HomeMy WebLinkAboutResolution - 2021-R0374 - Contract HHS001081400001 - Substance Use Disorder Prevention Grant HHSC 9.28.21Resolution No. 2021-R0374
Item No. 7.15
September 28, 2021
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the acts of the Mayor of the City of Lubbock in executing, on behalf of the City of
Lubbock, Health and Human Services Commission (HHSC) Contract No. HHS001081400001,
under the Substance Use Disorder Prevention Grant Program, by and between the City of
Lubbock and the State of Texas acting by and through HHSC, and related documents are hereby
ratified in full. Said Contract is attached hereto and incorporated in this resolution as if fully set
forth herein and shall be included in the minutes of the City Council.
Passed by the City Council on
ATTEST:
r) "ae� A",
Reb cca Garza, City Secret ry
APPROVED AS TO CONTENT:
APPROVED AS TO FORM:
R n ooke, Kssistant City Attorney
September 28, 2021
--L& --- ----
DANIEL M. POPE, MAYOR
RES.HHSC Contract No. HHS001081400001 Ratification
9.10.21
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
Resolution No. 2021-R0374
SIGNATURE DOCUMENT FOR
HEALTH AND HUMAN SERVICES COMMISSION
CONTRACT No. HHS001081400001
UNDER THE
SUBSTANCE USE DISORDER PREVENTION
GRANT PROGRAM
I. PURPOSE
The Health and Human Services Commission ("System Agency"), a pass -through entity,
and City of Lubbock ("Grantee") (each a "Party" and collectively the "Parties") enter into
the following grant contract to provide funding for the Prevention Grant Program services
(the "Contract').
II. LEGAL AUTHORITY
This Contract is authorized by and in compliance with the provisions of Texas Government
Code Chapter 531.
III. DURATION
The Contract is effective on September 1, 2021 and terminates on August 31, 2024, unless
renewed, extended, or terminated pursuant to the terms and conditions of the Contract.
System Agency, at its sole discretion, may extend this Contract for any period(s) of time,
provided the Contract term, including all extensions or renewals, does not exceed five
years. Notwithstanding the limitation in the preceding sentence, System Agency, at its sole
discretion, also may extend the Contract beyond five years as necessary to ensure
continuity of service, for purposes of transition, or as otherwise determined by System
Agency to serve the best interest of the State.
IV. BUDGET
System Agency Share total reimbursements will not exceed $1,821,218.00 for the
period from September 1, 2021 through August 31, 2024. Fiscal year allocations
are documented in Attachment B, Fiscal Requirements.
All expenditures under the Contract will be in accordance with ATTACHMENT B, BUDGET.
1. Fiscal Year 2022 Allocations are as follows:
Program ID
FY22 System
Age cShare
FY22 Match
Requirement
FY22 Total
Contract Value
SA/YPS
$0.00
$0.00
$0.00
SA/YPU
$0.00
$0.00
$0.00
SA/YPI
$0.00
$0.00
$0.00
SA/CCP
$250,000.00
$12,500.00
$262,500.00
SA/CCP-COV
$208,791.00
$0.00
$208,791.00
SA/PRC
$250,000.00
$12,500.00
$262,500.00
HHSC Grant - v 2.14
Effective: February 1, 2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
Total $708,791.00 $25,000.00 $733,791.00
2. Fiscal Year 2023 allocations are as follows:
Program ID
FY22 System
Age cShare
FY22 Match
Requirement
FY22 Total
Contract Value
SA/YPS
$0.00
$0.00
$0.00
SA/YPU
$0.00
$0.00
$0.00
SA/YPI
$0.00
$0.00
$0.00
SA/CCP
$250,000.00
$12,500.00
$262,500.00
SA/CCP-COV
$112,427.00
$0.00
$112,427.00
SA/PRC
$250,000.00
$12,500.00
$262,500.00
Total
$612,427.00
$25,000.00
$637,427.00
3. Fiscal Year 2024 allocations are as follows:
Program ID
FY22 System
Age cShare
FY22 Match
Requirement
FY22 Total
Contract Value
SA/YPS
$0.00
$0.00
$0.00
SA/YPU
$0.00
$0.00
$0.00
SA/YPI
$0.00
$0.00
$0.00
SA/CCP
$250,000.00
$12,500.00
$262,500.00
SA/CCP-COV
$0.00
$0.00
$0.00
SA/PRC
$250,000.00
$12,500.00
$262,500.00
Total
$500,000.00
$25,000.00
$525,000.00
V. REPORTING REQUIREMENTS
A. Grantee shall submit all documents identified below, in accordance with
ATTACHMENT A, GENERAL STATEMENT OF WORK and
ATTACHMENT C-
DELIVERABLES & PERFORMANCE MEASURES:
1. Program Staffing Form
2. CMBHS Security Attestation Form
3. Implementation Plan
4. General Ledger (for each funded program)
5. Financial Status Report (FSR) (for each funded program)
6. Performance Measures (for each funded program)
HHSC Contract # HHS001081400001
Page 2of5
HHSC Grant - v 2.14
Effective: February 1, 2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
7. Invoices (for each funded program) in CMBHS
8. Contract Closeout Document (for each funded program)
B. In accordance with Article IV (D), if Grantee is allocated funding for YPS, YPU,
or YPI Programs, Grantee is required to submit all documents identified below,
which is documented in Attachment A-1, Youth Prevention Statement of Work.
1. Curriculum Outcome Measure Reports
C. In accordance with Article IV (D), if Grantee is allocated funding for CCP and
CCP-COV Programs, Grantee is required to submit all documents identified
below, which is documented in Attachment A-2, Community Coalitions
Partnership Statement of Work.
1. Community Needs Assessment (CNA)
2. Logic Model
3. Five -Year Strategic Plan
4. Initial Evaluation Plan
5. Quarterly Reports
D. In accordance with Article IV (D), if Grantee is allocated funding for PRC
Program, Grantee is required to submit all documents identified below, which is
documented in Attachment A-3, Prevention Resource Centers Statement of Work.
1. Mid -year Report
2. Regional Needs Assessment
3. Post Regional Needs Assessment to website
VI. CONTRACT REPRESENTATIVES
The following will act as the representative authorized to administer activities under this
Contract on behalf of their respective Party.
System Agency
Health and Human Services
Commission
P.O. Box 149347
Austin, TX 78714
Attention: Bryan Hunter, Contract Manager
HHSC Grant - v 2.14
Effective: February 1, 2019
Grantee
City of Lubbock
806 18th street
Lubbock Texas 79401
Attention: Daniel Pope
HHSC Contract # HHS001081400001
Page 3 of 5
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
VII. LEGAL NOTICES
Any legal notice required under this Contract shall be deemed delivered when deposited by
the System Agency either in the United States mail, postage paid, certified, return receipt
requested; or with a common carrier, overnight, signature required, to the appropriate address
below:
System Agency
Health and Human Services Commission
1100 W. 491h Street, MC 1911
Austin, TX 78756
Attention: General Counsel
VIII. NOTICE REQUIREMENTS
Grantee
City of Lubbock
806 10 Street
Lubbock, TX 79401
Attention: Daniel Pope
Notice given by Grantee will be deemed effective when received by the System Agency.
Either Party may change its address for notices by providing written notice to the other Party.
All notices submitted to System Agency must:
A. include the Contract number;
B. be sent to the person(s) identified in the Contract; and,
C. comply with all terms and conditions of the Contract.
IX. ADDITIONAL GRANT INFORMATION
Grantee Data Universal Numbering System (DUNS) Number: 58213893
Federal Award Identification Number (FAIN): B08TIO83478-01
Catalog of Federal Domestic Assistance (CFDA) Name and Number (list all that apply):
• Name — Number 93.959
Federal Award Date: 02/02/2021
Federal Award Period: 10/01/2020-09/30/2022
Name of Federal Awarding Agency:
Awarding Official Contact Information:
HHSC Grant - v 2.14
Effective: February 1, 2019
Department of Health and Human
Services
Wendy Pang, Grants
Management Specialist Center
for Substance Abuse Treatment
wendv.nan6samhsa.hhs.eov
240-276-1419
SIGNATURE PAGE FOLLOWS
HHSC Contract # HHS001081400001
Page 4 of 5
DocuSign Envelope ID: 8A024363-682A-4C87-8B1F-FE05D527850C
SIGNATURE PAGE FOR SYSTEM AGENCY
CONTRACT No. HHS001081400001
HEALTH AND HUMAN SERVICES CITY OF LUBBOCK
COMMISSION
DmuSigned by:
Peps,
3F037883155540F .
Daniel Pope
Mayor
Date of Execution: Date of Execution: September 8, 2021
THE FOLLOWING ATTACHMENTS TO SYSTEM AGENCY CONTRACT NO.
HHS001081400001 ARE INCORPORATED BY REFERENCE:
ATTACHMENT A - GENERAL STATEMENT OF WORK
ATTACHMENT A-1- YOUTH PREVENTION STATEMENT OF WORK
ATTACHMENT A-2 - COMMUNITY COALITION PARTNERSHIP STATEMENT OF WORK
ATTACHMENT A-3 - PREVENTION RESOURCE CENTERS STATEMENT OF WORK
ATTACHMENT B — FISCAL REQUIREMENTS
ATTACHMENT B-1- APPROVED CATEGORICAL BUDGET
ATTACHMENT C — DELIVERABLES & PERFORMANCE MEASURES
ATTACHMENT D — HHSC UNIFORM TERMS & CONDITIONS GRANT V 2.16.1
ATTACHMENT E-- CONTRACT AFFIRMATIONS
ATTACHMENT F -- HHSC ADDITIONAL PROVISIONS VERSION 1.0, SEPTEMBER 2021
ATTACHMENT G — FEDERAL ASSURANCES AND CERTIFICATIONS
ATTACHMENT 11— DATA USE AGREEMENT
ATTACHMENT I —FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA)
ATTACHMENTS FOLLOW
HHSC Contract # HHS001081400001
Page 5 of 5
HHSC Grant - v 2.14
Effective: February 1, 2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8B 1 F-FED5D527850C
ATTACHMENT A
GENERAL STATEMENT OF WORK
I. PURPOSE
To provide prevention and behavioral health promotion strategies for programs referenced
in Contract Signature Document, Article IV (D), Grantee's Prevention Grant Program(s).
Grantee is required to adhere to the requirements within the following documents:
A. Grantee Implementation Plan, as approved by System Agency and incorporated into
the Contract thereafter by reference; and
B. Prevention and Behavioral Health Promotion Program Guidance document (hereafter
referred to as the "Program Guide") https://hhs.texas.gov/about-hhs/process-
improvement/improvin g-services-texans/behavioral-health-services/substance-use-
misuse-prevention.
II. GOAL
To prevent substance use and misuse and promote behavioral health and wellness in youth,
families, and communities across Texas. Grantees will implement the following strategies
as outlined in the Program Guide:
A. Prevention Education,
B. Information Dissemination,
C. Positive Alternatives,
D. Problem Identification and Referral,
E. Community -Based Processes,
F. Environmental and Social Policies.
III. GENERAL RESPONSIBILITIES
Grantee shall:
A. Provide prevention services and activities in accordance with the rules in Title 26 of
the Texas Administrative Code (TAC), Chapter 321(A) and as outlined in this
agreement, the Program Guide and the System -Agency approved grantee
Implementation Plan.
B. Submit an annual Implementation Plan for review and approval by System Agency that
details how all required services and strategies will be implemented locally. Any
changes to the Implementation Plan must receive prior approval of System Agency.
The Implementation Plan template is located in the Program Guide.
C. Develop policies and procedures as required by 1 TAC §392.511 and outlined within
the Program Guide, "Policy and Procedures Guidance" and make them available for
inspection by the System Agency.
D. Follow the National Standards for Culturally and Linguistically Appropriate Services
in Health and Health Care (The National CLAS Standards, 2013) and demonstrate
HHSC Contract #HHS001081400001
Page 1 of 6
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT A
GENERAL STATEMENT OF WORK
good -faith efforts to reach out to under -served populations as detailed within the
Program Guide, "Adherence to CLAS Standards'.
E. Secure and maintain community agreements with partners that adhere to the Program
Guide, "Community Agreements". Agreements may include a Memorandum of
Understanding (MOU), a Letter of Agreement (LOA), Memorandum of Agreement
(MOA) or other agreement as approved by System Agency.
F. Appropriate level staff shall participate in System Agency meetings, trainings, and
state -scheduled calls per requirements in the Program Guide, "Required HHS
Meetings and Communication".
G. Submit additional documentation as requested by the System Agency.
H. Post in a prominent location, legible prohibitions against firearms, weapons, alcohol,
and illegal drugs, illegal activities, and violence at program sites that do not have the
existing prohibitions posted.
I. Conduct and document quarterly fidelity and quality assurance checks of all required
activities.
J. System Agency requires all deliverables excluding the CMBHS deliverables be
submitted within Globalscape EFT, and/or any alternative method required by System
Agency. Grantee is required to maintain access to required systems or platforms for
the term of this contract.
IV. STAFFING AND STAFF COMPETENCY REQUIREMENTS
A. Grantee shall designate two media representatives to assist with the statewide media
campaign as described in the Program Guide. Grantee's participation is required.
B. The Prevention Program Director and all other prevention program staff must complete
the general required trainings as specified in the Program Guide, Section General Staff
Training Requirements. All training and certification documentation must be
maintained within the employees' file for System Agency review upon request.
V. CRIMINAL BACKGROUND VERIFICATION REQUIREMENTS
Grantee shall establish and adhere to policies on conducting criminal background checks
of potential employees, volunteers and/or subcontractors, which at a minimum must
include:
A. A pre -employment criminal background check for any individual that will have direct
contact with youth, families, or other participants;
B. Standards detailing hiring decisions for employees with a background check finding;
and,
C. Requirements for employees to report post -employment instances that would
negatively impact subsequent background checks.
HHSC Contract #HHS001081400001
Page 2 of 6
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT A
GENERAL STATEMENT OF WORK
VI. CONSENT
Grantees are required to obtain consent from participants and their parents/legal guardians
in accordance with applicable laws. This includes obtaining consent for any youth
prevention program services as well as any activities, including Positive Alternatives, that
occur off -site or involve participant travel. Grantee will document consent using a form or
process created by Grantee. Grantee will maintain all relevant consent documentation on
file.
VII. DOCUMENTATION OF STRATEGIES AND SERVICES
Grantee shall utilize the Prevention Activity Tracking Tool (PATT), or other electronic
tools as required by the System Agency, to document prevention activities as outlined in
the Program Guide, "Documentation of Strategies and Services".
VIII. CLINICAL MANAGEMENT FOR BEHAVIORAL HEALTH SERVICES
(CMBHS) COMPONENTS
A. Grantee shall use the CMBHS components/functionality specified below, in
accordance with the System Agency instructions:
1. Request/maintain user access for appropriate staff, (including access control and
credential maintenance);
2. Provider detail;
3. Performance Measures;
4. Financial Status Reports (FSR);
5. Invoices; and
6. Curriculum Outcome Measures (YPS, YPU, and YPI Programs only).
B. Designate a Security Administrator and a back-up Security Administrator. The Security
Administrator is required to implement and maintain a system for management of user
accounts/user roles to ensure that all the CMBHS user accounts are current.
C. Notify the CMBHS Helpdesk within 10 business days of any change to the designated
Security Administrator or the back-up Security Administrator.
D. In addition to CMBHS Helpdesk notification, Grantee shall submit a signed CMBHS
Security Attestation Form and a list of Grantee's employees, contracted laborers and
sub -Grantees authorized to have access to secure data. The CMB1iS Security
Attestation Form shall be submitted electronically on or before the 151h day of
September and March 151h, to the designated folder in Globalscape EFT.
E. Establish and maintain a security policy that ensures adequate system security and
protection of confidential information.
F. Ensure that access to CMBHS is restricted to only authorized users. Grantee shall,
within 24 hours, remove access to users who are no longer authorized to have access
to secure data.
HHSC Contract #HHS001081400001
Page 3 of 6
DocuSign Envelope ID: 8AD24363-682A-4C87-8B 1 F-FED5D527850C
ATTACHMENT A
GENERAL STATEMENT OF WORK
G. Attend System Agency training on CMBHS documentation.
H. Use other CMBHS components and meet CMBHS training requirements per request
by the System's Agency. (The use of CMBHS is not limited to the components and
functionality listed above.)
IX. DELIVERABLE AND REPORTING REQUIREMENTS
A. Grantee shall submit all required reports of monitoring activities to System Agency by
the applicable due dates outlined in Attachment C, Deliverables and Performance
Measures.
B. The following reports must be submitted to System Agency via GlobalScape EFT
(https:Hsftp.hhs.texas.gov) by the required due dates and report name described in the
Attachment C, Deliverables and Performance Measures.
1. In addition to Clinical Management for Behavioral Health Services (CMBHS),
Grantees are required to submit data, reports, performance measures, and any other
requested information into data systems designated by the System Agency.
2. Grantee will submit the Program Staffing Form within 10 business days of a
revision using the System -Agency process outlined in the Program Guide.
3. Grantee shall submit an annual Implementation Plan for System Agency approval.
The approved Implementation Plan shall be incorporated as part of the Contract.
4. Grantee shall submit a Financial Status Report (FSR), for each awarded program
referenced in the Signature Page, Section IV, (D), Grantee's Prevention Grant
Program(s).
5. Grantee shall submit a General Ledger for each awarded program referenced in
the Signature Page, Section IV, (D), Grantee's Prevention Grant Program(s) to
support each Program's FSR.
6. Grantee shall submit monthly invoices in Clinical Management for Behavioral
Health Services (CMBHS) for each awarded program referenced in the Signature
Page, Section IV, (D), Grantee's Prevention Grant Program(s).
7. Grantee shall submit annual Contract Closeout documentation, for each awarded
program referenced in the Signature Page, Section IV, (D) Grantee's Prevention
Grant Program(s), this is required each fiscal year, and a final contract closeout will
be due October 15.
8. Grantee shall submit a CMBHS Security Attestation Form twice a fiscal year.
9. Grantee will report the performance measures for the previous month's activities in
CMBHS by the 15th of the current month, for each awarded program referenced in
the Signature Page, Section IV, (D) Grantee's Prevention Grant Program(s).
10. Grantee's duty to submit documents will survive the termination or expiration of
this Contract.
HHSC Contract #HHS001081400001
Page 4 of 6
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT A
GENERAL STATEMENT OF WORK
X. PERFORMANCE MEASURE DEFINITIONS AND GUIDANCE
A. Grantee shall reference Program Guide, "Performance Measure Definitions and
Guidance" for the YP, PRC, and CCP performance measure definitions and guidance
regarding the data to report.
B. Grantee shall report the performance measures required by each funded program
documented in Attachment C, Deliverables and Performance Measures.
C. System Agency will monitor Grantee's performance of the requirements in
Attachment A, specific program Statements of Work as applicable, and Attachment
C Deliverables and Performance Measures.
XI. SYSTEM AGENCY INFORMATION
Name:
Bryan Hunter
Email:
Bryan.Hunterrrhhs.texas.gov
Telephone:
512-206-5313
Address:
909 W 451h Street, Bldg. 555 MC 2058
Cit /Zi :
Austin TX 78751
XII. RENEWALS
No renewal options available for this contract.
XII. GRANTEE INFORMATION
Grantee TIN
17560005906
Subrecipient
Contract Detremination
Cost Reimbursement
Payment Method:
HHSC Contract #HHS001081400001
Page 5 of 6
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1 F-FED5D527850C
ATTACHMENT A-1
YOUTH PREVENTION PROGRAMS
THIS STATEMENT OF WORK IS NOT
CURRENTLY APPLICABLE TO THIS CONTRACT.
Page I of 1
DocuSign Envelope ID: 8AD24363-682A-4C87-861F-FED5D527850C
ATTACHMENT A-2
COMMUNITY COALITION PARTNERSHIP
STATEMENT OF WORK
I. PURPOSE
The purpose of the Community Coalition Partnership (CCP) is to mobilize the community
to implement evidence -based environmental strategies related to substance use and misuse
prevention and behavioral health promotion. Grantee may take an approach that addresses
the Social Determinants of Health with an effort to produce outcomes that change policies
and influence social norms.
II. GOALS
A. To increase citizen participation and commitment among all sectors of the community
towards reducing substance use and misuse and promoting behavioral health.
B. To create community environments that foster behavioral health and wellness and
address environmental factors that lead to substance use and misuse.
C. To increase community awareness regarding substance use and misuse through the
dissemination of information through community -based processes that includes
presentations, media campaigns, and other distribution networks.
III. SERVICE AREA
A. Grantee shall provide services and focus CCP strategies in the counties (service area)
listed below, as approved by System Agency:
Region: 1
Counties: Lubbock, Hockley
B. Grantee may request to add and/or delete counties referenced in Section III (A);
however, all requests for additional counties must be within the same region. The
counties per HHS region are documented at the following link:
https:/jhhs.texas.gov/sites'defaultifilesidocumentslabout-hhsl'hhs-regional-map.pdf
C. Grantee's request to revise the service are shall comply with the following
requirements:
1. Submit email requests to the assigned contract manager and the SA Mailbox,
SubstanceAbuse.Contracts Lhhs.texas. o_v.
2. The requests must include the following information:
i. Legal Entity Name;
ii. Contract number;
iii. Program ID;
iv. Current service area;
V. Revised service area;
vi. Justification for service area change.
D. System Agency may revise the Service area in accordance with Attachment F, HHSC
Additional Provisions, Section 4. Miscellaneous Provisions, A. Minor Administrative
Changes. All revisions to the service area are considered a minor administrative change
HHSC Contract #HHS001081400001
Pagel of 4
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT A-2
COMMUNITY COALITION PARTNERSHIP
STATEMENT OF WORK
and do not require an amendment. System Agency shall provide a written notification
to document revisions to the service area.
IV. TARGET POPULATION
The coalition's sector representation should strategically align with the targeted strategies
as outlined in the Program Guide, hgps://hhs.texas.gov/about-hhs/process-
improvement/improving-services-texans/behavioral-health-services/substance-use-
misuse-prevention.
The CCP should implement strategies to enhance outcomes for the following populations:
A. The primary population is adolescents (ages 12-17) and young adults (ages 18-25)
within the approved service area.
B. The secondary population is the general population across the lifespan within the
approved service area.
V. GRANTEE RESPONSIBILITIES
Grantee shall:
A. Conduct prevention services and activities through the operation of one or
more coalition(s) that utilize(s) the Strategic Prevention Framework (SPF) process as
a guide.
B. Implement the combination of Center for Substance Abuse Prevention (CSAP)
strategies identified in the Program Guide including: information
dissemination, alternative activities; community -based processes; and environmental
strategies to shift related policies, practices, norms and community conditions.
C. Develop, implement, and maintain a policy to reflect the CCP coalition's cultural
competency efforts; maintain current policies and procedures and make them
available for System Agency review upon request.
D. Document application of CLAS (Culturally and Linguistically Appropriate
Services) standards by completing the CLAS section of the Quarterly Reporting
form.
E. Collaborate with the PRCs (Prevention Resource Centers) on Tobacco Retail
Education endeavors as needed to prevent tobacco use.
F. Use supplemental block grant funds awarded to address the negative impact of
COVID-19 on behavioral health, in accordance to the guidance provided by System
Agency in the Program Guide. The COVID-19 funding will be managed under the
Program ID (CCP-COV) and require separate invoicing and FSR submissions. At
minimum, Grantee shall:
1. Develop and implement community -wide activities that reduce stress, address
trauma, or promote behavioral health and wellness;
HHSC Contract #HHS001081400001
Page 2 of 4
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT A-2
COMMUNITY COALITION PARTNERSHIP
STATEMENT OF WORK
2. Develop and implement projects that change physical environment, build
community resilience, or improve systemic processes to enhance behavioral health
and wellness;
3. Document strategies as documented above in Section V. (F 1-2) in the
Implementation Plan for review and approval by System Agency. Grantee will not
implement strategies prior to receiving System Agency approval. Any changes to
strategies will be submitted to System Agency and approved in the Implementation
Plan prior to implementation;
4. Use data to prioritize strategies as documented above in Section V. (F 1-2), detailed
in Program Guide, "COVID-19 Supplemental Funding Guidance";
5. Prioritize behavioral health equity; and
6. Focus services and resources in areas disproportionately impacted by COVID-19.
G. All proposed strategies must be approved by System Agency prior to implementation and
documented in the Implementation Plan.
VI. POLICY/PROCEDURAL REQUIREMENTS
Grantee shall:
A. Operate in accordance with the rules in Title 26 of the Texas Administrative Code
(TAC), Chapter 321
(https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac view�4&ti=26&pt—1
&ch=321).
B. Ensure all program staff for this contract shall be registered with and have access to
the CCP forum. Staff must request access using procedures outlined in the Program
Guide, "Community Coalition Partnership Program Specific Staffing Requirements".
C. Follow the submission schedule and reporting requirements detailed in Attachment
C, Deliverables and Performance Measures.
D. Submit required reports to System Agency by the applicable due dates outlined in
Attachment C, Deliverables and Performance Measures.
E. If the due date for all required deliverables is on a weekend or holiday, the due date is
the following business day.
VII. COMMUNITY COALITION PARTNERSHIP STAFFING REQUIREMENTS
A. In addition to the staffing requirements outlined in the Attachment A, General
Statement of Work, Community Coalition Partnership Programs must:
a. Employ a minimum of one Program Director at .25 Full -Time Equivalent
(FTE) per coalition funded.
b. Employ a minimum of one Coalition Coordinator at 1.0 FTE per coalition
funded.
B. CCP staff shall receive coalition competency training as outlined in the Program
Guide.
HHSC Contract #HHS001081400001
Page 3 of 4
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT A-2
COMMUNITY COALITION PARTNERSHIP
STATEMENT OF WORK
VIII. PERFORMANCE MEASURES
Grantee shall report in CMBHS all required performance measures documented on
Attachment C, Deliverables and Performance Measures. Grantee shall ensure all
performance measures are submitted by the due date.
IX. DELIVERABLE AND REPORTING REQUIREMENTS
A. Grantee shall submit the CCP program report/deliverables in accordance with
Attachment C, Deliverables and Performance Measures.
B. The CCP program deliverables described above are as follows:
1. Quarterly Reports: Using approved System Agency template, the Grantee will
document accomplishments and barriers during the implementation of
programmatic activities.
HHSC Contract #HHS001081400001
Page 4 of 4
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT A-3
PREVENTION RESOURCE CENTERS
STATEMENT OF WORK
I. PURPOSE
The purpose of the Prevention Resource Centers (PRCs) is to increase the capacity of the
statewide substance misuse prevention system. PRC services seek to enhance community
collaboration, increase community awareness and readiness, provide information and
resources on substance use and related behavioral health data, and support professional
development of the prevention workforce, and strengthen regional compliance with tobacco
and nicotine laws.
II. GOALS
A. To maintain and serve as the primary resource for substance use and related
behavioral health data for the region.
B. To build the prevention workforce capacity through technical support and coordination
of prevention trainings.
C. To increase community awareness of substance use and misuse and the broader social
determinants that impact behavioral health by disseminating information across a wide
variety of media outlets and distribution networks.
D. To strengthen compliance with existing laws on the sale of tobacco and nicotine
products to minors through education and monitoring activities.
III. SERVICE AREA
A. Grantee shall provide services and focus PRC strategies in the counties (service area)
listed below, as approved by System Agency:
Region: 1
Counties: Armstrong, Bailey, Briscoe, Carson, Castro, Childress, Cochran,
Collingsworth, Crosby, Dallam, Deaf Smith, Dickens, Donley, Floyd, Garza, Gray,
Hale, Hall, Hansford, Hartle,y Hemphill, Hockley, Hutchinson, King, Lamb,
Lipscomb, Lubbock, Lynn, Moore, Motley, Ochiltree, Oldham, Partner, Potter,
Randall, Roberts, Sherman, Swisher, Terry, Wheeler, Yoakum
B. Grantee may request to add and/or delete counties referenced in Section III (A);
however, all requests for additional counties must be within the same region. The
counties per HHS region are documented at the following link:
httgs://hhs.texas. gov/sites/default/files/documents/about-hhs/hhs-regional-mU.pdf
C. Grantee's request to revise the service are shall comply with the following
requirements:
1. Submit email requests to the assigned contract manager and the SA Mailbox,
SubstanceAbuse.Contracts(d)hhs.texas. ov.
2. The requests must include the following information:
i. Legal Entity Name;
ii. Contract number;
HHSC Contract #HHS001081400001
Page 1 of 4
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT A-3
PREVENTION RESOURCE CENTERS
STATEMENT OF WORK
iii. Program ID;
iv. Current service area;
V. Revised service area;
vi. Justification for service area change.
D. System Agency may revise the service area in accordance with Attachment F,
HHSC Additional Provisions, Section 4. Miscellaneous Provisions, A. Minor
Administrative Changes. All revisions to the service area are considered a minor
administrative change and do not require an amendment. System Agency shall
provide a written notification to the service area.
IV. TARGET POPULATION
A. The primary target population is all System Agency -funded substance misuse
prevention providers in the region.
B. The target population may also include school administrators and teachers, community
groups and coalitions, education services centers (ESCs), local mental health
authorities (LMHAs), substance use disorder intervention and treatment organizations,
law enforcement, healthcare entities, healthcare providers, pharmaceutical entities that
hold information about substance use or prescription medication, tobacco retailers,
higher education institutions, and community stakeholders including youth, young
adults, parents, and residents in Texas.
V. GRANTEE RESPONSIBILITIES
Grantee shall:
A. Conduct prevention services and activities in accordance with the rules in -Title 26 of
the Texas Administrative Code (TAC), Chapter 321(A);
B. Implement Center for Substance Abuse Prevention (CSAP) Strategies associated with
each PRC core function outlined in the Program Guide, Section V "Required
Frameworks/Models. The Program guide can be found at the following site:
httpL //hhs.texas.gov/about-hhs/process-improvement/improving-services-
texans/behavioral-health-services/substance-use-misuse-prevention.
VI. PRC CORE FUNCTIONS
A. Data Resource Coordination (Data Core)
A goal of each Prevention Resource Center (PRC) is to maintain and serve as the primary
resource for substance use and related behavioral health data for the region. This includes
collecting, analyzing, and synthesizing data for local needs assessments and sharing data
with other funded prevention programs and community members at large as detailed in the
Program Guide. Grantee will also develop and maintain a Regional Epidemiological
Workgroup (REW) and develop a Regional Needs Assessment as outlined in the Program
Guide.
HHSC Contract #HHS001081400001
Page 2 of 4
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT A-3
PREVENTION RESOURCE CENTERS
STATEMENT OF WORK
B. Training and Professional Development Coordination (Training Core)
A goal of the PRC Training Core is to build the prevention workforce capacity through
technical support and coordination of prevention trainings. This goal will be addressed
through the implementation of the CSAP strategy of Community -Based Processes, which
is designed to enhance the ability of the community to more effectively provide prevention
services. Grantee will conduct and document activities within the PRC Training Core in
accordance with requirements in the Program Guide. This includes but is not limited to
working with the System Agency -funded training entity and other community -based
organizations to: host trainings; identify training locations; and promote/coordinate
regional trainings.
C. Media Awareness Activities Coordination (Media Core)
A goal of each Prevention Resource Center (PRC) is to increase awareness of the
community regarding substance use and misuse through Media Awareness Activities.
Media Awareness Activities are marketing efforts that serve the target population. As part
of this requirement, grantees will implement strategies as outlined in the Program Guide,
including but not limited to: developing messaging; promoting messaging; maintaining
social media accounts; and, participating in the Statewide Media Campaign.
D. Tobacco -Specific Prevention Activities Coordination (Tobacco Prevention Core)
A goal of the PRCs is to strengthen compliance with existing laws on the sale of tobacco
and nicotine products to minors through education and monitoring activities. This will be
conducted in accordance to the Program Guide including but not limited to: conducting on -
site, voluntary checks with tobacco retailers to assess compliance with tobacco laws;
providing education to tobacco retailers in the region; and conducting follow-up visits for
retailers with tobacco -related violations.
VII. POLICY/PROCEDURAL REQUIREMENTS
Grantee shall:
A. Submit required reports of monitoring activities for PRC program to System Agency
by the applicable due dates outlined in Attachment C, Deliverables and Performance
Measures.
B. Designate the number of Media Representatives described in the Program Guide.
C. Register for and maintain access to the PRC forum in accordance with the Program
Guide "Required HHS Meetings and Communications". Staff must request access
using procedures outlined by the System Agency.
VIII. DELIVERABLE AND REPORTING REQUIREMENTS
A. Grantee shall submit all PRC reports/deliverables by the due dates, in accordance with
Attachment C, Deliverables and Performance Measures.
B. The PRC program deliverables described above are as follows:
1. Mid -year Report: In this report, the Grantee indicates their progress toward their
fiscal year performance measures and other goals, provide reasons for any
difficulties in reaching targets, and describe successes and challenges faced.
HHSC Contract #HHS001081400001
Page 3 of 4
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT A-3
PREVENTION RESOURCE CENTERS
STATEMENT OF WORK
2. Regional Needs Assessment: Using a template developed by the System Agency
in consultation with the PRCs, the Grantee shall collect, present, and analyze
primary and secondary data relevant to prevention and behavioral health
promotion.
3. Post Regional Needs Assessment to website: The Grantee will post a PDF of their
completed Regional Needs Assessment to their organization's website.
IX. PRC STAFFING REQUIREMENTS
A. In addition to the staffing requirements outlined in the Attachment A, General
Statement of Work, PRC Programs must employ a:
1. Program Director at a minimum of .50 Full -Time Equivalent (FTE) to oversee
program and ensure compliance with implementation requirements.
2. Data Coordinator, at a minimum of 1 FTE, who will conduct prevention program
services focused on the Data Core requirements of this Contract.
3. Public Relations Coordinator, at a minimum of 1 FTE, who will conduct prevention
program services focused on the Media and Training Prevention Core requirements
of this Contract.
4. Tobacco Prevention Coordinator, at a minimum of 1 FTE, who will conduct
prevention program services focused on the Tobacco Prevention Core
requirements of this Contract.
B. PRC staff shall receive prevention resource training(s) and tobacco law training
outlined in the Program Guide "Prevention Resource Center Specific Staff Training
Requirements". Grantee shall ensure the trainings are held within the timeframes
documented in the Program guide.
X. PERFORMANCE MEASURES
A. Grantee's performance will be measured in part on the achievement of the PRC
Program performance measures.
B. Grantee shall report these performance measures monthly through CMBHS under the
Measures component.
C. The PRC program Performance Measures can be referenced in Attachment C,
Deliverables and Performance Measures.
HHSC Contract #HHS001081400001
Page 4 of 4
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT B
FISCAL REQUIREMENTS
Grantee shall ensure compliance to the fiscal requirements of the Contract, as follows:
A. This Contract is funded from the United States Health & Humans Services (HHS),
Substance Abuse and Mental Health Services Administration (SAMSHA), Substance
Abuse Prevention Treatment (SAPT) Grant, Assistance Listing Number (ALN) 93.959.
B. Compliance with the Code of Federal Regulation (CFR), 45 CFR Part 96, Subpart C, as
applicable, referenced at the following link: littps: ecfi.io'Title-
45 pt45.1.96 sp45.1.96.c;
C. Compliance with the following Grant requirements, located at System Agency's website,
hitpc,: hhs.texas.goN `doing-business-h11s'g►•ants.
1. Electronic Code of Federal Regulations (2 CFR 200);
2. Federal Uniform Grant Guidance;
3. Grant Technical Assistance guide; and
4. Texas Grant Management Standards.
D. Access the Transactions List report in CMBHS to identify the amount of federal funds
allocated to this award for each transaction.
E. The SAPT grant, Assistance Listing number 93.959 requires a five (5%) percent match
requirement.
F. Any unexpended balance associated with any other System Agency -funded contract may
not be applied to this Contract.
G. Compliance to the following Invoicing and Payment requirements:
1. Submit monthly invoices to the System Agency utilizing CMBHS. Monthly
invoices required for all Programs awarded funding, in accordance with the
Contract Signature document, Section IV, Budget (D). All invoices shall be
submitted by the deadlines established in Attachment C, Deliverables and
Performance Measures.
2. Be paid on a monthly basis and in accordance with services performed under this
Contract.
3. In Fiscal Year 2023, the CCP-COV Program activities shall end on March 14,
2023. Grantee shall submit the final invoice for this Program by April 15, 2023.
H. The Contract Fiscal Year allocation information is as follows:
1. System Agency Share total reimbursements will not exceed $1,821,218.00 for the
period from September 1, 2021 through August 31, 2024, as follows:
i.Fiscal Year 2022, September 1, 2021 through August 31, 2022 -
$708,791.00;
HHSC Contract # HHS001081400001
Pagel of 3
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT B
FISCAL REQUIREMENTS
ii.Fiscal Year 2023, September 1, 2022 through August 31, 2023 -
$612,427.00;
iii.Fiscal Year 2024, September 1, 2023 through August 31, 2024 -
$500,000.00.
2. For each Fiscal Year noted in Section H, (1) (i-iii), Grantee shall provide a five
percent (5%) match requirement, as follows:
i. Fiscal Year 2022, September 1, 2021 through August 31, 2022:
$25,000.00;
ii. Fiscal Year 2023, September 1, 2022 through August 31, 2023:
$25,000.00;
iii. Fiscal Year 2024, September 1, 2023 through August 31, 2024:
$25,000.00.
3. The total amount of this Contract, including applicable match will not exceed
$1,896,218.00 as documented below:
i.Fiscal Year 2022, September 1, 2021 through August 31, 2022 -
$733,791.00;
ii.Fiscal Year 2023, September 1, 2022 through August 31, 2023 -
$637,427.00;
iii.Fiscal Year 2024, September 1, 2023 through August 31, 2024 -
$525,000.00.
4. All Grantees awarded funding for a CCP Program are receiving Substance Abuse
Block Grant (SAPT) Funding for the COVID-19 activities referenced in
Attachment A-3, Community Coalitions Partnership Statement of Work. The
COVID-19 funding is included in the allocation information referenced in Section
H, 1 (i-iii); fiscal year allocations are as follows:
i.Fiscal Year 2022, September 1, 2021 through August 31, 2022 -
$208,791.00;
ii.Fiscal Year 2023, September 1, 2022 through March 14, 2023 -
$112,427.00.
I. The Cost Reimbursement Budget information is as follows:
1. The Cost Reimbursement budget documents all approved and allowable
expenditures; Grantee shall only utilize the funding detailed in Attachment 13-1
for approved and allowable costs. If Grantee requests to utilize funds for an
expense not documented on the approved budget, Grantee shall notify, in
writing, the System Agency assigned contract manager and request approval
prior to utilizing the funds. System Agency shall provide written notification
regarding if the requested expense is approved.
2. If needed, Grantee may revise the Attachment B-1, Approved Cost
Reimbursement Budget, which documents the approved budget for each
allocated Program. The requirements for each allocated Program are as follows:
i.Grantee may transfer funds from the budgeted direct categories only; with
the exception of the Equipment Category. Grantee may transfer up to 10
percent of the allocated fiscal year Program amount without System Agency
HHSC Contract # HHS001081400001
Page 2 of 3
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT B
FISCAL REQUIREMENTS
approval. Budget revisions exceeding the ten percent requirement require
System Agency's written approval.
ii.Grantee may request revisions to the approved Cost Reimbursement
budgeted direct categories that exceed the 10 percent requirement stated in
Attachment B-1, Approved Categorical Budget, excluding `Equipment'
and/or `Indirect Cost' categories, by submitting a written request to the
assigned contract manager. This change is considered a minor
administrative change and does not require an amendment, in accordance
with Attachment F, HHSC Additional Provisions, Section 4.
Miscellaneous Provisions, item A. Minor Administrative Changes.
System Agency will provide written notification of the approval or denial
of the request. The budget revisions are not authorized, and funds cannot be
utilized until Grantee receives written approval.
iii. Grantee may request transferring funds between awarded Programs by
submitting a written request to the assigned Contract Manager. This change
is considered a minor administrative chance and does not reauire an
amendment, in accordance with Attachment F, HHSC Additional
Provisions, Section 4. Miscellaneous Provisions, item A. Minor
Administrative Changes. System Agency will provide written notification
of the approval or denial of the request. The budget revisions are not
authorized, and funds cannot be utilized until Grantee receives written
approval.
iv.Grantee may revise the Cost Reimbursement budget `Equipment' and/or
`Indirect Cost' categories, however a formal Amendment is required.
Grantee shall submit to the assigned contract manager a written request to
revise the budget, which includes a justification for the revisions. The
assigned Contract Manager shall provide written notification stating if the
requested revision is approved. If the revision is approved, the budget
revision is not authorized, and funds cannot be utilized until the
Amendment is executed and signed by both parties.
3. The budgeted indirect cost amount is provisional and subject to change. The
System Agency reserves the right to negotiate Grantee's indirect cost amount,
which may require Grantee to provide additional supporting documentation to the
assigned contract manager.
4. Grantee shall submit annual categorical budgets for Fiscal Years 2023-2024 on the
System Agency approved template in accordance to the deadline documented in
Attachment C, Deliverables and Performance Measures. System Agency will
provide written notification of the annual budget approval.
5. The approved fiscal year Categorical Budget for all awarded Program services is
referenced in Attachment B-1: Approved Categorical Budget.
HHSC Contract # IIHS001081400001
Page 3 of 3
DocuSign Envelope ID: 8AD24363.682A-4C87-8B1F-FE05D527850C
Attachment B-1
PREVENTION MASTER SUMMARY PAGE
Organization Name:
Contract Number:
Prevention Program(s) Contracted to Provide:
Region:
Fiscal Year:
Total Contract Value (System Agency+Match)
Date Submitted to HHSC:
Master Budget Roll -Up
City of Lubbock Health
HHS001081400001
CCP, CCP-COV, PRC
2021-2024
Budget Categories
System Agency Funds
Requested
Cash Match
Non System
A enc funds
Category Total
Personnel
$190,948.00
$0.00
$0.00
$190,948.00
Fringe Benefits
$91,655.00
$0.00
$0.00
$91,655.00
Travel
$61,175.00
$0.00
$0.00
$61,176.00
Equipment
$0.00
$0.00
$0.00
$0.00
Supplies
$101,655.00
$0.00
$0.00
$101,655.00
Contractual
$217,600.00
$0.00
$0.00
$217,600.00
Other
$45,758.00
$25,000.00
$0.00
$70,758.00
Total Direct Costs
$708,791.00
$25,000.00
$0.00
$733,791.00
Indirect Costs
$0.00
$0.00
$0.00
$0.00
Totals
$708,791.00
$25,000.00
$0.00
$733 791.00
DocuSign Envelope ID: 8AD24363-682AAC87-8B1F-FED5D527850C
CCP PROGRAM
Non-Svstem Aaencv Funds
Budget Categories
System Agency
Funds Requested
Cash Match
In -Kind
Category Total
Personnel
$ 85,721.00
$
$ 85,721.00
Fringe Benefits
$ 41,146.00
$
$ 41,146.00
Travel
$ 43,075.00
$
$ 43,075.00
Equipment
$ -
$
$
Supplies
$ 8,000.00
$
$ 8,000.00
Contractual
$ 46,800.00
$
$ 46,800.00
Other
$ 25,258.00
$ 12,500.00
$ -
$ 37,758.00
Total Direct Costs
$ 250,000.00
$ 12,500.00
$ -
$ 262,500.00
Indirect Costs
$ -
$ _
$
Totals
$ 250,000.00
$ 12,500.00
$
$ 262,500.00
DocuSign Envelope 10:8AD24363-682A-4C87-8B1F-FED50527850C
CCP-COV PROGRAM
Non-Svstem Agency Funds
Budget Categories
System Agency
Funds Requested
Cash Match
In -Kind
Category Total
Personnel
$ -
$ -
$
Fringe Benefits
$ -
$ -
$
Travel
$ -
$ -
$
Equipment
$ -
$ -
$
Supplies
$ 91,791.00
$ -
$ 91,791.00
Contractual
$ 100,000.00
$ -
$ 100,000.00
Other
$ 17,000.00
$ -
$ 17,000.00
Total Direct Costs
$ 208,791.00
$ -
$ -
$ 208,791.00
Indirect Costs
$ -
$ -
$
Totals
$ 208,791.00
$
$
$ 208,791.00
DocuSign Envelope ID: 8AD24363.682A-4C87-8B1F-FED5D527850C
PRC PROGRAM
Non-Svstem Aciencv Funds
Budget Categories
System Agency
Funds Requested
Cash Match
In -Kind
Category Total
Personnel
$ 105,227.00
$ -
$ 105,227.00
Fringe Benefits
$ 50,509.00
$ -
$ 50,509.00
Travel
$ 18,100.00
$ -
$ 18,100.00
Equipment
$ -
$ -
$
Supplies
$ 1,864.00
$
$ 1,864.00
Contractual
$ 70,800.00
$
$ 70,800.00
Other
$ 3,500.00
$ 12,500.00
$ -
$ 16,000.00
Total Direct Costs
$ 250,000.00
$ 12,500.00
$ -
$ 262,500.00
Indirect Costs
$ -
$ _
$
Totals
$ 250,000.00
$ 12,500.00
$ -
$ 262,500.00
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
Attachment C
Deliverables and Performance Measures
1. All deliverables for the Contract are listed in the below deliverable table; Grantee is required to submit all deliverablaes for the Attachment A, General
Statement of Work, Attachment B, Budget, and for all Prevention Programs (YP's, PRC, CCP) awarded in accordance with the Contract Signature Document.
2. Grantee shall ensure all required deliverables are submitted as follows:
a. The deliverables submitted in GlobalScape shall be named the deliverable name refemced in column "Report Name".
b. Reports are submitted by the due date in column "Due Date". Note: Deliverables due on the weekend and/or holiday are due the next business day.
c. Reports are submitted by the submission system documented in the column "submission system". All deliverables are submitted by one of the two
methods, GlobalScape, and/or CMBHS.
d. System Agency may request deliverables to be submitted through an alternate submission system.
3. Grantee is required to submit performance measures in CMBHS for all Prevention Programs awarded. Grantee shall ensure compliance to the following
requirements:
a. CCP, PRC and YP performance measures are submitted in CMBHS by the 15th of the current month. Grantee shall report the previous months activities.
b. Performance will be measured in part on the achievement of the key performance measures.
c. Guidance concering each performance measure can be found in the Program Guide, "Performance Measure Definitions and Guidance."
Requirement
Report Name
Due Date*
Submission System
Attach A, General
Program Staffing Form
Per fiscal year: September 15 and within 10
GlobalScape
Statement of Work
business days of a revision.
Attach A, General
CMBHS Security Attestation Form and
Per fiscal year: September 15'h & March 15'h
GlobalScape
Statement of Work
Listing of Authorized Users
FY23-24 Categorical Budget, as follows:
Attacment B, Budget
Cateogorical Budget
FY22: FY23 budget due June 1, 2022
GlobalScape
FY23: FY24 budget due June 1, 2023
Annually, on the following schedule:
Attach A, General
Implementation Plan
FY22 Implementatin Plan: September 30, 2021
GlobalScape
Statement of Work
FY23 Implementation Plan: by July 15'h, 2022
FY24 Implementation Plan: by Jul 15'h, 2023
Per fiscal year, quarterly report schedule:
Q 1 reporting period, due December 31 st
Attach A, General
Statement of Work
General Ledger (for each funded program)
Q2 reporting period, due March 31S`
GlobalScape
Q3 reporting period, due June 30th
4 reporting eriod, due September 30th
Page 1of5
Attachment C
Deliverables and Performance Measures
1. All deliverables for the Contract are listed in the below deliverable table. Grantee is required to submit all deliverablaes for the Attachment A, General
Statement of Work, Attachment B, Budget, and for all Prevention Programs (YP's, PRC, CCP) awarded in accordance with the Contract Signature Document.
2. Grantee shall ensure all required deliverables are submitted as follows:
a. The deliverables submitted in GlobalScape shall be named the deliverable name refernced in column "Report Name".
b. Reports are submitted by the due date in column "Due Date". Note: Deliverables due on the weekend and/or holiday are due the next business day.
c. Reports are submitted by the submission system documented in the column "submission system". All deliverables are submitted by one of the two
methods, GlobalScape, and/or CMBHS.
d. System Agency may request deliverables to be submitted through an alternate submission system.
3. Grantee is required to submit performance measures in CMBHS for all Prevention Programs awarded. Grantee shall ensure compliance to the following
requirements:
a. CCP, PRC and YP performance measures are submitted in CMBHS by the 15th of the current month. Grantee shall report the previous months activities.
b. Performance will be measured in part on the achievement of the key performance measures.
c. Guidance concering each performance measure can be found in the Program Guide, "Performance Measure Definitions and Guidance."
Requirement
Report Name
Due Date*
Submission System
Per fiscal year, quarterly report schedule for
Financial Status Report (FSR) report:
Attach A. General
Financial Status Reports (FSRs) (for each
QI reporting period, due December 31st
Statement of Work
funded program)
CMBHS
Q2 reporting period, due March 31S`
Q3 reporting period, due June 30th
Q4 reporting period, due September 30th
NOTE. The Final FSR is due 45 days after
contract end date.
Attach A. General
Performance Measures (for each funded
Report previous month's activities due on the
CMBHS or other system designated
Statement of Work
program)
15th of the current month.
by System Agency
Attach A, General
Invoices (for each funded program)
Invoices for the previous month's activities on
CMBHS
Statement of Work
the 15 of the current month.
Attach A, General
Closeout documents (for each funded
Final closeout documents due October 15th each
Ifiscalyear
Statement of Work
program)
GlobalScape
Attachment A-1, YP SOW Reporting Requirements
Attach A- I, YP Statement
Curriculum Outcome Measures Reports
Due within 20 calendar days after the curriculum
cycle has been completed. Submit each
CMBHS or other system designated
of Work
individual curriculum cycle and the associated
by System Agency
Attachment A-2, CCP SOW Reporting Requirements
Attach A-2. CCP
-7
Statement of Work
Community Needs Assessment (CNA)
FY22: October 30th
GlobalScape
Page 2 of 5
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
Attachment C
Deliverables and Performance Measures
1. All deliverables for the Contract are listed in the below deliverable table. Grantee is required to submit all deliverablaes for the Attachment A, General
Statement of Work, Attachment B, Budget, and for all Prevention Programs (YP's, PRC, CCP) awarded in accordance with the Contract Signature Document.
2. Grantee shall ensure all required deliverables are submitted as follows:
a. The deliverables submitted in GlobalScape shall be named the deliverable name refemced in column "Report Name".
b. Reports are submitted by the due date in column "Due Date". Note: Deliverables due on the weekend and/or holiday are due the next business day.
c. Reports are submitted by the submission system documented in the column "submission system". All deliverables are submitted by one of the two
methods, GlobalScape, and/or CMBHS.
d. System Agency may request deliverables to be submitted through an alternate submission system.
3. Grantee is required to submit performance measures in CMBHS for all Prevention Programs awarded. Grantee shall ensure compliance to the following
requirements:
a. CCP, PRC and YP performance measures are submitted in CMBHS by the 15th of the current month. Grantee shall report the previous months activities.
b. Performance will be measured in part on the achievement of the key performance measures.
c. Guidance concering each performance measure can be found in the Program Guide, "Performance Measure Definitions and Guidance."
Requirement
Report Name
Due Date*
Submission System
Attach A-2, CCP
Logic Model
FY22: November 30th
GlobalScape
Statement of Work
Attach A-2, CCP
Five -Year Strategic Plan
FY22: December 30th
GlobalScape
Statement of Work
Attach A-2, CCP
Initial Evaluation Plan
FY22: January 30th
GlobalScape
Statement of Work
'
GlobalScape
Q 1 reporting period, due December 15th
Attach A-2, CCP
Quarterly Reports
Q2 reporting period, due March 15th
Statement of Work
Q3 reporting period, due June 15th
4 reporting riod, due September 15th
Attachment A-3, PRC
SOW Reporting Requirements
Attach A-3, PRC
Mid -year Report
Each Fiscal Year, due March 31st
GlobalScape
Statement of Work
Attach A-3, PRC
Regional Needs Assessment
Each Fiscal Year, due July 30th
GlobalScape
Statement of Work
Attach A-3, PRC
Post Regional Needs Assessment to website
Each Fiscal Year, August 31 st
GlobalScape
Statement of Work
Note: Deliverables due on the weekend and/or holiday are due date is the next business day.
Page 3 of 5
Attachment C
Deliverables and Performance Measures
CCP 1
CCP 2
CCP 3
CCP 4
CCP 5
CCP 6
Lubbock HEARD Coalition
Total CCP FTEs:
2
City of Lubbock Health Department
1
See Program Attachment A2
3D. Number of media awareness activities (not including social
media) focused on prevention and behavorial health promotion,
3E. Number of social media messages focused on prevention an
behavorial health promotion messaging and the statewide media
campaign.
4A. Number of community -based processes focused on
prevention and behavorial health promotion.
4B. Number of adults attending community -based processes
focused on prevention and behavorial health promotion.
4C. Number of youth attending community -based processes
focused on prevention and behavorial health promotion.
5A. Number of changed policies and social norms related to
prevention and behavorial health promotion.
S1. Number of projects that change physical environment, build
Sept -Nov
Dec -Feb
Mar -May
Jun -Aug
Annual
1
1
1
0
3
36
36
36
36
144
68
68
68
68
272
400
400
400
400
1600
80
80
80
80
320
0
0
0
2
2
community resilience, or improve systemic processes to enhance 0 0 0 2 2
behavioral health and wellness.
S2. Number of youth attending stress reduction/trauma healing 60
activities.
0 15 15 30
S3. Number of adults attending stress reduction/trauma healing 240
activities. 0 60 60 120
Organization Name:
Region:
Approved
PRC ;� PRC Name jn- Performance Measures
*Note: Due to rounding, the sum of quarterly targets in the formula projections may be slightly higher or lower than the annual targets. HHSC will adjust the quarterly targets
to equal the annual targets in the final contract measures.
**Compliance check measures are TBD as they are calculated based on the number of licensed tobacco retailers in each region:
1) In PRC regions with fewer than 2,400 licensed tobacco retailers, Grantee must visit a minimum of 25% of active retailers (unduplicated) each quarter. Grantee will visit
100% of the active tobacco retailers throughout the term of the fiscal year.
2) In PRC regions with 2,400 to 4,000 licensed tobacco retailers, Grantee must visit 2,000 of the active tobacco retailers in the region, throughout the term of the fiscal year.
Grantee will visit a minimum of 25% of the active tobacco retailers (unduplicated) each quarter.
3) In PRC regions with more than 4,000 licensed tobacco retailers, Grantee will visit a minimum of 210 (unduplicated) tobacco retailers per month throughout the term of this
Contract.
DocuSign Envelope ID. 8AD24363-682A-4C87-8B1F-FED5D527850C
HHSC Uniform Terms and Conditions Version 2.16.1
Published and Effective: March 26, 2019
Responsible Office: Chief Counsel
TEXAS
Health and Human Services
Health and Human Services Commission
HHSC Uniform Terms and Conditions - Grant
Version 2.16.1
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
TABLE OF CONTENTS
ARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS .................................... 4
1.1
Definitions......................................................................................................................
4
1.2
Interpretive Provisions....................................................................................................
6
ARTICLE II. PAYMENT METHODS AND RESTRICTIONS ..............................................
6
2.1
Payment Methods...........................................................................................................
6
2.2
Final Billing Submission................................................................................................
7
2.3
Financial Status Reports(FSRs).....................................................................................
7
2.4
Use of Funds...................................................................................................................
7
2.5
Use for Match Prohibited...............................................................................................
7
2.6
Program Income.............................................................................................................
7
2.7
Nonsupplanting...............................................................................................................8
2.8
Allowable Costs..............................................................................................................
8
2.9
Indirect Cost Rates.........................................................................................................
8
ARTICLE III. STATE AND FEDERAL FUNDING................................................................
8
3.1
Funding...........................................................................................................................8
3.2
No Debt Against the State.. : ...........................................................................................
8
3.3
Debt and Delinquencies..................................................................................................
8
3.4
Recapture of Funds.........................................................................................................
8
ARTICLE IV. ALLOWABLE COSTS AND AUDIT REQUIREMENTS ............................. 9
4.1
Allowable Costs............................................................................................................. 9
4.2
Audits and Financial Statements..................................................................................
10
4.3
Submission of Audits and Financial Statements..........................................................
11
ARTICLE V. AFFIRMATIONS, ASSURANCES AND CERTIFICATIONS .....................
11
5.1
General Affirmations....................................................................................................
11
5.2
Federal Assurances.......................................................................................................
11
5.3
Federal Certifications...................................................................................................
11
ARTICLE
VI. INTELLECTUAL PROPERTY......................................................................
11
6.1
Ownership of Work Product........................................................................................
11
6.2
Grantees Pre-existing Works.......................................................................................
12
6.3
Agreements with Employees and Subcontractors.......................................................
12
6.4
Delivery Upon Termination or Expiration..................................................................
12
6.5
Survival........................................................................................................................12
HHSC Grantce Uniform Terms and Conditions
Page 2 of 21
v. 2.16.1
Effective 0126 2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ARTICLE VII. RECORDS, AUDIT, AND DISCLOSURE ...................................................
13
7.1
Books and Records...................................................................................•----...............
13
7.2
Access to Records, Books, and Documents.................................................................
13
7.3
Response/Compliance with Audit or Inspection Findings ...........................................
13
7.4
SAO Audit....................................................................................................................
14
7.5
Confidentiality..............................................................................................................14
ARTICLE VIII. CONTRACT MANAGEMENT AND EARLY TERMINATION ............
14
8.1
Contract Remedies........................................................................................................
14
8.2
Termination for Convenience.......................................................................................
14
8.3
Termination for Cause..................................................................................................
14
ARTICLE IX. MISCELLANEOUS PROVISIONS................................................................
15
9.1
Amendment..................................................................................................................
15
9.2
Insurance......................................................................................................................
15
9.3
Legal Obligations.........................................................................................................
15
9.4
Permitting and Licensure..............................................................................................
16
9.5
Indemnity......................................................................................................................
16
9.6
Assignments.................................................................................................................
16
9.7
Independent Contractor................................................................................................
17
9.8
Technical Guidance Letters..........................................................................................
17
9.9
Dispute Resolution.......................................................................................................
17
9.10
Governing Law and Venue...........................................................................................
17
9.11
Severability...................................................................................................................17
9.12
Survivability.................................................................................................................18
9.13
Force Majeure...............................................................................................................
18
9.14
No Waiver of Provisions..............................................................................................
18
9.15
Publicity........................................................................................................................18
9.16
Prohibition on Non -compete Restrictions....................................................................
19
9.17
No Waiver of Sovereign Immunity..............................................................................
19
9.18
Entire Contract and Modification.................................................................................
19
9.19
Counterparts.................................................................................................................
19
9.20
Proper Authority...........................................................................................................
19
9.21
E-Verify Program..........................................................................................................
19
9.22
Civil Rights...................................................................................................................
19
9.23
System Agency Data.....................................................................................................
21
HHSC Grantcc Uniform Terra; and Conditions
Page 3 of 21
v. 2.16.1
Effective 03 26:2019
DocuSign Envelope ID: 8AD24363-682A4C87-8B1F-FED5D527850C
ARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS
1.1 DEFINITIONS
As used in this Contract, unless the context clearly indicates otherwise, the following terms
and conditions have the meanings assigned below:
"Amendment" means a written agreement, signed by the Parties, which documents changes
to the Contract other than those permitted by Work Orders or Technical Guidance Letters.
"Attachment" means documents, terms, conditions, or information added to this Contract
following the Signature Document or included by reference, and made a part of this
Contract.
"Contract" means the Signature Document, these Uniform Terms and Conditions, along with
any Attachments, and any Amendments, or Technical Guidance Letters that may be issued
by the System Agency, to be incorporated by reference for all purposes.
"Deliverable" means the work product(s), including all reports and project documentation,
required to be submitted by Grantee to the System Agency.
"Effective Date" means the date agreed to by the Parties as the date on which the Contract
takes effect.
"Federal Fiscal Year" means the period beginning October 1 and ending September 30 each
year, which is the annual accounting period for the United States government.
"GAAP" means Generally Accepted Accounting Principles.
"GASB" means the Governmental Accounting Standards Board.
"Grantee" means the Party receiving funds under this Contract. May also be referred to as
"Contractor" in certain attachments.
"Health and Human Services Commission" or "HHSC" means the administrative agency
established under Chapter 531, Texas Government Code, or its designee.
"HUB" means Historically Underutilized Business, as defined by Chapter 2161 of the
Texas Government Code.
"Intellectual Property Rights" means the worldwide proprietary rights or interests, including
patent, copyright, trade secret, and trademark rights, as such right may be evidenced by or
embodied in:
i. any idea, design, concept, personality right, method, process, technique, apparatus,
invention, discovery, or improvement;
ii. any work of authorship, including any compilation, computer code, website or web
page design, literary work, pictorial work, or graphic work;
iii. any trademark, service mark, trade dress, trade name, branding, or other indicia of
source or origin;
iv. domain name registrations; and
v. any other proprietary or similar rights. The Intellectual Property Rights of a Party
include all worldwide proprietary rights or interests that the Party may have acquired
by assignment, by exclusive license, or by license with the right to grant sublicenses.
HHSC Grantee Unitorm Terms and Condition,
Page 4 of 21
v. 2.16.1
Effective 0326i2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8B 1 F-FED5D527850C
"Mentor Protege" means the Comptroller of Public Accounts' leadership program found
at: http://www.window.state.tx.us/procurement/prog/hub/mentoiprotege./.
"Parties" means the System Agency and Grantee, collectively.
"Party" means either the System Agency or Grantee, individually.
"Program" means the statutorily authorized activities of the System Agency under which
this Contract has been awarded.
"Project" means specific activities of the Grantee that are supported by funds provided under
this Contract.
"Public Infonnation Act" or "PIA" means Chapter 552 of the Texas Government Code.
"Signature Document" means the document executed by both Parties that specifically sets
forth all of the documents that constitute the Contract.
"Solicitation" or "Request for Applications I RFAT means the document (including all
amendments and attachments) issued by the System Agency under which applications for
Program funds were requested, which is incorporated by reference for all purposes in its
entirety.
"Solicitation Response" or "Application" means Grantee's full and complete response
(including any attachments and addenda) to the Solicitation, which is incorporated by
reference for all purposes in its entirety.
"State Fiscal Year" means the period beginning September 1 and ending August 31 each
year, which is the annual accounting period for the State of Texas.
"State of Texas Textravel" means Texas Administrative Code, Title 34, Part 1, Chapter 5,
Subchapter C, Section 5.22, relative to travel reimbursements under this Contract, if any.
"Statement of Work" means the description of activities performed in completing the Project,
as specified in the Contract and as may be amended.
"System Agency" means HHSC or any of the agencies of the State of Texas that are overseen
by HHSC under authority granted under State law and the officers, employees, authorized
representatives and designees of those agencies. These agencies include: HHSC and the
Department of State Health Services.
"Technical Guidance Letter" or "TGL" means an instruction, clarification, or interpretation
of the requirements of the Contract, issued by the System Agency to the Grantee.
"Work Product" means any and all works, including work papers, notes, materials,
approaches, designs, specifications, systems, innovations, improvements, inventions,
software, programs, source code, documentation, training materials, audio or audiovisual
recordings, methodologies, concepts, studies, reports, whether finished or unfinished, and
whether or not included in the deliverables, that are developed, produced, generated or
provided by Grantee in connection with Grantee's performance of its duties under the
Contract or through use of any funding provided under this Contract.
"Uniform Grant Management Standards" or "UGMS" means uniform grant and contract
administration procedures, developed under the authority of Chapter 783 of the Texas
HHSC Grantee Uniform Term; and Condition
Page 5 of 21
v. 2.16.1
Effective 03/26/2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8BIF-FED5D527850C
Government Code, to promote the efficient use of public funds in local government and in
programs requiring cooperation among local, state, and federal agencies.
1.2 INTERPRETIVE PROVISIONS
A. The meanings of defined terms include the singular and plural forms.
B. The words "hereof," "herein," "hereunder," and similar words refer to this Contract
as a whole and not to any particular provision, section, Attachment, or schedule of this
Contract unless otherwise specified.
C. The term "including" is not limiting and means "including without limitation" and,
unless otherwise expressly provided in this Contract, (i) references to contracts (including
this Contract) and other contractual instruments shall be deemed to include all
subsequent Amendments and other modifications, but only to the extent that such
Amendments and other modifications are not prohibited by the terms of this Contract,
and (ii) references to any statute or regulation are to be construed as including all
statutory and regulatory provisions consolidating, amending, replacing, supplementing,
or interpreting the statute or regulation.
D. Any references to "sections," "appendices," or "attachments" are references to sections,
appendices, or attachments of the Contract.
E. Any references to agreements, contracts, statutes, or administrative rules or regulations
in the Contract are references to these documents as amended, modified, or
supplemented from time to time during the term of the Contract.
F. The captions and headings of this Contract are for convenience of reference only and do
not affect the interpretation of this Contract.
G. All Attachments, including those incorporated by reference, and any Amendments are
considered part of the terms of this Contract.
H. This Contract may use several different limitations, regulations, or policies to regulate
the same or similar matters. All such limitations, regulations, and policies are
cumulative and each will be performed in accordance with its terms.
I. Unless otherwise expressly provided, reference to any action of the System Agency or
by the System Agency by way of consent, approval, or waiver will be deemed
modified by the phrase "in its sole discretion."
J. Time is of the essence in this Contract.
ARTICLE II. PAYMENT METHODS AND RESTRICTIONS
2.1 PAYMENT METHODS
A. Except as otherwise provided by this Contract, the payment method will be one or more
of the following:
i. Cost Reimbursement. This payment method is based on an approved budget and
submission of a request for reimbursement of expenses Grantee has incurred at the
time of the request;
ii. Unit rate/fee-for-service. This payment method is based on a fixed price or a specified
rate(s) or fee(s) for delivery of a specified unit(s) of service and acceptable
submission of all required documentation, forms and/or reports; or
iii. Advance payment. This payment method is based on disbursal of the minimum
necessary funds to carry out the Program or Project where the Grantee has
1IIISC GIa111C011ni1iinn loon, and (luxlnion
6 o f 7_ I
v. 2.16.1
Effective 03126i2019
DocuSign Envelope ID: 8AD24363-682A4C87-8B1F-FED5D527850C
implemented appropriate safeguards. This payment method will only be utilized in
accordance with governing law, state and federal regulations, and at the sole
discretion of the System Agency.
B. Grantee shall bill the System Agency in accordance with the Contract. Unless otherwise
specified in the Contract, Grantee shall submit requests for reimbursement or payment
monthly by the last business day of the month following the month in which expenses
were incurred or services provided. Grantee shall maintain all documentation that
substantiates invoices and make the documentation available to the System Agency upon
request.
2.2 FINAL BILLING SUBMISSION
Unless otherwise provided by the System Agency, Grantee shall submit a reimbursement
or payment request as a final close-out invoice not later than forty-five (45) calendar days
following the end of the term of the Contract. Reimbursement or payment requests received
after the deadline may not be paid.
2.3 FINANCIAL STATUS REPORTS (FSRS)
Except as otherwise provided, for contracts with categorical budgets, Grantee shall submit
quarterly FSRs to System Agency by the last business day of the month following the end
of each quarter for System Agency review and financial assessment. Grantee shall submit
the final FSR no later than forty-five (45) calendar days following the end of the applicable
term.
2.4 USE OF FUNDS
Grantee shall expend funds under this Contract only for approved services and for reasonable
and allowable expenses directly related to those services.
2.5 USE FOR MATCH PROHIBITED
Grantee shall not use funds provided under this Contract for matching purposes in securing
other funding without the written approval of the System Agency.
2.6 PROGRAM INCOME
Income directly generated from funds provided under this Contract or earned only as a result
of such funds is Program Income. Unless otherwise required under the Program, Grantee
shall use Program Income, as provided in UGMS Section III, Subpart C, .25(g)(2), to
further the Program, and Grantee shall spend the Program Income on the Project. Grantee
shall identify and report Program Income in accordance with the Contract, applicable law,
and any programmatic guidance. Grantee shall expend Program Income during the Contract
term, when earned, and may not carry Program Income forward to any succeeding term.
Grantee shall refund Program Income to the System Agency if the Program Income is not
expended in the term in which it is earned. The System Agency may base future funding
levels, in part, upon Grantee's proficiency in identifying, billing, collecting, and reporting
Program Income, and in using Program Income for the purposes and under the conditions
specified in this Contract.
FIHSC Grantee Uniform Term; and Condition;
Page 7 of 21
v. 2.16.1
Effective 03/2612019
DocuSign Envelope ID: 8AD24363-682A4C87-8B1F-FED5D527850C
2.7 NONSUPPLANTING
Grant funds may be used to supplement existing, new or corresponding programming and
related activities. Grant funds may not be used to supplant (replace) existing funds in place
to support current programs and related activities.
2.8 ALLOWABLE COSTS
Allowable Costs are restricted to costs that comply with the Texas Uniform Grant
Management Standards (UGMS) and applicable state and federal rules and law. The Parties
agree that all the requirements of the UGMS apply to this Contract, including the criteria for
Allowable Costs. Additional federal requirements apply if this Contract is funded, in whole
or in part, with federal funds.
2.9 INDIRECT COST RATES
The System Agency may acknowledge an indirect cost rate for Grantees that is utilized for
all applicable contracts. Grantee will provide the necessary financial documents to determine
the indirect cost rate in accordance with the Uniform Grant Guidance (UGG) and Uniform
Grant Management Standards (UGMS).
ARTICLE III. STATE AND FEDERAL FUNDING
3.1 FUNDING
This Contract is subject to termination or cancellation, without penalty to System Agency,
either in whole or in part, subject to the availability of state funds. System Agency is a state
agency whose authority and appropriations are subject to actions of the Texas Legislature. If
System Agency becomes subject to a legislative change, revocation of statutory authority, or
lack of appropriated funds that would render either System Agency's or Grantee's delivery
or performance under the Contract impossible or unnecessary, the Contract will be
terminated or cancelled and be deemed null and void. In the event of a termination or
cancellation under this Section, System Agency will not be liable to Grantee for any
damages, that are caused or associated with such termination, or cancellation, and System
Agency will not be required to give prior notice.
3.2 NO DEBT AGAINST THE STATE
This Contract will not be construed as creating any debt by or on behalf of the State of Texas.
3.3 DEBT AND DELINQUENCIES
Grantee agrees that any payments due under the Contract shall be directly applied towards
eliminating any debt or delinquency it has to the State of Texas including, but not limited to,
delinquent taxes, delinquent student loan payments, and delinquent child support.
3.4 RECAPTURE OF FUNDS
A. At its sole discretion, the System Agency may i) withhold all or part of any payments to
Grantee to offset overpayments, unallowable or ineligible costs made to the Grantee, or
if any required financial status report(s) is not submitted by the due date(s), or ii) require
Grantee to promptly refund or credit - within thirty (30) calendar days of written notice -
,
v. 2.16.1
Effective 03:2612019
DocuSign Envelope ID: 8AD24363-682A-4C87-861 F-FED5D527850C
any funds erroneously paid by System Agency which are not expressly authorized under
the Contract.
B. "Overpayments" as used in this Section include payments (i) made by the System
Agency that exceed the maximum allowable rates; (ii) that are not allowed under applicable
laws, rules, or regulations; or (iii) that are otherwise inconsistent with this Contract,
including any unapproved expenditures. Grantee understands and agrees that it will be
liable to the System Agency for any costs disallowed pursuant to financial and
compliance audit(s) of funds received under this Contract. Grantee further understands
and agrees that reimbursement of such disallowed costs shall be paid by Grantee from
funds which were not provided or otherwise made available to Grantee under this
Contract.
ARTICLE IV. ALLOWABLE COSTS AND AUDIT REQUIREMENTS
4.1 ALLOWABLE COSTS
A. System Agency will reimburse the allowable costs incurred in performing the Project that
are sufficiently documented. Grantee must have incurred a cost prior to claiming
reimbursement and within the applicable term to be eligible for reimbursement under
this Contract. At its sole discretion, the System Agency will determine whether costs
submitted by Grantee are allowable and eligible for reimbursement. The System Agency
may take repayment (recoup) from funds available under this Contract in amounts
necessary to fulfill Grantee's repayment obligations. Applicable cost principles, audit
requirements, and administrative requirements include, but are not limited to:
Applicable Entity
Applicable Cost
Audit
Administrative
Principles
Requirements
Requirements
State, Local, and
2 CFR Part 200 and
2 CFR
Part
200,
2 CFR Part 200 and
Tribal
UGMS
Subpart
F
and
UGMS
Governments
UGMS
Educational
2 CFR Part 200 and
2 CFR
Part
200,
2 CFR Part 200 and
Institutions
UGMS
Subpart
F
and
UGMS
UGMS
Non -Profit
2 CFR Part 200 and
2 CFR
Part
200,
2 CFR Part 200 and
Organizations
UGMS
Subpart
F
and
UGMS
UGMS
HHSC Crantce Uniform Term, and Conditions
Pa.-e 9 of 21
v. 2.16.1
Effective OM6 2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
For -profit
48 CFR Part 31,
2 CFR Part 200,
2 CFR Part 200 and
Organization
Contract Cost
Subpart F and
UGMS
other than a
Principles and
UGMS
hospital and an
Procedures, or
organization
Uniform cost
named in OMB
accounting
Circular A-122
standards that
(2 CFR Part,
comply with cost
230) as not
principles
subject to that
acceptable to the
circular.
federal or state
awarding agency
B. OMB Circulars will be applied with the modifications prescribed by UGMS with effect
given to whichever provision imposes the more stringent requirement in the event of a
conflict.
4.2 AUDITS AND FINANCIAL STATEMENTS
A. Audits
i. HHS Single Audit Unit will notify Grantee to complete the Single Audit
Determination Form. If Grantee fails to complete the form within thirty (30) calendar
days after receipt of notice, Grantee will be subject to the sanctions and remedies for
non-compliance with this Contract.
ii. If Grantee, within Grantee's fiscal year, expends at least SEVEN HUNDRED FIFTY
THOUSAND DOLLARS ($750,000) in federal funds awarded, Grantee shall have a
single audit or program -specific audit in accordance with 2 CFR 200. The federal
threshold amount includes federal funds passed through by way of state agency
awards.
iii. If Grantee, within Grantee's fiscal year, expends at least SEVEN HUNDRED FIFTY
THOUSAND DOLLARS ($750,000) in state funds awarded, Grantee shall have a
single audit or program -specific audit in accordance with UGMS, State of Texas
Single Audit Circular. The audit must be conducted by an independent certified public
accountant and in accordance with 2 CFR 200, Government Auditing Standards, and
UGMS.
iv. For -profit Grantees whose expenditures meet or exceed the federal or state
expenditure thresholds stated above shall follow the guidelines in 2 CFR 200 or
UGMS, as applicable, for their program -specific audits.
v. Each Grantee that is required to obtain a single audit must competitively re -procure
single audit services once every six years. Grantee shall procure audit services in
compliance with this section, state procurement procedures, as well as with the
provisions of UGMS.
B. Financial Statements
Each Grantee that does not meet the expenditure threshold for a single audit or program -
specific audit, must provide financial statements.
HHSC Grantee Uniform Terms and Condition,
Page 10 of 21
v. 2.16.1
Effective 03 26.2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8BIF-FED5D527850C
4.3 SUBMISSION OF AUDITS AND FINANCIAL STATEMENTS
A. Audits
Due the earlier of 30 days after receipt of the independent certified public accountant's
report or nine months after the end of the fiscal year, Grantee shall submit electronically
one copy of the single audit or program -specific audit to the System Agency via:
i. HHS portal at: or,
https://hhspoi-tal.hlis.state.tx.us/heartwebextr/hhscSau
ii. Email to: single audit report CiAhsc.state.tx.us.
B. Financial Statements
Due no later than nine months after the Grantee's fiscal year end, Grantees which are not
required to submit an audit, shall submit electronically financial statements via:
i. HHS portal at:
https://hhsportal.lihs.state.tx.us/heartwebextr/hhscSau; or,
ii. Email to: single_audit_report@hhsc.state.tx.us.
ARTICLE V. AFFIRMATIONS, ASSURANCES AND CERTIFICATIONS
5.1 GENERAL AFFIRMATIONS
Grantee certifies that, to the extent General Affirmations are incorporated into the Contract
under the Signature Document, the Grantee has reviewed the General Affirmations and that
Grantee is in compliance with all requirements.
5.2 FEDERAL ASSURANCES
Grantee further certifies that, to the extent Federal Assurances are incorporated into the
Contract under the Signature Document, the Grantee has reviewed the Federal Assurances
and that Grantee is in compliance with all requirements.
5.3 FEDERAL CERTIFICATIONS
Grantee further certifies that, to the extent Federal Certifications are incorporated into the
Contract under the Signature Document, the Grantee has reviewed the Federal
Certifications and that Grantee is in compliance with all requirements. In addition, Grantee
certifies that it is in compliance with all applicable federal laws, rules, and regulations, as they
may pertain to this Contract.
ARTICLE VI. INTELLECTUAL PROPERTY
6.1 OWNERSHIP OF WORK PRODUCT
All right, title, and interest in the Work Product, including all Intellectual Property Rights
therein, is exclusively owned by System Agency. Grantee and Grantee's employees will have
no rights in or ownership of the Work Product or any other property of System Agency. Any
and all Work Product that is copyrightable under United States copyright law is deemed to
be "work made for hire" owned by System Agency, as provided by Title 17 of the United
States Code. To the extent that Work Product does not qualify as a "work made for hire"
under applicable federal law, Grantee hereby irrevocably assigns and transfers to System
Agency, its successors and assigns, the entire right, title, and interest in and to the Work
Product, including any and all Intellectual Property Rights embodied therein or associated
HHSC Grantee Lnitbrm Terms and Condition;
Pagc I I of 21
v. 2.16.1
Effective 03/26/2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
therewith, and in and to all works based upon, derived from, or incorporating the Work
Product, and in and to all income, royalties, damages, claims and payments now or hereafter
due or payable with respect thereto, and in and to all causes of action, either in law or in
equity for past, present or future infringement based on the copyrights, and in and to all rights
corresponding to the foregoing. Grantee agrees to execute all papers and to perform such
other property rights as System Agency may deem necessary to secure for System Agency
or its designee the rights herein assigned. In the event that Grantee has any rights in and to
the Work Product that cannot be assigned to System Agency, Grantee hereby grants to
System Agency an exclusive, worldwide, royalty -free, transferable, irrevocable, and
perpetual license, with the right to sublicense, to reproduce, distribute, modify, create
derivative works of, publicly perform and publicly display, make, have made, use, sell and
offer for sale the Work Product and any products developed by practicing such rights.
6.2 GRANTEE'S PRE-EXISTING WORKS
To the extent that Grantee incorporates into the Work Product any works of Grantee that
were created by Grantee or that Grantee acquired rights in prior to the Effective Date of this
Contract ("Incorporated Pre-existing Works"), Grantee retains ownership of such
Incorporated Pre-existing Works, and Grantee hereby grants to System Agency an
irrevocable, perpetual, non-exclusive, royalty -free, transferable, worldwide right and license,
with the right to sublicense, to use, modify, copy, create derivative works of, publish,
publicly perform and display, sell, offer to sell, make and have made, the Incorporated Pre-
existing Works, in any medium, with or without the associated Work Product. Grantee
represents, warrants, and covenants to System Agency that Grantee has all necessary right
and authority to grant the foregoing license in the Incorporated Pre-existing Works to System
Agency.
6.3 AGREEMENTS WITH EMPLOYEES AND SUBCONTRACTORS
Grantee shall have written, binding agreements with its employees and subcontractors that
include provisions sufficient to give effect to and enable Grantee's compliance with
Grantee's obligations under this Article VI.
6.4 DELIVERY UPON TERMINATION OR EXPIRATION
No later than the first calendar day after the termination or expiration of the Contract or upon
System Agency's request, Grantee shall deliver to System Agency all completed, or partially
completed, Work Product, including any Incorporated Pre-existing Works, and any and all
versions thereof. Grantee's failure to timely deliver such Work Product is a material breach
of the Contract. Grantee will not retain any copies of the Work Product or any documentation
or other products or results of Grantee's activities under the Contract without the prior written
consent of System Agency.
6.5 SURVIVAL
The provisions and obligations of this Article VI survive any termination or expiration of
the Contract.
HHSC Grantee Uniform Terms and Conditions
Page 12 of21
v. 2.16.1
Effective 01262019
DocuSign Envelope ID: 8AD24363-682A-4C87-8BIF-FED5D527850C
ARTICLE VII. RECORDS, AUDIT, AND DISCLOSURE
7.1 BOOKS AND RECORDS
Grantee shall keep and maintain under GAAP or GASB, as applicable, full, true, and
complete records necessary to fully disclose to the System Agency, the Texas State
Auditor's Office, the United States Government, and their authorized representatives
sufficient information to determine compliance with the terms and conditions of this Contract
and all state and federal rules, regulations, and statutes. Unless otherwise specified in this
Contract, Grantee shall maintain legible copies of this Contract and all related documents
for a minimum of seven (7) years after the termination of the Contract period or seven (7)
years after the completion of any litigation or dispute involving the Contract, whichever is
later.
7.2 ACCESS TO RECORDS, BOOKS, AND DOCUMENTS
In addition to any right of access arising by operation of law, Grantee and any of
Grantee's affiliate or subsidiary organizations, or Subcontractors shall permit the System
Agency or any of its duly authorized representatives, as well as duly authorized federal,
state or local authorities, unrestricted access to and the right to examine any site where
business is conducted or services are performed, and all records, which includes but is not
limited to financial, client and patient records, books, papers or documents related to this
Contract. If the Contract includes federal funds, federal agencies that shall have a right
of access to records as described in this section include: the federal agency providing the
funds, the Comptroller General of the United States, the General Accounting Office, the
Office of the Inspector General, and any of their authorized representatives. In addition,
agencies of the State of Texas that shall have a right of access to records as described in
this section include: the System Agency, HHSC, HHSC's contracted examiners, the State
Auditor's Office, the Office of the Texas Attorney General, and any successor agencies.
Each of these entities may be a duly authorized authority. If deemed necessary by the System
Agency or any duly authorized authority, for the purpose of investigation or hearing,
Grantee shall produce original documents related to this Contract. The System Agency and
any duly authorized authority shall have the right to audit billings both before and after
payment, and all documentation that substantiates the billings. Grantee shall include this
provision concerning the right of access to, and examination of, sites and information
related to this Contract in any Subcontract it awards.
7.3 RESPONSE/COMPLIANCE WITH AUDIT OR INSPECTION FINDINGS
A. Grantee must act to ensure its and its Subcontractors' compliance with all corrections
necessary to address any finding of noncompliance with any law, regulation, audit
requirement, or generally accepted accounting principle, or any other deficiency
identified in any audit, review, or inspection of the Contract and the services and
Deliverables provided. Any such correction will be at Grantee's or its Subcontractor's
sole expense. Whether Grantee's action corrects the noncompliance shall be solely the
decision of the System Agency.
B. As part of the services, Grantee must provide to HHSC upon request a copy of those
portions of Grantee's and its Subcontractors' internal audit reports relating to the services
and Deliverables provided to the State under the Contract.
HHSC Grantee Uniform Term, and COIXIMOn,
Page 13 of 21
v. 2.16.1
Effective 03:26 2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
7.4 SAO AUDIT
A. The state auditor may conduct an audit or investigation of any entity receiving funds from
the state directly under the Contract or indirectly through a subcontract under the
Contract. The acceptance of funds directly under the Contract or indirectly through a
subcontract under the Contract acts as acceptance of the authority of the state auditor,
under the direction of the legislative audit committee, to conduct an audit or investigation
in connection with those funds. Under the direction of the legislative audit committee, an
entity that is the subject of an audit or investigation by the state auditor must provide the
state auditor with access to any information the state auditor considers relevant to the
investigation or audit.
B. Grantee shall comply with any rules and procedures of the state auditor in the
implementation and enforcement of Section 2262.154 of the Texas Government Code.
7.5 CONFIDENTIALITY
Grantee shall maintain as confidential, and shall not disclose to third parties without System
Agency's prior written consent, any System Agency information including but not limited to
System Agency's business activities, practices, systems, conditions and services. This
section will survive termination or expiration of this Contract.
ARTICLE VIII. CONTRACT REMEDIES AND EARLY TERMINATION
8.1 CONTRACT REMEDIES
To ensure Grantee's full performance of the Contract and compliance with applicable
law, the System Agency reserves the right to hold Grantee accountable for breach of contract
or substandard performance and may take remedial or corrective actions, including, but not
limited to:
i. suspending all or part of the Contract;
ii. requiring the Grantee to take specific actions in order to remain in compliance with
the Contract;
iii. recouping payments made by the System Agency to the Grantee found to be in error;
iv. suspending, limiting, or placing conditions on the Grantee's continued performance
of the Project;
v. imposing any other remedies, sanctions or penalties authorized under this Contract or
permitted by federal or state statute, law, regulation or rule.
8.2 TERMINATION FOR CONVENIENCE
The System Agency may terminate the Contract at any time when, in its sole discretion,
the System Agency determines that termination is in the best interests of the State of
Texas. The termination will be effective on the date specified in HHSC's notice of
termination. The System Agency's right to terminate the Contract for convenience is
cumulative of all rights and remedies which exist now or in the future.
8.3 TERMINATION FOR CAUSE
Except as otherwise provided by the U.S. Bankruptcy Code, or any successor law, the
System Agency may terminate the Contract, in whole or in part, upon either of the following
conditions:
v. 2.16.1
Effective 03!26'2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8BIF-FED5D527850C
i. Material Breach
The System Agency will have the right to terminate the Contract in whole or
in part if the System Agency determines, in its sole discretion, that Grantee has
materially breached the Contract or has failed to adhere to any laws, ordinances,
rules, regulations or orders of any public authority having jurisdiction and such
violation prevents or substantially impairs perfonnance of Grantee's duties under the
Contract. Grantee's misrepresentation in any aspect of Grantee's Solicitation
Response, if any, or Grantee's addition to the Excluded Parties List System (EPLS)
will also constitute a material breach of the Contract.
ii. Failure to Maintain Financial Viability
The System Agency may terminate the Contract if, in its sole discretion, the System
Agency has a good faith belief that Grantee no longer maintains the financial
viability required to complete the services and Deliverables, or otherwise fully
perform its responsibilities under the Contract.
ARTICLE IX. MISCELLANEOUS PROVISIONS
9.1 AMENDMENT
The Contract may only be amended by an Amendment executed by both Parties.
9.2 INSURANCE
A. Unless otherwise specified in this Contract, Grantee shall acquire and maintain, for the
duration of this Contract, insurance coverage necessary to ensure proper fulfillment
of this Contract and potential liabilities thereunder with financially sound and reputable
insurers licensed by the Texas Department of Insurance, in the type and amount
customarily carried within the industry as determined by the System Agency. Grantee
shall provide evidence of insurance as required under this Contract, including a schedule
of coverage or underwriter's schedules establishing to the satisfaction of the System
Agency the nature and extent of coverage granted by each such policy, upon request
by the System Agency. In the event that any policy is determined by the System
Agency to be deficient to comply with the terms of this Contract, Grantee shall secure
such additional policies or coverage as the System Agency may reasonably request or
that are required by law or regulation. If coverage expires during the term of this Contract,
Grantee must produce renewal certificates for each type of coverage.
B. These and all other insurance requirements under the Contract apply to both Grantee and
its Subcontractors, if any. Grantee is responsible for ensuring its Subcontractors'
compliance with all requirements.
9.3 LEGAL OBLIGATIONS
Grantee shall comply with all applicable federal, state, and local laws, ordinances, and
regulations, including all federal and state accessibility laws relating to direct and indirect
use of information and communication technology. Grantee shall be deemed to have
knowledge of all applicable laws and regulations and be deemed to understand them.
v. 2.16.1
Effective 03.26i2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
9.4 PERMITTING AND LICENSURE
At Grantee's sole expense, Grantee shall procure and maintain for the duration of this
Contract any state, county, city, or federal license, authorization, insurance, waiver, permit,
qualification or certification required by statute, ordinance, law, or regulation to be held by
Grantee to provide the goods or services required by this Contract. Grantee shall be
responsible for payment of all taxes, assessments, fees, premiums, permits, and licenses
required by law. Grantee shall be responsible for payment of any such government
obligations not paid by its Subcontractors during performance of this Contract.
9.5 INDEMNITY
A. GRANTEE SHALL DEFEND, INDEMNIFY AND HOLD HARMLESS THE
STATE OF TEXAS AND SYSTEM AGENCY, AND/OR THEIR OFFICERS,
AGENTS, EMPLOYEES, REPRESENTATIVES, CONTRACTORS,
ASSIGNEES, AND/OR DESIGNEES FROM ANY AND ALL LIABILITY,
ACTIONS, CLAIMS, DEMANDS, OR SUITS, AND ALL RELATED COSTS,
ATTORNEY FEES, AND EXPENSES ARISING OUT OF OR RESULTING
FROM ANY ACTS OR OMISSIONS OF GRANTEE OR ITS AGENTS,
EMPLOYEES, SUBCONTRACTORS, ORDER FULFILLERS, OR SUPPLIERS
OF SUBCONTRACTORS IN THE EXECUTION OR PERFORMANCE OF THE
CONTRACT AND ANY PURCHASE ORDERS ISSUED UNDER THE
CONTRACT. THE DEFENSE SHALL BE COORDINATED BY GRANTEE
WITH THE OFFICE OF THE TEXAS ATTORNEY GENERAL WHEN TEXAS
STATE AGENCIES ARE NAMED DEFENDANTS IN ANY LAWSUIT AND
GRANTEE MAY NOT AGREE TO ANY SETTLEMENT WITHOUT FIRST
OBTAINING THE CONCURRENCE FROM THE OFFICE OF THE TEXAS
ATTORNEY GENERAL. GRANTEE AND SYSTEM AGENCY AGREE TO
FURNISH TIMELY WRITTEN NOTICE TO EACH OTHER OF ANY SUCH
CLAIM.
B. THIS PARAGRAPH IS NOT INTENDED TO AND SHALL NOT BE
CONSTRUED TO REQUIRE GRANTEE TO INDEMNIFY OR HOLD
HARMLESS THE STATE OR THE SYSTEM AGENCY FOR ANY CLAIMS OR
LIABILITIES RESULTING FROM THE NEGLEGENT ACTS OR OMISSIONS
OF THE SYSTEM AGENCY OR ITS EMPLOYEES.
C. For the avoidance of doubt, System Agency shall not indemnify Grantee or any
other entity under the Contract.
9.6 ASSIGNMENTS
A. Grantee may not assign all or any portion of its rights under, interests in, or duties
required under this Contract without prior written consent of the System Agency,
which may be withheld or granted at the sole discretion of the System Agency. Except
where otherwise agreed in writing by the System Agency, assignment will not release
Grantee from its obligations under the Contract.
B. Grantee understands and agrees the System Agency may in one or more transactions
assign, pledge, or transfer the Contract. This assignment will only be made to another
State agency or a non -state agency that is contracted to perform agency support.
HHSC Grantee L nitorm Terms and Conditions
Page 16 of 21
v. 2.16.1
Effective 03/26: 2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8BIF-FED5D527850C
9.7 INDEPENDENT CONTRACTOR
Grantee and Grantee's employees, representatives, agents, Subcontractors, suppliers, and
third -party service providers shall serve as independent contractors in providing the services
under the Contract. Neither Grantee nor System Agency is an agent of the other and neither
may make any commitments on the other party's behalf. Should Grantee subcontract any of
the services required in the Contract, Grantee expressly understands and acknowledges that
in entering such subcontract(s), System Agency is in no manner liable to any
Subcontractor(s) of Grantee. In no event shall this provision relieve Grantee of the
responsibility for ensuring that the services performed under all subcontracts are rendered in
compliance with the Contract. Grantee shall have no claim against System Agency for
vacation pay, sick leave, retirement benefits, social security, worker's compensation, health
or disability benefits, unemployment insurance benefits, or employee benefits of any kind.
The Contract shall not create any joint venture, partnership, agency, or employment
relationship between Grantee and System Agency.
9.8 TECHNICAL GUIDANCE LETTERS
In the sole discretion of the System Agency, and in conformance with federal and state law,
the System Agency may issue instructions, clarifications, or interpretations as may be
required during work performance in the form of a Technical Guidance Letter (TGL).
A TGL must be in writing, and may be delivered by regular mail, electronic mail, or
facsimile transmission. Any TGL issued by the System Agency will be incorporated into the
Contract by reference for all purposes when it is issued.
9.9 DISPUTE RESOLUTION
A. The dispute resolution process provided for in Chapter 2260 of the Texas Government
Code must be used to attempt to resolve any dispute arising under the Contract.
B. If a contract dispute arises that cannot be resolved to the satisfaction of the Parties, either
Party may notify the other Party in writing of the dispute. If the Parties are unable to
satisfactorily resolve the dispute within fourteen (14) days of the written notification, the
Parties must use the dispute resolution process provided for in Chapter 2260 of the Texas
Government Code to attempt to resolve the dispute. This provision will not apply to any
matter with respect to which either Party may make a decision within its respective sole
discretion.
9.10 GOVERNING LAW AND VENUE
The Contract shall be governed by and construed in accordance with the laws of the State of
Texas, without regard to the conflicts of law provisions. The venue of any suit arising under
the Contract is fixed in any court of competent jurisdiction of Travis County, Texas, unless
the specific venue is otherwise identified in a statute which directly names or otherwise
identifies its applicability to the System Agency.
9.11 SEVERABILITY
If any provision contained in this Contract is held to be unenforceable by a court of
law or equity, this Contract shall be construed as if such provision did not exist and the non-
v. 2.16.1
Effective 03 26 2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
enforceability of such provision shall not be held to render any other provision or
provisions of this Contract unenforceable.
9.12 SURVIVABILITY
Expiration or termination of the Contract for any reason does not release Grantee from any
liability or obligation set forth in the Contract that is expressly stated to survive any such
expiration or termination, that by its nature would be intended to be applicable following any
such expiration or termination, or that is necessary to fulfill the essential purpose of the
Contract, including without limitation the provisions regarding warranty, indemnification,
confidentiality, and rights and remedies upon termination.
9.13 FORCE MAJEURE
Neither Grantee nor System Agency shall be liable to the other for any delay in, or failure of
performance, of any requirement included in the Contract caused by force majeure. The
existence of such causes of delay or failure shall extend the period of performance until after
the causes of delay or failure have been removed provided the non -performing party
exercises all reasonable due diligence to perform. Force majeure is defined as acts of God,
war, fires, explosions, hurricanes, floods, failure of transportation, or other causes that are
beyond the reasonable control of either party and that by exercise of due foresight such party
could not reasonably have been expected to avoid, and which, by the exercise of all
reasonable due diligence, such party is unable to overcome.
9.14 NO WAIVER OF PROVISIONS
The failure of the System Agency to object to or to take affirmative action with respect to
any conduct of the Grantee which is in violation or breach of the terms of the Contract shall
not be construed as a waiver of the violation or breach, or of any future violation or breach.
9.15 PUBLICITY
A. Except as provided in the paragraph below, Grantee must not use the name of, or
directly or indirectly refer to, the System Agency, the State of Texas, or any other
State agency in any media release, public announcement, or public disclosure relating
to the Contract or its subject matter, including in any promotional or marketing
materials, customer lists, or business presentations.
B. Grantee may publish, at its sole expense, results of Grantee performance under the
Contract with the System Agency's prior review and approval, which the System
Agency may exercise at its sole discretion. Any publication (written, visual, or sound)
will acknowledge the support received from the System Agency and any Federal agency,
as appropriate.
C. Contractor is prohibited from using the Work for any Contractor or third party marketing,
advertising, or promotional activities, without the prior written consent of System
Agency. The foregoing prohibition includes, without limitation, the placement of
banners, pop-up ads, or other advertisements promoting Contractor's or a third party's
products, services, workshops, trainings, or other commercial offerings on any website
portal or internet-based service or software application hosted or managed by Contractor
as part of the Work.
HHSC Grantee Uniform Tents and Condition,
Page 18 of 21
v. 2.16.1
Effective 03/262019
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
9.16 PROHIBITION ON NON -COMPETE RESTRICTIONS
Grantee shall not require any employees or Subcontractors to agree to any conditions,
such as non -compete clauses or other contractual arrangements that would limit or restrict
such persons or entities from employment or contracting with the State of Texas.
9.17 NO WAIVER OF SOVEREIGN IMMUNITY
Nothing in the Contract will be construed as a waiver of the System Agency's or the
State's sovereign immunity. This Contract shall not constitute or be construed as a waiver of
any of the privileges, rights, defenses, remedies, or immunities available to the System
Agency or the State of Texas. The failure to enforce, or any delay in the enforcement, of any
privileges, rights, defenses, remedies, or immunities available to the System Agency or the
State of Texas under the Contract or under applicable law shall not constitute a waiver of
such privileges, rights, defenses, remedies, or immunities or be considered as a basis for
estoppel. System Agency does not waive any privileges, rights, defenses, or immunities
available to System Agency by entering into the Contract or by its conduct prior to or
subsequent to entering into the Contract.
9.18 ENTIRE CONTRACT AND MODIFICATION
The Contract constitutes the entire agreement of the Parties and is intended as a complete
and exclusive statement of the promises, representations, negotiations, discussions, and other
agreements that may have been made in connection with the subject matter hereof. Any
additional or conflicting terms in any future document incorporated into the Contract
will be harmonized with this Contract to the extent possible.
9.19 COUNTERPARTS
This Contract may be executed in any number of counterparts, each of which will be an
original, and all such counterparts will together constitute but one and the same Contract.
9.20 PROPER AUTHORITY
Each Party represents and warrants that the person executing this Contract on its behalf
has full power and authority to enter into this Contract.
9.21 E-VERIFY PROGRAM
Grantee certifies that it utilizes and will continue to utilize the U.S. Department of
Homeland Security's E-Verify system to determine the eligibility of:
i. all persons employed to perform duties within Texas during the term of the Contract;
and
ii. all persons, (including subcontractors) assigned by the Grantee to perform work
pursuant to the Contract within the United States of America.
9.22 CIVIL RIGHTS
A. Grantee agrees to comply with state and federal anti -discrimination laws, including:
i. Title VI of the Civil Rights Act of 1964 (42 U.S.C. §2000d et seq.);
ii. Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. §794);
iii. Americans with Disabilities Act of 1990 (42 U.S.C. § 12101 et seq.);
iv. Age Discrimination Act of 1975 (42 U.S.C. §§6101-6107);
HHSC Grantee Uiutbrm Term, and Condition;
Page 19 of 21
v. 2.16.1
Effective 03/26/2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
v. Title IX of the Education Amendments of 1972 (20 U.S.C. §§ 1681-1688);
vi. Food and Nutrition Act of 2008 (7 U.S.C. §201 let seq.); and
vii. The System Agency's administrative rules, as set forth in the Texas Administrative
Code, to the extent applicable to this Contract.
B. Grantee agrees to comply with all amendments to the above -referenced laws, and all
requirements imposed by the regulations issued pursuant to these laws. These laws
provide in part that no persons in the United States may, on the grounds of race, color,
national origin, sex, age, disability, political beliefs, or religion, be excluded from
participation in or denied any aid, care, service or other benefits provided by Federal or
State funding, or otherwise be subjected to discrimination.
C. Grantee agrees to comply with Title VI of the Civil Rights Act of 1964, and its
implementing regulations at 45 C.F.R. Part 80 or 7 C.F.R. Part 15, prohibiting a
contractor from adopting and implementing policies and procedures that exclude or
have the effect of excluding or limiting the participation of clients in its programs,
benefits, or activities on the basis of national origin. State and federal civil rights
laws require contractors to provide alternative methods for ensuring access to services
for applicants and recipients who cannot express themselves fluently in English.
Grantee agrees to take reasonable steps to provide services and information, both orally
and in writing, in appropriate languages other than English, in order to ensure that
persons with limited English proficiency are effectively informed and can have
meaningful access to programs, benefits, and activities.
D. Grantee agrees to post applicable civil rights posters in areas open to the public
informing clients of their civil rights and including contact information for the HHS Civil
Rights Office. The posters are available on the HHS website at:
http://hhscx.hhsc.texas.gov/system-support- services/civil-rightslpublications
E. Grantee agrees to comply with Executive Order 13279, and its implementing
regulations at 45 C.F.R. Part 87 or 7 C.F.R. Part 16. These provide in part that any
organization that participates in programs funded by direct financial assistance from the
United States Department of Agriculture or the United States Department of Health
and Human Services shall not discriminate against a program beneficiary or prospective
program beneficiary on the basis of religion or religious belief.
F. Upon request, Grantee shall provide HHSC's Civil Rights Office with copies of the
Grantee's civil rights policies and procedures.
G. Grantee must notify HHSC's Civil Rights Office of any civil rights complaints received
relating to its performance under this Contract. This notice must be delivered no more
than ten (10) calendar days after receipt of a complaint. Notice provided pursuant to
this section must be directed to:
HHSC Civil Rights Office
701 W. 51st Street, Mail Code W206
Austin, Texas 78751
Phone Toll Free: (888) 388-6332
Phone: (512) 438-4313
TTY Toll Free: (877) 432-7232
Fax: (512) 438-5885.
v. 2.16.1
Effective 03:26.2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
9.23 SYSTEM AGENCY DATA
As between the Parties, all data and information acquired, accessed, or made available to
Contractor by or through System Agency or System Agency contractors, including all
electronic data generated, processed, transmitted, or stored by Contractor in the course of
providing data processing services in connection with Contractor's performance hereunder,
(the "System Agency Data"), is owned solely by System Agency. Contractor has no right
or license to use, analyze, aggregate, transmit, create derivatives of, copy, disclose, or process
the System Agency Data except as required for Contractor to fulfill its obligations under the
Contract or as authorized in advance in writing by System Agency. For the avoidance of
doubt, Contractor is expressly prohibited from using, and from permitting any third party to
use, System Agency Data for marketing, research, or other non -governmental or commercial
purposes, without the prior written consent of System Agency.
HHSC Grantcc Uniform Terms and Conditions
Page 21 of 21
v. 2.16.1
Effective 03 26r2019
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
HEALTH AND HUMAN SERVICES
CONTRACT NO. HHS001081400001
Attachment E CONTRACT AFFIRMATIONS
For purposes of these Contract Affirmations, HHS includes both the Health and Human Services
Commission (HHSC) and the Department of State Health Services (DSHS). System Agency
refers to HHSC, DSHS, or both, that will be a party to this Contract. These Contract
Affirmations apply to all Contractors regardless of their business form (e.g., individual,
partnership, corporation).
By entering into this Contract, Contractor affirms, without exception, understands, and agrees
to comply with the following items through the life of the Contract:
1. Contractor represents and warrants that these Contract Affirmations apply to Contractor
and all of Contractor's principals, officers, directors, shareholders, partners, owners, agents,
employees, subcontractors, independent contractors, and any other representatives who
may provide services under, who have a financial interest in, or otherwise are interested in
this Contract and any related Solicitation.
2. Complete and Accurate Information
Contractor represents and warrants that all statements and information provided to HHS
are current, complete, and accurate. This includes all statements and information in this
Contract and any related Solicitation Response.
3. Public Information Act
Contractor understands that HHS will comply with the Texas Public Information Act
(Chapter 552 of the Texas Government Code) as interpreted by judicial rulings and
opinions of the Attorney General of the State of Texas. Information, documentation, and
other material prepared and submitted in connection with this Contract or any related
Solicitation may be subject to public disclosure pursuant to the Texas Public Information
Act. In accordance with Section 2252.907 of the Texas Government Code, Contractor is
required to make any information created or exchanged with the State pursuant to the
Contract, and not otherwise excepted from disclosure under the Texas Public Information
Act, available in a format that is accessible by the public at no additional charge to the
State.
4. Contracting Information Requirements
Contractor represents and warrants that it will comply with the requirements of Section
552.372(a) of the Texas Government Code. Except as provided by Section 552.374(c) of
the Texas Government Code, the requirements of Subchapter J (Additional Provisions
Related to Contracting Information), Chapter 552 of the Government Code, may apply to
the Contract and the Contractor agrees that the Contract can be terminated if the Contractor
knowingly or intentionally fails to comply with a requirement of that subchapter.
Health and Human Services
Contract Affirmations v. 1.7
Effective November 2020
Page 1 of 10
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
5. Assignment
A. Contractor shall not assign its rights under the contract or delegate the performance of
its duties under the contract without prior written approval from System Agency. Any
attempted assignment in violation of this provision is void and without effect.
B. Contractor understands and agrees the System Agency may in one or more transactions
assign, pledge, or transfer the Contract. Upon receipt of System Agency's notice of
assignment, pledge, or transfer, Contractor shall cooperate with System Agency in
giving effect to such assignment, pledge, or transfer, at no cost to System Agency or to
the recipient entity.
6. Terms and Conditions
Contractor accepts the Solicitation terms and conditions unless specifically noted by
exceptions advanced in the form and manner directed in the Solicitation, if any, under
which this Contract was awarded. Contractor agrees that all exceptions to the Solicitation,
as well as terms and conditions advanced by Contractor that differ in any manner from
HHS' terms and conditions, if any, are rejected unless expressly accepted by System
Agency in writing.
7. HHS Right to Use
Contractor agrees that HHS has the right to use, produce, and distribute copies of and to
disclose to HHS employees, agents, and contractors and other governmental entities all or
part of this Contract or any related Solicitation Response as HHS deems necessary to
complete the procurement process or comply with state or federal laws.
8. Release from Liability
Contractor generally releases from liability and waives all claims against any party
providing information about the Contractor at the request of System Agency.
9. Dealings with Public Servants
Contractor has not given, has not offered to give, and does not intend to give at any time
hereafter any economic opportunity, future employment, gift, loan, gratuity, special
discount, trip, favor, or service to a public servant in connection with this Contract or any
related Solicitation, or related Solicitation Response.
10. Financial Participation Prohibited
Under Section 2155.004, Texas Government Code (relating to financial participation in
preparing solicitations), Contractor certifies that the individual or business entity named in
this Contract and any related Solicitation Response is not ineligible to receive this Contract
and acknowledges that this Contract may be terminated and payment withheld if this
certification is inaccurate.
11. Prior Disaster Relief Contract Violation
Under Sections 2155.006 and 2261.053 of the Texas Government Code (relating to
convictions and penalties regarding Hurricane Rita, Hurricane Katrina, and other
disasters), the Contractor certifies that the individual or business entity named in this
Contract and any related Solicitation Response is not ineligible to receive this Contract and
Health and Human Services
Contract Affirmations v. 1.7
Effective November 2020
Page 2 of 10
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
acknowledges that this Contract may be terminated and payment withheld if this
certification is inaccurate.
12. Child Support Obligation
Under Section 231.006(d) of the Texas Family Code regarding child support, Contractor
certifies that the individual or business entity named in this Contract and any related
Solicitation Response is not ineligible to receive the specified payment and acknowledges
that the Contract may be terminated and payment may be withheld if this certification is
inaccurate.
13. Suspension and Debarment
Contractor certifies that it and its principals are not suspended or debarred from doing
business with the state or federal government as listed on the State of Texas Debarred
Vendor List maintained by the Texas Comptroller of Public Accounts and the System for
Award Management (SAM) maintained by the General Services Administration. This
certification is made pursuant to the regulations implementing Executive Order 12549 and
Executive Order 12689, Debarment and Suspension, 2 C.F.R. Part 376, and any relevant
regulations promulgated by the Department or Agency funding this project. This provision
shall be included in its entirety in Contractor's subcontracts, if any, if payment in whole or
in part is from federal funds.
14. Excluded Parties
Contractor certifies that it is not listed in the prohibited vendors list authorized by
Executive Order 13224, "Blocking Property and Prohibiting Transactions with Persons
Who Commit, Threaten to Commit, or Support Terrorism, " published by the United States
Department of the Treasury, Office of Foreign Assets Control.'
15. Foreign Terrorist Organizations
Contractor represents and warrants that it is not engaged in business with Iran, Sudan, or a
foreign terrorist organization, as prohibited by Section 2252.152 of the Texas Government
Code.
16. Executive Head of a State Agency
In accordance with Section 669.003 of the Texas Government Code, relating to contracting
with the executive head of a state agency, Contractor certifies that it is not (1) the executive
head of an HHS agency, (2) a person who at any time during the four years before the date
of this Contract was the executive head of an HHS agency, or (3) a person who employs a
current or former executive head of an HHS agency.
17. Human Trafficking Prohibition
Under Section 2155.0061 of the Texas Government Code, Contractor certifies that the
individual or business entity named in this Contract is not ineligible to receive this contract
and acknowledges that this Contract may be terminated and payment withheld if this
certification is inaccurate.
Health and Human Services
Contract Affirmations v. 1.7
Effective November 2020
Page 3 of 10
DocuSign Envelope ID: 8AD24363-682A-4C87-8B 1 F-FED5D527850C
18. Franchise Tax Status
Contractor represents and warrants that it is not currently delinquent in the payment of any
franchise taxes owed the State of Texas under Chapter 171 of the Texas Tax Code.
19. Debts and Delinquencies
Contractor agrees that any payments due under this Contract shall be applied towards any
debt or delinquency that is owed to the State of Texas.
20. Lobbying Prohibition
Contractor represents and warrants that payments to Contractor and Contractor's receipt of
appropriated or other funds under this Contract or any related Solicitation are not prohibited
by Sections 556.005, 556.0055, or 556.008 of the Texas Government Code (relating to use
of appropriated money or state funds to employ or pay lobbyists, lobbying expenses, or
influence legislation).
21. Buy Texas
Contractor agrees to comply with Section 2155.4441 of the Texas Government Code,
requiring the purchase of products and materials produced in the State of Texas in
performing service contracts.
22. Disaster Recovery Plan
Contractor agrees that upon request of System Agency, Contractor shall provide copies of
its most recent business continuity and disaster recovery plans.
23. Computer Equipment Recycling Program
If this Contract is for the purchase or lease of computer equipment, then Contractor certifies
that it is in compliance with Subchapter Y, Chapter 361 of the Texas Health and Safety
Code related to the Computer Equipment Recycling Program and the Texas Commission
on Environmental Quality rules in 30 TAC Chapter 328.
24. Television Equipment Recycling Program
If this Contract is for the purchase or lease of covered television equipment, then Contractor
certifies that it is compliance with Subchapter Z, Chapter 361 of the Texas Health and
Safety Code related to the Television Equipment Recycling Program.
25. Cybersecurity Training
A. Contractor represents and warrants that it will comply with the requirements of Section
2054.5192 of the Texas Government Code relating to cybersecurity training and
required verification of completion of the training program.
B. Contractor represents and warrants that if Contractor or Subcontractors, officers, or
employees of Contractor have access to any state computer system or database, the
Contractor, Subcontractors, officers, and employees of Contractor shall complete
cybersecurity training pursuant to and in accordance with Government Code, Section
2054.5192.
Health and Human Services
Contract Affirmations v. 1.7
Effective November 2020
Page 4 of 10
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
26. Restricted Employment for Certain State Personnel
Contractor acknowledges that, pursuant to Section 572.069 of the Texas Government
Code, a former state officer or employee of a state agency who during the period of state
service or employment participated on behalf of a state agency in a procurement or contract
negotiation involving Contractor may not accept employment from Contractor before the
second anniversary of the date the Contract is signed or the procurement is terminated or
withdrawn.
27. No Conflicts of Interest
A. Contractor represents and warrants that it has no actual or potential conflicts of interest
in providing the requested goods or services to System Agency under this Contract or
any related Solicitation and that Contractor's provision of the requested goods and/or
services under this Contract and any related Solicitation will not constitute an actual or
potential conflict of interest or reasonably create an appearance of impropriety.
B. Contractor agrees that, if after execution of the Contract, Contractor discovers or is
made aware of a Conflict of Interest, Contractor will immediately and fully disclose
such interest in writing to System Agency. In addition, Contractor will promptly and
fully disclose any relationship that might be perceived or represented as a conflict after
its discovery by Contractor or by System Agency as a potential conflict. System
Agency reserves the right to make a final determination regarding the existence of
Conflicts of Interest, and Contractor agrees to abide by System Agency's decision.
28. Fraud, Waste, and Abuse
Contractor understands that HHS does not tolerate any type of fraud, waste, or abuse.
Violations of law, agency policies, or standards of ethical conduct will be investigated, and
appropriate actions will be taken. Pursuant to Texas Government Code, Section 321.022,
if the administrative head of a department or entity that is subject to audit by the state
auditor has reasonable cause to believe that money received from the state by the
department or entity or by a client or contractor of the department or entity may have been
lost, misappropriated, or misused, or that other fraudulent or unlawful conduct has occurred
in relation to the operation of the department or entity, the administrative head shall report
the reason and basis for the belief to the Texas State Auditor's Office (SAO). All employees
or contractors who have reasonable cause to believe that fraud, waste, or abuse has occurred
(including misconduct by any HHS employee, Grantee officer, agent, employee, or
subcontractor that would constitute fraud, waste, or abuse) are required to immediately
report the questioned activity to the Health and Human Services Commission's Office of
Inspector General. Contractor agrees to comply with all applicable laws, rules, regulations,
and System Agency policies regarding fraud, waste, and abuse including, but not limited
to, HHS Circular C-027.
A report to the SAO must be made through one of the following avenues:
• SAO Toll Free Hotline: 1-800-TX-AUDIT
• SAO website: http://sao.fraud.state.tx.us.
All reports made to the OIG must be made through one of the following avenues:
• OIG Toll Free Hotline 1-800-436-6184
Health and Human Services
Contract Affirmations v. 1.7
Effective November 2020
Page 5 of 10
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
• OIG Website: ReportTexasFraud.com
• Internal Affairs Email: InternalAffairsReferral@hhsc.state.tx.us
• OIG Hotline Email: OIGFraudHotline(a�hhsc.state.tx.us.
• OIG Mailing Address: Office of Inspector General
Attn: Fraud Hotline
MC 1300
P.O. Box 85200
Austin, Texas 78708-5200
29. Antitrust
The undersigned affirms under penalty of perjury of the laws of the State of Texas that:
A. in connection with this Contract and any related Solicitation Response, neither I nor
any representative of the Contractor has violated any provision of the Texas Free
Enterprise and Antitrust Act, Tex. Bus. & Comm. Code Chapter 15;
B. in connection with this Contract and any related Solicitation Response, neither I nor
any representative of the Contractor has violated any federal antitrust law; and
C. neither I nor any representative of the Contractor has directly or indirectly
communicated any of the contents of this Contract and any related Solicitation
Response to a competitor of the Contractor or any other company, corporation, firm,
partnership or individual engaged in the same line of business as the Contractor.
30. Legal and Regulatory Actions
Contractor represents and warrants that it is not aware of and has received no notice of any
court or governmental agency proceeding, investigation, or other action pending or
threatened against Contractor or any of the individuals or entities included in numbered
paragraph I of these Contract Affirmations within the five (5) calendar years immediately
preceding execution of this Contract or the submission of any related Solicitation Response
that would or could impair Contractor's performance under this Contract, relate to the
contracted or similar goods or services, or otherwise be relevant to System Agency's
consideration of entering into this Contract. If Contractor is unable to make the preceding
representation and warranty, then Contractor instead represents and warrants that it has
provided to System Agency a complete, detailed disclosure of any such court or
governmental agency proceeding, investigation, or other action that would or could impair
Contractor's performance under this Contract, relate to the contracted or similar goods or
services, or otherwise be relevant to System Agency's consideration of entering into this
Contract. In addition, Contractor acknowledges this is a continuing disclosure requirement.
Contractor represents and warrants that Contractor shall notify System Agency in writing
within five (5) business days of any changes to the representations or warranties in this
clause and understands that failure to so timely update System Agency shall constitute
breach of contract and may result in immediate contract termination.
Health and Human Services
Contract Affirmations v. 1.7
Effective November 2020
Page 6 of 10
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
31. No Felony Criminal Convictions
Contractor represents that neither Contractor nor any of its employees, agents, or
representatives, including any subcontractors and employees, agents, or representative of
such subcontractors, have been convicted of a felony criminal offense or that if such a
conviction has occurred Contractor has fully advised System Agency in writing of the facts
and circumstances surrounding the convictions.
32. Unfair Business Practices
Contractor represents and warrants that it has not been the subject of allegations of
Deceptive Trade Practices violations under Chapter 17 of the Texas Business and
Commerce Code, or allegations of any unfair business practice in any administrative
hearing or court suit and that Contractor has not been found to be liable for such practices
in such proceedings. Contractor certifies that it has no officers who have served as officers
of other entities who have been the subject of allegations of Deceptive Trade Practices
violations or allegations of any unfair business practices in an administrative hearing or
court suit and that such officers have not been found to be liable for such practices in such
proceedings.
33. Entities that Boycott Israel
Contractor represents and warrants that (1) it does not, and shall not for the duration of the
Contract, boycott Israel or (2) the verification required by Section 2271.002 of the Texas
Government Code does not apply to the Contract. If circumstances relevant to this
provision change during the course of the contract, Contractor shall promptly notify System
Agency.
34. E-Verify
Contractor certifies that for contracts for services, Contractor shall utilize the U.S.
Department of Homeland Security's E-Verify system during the term of this Contract to
determine the eligibility of:
1. all persons employed by Contractor to perform duties within Texas; and
2. all persons, including subcontractors, assigned by Contractor to perform work
pursuant to this Contract within the United States of America.
35. Former Agency Employees — Certain Contracts
If this Contract is an employment contract, a professional services contract under Chapter
2254 of the Texas Government Code, or a consulting services contract under Chapter 2254
of the Texas Government Code, in accordance with Section 2252.901 of the Texas
Government Code, Contractor represents and warrants that neither Contractor nor any of
Contractor's employees including, but not limited to, those authorized to provide services
under the contract, were former employees of an HHS Agency during the twelve (12)
month period immediately prior to the date of the execution of the contract.
Health and Human Services
Contract Affirmations v. 1.7
Effective November 2020
Page 7 of 10
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
36. Disclosure of Prior State Employment — Consulting Services
If this Contract is for consulting services,
A. In accordance with Section 2254.033 of the Texas Government Code, a Contractor
providing consulting services who has been employed by, or employs an individual
who has been employed by, System Agency or another State of Texas agency at any
time during the two years preceding the submission of Contractor's offer to provide
services must disclose the following information in its offer to provide services.
Contractor hereby certifies that this information was provided and remains true, correct,
and complete:
1. Name of individual(s) (Contractor or employee(s));
2. Status;
3. The nature of the previous employment with HHSC or the other State of Texas
agency;
4. The date the employment was terminated and the reason for the termination; and
5. The annual rate of compensation for the employment at the time of its termination.
B. If no information was provided in response to Section A above, Contractor certifies
that neither Contractor nor any individual employed by Contractor was employed by
System Agency or any other State of Texas agency at any time during the two years
preceding the submission of Contractor's offer to provide services.
37. Abortion Funding Limitation
Contractor understands, acknowledges, and agrees that, pursuant to Article IX, Section
6.25 of the General Appropriations Act (the Act), to the extent allowed by federal and state
law, money appropriated by the Texas Legislature may not be distributed to any individual
or entity that, during the period for which funds are appropriated under the Act:
1. performs an abortion procedure that is not reimbursable under the state's Medicaid
program;
2. is commonly owned, managed, or controlled by an entity that performs an abortion
procedure that is not reimbursable under the state's Medicaid program; or
3. is a franchise or affiliate of an entity that performs an abortion procedure that is not
reimbursable under the state's Medicaid program. The provision does not apply to a
hospital licensed under Chapter 241, Health and Safety Code, or an office exempt under
Section 245.004(2), Health and Safety Code. Contractor represents and warrants that it
is not ineligible, nor will it be ineligible during the term of this Contract, to receive
appropriated funding pursuant to Article IX, Section 6.25.
38. Funding Eligibility
Contractor understands, acknowledges, and agrees that, pursuant to Chapter 2272 of the
Texas Government Code, except as exempted under that Chapter, HHSC cannot contract
with an abortion provider or an affiliate of an abortion provider. Contractor certifies that it
is not ineligible to contract with HHSC under the terms of Chapter 2272 of the Texas
Government Code.
Health and Human Services
Contract Affirmations v. 1.7
Effective November 2020
Page 8 of 10
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
39. Prohibition on Certain Telecommunications and Video Surveillance Services or
Equipment (2 CFR 200.216)
Contractor certifies that the individual or business entity named in this Response or
contract is not ineligible to receive the specified contract or funding pursuant to 2 CFR
200.216.
40. False Representation
Contractor understands, acknowledges, and agrees that any false representation or any
failure to comply with a representation, warranty, or certification made by Contractor is
subject to all civil and criminal consequences provided at law or in equity including, but
not limited to, immediate termination of this Contract.
41. False Statements
Contractor represents and warrants that all statements and information prepared and
submitted by Contractor in this Contract and any related Solicitation Response are current,
complete, true, and accurate. Contractor acknowledges any false statement or material
misrepresentation made by Contractor during the performance of this Contract or any
related Solicitation is a material breach of contract and may void this Contract. Further,
Contractor understands, acknowledges, and agrees that any false representation or any
failure to comply with a representation, warranty, or certification made by Contractor is
subject to all civil and criminal consequences provided at law or in equity including, but
not limited to, immediate termination of this Contract.
42. Permits and License
Contractor represents and warrants that it will comply with all applicable laws and maintain
all permits and licenses required by applicable city, county, state, and federal rules,
regulations, statutes, codes, and other laws that pertain to this Contract.
43. Drug -Free Workplace
Contractor represents and warrants that it shall comply with the applicable provisions of
the Drug -Free Work Place Act of 1988 (41 U.S.C. §701 et seq.) and maintain a drug -free
work environment.
44. Equal Employment Opportunity
Contractor represents and warrants its compliance with all applicable duly enacted state
and federal laws governing equal employment opportunities.
45. Federal Occupational Safety and Health Law
Contractor represents and warrants that all articles and services shall meet or exceed the
safety standards established and promulgated under the Federal Occupational Safety and
Health Act of 1970, as amended (29 U.S.C. Chapter 15).
Health and Human Services
Contract Affirmations v. 1.7
Effective November 2020
Page 9 of 10
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
46. Signature Authority
Contractor represents and warrants that the individual signing this Contract Affirmations
document is authorized to sign on behalf of Contractor and to bind the Contractor.
Authorized representative on behalf of Contractor must complete and sign the following:
City of Lubbock
Legal Name of Contractor
Assumed Business Name of Contractor, if applicable (d/b/a or `doing business as')
Texas County(s) for Assumed Business Name (d/b/a or `doing business as')
Attach Assumed Name Certificate(s) filed with the Texas Secretary of State and Assumed
Name Certificate(s), if any, for each Texas County Where Assumed Name Certificate(s) has
been filed
Signed by:
[D�
a&�tt
F0378831555rOF
Signature of Authorized Representative
Daniel Pope
Printed Name of Authorized Representative
First, Middle Name or Initial, and Last Name
1314 Ave K
Physical Street Address
Mailine Address if different
806-775-2010
Phone Number
dpope@mylubbock.us
Email Address
75-6000590
Federal Employer Identification Number
NA
Texas Franchise Tax Number
September 8, 2021
Date Signed
Mayor
Title of Authorized Representative
Lubbock, Tx 79401
City. State. Zip Code
L- I
City, State, Zip Code
Fax Number
058213893
DUNS Number
17560005906
Texas Payee ID No. —11 digits
NA
Texas Secretary of State Filing
Number
Health and Human Services
Contract Affirmations v. 1.7
Effective November 2020
Page 10 of 10
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
TEXAS
Health and Human Services
Health and Human Services (HHS)
Additional Provisions
Version 1.0
Effective: September 2021
DocuSign Envelope ID 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
TABLE OF CONTENTS
1.
SPECIAL DEFINITIONS............................................................................................ 1
2.
GRANTEES PERSONAL AND SUBCONTRACTORS .......................................... 2
3.
CONFIDENTIALITY - CONFIDENTIAL SYSTEM INFORMATION ............... 4
4.
MISCELLANEOUS PROVISIONS............................................................................ 4
5.
HHSC VENDOR ACCESS..........................................................................................
5
6.
HHSC APPROVAL OF STAFFING.......................................................................... 5
7.
TURNOVER PLAN...................................................................................................... 6
8.
TURNOVER ASSISTANCE....................................................................................... 6
9.
TRADEMARK LICENSE...........................................................................................
6
10.
TRADEMARK OWNERSHIP....................................................................................
7
11.
NOTICE OF CRIMINAL ACTIVITY AND DISCIPLINARY ACTIONS............
7
12.
NOTICE OF IRS OR TWC INSOLVENCY.............................................................
7
13.
DISASTER SERVICES................................................................................................
7
14.
NOTICE OF A LICENSE ACTION...........................................................................
8
15.
NOTION OF A CONTRACT ACTION.....................................................................
8
16.
CHILD ABUSE REPORTING REQUIREMENT....................................................
8
17.
ABUSE, NEGLECT, EXPLOITATION....................................................................
9
18.
GRANTEE'S NOTIFICATION OF CHANGE OF CONTACT PERSON OR
KEYPERSONNEL......................................................................................................................
9
19.
NOTION OF ORGANIZATIONAL CHANGE........................................................
9
20.
SIGNIFICANT INCIDENTS.......................................................................................
9
21.
RESPONSIBILITIES AND RESTRICTIONS CONCERNING GOVERNING
BODY, OFFICERS AND EMPLOYEES...................................................................................
9
22.
DIRECT OPERATION..............................................................................................
10
23.
INTERIM EXTENSION AMENDMENT................................................................
10
24.
MEDICAL RECORDS RETENTION......................................................................
10
25.
GRANTEE'S CERTIFICATION OF MEETING OR EXCEEDING TOBACCO -
FREE
WORKPLACE POLICY MINIMUM STANDARDS .................................................
11
26.
ELECTRONIC AND INFORMATION RESOURCES ACCESSIBILITY AND
SECURITY
STANDARDS........................................................................................................11
27.
EQUIPMENT, SUPPLIES AND PROPERTY........................................................
13
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
28. CLINICAL MANAGEMENT FOR BEHAVIORAL HEALTH SERVICES
(CMBHS) SYSTEM....................................................................................................................19
29. HIV/AIDS MODEL WORKPLACE GUIDELINES .............................................. 21
30. MEDICAID ENROLLMENT.................................................................................... 21
31. BILLING FOR TREATMENT AND PAYMENT RESTRICTIONS ................... 21
32. PERSONS ON PROBATIONS OR PAROLE ............. ERROR! BOOKMARK NOT
DEFINED.
33. SUBSTANCE ABUSE BLOCK GRANT (SABG) REQUIREMENTS ................. 21
34. MATCH AND PROGRAM INCOME...................................................................... 22
35. CONTRACT RECONCILIATION.......................................................................... 22
36. BREACH OF CONTRACT AND LIQUIDATED DAMAGES ............................. 22
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
The terms and conditions of these Additional Provisions are incorporated into and made a part of
the Contract. Capitalized items used in these Additional Provisons and not otherwise defined have
the meanings assigned to them in HHSC Uniform Terms and Conditions.
If any provision contained in this HHSC Special Conditions is in conflict with, or inconsistent with
the HHSC Uniform Terms and Conditions (UTC), the provision contained in the UTCs shall
prevail.
1. SPECIAL DEFINITIONS
A. "Conflict of Interest" means a set of facts or circumstances, a relationship, or other
situation under which Grantee, a Subcontractor, or individual has past, present, or currently
planned personal or financial activities or interests that either directly or indirectly: (1)
impairs or diminishes the Grantee's, or Subcontractor's ability to render impartial or
objective assistance or advice to the HHSC; or (2) provides the Grantee or Subcontractor
an unfair competitive advantage in future HHSC procurements.
B. "Grantee Agents" means Grantee's representatives, employees, officers, as well as any
contractor or subgrantee's employees, contractors, officers, principals and agents.
C. "Data Use Agreement" means the agreement incorporated into the Contract to facilitate
creation, receipt, maintenance, use, disclosure or access to Confidential Information.
D. "Item of Noncompliance" means Grantee's acts or omissions that: (1) violate a provision
of the Contract; (2) fail to ensure adequate performance of the Project; (3) represent a
failure of Grantee to be responsive to a request of HHSC relating to the Project under the
Contract.
E. "Minor Administrative Change" refers to a change to the Contract that does not increase
the fees or term and done in accordance with Section 4.
F. "Other Confidential System Information" means any communication or record
(whether oral, written, electronically stored or transmitted, or in any other form) provided
to or made available to Grantee; or that Grantee may create, receive, maintain, use, disclose
or have access to on behalf of HHSC or through performance of the Project, which is not
designated as Confidential Information in a Data Use Agreement.
G. "State" means the State of Texas and, unless otherwise indicated or appropriate, will be
interpreted to mean HHSC and other agencies of the State of Texas that may participate in
the administration of HHSC Programs; provided, however, that no provision will be
interpreted to include any entity other than HHSC as the contracting agency.
H. "Software" means all operating system and applications software used or created by
Grantee to perform the work under the Contract.
I. "Third Party Software" refers to software programs or plug -ins developed by companies
or individuals other than Grantee which are used in performance of the Project. It does not
include items which are ancillary to the performance of the Project, such as internal systems
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
of Grantee which were deployed by Grantee prior to the Contract and not procured to
perform the Project.
"UTC" means the HHSC Uniform Terms and Conditions — Grant, Version 2.16.1.
2. GRANTEES PERSONAL AND SUBCONTRACTORS
A. Qualifications
Grantee agrees to maintain the organizational and administrative capacity and capabilities to
carry out all duties and responsibilities under the Contract. Grantee Agents assigned to perform
the duties and responsibilities under the Contract must be and remain properly trained and
qualified for the functions they are to perform. Notwithstanding the transfer or turnover of
personnel, Grantee remains obligated to perform all duties and responsibilities under the
Contract without degradation and in strict accordance with the terms of the Contract.
A. Conduct and Removal
While performing the Project, Grantee Agents must comply with applicable Contract terms,
State and federal rules, regulations, HHSC's policies, and HHSC's requests regarding personal
and professional conduct; and otherwise conduct themselves in a businesslike and professional
manner.
If HHSC determines in good faith that a particular Grantee Agent is not conducting himself or
herself in accordance with the terms of the Contract, HHSC may provide Grantee with notice
and documentation regarding its concerns. Upon receipt of such notice, Grantee must promptly
investigate the matter and, at HHSC's election, take appropriate action that may include
removing the Grantee Agent from performing the Project.
B. Contracts with Subcontractors
1. Grantee may enter into contracts with subcontractors unless restricted or otherwise
prohibited in the Contract.
2. Grantees are prohibited from subcontracting with for -profit organizations under this
Contract.
3. Prior to entering into a subcontract agreement equaling or exceeding $100,000, Grantee
will obtain written approval from the System Agency.
4. Grantee will obtain written approval from System Agency before modifying any
subcontract agreement to cause the agreement to exceed $100,000.
5. Grantee will establish written policies and procedures for competitive procurement and
monitoring of subcontracts and will develop a subcontracting monitoring plan.
6. Monitor subcontractors for both financial and programmatic performance and will
maintain pertinent records.
7. Submit quarterly subcontracting monitoring reports to the System Agency in a format
determined by the System Agency.
8. Ensure all subcontracts, must be in writing and include the following:
i. Name and address of all parties and subcontractor's Vendor Identification
Number (VIN) or Employee Identification Number (EIN);
ii. Detailed description of the services to be provided;
iii. Measureable method and rate of payment and total not -to -exceed amount of the
contract;
2
DocuSign Envelope ID: 8AD24363-682A-4C87-8131 F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
iv. Clearly defined and executable termination clause; and
V. Beginning and ending dates that coincide with the dates of the Contract.
9. Ensure and be responsible for the performance of the subcontractor(s).
10. Not contract with a subcontractor, at any tier, that is debarred, suspended, or excluded
from or ineligible for participation in federal assistance programs or if the subcontractor
would be otherwise ineligible to abide by the terms of this Contract.
C. Status of Subcontractors
Grantees will require that all subcontractors certify that they are/have:
1. In good standing with all state and federal funding and regulatory agencies;
2. Not currently debarred, suspended or otherwise excluded from participation in
federal grant programs;
3. Not delinquent on any repayment agreements;
4. Not had a required license or certification revoked;
5. Not ineligible under the terms of the Contract; and
6. Not had a System Agency contract terminated for cause.
D. Incorporation of Terms in Subcontracts
1. Grantee will include in all its contracts with subrecipient subcontractors and solicitations
for subrecipient subcontracts, without modification (except as required to make
applicable to the subcontract) the following provisions:
i. Statements of Work
ii. Uniform Terms and Conditions
iii. Special Conditions
iv. Federal Assurances and Certifications
V. Non -Exclusive List of Applicable Laws
vi. A provision granting to the System Agency, State Auditor's Office (SAO),
Office of Inspector General (OIG), and the Comptroller General of the United
States, and any of their representatives, the right of access to inspect the work
and the premises on which any work is performed, and the right to audit the
subcontractor.
2.Grantee will ensure that all written agreements with subcontractors incorporate the terms
of this Contract so that all terms, conditions, provisions, requirements, duties and
liabilities under this Contract applicable to the services provided or activities conducted
by a subcontractor are passed down to that subcontractor.
3. No provision of this Contract creates privity of contract between the System Agency and
any subcontractor of Grantee.
E. Notice of Legal Matter or Litigation
Grantee will send notice to the Substance Use Disorder (SUD) email box,
SubstanceAbuse. ContractsAhhsc. state. tx. us of any litigation or legal matter related to or
affecting this Contract within seven calendar days of becoming aware of the litigation or
legal matter.
F. Unilateral Amendment
3
DocuSign Envelope ID: 8AD24363-682A-4C87-861F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
The System Agency reserves the right to amend this Contract through execution of a unilateral
amendment signed by the contract manager for this Contract and provided to the Grantee
with ten days notice prior to execution of the amendment under the following circumstances
to:
1. To comply with a court order or judgement
2. Incorporate new or revised federal or state laws, regulations, rules or policies
3. Correct an obvious clerical error in this Contract;
4. Change the name of the Contractor in order to reflect the Contractor's name as recorded
by the Texas Secretary of State.
5. To correct the name, mailing address, or contact information for persons name in the
Contract;
6. To update service descriptions or rates (if applicable);
3. CONFIDENTIALITY — CONFIDENTIAL SYSTEM INFORMATION
HHSC prohibits the unauthorized disclosure of Other Confidential Information. Grantee and all
Grantee Agents will not disclose or use any Other Confidential Information in any manner except
as is necessary for the Project or the proper discharge of obligations and securing of rights under
the Contract. Grantee will have a system in effect to protect Other Confidential Information. Any
disclosure or transfer of Other Confidential Information by Grantee, including information
requested to do so by HHSC, will be in accordance with the Contract. If Grantee receives a request
for Other Confidential Information, Grantee will immediately notify HHSC of the request, and
will make reasonable efforts to protect the Other Confidential Information from disclosure until
further instructed by the HHSC.
Grantee will notify HHSC promptly of any unauthorized possession, use, knowledge, or attempt
thereof, of any Other Confidential Information by any person or entity that may become known to
Grantee. Grantee will furnish to HHSC all known details of the unauthorized possession, use, or
knowledge, or attempt thereof, and use reasonable efforts to assist HHSC in investigating or
preventing the reoccurrence of any unauthorized possession, use, or knowledge, or attempt thereof,
of Other Confidential Information.
HHSC will have the right to recover from Grantee all damages and liabilities caused by or arising
from Grantee or Grantee Agents' failure to protect HHSC's Other Confidential Information as
required by this section.
IN COORDINATION WITH THE INDEMNITY PROVISIONS CONTAINED IN THE
UTC, Grantee WILL IDEMNITY AND HOLD HARMLESS HHSC FROM ALL
DAMAGES, COSTS, LIABILTIES, AND EXPENSES (INCLUDING WITHOUT
LIMITATION REASONABLE ATTORNEYS' FEES AND COSTS) CAUSED BY OR
ARISING FROM Grantee OR Grantee AGENTS FAILURE TO PROTECT OTHER
CONFIDENTIAL INFORMATION. Grantee WILL FULFILL THIS PROVISION WITH
COUNSEL APPROVED BY HHSC.
4. MISCELLANEOUS PROVISIONS
A. Minor Administrative Changes
System Agency is authorized to provide written approval of mutually agreed upon Minor
Administrative Changes to the Project or the Contract that do not increase the fees or term.
4
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
Upon approval of a Minor Administrative Change, HHSC and Grantee will maintain written
notice that the change has been accepted in their Contract files.
B. Conflicts of Interest
Grantee warrants to the best of its knowledge and belief, except to the extent already disclosed
to HHSC, there are no facts or circumstances that could give rise to a Conflict of Interest and
further that Grantee or Grantee Agents have no interest and will not acquire any direct or
indirect interest that would conflict in any manner or degree with their performance under the
Contract. Grantee will, and require Grantee Agents, to establish safeguards to prohibit Contract
Agents from using their positions for a purpose that constitutes or presents the appearance of
personal or Organizational Conflict of Interest, or for personal gain. Grantee and Grantee
Agents will operate with complete independence and objectivity without actual, potential or
apparent Conflict of Interest with respect to the activities conducted under the Contract.
Grantee agrees that, if after Grantee's execution of the Contract, Grantee discovers or is made
aware of a Conflict of Interest, Grantee will immediately and fully disclose such interest in
writing to HHSC. In addition, Grantee will promptly and fully disclose any relationship that
might be perceived or represented as a conflict after its discovery by Grantee or by HHSC as
a potential conflict. HHSC reserves the right to make a final determination regarding the
existence of Conflicts of Interest, and Grantee agrees to abide by HHSC's decision.
If HHSC determines that Grantee was aware of a Conflict of Interest and did not disclose the
conflict to HHSC, such nondisclosure will be considered a material breach of the Contract.
Furthermore, such breach may be submitted to the Office of the Attorney General, Texas.
C. Flow Down Provisions
Grantee must include any applicable provisions of the Contract in all subcontracts based on
the scope and magnitude of work to be performed by such Subcontractor. Any necessary terms
will be modified appropriately to preserve the State's rights under the Contract.
5. HHSC VENDOR ACCESS
At HHSC's request, Grantee will allow parties interested in responding to other HHSC
solicitations to have reasonable access during normal business hours to the Work, software,
systems documentation, and site visits to the Grantee's facilities. Grantee may elect to have such
parties inspecting the Work, facilities, software or systems documentation to agree to use the
information so obtained only in the State of Texas and only for the purpose of responding to the
relevant HHSC solicitation.
G. HHSC APPROVAL OF STAFFING
A. Grantee shall not employ or contract with or permit the employment of unfit or unqualified
persons or persons not skilled in the tasks assigned to them. Grantee shall at all times
employ sufficient labor to carry out functions and services in the manner and time
prescribed by the Contract. Grantee shall be responsible to HHSC for the acts and
omissions of Grantee's employees, agents (including, but not limited to, lobbyists) and
Subcontractors and Grantee shall enforce strict discipline among Grantee's employees,
5
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
agents (including, but not limited to, lobbyists) and Subcontractors performing the services
under the Contract.
B. Any person employed by Grantee shall, at the written request of HHSC, and within
HHSC's sole discretion, be removed immediately by the Contractor from work relating to
the Contract.
7. TURNOVER PLAN
HHSC, in its sole discretion, may require Grantee to develop and submit a Turnover Plan at any
time during the term of the Contract. Grantee must submit the Turnover Plan to HHSC for review
and approval. The Turnover Plan must describe Grantee's policies and procedures that will ensure:
A. The least disruption in the delivery of the Work during Turnover to HHSC or its designee;
and
B. Full cooperation with HHSC or its designee in transferring the Work and the obligations
of the Contract.
8. TURNOVER ASSISTANCE
Grantee will provide any assistance and actions reasonably necessary to enable HHSC or its
designee to effectively close out the Contract and transfer the Work and the obligations of the
Contract to another vendor or to perform the Work by itself. Grantee agrees that this obligation
survives the termination, regardless of whether for cause or convenience, or the expiration of the
Contract and remains in effect until completed to the satisfaction of HHSC.
9. TRADEMARK LICENSE
HHSC grants to Contractor, for the term of the Contract, a limited non-exclusive, royalty -free,
non -assignable, non -transferable license to reproduce HHSC's trademarks on published materials
in the United States related to the performance of the Contract, provided that such license is
expressly conditional upon, and subject to, the following:
A. Grantee is in compliance with all provisions of the Contract;
B. Grantee's use of the trademarks is strictly in accordance with the quality standards and in
conformance with the reproduction requirements set forth or as otherwise communicated
by HHSC;
C. Grantee takes no action to damage the goodwill associated with the trademarks, and
refrains from any attempt to contest, attack, dispute, challenge, cancel and/or oppose
HHSC's right, title and interest in the trademarks or their validity;
D. Grantee makes no attempt to sublicense any rights under this trademark license; and
E. Grantee complies with any marking requests HHSC may make in relation to the
trademarks, including without limitation to use the phase "Registered Trademark," the
registered trademark symbol "®" for registered trademarks, and the system "TM" for
unregistered trademarks.
N
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
10. TRADEMARK OWNERSHIP
Grantee acknowledges and agrees that the trademarks remain the exclusive property of HHSC,
that all right, title and interest in and to the trademarks is exclusively held by HHSC, and all
goodwill associated with such trademarks inures solely to HHSC.
11. NOTICE OF CRIMINAL ACTIVITY AND DISCIPLINARY ACTIONS
A. Grantee shall immediately report in writing to its assigned HHSC contract manager when
Grantee learns of or has any reason to believe it or any person with ownership or controlling
interest in Grantee, or their agent, employee, subcontractor or volunteer who is providing
services under this Contract has:
1. Engaged in any activity that could constitute a criminal offense equal to or greater than a
Class A misdemeanor or grounds for disciplinary action by a state or federal regulatory
authority; or
2. Been placed on community supervision, received deferred adjudication, or been indicted
for or convicted of a criminal offense relating to involvement in any financial matter,
federal or state program or felony sex crime.
B. Grantee shall not permit any person who engaged, or was alleged to have engaged, in any
activity subject to reporting under this section to perform direct client services or have direct
contact with clients, unless otherwise directed in writing by the System Agency.
12. NOTICE OF IRS OR TWC INSOLVENCY
Grantee shall notify in writing its assigned HHSC contract manager of any insolvency, incapacity
or outstanding unpaid obligations of Grantee owed to the Internal Revenue Service (IRS) or
the State of Texas, or any agency or political subdivision of the State of Texas within five days of
the date of Grantee's becoming aware of such.
13. DISASTER SERVICES
In the event of a local, state, or federal emergency, including natural, man-made, criminal,
terrorist, and/or bioterrorism events, declared as a state disaster by the Governor, or a federal
disaster declared by the appropriate federal official, Grantee may be called upon to assist the
System Agency in providing the following services:
A. Expand, increase, or modify service delivery in impacted areas;
B. Community evacuation;
C. Health and medical assistance;
D. Assessment of health and medical needs;
E. Health surveillance;
F. Medical care personnel;
G. Health and medical equipment and supplies;
H. Patient evacuation;
I. In -hospital care and hospital facility status;
J. Food, drug and medical device safety;
7
DocuSign Envelope ID: 8AD24363-682A4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
K. Worker health and safety;
L. Mental health and substance abuse;
M. Public health information;
N. Vector control and veterinary services; and
O. Victim identification and mortuary services.
Disaster related services may not commence, or expenditures incurred, until System Agency
provides Grantee with a written Notification to Proceed. The contract may be amended to
incorporate additional funds and performance or reporting requirements to support disaster
services in the event services must be expanded, increased, or modified.
14. NOTICE OF A LICENSE ACTION
Grantee shall notify its assigned HHSC contract manager of any action impacting Grantee's license
to provide services under this Contract within five days of becoming aware of the action and
include the following:
A. Reason for such action;
B. Name and contact information of the local, state or federal department or agency or entity;
C. Date of the license action; and
D. License or case reference number.
15. NOTION OF A CONTRACT ACTION
Grantee will send notice to the Substance Use Disorder (SUD) email box,
SubstanceAbuse.Contracts(a)hhsc.state.tx.us if Grantee has had any contract suspended or
terminated for cause by any local, state or federal department or agency or nonprofit entity within
five (5) business days of becoming aware of the action and include the following:
A. Reason for such action;
B. Name and contact information of the loca, state or federal department or agency or entity;
C. Date of the contract;
D. Date of suspension or termination; and
E. Contract or case reference number.
16. CHILD ABUSE REPORTING REQUIREMENT
Grantee will:
A. Comply with child abuse and neglect reporting requirements in Texas Family Code
Chapter 261. This section is in addition to and does not supersede any other legal obligation
of the Grantee to report child abuse.
B. Develop, implement and enforce a written policy that includes at a minimum the System
Agency's Child Abuse Screening, Documenting, and Reporting Policy for
Grantees/Providers and train all staff on reporting requirements.
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
1. Use the System Agency Child Abuse Reporting Form located at
https://www.dfps.state.tx.us/Contact_Us/report_abuse.asp as required by the System
Agency.
C. Retain reporting documentation on site and make it available for inspection by the System
Agency.
17. ABUSE, NEGLECT, EXPLOITATION
Grantee will;
A. Take all steps necessary, to protect the health, safety and welfare of its clients and
participants.
B. Develop and implement written policies and procedures for abuse, neglect and exploitation.
C. Notify appropriate authorities of any allegations of abuse, neglect or exploitation as
required by 25 TAC § 448.703.
18. GRANTEE'S NOTIFICATION OF CHANGE OF CONTACT PERSON OR KEY PERSONNEL
Within 10 business days, Grantee will submit notice to the SUD email box,
SubstanceAbuse. Contracts (ahhsc.state.tx.us and Substance_ Use Disorder(a?hhsc.state.tx.us of
any change in the Grantee's Contact Persons or Key Personnel. T
19. NOTION OF ORGANIZATIONAL CHANGE
Grantee will submit notice to the SUD email box, Substanc_e..Abuse. ContractsLa!hhsc.state. tx.us
and Substance _Use �DisorderLa),hhsc.state. tx.us within ten (10) business days of any change to
Grantee's name, contact information, organizational structure, such as merger, acquisition, or
change in form of business, legal standing, or authority to do business in Texas.
20. SIGNIFICANT INCIDENTS
In addition to notifying the appropriate authorities, Grantee will submit notice to the SUD email
box, SubstanceAbuse.Contracts hhsc.state.ts.us and Substance Use Disorder(a hhsc.state.tx.us
significant incidents involving substantial distruption of Grantee's program operation or affecting
or potentially affecting the health, safety or welfare of the System Agency funded clients or
participants within three calendar dys of discovery.
21. RESPONSIBILITIES AND RESTRICTIONS CONCERNING GOVERNING BODY, OFFICERS AND
EMPLOYEES
Grantee and its governing body will:
A. Bear full responsibility for the integrity of the fiscal and programmatic management of the
organization.
B. Be accountable for all funds and materials received from the System Agency. The
responsibility of Grantee's governing body will also include accountability for compliance
with the System Agency Rules, policies, procedures, and applicable federal and state laws
and regulations; and correction of fiscal and program deficiencies identified through self -
evaluation and the System Agency's monitoring processes.
C. Ensure separation of powers, duties, and functions of governing body members and staff.
No member of Grantee's governing body, or officer or employee of Grantee will vote for,
M
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1 F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
confirm or act to influence the employment, compensation or change in status of any person
related within the second degree of affinity or the third degree of consanguinity (as defined
in Texas Government Code Chapter 573) to the member of the governing body or the
officer or any employee authorized to employ or supervise such person. This prohibition
does not prohibit the continued employment of a person who has been continuously
employed for a period of two years prior to the election, appointment or employment of
the officer, employee, or governing body member related to such person in the prohibited
degree. These restrictions also apply to the governing body, officers, and employees of
Grantee's subcontractors.
22. DIRECT OPERATION
System Agency may temporarily assume operations of a Grantee's program or programs funded
under this Contract when the continued operation of the program by Grantee puts, at risk, the health
or safety of clients and/or participants served by Grantee.
23. INTERIM EXTENSION AMENDMENT
A. Prior to or on the expiration date of this Contract, the Parties agree that this Contract can
be extended as provided under this Section, subject to the availability of funding.
B. The System Agency will provide written notice of interim extension amendment to the
Grantee under one of the following circumstances:
1. Continue provision of services in response to a disaster declared by the governor; or
2. To ensure that services to clients continue without interruption.
C. The System Agency will provide written notice of the interim extension amendment that
specifies the reason and length of time for the extension.
D. Grantee will provide and invoice for services in the same manner as stated in the Contract.
E. An interim extension under Section (b)(1) above will extend the term of the contract not
longer than 30 days after governor's disaster declaration is declared unless the Parties agree
to a shorter period of time.
F. An interim extension under Section (b)(2) above will be a one-time extension for time
determined by the System Agency.
24. MEDICAL RECORDS RETENTION
Grantee will;
A. Retain medical records in accordance with 22 TAC § 165.1(b) or other applicable statutes,
rules and regulations governing medical information.
B. Retain and preserve records in accordance with applicable state and federal statutes, rules
and regulations.
C. Maintain all non -financial records that are generated or collected by Grantee under the
provisions of this Contract for a period of at least seven years after the termination of this
Contract.
D. Retain the records in accordance with the federal retention period, if the federal retention
period for services funded through Medicaid is more than seven years.
10
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
E. Retain all records pertaining to this Contract that are the subject of litigation or an audit
until the litigation has ended or all questions pertaining to the audit are resolved.
F. Include this provision concerning records retention in any subcontract it awards.
G. Ensure that records relating to this Contract are securely stored and are accessible by the
System Agency upon System Agency's request for at least seven years from the date
Grantee ceases business or from the date this Contract terminates, whichever is sooner.
H. Provide and update as necessary, the name and address of the party responsible for storage
of records to the SUD email box, SubstanceAbuse.Contracts@hhsc.state.tx.us.
25. GRANTEE'S CERTIFICATION OF MEETING OR EXCEEDING TOBACCO -FREE WORKPLACE
POLICY MINIMUM STANDARDS
Grantee certifies that it has adopted and enforces a Tobacco -Free Workplace Policy that meets or
exceeds all of the following minimum standards of:
A. Prohibiting the use of all forms of tobacco products, including but not limited to
cigarettes, cigars, pipes, water pipes (hookah), bidis, kreteks, electronic cigarettes,
smokeless tobacco, snuff and chewing tobacco;
B. Designating the property to which this Policy applies as a "designated area," which must
at least comprise all buildings and structures where activities funded under this Contract
are taking place, as well as Grantee owned, leased, or controlled sidewalks, parking lots,
walkways, and attached parking structures immediately adjacent to this designated area;
C. Applying to all employees and visitors in this designated area; and
D. Providing for or referring its employees to tobacco use cessation services.
If Grantee cannot meet these minimum standards, it must obtain a waiver from the System Agency.
26. ELECTRONIC AND INFORMATION RESOURCES ACCESSIBILITY AND SECURITY STANDARDS
A. Applicability
The following Electronic and Information Resources (EIR) requirements apply to the Contract
because the Grantee performs services that include EIR that the System Agency's employees
are required or permitted to access or members of the public are required or permitted to access.
This Section does not apply to incidental uses of EIR in the performance of the Agreement,
unless the Parties agree that the EIR will become property of the State of Texas or will be used
by HHSC's clients or recipients after completion of the Agreement.
Nothing in this section is intended to prescribe the use of particular designs or technologies or
to prevent the use of alternative technologies, provided they result in substantially equivalent
or greater access to and use of a Product.
B. Definitions
1."Accessibility Standards" means accessibility standards and specifications for Texas
agency and institution of higher education websites and EIR set forth in 1 TAC Chapter
206 and/or Chapter 213.
2."Electronic and Information Resources" means information resources, including
information resources technologies, and any equipment or interconnected system of
11
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
equipment that is used in the creation, conversion, duplication, or delivery of data or
information. The term includes telephones and other telecommunications products,
information kiosks, transaction machines, Internet websites, multimedia resources, and
office equipment, including copy machines and fax machines.
3."Electronic and Information Resources Accessibility Standards" means the
accessibility standards for electronic and information resources contained in 1 Texas
Administrative Code Chapter 213.
4."Product" means information resources technology that is, or is related to EIR.
5."Web Site Accessibility Standards/Specifications" means standards contained in
Volume 1 Tex. Admin. Code Chapter 206(c) Accessibility Requirements. Under Tex.
Gov't Code Chapter 2054, Subchapter M, and implementing rules of the Texas
Department of Information Resources, the System Agency must procure Products and
services that comply with the Accessibility Standards when those Products are available in
the commercial marketplace or when those Products are developed in response to a
procurement solicitation. Accordingly, Grantee must provide electronic and information
resources and associated Product documentation and technical support that comply with
the Accessibility Standards.
C. Evaluation, Testing and Monitoring
1. The System Agency may review, test, evaluate and monitor Grantee's Products and
services, as well as associated documentation and technical support for compliance with
the Accessibility Standards. Review, testing, evaluation and monitoring may be
conducted before and after the award of a contract. Testing and monitoring may include
user acceptance testing. Neither the review, testing (including acceptance testing),
evaluation or monitoring of any Product or service, nor the absence of review, testing,
evaluation or monitoring, will result in a waiver of the State's right to contest the
Grantee's assertion of compliance with the Accessibility Standards.
2. Grantee agrees to cooperate fully and provide the System Agency and its
representatives timely access to Products, records, and other items and information
needed to conduct such review, evaluation, testing, and monitoring.
D. Representations and Warranties
1. Grantee represents and warrants that:
i. As of the Effective Date of the Contract, the Products and associated
documentation and technical support comply with the Accessibility Standards
as they exist at the time of entering the Agreement, unless and to the extent the
Parties otherwise expressly agree in writing; and
ii. If the Products will be in the custodyof the state or a System Agency's client or
recipient after the Contract expiration or termination, the Products will continue
to comply with Accessibility Standards after the expiration or termination of the
Contract Term, unless the System Agency or its clients or recipients, as
applicable, use the Products in a manner that renders it noncompliant.
2. In the event Grantee becomes aware, or is notified that the Product or service and
associated documentation and technical support do not comply with the Accessibility
Standards, Grantee represents and warrants that it will, in a timely manner and at no
cost to the System Agency, perform all necessary steps to satisfy the Accessibility
12
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
Standards, including remediation, replacement, and upgrading of the Product or
service, or providing a suitable substitute.
i. Grantee acknowledges and agrees that these representations and warranties are
essential inducements on which the System Agency relies in awarding this
Contract.
ii. Grantee's representations and warranties under this subsection will survive the
termination or expiration of the Contract and will remain in full force and effect
throughout the useful life of the Product.
E. Remedies
1. Under Tex. Gov't Code § 2054.465, neither the Grantee nor any other person has cause
of action against the System Agency for a claim of a failure to comply with Tex. Gov't
Code Chapter 2054, Subchapter M, and rules of the Department of Information
Resources.
2. In the event of a breach of Grantee's representations and warranties, Grantee will be
liable for direct, consequential, indirect, special, or liquidated damages and any other
remedies to which the System Agency may be entitled under this Contract and other
applicable law. This remedy is cumulative of any other remedies to which the System
Agency may be entitled under this Contract and other applicable law.
27. EQUIPMENT, SUPPLIES AND PROPERTY
A. Equipment
Equipment is defined as tangible personal property having a useful lifetime of more than one
year and a per -unit acquisition cost that exceeds $5,000 or more.
Grantee will:
1. Inventory all equipment and report the inventory on the Grantees Property Inventory
Form.
2. Initiate the purchase of all equipment, approved in writing by the System Agency, in the
first quarter of the Contract or Contract term, as applicable. Failure to initiate purchase of
equipment may result in the loss of availability of funds for the purchase of equipment.
Requests to purchase previously approved equipment after the first quarter in the Contract
must be submitted to the SUD email box, SubstanceAbuse.ContractsCa?hhsc.state.tx.us.
B. Equipment List
1. All items of equipment to be purchased with funds under this Contract must be itemized
in Grantee's equipment list as finally approved by the System Agency in the executed
Contract.
The equipment list must include:
i. Description of the property;
ii. Serial numer or other identification number;
iii. Source of funding for the property (including the Federal Assistance
Identification Number);
iv. Who holds titile,
V. Acquisition date and cost of the property;
vi. Percentage of Federal particiapation of the project costs for the Federal award
under which the property was acquired;
13
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
vii. Location use and condition of the property; and
viii. Any ultimate disposition data including the date of disposal and sale price of
property.
2. Any changes to the approved equipment list in this Contract must be approved in writing
by the System Agency prior to the purchase of equipment.
3. Grantee will submit to the assigned contract manager, a written description including
complete product specifications and need justification prior to purchasing any item of
unapproved equipment. If approved, the System Agency will acknowledge its approval
by means of a written amendment.
C. Supplies
1. Supplies are defined as consumable items necessary to carry out the services under this
Contract including medical supplies, drugs, janitorial supplies, officesupplies, patient
educational supplies, software, and any items of tangible personal property other than
those defined as equipment above.
2. Tangible personal property includes controlled assets, including firearms, regardless of
the acquisition cost, and the following assets with an acquisition cost of $500 or more,
but less than $5,000, which includes desktop and laptop computers (including
notebooks, tablets and similar devices), non -portable printers and copiers, emergency
management equipment, communication devices and systems, medical and laboratory
equipment, and media equipment are also considered Supplies.
3. Prior approval by the System Agency of the purchase of Controlled Assets is not
required, but such purchases must be reported on the Grantees Property Inventory
Form.
D. Property Inventory and Protection of Assets
Grantee will;
1. Maintain an inventory of equipment, supplies defined as controlled assets, and property
described in this Contract and submit to the assigned contract manager, upon request.
2. Maintain, repair and protect assets under this Contract to assure their full availability
and usefulness.
3. If Grantee is indemnified, reimbursed or otherwise compensated for any loss of,
destruction of, or damage to the assets provided or obtained under this Contract, use
the proceeds to repair or replace those assets.
E. Assets as Collateral Prohibited
Grantees will not encumber equipment purchased with System Agency funds without prior
written approval from the System Agency.
F. Bankruptcy
In the event of bankruptcy, Grantee will;
1. Sever the System Agency property, equipment, and supplies in possession of Grantee
from the bankruptcy, and title must revert to the System Agency.
2. When directed by the System Agency, return all such property, equipment and supplies
to the System Agency.
3. Ensure that its subcontracts, if any, contain a specific provision requiring that in the
14
DocuSign Envelope ID: 8AD24363-682A-4CB7-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
event of the subcontractor's bankruptcy, the subcontractor must sever the System
Agency property, equipment, and supplies in possession of the subcontractor from the
bankruptcy, and title must revert to the System Agency, who may require that the
property, equipment and supplies be returned to the System Agency.
G. Title to Property
At the expiration or termination of this Contact for any reason, title to any remaining equipment
and supplies purchased with funds under this Contract reverts to System Agency. Title may be
transferred to any other party designated by System Agency. The System Agency may, at its
option and to the extent allowed by law, transfer the reversionary interest to such property to
Grantee.
H. Disposition of Property
1. Grantee will follow the procedures in the American Hospital Association's (AHA)
"Estimated Useful Lives of Depreciable Hospital Assets" in disposing, at any time
during or after the Contract term, of equipment purchased with the System Agency
funds, except when federal or state statutory requirements supersede or when the
equipment requires licensure or registration by the state, or when the acquisition price
of the equipment is equal to or greater than $5,000.
2. All other equipment not listed in the AHA reference (other than equipment that requires
licensure or registration or that has an acquisition cost equal to or greater than $5,000)
will be controlled by the requirements of UGMS.
3. If, prior to the end of the useful life, any item of equipment is no longer needed to
perform services under this Contract, or becomes inoperable, or if the equipment
requires licensure or registration or had an acquisition price equal to or greater than
$5,000, Grantee will request disposition approval and instructions in writing from the
contract manager assigned to this Contract.
4. After an item reaches the end of its useful life, Grantee will ensure that disposition of
any equipment is in accordance with Generally Accepted Accounting Principles, and
any applicable federal guidance.
I. Closeout of Equipment
1. At the end of the term of a Contract that has no additional renewals or that will not be
renewed (Closeout), or when a Contract is otherwise terminated, Grantee will submit
to the SUD email box, SubstanceAbuse. Contracts ri.hhsc.state.tx.us an inventory of
equipment purchased with System Agency funds and request disposition instructions
for such equipment.
2. All equipment purchased with System Agency funds must be secured by Grantee at the
time of Closeout, or termination of this Contract, and must be disposed of according to
the System Agency's disposition instructions, which may include return of the
equipment to System Agency or transfer of possession to another System Agency
Grantee, at Grantee's expense.
J. Insurance
In addition to the Insurance provision of the Uniform Terms and Conditions, Grantee will:
15
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
1. Maintain insurance or other means of repairing or replacing assets purchased with
System Agency funds.
2. Repair or replace with comparable equipment any such equipment not covered by
insurance that is lost, stolen, damage or destroyed. If any insured equipment purchased
with System Agency funds is lost, stolen, damaged or destroyed.
3. Notify the contract manager assigned to this Contract within 5 business days of learning
of the lolss, to obtain instructions whether to submit and pursue an insurance claim.
4. Use any insurance proceeds to repair the equipment or replace the equipment with
comparable equipment or remit the insurance proceeds to System Agency.
K. Travel
The System Agency's travel policy will apply to all travel reimbursement if Grantee does not
have a formal Travel Policy. If Grantee has a formal Travel Policy,
Grantee will:
1. Submit Grantee's formal travel policy to be approved by the assigned contract manager.
2. Ensure travel policy specifies reimbursement limits for meals, lodging, and the mileage
rate.
3. Ensure all travel costs are reasonable and necessary.
4. Ensure all out-of-state travel is approved by the assigned contract manager prior to
travel.
5. Submit all out-of-state travel requests to the SUD email box,
SubstanceAbuse.ContractsCtihhsc.state.tx.us, at least, thirty (30) days prior to travel.
L. Management and Control Systems
Grantee will:
1. Maintain an appropriate contract administration system to ensure that all terms,
conditions, and specifications are met during the term of the contract through the
completion of the closeout procedures.
2. Develop, implement, and maintain financial management and control systems that meet
or exceed the requirements of Uniform Statewide Accounting System (UGMS). Those
requirements and procedures include, at a minimum, the following:
i. 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;
ii. Financial management systems that include accurate accounting records that are
accessible and identify the source and application of funds provided under each
Contract of this Contract, and original source documentation substantiating that
costs are specifically and solely allocable to a Contract and its Contract and are
traceable from the transaction to the general ledger;
iii. Effective internal and budgetary controls;
iv. Comparison of actual costs to budget; determination of reasonableness,
allowableness, and allocability of costs;
v. Timely and appropriate audits and resolution of any findings;
vi. Billing and collection policies; and
vii. Mechanism capable of billing and making reasonable efforts to collect from
16
DocuSign Envelope ID: 8AD24363-682A-4C87-8131F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
clients and third parties.
M. Property Acquistions
System Agency funds must not be used to purchase buildings or real property. Any costs
related to the initial acquisition of the buildings or real property are not allowable.
N. Condition Precedent to Requesting Payment
Grantee will disburse program income, rebates, refunds, contract settlements, audit
recoveries, and interest earned on such funds before requesting cash payments including any
advance payments from the System Agency.
O. Overtime Compensation
1. Except as provided in this section, Grantee will 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 employee's normal rate of pay for
hours worked in excess of normal working hours.
2. Funds provided under this Contract may be used to pay the premium portion of
overtime only under the following conditions:
i. With the prior written approval of System Agency;
ii. Temporarily, in the case of an emergency or an occasional operational bottleneck;
iii. When employees are performing indirect functions, such as administration,
maintenance, or accounting;
iv. In performance of tests, laboratory procedures, or similar operations that are
continuous in nature and cannot reasonably be interrupted or otherwise
completed; or
v. When lower overall cost to System Agency will result.
P. Fidelity Bond
For the benefit of System Agency, Grantee is required to carry a fidelity bond or insurance
coverage equal to the amount of funding provided under this Contract up to $100,000 that
covers each employee of Grantee handling funds under this Contract, including person(s)
authorizing payment of such funds.
1. The fidelity bond or insurance must provide for indemnification of losses occasioned
by any fraudulent or dishonest act or acts committed by any of Grantee's employees,
either individually or in concert with others, and/or failure of Grantee or any of its
employees to perform faithfully his/her duties or to account properly for all monies and
property received by virtue of his/her position or employment. The bond or insurance
acquired under this section must include coverage for third party property.
2. Grantee will notify, and obtain prior approval from, the System Agency Contract
Oversight and Support Section before settling a claim on the fidelity bond or insurance.
Q. Liability Coverage
For the benefit of System Agency, Grantee will at all times maintain liability insurance
coverage, referred to in Tex. Gov. Code § 2261.102, as "director and officer liability coverage"
or similar coverage for all persons in management or governing positions within Grantee's
17
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
organization or with management or governing authority over Grantee's organization
(collectively "responsible persons").
Grantee will:
1. Maintain copies of liability policies on site for inspection by System Agency and will
submit copies of policies to System Agency upon request.
2. Maintain liability insurance coverage in an amount not less than the total value of this
Contract and that is sufficient to protect the interests of System Agency in the event an
actionable act or omission by a responsible person damages System Agency's interests.
3. Notify, and obtain prior approval from, the System Agency Contract Oversight and
Support Section before settling a claim on the insurance.
R. Quality Management
Grantee will:
1. Comply with quality management requirements as directed by the System Agency.
2. Develop and implement a Quality Management Plan (QMP) that conforms with 25
TAC § 448.504 and make the QMP available to System Agency upon request. The
QMP must be developed no later than the end of the first quarter of the Contract term.
3. Update and revise the QMP each biennium or sooner, if necessary. Grantee's governing
body will review and approve the initial QMP, within the first quarter of the Contract
term, and each updated and revised QMP thereafter. The QMP must describe Grantee's
methods to measure, assess, and improve -
i. Implementation of evidence -based practices, programs and research -based
approaches to service delivery;
ii. Client/participant satisfaction with the services provided by Grantee;
iii. Service capacity and access to services;
iv. Client/participant continuum of care; and
v. Accuracy of data reported to the state.
4. Participate in continuous quality improvement (CQI) activities as defined and
scheduled by the state including, but not limited to data verification, performing self -
reviews; submitting self -review results and supporting documentation for the state's
desk reviews; and participating in the state's onsite or desk reviews.
5. Submit plan of improvement or corrective action plan and supporting documentation
as requested by System Agency.
6. Participate in and actively pursue CQI activities that support performance and
outcomes improvement.
7. Respond to consultation recommendations by System Agency, which may include, but
are not limited to the following:
i. Staffing training;
ii. Self -monitoring activities guided by System Agency, including use of quality
management tools to self -identify compliance issues; and
iii. Monitoring of performance reports in the System Agency electronic clinical
management system
S. Abuse, Neglect, Exploitation
Grantee will:
18
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
1. Take all steps necessary, to protect the health, safety and welfare of its clients and
participants.
2. Develop and implement written policies and procedures for abuse, neglect and
exploitation.
3. Notify appropriate authorities of any allegations of abuse, neglect, or exploitation as
required by 25 TAC § 448.703.
T. Personnel Requirements and Documentation
Grantee will;
1. Maintain current personnel documentation on each employee. All documents must be
factual and accurate. Health -related information must be stored separately with
restricted access as appropriate under Tex. Gov. Code §552.102. training records may
be stored separately from the main personnel file but must be easily accessible upon
request. Required documentation includes the following, as applicable:
i. A copy of the current job description signed by the employee;
ii. Application or resume with documentation of required qualifications and
verification of required credentials;
iii. Verification of work experience;
iv. Annual performance evaluations;
V. Personnel data that includes date hired, rate of pay, and documentation of all
pay increases and bonuses;
vi. Documentation of appropriate screening and/or background checks, to include
probation or parole documentation;
vii. Signed documentation of initial and other required training; and
viii. Records of any disciplinary actions.
2. Document authentication must include signature, credentials when applicable, and
date. If the document relates to past activity, the date of the activity must also be
recorded. Documentation must be permanent and legible. When it is necessary to
correct a required document, the error must be marked through with a single line, dated,
and initialed by the writer.
28. CLINICAL MANAGEMENT FOR BEHAVIORAL HEALTH SERVICES (CMBHS) SYSTEM
The CMBHS is the official record of documentation by System Agency.
Grantee shall:
1. request access to CMBHS via the CMBHS Helpline at (866) 806-7806.
2. use the CMBHS time frames specified by System Agency.
3. use System Agency -specified functionality of the CMBHS in its entirety.
4. submit all bills and reports to System Agency through the CMBHS, unless otherwise
instructed
A. Resources
Grantee shall ensure that Grantee's employees have appropriate Internet access and an
adequate number of computers of sufficient capabilities to use the CMBHS. Equipment
purchased with System Agency funds must be inventoried, maintained in working order, and
secured.
19
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1 F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
B. Security Administrator and Authorized Users
Grantee shall:
1. Designate a Security Administrator and a back-up Security Administrator. The Security
Administrator is required to implement and maintain a system for management of user
accounts/user roles to ensure that all the CMBHS user accounts are current.
2. Have a security policy that ensures adequate system security and protection of
confidential information.
3. Notify the CMBHS Help -desk within ten (10) business days of any change to the
designated Security Administrator or the back-up Security Administrator.
Grantee will:
i. Ensure that access to CMBHS is restricted to only currently authorized users.
ii. Within 24 hours, remove access to users who are no longer authorized to have
access to secure data in CMBHS.
iii. Maintain the CMBHS Authorized Users List which includes former and current
Grantee's employees, contracted labor, subcontractors or any other users
authorized to have access to secure data in CMBHS. The CMBHS Authorized
Users List shall document whose authority has been added and terminated; and
the date the authority was added and terminated.
4. Submit the CMBHS Security Attestation Form and the CMBHS Authorized Users List
as stated in Attachment A, to the following e-mail address:
SubstanceAbuse.Contracts(ci: hhsc.state.tx.us.
5. continually maintain the current CMBHS Authorized Users List on file and make
available to System Agency upon request within five business days.
6. immediately block access to CMBHS of any person who should no longer have access
to CMBHS, due to severance of employment with Grantee or otherwise,
i. immediately modify access when there is a change in a user's job
responsibilities that affects the user's need for access to CMBHS,
ii. update records on a daily basis to reflect any changes in account status.
C. Security Violations and Accounts Updates
Grantee will adhere to the Confidentiality Article requirements and HHS Data Usage
Agreement of this contract and immediately contact System Agency if a security violation is
detected, or if Grantee has any reason to suspect that the security or integrity of the CMBHS
data has been or may be compromised in any way.
D. Electronic Transfer of Information
Grantee will establish and maintain adequate internal controls, security, and oversight for the
approval and electronic transfer of information regarding payments and reporting
requirements. Grantee certifies that the electronic payment requests and reports transmitted
will contain true, accurate, and complete information.
E. Access
System Agency reserves the right to limit or deny access, to the CMBHS by Grantee, at any
time for any reason deemed appropriate by System Agency. Grantee access to CMBHS will
20
DocuSign Envelope lU 8AD24363-682A-4C87-8B 1 F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
be placed in inactive status when theGrantee ceases to have an executed contract with System
Agency Mental Health and Substance Abuse Division.
F. Customer Support and Training
System Agency will provide support for the CMBHS, including problem tracking and problem
resolution. System Agency will provide telephone numbers for Grantees to obtain access to
expert assistance for CMBHS-related problem resolution. System Agency will provide initial
CMBHS training. Grantee shall provide subsequent ongoing end -user training.
29. HIV/AIDS MODEL WORKPLACE GUIDELINES
Grantee will:
A. Implement the System Agency's policies based on the Human Immunodeficiency
Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), AIDS Model Workplace
Guidelines for Businesses at http://www.dshs.state.tx.us/hivstd/policy/policies.shtm, State
Agencies and State Grantees Policy No. 090.021.
B. Educate employee and clients concerning HIV and its related conditions, including AIDS,
in accordance with the Texas Health & Safety Code §§ 85.112-114.
30. MEDICAID ENROLLMENT
Treatment Grantees shall enroll as a provider with Texas Medicaid and Healthcare Partnership
(TMHP) and all Medicaid Managed Care organizations in Grantee's service region within the
first quarter of this procurement term and maintain through the procurement term.
31. BILLING FOR TREATMENT AND PAYMENT RESTRICTIONS
Grantees will;
A. Bill for only one intensity of service and service type (either outpatient or residential)
per client per day
B. Not bill for an intensity of service and service type if another System Agency -funded
Treatment Grantee is providing and billing System Agency for another intensity of
service and service type.
The following are the exception to item b.:
A client may receive;
i. co-occurring psychiatric / substance use disorder services,
ii. ambulatory detoxification, or
iii. opioid substitution therapy services, at the same time the client receives SUD
outpatient or residential treatment services or items 1-3 listed above.
If two Grantees provide services to the same client under this exception, the Grantees must
coordinate services and both Grantees must document the service coordination in CMBHS.
32. SUBSTANCE ABUSE BLOCK GRANT (SABG) REQUIREMENTS
Grantee will comply with the requirements of the SABG, including the restrictions on expenditure
of grant funds, stated in 45 CFR § 96.135 and the Notice of Grant Award:
The State shall not expend the Block Grant on the following activities:
21
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
A. To provide inpatient hospital services, except as provided in paragraph (c) of this
section;
B. To make cash payments to intended recipients of health services;
C. To purchase or improve land, purchase, construct, or permanently improve (other than
minor remodeling) any building or other facility, or purchase major medical equipment;
D. To satisfy any requirement for the expenditure of non -Federal funds as a condition for
the receipt of Federal funds;
E. To provide financial assistance to any entity other than a public or nonprofit private
entity; or
F. To provide individuals with hypodermic needles or syringes so that such individuals
may use illegal drugs, unless the Surgeon General of the Public Health Service
determines that a demonstration needle exchange program would be effective in
reducing drug abuse and the risk that the public will become infected with the
etiologic agent for AIDS.
33. MATCH AND PROGRAM INCOME
Grantee will:
A. Contribute match that is, at minimum, the percentage, stated on Attachment B, of Total
System Agency Share unless otherwise stated on Attachment B.
B. Report match on each Financial Status Report (FSR) or Quarterly Match Report,
including description, source, and dollar amount in the FSR comment section for the
non -System Agency funding and in -kind contributions for the program or as directed
by System Agency.
C. Adhere to the Program Income requirements in Uniform Grants Management Standards
(UGMS) or Texas Grant Management Standards (TxGMS) as appropriate.
D. Not use program income as match without prior approval of the contract manager
assigned to the Contract.
E. If the match ratio requirement is not met by the beginning of the last three months
ofthe term of the Contract, System Agency may withhold or reduce payments to satisfy
match insufficiency or demand a refund of the amount of the match insufficiency.
34. CONTRACT RECONCILIATION
Grantee, within 45 calendar days after the end of each fiscal term year, will submit to the System
Agency email box, SubstanceAbuse.Contractsphhsc.state.tx.us, financial and reconciliation
reports required by System Agency in forms as determined by System Agency.
35. BREACH OF CONTRACT AND LIQUIDATED DAMAGES
A. Contract Monitoring
System Agency:
Will monitor Grantee for programmatic and financial compliance with this Contract
and;
22
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
2. May impose liquidated damages for any breach of this Contract.
3. But its discretion, may place Grantee on accelerated monitoring, which entails more
frequent or more extensive monitoring than ordinarily conducted by System Agency.
4. May allow the Grantee the opportunity to correct identified deficiencies prior to
imposing actions stated in this section.
B. Liquidated Damages.
Grantee agrees that noncompliance with the requirements specified in the Contract causes
damages to System Agency that are difficult to ascertain and quantify.
Grantee further agrees that System Agency may impose liquidated damages each month for so
long as the noncompliance continues. Failure to comply with any of the Contract requirements,
System Agency may impose liquidated damages of:
1. $500 for the first occurrence of noncompliance during a fiscal year;
2. $750 for the second occurrence of noncompliance with the same requirement
during the same fiscal year; and
3. $1,000 for the third and subsequent occurrence(s) of noncompliance with the
same requirement during the same fiscal year.
C. Grantee Repayment
System Agency may withhold payments to Grantee to satisfy any recoupment or liquidated
damage imposed by System Agency under this Article. System Agency may take repayment
from funds available under this Contract, active or expired, or any subsequent renewal, in
amounts necessary to fulfill Grantee's repayment obligations.
D. Notice of Liquidated Damages
System Agency will formally notify Grantee in writing when liquidated damages action is
imposed, stating the nature of the action, the reasons for imposing, and the method of
appealing. Grantee must submit a written appeal, within ten (10) calendar days of receipt of
the notice, to the SUD email box, SubstanceAbuse.Contractsphhsc.state, tx.us.
A submitted appeal must;
1. Include documented proof that Grantee submitted the information by the due date or
received an exemption from the assigned contract manager.
2. Demonstrate the findings on which the Liquidated Damage is based are either invalid
or do not warrant the action(s).
If System Agency determines the liquidated damage is warranted, System Agency's decision
is final and the remedy or sanction shall be imposed.
23
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ATTACHMENT F
HHSC ADDITIONAL PROVISIONS
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
24
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
FLULKAL AJ5UKANl:t FUK NUN-UUNS I KUL; I IUN
PROJECT AND FEDERAL LOBBYING FORM
TEXAS
A Si
Health and Human Services
FEDERAL ASSURANCES FOR NON -CONSTRUCTION
PROJECT AND FEDERAL LOBBYING FORM
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
FtUtKAL AJJUKANl;t1 FUK NUN -
CONSTRUCTION PROJECT AND FEDERAL
LOBBYING FORM
ASSURANCES - NON -CONSTRUCTION PROGRAMS
OMB Number: 4040-0007
Expiration Date: 01/31/2019
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0040), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND
IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
NOTE: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the
awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances.
If such is the case, you will be notified.
As the duly authorized representative of the applicant, I certify that the applicant:
1. Has the legal authority to apply for Federal assistance
and the institutional, managerial and financial capability
(including funds sufficient to pay the non -Federal share
of project cost) to ensure proper planning, management
and completion of the project described in this
application.
2. Will give the awarding agency, the Comptroller General
of the United States and, if appropriate, the State,
through any authorized representative, access to and
the right to examine all records, books, papers, or
documents related to the award; and will establish a
proper accounting system in accordance with generally
accepted accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from
using their positions for a purpose that constitutes or
presents the appearance of personal or organizational
conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable
time frame after receipt of approval of the awarding
agency.
5. Will comply with the Intergovernmental Personnel Act of
1970 (42 U.S.C. §§4728-4763) relating to prescribed
standards for merit systems for programs funded under
one of the 19 statutes or regulations specified in
Appendix A of OPM's Standards for a Merit System of
Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all Federal statutes relating to
nondiscrimination. These include but are not limited to:
(a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)
which prohibits discrimination on the basis of race, color
or national origin; (b) Title IX of the Education
Amendments of 1972, as amended (20 U.S.C.§§1681-
1683, and 1685-1686), which prohibits discrimination on
the basis of sex; (c) Section 504 of the Rehabilitation
Act of 1973, as amended (29 U.S.C. §794), which
prohibits discrimination on the basis of handicaps; (d)
the Age Discrimination Act of 1975, as amended (42 U.
S.C. §§6101-6107), which prohibits discrimination on
the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended,
relating to nondiscrimination on the basis of drug
abuse; (f) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation
Act of 1970 (P.L. 91-616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or
alcoholism; (g) §§523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290
ee- 3), as amended, relating to confidentiality of alcohol
and drug abuse patient records; (h) Title VIII of the Civil
Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as
amended, relating to nondiscrimination in the sale,
rental or financing of housing; (i) any other
nondiscrimination provisions in the specific statute(s)
under which application for Federal assistance is being
made; and, 0) the requirements of any other
nondiscrimination statute(s) which may apply to the
application.
Will comply, or has already complied, with the
requirements of Titles II and III of the Uniform
Relocation Assistance and Real Property Acquisition
Policies Act of 1970 (P.L. 91-646) which provide for
fair and equitable treatment of persons displaced or
whose property is acquired as a result of Federal or
federally -assisted programs. These requirements
apply to all interests in real property acquired for
project purposes regardless of Federal participation in
purchases.
8. Will comply, as applicable, with provisions of the
Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328)
which limit the political activities of employees whose
principal employment activities are funded in whole
or in part with Federal funds.
Previous Edition Usable Standard Form 424B (Rev. 7.97)
Authorized for Local Reproduction Prescribed by OMB Circular A-102
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
t-tULKAL A,JUKANI;tb FUK NUN -
CONSTRUCTION PROJECT AND FEDERAL
LOBBYING FORM
9. Will comply, as applicable, with the provisions of the Davis- 13. Will assist the awarding agency in assuring compliance
Bacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act with Section 106 of the National Historic Preservation
(40 U.S.C. §276c and 18 U.S.C. §874), and the Contract Act of 1966, as amended (16 U.S.C. §470), EO 11593
Work Hours and Safety Standards Act (40 U.S.C. §§327- (identification and protection of historic properties), and
333), regarding labor standards for federally -assisted the Archaeological and Historic Preservation Act of
construction subagreements. 1974 (16 U.S.C. §§469a-1 et seq.).
10. Will comply, if applicable, with flood insurance purchase
requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires
recipients in a special Flood hazard area to participate in the
program and to purchase flood insurance if the total cost of
insurable construction and acquisition is $10,000 or more.
11. Will comply with environmental standards which may be
prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National
Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating
facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in
floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management
program developed under the Coastal Zone Management
Act of 1972 (16 U.S.C. §§1451 et seq.); (f) conformity of
Federal actions to State (Clean Air) Implementation Plans
under Section 176(c) of the Clean Air Act of 1955, as
amended (42 U.S.C. §§7401 et seq.); (g) protection of
underground sources of drinking water under the Safe
Drinking Water Act of 1974, as amended (P.L. 93-523);
and, (h) protection of endangered species under the
Endangered Species Act of 1973, as amended (P.L. 93-
205).
12. Will comply with the Wild and Scenic Rivers Act of
1968 (16 U.S.C. §§1271 et seq.) related to protecting
components or potential components of the national
wild and scenic rivers system.
14. Will comply with P.L. 93-348 regarding the protection of
human subjects involved in research, development, and
related activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of
1966 (P.L. 89-544, as amended, 7 U.S.C. §§2131 et
seq.) pertaining to the care, handling, and treatment of
warm blooded animals held for research, teaching, or
other activities supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning
Prevention Act (42 U.S.C. §§4801 et seq.) which
prohibits the use of lead -based paint in construction or
rehabilitation of residence structures.
17. Witl cause to be performed the required financial and
compliance audits in accordance with the Single Audit
Act Amendments of 1996 and OMB Circular No. A-133,
"Audits of States, Local Governments, and Non -Profit
Organizations."
18. Will comply with all applicable requirements of all other
Federal laws, executive orders, regulations, and policies
governing this program.
19, Will comply with the requirements of Section 106(g) of
the Trafficking Victims Protection Act (TVPA) of 2000, as
amended (22 U.S.C. 7104) which prohibits grant award
recipients or a sub -recipient from (1) Engaging in severe
forms of trafficking in persons during the period of time
that the award is in effect (2) Procuring a commercial
sex act during the period of time that the award is in
effect or (3) Using forced labor in the performance of the
award or subawards under the award.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
—Doeuftned by.
Via Port -
APPLICANT ORGANIZATION
TITLE
ayo r
DATE SUBMITTED
lty ot Lubbock
colibel S.
Standard Form 424B (Rev. 7-97) Back
DocuSign Envelope ID: SAD243G3-f82A-4C87-861F-FED5D527850C
uuvio 1 Rules I IVIV fRVJCti I HIVU fCUCRHL
LOBBYING FORM
CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of an agency, a Member of
Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with
the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the
entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or
modification of any Federal contract, grant, loan, or 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-LLL, "Disclosure of Lobbying Activities," 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.
Statement for Loan Guarantees and Loan Insurance
The undersigned states, to the best of his or her knowledge and belief, that:
If any 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 commitment providing for the United States to insure or
guarantee a loan, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying
Activities;' in accordance with its instructions. Submission of this statement 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 statement shall be subject to a civil penalty of not less than $10,000 and not more than $100,000
for each such failure.
* APPLICANT'S ORGANIZATION
city of Lubbock
* PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE
Prefix: * First Name: and a I Middle Name:
* Last Name: rope Suffix:
* Title: Mayor
* SIGNATURE: DoeuSlg"dby- * DATE:repLeultler ] 2021
VA'A Pert,
3F037B03155540F
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
DATA USE AGREEMENT
BETWEEN THE
TEXAS HEALTH AND HUMAN SERVICES SYSTEM
AND
CONTRACTOR
This Data Use Agreement ("DUA") is effective as of the date of the Base Contract into which it is
incorporated ("Effective Date"), by and between the Texas Health and Human Services System, which
includes the Texas Health and Human Services Commission and the Department of State Health Services
("HHS") and Contractor (the "Base Contract").
ARTICLE 1. PURPOSE; APPLICABILITY; ORDER OF PRECEDENCE
The purpose of this DUA is to facilitate access to, creation, receipt, maintenance, use, disclosure or
transmission of Confidential Information with Contractor, and describe Contractor's rights and obligations
with respect to the Confidential Information and the limited purposes for which the Contractor may create,
receive, maintain, use, disclose or have access to Confidential Information. This DUA also describes
HHS's remedies in the event of Contractor's noncompliance with its obligations under this DUA. This
DUA applies to both HHS business associates, as "business associate" is defined in the Health Insurance
Portability and Accountability Act (HIPAA , and contractors who are not business associates, who create,
receive, maintain, use, disclose or have access to Confidential Information on behalf of HHS, its programs
or clients as described in the Base Contract. As a best practice, HHS requires its contractors to comply with
the terms of this DUA to safeguard all types of Confidential Information.
As of the Effective Date of this DUA, if any provision of the Base Contract conflicts with this
DUA, this DUA controls.
ARTICLE 2. DEFINITIONS
For the purposes of this DUA, capitalized, underlined terms have the following meanings:
"Authorized Purpose" means the specific purpose or purposes described in the Base Contract for
Contractor to fulfill its obligations under the Base Contract, or any other purpose expressly authorized by
HHS in writing in advance.
"Authorized User" means a person:
(1) Who is authorized to create, receive, maintain, have access to, process, view, handle,
examine, interpret, or analyze Confidential Information pursuant to this DUA;
(2) For whom Contractor warrants and represents has a demonstrable need to create, receive,
maintain, use, disclose or have access to the Confidential Information; and
(3) Who has agreed in writing to be bound by the disclosure and use limitations pertaining to
the Confidential Information as required by this DUA.
"Breach" means an impermissible use or disclosure of electronic or non -electronic sensitive personal information by an
unauthorized person or for an unauthorized purpose that compromises the security or privacy of Confidential Information
such that the use or disclosure poses a risk of reputational harm, theft of financial information, identity theft, or medical
identity theft. Any acquisition, access, use, disclosure or loss of Confidential Information other than as permitted by this
HHS Data Use Agreement v.8.5 October 23, 2019
1of11
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
DUA shall be presumed to be a Breach unless Contractor demonstrates, based on a risk assessment, that there is a low
probability that the Confidential Information has been compromised.
"Confidential Information" means any communication or record (whether oral, written, electronically
stored or transmitted, or in any other form) provided to or made available to Contractor or that Contractor
may create, receive, maintain, use, disclose or have access to on behalf of HHS that consists of or
includes any or all of the following:
(1) Education records as defined in the Family Educational Rights and Privacy Act, 20 U.S.C.
§ 1232g; 34 C.F.R. Part 99
(2) Federal Tax Information as defined in Internal Revenue Code §6103 and Internal Revenue
Service Publication 1075;
(3) Personal Identifying Information (PII as defined in Texas Business and Commerce Code,
Chapter 521;
(4) Protected Health Information (PI) in any form including without limitation, Electronic
Protected Health Information or Unsecured Protected Health Information as defined in 45
C.F.R. § 160.103;
(5) Sensitive Personal Information (SPI) as defined in Texas Business and Commerce Code,
Chapter 521;
(6) Social Security Administration Data, including, without limitation, Medicaid information
means disclosures of information made by the Social Security Administration or the
Centers for Medicare and Medicaid Services from a federal system of records for
administration of federally funded benefit programs under the Social Security Act, 42
U.S.C., Chapter 7;
(7) All privileged work product;
(8) All information designated as confidential under the constitution and laws of the State of
Texas and of the United States, including the Texas Health & Safety Code and the Texas
Public Information Act, Texas Government Code, Chapter 552.
"Destroy", "Destruction", for Confidential Information. means:
(1) Paper, film, or other hard copy media have been shredded or destroyed such that the
Confidential Information cannot be read or otherwise cannot be reconstructed. Redaction is specifically
excluded as a means of data destruction.
(2) Electronic media have been cleared, purged, or destroyed consistent with NIST Special
Publication 800-88, "Guidelines for Media Sanitization," such that the Confidential Information cannot be
retrieved.
"Discover, Discovery" means the first day on which a Breach becomes known to Contractor, or, by
exercising reasonable diligence would have been known to Contractor.
"Leeally Authorized Rearesentative" of an individual, including as provided in 45 CFR 435.923
(authorized representative); 45 CFR 164.502(g)(1) (personal representative); Tex. Occ. Code § 151.002(6);
Tex. H. & S. Code § 166.164 (medical power of attorney); and Texas Estates Code § 22.031(representative).
"Required by Law" means a mandate contained in law that compels an entity to use or disclose
Confidential Information that is enforceable in a court of law, including court orders, warrants, subpoenas
or investigative demands.
HHS Data Use Agreement v.8.5 October 23, 2019
2ofII
DocuSign Envelope ID: 8AD24363-682A-4C87-8BlF-FED5D527850C
"Subcontractor" means a person who contracts with a prime contractor to work, to supply commodities,
or to contribute toward completing work for a governmental entity.
"Workforce" means employees, volunteers, trainees or other persons whose performance of work is under
the direct control of a party, whether or not they are paid by that party.
ARTICLE 3. CONTRACTOR'S DUTIES REGARDING CONFIDENTIAL INFORMATION
Section 3.01 Obligations of Contractor
Contractor agrees that:
(A) With respect to PHI, Contractor shall:
(1) Make PHI available in a designated record set if requested by HHS, if Contractor maintains
PHI in a designated record set, as defined in HIPAA.
(2) Provide to HHS data aggregation services related to the healthcare operations Contractor
performs for HHS pursuant to the Base Contract, if requested by HHS, if Contractor provides data
aggregation services as defined in HIPAA.
(3) Provide access to PHI to an individual who is requesting his or her own PHI, or such
individual's Legally Authorized Representative, in compliance with the requirements of HIPAA.
(4) Make PHI available to HHS for amendment, and incorporate any amendments to PHI that
HHS directs, in compliance with HIPAA.
(5) Document and make available to HHS, an accounting of disclosures in compliance with
the requirements of HIPAA.
(6) If Contractor receives a request for access, amendment or accounting of PHI by any
individual, promptly forward the request to HHS or, if forwarding the request would violate HIPAA,
promptly notify HHS of the request and of Contractor's response. HHS will respond to all such requests,
unless Contractor is Required by Law to respond or HHS has given prior written consent for Contractor to
respond to and account for all such requests.
(B) With respect to ALL Confidential Information, Contractor shall:
(1) Exercise reasonable care and no less than the same degree of care Contractor uses to protect
its own confidential, proprietary and trade secret information to prevent Confidential Information from
being used in a manner that is not expressly an Authorized Purpose or as Required by Law. Contractor will
access, create, maintain, receive, use, disclose, transmit or Destroy Confidential Information in a secure
fashion that protects against any reasonably anticipated threats or hazards to the security or integrity of such
information or unauthorized uses.
(2) Establish, implement and maintain appropriate procedural, administrative, physical and
technical safeguards to preserve and maintain the confidentiality, integrity, and availability of the
Confidential Information, in accordance with applicable laws or regulations relating to Confidential
Information, to prevent any unauthorized use or disclosure of Confidential Information as long as
Contractor has such Confidential Information in its actual or constructive possession.
(3) Implement, update as necessary, and document privacy, security and Breach notice policies
and procedures and an incident response plan to address a Breach, to comply with the privacy, security and
breach notice requirements of this DUA prior to conducting work under the Base Contract. Contractor
HHS Data Use Agreement v.8.5 October 23, 2019
3ofII
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
shall produce, within three business days of a request by HHS, copies of its policies and procedures and
records relating to the use or disclosure of Confidential Information.
(4) Obtain HHS's prior written consent to disclose or allow access to any portion of the
Confidential Information to any person, other than Authorized Users, Workforce or Subcontractors of
Contractor who have completed training in confidentiality, privacy, security and the importance of promptly
reporting any Breach to Contractor's management and as permitted in Section 3.01(A)(3), above. Contractor
shall produce evidence of completed training to HHS upon request. HHS, at its election, may assist
Contractor in training and education on specific or unique HHS processes, systems and/or requirements.
All of Contractor's Authorized Users, Workforce and Subcontractors with access to a state computer system
or database will complete a cybersecurity training program certified under Texas Government Code Section
2054.519 by the Texas Department of Information Resources.
(5) Establish, implement and maintain appropriate sanctions against any member of its
Workforce or Subcontractor who fails to comply with this DUA, the Base Contract or applicable law.
Contractor shall maintain evidence of sanctions and produce it to HHS upon request.
(6) Obtain prior written approval of HHS, to disclose or provide access to any Confidential
Information on the basis that such act is Required by Law, so that HHS may have the opportunity to object
to the disclosure or access and seek appropriate relief. If HHS objects to such disclosure or access,
Contractor shall refrain from disclosing or providing access to the Confidential Information until HHS has
exhausted all alternatives for relief.
(7) Certify that its Authorized Users each have a demonstrated need to know and have access
to Confidential Information solely to the minimum extent necessary to accomplish the Authorized Purpose
and that each has agreed in writing to be bound by the disclosure and use limitations pertaining to the
Confidential Information contained in this DUA. Contractor and its Subcontractors shall maintain at all
times an updated, complete, accurate list of Authorized Users and supply it to HHS upon request.
(8) Provide, and shall cause its Subcontractors and agents to provide, to HHS periodic written
confirmation of compliance with controls and the terms and conditions of this DUA.
(9) Return to HHS or Destroy, at HHS's election and at Contractor's expense, all Confidential
Information received from HHS or created or maintained by Contractor or any of Contractor's agents or
Subcontractors on HHS's behalf upon the termination or expiration of this DUA, if reasonably feasible and
permitted by law. Contractor shall certify in writing to HHS that all such Confidential Information has
been Destroyed or returned to HHS, and that Contractor and its agents and Subcontractors have retained no
copies thereof. Notwithstanding the foregoing, Contractor acknowledges and agrees that it may not Destroy
any Confidential Information if federal or state law, or HHS record retention policy or a litigation hold
notice prohibits such Destruction. If such return or Destruction is not reasonably feasible, or is
impermissible by law, Contractor shall immediately notify HHS of the reasons such return or Destruction
is not feasible and agree to extend the protections of this DUA to the Confidential Information for as long
as Contractor maintains such Confidential Information.
(10) Complete and return with the Base Contract to HHS, attached as Attachment 2 to this DUA,
the HHS Security and Privacy Initial Inquiry (SPI) at https://hhs.texas.Pov/laws-
re rulationsiforms/miscellaneous/hhs-information-securit - rivac initial -in uir -s i. The SPI identifies
basic privacy and security controls with which Contractor must comply to protect Confidential Information.
Contractor shall comply with periodic security controls compliance assessment and monitoring by HHS as
required by state and federal law, based on the type of Confidential Information Contractor creates, receives,
maintains, uses, discloses or has access to and the Authorized Purpose and level of risk. Contractor's
HHS Data Use Agreement v.8.5 October 23, 2019
4of11
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
security controls shall be based on the National Institute of Standards and Technology (MIST) Special
Publication 800-53. Contractor shall update its security controls assessment whenever there are significant
changes in security controls for HHS Confidential Information and shall provide the updated document to
HHS. HHS also reserves the right to request updates as needed to satisfy state and federal monitoring
requirements.
(11) Comply with the HHS Acceptable Use Policy (AUP) and require each Subcontractor and
Workforce member who has direct access to HHS Information Resources, as defined in the AUP, to execute
an HHS Acceptable Use Agreement.
(12) Only conduct secure transmissions of Confidential Information whether in paper, oral or
electronic form. A secure transmission of electronic Confidential Information in motion includes secure
File Transfer Protocol (SFTP) or encryption at an appropriate level as required by rule, regulation or law.
Confidential Information at rest requires encryption unless there is adequate administrative, technical, and
physical security as required by rule, regulation or law. All electronic data transfer and communications of
Confidential Information shall be through secure systems. Contractor shall provide proof of system, media
or device security and/or encryption to HHS no later than 48 hours after HHS's written request in response
to a compliance investigation, audit, or the Discovery of a Breach. HHS may also request production of
proof of security at other times as necessary to satisfy state and federal monitoring requirements.
Deidentification of Confidential Information in accordance with HIPAA de -identification standards is
deemed secure.
(13) Designate and identify a person or persons, as Privacy Official and Information Security
Official, each of whom is authorized to act on behalf of Contractor and is responsible for the development
and implementation of the privacy and security requirements in this DUA. Contractor shall provide name
and current address, phone number and e-mail address for such designated officials to HHS upon execution
of this DUA and prior to any change. Upon written notice from HHS, Contractor shall promptly remove
and replace such official(s) if such official(s) is not performing the required functions.
(14) Make available to HHS any information HHS requires to fulfill HHS's obligations to
provide access to, or copies of, Confidential Information in accordance with applicable laws, regulations or
demands of a regulatory authority relating to Confidential Information. Contractor shall provide such
information in a time and manner reasonably agreed upon or as designated by the applicable law or
regulatory authority.
(15) Comply with the following laws and standards if applicable to the type of Confidential
Information and Contractor's Authorized Purpose:
• Title 1, Part 10, Chapter 202, Subchapter B, Texas Administrative Code;
• The Privacy Act of 1974;
• OMB Memorandum 17-12;
• The Federal Information Security Management Act of 2002 (FISMA);
• The Health Insurance Portability and Accountability Act of 1996 (HIPAA);
• Internal Revenue Publication 1075 — Tax Information Security Guidelines for Federal, State
and Local Agencies;
• National Institute of Standards and Technology (MIST) Special Publication 800-66 Revision 1
— An Introductory Resource Guide for Implementing the Health Insurance Portability and
Accountability Act (HIPAA) Security Rule;
HHS Data Use Agreement v.8.5 October 23, 2019
5of11
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
• NIST Special Publications 800-53 and 800-53A — Recommended Security Controls for Federal
Information Systems and Organizations, as currently revised;
• NIST Special Publication 80047 — Security Guide for Interconnecting Information
Technology Systems;
• NIST Special Publication 800-88, Guidelines for Media Sanitization:
• NIST Special Publication 800-111, Guide to Storage of Encryption Technologies for End User
Devices containing PHI;
• Family Educational Rights and Privacy Act
• Texas Business and Commerce Code, Chapter 521;
• Any other State or Federal law, regulation, or administrative rule relating to the specific HHS
program area that Contractor supports on behalf of HHS.
(16) Be permitted to use or disclose Confidential Information for the proper management and
administration of Contractor or to carry out Contractor's legal responsibilities, except as otherwise
limited by this DUA, the Base Contract, or law applicable to the Confidential Information, if:
(a) Disclosure is Required by Law-
(b) Contractor obtains reasonable assurances from the person to whom the information is
disclosed that the person shall:
1. Maintain the confidentiality of the Confidential Information in accordance with
this DUA;
2. Use or further disclose the information only as Required by Law or for the
Authorized Purpose for which it was disclosed to the person; and
3. Notify Contractor in accordance with Section 4.01 of a Breach of Confidential
Information that the person Discovers or should have Discovered with the exercise of
reasonable diligence.
(C) With respect to ALL Confidential Information, Contractor shall NOT:
(1) Attempt to re -identify or further identify Confidential Information that has been
deidentified, or attempt to contact any persons whose records are contained in the Confidential Information,
except for an Authorized Purpose, without express written authorization from HHS.
(2) Engage in prohibited marketing or sale of Confidential Information.
(3) Permit, or enter into any agreement with a Subcontractor to, create, receive, maintain, use,
disclose, have access to or transmit Confidential Information, on behalf of HHS without requiring that
Subcontractor first execute either the Form Subcontractor Agreement, Attachment 1, or Contractor's own
Subcontractor agreement that ensures that the Subcontractor shall comply with the same safeguards and
restrictions contained in this DUA for Confidential Information. Contractor is directly responsible for its
Subcontractors' compliance with, and enforcement of, this DUA.
HHS Data Use Agreement v.8.5 October 23, 2019
6of11
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
ARTICLE 4. BREACH NOTICE, REPORTING AND CORRECTION REQUIREMENTS
Section 4.01. Cooperation and Financial Responsibility.
(A) Contractor shall, at Contractor's expense, cooperate fully with HHS in investigating,
mitigating to the extent practicable, and issuing notifications as directed by HHS, for any Breach of
Confidential Information.
(B) Contractor shall make Confidential Information in Contractor's possession available
pursuant to the requirements of HIPAA or other applicable law upon a determination of a Breach.
(C) Contractor's obligation begins at the Discovery of a Breach and continues as long as related
activity continues, until all effects of the Breach are mitigated to HHS's satisfaction (the "incident response
period").
Section 4.02. Initial Breach Notice.
For federal information obtained from a federal system of records, including Federal Tax Information and
Social Security Administration Data (which includes Medicaid and other governmental benefit program
Confidential Information), Contractor shall notify HHS of the Breach within the first consecutive clock
hour of Discovery. The Base Contract shall specify whether Confidential Information is obtained from a
federal system of records. For all other types of Confidential Information Contractor shall notify HHS of
the Breach not more than 24 hours after Discovery, or in a timeframe otherwise approved by HHS in
writing. Contractor shall initially report to HHS's Privacy and Security Officers via email at:
privacya,HHSC.state.tx.us and to the HHS division responsible for the Base Contract.
Contractor shall report all information reasonably available to Contractor about the Breach.
Contractor shall provide contact information to HHS for Contractor's single point of contact who will
communicate with HHS both on and off business hours during the incident response period.
Section 4.03 Third Business Day Notice: No later than 5 p.m. on the third business day after Discovery,
or a time within which Discovery reasonably should have been made by Contractor of a Breach of
Confidential Information, Contractor shall provide written notification to HHS of all reasonably available
information about the Breach, and Contractor's investigation, including, to the extent known to Contractor:
a. The date the Breach occurred;
b. The date of Contractor's and, if applicable, Subcontractor's Discovery;
c. A brief description of the Breach, including how it occurred and who is responsible (or
hypotheses, if not yet determined);
d. A brief description of Contractor's investigation and the status of the investigation;
e. A description of the types and amount of Confidential Information involved;
f. Identification of and number of all individuals reasonably believed to be affected, including
first and last name of the individual and if applicable, the Legally authorized representative, last
known address, age, telephone number, and email address if it is a preferred contact method;
g. Contractor's initial risk assessment of the Breach demonstrating whether individual or other
notices are required by applicable law or this DUA for HHS approval, including an analysis of
whether there is a low probability of compromise of the Confidential Information or whether any
legal exceptions to notification apply;
h. Contractor's recommendation for HHS's approval as to the steps individuals and/or Contractor
on behalf of individuals, should take to protect the individuals from potential harms, including
HHS Data Use Agreement v.8.5 October 23, 2019
7of11
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
Contractor's provision of notifications, credit protection, claims monitoring, and any specific
protections for a Legally Authorized Representative to take on behalf of an individual with
special capacity or circumstances;
i. The steps Contractor has taken to mitigate the harm or potential harm caused (including without
limitation the provision of sufficient resources to mitigate);
j. The steps Contractor has taken, or will take, to prevent or reduce the likelihood of recurrence
of a similar Breach,
k. Identify, describe or estimate of the persons, Workforce, Subcontractor, or individuals and any
law enforcement that may be involved in the Breach;
1. A reasonable schedule for Contractor to provide regular updates regarding response to the
Breach, but no less than every three (3) business days, or as otherwise directed by HHS in
writing, including information about risk estimations, reporting, notification, if any, mitigation,
corrective action, root cause analysis and when such activities are expected to be completed;
and
in. Any reasonably available, pertinent information, documents or reports related to a Breach that
HHS requests following Discovery.
Section 4.04. Investigation. Response and Mitigation.
(A) Contractor shall immediately conduct a full and complete investigation, respond to the
Breach, commit necessary and appropriate staff and resources to expeditiously respond, and report
as required to HHS for incident response purposes and for purposes of HHS's compliance with
report and notification requirements, to the satisfaction of HHS.
(B) Contractor shall complete or participate in a risk assessment as directed by HHS following
a Breach, and provide the final assessment, corrective actions and mitigations to HHS for review
and approval.
(C) Contractor shall fully cooperate with HHS to respond to inquiries and/or proceedings by
state and federal authorities, persons and/or individuals about the Breach.
(D) Contractor shall fully cooperate with HHS's efforts to seek appropriate injunctive relief or
otherwise prevent or curtail such Breach, or to recover or protect any Confidential Information,
including complying with reasonable corrective action or measures, as specified by HHS in a
Corrective Action Plan if directed by HHS under the Base Contract.
Section 4.05. Breach Notification to Individuals and Reporting to Authorities.
(A) HHS may direct Contractor to provide Breach notification to individuals, regulators or
third -parties, as specified by HHS following a Breach.
(B) Contractor must comply with all applicable legal and regulatory requirements in the time,
manner and content of any notification to individuals, regulators or third -parties, or any notice
required by other state or federal authorities, including without limitation, notifications required by
Texas Business and Commerce Code, Chapter 521.053(b) and HIPAA. Notice letters will be in
Contractor's name and on Contractor's letterhead, unless otherwise directed by HHS, and will
contain contact information, including the name and title of Contractor's representative, an email
address and a toll -free telephone number, for the individual to obtain additional information.
(C) Contractor shall provide HHS with draft notifications for HHS approval prior to
distribution and copies of distributed and approved communications.
HHS Data Use Agreement v.8.5 October 23, 2019
8ofII
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
(D) Contractor shall have the burden of demonstrating to the satisfaction of HHS that any
required notification was timely made. If there are delays outside of Contractor's control,
Contractor shall provide written documentation to HHS of the reasons for the delay.
(E) If HHS directs Contractor to provide notifications, HHS shall, in the time and manner
reasonably requested by Contractor, cooperate and assist with Contractor's information requests in
order to make such notifications.
ARTICLE 5. GENERAL PROVISIONS
Section 5.01 Ownership of Confidential Information
Contractor acknowledges and agrees that the Confidential Information is and shall remain the property of
HHS. Contractor agrees it acquires no title or rights to the Confidential Information.
Section 5.02 HHS Commitment and Obligations
HHS will not request Contractor to create, maintain, transmit, use or disclose PHI in any manner that would
not be permissible under applicable law if done by HHS.
Section 5.03 HHS Right to Inspection
At any time upon reasonable notice to Contractor, or if HHS determines that Contractor has violated this
DUA, HHS, directly or through its agent, will have the right to inspect the facilities, systems, books and
records of Contractor to monitor compliance with this DUA. For purposes of this subsection, HHS's
agent(s) include, without limitation, the HHS Office of the Inspector General, the Office of the Attorney
General of Texas, the State Auditor's Office, outside consultants, legal counsel or other designee.
Section 5.04 Term, Termination of DUA; Survival
This DUA will be effective on the date on which Contractor executes the Base Contract and will terminate
upon termination of the Base Contract and as set forth herein. If the Base Contract is extended, this DUA
is extended to run concurrent with the Base Contract.
(A) If HHS determines that Contractor has violated a material term of this DUA; HHS may in its
sole discretion:
(1) Exercise any of its rights including but not limited to reports, access and inspection under
this DUA and/or the Base Contract; or
(2) Require Contractor to submit to a corrective action plan, including a plan for monitoring
and plan for reporting as HHS may determine necessary to maintain compliance with this DUA; or
(3) Provide Contractor with a reasonable period to cure the violation as determined by HHS;
or
(4) Terminate the DUA and Base Contract immediately and seek relief in a court of competent
jurisdiction in Travis County, Texas.
Before exercising any of these options, HHS will provide written notice to Contractor describing the
violation and the action it intends to take.
(B) If neither termination nor cure is feasible, HHS shall report the violation to the applicable regulatory
authorities.
HHS Data Use Agreement v.8.5 October 23, 2019
9of11
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
(C) The duties of Contractor or its Subcontractor under this DUA survive the expiration or termination
of this DUA until all the Confidential Information is Destroyed or returned to HHS, as required by this
DUA.
Section 5.05 Iniunctive Relief
(A) Contractor acknowledges and agrees that HHS may suffer irreparable injury if Contractor
or its Subcontractor fails to comply with any of the terms of this DUA with respect to the Confidential
Information or a provision of HIPAA or other laws or regulations applicable to Confidential Information.
(B) Contractor further agrees that monetary damages may be inadequate to compensate HHS
for Contractor's or its Subcontractor's failure to comply. Accordingly, Contractor agrees that HHS will, in
addition to any other remedies available to it at law or in equity, be entitled to seek injunctive relief without
posting a bond and without the necessity of demonstrating actual damages, to enforce the terms of this
DUA.
Section 5.06 Indemnification
Contractor shall indemnify, defend and hold harmless HHS and its respective Executive Commissioner,
employees, Subcontractors, agents (including other state agencies acting on behalf of HHS) or other
members of HHS' Workforce (each of the foregoing hereinafter referred to as "Indemnified Party") against
all actual and direct losses suffered by the Indemnified Party and all liability to third parties arising from or
in connection with any breach of this DUA or from any acts or omissions related to this DUA by Contractor
or its employees, directors, officers, Subcontractors, or agents or other members of Contractor's Workforce.
The duty to indemnify, defend and hold harmless is independent of the duty to insure. Upon demand,
Contractor shall reimburse HHS for any and all losses, liabilities, lost profits, fines, penalties, costs or
expenses (including costs of required notices, investigation, and mitigation of a Breach, fines or penalties
imposed on an Indemnified Party by a regulatory authority, and reasonable attorneys' fees) which may be
imposed upon any Indemnified Party to the extent caused by and which results from the Contractor's failure
to meet any of its obligations under this DUA. Contractor's obligation to defend, indemnify and hold
harmless any Indemnified Party will survive the expiration or termination of this DUA.
Section 5.07 Insurance
(A) In addition to any insurance required in the Base Contract, at HHS's option, HHS may
require Contractor to maintain, at its expense, the special and/or custom first- and third -party insurance
coverages, including without limitation data breach, cyber liability, crime theft and notification expense
coverages, with policy limits sufficient to cover any liability arising under this DUA, naming the State
of Texas, acting through HHS, as an additional named insured and loss payee, with primary and
noncontributory status.
(B) Contractor shall provide HHS with written proof that required insurance coverage is in
effect, at the request of HHS.
Section 5.08 Entirety of the Contract
This DUA is incorporated by reference into the Base Contract and, together with the Base Contract,
constitutes the entire agreement between the parties. No change, waiver, or discharge of obligations arising
under those documents will be valid unless in writing and executed by the party against whom such change,
waiver, or discharge is sought to be enforced.
HHS Data Use Agreement v.8.5 October 23, 2019
10 of 11
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
Section 5.09 Automatic Amendment and Interpretation
Upon the effective date of any amendment or issuance of additional regulations to any law applicable to
Confidential Information, this DUA will automatically be amended so that the obligations imposed on HHS
and/or Contractor remain in compliance with such requirements. Any ambiguity in this DUA will be
resolved in favor of a meaning that permits HHS and Contractor to comply with laws applicable to
Confidential Information.
Section 5.10 Notices; Requests for Approval
All notices and requests for approval related to this DUA must be directed to the HHS Chief Privacy Officer
at privac y(iftsc.state. tx.us.
HHS Data Use Agreement v.8.5 October 23, 2019
11 of 11
DocuSign Envelope ID: 8AD24363-682A4C87-8BIF-FED5D527850C
ATTACHMENT 1. SUBCONTRACTOR AGREEMENT FORM
HHS CONTRACT NUMBER
The DUA between HHS and Contractor establishes the permitted and required uses and
disclosures of Confidential Information by Contractor.
Contractor has subcontracted with (Subcontractor)
for performance of duties on behalf of CONTRACTOR which are subject to the DUA.
Subcontractor acknowledges, understands and agrees to be bound by the same terms and
conditions applicable to Contractor under the DUA, incorporated by reference in this
Agreement, with respect to HHS Confidential Information. Contractor and Subcontractor agree
that HHS is a third -party beneficiary to applicable provisions of the subcontract.
HHS has the right, but not the obligation, to review or approve the terms and conditions of the
subcontract by virtue of this Subcontractor Agreement Form.
Contractor and Subcontractor assure HHS that any Breach as defined by the DUA that
Subcontractor Discovers shall be reported to HHS by Contractor in the time, manner and content
required by the DUA.
If Contractor knows or should have known in the exercise of reasonable diligence of a pattern
of activity or practice by Subcontractor that constitutes a material breach or violation of the
DUA or the Subcontractor's obligations, Contractor shall:
1. Take reasonable steps to cure the violation or end the violation, as applicable;
2. If the steps are unsuccessful, terminate the contract or arrangement with Subcontractor,
if feasible;
3. Notify HHS immediately upon Discovery of the pattern of activity or practice of
Subcontractor that constitutes a material breach or violation of the DUA and keep HHS
reasonably and regularly informed about steps Contractor is taking to cure or end the
violation or terminate Subcontractor's contract or arrangement.
This Subcontractor Agreement Form is executed by the parties in their capacities
indicated below.
CONTRACTOR
SUBCONTRACTOR
BY: BY:
NAME: NAME:
TITLE:
TITLE:
DATE , 202 . DATE:
HHS Data Use Agreement v. 8.5
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
Attachment 2-
Security and Privacy Initial Inquiry
[Attach Completed SPI Here]
DocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA)
CERTIFICATION
The certifications enumerated below represent material facts upon which HHSC relies when reporting
information to the federal government required under federal law. If HHSC later determines that the
Contractor knowingly rendered an erroneous certification, HHSC may pursue all available remedies in
accordance with Texas and U.S. laws. Signor further agrees that it will provide immediate written notice
to HHSC if at any time Signor learns that any of the certifications provided for below were erroneous
when submitted or have since become erroneous by reason of changed circumstances. If the Signor
cannot certify all of the statements contained in this section, Signor must provide written notice to
Legal Name of Contractor:
FFATA Contact # 1 Name, Email and Phone Number:
City of Lubbock
Linda Cuellar
Lcuellar@mylubbock.us
806-775-3253
Primary Address of Contractor:
FFATA Contact #2 Name, Email and Phone Number:
1314 Ave K
ZIP Code: 9-digits Required www.usps.com
Primary DUNS Number: 9-digits Required
http://www.dnb.com/us/
058 13 93
794
1- 830
1
1 -
I
I
I
I I
State of Texas Comptroller Vendor Identification Number (VIN) 14 Digits
000 756 00 906
Printed Name of Authorized Representative
Signature of Authorized Representative
Daniel Pope
F ed by:
aiut�, pepc.
Title of Authorized Representative
Date
Mayor
September 8, 2021
- 1 -
OocuSign Envelope ID: 8AD24363-682A-4C87-8B1F-FED5D527850C
FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA)
CERTIFICATION
As the duly authorized representative (Signor) of the Contractor, I hereby certifythat
the statements made by me in this certification form are true, complete and correct to
the best of my knowledge.
Did your organization have a gross incoA, from all sources, of less than $300,000 in
your previous tax year? ❑ Yes ❑ No
If your answer is "Yes," skip questions "A," "B," and "C" and finish the certification.
If your answer is "No," answer questions "A" and "B."
A. Certification Reeardine Percent W of Annual Gross from Federal Awards.
Did your organization receive 80% or more of its 6nnual gross revenue from federal
awards during the preceding fiscal year? ❑ Yes ❑ No
B. Certification Regarding Amount of Annual Gross from Federal Awards.
Did your organization receive $25 minion or more in annual gross revenues from federal
awards in the preceding fiscal year? ❑ Yes ❑ No
If your answer is "Yes" to both question "A" and "B," you must answer question "C."
If your answer is "No" to either question "A" or "B," skip question "C" and finish the
certification.
C. Certification Reeardine Public Access to Compensation Information.
Does the public have access to information about the highly compensated officers/senior
executives in your business or organization (including parent organization, all branches,
and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d)
of the Securities Exchange Act of 1934 (15 US.C. 78m(a), 78o(d)) or section 6104 of the
Internal Revenue Code of1986? ❑ Yes ❑ No
If your answer is "Yes" to this question, where can this information be accessed?
If your answer is "No" to this question, you must provide the names and total
compensation of the top five highly compensated officers below.
Provide compensation information here:
Certificate Of Completion
Envelope Id: 8AD24363682A4C878B1FFED5D527850C
Subject: New $1,896,218; HHS001081400001; City of Lubbock; HHSC/MSS-IDD/BHS/SUD
Source Envelope:
Document Pages: 117 Signatures: 5
Certificate Pages: 2 Initials: 0
AutoNav: Enabled
Envelopeld Stamping: Enabled
Time Zone: (UTC-06:00) Central Time (US & Canada)
Record Tracking
Status: Original
8/20/2021 4:26:36 PM
Signer Events
Daniel Pope
dpope@mylubbock.us
Mayor
City of Lubbock
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Sonja Gaines
Sonja.Gaines@hhs.texas.gov
SG
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events
Editor Delivery Events
Agent Delivery Events
Intermediary Delivery Events
Certified Delivery Events
Carbon Copy Events
Annalee Arredondo
Annalee.Arredondo@hhs.texas.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Holder: Texas Health and Human Services
Commission
PCS—DocuSign@hhsc.state.tx.us
Signature
nIdby:[D-USIgcun ita Poet
3F03786315554OF
Signature Adoption: Pre -selected Style
Using IP Address: 208.84.91.41
Signature
Status
Status
Status
Status
Status
COPIED
DocuSign
Status: Sent
Envelope Originator:
Texas Health and Human Services Commission
1100 W. 49th St.
Austin, TX 78756
PCS_DocuSign@hhsc.state.tx.us
IP Address: 167.137.1.15
Location: DocuSign
Timestamp
Sent: 8/20/2021 4:53:27 PM
Viewed: 9/8/2021 8:55:05 AM
Signed: 9/8/2021 9:02:17 AM
Sent: 9/8/2021 9:02:23 AM
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Sent: 8/20/2021 4:53:27 PM
Viewed: 8/26/2021 9:36:33 AM
SUDCMU COPIED Sent: 8/20/2021 4:53:27 PM
substanceabuse.contracts@hhs.texas.gov Viewed: 8/20/2021 8:41:10 PM
Security Level: Email, Account Authentication
(None)
Carbon Copy Events
Status
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Bryan Hunter
Bryan.Hunter@hhs-texas-gov
COPIED
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events
Signature
Notary Events
Signature
Envelope Summary Events
Status
Envelope Sent
Hashed/Encrypted
Payment Events Status
Timestamp
Sent: 8/20/2021 4:53:26 PM
Viewed: 8/27/2021 7:53:50 AM
Timestamp
Timestamp
Timestamps
8/20/2021 4:53:27 PM
Timestamps
CITY OF LUBBOCK
ATTEST:
By:
DANIEL M. POPE, Mayor
ATTEST:
By:
- IV -V
REBE CA GARZA, City cr ary
APPROVE O CONTENT:
By:
KATHERINE WELLS, Director of Public Health
APPROVED AS TO FORM:
By:
A ROWK, Assistant City Attorney