HomeMy WebLinkAboutResolution - 2021-R0327 - Amendment No. 1 Contract HHS000812700012 with DSHS 9.7.21Resolution No. 2021-R0327
Item No. 2.9
September 7, 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 o
Lubbock, Amendment No. 1 to the Department of State Health Services (DSHS) Contract No.
HHS000812700012, to provide funding for COVID-19 activities, by and between the City o
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
ATTEST:
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RebeGarza, City SecretU
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APPROVED AS TO CONTENT:
Bill H erton, Deputy Cit344anager
APPROVED AS TO FORM:
Ry n Yooke,As`sistant City Attorney
September 7, 2021
DANIEL M. POPE, MAYOR
RES.DSHS Contract No. HHS000812700012 Amendment No.1 Ratification
9.1.21
DocuSign Envelope ID: CB325701 -D816-4C4F-9D5F-C41 I D5217EA2
Resolution No. 2021-R0327
DEPARTMENT OF STATE HEALTH SERVICES
CONTRACT No. HHS000812700012
AMENDMENT No. 1
The DEPARTMENT OF STATE HEALTH SERVICES ("SYSTEM AGENCY" OR "DSHS") and CITY OF
LUBBOCK ("GRANTEE"), who are collectively referred to herein as the "Parties," to that certain
grant contract for COVID-19 activities effective August 17, 2020, and denominated DSHS
Contract No. HHS000812700012 ("Contract"), now desire to amend the Contract.
WHEREAS, the Parties desire to revise the Statement of Work;
WHEREAS, the Parties desire to revise the Budget to add additional funding; and
WHEREAS, the Parties desire to extend the term of the Contract.
NOW, THEREFORE, the Parties hereby amend and modify the Contract as follows:
1. SECTION III of the Contract, DURATION, is hereby amended to reflect a revised termination
date of July 31, 2023.
2. SECTION IV of the Contract, BUDGET, is hereby amended to add $193,635.00 to the
Contract for a total not -to -exceed amount of $348,543.00 for COVID-19 activities.
The total amount of the Contract includes $154,908.00 for the period beginning August 17,
2020, and ending April 30, 2022, and the addition of $193,635.00 for the period beginning
with the effective date of this Amendment and ending July 31, 2023. All expenditures
under the Contract will be in accordance with ATTACHMENT B-1, REVISED BUDGET.
3. ATTACHMENT A of the Contract, STATEMENT OF WORK, is hereby deleted in its entirety
and replaced with ATTACHMENT A-1, REVISED STATEMENT OF WORK and supplemented
with the addition of ATTACHMENT A-2, SUPPLEMENTAL STATEMENT OF WORK.
4. ATTACHMENT B of the Contract, BUDGET, is hereby deleted in its entirety and replaced
with ATTACHMENT B-1, REVISED BUDGET.
5. This Amendment No. 1 shall be effective as of the date last signed below.
6. Except as amended and modified by this Amendment No. 1, all terms and conditions of
the Contract shall remain in full force and effect.
7. Any further revisions to the Contract shall be by written agreement of the Parties.
SIGNATURE PAGE FOLLOWS
System Agency Contract No. HHS000812700012
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SIGNATURE PAGE FOR AMENDMENT No. 1
DSHS CONTRACT No. HHS000812700012
SYSTEM AGENCY GRANTEE
Signature
Signature
Date of Execution: Date of Execution: September 7, 2021
THE FOLLOWING ATTACHMENTS ARE ATTACHED AND INCORPORATED AS PART OF THE
CONTRACT:
ATTACHMENT A-1 REVISED STATEMENT OF WORK
ATTACHMENT A-2 SUPPLEMENTAL STATEMENT OF WORK
ATTACHMENT B-1 REVISED BUDGET
System Agency Contract No. HHS000812700012
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ATTACHMENT A-1
REVISED STATEMENT OF WORK
I. GRANTEE RESPONSIBILITIES
Grantee will:
A. Enhance public health follow-up activities, including:
1. Conducting case investigations;
2. Eliciting or identifying individuals who may have been exposed to COVID-19;
3. Notifying individuals of COVID-19 exposure; and
4. Providing referrals to COVID-19 testing, vaccine resources and other follow-up
services.
Data must be entered into the DSHS data system in accordance with DSHS published
guidance. Grantee may not incur COVID-19 contact tracing Call Center expenditures
beyond 8/31/2021.
B. Improve morbidity and mortality surveillance, including:
1. Establish or enhance community -based surveillance - Surveillance of populations and
individuals includes but is not limited to those without severe illness, those with travel
to high -risk locations, or those who are contacts to known cases.
2. Monitor and report daily COVID-19 probable and confirmed COVID cases (including
deaths) to DSHS.
3. Track and send Emergency Department and outpatient visits for coronavirus (COVID)-
like illness, as well as other illnesses, to Texas Syndromic Surveillance System (TxS2).
4. Send copies of all admission, discharge, and transfer (ADT) messages to the Centers
for Disease Control and Prevention (CDC) National Syndromic Surveillance Program
(NSSP).
5. Monitor and utilize available data in the CDC's National Healthcare Safety Network
(NHSN) for confirmed 2019 novel coronavirus (COVID-19) infection or for COVID-
like illness.
a. Long-term care: https: ;'www.cdc.gov/nhsn/Itc/covidl9/index.html
b. Acute care: https://www.cdc.gov/nhsn/acute-care-hospital/covidl9/index.html
6. Work with long-term care facilities to enroll the facility in the NHSN Long -Term Care
Facility (LTCF) COVID-19 Module.
7. Provide requested information on COVID-19 associated deaths to DSHS within three
business days.
C. Enhance laboratory testing and reporting capacity:
1. Establish or expand capacity to test all symptomatic individuals, and secondarily
expand capacity to achieve community -based surveillance. This capacity would entail
increasing testing capabilities above the current number of specimens that can be tested
System Agency Contract No. HHS000812700012
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at the jurisdiction's public health laboratory or by establishing new testing capabilities
at the jurisdiction's laboratory.
2. Screen for past infection (e.g., serology) for health care workers, employees of high -
risk facilities, critical infrastructure workforce, and childcare providers.
3. Obtain all jurisdictional laboratory test data electronically, including from new, non-
traditional testing settings, and using alternative file formats (e.g., .csv or .xls) to help
automate. In addition to other reportable results, this should include all COVID-19-
related testing data, including all tests to detect severe acute respiratory syndrome
coronavirus 2 (SAR-CoV-2) and serology testing.
4. Report all COVID-19-related line level testing data (negatives, positives,
indeterminates, serology) daily to DSHS. Data must meet new federal Coronavirus Aid,
Relief, and Economic Security (CARES) Act laboratory guidance. All public health
data must be reported electronically to DSHS in compliance with the Texas
Administrative Code and within appropriate reporting timeframes.
D. Prevent and control COVID-19 in healthcare settings and protect other vulnerable or high -
risk populations:
1. Assess and monitor COVID-19 infections in healthcare workers across the healthcare
spectrum.
2. Perform infection control assessments using preparedness tools approved by DSHS to
ensure interventions are in place to protect high -risk populations.
3. Monitor and help implement mitigation strategies for COVID-19 in all high -risk
healthcare facilities (e.g., hospitals, dialysis clinics, cancer clinics, nursing homes, and
other long-term care facilities).
4. Monitor and help implement mitigation strategies for other high -risk employment
settings (e.g., meat processing facilities) and congregate living settings (e.g., prisons,
youth homes, shelters).
a. This includes coordinating with the Texas Department of Criminal Justice when
individuals are released from serving their prison term and will be returning to the
jurisdiction. These individuals may have been exposed to COVID-19 while in
prison and/or may be COVID-19-positive and require additional public health
follow-up.
E. Monitor and mitigate COVID-19 introductions from connected jurisdictions (i.e.,
neighboring cities and states, including air travel).
F. Work with healthcare system to manage and monitor system capacity.
1. Assess and monitor the number and availability of critical care staff, necessary PPE
and potentially life-saving medical equipment, as well as access to testing services.
2. Leverage NHSN data to monitor healthcare worker staffing, Patient Impact, Hospital
Capacity, and healthcare supplies (PPE, PAPRs, ventilators, etc.). Grantee will request
access to the NHSN database within 30 days of the execution of this Contract or within
30 days of hire for the position completing the data entry. Upon access approval,
System Agency Contract No. HHS000812700012
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Grantee will review available NHSN data (at least monthly) to assess gaps in the
healthcare system.
G. Improve understanding of jurisdictional communities with respect to COVID-19 risk.
Grantee must build an understanding of population density and high -risk population
density (i.e., population of >65 yrs., proportion of population with underlying conditions,
households with limited English fluency, healthcare -seeking behavior, populations without
insurance and those below poverty level).
H. Submit a quarterly report on the report template to be provided by DSHS. Quarterly reports
are due on or before the 15th of the month following the end of the quarter being reported
on. Each report must contain a summary of activities that occurred during the preceding
quarter for each activity listed above in Section I, A through G. Submit quarterly reports
by electronic mail to COVID.ContractsC&dshs.texas.gov. The email "Subject Line" and
the name of the attached file for all reports should be clearly identified with the Grantee's
Name, Contract Number, IDCU/COVID and the quarter the report covers.
I. May use funds to pay pre -award costs which date back to January 20, 2020, that are directly
related to the COVID-19 outbreak response. All pre -award costs must be approved in
writing by DSHS.
J. Not use funds for research, clinical care, fundraising activities, construction or major
renovations, to supplant existing state or federal funds for activities, or funding an award
to another party or provider who is ineligible. Other than normal and recognized executive -
legislative relationships, no funds may be used for:
1. Publicity or propaganda purposes, for the preparation, distribution, or use of any
material designed to support or defeat the enactment of legislation before any
legislative body;
2. The salary or expenses of any grant or contract recipient, or agent acting for such
recipient, related to any activity designed to influence the enactment of legislation,
appropriations, regulation, administrative act or Executive order proposed or pending
before any legislative body.
K. 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.
L. Grantee shall maintain an inventory of Equipment, supplies defined as Controlled Assets,
and real property and submit an annual cumulative report of the equipment and other
property on the DSHS Contractor's Property Inventory Report located at
https:i'/www.dshs.state.tx.us/p,rants.,,-'fonns.shtm to CMSInvoices(&dshs.texas.M and
COVID.ContractsAdshs.texas.gov not later than October 15 of each year. If Grantee did
not purchase Equipment or other property, this report is still required to be submitted.
System Agency Contract No. HHS000812700012
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M. DSHS funds must not be used to purchase buildings or real property without prior written
approval from DSHS. Any costs related to the initial acquisition of the buildings or real
property are not allowable without written pre -approval.
N. 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 DSHS. Title
may be transferred to any other party designated by DSHS. DSHS may, at its option and
to the extent allowed by law, transfer the reversionary interest to such property to Grantee.
II. PERFORMANCE MEASURES
The System Agency will monitor the Grantee's performance of the requirements in
Attachments A-1 and A-2 and compliance with the Contract's terms and conditions.
III.INVOICE AND PAYMENT
A. Grantee will request payments using the State of Texas Purchase Voucher (Form B-13)
located at http:i/www.dshs.state.tx.us.-grants.!fonns.shtm. Voucher and any supporting
documentation will be mailed or submitted by fax or electronic mail to all
addresses/number below.
Department of State Health Services
Claims Processing Unit, MC 1940
1100 West 49 h Street
P.O. Box 149347
Austin, TX 78714-9347
FAX: (512) 458-7442
EMAIL: invoices(a,dshs.state.tx.us and
EMAIL: CMSInvoicesAdshs.texas.gov and
EMAIL: COVID.Contracts ddshs.texas. ov
B. Grantee will be paid on a cost reimbursement basis and in accordance with the Revised
Budget in Attachment B-1 of this Contract.
C. Grantee will submit requests for reimbursement (Form B-13) and financial expenditure
template 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 DSHS upon request.
In the event a cost reimbursed under the Contract is later determined to be unallowable,
then the Grantee will reimburse DSHS for that cost.
D. Grantee will submit quarterly Financial Status Reports (FSRs) to DSHS by the last
business day of the month following the end of each quarter of the Contract for DSHS
review and financial assessment.
E. Grantee will submit request for reimbursement (13-13) as a final close-out invoice not later
than forty-five (45) calendar days following the end of the term of the Contract.
System Agency Contract No. HHS000812700012
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Reimbursement requests received in the DSHS office more than forty-five (45) calendar
days following the termination of the Contract may not be paid.
F. Grantee will submit a final FSR as a final close-out FSR not later than forty-five (45)
calendar days following the end of the term of the Contract.
System Agency Contract No. HHS000812700012
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ATTACHMENT A-2
SUPPLEMENTAL STATEMENT OF WORK
I. GRANTEE RESPONSIBILITIES
Grantee will perform activities as submitted in their DSHS-approved budget for this specific
funding contract period. Only activities listed below are approved for this funding and any
additional activities not listed in the approved budget must be submitted for DSHS
consideration and approval. The activities for this contract funding period are as follows:
A. Enhance Laboratory, Surveillance, Informatics and other Workforce Capacity,
including:
1. Train and hire staff to improve laboratory workforce ability to address issues around
laboratory safety, quality management, inventory management, specimen
management, diagnostic and surveillance testing and reporting results.
2. Build expertise for healthcare and community outbreak response and infection
prevention and control (IPC) among local health departments.
3. Train and hire staff to improve the capacities of the epidemiology and informatics
workforce to effectively conduct surveillance and response of COVID-19 (including
case investigation and public health follow-up activities) and other emerging infections
and conditions of public health significance. This should include staff who can address
unique cultural needs of those at higher risk for COVID-19.
4. Build Grantee staff expertise to support management of the COVID-19-related
activities within the jurisdiction and integrate into the broader Epidemiology and
Laboratory Capacity (ELC) portfolio of activities (e.g., additional leadership, program
and project managers, budget staff).
Increase capacity for timely data management, analysis, and reporting for COVID-19
and other emerging coronavirus and other infections and conditions of public health
significance.
B. Strengthen Laboratory Testing
1. Establish or expand capacity to quickly, accurately and safely test for SARS-CoV-
2/COVID-19 and build infectious disease preparedness for future coronavirus and other
events involving other pathogens with potential for broad community spread.
a. Develop systems to improve speed and efficiency of specimen submission to
clinical and reference laboratories.
b. Strengthen ability to rapidly respond to testing (e.g., nucleic acid amplification test
[NAAT], antigen) as necessary to ensure that optimal utilization of existing and
new testing platforms can be supported to help meet increases in testing demand in
a timely manner. Laboratory Response Networks (LRNs) and Local Health
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Departments (LHDs) with laboratories are strongly encouraged to diversify their
testing platforms to enable them to pivot depending on reagent and supply
availabilities.
c. Perform serology testing with an FDA Emergency Use Authorization (EUA)
authorized serological assay as appropriate to respond to emerging pandemics in
order to conduct surveillance for past infection and monitor community exposure.
d. Build local capacity for testing of COVID-19/SARS-CoV-2 including within high -
risk settings or in vulnerable populations that reside in their communities.
e. Apply laboratory safety methods to ensure worker safety when managing and
testing samples that may contain SARS-CoV-2/COVID-19.
f. Laboratories and LRNs are encouraged to implement new technologies to meet
local needs.
g. Augment or add specificity to existing laboratory response plans for future
coronavirus and other outbreak responses caused by an infectious disease. Provider
must establish a plan to maintain the activity when the funds are no longer available.
This is an optional activity.
2. Enhance laboratory testing capacity for SARS-CoV-2/COVID-19 by ensuring
public/private laboratory testing providers have access to biosafety resources for
SARS-CoV-2 specimen collection and/or testing.
C. Advance Electronic Data Exchange at Public Health Labs
Enhance and expand laboratory information infrastructure, to improve jurisdictional
visibility on laboratory data (tests performed) from all testing sites and enable faster
and more complete data exchange and reporting with DSHS.
a. Employ a well -functioning Laboratory Information Management System (LIMS)
system to support efficient data flows within the PHL and its partners. This includes
expanding existing capacity of the current LIMS to improve data exchange and
increase data flows through LIMS maintenance, new configurations/modules, and
enhancements. Implement new/replacement LIMS where needed.
Note: If implementing new or replacement systems, develop an implementation
plan, including appropriate milestones and timeline to completion.
Implementation plans will be reviewed and approved for consistency with the
activities set forth by DSHS prior to start of implementation.
b. Ensure ability to administer LIMS. Ensure the ability to configure all tests that are
in LIMS, including new tests, EUAs, etc., in a timely manner. Ensure expanding
needs for administration and management of LIMS system are covered through
dedicated staff.
c. Interface diagnostic equipment to directly report laboratory results into LIMS.
D. Improve Surveillance and Reporting of Electronic Health Data
1. Establish complete, up-to-date, timely reporting of morbidity and mortality to DSHS
due to COVID-19 and other coronavirus and other emerging infections which impact
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conditions of public health significance, with required associated data fields in a
machine-readable format, by:
a. Establishing or enhancing community -based surveillance, including surveillance of
vulnerable populations, individuals without severe illness, those with recent travel
to high -risk locations, or who are contacts to known cases; and
b. Monitoring changes to daily incidence rates of COVID-19 and other conditions of
public health significance at the county or zip code level to inform community
mitigation strategies.
2. Establish additional and ongoing surveillance methods (e.g., sentinel surveillance) for
COVID-19 and other conditions of public health significance.
Enhance capacity to work with testing facilities to onboard and improve electronic
laboratory reporting (ELR) to receive data from new or non-traditional testing settings.
Use alternative data flows (e.g., reporting portals) and file formats (e.g., CSV or XLS)
to help automate submissions where appropriate. In addition to other reportable results,
this should include all COVID-19/SARS-CoV-2-related testing data (i.e., tests to detect
SARS-CoV-2 including serology testing).
4. Improve understanding of capacity, resources, and patient impact at healthcare
facilities through electronic reporting.
a. Require expansion of reporting facility capacity, resources, and patient impact
information, such as patients admitted and hospitalized, in an electronic, machine-
readable, as well as human -readable, visual, and tabular manner, to achieve 100%
coverage in jurisdiction and include daily data from all acute care, long-term care,
and ambulatory care settings. Use these data to monitor facilities with confirmed
cases of COVID-19/SARS-CoV-2 infection or with COVID-like illness among
staff or residents and facilities at high risk of acquiring COVID-19/SARS-CoV-2
cases and COVID-like illness among staff or residents.
b. Increase Admit, Discharge, and Transfer (ADT) messaging and use to achieve
comprehensive surveillance of emergency room visits, hospital admissions, facility
and department transfers, and discharges to provide an early warning signal, to
monitor the impact on hospitals, and to understand the growth of serious cases
requiring admission.
5. Implement new/replacement systems where needed. Ensure systems are interoperable
and that data can be linked across systems (e.g., public health, healthcare, private labs),
including adding the capacity for lab data and other data to be used by the
software/tools that are being deployed for case investigation and public health follow-
up activities.
6. Establish or improve systems to ensure complete, accurate and immediate (within 24
hours) data transmission that allows for automated transmission of data to DSHS in a
machine-readable format.
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a. Submit all case reports in an immediate way to DSHS for COVID-19/SARS-CoV-
2 and other conditions of public health significance with associated required data
fields in a machine-readable format.
b. Report requested COVID-19/SARS-CoV-2-related data, including line level
testing data (negatives, positives, indeterminates, serology, antigen, nucleic acid)
daily by county or Zip code to DSHS.
c. Establish these systems in such a manner that they may be used on an ongoing basis
for surveillance of, and reporting on, routine and other threats to the public health
and conditions of public health significance.
E. Use Laboratory Data to Enhance Investigation, Response and Prevention
Use laboratory data to initiate and conduct case investigation and public health follow-
up activities and implement containment measures.
a. Conduct necessary case investigation and public health follow-up activities
including contact elicitation/identification, contact notification, contact testing, and
follow-up. Activities could include traditional case investigation and public health
follow-up activities and/or proximity/location-based methods, as well as methods
adapted for healthcare facilities, employers, elementary and secondary schools,
childcare facilities, institutions of higher education or in other settings.
b. Utilize tools (e.g., geographic information systems and methods) that assist in the
rapid mapping and tracking of disease cases for timely and effective epidemic
monitoring and response, incorporating laboratory testing results and other data
sources.
2. Identify cases and exposure to COVID-19 in high -risk settings or within populations at
increased risk of severe illness or death to target mitigation strategies and referral for
therapies (for example, monoclonal antibodies) to prevent hospitalization.
a. Assess and monitor infections in healthcare workers across the healthcare
spectrum.
b. Monitor cases and exposure to COVID-19 to identify need for targeted mitigation
strategies to isolate and prevent further spread within high -risk healthcare facilities
(e.g., hospitals, dialysis clinics, cancer clinics, nursing homes, and other long-term
care facilities).
c. Monitor cases and exposure to COVID-19 to identify need for targeted mitigation
strategies to isolate and prevent further spread within high -risk occupational
settings (e.g., meat processing facilities) and congregate living settings (e.g.,
correctional facilities, youth homes, shelters).
d. Work with DSHS to build capacity for reporting, rapid containment and prevention
of COVID- I 9/SARS-CoV-2 within high -risk settings or in vulnerable populations
that reside in their communities.
e. Jurisdictions should ensure systems are in place to link test results to relevant public
health strategies, including prevention and treatment.
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3. Implement prevention strategies in high -risk settings or within vulnerable populations
(including tribal nations as appropriate) including proactive monitoring for
asymptomatic case detection.
Note: These additional resources are intended to be directed toward testing, case
investigation and public health follow-up activities, surveillance, containment, and
mitigation, including support for workforce, epidemiology, use by employers,
elementary and secondary schools, childcare facilities, institutions of higher
education, long-term care facilities, or in other settings, scale -up of testing by public
health, academic, commercial, and hospital laboratories, and community -based
testing sites, mobile testing units, healthcare facilities, and other entities engaged
in COVID-19 testing, and other related activities related to COVID-19 testing,
case investigation and public health follow-up activities, surveillance, containment,
and mitigation which may include interstate compacts or other mutual aid
agreements for such purposes.
a. Build capacity for infection prevention and control in long-term care facilities
(LTCFs) (e.g., at least one Infection Preventionist [IP] for every facility) and
outpatient settings.
i. Build capacity for LTCFs to safely care for infected and exposed residents of
LTCFs and other congregate settings.
ii. Assist with enrollment of all LTCFs into NHSN at
https://www.cdc.gov/nhsn/Itc/enroll.html.
b. Build capacity for infection prevention and control in elementary and secondary
schools, childcare facilities, and/or institutions of higher education.
c. Increase Infection Prevention and Control (IPC) assessment capacity on site using
tele-ICAR.
d. Perform preparedness assessment to ensure interventions are in place to protect
high -risk populations.
e. Coordinate as appropriate with federally funded entities responsible for providing
health services to higher -risk populations (e.g., tribal nations and federally qualified
health centers).
F. May use funds to pay pre -award costs which date back to February 1, 2021, that are directly
related to the COVID-19 outbreak response. All pre -award costs must be approved in
writing by DSHS.
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ATTACHMENT B-1
REVISED BUDGET
Categorical Budget CARES Funding Expansion Funding
Budget Period
PERSONNEL
FRINGE BENEFITS
TRAVEL
EQUIPMENT
SUPPLIES
CONTRACTUAL
OTHER
TOTAL DIRECT
CHARGES
INDIRECT CHARGES
TOTAL
August 17, 2020
to
April 30, 2022
$58,126.00
$26,157.00
$0.00
$0.00
$0.00
$70,625.00
$0.00
$154,908.00
$0.00
$154,908.00
Effective date
to
July 31, 2023
$31,250.00
$14,063.00
$0.00
$0.00
$65,000.00
$83,322.00
$0.00
$193,635.00
$0.00
$193,635.00
System Agency Contract No. HHS000812700012
Page 13 of 13
Contract Total
$89,376.00
$40,220.00
$0.00
$0.00
$65,000.00
$153,947.00
$0.00
$348,543.00
$0.00
$348,543.00
Certificate Of Completion
Envelope Id: CB325701 D8164C4F9D5FC411 D5217EA2
Subject: HHS000812700012, City of Lubbock, Amendment 1
Source Envelope:
Document Pages: 13 Signatures: 0
Certificate Pages: 5 Initials: 0
AutoNav: Enabled
Envelopeld Stamping: Enabled
Time Zone: (UTC-06:00) Central Time (US & Canada)
Record Tracking
Status: Original
8/19/2021 4:10:59 PM
Signer Events
Daniel Pope
dpope@mylubbock.us
Mayor
City of Lubbock
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 8/13/2021 3:50:29 PM
ID:8a57c20a-5424-4173-bbb5-e04a02cc03e6
Susana Garcia
Susana.Garcia@dshs.texas.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 8/19/2021 11:08:09 AM
ID:886940af-4bbb-4328-bc74-c72cd6f2194c
Patty Melchior
Patty. Melchior@dshs.texas.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 8/19/2021 11:16:15 AM
ID:bcl9cbd6-93e6-427b-al6e-6e78cabe3481
Imelda Garcia
meldaM.Garcia@dshs.texas.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 7/6/2021 8:08:45 AM
ID:la6909aa-b026-45a9-be9f-4240c2e32ff9
In Person Signer Events
Editor Delivery Events
Agent Delivery Events
Intermediary Delivery Events
Holder: CMS internal Routing Mailbox
CMS.InternalRouting@dshs.texas.gov
Signature
Signature
Status
Status
Status
DocuSign
Status: Sent
Envelope Originator:
CMS Internal Routing Mailbox
11493 Sunset Hills Road
#100
Reston, VA 20190
CMS.InternalRouting@dshs.texas.gov
IP Address: 160.42.85.9
Location: DocuSign
Timestamp
Sent: 8/19/2021 4:16:29 PM
Timestamp
Timestamp
Timestamp
Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Katherine Wells COPIED Sent: 8/19/2021 4:16:30 PM
kwells@mylubbock.us Viewed: 8/19/2021 4:59:24 PM
Director of Public Health
City of Lubbock
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Caeli Paradise
caeli.paradise@dshs.texas.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 6/2/2021 4:43:26 PM
ID:c86e69bb-8cOa-48d7-aa2c-9466743e396f
Dawn Ferriter
dawn.ferriter@dshs.texas.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
CMS Internal Routing Mailbox
CMS.InternalRouting@dshs.texas.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 8/19/2021 4:16:30 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
Electronic Record and Signature Disclosure created on: 9/14/2020 7:10:18 PM
Parties agreed to: Daniel Pope, Susana Garcia, Patty Melchior, Imelda Garcia, Caeli Paradise
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, DSHS Contract Management Section (we, us or Company) may be required
by law to provide to you certain written notices or disclosures. Described below are the terms
and conditions for providing to you such notices and disclosures electronically through the
DocuSign system. Please read the information below carefully and thoroughly, and if you can
access this information electronically to your satisfaction and agree to this Electronic Record and
Signature Disclosure (ERSD), please confirm your agreement by selecting the check -box next to
`I agree to use electronic records and signatures' before clicking `CONTINUE' within the
DocuSign system.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available
electronically to you by us. You will have the ability to download and print documents we send
to you through the DocuSign system during and immediately after the signing session and, if you
elect to create a DocuSign account, you may access the documents for a limited period of time
(usually 30 days) after such documents are first sent to you. After such time, if you wish for us to
send you paper copies of any such documents from our office to you, you will be charged a
$0.00 per -page fee. You may request delivery of such paper copies from us by following the
procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time
change your mind and tell us that thereafter you want to receive required notices and disclosures
only in paper format. How you must inform us of your decision to receive future notices and
disclosure in paper format and withdraw your consent to receive notices and disclosures
electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to
receive required notices and consents electronically from us or to sign electronically documents
from us.
All notices and disclosures will be sent to you electronically
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through the DocuSign system all required notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or made
available to you during the course of our relationship with you. To reduce the chance of you
inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process, please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
How to contact DSHS Contract Management Section:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: alison.joffrion@hhsc.state.tx.us
To advise DSHS Contract Management Section of your new email address
To let us know of a change in your email address where we should send notices and disclosures
electronically to you, you must send an email message to us at alison.joffrion@hhsc.state.tx.us
and in the body of such request you must state: your previous email address, your new email
address. We do not require any other information from you to change your email address.
If you created a DocuSign account, you may update it with your new email address through your
account preferences.
To request paper copies from DSHS Contract Management Section
To request delivery from us of paper copies of the notices and disclosures previously provided
by us to you electronically, you must send us an email to alison.joffrion@hhsc.state.tx.us and in
the body of such request you must state your email address, full name, mailing address, and
telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with DSHS Contract Management Section
To inform us that you no longer wish to receive future notices and disclosures in electronic
format you may:
i. decline to sign a document from within your signing session, and on the subsequent page,
select the check -box indicating you wish to withdraw your consent, or you may;
ii. send us an email to alisonjoffrion@hhsc.state.tx.us and in the body of such request you must
state your email, full name, mailing address, and telephone number. We do not need any other
information from you to withdraw consent.. The consequences of your withdrawing consent for
online documents will be that transactions may take a longer time to process..
Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The
current system requirements are found here: https:'/'support.docusi n�guides.'signer- ug ide-
si ning-system-requirements.
Acknowledging your access and consent to receive and sign documents electronically
To confirm to us that you can access this information electronically, which will be similar to
other electronic notices and disclosures that we will provide to you, please confirm that you have
read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for
your future reference and access; or (ii) that you are able to email this ERSD to an email address
where you will be able to print on paper or save it for your future reference and access. Further,
if you consent to receiving notices and disclosures exclusively in electronic format as described
herein, then select the check -box next to `I agree to use electronic records and signatures' before
clicking `CONTINUE' within the DocuSign system.
By selecting the check -box next to `1 agree to use electronic records and signatures', you confirm
that:
You can access and read this Electronic Record and Signature Disclosure; and
You can print on paper this Electronic Record and Signature Disclosure, or save or send
this Electronic Record and Disclosure to a location where you can print it, for future
reference and access; and
Until or unless you notify DSHS Contract Management Section as described above, you
consent to receive exclusively through electronic means all notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided
or made available to you by DSHS Contract Management Section during the course of
your relationship with DSHS Contract Management Section.
CITY OF LUBBOCK
ATTEST:
By: ��4
DANIEL M. POP , Mayor
ATTEST:
By:
REB TCA GARZA, City ec tary
APPROVED AS TO CONTENT:
By:
lZkT RINE WELLS, Director of Public Health
APPROVED AS TO FORM:
By:
A rR OKE, Assistant City Attorney