HomeMy WebLinkAboutResolution - 4434 - Agreement - TDOH - HIV Counseling Services - 03_24_1994Resolution No. 4434
March 24, 1994
Item #34
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the Mayor of the City of Lubbock BE and is hereby authorized and directed to
execute for and on behalf of the City of Lubbock an Agreement with Texas Department of Health
to provide HIV counseling services. Said Agreement is attached hereto and incorporated in this
Resolution as if fully set forth herein and shall be included in the minutes of the Council.
Passed by the City Council this 24th day of March 1994.
ATTEST: -
Betty M. Jolmon,(City Secretary
APPROVED AS TO CONTENT:
s • �i• i
4 '
APPROVED AS TO FORM:
artsell
Assistant City Attorney
rx:ap\o:\r011.Rcs
March 15,1994
RECEIVED
TEXAS DEPARTMENT OF HEALTH CONTRACT
t100 West 49th Street
Austin, Texas 78756-3199
STATE OF TEXAS
COUNTY OF TRAVIS TDH Document No. C5000255
' 161994
,_L,ad(XK CiTY HEALTH DEF'
This contract is between the Texas Department of Health, hereinafter referred to
as RECEIVING AGENCY, and the party listed below as PERFORMING AGENCY and
includes general provisions and attachments detailing scopes) of work and
special provisions.
+ PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT
-----------------------------------------------------------------------------------
+ (PRINT or TYPE)
! Mailing Address: P. 0. BOX 2548
LUBBOCK
TX 79408-25481
ity
(M 1p) I
I Street Address: 1902 TEXAS AVENUE
LUBBOCK
TX 79405-11171
I(Tt aitterent)
-----------------------------------------------------------------------------------
I
1 Authorized
i
y Contracting Entity: CITY OF LUBBOCK
t ditterent trom
Payee Name: CITY OF LUBBOCK HEALTH DEPARTMENT
!(Must match witn vendor i en i
ica ion number s own
a ow) i
' Payee Address: P. 0. BOX 2000
LUBBOCK
TX 79457 00001
!(Must match with vendor identification
num er s own
aelow)
1 State of Texas Vendor Identification No. (14 digits): 17560005906037
Finance Officer/Contact: DOUG GOODMAN
!
+ Type of Organization: Cit
I
1 Designate: Elementary/secon ary school, junior college
senior co ege
universe y
cityy county, other political subdivision, council
district,
of governments, judicial
1
community services program, individual,
or other (define)
Is this a small business No (Yes/No) and/or minority/woman
owned No
(Yes/No)
! Is this a non-profit business Yes (Yes/No)
I
+ PAYEE AGENCY Fiscal Year Ending Month: SEPTEMBER
!_ -----------------------------------------------------------------------------------
_!
SUMMARY OF TRANSACTION:
!
Contract for public health services.
!
1
i
i
!
!
i
i
COVER - Page 1
0 E T A 1 L S OF A7TACH.E.4TS
F1Manclai Assistance ;
Am. ; TON ; Term ; Source of Oirec: Total Assistance
No. timm ; Bea ?n cno Funasz ; Amount lss's:ance ; -,mount MH. Snare;
01 ; HI:-GHC-LHS 1/ ii WI,2/3104; '13.140 ; 35,000.0C; .00; is 0 .CO;
I • 1
I I i I
1
1 l 1 1 I I 1
1 1 1 1 1 I
1 ! 1 1 1
i 1 i 1 1 1
I 1 I 1 1 1 1 1
1 1 1 1 I 1 1 1
I 1 1 1 1 1 I
t I 1 1 1 1 I 1
1 1 i 1 i
1 1 1 I 1 I 1
t ! 1 I 1 1 1 1
1 1 1 1 1 I 1 1
I 1 1 1 1 1 1 i
i 1 1 1 I 1
1 I 1 1 1 1 1
1 t 1 7 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
f 1 1 i 1 f
I 1 1 I 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 t
1 1 t 1 I i i 1
1 1 1 1 1 1 1 I
1 1 7 1 1 1 i
1 1 I 1 1 1 I I
1 1 1 1 1 1 1 1
i 1 1 i t I 3 i
1 i 1 I 1 1 i 1
1 l 1 1 7 i i i
1 1 1 I 1 I 1 1
i I 1 1 t I I 1
1 1 1 1 1 1 1 I
1 1 1 1 I 1 1 I
1 1 1 1 I 1 1 1
i 1 1 7 1 1 I t
1 1 1 I 1 1 1 I
1 I 1 i i I I 1
1 1 t I 1 1 1 1
1 i 1 1 1 1 1 1
1 1 1 I 1 1 i 1
1 1 1 I 1 1 I i
1 1 t 1 I I I 1
1 1 1 1 1 1 I 1
1 1 1 1 1 I 1 1
1 i 1 i 1 t 1 i
i 1 1 1 i i 1 i
1 1 1 1 1 ! 1 1
i I 1 t 1 1 t 1
1 1 1 1 I 1 1 1
1 I 1 I 1 i 1 i
1 1 1 I I 1 I t
1 1 I 1 I 1 1 1
1 1 ( 1 I t 1 f
1 1 1 1 i I I i
1 1 1 1 1 I 1 1
1 1 1 1 t i 1
1 I 1 1 1 I 1 1
i t 1 I 1 I i 1
1 I 1 1 1 I 1 1
1 1 1 I 1 I { 1
1 1 1 1 1 I I 1
i 1 1 I I i 1 1
I ! 1 1 1 1 1 1
1 { { 1 1 1 1 1
1 I i 1 I I 1 t
I---------------------------------------------------------
------------------------------------------------
------------i
TDH Document No. C5000255 TOTALS ; s 35,000.00: $ .001, $ 35,000.00:
I 1
! 1 1 1 1
«Federal funds are indicated by a number from the Catalog of Federal Domestic Assistance (CFDA), if applicable.
REFER TO BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS.
COVER - Rage 2
EtECUTED IN OUPLICATE ORIGINALS ON THE DATES SHOWN.
CITY ;L LUBSOCK T0H 0ac3ment No.: C5000M-'-J1
Authorized Contracc;ng Entity hype ae ve
if different from PERFORMING AGENCY)
for ana in behalf of:
David R. Langston, Mayor
(Name and Title)
TEXAS DEPARTMENT OF HEALTH
RECEIVIVG AGENCY
3y:
iSignature of person istnorized
to sign contracts)
Linda Farrow, Chief
Bureau of Financial Services
(Name and Title?
Date: March 24, 1994 Date:
RECOMMENDED:
B?iPERFORKING
— a�= AGENCY D" r,iferent from per
authorized to sign contract)
APPROVED AS TO FORK:
By:
Office of General Counsel
COVER - Page 3
DOCUMENT NO. C5000255
ATTACHMENT NO. 01
PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: HIV DIVISION
TERM: January 1, 1994 THROUGH December 31, 1994
SECTION I. SCOPE OF WORK:
PERFORMING AGENCY agrees to conduct counseling, testing, referral, and partner
elicitation/notification (CTRPN) activities to help reduce the spread of human
immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). CTRPN
activities include establishing and maintaining anonymous and/or confidential
HIV testing programs for persons at risk of HIV infection due to individual
sexual behavior, injecting drug use, or other risk behaviors.
All information and educational materials developed and provided by PERFORMING
AGENCY will be accurate, comprehensive, and consistent with current findings
of the United States Public Health Service.
PERFORMING AGENCY agrees that all activities will be performed in accordance
with RECEIVING AGENCY'S request for proposal (RFP) and assurances, and PER-
FORMING AGENCY'S objectives, activities work plans, and detailed budgets as
approved by RECEIVING AGENCY. All of the above named documents are adopted by
reference as part of this Attachment. All revisions to said documents will be
approved by RECEIVING AGENCY and transmitted in writing to PERFORMING AGENCY.
PERFORMING AGENCY will provide CTRPN services to the target population defined
as:
1. Males who routinely have sex with other males.
2. Males who occasionally have sex with other males.
3. Males who have sex with males and females.
4. Males and females with multiple sex partners.
5. Persons with a history of sexually transmitted diseases.
6. Persons with a history of high risk behavior.
PERFORMING AGENCY will perform the following Counseling and Testing Services:
1. Offer voluntary, anonymous and/or confidential HIV testing to clients
who may want to be tested.
2. Provide culturally sensitive and effective pretest and posttest counsel-
ing based on TDH approved guidelines.
3. Publicize HIV counseling and testing services so that potential clients
will know where and when services are available.
4. Offer HIV counseling and testing services at a location that is conve-
nient for the majority of the target population and during hours
established to reach these clients.
-1-
5. Use optically scannable forms supplied by RECEIVING AGENCY or a similiar
TDH approved instrument to collect demographic information and unlinked
test result data.
6. Utilize RECEIVING AGENCY'S Laboratory, for all ELISA and Western Blot
testing unless otherwise approved in writing by the RECEIVING AGENCY.
7. PERFORMING AGENCY will develop and maintain a referral plan by which
reciprocal linkages are established with other service providers
(especially other RECEIVING AGENCY funded providers) for the purpose of:
a. Case management
b. Extended HIV prevention counseling
c. CD4 testing
d. T6 skin testing
e. Immunizations
f. STD screening
g. Family planning
h. Gynecological exam
i. Substance abuse treatment
j. Medical evaluation for HIV illness
k. Medical follow-up
1. Antiviral therapy
m. PCP prophylaxis
n. Psychosocial needs assessment
o. Professional psychosocial counseling
p. Emotional support groups
q. Financial eligibility assistance
r. Legal assistance
PERFORMING AGENCY will perform the following Partner Elicitation/Notification
Services:
1. All partner elicitation/notification services must be consistent with
RECEIVING AGENCY'S pretest and posttest counseling guidelines and the
TDH Seropositive and Partner Notification Guidelines which are incorporated
by reference and made part hereof.
2. Partner notification must be mentioned in every pretest session and
encouraged and discussed with every HIV positive client during the posttest
counseling session.
3. If the client prefers to make the partner notification personally, provide
guidance/coaching in making the notification during the posttest counseling
session.
4. If the client would like to inform partner(s) but is not sure whether they
will be able to do so, a verbal agreement/contract will be established. In
the contract, the client agrees to notify partner(s) by a specific date. The
client provides full names and locating information with the knowledge that
this information will be relayed to the local Health Department/regional
STD program who will confidentially notify the partner(s) if the referral
-2-
is not completed as agreed.
5. If the client does not want to notify partner(s) or in the counselor's
opinion is incapable, elicit adequate information for STD personnel to make
the notification. Elicited information will be referred to the local health
department/regional STD program receiving funds for partner notification
activities.
6. PERFORMING AGENCY agrees to report HIV partner elicitation data using the
RECEIVING AGENCY'S Partner Elicitation Report Form.
PERFORMING AGENCY agrees to comply with the following CTRPN Quality Assurance
Guidelines:
1. PERFORMING AGENCY assures that pretest and posttest counseling sessions
are performed by staff who have successfully completed counseling
training from a course and instructor approved by RECEIVING AGENCY.
2. PERFORMING AGENCY will conduct monitoring of counseling, testing, referral
and partner notification sessions. Through use of Quality Assurance
Systems (QAS) the PERFORMING AGENCY program manager will possess current
information and will monitor counselor performance (at least monthly for
months 1-6 of employment, bimonthly for months 7-12, and quarterly for
experienced counselors whether directly supervised or on independent
assignment.) A written record (TDH skills assessment form or other TDH
approved model) of the monitored session is to be kept on file.
3. PERFORMING AGENCY agrees to facilitate RECEIVING AGENCY review of
scheduled counseling, testing, referral, and partner notification
sessions.
PERFORMING AGENCY agrees to comply with Chapters 81 and 85 of the Health and
Safety Code and relevant portions of Chapter 6A (Public Health Service) of
Title 42 (The Public Health & Welfare) of the U.S. Code, as amended.
PERFORMING AGENCY will provide an estimated 1.520 clients with
services/units of service in or benefiting the county(ies)/area defined as:
LUBBOCK.
SECTION II. LEGAL AUTHORITY TO CONTRACT:
Chapters 12 and 121 of the Health and Safety Code.
SECTION III. SPECIAL PROVISIONS:
RECEIVING AGENCY will supply PERFORMING AGENCY with the most current version
of the document entitled "Content of AIDS -Related Written Materials,
Pictorials, Audiovisuals, Questionnaires, Survey Instruments, and Educational
Sessions in Centers for Disease Control Assistance Programs," and its preface
which is written by RECEIVING AGENCY. PERFORMING AGENCY has provided
RECEIVING AGENCY with written acknowledgement of receipt and assurance of
compliance with these guidelines. All of the above referenced documents are
Q9D
2
incorporated as part of this Attachment as though written herein verbatim.
Due to the sensitive and highly personal nature of HIV/AIDS-related infor-
mation, strict adherence to the General Provisions Confidentiality Article
is required. PERFORMING AGENCY success depends upon whether persons at risk
believe that the program observes this principle. In addition to these
conditions, PERFORMING AGENCY will comply with TDH Bureau HIV STD Control's
HIV Serologic Testing and Documentation Guidelines. All of the above
referenced documents are incorporated as part of this Attachment as
though written herein verbatim.
PERFORMING AGENCY agrees to submit program and financial reports in accordance
with the time frames listed below.
QUARTERLY REPORTS
REPORT PERIOD
TYPE REPORT
DUE
DATE
Jan.,
Feb., Mar.
Program
Apr.
20
Financial
Apr.
30
Apr.,
May, June
Program
July
20
Financial
July
30
July,
August, Sept.
Program
Oct.
20
Financial
Oct.
30
Oct.,
Nov., Dec.
Program
Jan.
20
Financial
Jan.
30
ANNUAL REPORTS
REPORT PERIOD TYPE REPORT DUE DATE
Jan. 1, 1994 - Dec. 31, 1994 Financial Feb. 15, 1995
PERFORMING AGENCY, or any subcontractor, shall not transfer a client record
(including a patient record) to another entity or person without written
consent from the client or patient, or someone authorized to act on his or her
behalf; however, the RECEIVING AGENCY (TEXAS DEPARTMENT OF HEALTH) may require
PERFORMING AGENCY, or any subcontractor, to transfer a client or patient
record to the RECEIVING AGENCY (TEXAS DEPARTMENT OF HEALTH) if the transfer
is necessary to protect either the confidentiality of the record or the health
and welfare of the client or patient.
The RECEIVING AGENCY (TEXAS DEPARTMENT OF HEALTH) shall have access to a
client record (including a patient record) in the possession of PERFORMING
AGENCY, or any subcontractor, under authority of the Health and Safety Code,
Chapters 81 and 85, and the Texas Revised Civil Statutes, Article 4495b
(Medical Practice Act). In such cases, the RECEIVING AGENCY (TEXAS DEPARTMENT
OF HEALTH) shall keep confidential any information obtained from the client
or patient record, as required by the Health and Safety Code, Chapter 81, and
.LC
the Texas Revised Civil Statutes, Article 4495b.
PERFORMING AGENCY will submit quarterly activity reports within 20 days after
the end of each quarter, that are prepared in the format provided by the
RECEIVING AGENCY.
PERFORMING AGENCY will authorize their staff to attend training, conferences,
and meetings for which funds were budgeted and approved by RECEIVING AGENCY.
SECTION IV. BUDGET:
Personnel
$26,396.00
Fringe Benefits
6,439.00
Travel
400.00
Equipment
.00
Supplies
330.00
Contractual
.00
Other
45.00
Total Direct Costs
$33,610.00
Indirect
1,390.00*
TOTAL
$35,000.00
Financial status reports (FSRs) are due the 30th of April,
July,
October, January and the 15th of February.
Total reimbursements will not exceed $35,000.00.
*Indirect cost is based on UGCMA, Table 1.
-5-
GENERAL PROVISIONS FOR
TEXAS DEPARTMENT OF HEALTH CONTRACTS
PERFORMING AGENCY and RECEIVING AGENCY agree this contract, assurances, general
and/or special provisions, and Attachment(s) with detailed scope(s) of work and
budget(s), as applicable, incorporate all covenants and agreements pertaining
hereto. No prior agreement or understanding, oral or otherwise, of the parties
or their agents will be valid or, enforceable unless embodied in this contract.
The person or persons signing and executing this contract on behalf of PERFORMING
AGENCY, or representing themselves as signing and executing this contract on
behalf of PERFORMING AGENCY, do hereby warrant and guarantee that he, she, or
they have been duly authorized by PERFORMING AGENCY to execute this contract on
behalf of PERFORMING AGENCY and to validly and legally bind PERFORMING AGENCY to
all terms, performances, and provisions herein set forth.
PERFORMING AGENCY hereby assures compliance with the following terms and
conditions unless otherwise specified in the Attachment(s) hereto:
ARTICLE 1. scope of Work
PERFORMING AGENCY will perform the work outlined in they Scope(s) of Work
contained in the Attachment(s) hereto which is/are referenced in the Details of
Attachments and hereby incorporated and made a part of this contract, plus
amendments which may be added by additional Attachment(s) from time to time as
hereinafter provided.
Satisfactory performance of this contract will be measured in part by:
(1) adherence to the contract y ( 2 ) results of CPA or State Auditor reports; and,
3) timeliness, completeness, and accuracy of required reports.
ARTICLE 2. Term
The time period of this contract will be governed by the term(s) on the
Attachment (s). No commitment of contract funds is permitted prior to the first
day nor subsequent to the last day of the term. The term may be extended or
shortened by amendment(s).
ARTICLE 3. Funding
This contract is contingent upon funding being available for the term of the
Attachment(s) and PERFORMING AGENCY will have no right of action against
RECEIVING AGENCY in the event that RECEIVING AGENCY is unable to perform its
obligations under this contract as a result of the suspension, termination,
withdrawal, or failure of funding to RECEIVING AGENCY or lack of sufficient
funding of RECEIVING AGENCY for any Attachment(s) to this contract. If funds
become unavailable, provisions of the Termination Article will apply.
ARTICLE 4. Amendments
Contract Attachment(s) may be amended, and such amendments will be in writing and
duly executed by the parties hereto.
ARTICLE 5. SSeverability
If any provision of this contract will be construed to be illegal or invalid,
this will not affect the legality or validity of any of the other provisions
hereof. The illegal or invalid provision will be deemed stricken and deleted
herefrom to the same extent and effect as if never incorporated herein, but all
other provisions will continue.
1994 GENERAL PROVISIONS - Page 1 (5/93)
ARTICLE 6. Applicable Laws and Standard
This contract will be governed by the laws of the State of Texas and enabling
state/federal regulations, including federal grant requirements applicable to
funding sources as set out in Attachment(s) hereto, and Treasury Circular 1075
(31 CFR Part 203) as applicable to advance of funds.
PERFORMING AGENCY agrees Chapter 783, Texas Government Code Annotated (Vernon's
Pamphlet 1992), [Uniform Grant and Contract management Act (UGCMA)), as may be
amended by revised federal circulars to be incorporated in UGCMA by the
Governor's Budget and Planning Office, applies as terms and conditions of this
contract,and the standards are adopted by reference in their entirety. If a
conflict arises between the provisions of this contract and UGCMA, the provisions
of UGCMA will prevail unless expressly stated otherwise. A copy of this manual
and its references are provided to PERFORMING AGENCY by RECEIVING AGENCY upon
request.
PERFORMING AGENCY must obtain prior approval from RECEIVING AGENCY for major
project changes which are specified in RECEIVING AGENCY's institutional prior
approval procedures. These procedures are incorporated by reference as. a
condition of this contract.
In accordance with Section 1352 of Public Law 101-121, effective December 22,
1989, PERFORMING AGENCY is prohibited from using funds granted under this
contract for lobbying Congress or any agency in connection with a particular
contract. In addition, if at any time a contract exceeds $100,000, the law
requires certification that none of the funds provided by RECEIVING AGENCY to
PERFORMING AGENCY have been used for payment to lobbyists. Regardless of -funding
source, and if a contract exceeds 5100,000, a disclosure form must be completed
if PERFORMING AGENCY has any agreement with a lobbyist. This certification
and/or form is available upon request and must be forwarded to RECEIVING AGENCY
within 90 days of receipt.
PERFORMING AGENCY certifies by execution of this contract that its payment of
franchise taxes is current or, if PERFORMING AGENCY is exempt from payment of
franchise taxes, that it is not subject to the State of Texas franchise tax. A
false statement regarding franchise tax status will be treated as a material
breach of this contract and may be grounds for termination at the option of
RECEIVING AGENCY. If franchise tax payments become delinquent during the
Attachment term, payments under this contract will be held until PERFORMING
AGENCY's delinquent franchise tax is paid in full.
ARTICLE?. Debarment and Suspension
PERFORMING AGENCY further certifies by execution of this contract that it is not
ineligible for participation in federal or state assistance -programs under
Executive Order 12549, Debarment and Suspension, PERFORMING AGENCY certifies, by
submission of this contract, that neither it nor its principals is presently
debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from participation in this transaction by any Federal department or
agency. Where the PERFORMING AGENCY is, unable to certify to any of the
statements in this certification, PERFORMING AGENCY shall attach an explanation.
PERFORMING AGENCY specifically asserts that is has not knowingly failed to pay
a single substantial debt or a number of outstanding debts to a federal or state
agency or it is not subject to an outstanding judgment in a suit against
PERFORMING AGENCY for collection of the balance. A false statement regarding
PERFORMING AGENCY's status will be treated as a material breach of this contract
and may be grounds for termination at the option of RECEIVING AGENCY.
1994 GENERAL PROVISIONS - Page 2 (3/93)
ARTICLE S. Assurances
PERFORMING AGENCY will establish safeguards to prohibit employees from using
their positions for a purpose that constitutes or presents the appearance of
personal or organizational conflict of interest, or personal gain.
PERFORMING AGENCY will comply with the Intergovernmental Personnel Act of 1970
(42 U.S.C. SS 4728-4763) relating to prescribed standards for merit systems for
programs funded under one of the nineteen statutes or regulations specified in
Appendix A of the Office of Personnel Management's Standards for a Merit System
of Personnel Administration (5 CFR 900, Subpart F).
PERFORMING AGENCY will comply with all federal and state statutes relating to
nondiscrimination. These include but are not limited to: Title VI of the Civil
Rights Act of 1964, as amended (42 USC Sec. 2000e, et. seq.) which prohibits
discrimination on the basis of race, color or national origin; Title IX of the
Education Amendments of 1972, as amended (20 USC Sec. 1681-1683 and 1685-1686),
which prohibits discrimination on the basis of sex; the Rehabilitation Act of
1973, as amended (29 USC Seca 794), which prohibits discrimination on the basis
of handicaps; The Americans with Disabilities Act of 1990 (42 USC Sec. 12101 et.
seq.), which prohibits discrimination on the basis of disabilities; The Age
Discrimination Act of 1975, as amended (42 USC Sec. 6101-6107), which prohibits
discrimination on the basis of age; The Drug Abuse, Prevention, Treatment, and
Rehabilitation Act, as amended (21 USC Sec. 1101 et. seq.), relating to
discrimination on the basis of drug abuse; the Age Discrimination in Employment
Act of 1967, as amended (29 USC Sec. 621-634), which prohibits discrimination in
employment on the basis of age; the Comprehensive Alcohol Abuse and Alcoholism
Prevention, Treatment, and Rehabilitation Act of 1970, as amended (42 USC Sec.
4541 et. seq.), relating to nondiscrimination on the basis of alcohol abuse or
alcoholism; The Public Health Service Act of 1912, as amended (42 USC Sec. 290dd-
3 and 290ee-3), relating to confidentiality of alcohol and drug abuse patient
records; any other nondiscrimination provisions in the specific statute(s),
pertaining to applicable federal assistance; and the requirements of any other
nondiscrimination federal or state statutes) which might apply to this contract.
PERFORMING AGENCY will comply with environmental standards which may be
prescribed pursuant to the following: (a) institution of environmental quality
control measures under the National Environmental Policy Act of 1969 (P.L. 91-
190) and Executive Order (EO) 11514; (b) notification of violating facilities
pursuant to EO 11738; (c) conformity of Federal actions to State (Clear Air)
Implementation Plans under Section 176(c) of the Clear Air Act of 1955,- as
amended (42 U.S.C. SS 7401 et seq.); and (d) protection of underground sources
of drinking water under the Safe Drinking Water Act of 1974, as amended, P.L.
93-523.
PERFORMING AGENCY will comply with P.L. 93-348 regarding the protection of human
subjects involved in research, development, and related activities supported by
any applicable award of federal assistance.
PERFORMING AGENCY will comply with the Clinical Laboratory Improvement Amendments
of 1988 (CLIA), P.L. 100-578 (42 U.S.C. 263 a), which establish Federal
requirements for the regulation and certification of clinical laboratories.
PERFORMING AGENCY will comply with the OSHA Regulations on Bloodborne Pathogens,
56 Fed. Reg. 64175 (1991), 29 C.F.R. 1919.030, which set safety standards for
those workers and facilities who may handle bloodborne pathogens.
PERFORMING AGENCY assures it will not transfer or assign its interest in this
contract without the written consent of the RECEIVING AGENCY.
1994 GENERAL PROVISIONS - Page 3 (5/93)
ARTICLE 9. Standards For Financial_Ma_nagemen
PERFORMING AGENCY will develop, implement, and maintain financial management and
control systems that meet or exceed the requirements of UGCMA. Those
requirements include at a minimum:
1. 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;
2. Financial management system including accurate, correct, and complete
payroll, accounting, and financial reporting records, cost source
documentation, effective internal and budgetary controls, determination of
reasonableness, allocability, and allocability of costs, and timely and
appropriate audits and resolution of any findings; and,
3. Billing and collection policies including a charge schedule, a system for
discounting or adjusting charges based- on a person's income and family
size, apd a mechanism capable of billing and making reasonable efforts to
collect from patients and third parties.
In addition, PERFORMING AGENCY agrees to bill third party payors for services
provided under the Attachment(s), at no cost to the client. These potential
payors include, but are not limited to, Medicaid, private insurance carriers,
other available federal, state, local and private funds, etc. PERFORMING AGENCY
-is required to become a Medicaid provider for applicable program activities
funded in the Attachment (a) hereto, and will maximize efforts to obtain payment
-from Medicaid and all other available sources. -
ARTICLE 10. Allowable Costs and Audit Requirements
only those costa allowable under, UGCMA and any revisions thereto, plus any
applicable federal cost principles are eligible for reimbursement under this
Attachment(s). Applicable coat principles, audit requirements and administrative
requirements are as follows:
Audit Administrative
Applicable Cost Principles Requirements Requirements
A-87, State & Local Governments Circular A-128 UGCMA
To be eligible for reimbursement under this Attachment(s) a cost must have been
incurred within the Attachment term and paid by PERFORMING AGENCY prior to
claiming reimbursement from RECEIVING AGENCY or encumbered by the last day of the
Attachment term and liquidated no later than 45 days after the end of the
Attachment term.
Each PERFORMING AGENCY/AUTHORIZED CONTRACTING ENTITY receiving $25,000 or more
in total federal/state financial assistance during their fiscal year shall
arrange for an agency -wide financial and compliance audit of the PERFORMING
AGENCY'S/AUTHORIZED CONTRACTING ENTITY'S fiscal year. The audit must be
conducted by an independent CPA and must be in accordance with the applicable OMB
Circulars and Government Auditing Standards. Procurement of audit services will
comply with state procurement procedures, as well as provisions of UGCMA.
Within 30 days of receipt of audit report, PERFORMING AGENCY/AUTHORIZED
CONTRACTING ENTITY will submit a copy to RECEIVING AGENCY'S Internal Audit
Division.
ARTICLE 11. Overtime Compensation
None of the funds provided by Attachment(s) will be used to pay overtime.
PERFORMING AGENCY will be responsible for any obligations of overtime pay due
employees.
1994 GENERAL PROVISIONS - Page 4 (5/93)
ARTICLE 12. Terms and Conditions of Payment
For services satisfactorily performed pursuant to the Scope(s) of Work,
PERFORMING AGENCY will receive reimbursement for allowable costs. Reimbursements
will not exceed the total of each Attachment(s) hereto and are contingent on a
signed contract.
Claims for reimbursement will be made on a State of Texas Purchase Voucher (TDH
Form 1AG-37). Vouchers for reimbursement of actual expenses will be submitted
monthly within 20 days following the end of the month covered by the bill. A
make-up claim may be submitted as a final close-out bill not later than 45 days
following the end of Attachment term(s). Advance payment may be requested in
accordance with the applicable provisions of this contract.
Payments made for approved claims or notice of denial of claims submitted against
Attachment(s) to this contract will be mailed not later than 60 days after
receipt of monthly vouchers. Payment is considered made on the date postmarked.
Any reimbursements made by PERFORMING AGENCY to subcontractors will be made in
accordance with Article 601f, V.T.C.S.
Funding from this contract will not be used to supplant state or local funds, but
PERFORMING AGENCY will use such funds to increase state or local funds currently
available to PERFORMING AGENCY for a particular activity. PERFORMING AGENCY
further agrees to maintain to the best of its ability its; current level of
support, if any.
PERFORMING AGENCY will refund to RECEIVING AGENCY any funds PERFORMING AGENCY
claims and receives from RECEIVING AGENCY for the reimbursement of costs which
are determined by RECEIVING AGENCY to be ineligible for reimbursement.
RECEIVING AGENCY will have the right to withhold all or part of any future
payments to PERFORMING AGENCY to offset any reimbursement made to PERFORMING
AGENCY for any ineligible expenditures not refunded to RE:CEIVING AGENCY by
PERFORMING AGENCY.
Payment may be denied for noncompliance if required financial reports are not
on file for previous quarters or for the final period, or for failure to respond
to financial compliance monitoring reports, or if program requirements are not
met as specified in the Scope(s) of Work.
ARTICLE 13. Advance Payment
PERFORMING AGENCY may request, in writing, a one time advance with proper
justification and the concurrence of RECEIVING AGENCY. Amount of advance will be
determined by the amount and term of the Attachment(s)j however, for each
Attachment, the amount of the advance will not exceed one -sixth (1/6th) of_ a
twelve-month Attachment. Advance will be requested on a State of Texas
Purchase Voucher at the beginning of Attachment period or at a single later time
in the Attachment period if circumstances so warrant and the request is approved.
Advance funds will be liquidated during the Attachment term so that, after final
monthly billing, PERFORMING AGENCY will not have advance funds on hand. Advance
funds may be drawn only to meet immediate cash needs for disbursement (UGCMA and
federal circulars).
Amendments to this Attachment(s) may require upward or downward adjustment to the
allowable advance until it equates 1/6th of a twelve-month Attachment or
approximates two months operating costs. In the case of a downward adjustment,
PERFORMING AGENCY and RECEIVING AGENCY will agree on the amount of adjustment to
the advance. RECEIVING AGENCY retains the option to reduce future claims by the
required amount. In the case of an upward adjustment and PERFORMING AGENCY needs
additional funds to meet immediate operating expenses, PERFORMING AGENCY may
submit to RECEIVING AGENCY a written justification and State of Texas Purchase
1994 GENERAL PROVISIONS - Page 5 (5/93)
Voucher in the amount necessary to correct the ratio.
ARTICLE 14. Program Income
PERFORMING AGENCY will develop a fee for service system and a schedule of fees
for personal health services in accordance with the provisions of Chapter 12,
Sub -chapter D, Health and Safety Code and the Texas Board of Health rules
covering Fees for Clinical Health Services (25 TAC, Section 1.91) and other
applicable laws provided, however, that a patient may not be denied a service due
to inability to pay.
Both parties agree all revenues directly generated by an Attachment(s) supported
activity or earned only as a result of the Attachment(s) during the term of the
Attachment(s) are considered program income. This income will be identified and
reported quarterly and annually utilizing the report forms identified in the
Financial Reports Article of these provisions. PERFORMING AGENCY will retain the
program incolnne and use one of the following alternatives:
1. Where the PERFORMING AGENCY is reimbursed by RECEIVING AGENCY under a cost
reimbursement method, the additive or deductive alternatives for program_
income may be used. Under the additive method, PERFORMING AGENCY will add
the program income to the funds already committed to the project by both
the RECEIVING_ AGENCY and PERFORMING AGENCY. Funds will be used to further
the program objectives of the State/Federal statute under which the Scope
of Work for the Attachment(s) was made. Program income earned in a
current _budget period and not expended in that budget period may- be
carried forward to the next budget period but must be spent in the next.
budget period, or deducted from program expenditures. This policy will
apply unless specifically stated otherwise in the Special Provisions of
the contract Attachment(s). Under the deductive method, the PERFORMING
AGENCY will deduct the program income from the total allowable costs to
determine the net allowable costs.
2. Where the PERFORMING AGENCY is reimbursed by RECEIVING AGENCY under a
fixed price arrangement, only the deductive alternative for program income
will be used. PERFORMING AGENCY deducts the program income from the total
allowable project costs to determine the net allowable costs.
It is further understood that RECEIVING AGENCY will base future funding levels,
in part, upon the PERFORMING AGENCY's proficiency in identifying, billing,
collecting, and reporting income, and in utilizing it for the purposes and
conditions of the applicable Attachment(s).
Additional information is contained in RECEIVING AGENCY's Program Income Policy
interpreting UGCMA, which is incorporated by reference as a part of this
contract.
ARTICLE 15. Financial Reports
Financial reports are required as provided in UGCMA and will be filed regardless
of whether or not expenses have been incurred.
Quarterly
Financial Status Report, State of Texas Supplemental Form 269a (TDH Form
GC-4a), will be submitted within 30 days following the end of each quarter.
Annual/Final
A final financial report, Request for Advance or Reimbursement, Form 270 (TDH
Form GC-10) will be submitted not later than 45 days following the end of
Attachment term(s). If necessary, a State of Texas Purchase Voucher will be
1994 GENERAL PROVISIONS - Page 6 (5/93)
submitted if all costs have not been recovered or a refund will be made of excess
monies if costs incurred were less than funds received.
ARTICLE 16. Reports and Inspections
PERFORMING AGENCY will submit financial, program, progress, and other reports as
requested by RECEIVING AGENCY in the format agreed to by the parties hereto.
RECEIVING AGENCY and, when federal funds are involved, any authorized
representative(s) of the federal government have the right, at all reasonable
times, to inspect or otherwise evaluate the work (including client or patient
records) performed or being performed hereunder and the premises in which it is
being performed, including subcontractors. PERFORMING AGENCY will participate
in and provide reasonable access, facilities, and assistance to the
representatives. All inspections and evaluations will be performed in such a
manner as will not unduly delay the work.
PERFORMING AGENCY agrees that RECEIVING AGENCY and the federal government, or any
of their duly authorized representatives, will have access to any pertinent
books, documents, papers, and client or patient records of PERFORMING AGENCY for
the purpose of making audit, examination, excerpts, and transcripts of
transactions related to contract Attachment(s). RECEIVING AGENCY will have the
right to audit billings both before and after payment. Payment under
Attachment(s) will not foreclose the right of RECEIVING AGENCY to recover
excessive or illegal payments.
Any deficiencies identified by RECEIVING AGENCY upon examination of PERFORMING
AGENCY's records will be conveyed in writing to PERFORMING AGENCY. PERFORMING
AGENCY's resolution of findings will also be conveyed in writing to RECEIVING
AGENCY within 30 days of receipt of RECEIVING AGENCY's findings. A determination
by RECEIVING AGENCY of either an inadequate or inappropriate resolution of the
findings may result in the withholding of funds or suspension of the contract
Attachment (s). Any such withholding of funds or suspension will remain in effect
until the findings are properly remedied as determined by RECEIVING AGENCY.
PERFORMING AGENCY will retain all such records for a period of three years from
the date of the last expenditure report submitted under contract Attachment(s)
or until resolution of all audit questions, whichever time period is longer.
ARTICLE 17. Client Records
At the end of the Attachment term, all client records (including patient records)
are the property of PERFORMING AGENCY. RECEIVING AGENCY retains the right to
have access to the records or obtain copies for audit, examination, evaluation,
inspection, litigation, or other circumstances that may arise.
If at any time during the Attachment term(s), PERFORMING AGENCY and/or RECEIVING
AGENCY should decide to suspend or terminate the agreement, RECEIVING AGENCY may
require the transfer of client records (including patient records) upon written
notice to PERFORMING AGENCY, either to another entity that agrees to continue the
service or to RECEIVING AGENCY.
ARTICLE 18. Confidentia
PERFORMING` AGENCY will have a system in effect to protect client or patient
records and all other documents deemed confidential by law which are maintained
in connection with the activities funded under contract. Any disclosure or
transfer of confidential client or patient information by PERFORMING AGENCY,
including information required by the Reports and Inspections Article, will be
in accordance with applicable law.
1994 GENERAL PROVISIONS - Page 7 (5/93)
If providing direct client care, services, or programs, PERFORMING AGENCY agrees
to implement workplace policies based on the model guidelines adopted by
RECEIVING AGENCY and to educate employees and clients concerning the human
immunodeficiency virus (HIV) and its related conditions including acquired
immunodeficiency syndrome (AIDS). PERFORMING AGENCY agrees to develop and
implement policies regarding confidentiality of AIDS and HIV -related medical
information for employees of PERFORMING AGENCY and for clients, inmates,
patients, and residents served by PERFORMING AGENCY. Further, PERFORMING AGENCY
agrees to develop and implement an anti -discrimination policy assuring all
privileges and opportunities for any employee or client with a` communicable
disease. HIV -related policies will be based on accurate scientific information.
Such policies will be consistent with the model guidelines published by RECEIVING
AGENCY and with state and federal laws and regulations. A PERFORMING AGENCY
that does not adopt a confidentiality policy as herein required is not legally
eligible to receive state funds until the policy is developed and implemented.
ARTICLE 19. Equipment and supplies
Equipment is defined as tangible nonexpendable property with an acquisition cost
of over $500 and a useful life of more than one year. In accordance with Article
601b, V.T.C.S., Section 8.02(c), title to all equipment purchased from funds
provided herein will be in the name -0f PERFORMING AGENCY throughout the
Attachment(s) term(s)
Unless initially listed and approved in the Attachmentls), prior written approval
from RECEIVING AGENCY is required for any additions to or deletions of approved
equipment purchases having an acquisition cost .exceeding $500. To receive
approval for data processing hardware and software purchases with an acquisition
cost over $500, PERFORMING AGENCY must submit a detailed justification which
includes description of features, make and model, and cost, etc.
PERFORMING AGENCY will maintain an annual property and inventory listing and
submit a report (TDH Form GC-11) to RECEIVING AGENCY not later than"45 days from
the and of the Attachment(s) term(s). PERFORMING AGENCY will administer a program
of maintenance, repair, and protection of assets under this Attachment(s) so as
to assure their full availability and usefulness. In the event PERFORMING AGENCY
is indemnified, reimbursed, or otherwise compensated for any loss of, destruction
of, or damage to the assets provided under this Attachment(s), it will use the
proceeds to repair or replace said assets.
PERFORMING AGENCY agrees that upon termination of Attachment(s), title to any
remaining equipment purchased from funds as hereinabove provided will be
transferred to the RECEIVING AGENCY or any other party designated by the
RECEIVING AGENCY; provided, however, that RECEIVING AGENCY may, at its option and
to the extent allowed by law, transfer title to such property to the PERFORMING
AGENCY.
ARTICLE 20. Subcontractin
PERFORMING AGENCY may enter into agreements with subcontractors unless restricted
or otherwise prohibited in specific Attachment(s). Subcontracts, if any, entered
into by PERFORMING AGENCY will be in writing and subject to the requirements of
this contract. PERFORMING AGENCY agrees that it will be responsible to RECEIVING
AGENCY for the performance of any subcontractor. In addition, if PERFORMING
AGENCY elects to enter into an agreement which subcontracts out a substantial
portion of PERFORMING AGENCY's Scope of Work, prior written approval must be
obtained from RECEIVING AGENCY.
1994 GENERAL PROVISIONS - Page 8 (5/93)
ARTICLE 21. Convriahts, publications, and Patents
PERFORMING AGENCY understands and agrees that where activities supported by the
contract Attachment(s) produce original books, manuals, films, computer programs
(including executable computer programs and supporting data in any form), or
other original material, PERFORMING AGENCY may copyright such material subject
to any rights to same reserved by or vested in the federal government or any
agency thereof however, RECEIVING AGENCY may grant to PERFORMING AGENCY limited
rights to produce, publish, and use such materials as appropriate.
PERFORMING AGENCY may publish at its expense the results of contract performance
with prior RECEIVING AGENCY review and approval. Any publication (written,
visual, or sound) should include acknowledgment of the support received from
RECEIVING AGENCY and the appropriate federal agency, if applicable. At least
three copies of any such publication must be provided to RECEIVING AGENCY.
RECEIVING AGENCY reserves the right to require additional copies before or after
the initial review.
PERFORMING AGENCY and any subcontractor, as appropriate, must comply with the
standard patent rights clauses in 37 CFR Sec. 401.14 or FAR 52.227.11.
ARTICLE 22. Hold Harmless
PERFORMING AGENCY, which is not a state agency, assures that it is an independent
contractor and not an agent, servant, or employee of the state. Except to the
extent that Chapter 104 of the Texas Civil Practice and Remedies Code is
applicable to this contract, PERFORMING AGENCY agrees to hold RECEIVING AGENCY
and/or federal government harmless and to indemnify them from and against any and
all claims, demands, and causes of action of every kind and character which may
be asserted by any third party occurring or in any way incident to, arising out
of, or in connection with the performance of services by PERFORMING AGENCY 'under
this contract to the extent allowed by law, and to the extent of damages
permitted under Chapter 101 of the Texas Civil Practice and Remedies Code.
PERFORMING AGENCY, by acceptance of funds provided through contract
Attachment(s), agrees and ensures that personnel paid from these funds are duly
licensed and/or qualified to perform the required services.
ARTICLE 23. Bonding
Ea-th-person employed by PERFORMING AGENCY who handles funds under this contract,
including persons authorizing payment of such funds, will be covered by the terms_
of a fidelity bond providing for indemnification of losses occasioned by: (1) any
fraudulent or dishonest act or acts committed by any of PERFORMING AGENCY's
employees either individually or in concert with others, and/or, (2) failure of
PERFORMING AGENCY 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. This fidelity bond will be in the amount of not less
than Ten Thousand Dollars ($10,000).
In the event that PERFORMING AGENCY, being an independent contractor, maintains
a self-insurance program that provides for the indemnification of losses as
described in the above paragraph regarding fidelity bonds, then PERFORMING AGENCY
will provide the RECEIVING AGENCY a certified statement which summarizes its
self-insurance plan. The certified statement will be submitted at the time this
contract is submitted for approval. Any changes to said plan, which occur during
the term of this contract period, will be reported to RECEIVING AGENCY. The
self-insurance program should be based on the determination that the coverage can
be provided at a cost no greater than the cost of obtaining equivalent coverage
from an insurance company.
1994 GENERAL PROVISIONS - Page 9 (5/93)
ARTICLE 24. Susvension /Terminatio
If PERFORMING AGENCY fails to comply with RECEIVING AGENCY's reporting
requirements, the program objectives, or the contract award conditions, RECEIVING
AGENCY may withhold payments. RECEIVING AGENCY will provide advance written
notice to PERFORMING AGENCY which will identify the deficiency and RECEIVING
AGENCY's intent to withhold payments if the deficiency is not corrected within
a specific number of days. When the deficiency is corrected, RECEIVING AGENCY
will release any withheld payments with no further action. If PERFORMING AGENCY
fails to comply with the terms, conditions, or standards of this contract,
RECEIVING AGENCY may suspend the contract Attachment(s) and prohibit PERFORMING
AGENCY from incurring additional obligations of funds pending either corrective
action or termination. RECEIVING AGENCY will provide written notice to
PERFORMING AGENCY at least thirty (30) days in advance of the suspension date.
Such notice will detail the nature of noncompliance and specify a correction
date. PERFORMING AGENCY may request a hearing on the proposed suspension if such
request is made in writing within ten (10) days from any final notification of
suspension.
This contract or any Attachment(s) hereto may be terminated by either of the
parties hereto for noncompliance by the other party. A party intending to
terminate for noncompliance by the other party will provide written notice to the
other party at least thirty (30) days prior to the intended date of termination.
Such notice will include the reasons for the termination and will provide the
other party an opportunity to rebut the reasons in writing. A hearing may be
requested on the proposed termination if such request is made in writing within
ten (10) days from any final notification of termination. By such termination,
neither party may nullify obligations already incurred for performance or failure
to perform prior to the date of termination. Such termination will not be an
exclusive remedy but will be in addition to any other rights and remedies
provided by law or under this contract.
This contract or any Attachment(s) hereto may be terminated in whole, or in part,
when both parties agree that continuation would not produce results commensurate
with further expenditure of funds. Both parties will agree on the effective date
and, in the case of partial termination, the portion to be terminated. RECEIVING
AGENCY will immediately send PERFORMING AGENCY written notice of the terms agreed
to and such notice will become a part of the contract. PERFORMING AGENCY will
not incur new obligations for the terminated portion after the effective date of
termination and will cancel .as many outstanding obligations as possible.
RECEIVING AGENCY will allow full credit to PERFORMING AGENCY for noncancelable
obligations which were properly incurred prior to the termination date.
This contract or any Attachments) hereto may be terminated if funds allocated
for any Attachment(s) hereto should become reduced, depleted, or unavailable
during any Attachment(s) budget period, and RECEIVING AGENCY is unable to obtain
additional funds for such purposes. RECEIVING AGENCY will immediately provide
written notification to PERFORMING AGENCY of such fact and such Attachment(s) to
this contract is/are terminated upon receipt of that notification. PERFORMING
AGENCY will not incur new obligations after the effective date of termination and
will cancel as many outstanding obligations as possible. RECEIVING AGENCY will
allow full credit to PERFORMING AGENCY for noncancelable obligations which were
properly incurred prior to the termination date.
This contract or any Attachment(s) hereto may be terminated in the event that
federal or state laws or other requirements should be amended or judicially
interpreted so as to render continued fulfillment of this contract, on the part
of either party, unreasonable or impossible. If the parties should be unable to
agree upon amendment which would therefore be needed to enable the substantial
continuation of the services contemplated herein, then, upon written notification
by RECEIVING AGENCY to PERFORMING AGENCY, the parties will be discharged from any
further obligations created under the terms of this contract, except for the
1994 GENERAL PROVISIONS - Page 10 (5/93)
equitable settlement of the respective accrued interests or obligations as of the
date of termination.
ARTICLE 25. Personnel
All personnel funded by Attachment(s) to this contract are employees of
PERFORMING AGENCY which will be responsible for their direction and control and
liable for any of their acts or omissions.
PERFORMING AGENCY will have in place legally sufficient Due Process Hearing
Procedures for all of its employees filling state budgeted positions.
PERFORMING AGENCY will have full authority to employ, promote, suspend, demote,
discharge, and transfer within its organization any and all state budgeted
personnel funded by Attachment(s) to this contract provided, however, that any
demotion, suspension, or discharge of such state budgeted employees will be in
accordance with the Due Process Hearing Procedures as set out above. The only
distinction between state budgeted and local paid employees is that employees on
state budgeted positions receive state benefits and are subject to certain
duties, obligations, and restrictions as state employees as contained in state
law. One such restriction, as contained in the State Appropriations Act, is that
no employee paid on a state budgeted position may receive a salary supplement
from any source unless specifically authorized in the Appropriations Act or other
state law. This prohibition includes, but is not limited to, the payment to such
employee of a so-called "flat rate" car allowance or travel allowance. Any such
travel or per diem to these employees must be on a reimbursement basis, supported
by appropriate records, and may not exceed the reimbursement for mileage and/or
per diem allowed under the Appropriations Act and current state travel
regulations. This restriction will apply whether travel funds are provided in
Attachment(e) under this contract or from any other source.
PERFORMING AGENCY will utilize RECEIVING AGENCY's policies and procedures for
hiring and promoting individuals into state budgeted positions funded by
Attachments) to this contract. Qualifications of any individuals filling these
positions will be subject to approval of RECEIVING AGENCY's Bureau of Personnel
Management. The purpose of the approval is to ensure that individuals occupying
these positions meet minimum educational and experience requirements.
PERFORMING AGENCY will maintain required records and submit documents necessary -
to process personnel, payroll, leave and time records, and travel claims on state
budgeted positions. PERFORMING AGENCY will be furnished by RECEIVING AGENCY
state warrants for salary compensation or travel reimbursement for issuance to
employees on state budgeted positions.
An independent audit is not required as a condition of this contract if the
Attachment provides assistance through assignment of -state budgeted positions and
no funds are budgeted for local costs.
PERFORMING AGENCY may be reimbursed for local personnel costs or other categories
of expense used to fulfill the scope of work of Attachment(s) in lieu of being
furnished state payroll warrants after a state budgeted position becomes vacant.
Reimbursement will not exceed the balance of funds on the state budgeted position
after all benefits, obligations, and/or other entitlements are met. PERFORMING
AGENCY's Director, or other person(s) authorized elsewhere in this contract, may
submit a request for conversion. RECEIVING AGENCY will transmit formal approval
and a revised budget to PERFORMING AGENCY to complete the conversion.
ARTICLE 26. Funding Participation Requirement
PERFORMING AGENCY agrees funds provided through this contract will not be used
for matching purposes in securing other funding unless otherwise directed or
approved by RECEIVING AGENCY.
1994 GENERAL PROVISIONS - Page 11 (5/93)
ARTICLE 27. Performance -Based Attachment
History
RECEIVING AGENCY is responsible for developing performance -based public health
services contracts in response to the State Auditor's Report and requirements of
the Legislature. This system will enhance service delivery and improve
accountability and efficiency in the management of public health dollars.
Plans for initial implementation were designed to use the model objectives format
stemming from recommendations of the Committee on Model Objectives for Local
Public Health in Texas. The committee was composed of representatives of local
health departments and RECEIVING AGENCY's central and public health region
offices in consultation with the University of Texas School of Public Health in
Houston.
Purpose
The overall goal of performance -based contracts is improved public health
practices in Texas. The project is intended to: _
- identify public health needs and establish priorities which provide a
rational basis for resource allocation;
- project realistic outcomes based on activities which can be accomplished
with current or planned resources, communicate -needs, and build consensus
at all levels regarding directions to be taken in specific programs; and,
- institute a system for planning, implementing, managing, and evaluating
programs and monitoring progress toward reducing and/or alleviating public
health problems.
Required Program Areas
PERFORMING AGENCY has prepared outcome and process objectives, if they are
applicable and relative to the local needs and resources, for the following
program areas:
Food Protection HIV/AIDS
Public Health Promotion Refugee Health
Immunization Sexually Transmitted Diseases
Maternal and Child Health Tuberculosis
Chronic Disease Prevention & Control
These objectives are appended to the Community and Rural Health Attachment and
incorporated verbatim and made a part of this contract. PERFORMING AGENCY agrees
to monitor and report progress towards these objectives on a quarterly and annual
basis. The reporting requirements and format will be agreed upon by both
parties.
Pilot Program Areas
RECEIVING AGENCY will provide training, written documentation, and ongoing
technical assistance to PERFORMING AGENCY in the development of performance -based
objectives for the following pilot program areas:
Dental Health Services
Women, Infants, and Children Nutrition (WIC)
1994 GENERAL PROVISIONS - Page 12 (5/93)
For state fiscal year 1994, the parties recognize and agree that the
performance -based objectives for the pilot program areas are negotiable. If
PERFORMING AGENCY'S achievement is below the established levels, it will not
affect the right of PERFORMING AGENCY to funds provided through Attachment(e)
when the basic program Scope of Work has been fulfilled.
It is understood and agreed upon by both parties that PERFORMING AGENCY will be
required to append approved performance -based objectives for the pilot program
areas to the local health services contract for state fiscal year 1994.
RECEIVING AGENCY contact for matters pertaining to the performance -based public
health services project is the office of the Associate Commissioner for Community
and Rural Health.
1994 GENERAL PROVISIONS — Page 13 (5/93)
RECEIVED
OF TEXAS
Y OF TRAVIS
TEXAS DEPARTMENT OF HEALTH CONTRACT
1100 West 49th Street
Austin, Texas 78756-3199
TDH Document No. C5000255
161994
LU680CK CITY HEALTH DE!
Thi''s contract is between the Texas Department of Health, hereinafter referred to
as ',RECEIVING AGENCY, and the party listed below as PERFORMING AGENCY and
includes general provisions and attachments detailing scope(s) of work and
special provisions.
I PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT
1
I
t
+ (PRINT or TYPE)
! Mailing Address: P. 0. BOX 2548
LUBBOCK
TX 79408-2548!
l ,ty
O(Zip) j
! Street Address: 1902 TEXAS AVENUE
LUBBOCK
TX 79405-1117!
differen }its
-------------------------------------------------------------------------------------
(U£)(Zlp)��
!------------------------------------------------------------------------------------!
t Authorized
E Contracting Entity: CITY OF LUBBOCK
f different from PERFURMiNG
AGENCY)
!
! Payee Name: CITY OF LUBBOCK HEALTH DEPARTMENT
!
(Must match with vendor identification
number shown below)
Payee Address: P. 0. BOX 2000
LUBBOCK
TX 79457 00001
t (Must maith vendor identification
num er s own
5elow) t
y State of Texas Vendor Identification No. (14 digits):
17560005906037
y
Fi�lance Officer/Contact: DOUG GOODMAN
1
! i,
1 Type of Organization: City
1
t Designate: Elementary/secondary school, junior college,
senior college/university
t
! city, county, other political subdivision, council
of governments, judicial
t district, community services program, individual,
or otther (define)
!
t
Is'Ithis a small business No (Yes/No) and/or minority/woman
owned No
(Yes/No)
+ IsIthis a non-profit business Yes (Yes/No)
!
+ PAYEE AGENCY Fiscal Year Ending Month: SEPTEMBER
t
I
SUMMARY OF TRANSACTION:
t I
Contract for public health services.
t
!
1
COVER - Page 1
0 E f A I L S OF ATTACHMENTS
Att/; Financial Assistance ;
Am. ; TON ; Term ; Source of ; ; Direct ; Total Assistance ;
No. ; Program Begin End Funds, Amount Assistance _; Amount (TOP Share)
01 HIYIGHC-LHS 1/ 1/44;12131%94; 93.940 35,000.001 W 3510,40.00
i 1 t i 1 i i I
1 1 I I 1 I
S ! I 1 1 1 I
i I 1 i Y I 1
1 1 t I I 1 1 l
1 1 1 I 7 i 1
1 1 I 1 i f I 1
I l 1 i 1 I I
I f I 1 l I 1
1 I 1 1 1 { 1
I I 1 1 1 1 I
1 I I 1 t I 1 1
i i 1 i i 1 i 1
I I 1 1 I 1 1 1
I P i t i f
I I l 1 1 1 I I
I i I I I
1 1 1 1 1 1 1 I
1 1 1 V 1 i t I
i i i 1 i 1 i i
1 t I i i I I 1
1 t I I I I 1 I
1 1 i I 1 i t I
I I i t i I i i
1 I I 1 1 1 1 1
I 7 1 I 1 t I
I 1 I I 1 1 1 I
1 1 I 1 i t i i
I 1 1 1 1 I 1 1
1 l 1 1 1 1 1 1
i I 1 1 1 1 1 i
1 1 1 1 1 1 1 1
1 1 I I 1 1 1 1
1 1 1 1 t 1 1 1
1 I 1 1 1 i 7 I
1 1 1 1 I 1 1 1
i V 1 i 1 1 1 I
1 t 1 1 1 1 1 1
i i 1 1 1 t 1 1
1 1 1 1 1 1 1 I
1 I 1 1 1 1 t 1
f 1 1 1 1 I t 1
1 1 t 1 1 1 1 t
1 1 1 1 1 I 1 1
1 1 t i i i i 1
1 I 1 1 1 1 1 1
1 1 I i 1 1 1 1
1 1 1 1 I 1 ! 1
I 1 t 1 1 I i I
1 1 1 1 1 I 1 1
1 I 1 1 1 1 1 1
1 I 1 i I 1 1 1
i I 1 1 1 t 1 1
1 1 1 1 1 1 i 1
1 1 1 1 1 1 t
1 I 1 i 1 1 1 1
1 1 1 1 I 1 1 1
1 1 1 1 1 1 1 1
1 I 1 1 1 1 1 1
f 1 I 1 1 1 1 {
I t I 1 1 I I i
i l t 1 1 I 1 1
I I 1 1 1 1 1 1
I 1 1 1 1 1 1 i
1 I I I 1 I 1 I
1 1 1 I I 1 1 I
I 1 i i i 1 1 1
1 1 1 1 1 i 1 f
i 7 1 I 1 1 1 i
I 1 I 1 1 1 1 I
1 1 1 1 1 l 1 1
t I 1 t 1 I I t
1 I 1 1 1 1 t 1
7 1 1 1 V i i 1
i i f I I I I 1
1 1 I 1 I 1 1 1
1------------------------------------------------------------
TDH Document No. C5000255 TOTALS ; f 35,000.00; $ .00: 9 35,000.00,
1 1 1 I 1
f 1 I 1 I
#Federal funds are indicated by a number from the Catalog of Federal Domestic Assistance (CFDA), if applicable.
REFER TO BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS.
COVER - Page 2
EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN,
CITY OF LUBBOCK TDH Document No.: C5000255-01
Authorized Contracting Entity ;type acove
if different from PERFORMING AGENCY)
for ana in behalf of:
TEXAS DEPARTPENT OF HEALTH
RECEIVING AGENCY A
Linda Farrow, Chief
David R. Langston, Mayor Bureau of Financial Services
(Name and Title) (Name and Title)
Date: March 24, 1994 Date: `A — � — 'q L�
RECOMMENDED: APPROVED AS TO FOR .
By. _ By:
(PERFORMING AGENCY D' r, Gf ce o General Counsel
if different from per
authorized to sign contract)
COVER - Page 3
GENERAL PROVISIONS FOR
TEXAS DEPARTMENT OF.HEALTH CONTRACTS
PERFORMING AGENCY and RECEIVING AGENCY agree this contract, assurances, general
and/or special provisions, and Attachment(s) with detailed scope(s) of work and
budget(s), as applicable, incorporate all covenants and agreements pertaining
hereto. No prior agreement or understanding, oral or otherwise, of the parties
,or their agents will be valid or enforceable unless embodied in this contract.
The person or persons signing and executing this contract on behalf of PERFORMING
AGENCY, or representing themselves as signing and executing this contract on
behalf of PERFORMING AGENCY, do hereby warrant and guarantee that he, she, or
they have been duly authorized by PERFORMING AGENCY to execute this contract on
behalf of PERFORMING AGENCY and to validly and legally bind PERFORMING AGENCY to
all terms, performances, and provisions herein set forth.
PERFORMING AGENCY hereby assures compliance with the following terms and
conditions unless otherwise specified in the attachment(s) hereto:
ARTICLE 1. scope of Work
PERFORMING AGENCY will perform the work outlined in the Scope(s) of Work
contained in the Attachment(s) hereto which is/are referenced in the Details of
Attachments and hereby incorporated and made a part of this contract, plus
amendments which may be added by additional Attachment(s) from time to time as
hereinafter provided.
Satisfactory performance of this contract will be measured in part by:
(1) adherence to the contract; ( 2 ) results of CPA or State Auditor reports l and,
3) timeliness, completeness, and accuracy of required reports.
ARTICLE 2. Term
The time period of this contract will be governed by the term(s) on the
Attachment(s). No commitment of contract funds is permitted prior to the first
day nor subsequent to the last day of the term. The term may be extended or
shortened by amendment(s).
ARTICLE 3. Funding
This contract is contingent upon funding being available for the term of the
Attachment(s) and PERFORMING AGENCY will have no right of action against
RECEIVING AGENCY in the event that RECEIVING AGENCY is unable to perform its
obligations under this contract as a result of the suspension, termination,
withdrawal, or failure of funding to RECEIVING AGENCY or lack of sufficient
funding of RECEIVING AGENCY for any Attachment(s) to this contract. If funds
become unavailable, provisions of the Termination Article will apply.
ARTICLE 4. Amendments
Contract Attachment(s) may be amended, and such amendments will be in writing and
duly executed by the parties hereto.
ARTICLE 5. Severability
If any provision of this contract will be construed to be illegal or invalid,
this will not affect the legality or validity of any of the other provisions
hereof. The illegal or invalid provision will be deemed stricken and deleted
herefrom to the same extent and effect as if never Incorporated herein, but all
other provisions will continue.
2994 GENERAL PROVISIONS - Page 2 (5/93)
ARTICLE 6. Applicable Laws and Standards
This contract will be governed by the laws of the State of Texas and enabling
state/federal regulations, including federal grant requirements applicable to
funding sources as set out in Attachment(s) hereto, and Treasury Circular 1075
(32 CFR Part 203) as applicable to advance of funds.
PERFORMING AGENCY agrees Chapter 783, Texas Government Code Annotated (Vernon's
Pamphlet 1992), (Uniform Grant and Contract Management Act (UGCMA)], as may be
amended by revised federal circulars to be incorporated in UGCMA by the
Governor's Budget and Planning office, applies as terms and conditions of this
contract, and the standards are adopted by reference in their entirety. If a
conflict arises between the provisions of this contract and UGCMA, the provisions
of UGCMA will prevail unless expressly stated otherwise. A copy of this manual
and its references are provided to PERFORMING AGENCY by RECEIVING AGENCY upon
request.
PERFORMING AGENCY must obtain prior approval from RECEIVING AGENCY for major
project changes which are specified in RECEIVING. AGENCY's institutional prior
approval procedures. These procedures are incorporated by reference as. a
condition of this contract.
In accordance with Section 1352 of Public Law 101-121, effective December 22,
1989, PERFORMING AGENCY is prohibited from using funds granted under this
contract for lobbying Congress or any agency in connection with a particular
contract. In addition, if at any time a contract exceeds $100,000, the law
requires certification that none of the funds provided by RECEIVING AGENCY to
PERFORMING AGENCY have been used for payment to lobbyists. Regardless of -funding
source, and if a contract exceeds $100,000, a disclosure form must be completed
if PERFORMING AGENCY has any agreement with a lobbyist. This certification
and/or form is available upon request and must be forwarded to RECEIVING AGENCY
within 90 days of receipt.
PERFORMING AGENCY certifies by execution of this contract that its payment of
franchise taxes is current or, if PERFORMING AGENCY is exempt from payment of
franchise taxes, that it is not subject to the State of Texas franchise tax. A
false statement regarding franchise tax status will be treated as a material
breach of this contract and may be grounds for termination at the option of
RECEIVING AGENCY. If franchise tax payments become delinquent during the
Attachment term, payments under this contract will be held until PERFORMING
AGENCY's delinquent franchise tax is paid in full.
ARTICLE 7. Debarment and Suspension
PERFORMING AGENCY further certifies by execution of this contract that it is not
ineligible for participation in federal or state assistance .-programs under
Executive Order 12549, Debarment and Suspension. PERFORMING AGENCY certifies, by
submission of this contract, that neither it nor its principals is presently
debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from participation in this transaction by any Federal department or
agency. Where the PERFORMING AGENCY is unable to certify to any of the
statements in this certification, PERFORMING AGENCY shall attach an explanation.
PERFORMING AGENCY specifically asserts that is has not knowingly failed to pay
a single substantial debt or a number of outstanding debts to a federal or state
agency or it is not subject to an outstanding judgment in a suit against
PERFORMING AGENCY for collection of. the balance. A false statement regarding
PERFORMING AGENCY's status will be treated as a material breach of this contract
and may be grounds for termination at the option of RECEIVING AGENCY.
1994 GENERAL PROVISIONS - Page 2 (5/93)
1,
ARTICLE 8. Assurances
PERFORMING AGENCY will establish safeguards to prohibit employees from using
their positions for a purpose that constitutes or presents the appearance of
personal or organizational conflict of interest, or personal gain.
PERFORMING AGENCY will comply with the Intergovernmental Personnel Act of 1970
(42 U.S.C. SS 4728-4763) relating to prescribed standards for merit systems for
programs funded under one of the nineteen statutes or regulations specified in
Appendix A of the Office of Personnel Management's Standards for a Merit System
of Personnel Administration (5 CFR 900, Subpart F).
PERFORMING AGENCY will comply with all federal and state statutes relating to
nondiscrimination. These include but are not limited to: Title VI of the Civil
Rights Act of 1964, as amended (42 USC Sec. 2000e, et. seq.) which prohibits
discrimination on the basis of race, color or national origin; Title IX of the
Education Amendments of 1972, as amended (20 USC Sec. 1681-1683 and 1685-1686),
which prohibits discrimination on the basis of sex; the Rehabilitation Act of
1973, as amended (29 USC Sec 794), which prohibits discrimination on the basis
of handicaps; The Americans with Disabilities Act of 1990 (42 USC Sec. 12101 et.
seg.), which prohibits discrimination on the basis of disabilities; The Age
Discrimination Act of 1975, as amended (42 USC Sec. 6101-6107), which prohibits
discrimination on the basis of age; The Drug Abuse, Prevention, Treatment, and
Rehabilitation Act, as amended (21 USC Sec. 1101 et. seg.), relating to
discrimination on the basis of drug abuse; the Age Discrimination in Employment
Act of 1967, as amended (29 USC Sec. 621-634), which prohibits discrimination in
employment on the basis of age; the Comprehensive Alcohol Abuse and Alcoholism
Prevention, Treatment, and Rehabilitation Act of 1970, as amended (42 USC Sec.
4541 et. seg.), relating to nondiscrimination on the basis of alcohol abuse or
alcoholism; The Public Health Service Act of 1912, as amended (42 USC Sec. 290dd-
3 and 290ee-3), relating to confidentiality of alcohol and drug abuse patient
records; any other nondiscrimination provisions in the specific statute(s),
pertaining to applicable federal assistance; and the requirements of any other
nondiscrimination federal or state statutes) which might apply to this contract.
PERFORMING AGENCY will comply with environmental standards which may be
prescribed pursuant to the following: (a) institution of environmental quality
control measures undertheNational Environmental Policy Act of 1969 (P.L. 91-
190) and Executive order (EO) 11514; (b) notification of violating facilities
pursuant to Eo 11738; (c) conformity of Federal actions to State (Clear Air)
Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as
amended (42 U.S.C. SS 7401 et seg.); and (d) protection of underground sources
of drinking water under the Safe Drinking Water Act of 1974, as amended, P.L.
93-523.
PERFORMING AGENCY will comply with P.L. 93-348 regarding the protection of human
subjects involved in research, development, and related activities supported by
any applicable award of federal assistance.
PERFORMING AGENCY will comply with the Clinical Laboratory Improvement Amendments
of 1988 (CLIA), P.L. 100-578 (42 U.S.C. 263 a), which establish Federal
requirements for the regulation and certification of clinical laboratories.
PERFORMING AGENCY will comply with the OSHA Regulations on Bloodborne Pathogens,
56 Fed. Reg. 64175 (1991), 29 C.F.R. 1919.030, which set safety standards for
those workers and facilities who may handle bloodborne pathogens.
PERFORMING AGENCY assures it will not transfer or assign its interest in this
contract without the written consent of the RECEIVING AGENCY.
1994 GENERAL PROVISIONS - Page 3 (5/93)
ARTICLE 9. Standards For Financial_Mana_gement
PERFORMING AGENCY will develop, implement, and maintain financial management and
control systems that meet or exceed the requirements of UGCMA. Those
requirements include at a minimum:
1. 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;
2. Financial management system including accurate, correct, and complete
.payroll, accounting, and financial reporting records, cost source
documentation, effective internal and budgetary controls, determination of
reasonableness, allowability, and allocability of costs, and timely and
appropriate audits and resolution of any findings; and,
3. Billing and collection policies including a charge schedule, a system for
discounting or adjusting charges based on a person's income and family
size, and a mechanism capable of billing and making reasonable efforts to
collect from patients and third parties.
In addition, PERFORMING AGENCY agrees to bill third party payors for services
provided under the Attachment(s), at no cost to the client. These potential
payors include, but are not limited to, Medicaid, private insurance carriers,
other available federal, state, local and private funds, etc. PERFORMING AGENCY
-is required to become a Medicaid provider for applicable program activities
funded in the Attachment(s) hereto, and will maximize efforts to obtain payment
from Medicaid and all other available sources. -
ARTICLE 10. Allowable Costs and Audit Reauirement
Only those costs allowable under UGCMA and any revisions thereto, plus any
applicable federal cost principles are eligible for reimbursement under this
Attachment(s). Applicable cost principles, audit requirements and administrative
requirements are as follows:
Audit Administrative
Applicable Cost Principles Requirements Requirements
A-87, State & Local Governments Circular A-128 UGCMA
To be eligible for reimbursement under this Attachment(s) a cost must have been
incurred within the Attachment term and paid by PERFORMING AGENCY prior to
claiming reimbursement from RECEIVING AGENCY or encumbered by the last day of the
Attachment term and liquidated no later than 45 days after the end of the
Attachment term.
Each PERFORMING AGENCY/AUTHORIZED CONTRACTING ENTITY receiving $25,000 or more
in total federal/state financial assistance during their fiscal year shall
arrange for an agency -wide financial and compliance audit of the PERFORMING
AGENCY'S/AUTHORIZED CONTRACTING ENTITY'S fiscal year. The audit must be
conducted by an independent CPA and must be in accordance with the applicable OMB
Circulars and Government Auditing Standards.Procurement of audit services will
comply with state procurement procedures, as well as provisions of UGCMA.
Within 30 days of receipt of audit report, PERFORMING AGENCY/AUTHORIZED
CONTRACTING ENTITY will submit a copy to RECEIVING AGENCY'S Internal Audit
Division.
ARTICLE 11. Overtime Compensation
None of the funds provided by Attachment(s) will be used to pay overtime.
PERFORMING AGENCY will be responsible for any obligations of overtime pay due
employees.:
1994 GENERAL PROVISIONS - Page 4 (5/93)
ARTICLE 12. Terms and Conditions of Payment .
For services satisfactorily performed pursuant to the Scope(s) of Work,
PERFORMING AGENCY will receive reimbursement for allowable costs. Reimbursements
will not exceed the total of each Attachment(s) hereto and are contingent on a
signed contract.
Claims for reimbursement will be made on a State of Texas Purchase Voucher (TDH
Form OAG-37). Vouchers for reimbursement of actual expenses will be submitted
monthly within 20 days following the end of the month covered by the bill. A
make-up claim may be submitted as a final close-out bill not later than 45 days
following the end of Attachment term(s). Advance payment may requested in
accordance with the applicable provisions of this contract.
Payments made for approved claims or notice of denial of claims submitted against
Attachment(s) to this contract will be mailed not later than 60 days after
receipt of monthly vouchers. Payment is considered made on the date postmarked.
Any reimbursements made by PERFORMING AGENCY to subcontractors will be made in
accordance with Article 601f, V.T.C.S.
Funding from this contract will not be used to supplant state or local funds, but
PERFORMING AGENCY will use such funds to increase state or local funds currently
available to PERFORMING AGENCY for a particular activity. PERFORMING AGENCY
further agrees to maintain to the best of its ability its current level of
support, if any.
PERFORMING AGENCY will refund to RECEIVING AGENCY any funds PERFORMING AGENCY
claims and receives from RECEIVING AGENCY for the reimbursement of costs which
are determined by RECEIVING AGENCY to be ineligible for reimbursement.
RECEIVING AGENCY will have the right to withhold all or part of any future
payments to PERFORMING AGENCY to offset any reimbursement made to PERFORMING
AGENCY for any ineligible expenditures not refunded to RECEIVING AGENCY by
PERFORMING AGENCY.
Payment may be denied for noncompliance if required financial reports are not
on file for previous quarters or for the final period, or for failure to respond
to financial compliance monitoring reports, or if program requirements are not
met as specified in the Scope(s) of Work.
ARTICLE 13. Advance Payment
PERFORMING AGENCY may request, in writing, a one time advance with proper
justification and the concurrence of RECEIVING AGENCY. Amount of advance will be
determined by the amount and term of the Attachment(s)j however, for each
Attachment, the amount of the advance will not exceed one -sixth (1/6th) of_ a
twelve-month Attachment. Advance will be requested on a State of Texas
Purchase Voucher at the beginning of Attachment period or at a single later time
in the Attachment period if. circumstances so warrant and the request is approved.
Advance funds will be liquidated during the Attachment term so that, after final
monthly billing, PERFORMING AGENCY will not have advance funds on hand. Advance
funds may be drawn only to meet immediate cash needs for disbursement (UGCMA and
federal circulars).
Amendments to this Attachment(s) may require upward or downward adjustment to the
allowable advance until it equates 1/6th of a twelve-month Attachment or
approximates two months operating costs. In the case of a downward adjustment,
PERFORMING AGENCY and RECEIVING AGENCY will agree on the amount of adjustment to
the advance. RECEIVING AGENCY retains the option to reduce future claims by the
required amount. In the case of an upward adjustment and PERFORMING AGENCY needs
additional funds to meet immediate operating expenses, PERFORMING AGENCY may
submit to RECEIVING AGENCY a written justification and State of Texas Purchase
1994 GENERAL PROVISIONS - Page 5 (5/93)
Voucher in the amount necessary to correct the ratio.
ARTICLE 14. Program Income
PERFORMING AGENCY will develop a fee for service system and a schedule of fees
for personal health services in accordance with the provisions of chapter.12,
Sub -chapter D, Health and Safety Code and the Texas Board of Health rules
covering Fees for Clinical Health Services (25 TAC, Section 1.91) and other
applicable laws provided, however, that a patient may not be denied a service due
to inability to pay.
Both parties agree all revenues directly generated by an Attachment(s) supported
activity or earned only as a result of the Attachment(s) during the term of the
Attachment(s) are considered program income. This income will be identified and
reported quarterly and annually utilizing the report forma identified in the
Financial Reports Article of these provisions. PERFORMING AGENCY will retain the
program income and use one of the following alternatives:
1. Where the PERFORMING AGENCY, is reimbursed by RECEIVING AGENCY under a cost
reimbursement method, the additive or deductive alternatives for program_
income may be used. Under the additive method, PERFORMING AGENCY will add
the program income to the fundsalreadycommitted to the project, by both
the RECEIVING_ AGENCY and PERFORMING AGENCY. Funds will be used to further
the program objectives of the State/Federal statute under which the Scope
of Work for the Attachment(s) was made. Program income earned in a
- current _budget period and not expended in that budget period may- be
carried forward to the next budget period but must be spent in the next.
budget period, or deducted from program expenditures. This policy will
apply unless specifically stated otherwise in the Special Provisions of
the contract Attachment(s). Under the deductive method, the PERFORMING
AGENCY will deduct the program income from the total allowable costs to
determine the net allowable costs.
2. Where the PERFORMING AGENCY is reimbursed by RECEIVING AGENCY under a
fixed price arrangement, only the deductive alternative for program income
will be used. PERFORMING AGENCY deducts the program income from the total
allowable project costs to determine the net allowable coats.
It is further understood that RECEIVING AGENCY will base future funding levels.,
in part, upon the PERFORMING AGENCY's proficiency in identifying, billing,
collecting, and reporting income, and in utilizing it for the purposes and
conditions of the applicable Attachment(s).
Additional information is contained, in RECEIVING AGENCY's Program Income Policy
interpreting UGCMA, which is incorporated by reference as a part of this
contract.
ARTICLE 15. Financial Reports
Financial reports are required as provided in UGCMA and will be filed regardless
of whether or not expenses have been ,incurred.
Quarterly
Financial Status Report, ,State of Texas Supplemental Form 269a (TDH Form
GC-4a), will be submitted within 30 days following the end of each quarter.
Annual/Final
A final financial report, Request for Advance or Reimbursement, Form 270 (TDH
Form GC-10) will be submitted not later than 45 days following the end of
Attachment term(s). If necessary, a State of Texas Purchase Voucher will be
1994 GENERAL PROVISIONS.- Page 6 (5/93)
submitted if all costs have not been recovered or a refund will be made of excess
monies if costs incurred were less than funds received.
ARTICLE 16. Reports and Inspections
PERFORMING AGENCY will submit financial, program, progress, and other reports as
requested by RECEIVING AGENCY in the format agreed to by the parties hereto.
RECEIVING AGENCY and, when federal funds are involved, any authorized
representatives) of the federal government have the right, at all reasonable
times, to inspect or otherwise evaluate the work (including client or patient
records) performed or being performed hereunder and the premises in which it is
being performed, including subcontractors. PERFORMING AGENCY will participate
in and provide reasonable access, facilities, and assistance to the
representatives. All inspections and evaluations will be performed in such a
manner as will not unduly delay the work.
PERFORMING AGENCY agrees that RECEIVING AGENCY and the federal government, or any
of their duly authorized representatives, will have access to any pertinent
books, documents, papers, and client or patient records of PERFORMING AGENCY for
the purpose of making audit, examination, excerpts, and transcripts of
transactions related to contract Attachment(s). RECEIVING AGENCY will have the
right to audit billings both before and after payment. Payment under
Attachment(s) will not foreclose the right of RECEIVING AGENCY to recover
excessive or illegal payments.
Any deficiencies identified by RECEIVING AGENCY upon examination of PERFORMING
AGENCY's records will be conveyed in writing to PERFORMING AGENCY. PERFORMING
AGENCY's resolution of findings will also be conveyed in writing to RECEIVING
AGENCY within 30 days of receipt of RECEIVING AGENCY's findings. A determination
by RECEIVING AGENCY of either an inadequate or inappropriate resolution of the
findings may result in the withholding of funds or suspension of the contract
Attachment(s). Any such withholding of funds or suspension will remain in effect
until the findings are properly remedied as determined by RECEIVING AGENCY.
PERFORMING AGENCY will retain all such records for a period of three years from
the date of the last expenditure report submitted under contract Attachment(s)
or until resolution of all audit questions, whichever time period is longer.
ARTICLE 17. Client Records
At the end of the Attachment term, all client records (including patient records)
are the property of PERFORMING AGENCY. RECEIVING AGENCY retains the right to
have access to the records or obtain copies for audit, examination, evaluation,
inspection, litigation, or other circumstances that may arise.
If at any time during the Attachment term(s), PERFORMING AGENCY and/or RECEIVING
AGENCY should decide to suspend or terminate the agreement, RECEIVING AGENCY may
require the transfer of client records (including patient records) upon written
notice to PERFORMING AGENCY, either to another entity that agrees to continue the
service or to RECEIVING AGENCY.
ARTICLE 18. Confidentialit
PERFORMING AGENCY will have a system in effect to protect client or patient
records and all other documents deemed confidential by law which are maintained
in connection with the activities funded under contract. Any disclosure or
transfer of confidential client or patient information by PERFORMING AGENCY,
including information required by the Reports and Inspections Article, will be
in accordance with applicable law.
.1994 GENERAL PROVISIONS -.Page 7 (5/93)
If providing direct client care,, services, or programs, PERFORMING AGENCY agrees
to implement workplace policies based on the model guidelines adopted by
RECEIVING AGENCY and to educate employees and clients concerning the human
immunodeficiency virus (HIV) and its related conditions including acquired
immunodeficiency syndrome (AIDS). PERFORMING AGENCY agrees to develop and
implement policies regarding confidentiality of AIDS and HIV -related medical
information for employees of PERFORMING- AGENCY and for clients, inmates,
patients, and residents served by PERFORMING AGENCY. Further, PERFORMING AGENCY
agrees to develop and implement an anti -discrimination policy assuring all
privileges and opportunities for any employee or client with a communicable
disease. HIV -related policies will be based on accurate scientific information.
Such policies will be consistent with the model guidelines published by RECEIVING
AGENCY and with state and federal laws and regulations. A PERFORMING AGENCY
that does not adopt a confidentiality policy as herein required is not legally
eligible to receive state funds until the policy is developed and implemented.
ARTICLE 19. Equipment and Supolies
Equipment is defined as tangible nonexpendable property with an acquisition cost
of over $500 and a useful life of more than one year. In accordance with Article
601b, V.T.C.S., Section 8.02(c), title to all equipment purchased from funds
provided herein will be in the name -of PERFORMING AGENCY throughout the
Attachments) term(s).
Unless initially listed and approved in the Attachment1 s) , prior written approval
from RECEIVING AGENCY is required for any additions to or deletions of approved
equipment purchases having an acquisition cost exceeding $500. To receive
approval for data processing hardware and software purchases with an acquisition
cost over $500, PERFORMING AGENCY must submit a detailed justification which
includes description of features, make and model, and cost, etc.
PERFORMING AGENCY will maintain an annual property and inventory listing and
submit a report (TDH Form GC-11) to RECEIVING AGENCY not later than 45 days from
the end of the Attachment(s) term(s). PERFORMING AGENCY will administer a program
of maintenance,repair, and protection of assets under this Attachment(s) so as
to assure'their full availability and usefulness. In the event PERFORMING AGENCY
is indemnified, reimbursed, or otherwise compensated for any loss of, destruction
of, or damage to the assets provided under this Attachment(s), it will use the
proceeds to repair or replace said assets.
PERFORMING AGENCY agrees that upon termination of Attachment(s), title to any
remaining equipment purchased from funds as hereinabove provided will be
transferred to the RECEIVING AGENCY or any other party designated by the
RECEIVING AGENCY; provided, however, that RECEIVING AGENCY may, at its option and
to the extent allowed by law, transfer title to such property to the PERFORMING
AGENCY.
ARTICLE 20. Subcontracting
PERFORMING AGENCY may enter into agreements with subcontractors unless restricted
or otherwise prohibited in specific Attachment(s). Subcontracts, if any, entered
into by PERFORMING AGENCY will be in writing and subject to the requirements of
this contract. PERFORMING AGENCY agrees that it will be responsible to RECEIVING
AGENCY for the performance of any subcontractor. In addition, if PERFORMING
AGENCY elects to enter into an agreement which subcontracts out a substantial
portion of PERFORMING AGENCY's Scope of Work, prior written approval must be
obtained from RECEIVING AGENCY.
1994 GENERAL PROVISIONS - Page 8 (5/93)
ARTICLE 22. Convriahts, Publications, and Patents
PERFORMING AGENCY understands and agrees that where activities supported by the
contract Attachments) produce original books, manuals, films, computer programs
(including executable computer programs and supporting data in any form), or
other original material, PERFORMING AGENCY may -copyright such material subject
to any rights to same reserved by or vested in the federal government or any
agency thereof however, RECEIVING AGENCY may grant to PERFORMING AGENCY limited
rights to produce, publish, and use such materials as appropriate.
PERFORMING AGENCY may publish at its expense the results of contract performance
with prior RECEIVING AGENCY review and approval. Any publication (written,
visual, or sound) should include acknowledgment of the support received from
RECEIVING AGENCY and the appropriate federal agency, if applicable. At least
three copies of any such publication must be provided to RECEIVING AGENCY.
RECEIVING AGENCY reserves the right to require additional copies before or after
the initial review.
PERFORMING AGENCY and any subcontractor, as appropriate, must comply with the
standard patent rights clauses in 37 CFR Sec. 401.14 or FAR 52.227.11.
ARTICLE 22. Bold Harmless
PERFORMING AGENCY, which is not a state agency, assures that it is an independent
contractor and not an agent, servant, or employee of the state. Except to the
extent that Chapter 104 of the Texas Civil Practice and Remedies Code is
applicable to this contract, PERFORMING AGENCY agrees to hold RECEIVING AGENCY
and/or federal government harmless and to indemnify them from and against any and
all claims, demands, and causes of action of every kind and character which may
be asserted by any third party occurring or in any way incident to, arising out
of, or in connection with the performance of services by PERFORMING AGENCY under
this contract to the extent allowed by law, and to the extent of damages
permitted under Chapter 101 of the Texas Civil Practice and Remedies Code.
PERFORMING AGENCY, by acceptance of funds provided through contract
Attachment(s), agrees and ensures that personnel paid from these funds are duly
licensed and/or qualified to perform the required services.
ARTICLE 23. Bonding
Ea-ch-person employed by PERFORMING AGENCY who handles funds under this contract,
including persons authorizing payment of such funds, will be covered by the terms_
of a fidelity bond providing for indemnification of losses occasioned by: (1) any
fraudulent or dishonest act or acts committed by any of PERFORMING AGENCY's
employees either individually or in concert with others, and/or, (2) failure of
PERFORMING AGENCY 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. This fidelity bond will be in the amount of not less
than Ten Thousand Dollars ($10,000).
In the event that PERFORMING AGENCY, being an independent contractor, maintains
a self-insurance program that provides for, the indemnification of losses as
described in the above paragraph regarding fidelity bonds, then PERFORMING AGENCY
will provide the RECEIVING AGENCY a certified statement which summarizes its
self-insurance plan. The certified statement will be submitted at the time this
contract is submitted for approval. Any changes to said plan, which occur during
the term of this contract period, will be reported to RECEIVING AGENCY. The
self-insurance program should be based on the determination that the coverage can
be provided at a cost no greater than the cost of obtaining equivalent coverage
from an insurance company.
1994 GENERAL PROVISIONS - Page 9 (5/93)
ARTICLE 24. suspension/Terminatio
If PERFORMING AGENCY fails to comply with RECEIVING AGENCY's reporting
requirements, the program objectives, or the contract award conditions, RECEIVING
AGENCY may withhold payments. RECEIVING AGENCY will provide advance written
notice to PERFORMING AGENCY which will identify the deficiency and RECEIVING
AGENCY's intent to withhold payments if the deficiency is not corrected within
a specific number of days. When the deficiency is corrected, RECEIVING AGENCY
will release any withheld payments with no further action. If PERFORMING AGENCY
fails to comply with the terms, conditions, or standards of this contract,
RECEIVING AGENCY may suspend the contract Attachment(s) and prohibit PERFORMING
AGENCY from incurring additional obligations of funds pending either corrective
action or termination. RECEIVING AGENCY will provide written notice to
PERFORMING AGENCY at least thirty'(30) days in advance of the suspension date.
Such notice will detail the nature of noncompliance and specify a correction
date. PERFORMING AGENCY may request a hearing on the proposed suspension if such
request is made in writing within ten (10), days from any final notification of
suspension.
This contract or any Attachment(s) hereto may be terminated by either of the
parties hereto for noncompliance by the other party. A party intending to
terminate for noncompliance by the other party will provide written notice to the
other party at least thirty (30) days prior to the intended date of termination.
Such notice will include the reasons for the termination and will provide the
other party an opportunity to rebut the reasons in writing. A hearing may be
requested on the proposed termination if such request is made in writing within
ten (10) days from any final notification of termination. By such termination,
neither party may nullify obligations already incurred for performance or failure
to perform prior to the date of termination. Such termination will not be an
exclusive remedy but will be in addition to any other rights and remedies
provided by law or under this contract.
This contract or any Attachment(s) hereto may be terminated in whole, or in part,
when both parties agree that continuation would not produce results commensurate
with further expenditure of funds. Both parties will agree on the effective date
and, in the case of partial termination, the portion to be terminated. RECEIVING
AGENCY will immediately send PERFORMING AGENCY written notice of the terms agreed
to and such notice will become a part of the contract. PERFORMING AGENCY will
not incur new obligations for the terminated portion after the effective date of
termination and will cancel as many outstanding obligations as possible.
RECEIVING AGENCY will allow full credit to PERFORMING AGENCY for noncancelable
obligations which were properly incurred prior to the termination date.
This contract or any Attachment(s) hereto may be terminated if funds allocated
for any Attachment(s) hereto should become reduced, depleted, or unavailable
during any Attachment(s) budget period, and RECEIVING AGENCY is unable to obtain
additional funds for such purposes. RECEIVING AGENCY will immediately provide
written notification to PERFORMING AGENCY of such fact and such Attachment(s) to
this contract is/are terminated upon receipt of that notification. PERFORMING
AGENCY will not incur new obligations after the effective date of termination and
will cancel as many outstanding obligations as possible. RECEIVING AGENCY will
allow full credit to PERFORMING AGENCY for noncancelable obligations which were
properly incurred prior to the termination date.
This contract or any Attachment(s) hereto may be terminated in the event that
federal or state laws or other requirements should be amended or judicially
interpreted so as to render continued fulfillment of this contract, on the part
of either party, unreasonable or impossible. If the parties should be unable to
agree"upon amendment which would therefore be needed to enable the substantial
continuation of the services contemplated herein, then, upon written notification
by RECEIVING AGENCY to PERFORMING AGENCY, the parties will be discharged from any
further obligations created under the terms of this contract, except for the
1994 GENERAL PROVISIONS - Page 10 (5/93)
equitable settlement of the respective accrued interests or obligations as of the
date of termination.
ARTICLE 25. Personnel
All personnel funded by Attachment(s) to this contract are employees of
PERFORMING AGENCY which will be responsible for their direction and control and
liable for any of their acts or omissions.
PERFORMING AGENCY will have in place legally sufficient Due Process Hearing
Procedures for all of its employees filling state budgeted positions.
PERFORMING AGENCY will have full authority to employ, promote, suspend, demote,
discharge, and transfer within its organization any and all state budgeted
personnel funded by Attachment(s) to this contract provided, however, that any
demotion, suspension, or discharge of such state budgeted employees will be in
accordance with the Due Process Hearing Procedures as set out above. The only
distinction between state -budgeted and local paid employees is that employees on
state budgeted positions receive state benefits and are subject to certain
duties, obligations, and restrictions as state employees as contained in state
law. One such restriction, as contained in the State Appropriations Act, is that
no employee paid on a state budgeted position may receive a salary supplement
from any source unless specifically authorized in the Appropriations Act or other
state law. This prohibition includes, but is not limited to, the payment to such
employee of a so-called "flat rate" car allowance or travel allowance. Any such
travel or per diem to these employees must be on a reimbursement basis, supported
by appropriate records, and may not exceed the reimbursement for mileage and/or
per diem allowed under the Appropriations Act and current state travel
regulations. This restriction will apply whether travel funds are provided in
Attachment(s) under this contract or from any other source.
PERFORMING AGENCY will utilize RECEIVING AGENCY's policies and procedures for
hiring and promoting individuals into state budgeted positions funded by
Attachment(s) to this contract. Qualifications of any individuals filling these
positions will be subject to approval of RECEIVING AGENCY's Bureau of Personnel
Management. The purpose of the approval is to ensure that individuals occupying
these positions meet minimum educational and experience requirements.
PERFORMING AGENCY will maintain required records and submit documents necessary
-
to process personnel, payroll, leave and time records, and travel claims on state
budgeted positions. PERFORMING AGENCY will be furnished by RECEIVING AGENCY
state warrants for salary compensation or travel reimbursement for issuance to
employees on state budgeted positions.
An independent audit is not required as a condition of this contract if the
Attachment provides assistance through assignment of -state budgeted positions and
no funds are budgeted for local costs.
PERFORMING AGENCY may be reimbursed for local personnel costs or other categories
of expense used to fulfill the scope of work of Attachment(s) in lieu of being
furnished state payroll warrants after a state budgeted position becomes vacant.
Reimbursement will not exceed the balance of funds on the state budgeted position
after all benefits, obligations, and/or other entitlements are met. PERFORMING
AGENCY's Director, or other person(s) authorized elsewhere in this contract, may
submit a request for conversion. RECEIVING AGENCY will transmit formal approval
and a revised budget to PERFORMING AGENCY to complete the conversion.
ARTICLE 26. Funding Participation Requirement
PERFORMING AGENCY agrees funds provided through this contract will not be used
for matching purposes in securing other funding unless otherwise directed or
approved by RECEIVING AGENCY.
1994 GENERAL PROVISIONS - Page 11 (5/93)
ARTICLE 27. Performance -Based Attachments
History
RECEIVING AGENCY is responsible for developing performance -based public health
services contracts in response to the State Auditor's Report and requirements of
the Legislature. This system will enhance service delivery and improve
accountability and efficiency in the management of public health dollars.
Plans for initial implementation were designed to use the model objectives format
stemming from recommendations of the Committee on Model Objectives for Local
Public Health in Texas." The committee was composed of representatives of local
healthdepartments and RECEIVING AGENCY's central and public health region
offices in consultation with the University of Texas School of Public Health in
Houston.
Purpose
The overall goal of performance -based contracts is improved public health
practices in Texas. The project is intended to: _
- identify public health needs and establish priorities which provide a
rational basis for resource allocation;
- project realistic outcomes based on activities which can be accomplished
with current or planned resources, communicate needs, and build consensus
at all levels, regarding directions to be taken in specific programs; and,
- institute a system for planning, implementing, managing, and evaluating
programs and monitoring progress toward reducing and/or alleviating public
health problems.
Required Program Areas
PERFORMING AGENCY has prepared outcome and process objectives, if they are
applicable and relative to the local needs and resources, for the following
program areas:
Food Protection HIV/AIDS
Public Health Promotion Refugee Health
Immunization Sexually Transmitted Diseases
Maternal and Child Health Tuberculosis
Chronic Disease Prevention & Control
These objectives are appended to the Community and Rural Health Attachment and
incorporated verbatim and made a part of this contract. PERFORMING AGENCY agrees
to monitor and report progress towards these objectives on a quarterly and annual
basis. The reporting requirements and format will be agreed upon by both
parties.
Pilot Program Areas
RECEIVING AGENCY will provide training, written documentation, and ongoing
technical assistance to PERFORMING AGENCY in the development of performance -based
objectives for the following pilot program areas:
Dental Health Services
Women, Infants, and Children Nutrition (WIC)
1994 GENERAL PROVISIONS - Page 12 (5/93)
For state fiscal year 1994, the parties recognize and agree that the
performance -based objectives for the pilot program areas are negotiable. If
PERFORMING AGENCY'S achievement is below the established levels, it will not
affect the right of PERFORMING AGENCY to funds provided through Attachment(s)
when the basic program Scope of Work has been fulfilled.
It is understood and agreed upon by both parties that PERFORMING AGENCY will be
required to append approved performance -based objectives for the pilot program
areas to the local health services contract for state fiscal year 1994.
RECEIVING AGENCY contact for matters pertaining to the performance -based public
health services project is the Office of the Associate Commissioner for Community
and Rural Health.
1994 GENERAL PROVISIONS - Page 13 (5/93)
DOCUMENT NO. C5000258
ATTACHMENT NO. 01
PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: HIV DIVISION
TERM: January 1, 1994 THROUGH December 31, 1994
SECTION I. SCOPE OF WORK:
PERFORMING AGENCY agrees to conduct counseling, testing, referral, and partner
elicitation/notification (CTRPN) activities to help reduce the spread of human
immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). CTRPN
activities include establishing and maintaining anonymous and/or confidential
HIV testing programs for persons at risk of HIV infection due to individual
sexual behavior, injecting drug use, or other risk behaviors.
All information and educational materials developed and provided by PERFORMING
AGENCY will be accurate, comprehensive, and consistent with current findings
of the United States Public Health Service.
PERFORMING AGENCY agrees that all activities will be performed in accordance
with RECEIVING AGENCY'S request for proposal (RFP) and assurances, and PER-
FORMING AGENCY'S objectives, activities work plans, and detailed budgets as
approved by RECEIVING AGENCY. All of the above named documents are adopted by
reference as part of this Attachment. All revisions to said documents will be
approved by RECEIVING AGENCY and transmitted in writing to PERFORMING AGENCY.
PERFORMING AGENCY will provide CTRPN services to the target population defined
as:
1. Males who routinely have sex with other males.
2. Males who occasionally have sex with other males.
3. Males who have sex with males and females.
4. Males and females with multiple sex partners.
5. Persons with a history of sexually transmitted diseases.
6. Persons with a history of high risk behavior.
PERFORMING AGENCY will perform the following Counseling and Testing Services:
1. Offer voluntary, anonymous and/or confidential HIV testing to clients
who may want to be tested.
2. Provide culturally sensitive and effective pretest and posttest counsel-
ing based on TDH approved guidelines.
3. Publicize HIV counseling and testing services so that potential clients
will know where and when services are available.
4. Offer HIV counseling and testing services at a location that is conve-
nient for the majority of the target population and during hours
established to reach these clients.
-1-
5. Use optically scannable forms supplied by RECEIVING AGENCY or a similiar
TDH approved instrument to collect demographic information and unlinked
test result data.
6. Utilize RECEIVING AGENCY'S Laboratory, for all ELISA and Western Blot
testing unless otherwise approved in writing by the RECEIVING AGENCY.
7. PERFORMING AGENCY will develop and maintain a referral plan by which
reciprocal linkages are established with other service providers
(especially other RECEIVING AGENCY funded providers) for the purpose of:
a. Case management
b. Extended HIV prevention counseling
c. CD4 testing
d. TB skin testing
e. Immunizations
f. STD screening
g. Family planning
h. Gynecological exam
i. Substance abuse treatment
j. Medical evaluation for HIV illness
k. Medical follow-up
1. Antiviral therapy
m. PCP prophylaxis
n. Psychosocial needs assessment
o. Professional psychosocial counseling
p. Emotional support groups
q. Financial eligibility assistance
r. Legal assistance
PERFORMING AGENCY will perform the following Partner Elicitation/Notification
Services:
1. All partner elicitation/notification services must be consistent with
RECEIVING AGENCY'S pretest and posttest counseling guidelines and the
TDH Seropositive and Partner Notification Guidelines which are incorporated
by reference and made part hereof.
2. Partner notification must be mentioned in every pretest session and
encouraged and discussed with every HIV positive client during the posttest
counseling session.
3. If the client prefers to make the partner notification personally, provide
guidance/coaching in making the notification during the posttest counseling
session.
4. If the client would like to inform partner(s) but is not sure whether they
will be able to do so, a verbal agreement/contract will be established. In
the contract, the client agrees to notify partner(s) by a specific date. The
client provides full names and locating information with the knowledge that
this information will be relayed to the local Health Department/regional
STD program who will confidentially notify the partner(s) if the referral
-2-
is not completed as agreed.
5. If the client does not want to notify partner(s) or in the counselor's
opinion is incapable, elicit adequate information for STD personnel to make
the notification. Elicited information will be referred to the local health
department/regional STD program receiving funds for partner notification
activities.
6. PERFORMING AGENCY agrees to report HIV partner elicitation data using the
RECEIVING AGENCY'S Partner Elicitation Report Form.
PERFORMING AGENCY agrees to comply with the following CTRPN Quality Assurance
Guidelines:
1. PERFORMING AGENCY assures that pretest and posttest counseling sessions
are performed by staff who have successfully completed counseling
training from a course and instructor approved by RECEIVING AGENCY.
2. PERFORMING AGENCY will conduct monitoring of counseling, testing, referral
and partner notification sessions. Through use of Quality Assurance
Systems (QAS) the PERFORMING AGENCY program manager will possess current
information and will monitor counselor performance (at least monthly for
months 1-6 of employment, bimonthly for months 7-12, and quarterly for
experienced counselors whether directly supervised or on independent
assignment.) A written record (TDH skills assessment form or other TDH
approved model) of the monitored session is to be kept on file.
3. PERFORMING AGENCY agrees to facilitate RECEIVING AGENCY review of
scheduled counseling, testing, referral, and partner notification
sessions.
PERFORMING AGENCY agrees to comply with Chapters 81 and 85 of the Health and
Safety Code and relevant portions of Chapter 6A (Public Health Service) of
Title 42 (The Public Health & Welfare) of the U.S. Code, as amended.
PERFORMING AGENCY will provide an estimated 1,520 clients with
services/units of service in or benefiting the county(ies)/area defined as:
LUBBOCK.
SECTION II. LEGAL AUTHORITY TO CONTRACT:
Chapters 12 and 121 of the Health and Safety Code.
SECTION III. SPECIAL PROVISIONS:
RECEIVING AGENCY will supply PERFORMING AGENCY with the most current version
of the document entitled "Content of AIDS -Related Written Materials,
Pictorials, Audiovisuals, Questionnaires, Survey Instruments, and Educational
Sessions in Centers for Disease Control Assistance Programs," and its preface
which is written by RECEIVING AGENCY. PERFORMING AGENCY has provided
RECEIVING AGENCY with written acknowledgement of receipt and assurance of
compliance with these guidelines. All of the above referenced documents are
-3-
incorporated as part of this Attachment as though written herein verbatim.
Due to the sensitive and highly personal nature of HIV/AIDS-related infor-
mation, strict adherence to the General Provisions Confidentiality Article
is required. PERFORMING AGENCY success depends upon whether persons at risk
believe that the program observes this principle. In addition to these
conditions, PERFORMING AGENCY will comply with TDH Bureau HIV STD Control's
HIV Serologic Testing and Documentation Guidelines. All of the above
referenced documents are incorporated as part of this Attachment as
though written herein verbatim.
PERFORMING AGENCY agrees to submit program and financial reports in accordance
with the time frames listed below.
QUARTERLY REPORTS
REPORT PERIOD
TYPE REPORT
DUE
DATE
Jan.,
Feb., Mar.
Program
Apr.
20
Financial
Apr.
30
Apr.,
May, June
Program
July
20
Financial
July
30
July,
August, Sept.
Program
Oct.
20
Financial
Oct.
30
Oct.,
Nov., Dec.
Program
Jan.
20
Financial
Jan.
30
ANNUAL REPORTS
REPORT PERIOD TYPE REPORT DUE DATE
Jan. 1, 1994 - Dec. 31, 1994 Financial Feb. 15, 1995
PERFORMING AGENCY, or any subcontractor, shall not transfer a client record
(including a patient record) to another entity or person without written
consent from the client or patient, or someone authorized to act on his or her
behalf; however, the RECEIVING AGENCY (TEXAS DEPARTMENT OF HEALTH) may require
PERFORMING AGENCY, or any subcontractor, to transfer a client or patient
record to the RECEIVING AGENCY (TEXAS DEPARTMENT OF HEALTH) if the transfer
is necessary to protect either the confidentiality of the record or the health
and welfare of the client or patient.
The RECEIVING AGENCY (TEXAS DEPARTMENT OF HEALTH) shall have access to a
client record (including a patient record) in the possession of PERFORMING
AGENCY, or any subcontractor, under authority of the Health and Safety Code,
Chapters 81 and 85, and the Texas Revised Civil Statutes, Article 4495b
(Medical Practice Act). In such cases, the RECEIVING AGENCY (TEXAS DEPARTMENT
OF HEALTH) shall keep confidential any information obtained from the client
or patient record, as required by the Health and Safety Code, Chapter 81, and
-4-
the Texas Revised Civil Statutes, Article 4495b.
PERFORMING AGENCY will submit quarterly activity reports within 20 days after
the end of each quarter, that are prepared in the format provided by the
RECEIVING AGENCY.
PERFORMING AGENCY will authorize their staff to attend training, conferences,
and meetings for which funds were budgeted and approved by RECEIVING AGENCY.
SECTION IV. BUDGET:
Personnel
$26,396.00
Fringe Benefits
6,439.00
Travel
400.00
Equipment
.00
Supplies
330.00
Contractual
.00
Other
45.00
Total Direct Costs
$33,610.00
Indirect
1,390.00*
TOTAL
$35,000.00
Financial status reports (FSRs) are due the 30th of April,
July,
October, January and the 15th of February.
Total reimbursements will not exceed $35,000.00.
*Indirect cost is based on UGCMA, Table 1.
am