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HomeMy WebLinkAboutResolution - 2021-R0353 - Amendment No. 1 to Contract HHS000779500001 9.14.21Resolution No. 2021-R0353 Item No. 7.34 September 14, 2021 RESOLUTION i 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. 1 to the Health and Human Services Commission (HHSC) Contract No. HHS000779500001, under the Substance Use Disorder Treatment, to provide funding for Administrative Substance Use Disorder Services, 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 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: Rebe ca Garza, City Secre ry APPROVED AS TO CONTENT: Bill Howert eputy City Mana APPROVED AS TO FORM: R an ooke, ssistant City Attorney September 14, 2021 DANIEL M. POPE, MAYOR RES.HHSC Contract No. HHS000779500001 Amendment No. l Ratification 9.9.21 DocuSign Envelope ID: C2363107-007F4DB1-8900-FC4D74D5438C Resolution No. 2021-R0353 HEALTH AND HUMAN SERVICES COMMISSION CONTRACT No. HHS000779500001 AMENDMENT NO. 1 THE HEALTH AND HUMAN SERVICES COMMISSION ("System Agency") and CITY OF LUBBOCK ("Grantee"), each a "Party" and collectively the "Parties," to that certain Administrate Substance Use Disorder Services ("ADMIN") Contract, effective August 1, 2020 and denominated HHSC Contract No. HHS000779500001 (the "Contract"), now desire to amend the Contract. WHEREAS, the Parties desire to amend the Contract in accordance with ATTACHMENT D, UNIFORM TERMS & CONDITIONS -GRANTEE, SECTION 9.1 (AMENDMENT); WHEREAS, the Parties desire to extend the term of the Contract in accordance with ARTICLE III, DURATION, of the Contract Signature Page; WHEREAS, the Parties desire to incorporate the Grantee's Indirect Cost Rate Agreement ATTACHMENT H-1, FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM; WHEREAS, the Parties desire to revise Attachments to the existing Contract; and WHEREAS, the Parties desire to add total System Agency allocated funds to the Contract in the amount of $250,000.00 for each State Fiscal Year, 2022 through 2024, thereby increasing the not to exceed Total Contract Value. Now, THEREFORE, the Parties modify the Contract as follows: ATTACHMENT A, STATEMENT OF WORK, is deleted and replaced in its entirety with ATTACHMENT A, STATEMENT OF WORK (REVISED AUGUST 2021). 2. ATTACHMENT B, BUDGET is supplemented with ATTACHMENT B-1, FY2022-FY2024 BUDGET. 3. ATTACHMENT E, SPECIAL CONDITIONS VERSION 1.2 is replaced in its entirety with ATTACHMENT E, SPECIAL CONDITIONS VERSION 1.3. 4. ARTICLE III, DURATION, of the Contract Signature Page is amended to reflect a revised termination date of August 31, 2024. The revised termination date does not affect Parties' ability to renew, extend, modify, or terminate pursuant to the terms and conditions of the Contract. 5. ARTICLE IV, BUDGET, of the Contract Signature Page is amended to add state allotted funding of $250,000.00 (TWO HUNDRED FIFTY THOUSAND DOLLARS) for each State Fiscal Year ("FY") 2022 through FY 2024, resulting in a new annual funding amount of $1,126,272.000 (ONE MILLION ONE HUNDRED TWENTY-SIX THOUSAND TWO HUNDRED SEVENTY-TWO DOLLARS), as follows: Page 1 of System Agency Contract No. HHS000779500001 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C a. The System Agency allocated share by State Fiscal Year is as follows: i. FY 2022, September 1, 2021 through August 31, 2022: $250,000.00 ii. FY 2023, September 1, 2022 through August 31, 2023: $250,000.00 iii. FY 2024, September 1, 2023 through August 31, 2024: $250,000.00 Total Contract Value of System Agency allocated funds will not exceed $1,126,272.00 (ONE MILLION, ONE HUNDRED TWENTY-SIX THOUSAND, TWO HUNDRED SEVENTY- TWO DOLLARS). Any funds remaining by the end of the fiscal year will be forfeited and may not be carried forward or rolled over to the following fiscal year. 5. The Parties amend the Contract Signature Page to add Article X, Texas Grant Management Standards (TxGMS): X. TEXAS GRANT MANAGEMENT STANDARDS (TxGMS) The Texas Grant Management Standards (TxGMS), published by the Texas Comptroller, replaces the Uniform Grant Management Standards (UGMS) and applies to grant agreements that begin on or after January 1, 2022. Additionally, as provided in TxGMS, if a state awarding agency adds funds to a grant that existed before March 1, 2021, TxGMS will apply to it from that point forward, unless the state awarding agency specifically indicates that TxGMS will not apply. Applicable references to UGMS in this Grant Agreement will be superseded by TxGMS accordingly. 6. ATTACHMENT H-1, FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM, is attached to and incorporated into the Contract. 7. This Amendment shall be effective as of the date of last signature. 8. Except as amended and modified by this Amendment, 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 Page 2 of 3 System Agency Contract No. HHS000779500001 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C SIGNATURE PAGE FOR AMENDMENT No. 1 HEALTH AND HUMAN SERVICES COMMISSION CONTRACT No. HHS000779500001 HEALTH AND HUMAN SERVICES CITY OF LUBBOCK COMMISSION Doc Signed by: s :[au�.ic,l, Pelt, Y 3F037863155540F_ Daniel Pope Mayor Date of Execution: Date of Execution: September 8, 2021 THE FOLLOWING ATTACHMENTS ARE ATTACHED AND THEIR TERMS ARE HEREBY INCORPORATED AS PART OF THE CONTRACT: ATTACHMENT A STATEMENT OF WORK (REVISED AUGUST 2021) ATTACHMENT B-1 FY2022-FY20224 BUDGET ATTACHMENT E SPECIAL CONDITIONS VERSION 1.3 ATTACHMENT H -1 FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM Page 3 of 3 System Agency Contract No. HHS000779500001 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C The Administration (ADMIN) Program provides funds to the Grantee to administer and monitor the Grantee's subcontractors providing substance use disorder (SUD) services in accordance with the Substance Abuse Block Grant (SABG) block grant. The System Agency designates the Grantee to award subcontractors and manage services for indigent clients who meet eligibility for the following Programs: a. Co -Occurring Psychiatric and Substance Abuse Disorders (COPSD) b. Treatment for Youth (TRY); c. Treatment for Adults (TRA); and d. Treatment for Females (TRF) SECTION I. GRANTEE RESPONSIBILITIES Grantee shall: A. Hire or assign personnel to provide oversight of Grantee's subcontractors providing SUD services. B. Procure and enter into subcontract agreements with organization(s) to provide SUD services within four (4) months of this Contract execution. C. Provide System Agency the Grantee's employee contact list for the person(s) responsible for the following activities. Grantee list shall include the employees and supervisors contact information. 1. Overseeing grantee's contractors 2. Monitoring subcontractors 3. Submitting Daily Capacity Management and Wait List reports in Clinical Management for Behavioral Health Services (CMBHS) D. Ensure Grantee's subcontractor network contains services for the following programs and service types: 1. Adult Treatment (TRA) i. Adult Intensive Residential Services; ii. Adult Ambulatory Detoxification Services iii. Adult Residential Detoxification Services; iv. Adult Outpatient Services: (a) Adult Outpatient Group Counseling; (b) Adult Outpatient Group Education; (c) Adult Outpatient Individual Counseling. 2. Youth Treatment (TRY) i. Youth Outpatient Services (a) Youth Outpatient Group Counseling; (b) Youth Outpatient Group Education; (c) Youth Outpatient Individual Counseling; (d) Youth Adolescent Support; Page 1 of 9 System Agency Contract No. HHS000779500001 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C (e) Youth Family Counseling; (0 Youth Family Support; (g) Youth Psychiatrist Consultation. 3. Specialized Female Treatment (TRF) i. Adult Specialized Female Intensive Residential Services; ii. Adult Specialized Female Supportive Residential Services; iii. Adult Specialized Female Women with Children Intensive Residential Services; iv. Adult Specialized Female Outpatient Services (a) Adult Specialized Female Outpatient Group Counseling; (b) Adult Specialized Female Outpatient Group Education; (c) Adult Specialized Female Outpatient Individual Counseling. 4. Co -Occurring Psychiatric and Substance Abuse Disorders (COPSD) E. Provide each subcontractor identical service type rates as System Agency offers in all subrecipient fee -for -service agreements. F. Ensure all Grantee staff and subcontractors of Grantee adhere to all applicable requirements in this Contract. G. Ensure all Grantee staff and subcontractors of Grantee adhere to the most current Health and Human Services Commission (HHSC) Substance Use Disorder (SUD) Program Guide located at: https://hhs.texas.gov/doing-business- hhs/Trovider- )ortals/behavioral-health-services- roviders/substance-use-disorder- service -providers H. Ensure a Grantee representative with knowledge about Grantee and subcontract(s) system(s) and services attends the Outreach, Screening, Assessment, and Referrals (OSAR) quarterly regional collaborative meetings. I. Ensure current information on SUD services is represented on the Grantee's website listing the organizations the Grantee has contracts or agreements related to the provision of SUD services. J. Ensure Grantee's representatives attend training in Austin, TX or participate online in Clinical Management for Behavioral Health Services (CMBHS) training after contract execution and before subcontracted services begin. K. Ensure utilization of CMBHS to report Wait List and Daily Capacity Management in accordance with the SUD Program Guide https://hhs.texas.gov/doing-business- hhs/provider-portals/behavioral-health-services-providers/substance-use-disorder- service-providers. L. Grantee shall utilize a tool to monitor the performance of the subcontractors. Grantee may develop a monitoring tool, which shall be approved by System Agency, or utilize the Page 2 of 9 System Agency Contract No. HHS000779500001 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C System Agency's monitoring tool. M. Ensure that the monitoring tool, at minimum, contains the following information: 1. Date of review; 2. Name of subcontractor reviewed; 3. Type of review; 4. Name of staff conducting review; 5. List of findings; and 6. Plan to remediate findings and maintain corrections. N. Submit copies, to System Agency, of each written agreement obtained with subcontractors for the SUD services network. O. Submit Quality Management and Oversight Monitoring Schedule of subcontractors to System Agency to include all subcontractors of Grantee performing SUD services. P. Monitor all subcontractors' financial and programmatic performance and maintainrecords to be available for inspection by System Agency. Q. Be responsible to System Agency for the performance of all subcontractors. R. Submit to System Agency a quarterly report of all monitoring and activities (Monitoring Activity Report); the report must include the following: 1. Number of monitoring reviews conducted; 2. Types of monitoring reviews conducted; 3. Summary evaluation of findings and Grantee's plan of oversight to bring the providers into compliance; 4. Number and nature of complaints received on providers; 5. List of significant provider findings that must, at a minimum include the following: a. Immediate risk to health or safety; b. Client abuse, neglect, or exploitation; c. Licensure revocation or suspension; d. Fraud, waste or abuse reports; e. Reported criminal activity of any provider's staff. SECTION II: CLINICAL MANAGEMENT FOR BEHAVIORAL HEALTH SERVICES (CMBHS) SYSTEM MINIMUM REQUIREMENTS Grantee will: A. 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. B. Establish and maintain a security policy that ensures adequate system security and protection of confidential information. C. Notify the CMBHS Help -desk within ten (10) business days of any change to the designated Security Administrator or the back-up Security Administrator. Page 3 of 9 System Agency Contract No. HHS000779500001 DocuSign Envelope ID: C2363107-007F-4DB7-8900-FC4D74D5438C D. 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. E. In addition to CMBHS Helpdesk notification, Grantee shall submit a signed CMBHS Security Attestation Form and a list of Performing agency's employees, contracted laborers and sub -Performing Agency's authorized to have access to secure data. The CMBHS Security Attestation Form shall be submitted electronically on or before the 15t' day of September and March 15a', to the designated folder in GlobalScape EFT. F. Attend System Agency training on CMBHS documentation. SECTION III: REPORTING REOUIREMENTS A. Grantee shall submit required reports of monitoring activities to System Agency by the applicable due date outlined below. The following reports must be submitted to System Agency to GlobalScape EFT (htti2s://sftp.hiis.texas.gov ) by the required due date and report name described in Section IV: Submission Requirements: B. Grantee shall submit all documents listed in the table displayed in this section by the Due Date stated. C. Grantee will note that if the due date is on a weekend or holiday, then the document is due the following business day. D. Grantee shall submit a Financial Status Report (FSR), quarterly in CMBHS. FSR are due the last business day of the month following the end of each quarter. E. Grantee shall submit monthly invoices in Clinical Management for Behavioral Health Services (CMBHS) by the 15th of the following month. F. Grantee shall submit annual Contract Closeout documentation, this is required each fiscal year, and a final contract closeout will be due October 15 of the final fiscal year of the Contract. G. Grantee shall submit a CMBHS Security Attestation Form, the form shall be submitted electronically on or before September 15t' and March 15th to the to the designated folder in GlobalScape EFT. H. Grantee will report the performance measures for the previous month's activities in CMBHS by the 15th of the current month. I. Grantee's duty to submit documents will survive the termination or expiration of this Contract. Page 4 of 9 System Agency Contract No. HHS000779500001 DocuSign Envelope ID: C2363107-007F4DB1-8900-FC4D74D5438C Grantee shall maintain access to GlobalScape EFT at all times during the contract term. SECTION IV. SUBMISSION REQUIREMENT System Agency will monitor Performing Agency's performance of the requirements in Attachment A and compliance with the Contract's terms and conditions. Requirement Deliverable (Report Name Due Date Submission System Section II, E CMBHS Security Attestation September 15' and March 151h GlobalScape Form and list of authorized annually. users Section III, D Financial Status Report Financial Status Report (FSR) CMBHS (FSR) Quarterly; report includes the previous Quarter information, as follows: Ql reporting period, due December 31 st Q2 reporting period, due March 31 st Q3 reporting period, due June 30th Q4 reporting period, due September 30th Section III, E Claims in CMBHS All claims must be entered monthly. CMBHS Section I, O Quality Management and 5a' business day following the end GlobalScape Oversight — Monitoring of each quarter of the Contract term Schedule Section I, R Quality Management and 30 days following the end of the GlobalScape Oversight — quarter of the contract term Monitoring Activity Report Section III, F Closeout documents Final closeout documents due GlobalScape October 15th each fiscal year. Page 5 of 9 System Agency Contract No. HHS000779500001 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C Page 6 of 9 System Agency Contract No. HHS000779500001 DocuSign Envelope U C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT B-1 FY2022-FY2024 BUDGET Grantee Name: CITY OF LUBBOCK Contract Number: HHS000779500001 A. Funding is from the United States Health and Humans Services (HHS) and the Substance Abuse and Mental Health Services Administration (SAMSHA), which requires compliance to 45 CFR Part 96, Subpart C, as applicable: https:iiecfr.io Title 4511205.1.90 sp45.1. 96. c. B. Grantee shall comply with the requirements applicable in the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, 2 CFR 200, and the Texas Grant Management Standards (TxGMS) Standards. C. Grantee shall review and comply with the System Agency's Grants Technical Assistance guide, which provides guidance on financial administration in order to clarify applicable laws, rules and regulations. The Guide is located at the following: https:llhhs.texas..ov/doin.-business-hhsi grants. D. Grantee may access the Transactions List report in CMBHS to identify the amount of federal funds allocated to this award for each transaction. E. The Assisted Listing Number (ALN) number for the Substance Abuse Prevention and Treatment (SAPT) Block Grant is 93.959. The ALN number is identified in the CMBHS Transactions List report. F. Invoice and Payment 1. Grantee shall submit all monthly invoices to the System Agency through CMBHS. Grantee shall ensure the supportive documents for the expenditures are emailed to the assigned contract manager and copied to the Substance Use Disorder Contracts Mailbox: SubstanceAbuse.Contracts ahlisc.state. tx.us. 2. Grantee will be paid on a monthly basis and in accordance with services performed under this Contract. G. Any unexpended balance associated with any other System Agency -funded contract may not be applied to this Contract. H. Funding 1. System Agency Share total reimbursements will not exceed $750,000.00 for the period from September 1, 2021 through August 31, 2024, as follows: a. Fiscal Year 2022, September 1, 2021 through August 31, 2022 - $250,000.00 b. Fiscal Year 2023, September 1, 2022 through August 31, 2023 - $250,000.00 c. Fiscal Year 2024, September 1, 2023 through August 31, 2024 - $250,000.00 Page 7 of 9 System Agency Contract No. HHS000779500001 DocuSign Envelope ID: C2363107-007F-4D61-8900-FC4D74D5438C Cost Reimbursement Budget 1. The Cost Reimbursement budget documents all approved and allowable expenditures; Grantee shall only utilize the funding detailed in Attachments B and B=1 for approved and allowable costs. Grantee shall make all requests to utilize funding for expenses not documented in the approve budget in writing to, the System Agency assigned contract manager. System Agency shall provide written notification regarding if the requested expense is approved. 2. Grantee may make revisions to the System Agency -approved Cost Reimbursement budget. The requirements are as follows: a. Grantee may transfer funds from the budgeted direct categories only; with the exception of the Equipment Category. Grantee may transfer up to ten (10) percent of the Fiscal Year Contract value without System Agency approval. Budget revisions exceeding the ten percent requirement require System Agency's written approval. b. Grantee may request revisions to the approved Cost Reimbursement budgeted direct categories that exceed the ten (10) percent requirement stated in (I)(2)(a), by submitting a written request to the assigned contract manager. This change is considered a minor administrative change and does not require an amendment. The System Agency shall provide a Technical Guidance Letter (TGL) if the budget revision is approved; and the assigned Contract Manager will update CMBHS, as needed. 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 but 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. J. Categorical Budget The approved Categorical budget, per fiscal year is below: Page 8 of 9 System Agency Contract No. HHS000779500001 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C FY2022 thru FY2024 PERSONNEL $126,717.00 FRINGE BENEFITS $60,830.00 TRAVEL $7,920.00 SUPPLIES $5,328.00 CONTRACTUAL $18,600.00 EQUIPMENT $0.00 OTHER $30,605.00 TOTAL DIRECT CHARGES $250,000.00 INDIRECT CHARGES $0.00 TOTAL CONTRACT VALUE $250,000.00 MATCH $0.00 SYSTEM AGENCY SHARE $250,000.00 Page 9 of 9 System Agency Contract No. HHS000779500001 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) TEXAS Health and Human Services Health and Human Services Commission Special Conditions Version 1.3 Page 1 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) TABLE OF CONTENTS ARTICLEI -SPECIAL DEFINITIONS ............... ......... ..... ............................. «....«.«..... ............ ........ ..... ««........ ,.«............... ,......... ....... ........... ......... _.... _._............ ..... ................... «....... »........... 3 ARTICLEII - GRANTEES PERSONNELAND SUBCONTRACTORS............ ............................ ......................... ................. «.......... ».... ............. »...... ««..... ««............. ............... ........._....... .............. 4 3JI1Qualifications.........................................................................................................................................................................................................................4 2.02 Conduct and Removal...........................................................................................................................................................................................................4 2.03 Contracts with Subcontractors.............................................................................................................................................................................................4 2.04 Status of Subcontractors.......................................................................................................................................................................................................5 2.05 Incorporation of Terms in Subcontracts..............................................................................................................................................................................5 2.06 Notice of Legal Matter or Litigation..............................................................................................................................................................................6 2.07 Unilateral Amendment..................................................................................................................................................................................................6 ARTICLEIII - CONFIDENTIALITY ....................... ........ ......................... .............. ..«....... _........ «........ ...................................................................... _.... . ....................... ..................... «...... ..--.-6 3.01 Confidential System Information........................................................................................................................................................................................6 ARTICLEIV -MISCELLANEOUS PROVISIONS. ....... . ............. . .............. _ ............ . .. . ........ . ............... . ..... ......................... . ........... . ............. . ............... ...... . .................. 7 4.01 Minor Administrative Changes............................................................................................................................................................................................7 4.02 Conflicts of Interest.................................................................................................................................................................... ..............7 ............................. 4.03 Flow Down Provisions...........................................................................................................................................................................................................8 4.04 Disaster Declarations..............................................................................................................................................................8 ARTICLEV - DSHSLEGACY PROVISIONS .... »....... ............. .«.......................... _................. ......... ... ............ _........................ »................... ..... -........... ... ........... «.......... ................ ............._.9 5.01 Notice of a Contract Action..................................................................................................................................................................................................9 5.02 Notice of IRS or TWCInsolvency........................................................................................................................................................................................9 5.03 Notice of Criminal Activity and Disciplinary Actions.............................................................................................._.......................................................10 5.04 Child Abuse Reporting Requirement................................................................................................................................................................................10 5-05 Abuse, Neglect, Exploitation...............................................................................................................................................................................................10 5-06 Notification of Change of Contact Person or Key Personnel............................................................................................................................................10 5.07 Notification of Organization Change..................................................................................................................................................................................11 5.08 Significant Incidents....................................................................................._............................................................................................................... ..11 5.09 Responsibilities and Restrictions Concerning Governing Body, Officers, and Employees............................................................................................11 5.10 Direct Operations.................................................................................................................................................................................................................12 5.11 Interim Extension Amendment............................................................................................................................................................................................12 5.12 Medical Records Retention.................................................................................................................................................................................................12 5.13 Grantee's Certification of Meeting or Exceeding Tobacco -Free Workplace Policy Minimum Standards.................................................................... 13 5.14 Electronic and Information Resources Accessibility and Security Standards ................................................ »........... .................................................... 13 5.15 Equipment, Supplies and Property ...................................................................................................................................................................................15 5.16 Clinical Management for Behavioral Health Services (CMBIIS) System........................................................................................................................22 a. Resources......................................................................................... _............................................................................. ..................................................... 22 b. Security Administrator and Authorized Users................................................................................................................................................................. 22 C. Security Violations and Accounts Updates.......................................................................................................................................................................23 d. Electronic Transfer ofInformation.................................................................................................................................................................................... 23 e. Access...................................................................................................................................................................................................................................23 f. Customer Support and Training........................................................................................................................................................................................ 24 5.17 HIV/AIDS Model Workplace Guidelines......................................................................................................................................................................... 24 5.18 Medicaid Enrollment.........................................................................................................................................................................................................24 5.19 Billing for Treatment and Payment Restrictions.............................................................................................................................................................. 24 5.20 Persons on Probation or Parole.......................................................................................................................................................................................... 24 5.21 Substance Abuse Block Grant (SABG) Requirements......................................................................................................................................................25 5.22 Match and Program Income...............................................................................................................................................................................................25 5.23 Contract Reconciliation.....................................................................................................................................................................................................26 Page 2 of 27 DocuSign Envelope ID: C2363107-007F4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) The terms and conditions of these Special Conditions are incorporated into and made a part of the Contract. Capitalized items used in these Special Conditions and not otherwise defined have the meanings assigned to them in HHSC Uniform Terms and Conditions - Grant, Version 2.16.1. 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. If any provision contained in this HHSC Special Conditions is in conflict with, or inconsistent with the Substance Use Disorder Utilization Management Guidelines (UM), the provision contained in the UM shall prevail. ARTICLE I - SPECIAL DEFINITIONS "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. "Grantee Agents" means Grantee's representatives, employees, officers, as well as any contractor or subgrantee's employees, contractors, officers, principals and agents. "Data Use Agreement" means the agreement incorporated into the Contract to facilitate creation, receipt, maintenance, use, disclosure or access to Confidential Information. "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. "Minor Administrative Change" refers to a change to the Contract that does not increase the fees or term and done in accordance with Section 4.01 of these Special Conditions. "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. "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. Page 3 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REvISED AUGUST 2021) "Software" means all operating system and applications software used or created by Grantee to perform the work under the Contract. "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 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. ARTICLE II - GRANTEES PERSONNEL AND SUBCONTRACTORS 2.01 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 transferor 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. 2.02 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. Any person employed by Grantee shall, at the written request of HHSC, and within HHSC's sole discretion, be removed immediately by Grantee from work relating to the Contract. 2.03 Contracts with Subcontractors a. Grantee may enter into contracts with subcontractors unless restricted or otherwise prohibited in the Contract. b. Grantees are prohibited from subcontracting with for -profit organizations under this Contract. c. Prior to entering into a subcontract agreement equaling or exceeding $100,000, Grantee will Page 4 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) obtain written approval from the System Agency. d. Grantee will obtain written approval from System Agency before modifying any subcontract agreement to cause the agreement to exceed $100,000. e. Grantee will establish written policies and procedures for competitive procurement and monitoring of subcontracts and will develop a subcontracting monitoring plan. f. Grantee shall monitor subcontractors for both financial and programmatic performance and will maintain pertinent records. g. Grantee shall submit quarterly monitoring reports to the System Agency in a format determined by the System Agency. h. Grantee shall ensure that subcontracts are fully aware of the requirements placed upon them by state/federal statutes, rules, and regulations and by the provisions of this Contract. i. Grantee shall ensure all subcontracts, must be in writing and include the following: 1. Name and address of all parties and the subcontractor's Vendor IdentificationNumber (VIN) or Employee Identification Number (EIN); 2. Detailed description of the services to be provided; 3. Measurable method and rate of payment and total not -to -exceed amount of the contract; 4. Clearly defined and executable termination clause; and 5. Beginning and ending dates that coincide with the dates of the Contract. j. Grantee shall ensure and be responsible for the performance of the subcontractor(s). k. Grantee shall 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. 2.04 Status of Subcontractors Grantees will require that all subcontractors certify that they are/have: a. In good standing with all state and federal funding and regulatory agencies; b. Not currently debarred, suspended or otherwise excluded from participation in federal grant programs; c. Not delinquent on any repayment agreements; d. Not had a required license or certification revoked; e. Not ineligible under the terms of the Contract; and f. Not had a System Agency contract terminated for cause. 2.05 Incorporation of Terms in Subcontracts a. 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): 1. Statement of Work 2. Uniform Terms and Conditions 3. Special Conditions 4. Federal Assurances and Certifications 5. Non -Exclusive List of Applicable Laws 6. 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 Page 5 of 27 DocuSign Envelope ID: C2363107-007F-4DBI-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) 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. b. 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. c. No provision of this Contract creates privity of contract between the System Agency and any subcontractor of Grantee. 2.06 Notice of Legal Matter or Litigation Grantee will send notice to the Substance Use Disorder (SUD) email box, SubstanceAbuse.Contracts(a)hhsc.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. 2.07 Unilateral Amendment 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: a. To comply with a court order or judgment b. Incorporate new or revised federal or state laws, regulations, rules or policies c. Correct an obvious clerical error in this Contract; d. Change the name of the Contractor in order to reflect the Contractor's name as recorded by the Texas Secretary of State. e. To correct the name, mailing address, or contact information for persons named in the Contract; f. To update service descriptions or rates (if applicable); ARTICLE III - CONFIDENTIALITY 3.01 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 Page 6 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) 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 Informationby 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 INDEMNIFY AND HOLD HARMLESS HHSC FROM ALL DAMAGES, COSTS, LIABILITIES, 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. ARTICLE IV - MISCELLANEOUS PROVISIONS 4.01 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. Upon approval of a Minor Administrative Change, HHSC and Grantee will maintain written notice that the change has been accepted in their Contract files. 4.02 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 Page 7 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) 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 4.03 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. 4.04 Disaster Declarations In the event of a local, state, or federal emergency, including natural, pandemics, 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; k. Worker health and safety; 1. Mental health and substance abuse; in. Public health information; n. Vector control and veterinary services; and o. Victim identification and mortuary services. Page 8 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) 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. ARTICLE V - LEGACY PROVISIONS 5.01 Notice of a Contract Action Grantee will send notice to the Substance Use Disorder (SUD) email box, SubstanceAbuse.ContractsL&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 business 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 contract; d. Date of suspension or termination; and e. Contract or case reference number. 5.02 Notice of IRS or TWC Insolvency Grantee will send notice to the SUD email box, SubstanceAbuse.ContractsQhhsc.state.tx.us, of its insolvency, incapacity or outstanding unpaid obligations of Grantee to the Internal Revenue Service (IRS), Texas Workforce Commission (TWC), 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. Page 9 of 27 DocuSign Envelope ID C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) 5.03 Notice of Criminal Activity and Disciplinary Actions a. Grantee shall immediately send notice to the SUD email box, SubstanceAbuse.Contracts(&hhsc.state.tx.us when the Grantee learns of or has any reason to believe it or any person with ownership or controlling interest in the organization/business, or their agent, employee, subcontractor or volunteer that 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. 5.04 Child Abuse Reporting Requirement Grantee shall: 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. c. 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. d. retain reporting documentation on site and make it available for inspection bythe System Agency. 5.05 Abuse, Neglect, Exploitation Grantee shall; 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. 5.06 Grantee's Notification of Change of Contact Person or Key Personnel Page 10 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) Within 10 business days, Grantee will submit notice to the SUD email box, SubstanceAbuse.ContractsAhhsc.state.tx.us and Substance Use Disorder(a)hhsc.state.tx.us of any change in the Grantee's Contact Persons or Key Personnel. 5.07 Notice of OrganizationalChange Grantee will submit notice to the SUD email box, SubstanceAbuse.Contracts hhsc.state.tx.us and Substance_ Use Disorder@hhsc.state.tx.us within 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. 5.08 Significant Incidents In addition to notifying the appropriate authorities, Grantee will submit notice to the SUD email box, SubstanceAbuse.Contractstri hhsc.state.tx.us and Substance Use Disorder(q-)hhsc.state.tx.us significant incidents involving substantial disruption 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 days of discovery. 5.09 Responsibilities and Restrictions Concerning Governing Body, Officers and Employees Grantee and its governing bodyshall: 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, 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. Page 11 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) 5.10 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. 5.11 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. 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. 5.12 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 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 areresolved. 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. Page 12 of 27 DocuSign Envelope ID: C2363107-007F4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) h. Provide and update as necessary, the name and address of the party responsible for storage of records to the SUD emailbox, SubstanceAbuse.ContractsAhhsc.state.tx.us. 5.13 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. 5.14 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: "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. "Electronic and Information Resources" means information resources, including information resources technologies, and any equipment or interconnected system of Page 13 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) 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. "Electronic and Information Resources Accessibility Standards" means the accessibility standards for electronic and information resources contained in 1 Texas Administrative Code Chapter 213. "Product" means information resources technology that is, or is related to EIR. "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. Page 14 of 27 DocuSlgn Envelope ID: C2363107-007F4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) 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 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 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. 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. 5.15 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.Contracts@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 number or other identification number; Page 15 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) iii. Source of funding for the property (including the Federal Assistance Identification Number); iv. Who holds title, v. Acquisition date and cost of the property; A. Percentage of Federal participation in the project costs for the Federal award under which the property was acquired; 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, office supplies, 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 shall: 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. Page 16 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) e. Assets as Collateral Prohibited. Grantees will not encumber equipment purchased with System Agency funds without prior written approval from the System Agency. j. Bankruptcy. 1. In the event of bankruptcy, Grantee will; i. sever the System Agency property, equipment, and supplies in possession of Grantee from the bankruptcy, and title must revert to the System Agency. ii. when directed by the System Agency, return all such property, equipment and supplies to the System Agency. iii. ensure that its subcontracts, if any, contain a specific provision requiring that in the 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. Page 17 of 27 DocuSign Envelope ID. C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) 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.ContractsAhhsc.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 shall: 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, damaged 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 loss, 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 shall: 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.Contracts cvhhsc.state.tx.us at least thin 30 days prior to travel _ L Management and Control Systems Grantee will: Page 18 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) 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 clients and third parties. m. Property Acquisitions 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 Page 19 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) 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 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 Oversightand Support Section before settling a claim on the insurance. r. Quality Management. Grantee shall: 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 Agencyupon request. The QMP must be developed no later than the end of the first quarter of the Contract term. Page 20 of 27 DocuSign Envelope ID: C2363107-007F4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) 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. Staff 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 shall: Take all steps necessary, to protect the health, safety and welfare of its clients and participants. Develop and implement written policies and procedures for abuse, neglect and exploitation. Notify appropriate authorities of any allegations of abuse, neglect, or exploitation as required by 25 TAC § 448.703. t. Persons on Probation or Parole. Grantee will: 1. Develop and implement written policies and procedures that address the delivery of services by employees, subcontractors, or volunteers on probation or parole. 2. Notify the contract manager assigned to the Contract immediately of any of its employees, volunteers or subcontractors who are on parole or probation if the employee, volunteer, or subcontractor provides or will provide direct client or participant services or who has or may have direct contact with clients or participants. 3. Maintain copies of all notices required under this section for System Agency Page 21 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) review. u. Personnel Requirements and Documentation. Grantee shall: 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. 5.16 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. b. Security Administrator and Authorized Users Grantee shall: Page 22 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) 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 _ 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 be placed in inactive status when theGrantee ceases to have an executed contract with System Agency Mental Health and Substance Abuse Division. Page 23 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) 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. 5.17 HIV/AIDS Model Workplace Guidelines Grantee shall: 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 employees and clients concerning HIV and its related conditions, including AIDS, in accordance with the Texas. Health & Safety Code §§ 85.112-114. 5.18 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. 5.19 Billing for Treatment and Payment Restrictions Grantees shall: 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. c. The following are the exceptions to Item (b): A client may receive the following services at the same time the client receives SUD outpatient or residential treatment services: a. Co-occurring psychiatric / substance use disorder services, b. Ambulatory detoxification, or c. Opioid substitution therapy services. d. 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. 5.20 Persons on Probation or Parole. Grantee shall; a. Develop and implement written policies and procedures that address the delivery of Page 24 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) services by employees, subcontractors, or volunteers on probation or parole. b. Submit to the SUD email box, SubstanceAbuse.Contractsnu,hhsc.state. tx.us, notice of any of its employees, volunteers or subcontractors who are on parole or probation if the employee, volunteer, or subcontractor provides or will provide direct client or participant services or who has or may have direct contact with clients or participants. c. Maintain copies of all notices required under this section for System Agency review. d. Ensure that any person who is on probation or parole is prohibited from performing direct client/participant services or from having direct contact with clients or participants until authorized by System Agency. 5.21 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: 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. 5.22 Match and Program Income Grantee shall: 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). 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 of Page 25 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) the 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. 5.23 Contract Reconciliation Grantee, within 45 calendar days after the end of each fiscal term year, will submit to the System Agency email box, SubstanceAbuse.Contractsfc-hhsc.state.tx.us, financial and reconciliation reports required by System Agency in forms as determined by System Agency. 5.24 Breach of Contract and Liquidated Damages a. Contract Monitoring. System Agency: 1. will monitor Grantee for programmatic and financial compliance with this Contract and; 2. may impose liquidated damages for any breach of this Contract. 3. at 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 10 calendar days of receipt of the notice, to the SUD email box, SubstanceAbuse. Contracts(&hhsc. state. tx.us. Page 26 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C ATTACHMENT E (REVISED AUGUST 2021) 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. Page 27 of 27 DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C 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 I-cuellar@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/ 794 1- 830 - I I I I 058 13 93 State of Texas Comptroller Vendor Identification Number (VIN)14 Digits 000 756 00 906 Printed Name of Authorized Representative Signature of Authorized Representative DocuSigned by: Daniel pope �aan.it,�, Pelt, Title of Authorized Representative Date Mayor September 8, 2021 - 1 - DocuSign Envelope ID: C2363107-007F-4DB1-8900-FC4D74D5438C 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 Regarding 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 X." 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 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 U.S.0 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: -2- DocuSign Certificate Of Completion Envelope Id: C2363107C07F4DB18900FC4D74D5438C Status: Sent Subject: Amending $1,126.272.00: HHS000779500001; City of Lubbock A-1 ; HHSC/MSS-IDD-SUDCMU Source Envelope: Document Pages: 51 Signatures: 2 Envelope Originator: Certificate Pages: 2 Initials: 0 Texas Health and Human Services Commission AutoNav: Enabled 1100 W. 49th St. Envelopeld Stamping: Enabled Austin, TX 78756 Time Zone: (UTC-06:00) Central Time (US & Canada) PCS_DocuSign@hhsc.state.tx.us IP Address: 167.137-1.18 Record Tracking Status. Original 8/26/2021 9:55:21 AM 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@hhsc.state-tx.us Assoc. Commissioner IDD/BH Texas Health and Human Services Commission 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 Jennifer Silva Jennifer. SilvaO 1 @hhs,texas gov Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Holder: Texas Health and Human Services Location: DocuSign Commission PCS_DocuSign@hhsc.state,tx. us Signature Timestamp by: Sent: 8/26/2021 10:12:02 AM [DocuS,Un*d tea pore- Viewed: 8/26/2021 3:43:55 PM 3FO37BO315554OF Signed: 9/8/2021 9:05:27 AM Signature Adoption: Pre -selected Style Using IP Address- 208.84.91.41 Sent: 9/8/2021 9-.05*30 AM Signature Status Status Status Status Status I COPIED J Timestamp Timestamp Timestamp Timestamp Timestamp Timestamp Sent- 8/26/2021 10:12:01 AM Viewed: 8/27/2021 10:54:36 AM Carbon Copy Events SA Mailbox SubstanceAbuse.Contracts@hhsc.state.tx.us Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Status COPIED Bryan Hunter CO PI E D Bryan. H unter@hhs.texas.gov Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign '.Y.',' * y, r .! V�'1 s'Y 'Y � 7Lx • rs , i slr � Js,�i•, .. Witness Eventsri`Signatures,? Notary Events Envelope Summary Events Envelope Sent Signature Status Hashed/Encrypted Timestamp Sent: 8/26/2021 10:12:01 AM Viewed: 8/31/2021 4:56:33 PM Sent: 8/26/2021 10:12:01 AM Timestamp,�?�x�,s 4> fir. t�.�F �:,,lynfl TimestampLKrrx^ Timestamps 8/26/2021 10:12:01 AM ths -^`}'y4xS'Xt•2Y:,33T";ti,n :i. ilts•J n;RWtPt{I K`Ay.At:cjb�iTimestamPayment Even"sStatUS ji CITY OF LUBBOCK ATTEST: DANIEL M. POPE, Mayor ATTEST: By: '&' 'X' B CCA GARZA, tit Secr tary APPR D A TO CONTENT: By: k)j� KATHERINE WELLS, Director of Public Health APPROVED AS TO FORM: By: ex"AA R1fA/"ROdk1f,Assistant City Attorney