HomeMy WebLinkAboutResolution - 2021-R0179 - Amendment No.5 to PHEP Agreement with DSHS 5.11.2021Resolution No. 2021-R0179
Item No. 8.20
May 11, 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, Amendment No. 5 to the Department of State Health Services (DSHS) Contract No.
537-18-0127-00001, the Public Health Emergency Preparedness Cooperative Agreement; by and
between the City of Lubbock and the State of Texas acting by and through DSHS, and related
documents are hereby ratified in full. Said Amendment 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 May 11, 2021
DANIEL M. POPE, MAYOR
ATTEST:
D-'t� )��
Reb cca Garza, City Se reta
APPROVED AS TO CONTENT:
Bill Ho on, eputy City Ma�pger
APPROVED AS TO FORM:
Ryanyfooke, Assistant City Attorney
RES.DSHS Contract No. 537-18-0127-00001 Amendment 5 Ratification
4.14.21
DocuSign Envelope ID: 3883686D-EF97-4BCD-BDAD-6151B744B077
Resolution No. 2021-R0179
DEPARTMENT OF STATE HEALTH SERVICES
CONTRACT No. 537-18-0127-00001
AMENDMENT No. 5
The DEPARTMENT OF STATE HEALTH SERVICES ("System Agency") and CITY OF LUBBOCK
("Grantee"), each a "Party" and collectively the "Parties" to that certain Public Health Emergency
Preparedness ("PHEP") contract effective July 1, 2017 and denominated as System Agency
Contract No. 537-18-0127-00001 (the "Contract"), as amended, now want to further amend the
Contract.
WHEREAS, the Parties desire to amend the Contract in accordance with ATTACHMENT C,
UNIFORM TERMS AND CONDITIONS, ARTICLE IX, SECTION 9.01 (AMENDMENT) of the Contract;
WHEREAS, System Agency elects to extend the term of the Contract in accordance with ARTICLE
III, DURATION;
WHEREAS, the Parties desire to revise the Budget to add funds to the Contract for the period from
July 1, 2021, through June 30, 2022 ("Fiscal Year 2022" or "FY2022");
WHEREAS, the Parties desire to revise the Statement of Work;
WHEREAS, the Parties desire to modify the Notice to Proceed provision of the Contract; and
WHEREAS, the Parties desire to incorporate ATTACHMENT C.5- FFATA CERTIFICATION FORM
into the Contract.
Now THEREFORE, the Parties amend and modify the Contract as follows:
ARTICLE III, DURATION, of the Signature Document is amended to reflect a revised
termination date of June 30, 2022.
2. ARTICLE IV, BUDGET, of the Signature Document is amended to add $261,833.00 in federal
funding to the Contract and with the Grantee providing a total of $26,183.00 in matching funds
for FY2022. The total not -to -exceed amount of the Contract is therefore increased to
$1,421,918.00, of which $1,292,881.00 represents federal funding and $129,037.00 represents
matching funds. All expenditures under the Contract will be in accordance with the revised
budget set forth herein. Funds provided in support of one Contract activity may only be used
for that activity and may not be comingled with other funds provided under this Contract.
3. ARTICLE VIII, NOTICE TO PROCEED, of the Signature Document is deleted in its entirety and
replaced with the following:
VIII. NOTICE TO PROCEED
System Agency Contract No. 537-18-0127-00001
DocuSign Envelope ID: 3883686D-EF97-4BCD-BDAD-615lB744B077
Funding for this Contract is dependent on the award of the applicable federal grant. No FY2022
work may begin and no charges may be incurred until the System Agency issues a written
Notice to Proceed to Grantee. This Notice to Proceed may include an amended or ratified
budget which will be incorporated into this Contract by a subsequent amendment, as necessary.
Notwithstanding the preceding, at the discretion of the System Agency, Grantee may be
eligible to receive reimbursement for eligible expenses incurred during the period of
performance as defined by 2 CFR §200.309.
4. ATTACHMENT B, BUDGET, is amended by deleting the budget table in its entirety and replacing
it with the following:
FY18 Budget
FY19 Budget
FY20 Budget
FY21 Budget
FY22 Budget
Budget Categories
Summary
Summary
Summary
Summary
Summary
Total Budget
(7/1/17 —
(7/1/18 —
(7/1/19 —
(7/1/20 —
(7/1/21—
Summary
6/30/18)
6/30/19)
6/30/20)
6/30/21)
6/30/22)
Personnel
$155,220.00
$158,325.00
$151,780.00
$143,216.00
$139,049.00
$747,590.00
Fringe Benefits
$74,490.00
$75,521.00
$71,837.00
$66,252.00
$63,267.00
$351,367.00
Travel
$6,627.00
$4,675.00
$10,074.00
$11,749.00
$4,918.00
$38,043.00
Equipment
$0.00
$0.00
$0.00
$0.00
$11,634.00
$11,634.00
Supplies
$3,994.00
$4,250.00
$11,620.00
$13,161.00
$17,741.00
$50,766.00
Contractual
$9,000.00
$5,400.00
$5,400.00
$15,600.00
$15,600.00
$51,000.00
Other
$4,380.00
$8,040.00
$8,582.00
$11,855.00
$9,624.00
$42,481.00
Sum of DSHS Direct
Costs
$253,711.00
$256,211.00
$259,293.00
$261,833.00
$261,833.00
$1,292,881.00
Indirect Costs
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Sum of DSHS Direct
Costs and Indirect Costs
$253,711.00
$256,211.00
$259,293.00
$261,833.00
$261,833.00
$1,292,881.00
Plus, Required Match
(Cash or In -Kind)
$25,371.00
$25,371.00
$25,929.00
$26,183.00
$26,183.00
$129,037.00
Total Contract Amount
$279,082.00
$281,582.00
$285,222.00
$288,016.00
$288,016.00
$1,421,918.00
The Parties agree that Grantee shall provide total matching funds in the amount of $129,037.00.
5. ATTACHMENT A.5, FY2021 STATEMENT OF WORK, is amended and replaced in its entirety
with ATTACHMENT A.6, FY2022 STATEMENT OF WORK.
6. ATTACHMENT C.5, FFATA CERTIFICATION FORM is attached to this Amendment and
incorporated into the Contract as if fully set forth therein.
7. This Amendment shall be effective on July 1, 2021, or the date last signed below, whichever
is later.
System Agency Contract No. 537-18-0127-00001
DocuSlgn Envelope ID: 3883686D-EF974BCD-BDAD-6151B744B077
8. Except as amended or modified by this Amendment No.5, all terms and conditions of the
Contract, as amended, shall remain in full force and effect.
9. Any further revisions to the Contract shall be by written agreement of the Parties.
SIGNATURE PAGE FOLLOWS
System Agency Contract No. 537-18-0127-00001
DocuSign Envelope ID: 3883686D-EF97-4BCD-BDAD-6151 B744BO77
SIGNATURE PAGE FOR AMENDMENT No. 5
SYSTEM AGENCY CONTRACT NO. 537-18-0127-00001
DEPARTMENT OF STATE HEALTH SERVICES CITY OF LUBBOCK
Dmuftned by:
By �'�,1A,' Z.i Swis
Name:Jennifer Sims
Title: Deputy Commissioner
Date of Signature:April 1, 2021
DocuSigned by:
Name: Dan Pope
Title: Mayor
Date of Signature: March 31, 2021
THE FOLLOWING DOCUMENTS ARE ATTACHED TO THIS AMENDMENT AND THEIR RESPECTIVE
TERMS ARE HEREBY INCORPORATED INTO THE CONTRACT BY REFERENCE:
ATTACHMENT A.6 - FY2022 STATEMENT OF WORK
ATTACHMENT C.5- FFATA CERTIFICATION FORM
System Agency Contract No. 537-18-0127-00001
Reviewed as to content:
Katherine Wells, Director of Public Health
Reviewed as to form:
Ryan-Br�Assistant City Attorney
Attest:
Rebek,ca Garza, City Secret
DocuSign Envelope ID: 38836860-EF97-48CD-BDAD-6151B744B077
ATTACHMENT A.6
FY2022 STATEMENT OF WORK
July 1, 2021 through June 30, 2022
I. GRANTEE RESPONSIBILITIES
Grantee will:
A. Perform activities in support of the Public Health Emergency Preparedness ("PHEP")
Cooperative Agreement from the Centers for Disease Control and Prevention ("CDC") to
advance public health preparedness.
B. Perform the activities required under this Contract in the following county/ies: Lubbock
County.
C. Provide System Agency with situational awareness data generated through interoperable
networks of electronic data systems.
D. Address the following public health emergency preparedness capabilities:
1. Capability 1 — Community preparedness is the ability of communities to prepare for,
withstand, and recover from public health incidents in both the short- and long-term.
2. Capability 2 — Community recovery is the ability of communities to identify critical assets,
facilities, and other services within public health, emergency management, health care,
human services, mental/behavioral health, and environmental health sectors that can guide
and prioritize recovery operations.
3. Capability 3 — Emergency operations coordination is the ability to coordinate with
emergency management and to direct and support an incident or event with public health
or health care implications by establishing a standardized, scalable system of oversight,
organization, and supervision that is consistent with jurisdictional standards and practices
and the National Incident Management System ("NIMS").
4. Capability 4 — Emergency public information and warning is the ability to develop,
coordinate, and disseminate information, alerts, warnings, and notifications to the public
and incident management personnel.
5. Capability 5 — Fatality management is the ability to coordinate with partner organizations
and agencies to provide fatality management services to ensure the proper recovery and
preservation of remains; identification of the deceased; determination of cause and manner
of death; release of remains to an authorized individual; and provision of mental/behavioral
health assistance for the grieving. The role also may include supporting activities for the
identification, collection, documentation, retrieval, and transportation of human remains,
personal effects, and evidence to the examination location or incident morgue.
6. Capability 6 — Information sharing is the ability to conduct multijurisdictional and
multidisciplinary exchange of health -related information and situational awareness data
among federal, state, local, tribal, and territorial levels of government and the private
sector. This capability includes the routine sharing of information as well as issuing of
System Agency Contract No. 537-18-0127-00001
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DocuSign Envelope ID: 3883686D-EF97-4BCD-BDAD-6151 B744B077
ATTACHMENT A.6
FY2022 STATEMENT OF WORK
July 1, 2021 through June 30, 2022
public health alerts to all levels of government and the private sector in preparation for and
in response to events or incidents of public health significance.
7. Capability 7 — Mass care is the ability of public health agencies to coordinate with and
support partner agencies to address, within a congregate location (excluding shelter -in -
place locations), the public health, health care, mental/behavioral health, and human
services needs of those impacted by an incident. This capability includes coordinating
ongoing surveillance and public health assessments to ensure that health needs continue to
be met as the incident evolves.
8. Capability 8 — Medical countermeasure dispensing and administration is the ability to
provide medical countermeasures to targeted population(s) to prevent, mitigate, or treat the
adverse health effects of a public health incident, according to public health guidelines.
This capability focuses on dispensing and administering medical countermeasures, such as
vaccines, antiviral drugs, antibiotics, and antitoxins.
9. Capability 9 — Medical materiel management and distribution is the ability to acquire,
manage, transport, and track medical materiel during a public health incident or event and
the ability to recover and account for unused medical materiel, such as pharmaceuticals,
vaccines, gloves, masks, ventilators, or medical equipment after an incident.
10. Capability 10 — Medical surge is the ability to provide adequate medical evaluation and
care during events that exceed the limits of the normal medical infrastructure of an affected
community. It encompasses the ability of the health care system to endure a hazard impact,
maintain or rapidly recover operations that were compromised, and support the delivery of
medical care and associated public health services, including disease surveillance,
epidemiological inquiry, laboratory diagnostic services, and environmental health
assessments.
11. Capability 11 — Nonpharmaceutical interventions are actions that people and communities
can take to help slow the spread of illness or reduce the adverse impact of public health
emergencies. This capability focuses on communities, community partners, and
stakeholders recommending and implementing nonpharmaceutical interventions in
response to the needs of an incident, event, or threat. Nonpharmaceutical interventions may
include isolation; quarantine; restrictions on movement and travel advisories or warnings;
social distancing; external decontamination; hygiene; and precautionary protective
behaviors.
12. Capability 12 — Public health laboratory testing is the ability to implement and perform
methods to detect, characterize, and confirm public health threats. It also includes the
ability to report timely data, provide investigative support, and use partnerships to address
actual or potential exposure to threat agents in multiple matrices, including clinical
specimens and food, water, and other environmental samples. This capability supports
passive and active surveillance when preparing for, responding to, and recovering from
biological, chemical, and radiological (if a Radiological Laboratory Response Network is
established) public health threats and emergencies.
13. Capability 13 — Public health surveillance and epidemiological investigation is the ability
System Agency Contract No. 537-18-0127-00001
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DocuSlgn Envelope ID: 3883686D-EF97-4BCD-BDAD-6151B744B077
ATTACHMENT A.6
FY2022 STATEMENT OF WORK
July 1, 2021 through June 30, 2022
to create, maintain, support, and strengthen routine surveillance and detection systems and
epidemiological investigation processes. It also includes the ability to expand these systems
and processes in response to incidents of public health significance.
14. Capability 14 — Responder safety and health is the ability to protect public health and other
emergency responders during pre -deployment, deployment, and post -deployment.
15. Capability 15 — Volunteer management is the ability to coordinate with emergency
management and partner agencies to identify, recruit, register, verify, train, and engage
volunteers to support the jurisdictional public health agency's preparedness, response, and
recovery activities during pre -deployment, deployment, and post -deployment.
E. Match funds awarded under this Contract with costs or third -party contributions that are not
paid by the federal government under another award, except where authorized by federal
statute to be used for cost sharing or matching. The non-federal contributions (match) may be
provided directly or through donations from public or private entities and may be in cash or
in -kind donations, fairly evaluated, including plant, equipment, or services. The costs that the
Grantee incurs in fulfilling the matching or cost -sharing requirement are subject to the same
requirements, including the cost principles, that are applicable to the use of federal funds,
including prior approval requirements and other rules for allowable costs as described in 45
CFR 74.23 and 45 CFR 92.24, as amended.
Grantee will provide matching funds in the amount of ten percent (10%) of the Contract
amount as set forth in Attachment B, Budget. Cash match is defined as an expenditure of cash
by the Grantee on allowable costs of this Contract that are borne by the Grantee. In -kind match
is defined as the dollar value of non -cash contributions by a third party given in goods,
commodities, or services that are used in activities that benefit this Contract's project and that
are contributed by non-federal third parties without charge to the Grantee. The criteria for
match must:
1. Be an allowable cost under the applicable federal cost principle;
2. Be necessary and reasonable for the efficient accomplishment of project or program
objectives;
3. Be verifiable within the Grantee's (or subgrantee's) records;
4. Be documented, including methods and sources, in the approved budget (applies only
to cost reimbursement contracts);
5. Not be included as contributions toward any other federally -assisted project or program
(match can count only once);
6. Not be paid by the federal government under another award, except where authorized
by federal statute to be used for cost sharing or match;
7. Conform to other provisions of governing circulars/statutes/regulations as applicable
for the Contract;
8. Be adequately documented;
System Agency Contract No. 537-18-0127-00001
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ATTACHMENT A.6
FY2022 STATEMENT OF WORK
July 1, 2021 through June 30, 2022
9. Follow procedures for generally accepted accounting practices as well as meet audit
requirements; and
10. Value the in -kind contributions reported and be supported by documentation reflecting
the use of goods and/or services during the Contract term.
F. In the event of a local, state, or federal emergency, the Grantee has the authority to utilize
approximately five percent (5%) of the Grantee's staffs time supporting this Contract for
response efforts. System Agency will reimburse Grantee up to five percent of this Contract
funded by the CDC for personnel costs responding to an emergency event. Grantee will
maintain records to document the time spent on response efforts for auditing purposes.
Allowable activities also include participation in drills and exercises in the pre -event time
period. Grantee will notify the Assigned Contract Manager in writing when this provision is
implemented.
G. In the event of a public health emergency involving a portion of the state, mobilize and dispatch
staff or equipment purchased with funds from previous PHEP cooperative agreements, and not
currently performing critical duties in the jurisdiction served, to the affected area of the state
upon receipt of a written request from System Agency.
H. Coordinate activities and response plans within the jurisdiction with the state, regional, and
other local jurisdictions, among local agencies, and with hospitals and major health care
entities, jurisdictional Metropolitan Medical Response Systems, and Councils of Government.
I. Inform System Agency in writing if Grantee will not continue performance under this Contract
within thirty (30) days of receipt of an amended standard(s) or guideline(s). System Agency
may terminate this Contract immediately or within a reasonable period of time as determined
by System Agency.
J. Develop, implement, and maintain a timekeeping system for accurately documenting staff time
and salary expenditures for all staff funded through this Contract, including partial full-time
employees and temporary staff.
K. Complete and submit programmatic reports as directed by System Agency in a format specified
by System Agency and as needed to satisfy information -sharing requirements set forth in Texas
Government Code, Sections 421.071 and 421.072 (b) and (c), as amended. Grantee will provide
System Agency other reports, including financial reports, that System Agency determines
necessary to accomplish the objectives of this Contract and to monitor compliance.
L. Submit the Work Plan and Vulnerable Populations Plan that encompass the Contract term to
the System Agency to the Department of State Health Services ("DSHS") Center for Health
Emergency Preparedness and Response ("CHEPR") within an established timeframe and
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ATTACHMENT A.6
FY2022 STATEMENT OF WORK
July 1, 2021 through June 30, 2022
submission method designated by the Contractual Requirements Schedule.
M. Submit a current Integrated Preparedness (Plan ("IPP"; formerly the Multi -Year Training and
Exercise Plan ["MYTEP"]), which must include at least four years of progressive exercise
planning, to the System Agency within an established timeframe and submission method
designated by the Contractual Requirements Schedule, using the template provided by System
Agency.
N. Submit at least one After Action Review/Improvement Plan ("AAR/IP"). All AAR/1Ps must
be submitted to the System Agency within 60 calendar days, or 90 calendar days for Real
World Incident ("RWI"), of the completion of the exercise/response within an established
timeframe and submission method designated by the Contractual Requirements Schedule.
AAR/IPs must be completed in accordance with Notification and Reporting of Exercise Grant.
O. Complete and submit the Expanded Operational Readiness Review ("ORR') to CDC and
upload supporting documentation to the System Agency via the DSHS CHEPR External
SharePoint site by April 1, 2022. Documentation is required within an established timeframe
designated by the Contractual Requirements Schedule.
P. Submit the End -of -Year Performance Report to the System Agency within an established
timeframe and submission method designated by the Contractual Requirements Schedule.
Q. Designate a member of the PHEP program to attend two regional healthcare coalition meetings
during the Contract term, if meetings resume during the Contract term. Submit evidence of
attendance, within an established timeframe designated by the Contractual Requirements
Schedule.
R. Immediately notify System Agency in writing if Grantee is legally prohibited from providing
any report under this Contract.
S. Have plans, processes, and training in place to meet NIMS compliance requirements.
T. When using volunteers during the Contract term, the Grantee must designate a Texas Disaster
Volunteer Registry ("TDVR") State Emergency System for the Advanced Registration of
Volunteer Health Professionals (" ESAR-VHP") System Administrator, participate in required
administrator trainings, and utilize the system to identify volunteers.
U. Grantee may not use funds for research, clinical care, fund-raising activities or lobbying,
construction or major renovations, reimbursement of pre -award costs, to supplant existing state
or federal funds for activities, payment or reimbursement of backfilling costs for staff, purchase
System Agency Contract No. 537-18-0127-00001
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ATTACHMENT A.6
FY2022 STATEMENT OF WORK
July 1, 2021 through June 30, 2022
of vehicles of any kind, uniforms or furniture, or funding an award to another party or provider
who is ineligible.
V. None of the funds made available under this agreement may be used to promote or advocate
the legalization or practice of prostitution or sex trafficking. Nothing in the preceding sentence
shall be construed to preclude the provision to individuals of palliative care, treatment, or post -
exposure pharmaceutical prophylaxis, and necessary pharmaceuticals and commodities,
including test kits, condoms, and, when proven effective, microbicides.
W. Cooperate with System Agency to coordinate all planning, training and exercises performed
under this Contract with the Texas Division of Emergency Management ("TDEM"), or other
points of contact at the discretion of the Division for Regional and Local Health Operations,
to ensure consistency and coordination of requirements at the local level and eliminate
duplication of effort between the various domestic preparedness funding sources in the state.
X. Coordinate all risk communication activities with the System Agency Communications Unit by
using System Agency's core messages posted on the System Agency website and submitting
copies of draft risk communication materials to System Agency for coordination prior to
dissemination.
Y. Initiate the purchase of all equipment approved in writing by the System Agency in the first
quarter of the Contract term, as applicable. Failure to timely initiate the 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 assigned System Agency contract manager.
Z. Maintain an inventory of equipment, supplies defined as Controlled Assets, and real property.
Grantee shall submit an annual cumulative report of the equipment and other property on HHS
System Agency Grantee's Property Inventory Report to the assigned System Agency contract
manager by email not later than October 15 of each year. Controlled Assets include firearms,
regardless of the acquisition cost, and the following assets with an acquisition cost of $500 or
more, but less than $5,000: 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.
Controlled Assets are considered Supplies.
AA. Not use System Agency funds to purchase buildings or real property without prior written
approval from the System Agency. Any costs related to the initial acquisition of the buildings
or real property are not allowable without written pre -approval.
System Agency Contract No. 537-18-0127-00001
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DocuSign Envelope ID: 3883686D-EF97-4BCD-BDAD-6151B744B077
ATTACHMENT A.6
FY2022 STATEMENT OF WORK
July 1, 2021 through June 30, 2022
BB. At the expiration or termination of this Contract 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.
CC. Comply with all applicable federal and state laws, rules, and regulations, as amended,
including, but not limited to, the following:
1. Public Law 109-417, Pandemic and All -Hazards Preparedness and Advancing
Innovation Act ("PAHPAI");
2. Texas Health and Safety Code Chapter 81; and
3. Section 319C-1 of the Public Health Service (PHS) Act (47 USC § 247d-3a), as
amended.
DD. Comply with all applicable regulations, standards and guidelines in effect on the beginning
date of the term of this Contract.
EE. Submit other reports as required by System Agency. The initial reporting schedule for the
requirements is subject to change as System Agency and CDC may modify requirements and
due dates.
FF. Work with the Regional Health Care Coalition to develop comprehensive preparedness
strategies. Plans will be submitted to System Agency by the Health Care Coalition.
U. PERFORMANCE MEASURES
A. The System Agency will monitor the Grantee's performance of the requirements in this
Attachment A.6 and compliance with the Contract's terms and conditions.
B. Grantee will meet and report Performance Measures based on requirements that are developed
in coordination with System Agency for the Grantee's project as provided in Section I. Grantee
must also demonstrate adherence to PHEP reporting deadlines and the capability to receive,
stage, store, distribute, and dispense materiel during a public health emergency. Failure to meet
these requirements may result in withholding a portion of the current fiscal year PHEP base
award.
C. System Agency will send a Contractual Requirements Schedule for reporting these
Performance Measures within thirty (30) days of the Contract start date.
III. INVOICE AND PAYMENT
A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) monthly
System Agency Contract No. 537-18-0127-00001
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ATTACHMENT A.6
FY2022 STATEMENT OF WORK
July 1, 2021 through June 30, 2022
and acceptable supporting documentation for reimbursement of the required
services/deliverables. The Grantee will submit the Financial Status Report (FSR-269A).
Additionally, the Grantee will submit the Match Certification Form (B-13A), at the end of the
fourth quarter. Vouchers, supporting documentation, Financial Status Reports, and Match
Certification Forms should be mailed or emailed to the addresses below.
Department of State Health Services
Claims Processing Unit, MC 1940
1100 West 49th Street
P.O. Box 149347
Austin, TX 78714-9347
FAX: (512) 458-7442
EMAIL: invoices@dshs.texas.gov & CMSInvoices@dshs.texas.gov
B-13s and supporting documentation should be sent to: invoices e,dshs.texas.gov &
CMSInvoices@dshs.texas.g_ov & cc your Assigned Contract Manager.
FSRs should be sent to: FSRGrantsgdshs.texas.gov & CMSInvoicesng.dshs.texas. og_v & cc
your Assigned Contract Manager.
B. Grantee will be reimbursed on a monthly basis and in accordance with ATTACHMENT B,
BUDGET of the Contract.
C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the
event of financial shortfalls. System Agency will monitor Grantee's expenditures on a
quarterly basis. If expenditures are below that projected in Grantee's total Contract amount,
Grantee's budget may be subject to a decrease for the remainder of the Contract term. Vacant
positions existing after ninety (90) days may result in a decrease in funds.
D. Grantee may request a one-time working capital advance not to exceed twelve percent (12%)
of the total amount of the Contract funded by System Agency. All advances must be expended
by the end of the Contract term. Advances not expended by the end of the Contract term must
be refunded to System Agency. Grantee will repay all or part of advance funds at any time
during the Contract's term. However, if the advance has not been repaid prior to the last three
months of the Contract term, the Grantee must deduct at least one-third of the remaining
advance from each of the last three months' reimbursement requests. If the advance is not
repaid prior to the last three months of the Contract term, System Agency will reduce the
reimbursement request by one-third of the remaining balance of the advance.
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Attachment C.5
Fiscal Federal Funding Accountability and Transparency Act
(FFATA) CERTIFICATION
The certifications enumerated below represent material facts upon which DSHS relies when reporting
information to the federal government required under federal law. If the Department later determines
that the Contractor knowingly rendered an erroneous certification, DSHS may pursue all available
remedies in accordance with Texas and U.S. law. Signor further agrees that it will provide immediate
written notice to DSHS 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
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
Amber Aguilar
aaguilar@mylubbock.us
806-775-2149
ZIP Code: 9-digits Required www.usps.com
DUNS Number: 9-digits Required www.sam.aov
794 1-3 30 -
058 138 3
State of Texas Comptroller Vendor Identification Number (VIN)14 Digits
000 756 00 906
Printed Name of Authorized Representative
Signature of Authorized Representative
D.0 Ign" by:
Dan pope
DWA, P6 ft,
Title of Authorized Representative
Date
Mayor
March 31, 2021
-1-
Department of State Health Services Forth 4734 —June 2013
DocuSign Envelope ID: 3883686D-EF97-4BCD-BDAD-6151B744B077
Attachment C.5
Fiscal Federal Funding Accountability and Transparency Act
(FFATA) CERTIFICATION
As the duly authorized representative (Signor) of the Contractor, I hereby certify that
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 income, from all sources, of less than $300,000 in
your previous tax year? ❑ Yes ❑x 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 % of Annual Gross from Federal Awards.
Did your organization receive 80% or more of its annual gross revenue from federal
awards during the preceding fiscal year? ❑ Yes ❑x No
B. Certification Reeardine Amount of Annual Gross from Federal Awards.
Did your organization receive $25 million or more in annual gross revenues from federal
awards in the preceding fiscal year? Q 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 Regarding Public Access to Compensation Information.
Does the public have access to information about the compensation of the 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 U.S.C. 78m(a), 78o(d)) or section 6104 of the
Internal Revenue Code of 1986? ❑ 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.
For example:
John Blum:500000;Mary Redd:50000;Eric Gant:400000;Todd Platt:300000;
Sally Tom:300000
Provide compensation information here:
-2-
Department of State Health Services Form 4734 —June 2013
DocuSign Envelope ID: 3883686D-EF974BCD-BDAD-6151B744B077
TEXA
Health and Human
Services
The Honorable Daniel Pope, Mayor
City of Lubbock
P.O. Box 2000
Lubbock, Texas 79408
Texas Department of State Health Services
John Hellerstedt, M.O.
Commissioner
Subject: Public Health Emergency Preparedness Contract
Contract Number: 537-18-0127-00001, Amendment No. 5
Contract Amount: $1,421,918.00
Contract Term: July 1, 2017 through June 30, 2022
Dear Mayor Pope:
Enclosed is the Public Health Emergency Preparedness Amendment No. 5 between
the Department of State Health Services and City of Lubbock.
The purpose of this Contract is to perform activities in support of the Public Health
Emergency Preparedness (PHEP) Cooperative Agreement from the Centers for
Disease Control and Prevention (CDC) in support of public health emergency
preparedness.
This Amendment No. 5:
1) Increases the total contract value by $288,016.00 (reflecting $261,833.00
in federal funding and $26,183.00 in match funding) for FY2022;
2) Extends the end of the contract term to June 30, 2022; and
3) Revises attachments to the Contract.
Please let me know if you have any questions or need additional information.
Sincerely,
Beverly Taylor, CTCM
Contract Manager
512-776-2284
Beverly.Taylor@dshs.texas.gov
P.O. Box 149347 • Austin, Texas 78714-9347 • Phone:888-963-7111 • TTY: 800-735-2889 • www.dshs.texas.gov