program! End Source of Assistance (TDH Share)
No. 10 Begin Amount
Funds* i
01 ORASIV AC 09/01/98 08/31/99 State 93. 991 121,404.00 0.00 121,404.00
02 PHR4&S/EPSDT 09/01/98 02/28/99 State 93. 778 5,749.00 0.00 5,749.00
03 BCH/CASE 09/01/98 02/28/99 State 26,187.00 0.00 26,187.00
04 COPC/PRIMARY 09/01/98 08/31/99 State 211,415.00 0.00 211,415.00
05 BCNS/CARDS 10/01/98 09/30/99 10.557 93.268 0.00 0.00 0.00
TDH Document No.7560022067 99 Totals $364,755.00 $0.00 $364,755.00
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 ATTACHMENT FOR DETAILS.
Cover Page 2
DOCUMENT NO. 756002206799
ATTACHMENT NO. 05
PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: BUREAU OF CLINICAL AND NUTRITION SERVICES
TERM: October 01, 1998 THRU: September 30, 1999
SECTION I. SCOPE OF WORK:
PERFORMING AGENCY shall provide supplemental food vouchers, nutrition education, and
immunizations to enhance 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,
PERFORMING AGENCY shall:
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 shall be performed according to the
terms and specifications of RECEIVING AGENCY'S Special Supplemental Nutrition
Program for Women, Infants, and Children (WIC) and/or the United States Department
of Agriculture (USDA) as referenced below. During the term of this Attachment,
regulations, instructions, policies, and/or directives will be issued by USDA to
PERFORMING AGENCY as they are formulated and will appear in the State WIC Policy
and Procedures Manual, which is hereby incorporated by reference and made a part
hereof.
PERFORMING AGENCY will provide services in the authorized geographic service
area(s) described in PERFORMING AGENCY'S application and agreed to by
RECEIVING AGENCY. PERFORMING AGENCY can change the authorized
geographic service 'area(s) with approval from RECEIVING AGENCY. If RECEIVING
AGENCY disagrees on change of geographic service area(s), PERFORMING AGENCY
may terminate. this contract with at least thirty (30) days written notice.
B. Assist in the collection and evaluation of data which will identify medical benefits of this
nutrition-intervention program and furnish financial, dietary, medical, nutrition-education,
and any other special reports in a timely manner as required by 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
RECEIVING AGENCY Program's written policies.
D. Make available appropriate health services to participants whose incomes do not exceed
those specified in RECEIVING AGENCY'S Program policies, and inform applicants of
available health services. PERFORMING AGENCY shall have a system in place to
provide participants with the available health ~ervices or provide the services through
referral(s) supported by written agreements with health care providers.
A TT ACHMENT - Page 1
,
.
E. Issue prenumbered food vouchers furnished by 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
RECEMNG AGENCY; and be held fmancially responsible for all unaccounted for food
vouchers and/or those issued to ineligible participants. 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 Procedures Manual provided by RECEIVING AGENCY to
PERFORMING AGENCY or as otherwise approved in writing by RECEIVING
AGENCY Program.
G. Increase participation in WIC clinics in accordance with General Appropriations Act, 75th
Legislature, Regular Session, 1997, Article IT, 9 1 Other Provisions, Rider 47, and Health
and Safety Code, 9 32.021, VTCA, by offering services during extended hours of
operation outside the traditional times of 8:00 a.m. to 5:00 p.m., Monday through Friday.
H. Implement or expand PERFORMING AGENCY's breastfeeding peer counseling program
for training and salaries of peer counselors who assist pregnant and breastfeeding WIC
participants in normal breastfeeding situations if participation in this program is requested
by PERFORMING AGENCY and approved in writing by RECEIVING AGENCY.
I. Use International Board Certified Lactation Consultants (IBCLC) or the most qualified
equivalent to provide lactation consultation services to WIC clients who have breastfeeding
problems that are beyond the expertise of their local WIC staff and/or peer counselors if
participation in this option is requested by PERFORMING AGENCY and approved in
writing by RECEIVING AGENCY.
PERFORMING AGENCY shall 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. Any amended guidelines will become effective
within thirty (30) days of the receipt by PERFORMING AGENCY with PERFORMING
AGENCY'S consent.' These include: .
1. Child Nutrition Act of 1966, 42 USC 1786;
2. Public Laws 99-500 and 99-591;
3. Uniform Federal Assistance Regulations, 7 CFR Parts 3015 and 3016;
4. Applicable federal regulations located in 7 CFR Part 246;
5. State WIC Policy and Procedures Manual located in 25 TAC 9 31.1, and
, 6. Client Services Standards for Public Health and Community Clinics, revised June 1997.
fERFORMANCE MEASURES
The following performance measures will be used to assess, in part, PERFORMING AGENCY'S
effectiveness in providing the services described in this contract Attachment, without waiving the
enforceability of any of the other terms of the contract.
A TT ACHMENT - Page 2
95% of families who participate in the WIC program by receiving food vouchers shall also receive
nutrition education classes or individual counseling services to coincide with food voucher
issuance; '.
Of all pregnant women who enter the WIC program, at least 32 % shall be certified as eligible
during the period of the first trimester of their pregnancy;
87 % of clients who are enrolled in the program, excluding dual participants, transfer locked
and/or migrant clients, shall participate as food voucher recipients each month (breast-feeding
infants are also included in the client count);
33 % of infants whose mothers were participants in the program during pregnancy shall be breast-
fed at or before the time of their certification of eligibility; and
95 % of clients who indicate during the enrollment process that they have no source of health care
shall be referred to at least one source of health care at certification of eligibility.
A monthly activity report which demonstrates PERFORMING AGENCY'S efforts towards
meeting assigned annual targets shall be completed and submitted to RECEIVING AGENCY
within seven (7) working days after the end of each month.
SECTION II. SPECIAL PROVISIONS:
General Provisions, ASSURANCES Article, is hereby amended to include the following:
PERFORMING AGENCY hereby agrees that it shall comply with Title VI of the Civil Rights Act
of 1964, 42 USC 992000d et seq., Title IX of the Education Amendments of 1972, 20 USC
991681 et seq., Section 504 of the Rehabilitation Act of 1973, 29 USC 9794, Age Discrimination
Act of 1975,42 USC 996101 et seq.; all provisions required by implementing the regulations of
the Department of Agriculture, 7 CFR Part 246; 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 PERFORMING
AGENCY receives federal financial assistance from FNS; and hereby gives assurance that it shall
immediately take measures necessary to implement this Attachment.
PERFORMING AGENCY shall compile data, maintain records and submit reports, as required,
to permit effective enforcement of the nondiscrimination laws and permit authorized USDA and
State of Texas personnel, during normal working hours, to review such records, books, and
accounts as needed to ascertain compliance with the nondiscrimination laws. The Department of
'Agriculture, Food and Nutrition Service, has the right to seek judicial enforcement if
PERFORMING AGENCY violates any nondiscrimination laws. This Assurance is binding on
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 PERFORMING AGENCY.
ATTACHMENT - Page 3
General Provisions, STANDARDS FOR FINANCIAL MANAGEMENT Article, Item A,
regarding internal budgeting and Item C, regarding billing, collection, and fee schedules are not
applicable to this Attachment. ~,
General Provisions, ADVANCE PAYMENTS Article, is not applicable to this Attachment.
However, PERFORMING AGENCY will be allowed the option of receiving a two-month cash
advance in accordance with WIC Program Policy and Procedures.
General Provisions, OVERTIME COMPENSATION Article, is not applicable to this Attachment.
General Provisions, TERMS & CONDITIONS OF PAYMENT Article, is hereby modified to
include the following paragraphs:
The participant caseload will be assigned by RECEIVING AGENCY Program by giving written
notice to PERFORMING AGENCY and may be subject to change from time to time upon written
notice to PERFORMING AGENCY from RECEMNG AGENCY Program with PERFORMING
AGENCY'S concurrence. PERFORMING AGENCY assumes liability for all food costs resulting
from PERFORMING AGENCY exceeding assigned caseload. 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.
RECEMNG AGENCY will reimburse 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 PERFORMING
AGENCY'S total assigned caseload within any given month. Surplus funds (the amount by which
maximum reimbursements 'exceed actual costs) can be accumulated and carried forward within the
Attachment term. Surplus encumbered by September 30 must be billed and vouchers received by
RECEIVING AGENCY no later than December 31.
Federal FY99, the period covered by this Attachment, represents the third year of a new funding
formula for the Texas WIC Program. As such, a grandfathering of the full effects of the formula
will be continued this contract period with full implementation of the funding formula for the
contract period beginning FY 2000. During the term of the Attachment, PERFORMING
,AGENCY will earn administrative funds at the "hold harmless" rate of $~ for each
participant served as defmed above for the fIrst 15.688 clients served. All additional participants
served will be at the new funding rate of $lli.
Special Initiative "Immunizations" funding is incorporated into the rate-per-participant shown
above until PERFORMING AGENCY reaches a cumulative number of immunizations
administered for the Attachment period totaling .l.J.2Q and serves a total number of WIC
participants equal to 15.688. At that point, all additional immunizations funded under this
A TT ACHMENT - Page 4
Attachment and administered to WIC participants/applicants and their siblings will earn
administrative funds at the rate of $5.00 per immunization as reported to RECEMNG AGENCY
via the Texas .WIN automated system. The per-shot rate:,is based on actual cost. When the study
of cost-per-shot shows a different actual cost, then the rate of compensation paid per-shot will
change. The PERFORMING AGENCY will be notified of the change and will have thirty (30)
days to accept or terminate this contract. -
However, if PERFORMING AGENCY discontinues administering immunizations as a part of
its WIC Program services during the term of this agreement, then the "hold harmless" rate of
funding will be adjusted accordingly to subtract from it a commensurate amount of funds
represented in it for Special Initiative "Immunizations" funding. The adjustment in the "hold
harmless" rate will become effective the first day of the month after immunizations are
discontinued.
PERFORMING AGENCY agrees that:
(1) PERFORMING AGENCY shall identify and document separately not less than 19% of
total administrative costs as expenditures directly related to nutrition education. Nutrition
education expenditures shall be supported by documentation of participant attendance or
non-attendance.
(2) RECEIVING AGENCY will reimburse PERFORMING AGENCY for administrative
expenses at a rate not greater than 5.26 times the amount of properly documented
expenditures for nutrition education, but not more than is earned based on actual
participation not to exceed PERFORMING AGENCY'S assigned participant caseload, plus
any incentive funds allocated to PERFORMING AGENCY by the RECEIVING
AGENCY.
(3) RECEIVING AGENCY will limit (cap) PERFORMING AGENCY'S indirect costs to the
lesser of the rate approved by RECEIVING AGENCY'S Fiscal Division or twenty (20)
percent applied to PERFORMING AGENCY'S total direct salaries plus benefits
reimbursed by RECEIVING AGENCY. However, approval shall be obtained from
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 Management Standards (UGMS) for which approval can be granted by
the WIC Program office.
(4) RECEIVING AGENCY will identify annually to PERFORMING AGENCY an amount
of funds that must be spent for breastfeeding promotion. The allocation of breastfeeding
funds to PERFORMING AGENCY will be based on PERFORMING AGENCY'S
proportional share of the statewide combined total of pregnant and breastfeeding
participants as reported to RECEIVING AGENCY.
(5) RECEIVING 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 PERFORMING AGENCY, or
PERFORMING AGENCY is not complying with the provisions of USDA and/or
RECEIVING AGENCY directives.
ATTACHMENT - Page 5
(6) 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) RECEIVING AGENCY may amend or terminate this Attachment if available funds
become reduced, depleted, or unavailable during the term of the Attachment to the extent
that the WIC Program is unable to provide administrative funding at the rate(s) shown
above. RECEIVING AGENCY will provide written notification to PERFORMING
AGENCY of such fact.
(8) RECEIVING AGENCY may pay for additional services as specified in this Attachment
if provided by PERFORMING AGENCY during the term of this Attachment (but not
otherwise paid during the term of this Attachment) if it is in the best interest of the State
and RECEIVING AGENCY Program to do so. If PERFORMING AGENCY exceeds the
amount of earned administrative funds as stated above, PERFORMING AGENCY will
continue to bill RECEIVING AGENCY for the services provided. If additional funds
become available at a later date for the provision of these services, RECEIVING
AGENCY may pay PERFORMING AGENCY a share of these funds.
(9) In compliance with Rider 47, Current Appropriations Bill and Senate Bill 938, 75th
Legislature, RECEIVING AGENCY will provide incentives to WIC local agencies to
increase participation in the WIC program to the extent that federal funding is available.
PERFORMING AGENCY shall indicate separately on the face of the claim for reimbursement
(State of Texas Purchase Voucher, TDH Form B-13) the costs associated with nutrition education,
breast-feeding, 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 fmal report, Financial Status Report, Federal Form 269 (TDH Form GC-3), shall be submitted
no later than December 31, 1999.
General Provisions, REPORTS AND INSPECTIONS Article, paragraph one, is hereby modified
to include the following:
PERFORMING AGENCY shall submit Immunization Dose Forms on a weekly basis.
PERFORMING AGENCY shall comply with instructions from RECEIVING AGENCY to
transmit immunization activity by diskette or via modem at intervals specified by RECEIVING
, AGENCY.
General Provisions; EQUIPMENT AND SUPPLIES Article, is replaced with the following:
PERFORMING AGENCY shall accept responsibility and fmancialliability for all equipment and
supplies purchased with RECEIVING AGENCY funds, whether purchased locally by
PERFORMING AGENCY or by RECEMNG AGENCY and transferred to the care and custody
of PERFORMING AGENCY. PERFORMING AGENCY shall conduct an annual physical
ATTACHMENT - Page 6
inventory of all equipment purchased by RECEIVING AGENCY and submit it at a time to be
specified by RECEIVING AGENCY. RECEMNG AGENCY reserves the right to recover the
cost of equipment or supplies purchased by RECEIVING AGENCY and placed in the custody of
PERFORMING AGENCY if such articles are lost, stolen, or otherwise unaccounted for.
SECTION m. BUDGET:
All categories of costs billed to RECEIVING AGENCY, and allocation of such costs, must be in
accordance with the "Plan to Allocate Direct Costs" (P ADC) submitted by PERFORMING
AGENCY and approved by RECEIVING AGENCY. This document is incorporated herein by
reference and made a part of this Attachment.
ATTACHMENT - Page 7
CERTIFICATION REGARQING LOBBYlliQ.
~R CONTRACTS. GRANTS. LOANS AijD COOPERATNE AGREEMElm
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 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 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 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 sub recipients 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 than $10,000 and not more than $100,000 for each
such failure.
-!:jt-fY
ate .
756002206799-05
Application or Contract Number
,PARIS-LAMAR COUNTY HEALTH DEPARTMEN1
Organization Name
P. O. BOX 938
fARIS, TX 75460-0938