HomeMy WebLinkAboutResolution - 2022-R0229 - Amendment No. 2 DSHS Contract HHS000812700012 - COVID-19Resolution No. 2022-RO229
Item No. 7.23
May 10, 2022
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the Mayor of the City of Lubbock is hereby authorized and directed to execute, on
behalf of the City of Lubbock, Amendment No. 2 to the Department of State Health Services
(DSHS) Contract No. HHS000812700012, to provide funding for COVID-19 activities, by and
between the City of Lubbock and the State of Texas acting by and through DSHS, and all
related documents. 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:
Rebec a Garza, City Secretak")
APPROVED AS TO CONTENT:
Bill HoV*on, Deputy City
APPROVED AS TO FORM:
Assistant City Attorney
May 10, 2022
�=k
DANIEL M. POPE, MAYOR
RES.DSHS Contract No. HHS000812700012 Amendment No.2
4.11.22
DocuSign Envelope ID: 6F206FOC-EO08-4268-AEOD-8923236F66FC
Resolution No. 2022-RO229
DEPARTMENT OF STATE HEALTH SERVICES
CONTRACT No. HHS000812700012
AMENDMENT No. 2
The DEPARTMENT OF STATE HEALTH SERVICES ("SYSTEM AGENCY" or "DSHS") and
CITY OF LUBBOCK ("Grantee"), who are collectively referred to herein as the "Parties," to
that certain grant contract for COVID-19 activities effective August 17, 2020, and
denominated DSHS Contract No. HHS000812700012 ("Contract"), as amended, now desire
to further amend the Contract.
WHEREAS, the Parties desire to extend the term of the Contract;
WHEREAS, the Parties desire to revise the Statement of Work; and
WHEREAS, the Parties desire to revise the Budget.
Now, THEREFORE, the Parties hereby amend and modify the Contract as follows:
SECTION III of the Contract, DURATION, is hereby amended to reflect a revised
termination date of July 31, 2024.
2. SECTION IV of the Contract, BUDGET, is hereby deleted in its entirety and replaced
with the following language:
The total amount of this Contract will not exceed $348,543.00 for COVID-19 response
activities through July 31, 2024. Grantee is not required to provide matching funds.
All expenditures under the Contract will be in accordance with ATTACHMENT B-2,
REVISED BUDGET.
ATTACHMENT A-2 of the Contract, SUPPLEMENTAL STATEMENT OF WORK, is
hereby deleted in its entirety and replaced with ATTACHMENT A-3, REVISED
SUPPLEMENTAL STATEMENT OF WORK.
4. ATTACHMENT B-1 of the Contract, REVISED BUDGET, is hereby deleted in its
entirety and replaced with ATTACHMENT B-2, REVISED BUDGET.
5. This Amendment No. 2 shall be effective as of the date last signed below.
6. Except as amended and modified by this Amendment No. 2, all terms and conditions
of the Contract, as amended, shall remain in full force and effect.
7. Any further revisions to the Contract shall be by written agreement of the Parties.
SIGNATURE PAGE FOLLOWS
DocuSign Envelope ID: 6F206FOC-E008-4268-AEOD-8923236F66FC
SIGNATURE PAGE FOR AMENDMENT No. 2
DSHS CONTRACT No. HHS000812700012
SYSTEM AGENCY
DocuSigned by:
B y: 87AFD32AD9D24A9...
Imelda Garcia
Name:
Title: Associate Commissioner
Date of Execution: May 12, 2022
GRANTEE
DocuSigned by:
�ainic,l pert,
By EFF2196C547841C...
Daniel Pope
Name:
Title: Mayor
Date of Execution: May 12, 2022
THE FOLLOWING ATTACHMENTS ARE ATTACHED AND INCORPORATED AS PART OF THE
CONTRACT:
ATTACHMENT A-3 - REVISED SUPPLEMENTAL STATEMENT OF WORK
ATTACHMENT B-2 - REVISED BUDGET
2
DocuSign Envelope ID: 6F206FOC-E008-4268-AEOD-8923236F66FC
SIGNATURE PAGE FOR AMENDMENT No. 2
DSHS CONTRACT No. HHS000812700012
SYSTEM AGENCY GRANTEE
LIM
By:
Name: Name: Daniel M. Pope
Title:
Date of Execution:
Title: Mayor
Date of Execution: May 10, 2022
THE FOLLOWING ATTACHMENTS ARE ATTACHED AND INCORPORATED AS PART OF THE
CONTRACT:
ATTACHMENT A-3 - REVISED SUPPLEMENTAL STATEMENT OF WORK
ATTACHMENT B-2 - REVISED BUDGET
2
DocuSign Envelope ID: 6F206FOC-EO08-4268-AEOD-8923236F66FC
ATTACHMENT A-3
REVISED SUPPLEMENTAL STATEMENT OF WORK
I. GRANTEE RESPONSIBILITIES
Grantee will perform activities as submitted in their DSHS approved budgets for this
specific funding Contract period. All activities must be listed below to be approved for
this funding and any additional activities not listed in the approved budget must be
submitted for DSHS consideration and approval. The activities for this Contract funding
period are as follows:
A. Enhance Laboratory, Surveillance, Informatics and other Workforce Capacity,
including:
Train and hire staff to improve laboratory workforce ability to address issues
around laboratory safety, quality management, inventory management, specimen
management, diagnostic and surveillance testing and reporting results.
2. Build expertise for healthcare and community outbreak response and infection
prevention and control (IPC) among local health departments.
3. Train and hire staff to improve the capacities of the epidemiology and informatics
workforce to effectively conduct surveillance and response of COVID-19
(including case investigation and public health follow-up activities) and other
emerging infections and conditions of public health significance. This should
include staff who can address unique cultural needs of those at higher risk for
COVID-19. Grantee may not incur COVID-19 contact tracing or contact tracing
call center expenditures after 08i31/2021.
4. Build expertise to support management of the COVID-19-related activities within
the jurisdiction and integrate into the broader Epidemiology and Laboratory
Capacity (ELC) portfolio of activities (e.g., additional leadership, program and
project managers, budget staff, etc.).
5. Increase capacity for timely data management, analysis, and reporting for COVID-
19 and other emerging coronavirus and other infections and conditions of public
health significance.
B. Strengthen Laboratory Testing
Establish or expand capacity to quickly, accurately and safely test for SARS-CoV-
2/COVID-19 and build infectious disease preparedness for future coronavirus and
other events involving other pathogens with potential for broad community spread.
a. Develop systems to improve speed and efficiency of specimen submission to
clinical and reference laboratories.
b. Strengthen ability to rapidly respond to testing (e.g., nucleic acid amplification
test [NAAT], antigen, etc.) as necessary to ensure that optimal utilization of
existing and new testing platforms can be supported to help meet increases in
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testing demand in a timely manner. Laboratory Response Networks (LRNs)
and Local Health Departments (LHDs) with laboratories are strongly
encouraged to diversify their testing platforms to enable them to pivot
depending on reagent and supply availabilities.
c. Perform serology testing with an FDA Emergency Use Authorization (EUA)
authorized serological assay as appropriate to respond to emerging pandemics
in order to conduct surveillance for past infection and monitor community
exposure.
d. Build local capacity for testing of COVID-191SARS-CoV-2 including within
high -risk settings or in vulnerable populations that reside in their communities.
e. Apply laboratory safety methods to ensure worker safety when managing and
testing samples that may contain SARS-CoV-2/COVID-19.
f. Laboratories and LRNs are encouraged to implement new technologies to meet
local needs.
g. Augment or add specificity to existing laboratory response plans for future
coronavirus and other outbreak responses caused by an infectious disease.
Provider must be able to establish a plan to maintain the activity when the
funds are no longer available. This is an optional activity.
2. Enhance laboratory testing capacity for SARS-CoV-2/'COVID-19 by ensuring
public private laboratory testing providers have access to biosafety resources for
SARS-CoV-2 specimen collection and/or testing.
C. Advance Electronic Data Exchange at Public Health Labs
Enhance and expand laboratory information infrastructure, to improve
jurisdictional visibility on laboratory data (tests performed) from all testing sites
and enable faster and more complete data exchange and reporting with DSHS.
a. Employ a well -functioning Laboratory Information Management System
(LIMS) to support efficient data flows within the PHL and its partners. This
includes expanding existing capacity of the current LIMS to improve data
exchange and increase data flows through LIMS maintenance, new
configurations modules, and enhancements. Implement new/replacement
LIMS where needed.
Note: If implementing new or replacement systems, develop an
implementation plan, including appropriate milestones and timeline to
completion. Implementation plans will be reviewed and approved for
consistency with the activities set forth by DSHS prior to start of
implementation. Completion of the implementation plan is DSHS
verifying that the submitted electronic laboratory reporting (ELR) feeds
have been successfully processed in National Electronic Disease
Surveillance System (NEDSS).
b. Ensure ability to administer LIMS. Ensure the ability to configure all tests that
are in LIMS, including new tests, EUAs, etc., in a timely manner. Ensure
expanding needs for administration and management of LIMS are covered
through dedicated staff.
c. Interface diagnostic equipment to directly report laboratory results into LIMS.
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D. Improve Surveillance and Reporting of Electronic Health Data
Establish complete, up-to-date, timely reporting of morbidity and mortality to
DSHS due to COVID-19 and other coronavirus and other emerging infections
which impact conditions ofpublic health significance, with required associated
data fields in a machine-readable format, by:
a. Establishing or enhancing community -based surveillance, including
surveillance of vulnerable populations, individuals without severe illness,
those with recent travel to high -risk locations, or who are contacts to known
cases.
b. Monitoring changes to daily incidence rates of COVID-19 and other
conditions of public health significance at the county or Zip code level to
inform community mitigation strategies.
2. Establish additional and ongoing surveillance methods (e.g., sentinel
surveillance) for COVID-19 and other conditions of public health significance.
3. At the health department, enhance capacity to work with testing facilities to
onboard and improve ELR, including to receive data from new or non-
traditional testing settings. Use alternative data flows (e.g., reporting portals)
and file formats (e.g., CSV or XLS) to help automate where appropriate. In
addition to other reportable results, this should include all COVID-I9iSARS-
CoV-2-related testing data (i.e., tests to detect SARS-CoV-2 including
serology testing).
4. Improve understanding of capacity, resources, and patient impact at healthcare
facilities through electronic reporting.
a. Require expansion of reporting facility capacity, resources, and patient
impact information, such as patients admitted and hospitalized, in an
electronic, machine-readable, as well as human -readable, visual and tabular
manner, to achieve 100% coverage in jurisdiction and include daily data
from all acute care, long-term care, and ambulatory care settings. Use these
data to monitor facilities with confirmed cases of COVID-19'SARS-CoV-
2 infection or with COVID-like illness among staff or residents and
facilities at high risk of acquiring COVID-19'SARS-CoV-2 cases and
COVID-like illness among staff or residents.
b. Increase Admit, Discharge, Transfer (ADT) messaging and use to achieve
comprehensive surveillance of emergency room visits, hospital admissions,
facility and department transfers, and discharges to provide an early
warning signal, to monitor the impact on hospitals, and to understand the
growth of serious cases requiring admission.
5. Establish or improve systems to ensure complete, accurate and immediate
(within 24 hours) data transmission that allows for automated transmission of
data to DSHS in a machine-readable format.
Note: Use of an existing DSHS system is preferred. If implementing new
or replacement systems, develop an implementation plan, including the
process for automatic transmission of data to DSHS in a machine-readable
DocuSign Envelope ID: 6F206FOC-E008-4268-AEOD-8923236F66FC
format, appropriate milestones and timeline to completion.
Implementation plans will be reviewed and approved for consistency with
the activities set forth by DSHS prior to start of implementation.
a. Submit all case reports in an immediate way to DSHS for COVID-19: SARS-
CoV-2 and other conditions of public health significance with associated
required data fields in a machine-readable format.
b. Report requested COVID-19/SARS-CoV-2-related data, including line level
testing data (negatives, positives, indeterminates, serology, antigen, nucleic
acid) daily by county or Zip code to DSHS.
c. Establish these systems in such a manner that they may be used on an ongoing
basis for surveillance of, and reporting on, routine and other threats to the
public health and conditions of public health significance.
E. Use Laboratory Data to Enhance Investigation, Response and Prevention
Use laboratory data to initiate and conduct case investigation and public health
follow-up activities and implement containment measures.
a. Conduct necessary case investigation and public health follow-up activities
including contact elicitation/identification, contact notification, contact
testing, and follow-up. Activities could include traditional case investigation
and public health follow-up activities and/or proximity/location-based
methods, as well as methods adapted for healthcare facilities, employers,
elementary and secondary schools, childcare facilities, institutions of higher
education or in other settings. Data must be entered into the DSHS data system
in accordance with DSHS published guidance. Grantee may not incur
COVID-19 contact tracing call center expenditures beyond 8/31/2021.
b. Utilize tools (e.g., geographic information systems and methods) that assist in
the rapid mapping and tracking of disease cases for timely and effective
epidemic monitoring and response, incorporating laboratory testing results and
other data sources.
c. Assist in identifying facilities that are not submitting data through ELR.
Provide these facilities with information on the ELR onboarding process and
the appropriate contact information of DSHS team who can onboard the
facility to have their data be reported electronically and no longer sent by fax.
Also provide the names of these facilities to the DSHS team.
2. Identify cases and exposure to COVID-19 in high -risk settings or within
populations at increased risk of severe illness or death to target mitigation
strategies and referral for therapies (for example, monoclonal antibodies) to
prevent hospitalization.
a. Assess and monitor infections in healthcare workers across the healthcare
spectrum.
b. Monitor cases and exposure to COVID-19 to identify need for targeted
mitigation strategies to isolate and prevent further spread within high -risk
healthcare facilities (e.g., hospitals, dialysis clinics, cancer clinics, nursing
homes, other long-term care facilities, etc.).
c. Monitor cases and exposure to COVID-19 to identify need for targeted
mitigation strategies to isolate and prevent further spread within high -risk
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DocuSign Envelope ID: 6F206FOC-E008-4268-AEOD-8923236F66FC
occupational settings (e.g., meat processing facilities) and congregate living
settings (e.g., correctional facilities, youth homes, shelters).
d. Work with DSHS to build capacity for reporting, rapid containment and
prevention of COVID-19. SARS-CoV-2 within high -risk settings or in
vulnerable populations that reside in their communities.
e. Jurisdictions should ensure systems are in place to link test results to relevant
public health strategies, including prevention and treatment.
Note: Utilization of an existing DSHS system is preferred. If
implementing new or replacement systems, develop an implementation
plan, including the process for automatic transmission of data to DSHS in
a machine-readable format, appropriate milestones and timeline to
completion. Implementation plans will be reviewed and approved for
consistency with the activities set forth by DSHS prior to start of
implementation.
3. Implement prevention strategies in high -risk settings or within vulnerable
populations (including tribal nations as appropriate), including proactive
monitoring for asymptomatic case detection.
Note: These additional resources are intended to be directed toward testing,
case investigation and public health follow-up activities, surveillance,
containment, and mitigation, including support for workforce, epidemiology,
use by employers, elementary and secondary schools, childcare facilities,
institutions of higher education, long-term care facilities, or in other settings,
scale -up of testing by public health, academic, commercial, and hospital
laboratories, and community -based testing sites, mobile testing units,
healthcare facilities, and other entities engaged in COVID-19 testing, and
other related activities related to COVID-19 testing, case investigation and
public health follow-up activities, surveillance, containment, and mitigation
which may include interstate compacts or other mutual aid agreements for such
purposes.
a. Build capacity for infection prevention and control in long-term care facilities
(LTCFs) (e.g., at least one Infection Preventionist [IP] for every facility) and
outpatient settings.
L Build capacity for LTCFs to safely care for infected and exposed
residents of LTCFs and other congregate settings.
ii. Assist with enrollment of all LTCFs into CDC's National Healthcare
Safety Network NHSN at hLtps:,,-./www.cdc.gov�'nhsn/Itc/enroll.html.
b. Build capacity for infection prevention and control in elementary and
secondary schools, childcare facilities, and/or institutions of higher education.
c. Increase Infection Prevention and Control (IPC) assessment capacity on site
using tele-ICAR.
d. Perform preparedness assessment to ensure interventions are in place to protect
high -risk populations.
e. Coordinate as appropriate with federally funded entities responsible for
providing health services to higher -risk populations (e.g., tribal nations and
federally qualified health centers).
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DocuSign Envelope ID: 6F206FOC-E008-4268-AEOD-8923236F66FC
F. Submit a quarterly report on the report template to be provided by DSHS. Quarterly
reports are due on or before the 15'' of the month following the end of the quarter.
Each report must contain a summary of activities that occurred during the preceding
quarter for each activity listed above in Section I, Subsections A through E. Submit
quarterly reports by electronic mail to COVID.Contracts a7dshs.texas. ov. The email
"Subject Line" and the name of the attached file for all reports should be clearly
identified with the Grantee's Name, Contract Number, IDCU/COVID and the quarter
the report covers.
G. Not use funds for research, clinical care, fundraising activities, construction or major
renovations, to supplant existing state or federal funds for activities, or funding an
award to another party or provider who is ineligible. Other than normal and
recognized executive -legislative relationships, no funds may be used for:
1. Publicity or propaganda purposes, for the preparation, distribution, or use of any
material designed to support or defeat the enactment of legislation before any
legislative body;
2. The salary or expenses of any grant or contract recipient, or agent acting for such
recipient, related to any activity designed to influence the enactment of legislation,
appropriations, regulation, administrative act or Executive order proposed or
pending before any legislative body.
H. Controlled Assets include firearms, regardless of the acquisition cost, and the
following assets with an acquisition cost of $500 or more, but less than $5,000:
desktop and laptop computers (including notebooks, tablets and similar devices), non -
portable printers and copiers, emergency management equipment, communication
devices and systems, medical and laboratory equipment, and media equipment.
Controlled Assets are considered Supplies.
I. Grantee shall maintain an inventory of Equipment, supplies defined as Controlled
Assets, and real property and submit an annual cumulative report of the equipment
and other property on the DSHS Contractor's Property Inventory Report located at
httys:ii'www.dshs.state.tx.us/gEants/forms.shtm to CMSInvoices(66dshs.texas.gov and
COVID.Contractsrcidshs.texas. og_v not later than October 15 of each year. If Grantee
did not purchase Equipment or other property, this report is still required to be
submitted.
J. DSHS funds must not be used to purchase buildings or real property without prior
written approval from DSHS. Any costs related to the initial acquisition of the
buildings or real property are not allowable without written pre -approval.
K. At the expiration or termination of this Contact for any reason, title to any remaining
equipment and supplies purchased with funds under this Contract reverts to DSHS.
Title may be transferred to any other party designated by DSHS. DSHS may, at its
option and to the extent allowed by law, transfer the reversionary interest to such
property to Grantee.
M
DocuSign Envelope ID: 6F206FOC-EO08-4268-AEOD-8923236F66FC
Categorical Budget
Budget Period
PERSONNEL
FRINGE BENEFITS
TRAVEL
EQUIPMENT
SUPPLIES
CONTRACTUAL
OTHER
TOTAL DIRECT
CHARGES
INDIRECT CHARGES
TOTAL
ATTACHMENT B-2
REVISED BUDGET
CARES Funding
August 17, 2020
to
July 31, 2024
$58,126.00
$26,157.00
$0.00
$0.00
$0.00
$70,625.00
$0.00
$154,908.00
$0.00
$154,908.00
Expansion Funding
August 31, 2021
to
July 31, 2024
$31,250.00
$14,063.00
$0.00
$0.00
$65,000.00
$83,322.00
$0.00
$193,635.00
$0.00
$193,635.00
Contract Total
$89,376.00
$40,220.00
$0.00
$0.00
$65,000.00
$153,947.00
$0.00
$348,543.00
$0.00
$348,543.00
011
Certificate Of Completion
Envelopeld: 6F206FOCE0084268AEOD8923236F66FC
Subject: Please DocuSign: HHS000812700012, City of Lubbock, COVID Amendment 2
Source Envelope:
Document Pages: 9 Signatures: 0
Certificate Pages: 5 Initials: 0
AutoNav: Enabled
Envelopeld Stamping: Enabled
Time Zone: (UTC-06:00) Central Time (US & Canada)
Record Tracking
Status: Original
4/1/2022 3:53:38 PM
Signer Events
Daniel Pope
dpope@mail.ci.lubbock.tx.us
Mayor
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 4/1/2022 4:54:13 PM
ID: 4dd6ef6e-59d2-42 cf-8b60-697c7968bfa 1
Susana Garcia
Susana.Garcia@dshs.texas.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 4/1/2022 3:22:51 PM
ID:9e685877-67bc-46c4-931b-93b17f9b449d
Patty Melchior
Patty. Melchior@dshs.texas.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 4/1/2022 3:48:37 PM
ID: d15ea708-8807-"f6 bd2e-09ee3c25ec15
Imelda Garcia
ImeldaM.Garcia@dshs.texas.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 7/6/2021 8:08:45 AM
ID:1a6909aa-b026-45a9-be9f-4240c2e32ff9
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IP Address: 167.137.1.9
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Caeli Paradise COPIED Sent: 4/1/2022 3:59:33 PM
caeli.paradise@dshs.texas.gov
Contract Manager
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Electronic Record and Signature Disclosure:
Accepted: 12/21/2021 2:35:07 PM
ID:c6dab47b-ff17-4990-be85-4057f6a41671
Katherine Wells COPIED Sent: 4/1/2022 3:59:33 PM
kwells@mylubbock.us Viewed: 4/2/2022 10:00:50 AM
Director of Public Health
City of Lubbock
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DocuSign
Certificate Of Completion
Envelope Id: 6F206FOCE0084268AEOD8923236F66FC
Subject: Please DocuSign: HHS000812700012, City of Lubbock, COVID Amendment 2
Source Envelope:
Document Pages: 9 Signatures: 2
Certificate Pages: 6 Initials: 0
AutoNav: Enabled
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Time Zone: (UTC-06:00) Central Time (US & Canada)
Record Tracking
Status: Original
4/1/2022 3:53:38 PM
Signer Events
Daniel Pope
dpope@mail.ci.lubbock.tx.us
Mayor
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 4/1/2022 4:54:13 PM
ID:4dd6ef6e-59d2-42cf-8b60-697c7968bfa1
Susana Garcia
Susana.Garcia@dshs.texas.gov
CTCM, Unit Director
DSHS
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 5/12/2022 8:41:29 AM
ID:9e3cf7c2-3fc7-4c18-9e5b-3a8096f4c810
PATTY MELCHIOR
Patty. Melchior@dshs.texas.gov
Director, DSHS CMS
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 5/5/2022 12:43:08 PM
ID:f01589da-43a7-481e-996a-7c50409e5d48
Holder: CMS Internal Routing Mailbox
CMS.InternalRouting@dshs.texas.gov
Signature
ED ... Si,n,d by:
aln.it,l, �eP�
EFF219BC547841C...
Signature Adoption: Pre -selected Style
Signed by link sent to dpope@mail.ci.lubbock.tx.us
Using IP Address: 208.84.91.44
Completed
Signed by link sent to
Susana.Garcia@dshs.texas.gov
Using IP Address: 167.137.1.12
Completed
Signed by link sent to
Patty.Melchior@dshs.texas.gov
Using IP Address: 167.137.1.17
Status: Completed
Envelope Originator:
CMS Internal Routing Mailbox
11493 Sunset Hills Road
#100
Reston, VA 20190
CMS.InternalRouting@dshs.texas.gov
IP Address: 167.137.1.9
Location: DocuSign
Timestamp
Sent: 4/1/2022 3:59:33 PM
Resent: 4/29/2022 8:34:37 AM
Viewed: 4/29/2022 2:03:41 PM
Signed: 5/12/2022 8:40:53 AM
Sent: 5/12/2022 8:40:55 AM
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Signed: 5/12/2022 8:42:06 AM
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Signed: 5/12/2022 9:51:38 AM
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Imelda Garcia
DocuSigned by:
/
t,(,a.a. Gar6x
Ev87AFD32AD9D24A9...
Sent: 5/12/2022 9:51:40 AM
ImeldaM.Garcia@dshs.texas.govViewed:
5/12/2022 11:17:13 AM
Associate Commissioner
Signed: 5/12/2022 11:17:20 AM
Texas Health and Human Services Commission
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Signed by link sent to
ImeldaM.Garcia@dshs.texas.gov
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Signed using mobile
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ID:1a6909aa-b026-45a9-be9f-4240c2e32ff9
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Caeli Paradise Sent: 4/1/2022 3:59:33 PM
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ED
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(None)
Electronic Record and Signature Disclosure:
Accepted: 12/21/2021 2:35:07 PM
ID: c6dab47b-ff17-4990-be85-4057f6a41671
Katherine Wells Sent: 4/1/2022 3:59:33 PM
kwells@mylubbock.us Viewed: 4/2/2022 10:00:50 AM
Director of Public Health
City of Lubbock
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
CMS Internal Routing MailboxCOPIED Sent: 5/12/2022 11:17:22 AM
CMS.InternalRouting@dshs.texas.gov
DSHS Contract Management Section
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 4/1/2022 3:59:33 PM
Certified Delivered Security Checked 5/12/2022 11:17:13 AM
Signing Complete Security Checked 5/12/2022 11:17:20 AM
Envelope Summary Events Status
Completed Security Checked
Payment Events Status
Electronic Record and Signature Disclosure
Timestamps
5/12/2022 11:17:22 AM
Timestamps
Electronic Record and Signature Disclosure created on: 9/14/2020 7:10:18 PM
Parties agreed to: Daniel Pope, Susana Garcia, Patty Melchior, Imelda Garcia, Caeli Paradise
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, DSHS Contract Management Section (we, us or Company) may be required
by law to provide to you certain written notices or disclosures. Described below are the terms
and conditions for providing to you such notices and disclosures electronically through the
DocuSign system. Please read the information below carefully and thoroughly, and if you can
access this information electronically to your satisfaction and agree to this Electronic Record and
Signature Disclosure (ERSD), please confirm your agreement by selecting the check -box next to
`I agree to use electronic records and signatures' before clicking `CONTINUE' within the
DocuSign system.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available
electronically to you by us. You will have the ability to download and print documents we send
to you through the DocuSign system during and immediately after the signing session and, if you
elect to create a DocuSign account, you may access the documents for a limited period of time
(usually 30 days) after such documents are first sent to you. After such time, if you wish for us to
send you paper copies of any such documents from our office to you, you will be charged a
$0.00 per -page fee. You may request delivery of such paper copies from us by following the
procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time
change your mind and tell us that thereafter you want to receive required notices and disclosures
only in paper format. How you must inform us of your decision to receive future notices and
disclosure in paper format and withdraw your consent to receive notices and disclosures
electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to
receive required notices and consents electronically from us or to sign electronically documents
from us.
All notices and disclosures will be sent to you electronically
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through the DocuSign system all required notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or made
available to you during the course of our relationship with you. To reduce the chance of you
inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process, please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
How to contact DSHS Contract Management Section:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: alison.joffrion@hhsc.state.tx.us
To advise DSHS Contract Management Section of your new email address
To let us know of a change in your email address where we should send notices and disclosures
electronically to you, you must send an email message to us at alisonjoffrion@hhsc.state.tx.us
and in the body of such request you must state: your previous email address, your new email
address. We do not require any other information from you to change your email address.
If you created a DocuSign account, you may update it with your new email address through your
account preferences.
To request paper copies from DSHS Contract Management Section
To request delivery from us of paper copies of the notices and disclosures previously provided
by us to you electronically, you must send us an email to alison.joffrion@hhsc.state.tx.us and in
the body of such request you must state your email address, full name, mailing address, and
telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with DSHS Contract Management Section
To inform us that you no longer wish to receive future notices and disclosures in electronic
format you may:
i. decline to sign a document from within your signing session, and on the subsequent page,
select the check -box indicating you wish to withdraw your consent, or you may;
ii. send us an email to alisonjoffiion@hhsc.state.tx.us and in the body of such request you must
state your email, full name, mailing address, and telephone number. We do not need any other
information from you to withdraw consent.. The consequences of your withdrawing consent for
online documents will be that transactions may take a longer time to process..
Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The
current system requirements are found here: https:, /support.docusign com; guides/signer- guide-
siing-system-requirements.
Acknowledging your access and consent to receive and sign documents electronically
To confirm to us that you can access this information electronically, which will be similar to
other electronic notices and disclosures that we will provide to you, please confirm that you have
read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for
your future reference and access; or (ii) that you are able to email this ERSD to an email address
where you will be able to print on paper or save it for your future reference and access. Further,
if you consent to receiving notices and disclosures exclusively in electronic format as described
herein, then select the check -box next to `I agree to use electronic records and signatures' before
clicking `CONTINUE' within the DocuSign system.
By selecting the check -box next to `I agree to use electronic records and signatures', you confirm
that:
You can access and read this Electronic Record and Signature Disclosure; and
You can print on paper this Electronic Record and Signature Disclosure, or save or send
this Electronic Record and Disclosure to a location where you can print it, for future
reference and access; and
Until or unless you notify DSHS Contract Management Section as described above, you
consent to receive exclusively through electronic means all notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided
or made available to you by DSHS Contract Management Section during the course of
your relationship with DSHS Contract Management Section.
CITY OF LUBBOCK
ATTEST:
By: (D'v" '1K,
REB CCA GARZA, City Sectj
APPROVE S TO CONTENT:
By:
�-h hA- A
10ATHERINE WELLS, Director of Public Health
APPROVED AS TO FORM:
By: 17 , e-:
R O , ssistant City Attorney