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HomeMy WebLinkAboutResolution - 6438 - Agreement - TX Dept. Of Health - Public Health Services - 08_12_1999Resolution No- 6438 Aug. 12, 1999 Item No. 28 RESOLUTION NOW, THEREFORE, 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, Texas Department of Health Document No. 7560005906-2000 by and between the City of Lubbock and the Texas Department of Health for public health services, attached hereto and any associated documents, which Agreement shall be spread upon the minutes of the Council and as spread upon the minutes of this Council shall constitute and be a part of this Resolution as if fully copied herein in detail. Passed by the City Council this 12th day of Aug- , 1999 . I Y SI , MAY R ATTEST: Lwik Kay 'e arnell, City Secretary APPROVED AS TO CONTENT: Doug Goodman, Management Director of Health & Community Services APPROVED AS TO FORM: Linda L. Chamales Supervising Attorney -Office Practice Section cr:ccdocs/rDHContr5906. res.doc August 2, 1999 11=1i 1 - - .1• 1 .. it STATE OF TEXAS COUNTY OF TRAVIS Resolution No. &�3 Aug. 12, 1999 Item No. 28 TEXAS DEPARTMENT OF HEALTH 1100 WEST 49TH STREET AUSTIN, TEXAS 78756-3199 CONTRACT CHANGE NOTICE NO. Ql The Texas Department of Health, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in writing with LUBBOCK CITY HEALTH DEPARTMENT hereinafter referred to as PERFORMING AGENCY. The parties thereto now desire to amend such contract attachment(s) as follows: SUMMARY OF TRANSACTION: ATT. NO. 02: IMMUNIZATION DIVISION ATT. NO. 03: HIV - SURVEILLANCE ATT. NO. 04: REGIONAL/LOCAL HEALTH OPERATIONS ATT. NO. 05: BCH - POPULATION BASED SERVICES ATT. NO. 06: TB - PREVENTION AND CONTROL All terms and conditions not herebv amended remain in full force and effect. EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN. Authorized Contracting Entity (type above if different from PERFORMING AGENCY) for and in behalf of: PERFORMING AGENCY: HEALTH (Signature 4Wir y Siam, Mayw (Name and Title) Date. Aug. 12, 1999 RECOMMENDED: to sign contracts) By:Cq6ftL0--1 (PERFORMING AGENCY Director, if different from person authorized to sign contract) A roved as to for - LI.y MLLUdWy RECEIVING AGENCY: TEXAS DEPARTMENT OF HEALTH By: .'tolf44. - (Signature of ilerson authorized to sign contracts) Sidney P. Shelton, Chief Bureau of Financial Services (Name and Title) Date: I 1 J 1 / ! BN OMD - Rev. 3/99 Yla. '4'. A Im A ec-.� Cover Page W1 10 P I: - 1 . ■ DETAILS OF ATTACHMENTS Att/ Amd No. TDH Program/Assistance ID Term Financial Assistance- Direct Total Amount (TDH Share) Begin End Source of Funds* Amount 01 HIV/PREV 01/01/99 12/31/99 93.940 45,000.00 0.00 45,000.00 02 IMM/LOCALS 09/01/99 08/31/00 State 68,356.00 0.00 68,356.00 03 HIV/SURV 09/01/99 08/31/00 State 46,713.00 0.00 46,713.00 04 BRLHO 09/01/99 08/31/00 State 93.991 94,118.00 24,192.00 118,310.00 05 BCH/POP-BASE 09/01/99 08/31/00 State 117,580.00 0.00 117,580.00 06 TB/PC 09/01/99 08/31/00 1 State 20,073.00 0.00 20,073.00 TDH Document No.7560005906 2000 Totals Change No. 01 $391,840.00 $24,192.00 $416,032.00 *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 GENERAL PROVISIONS FOR TEXAS DEPARTMENT OF HEALTH GRANT CONTRACTS aGS) 2000 GENERAL PROVISIONS 4/99 • Any alteration to this document constitutes a couRfer-offer and must be approved in writing by the Texas Department of Health. GENERAL PROVISIONS FOR TEXAS DEPARTMENT OF HEALTH GRANT CONTRACT'S ARTICLE 1. Preamble PERFORMING AGENCY and RECEIVING AGENCY (the parties) hereby agree to make and enter into this grant contract (contract), to faithfully perform the duties prescribed by this contract and to uphold and abide by its terms and provisions. This contract consists of RECEIVING and PERFORMING AGENCY identifying data, Details of Attachment(s), authorized signatures, General Provisions, and Attachment(s) with detailed Scope(s) of Work, Special Provisions, budget(s), and exhibit(s) as applicable. This contract represents the complete and entire understanding and agreement of the parties. 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, 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 of its terms, performances, and provisions. PERFORMING AGENCY assures compliance with this contract, including these General Provisions unless otherwise specified in any Special Provisions of the Attachment(s) to this document. If these General Provisions are revised or replaced during the term of this contract, and PERFORMING AGENCY does not consent to comply with the modified General Provisions, PERFORMING AGENCY may exercise its termination options in accordance with the General Provisions, Termination Article. ARTICLE 2. Term The time period of this contract shall be governed by the term(s) of the Attachment(s). No commitment of contract funds is permitted prior to the first day or 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 the availability of funding for each Attachment for the term of the Attachment. PERFORMING AGENCY will have no right of action against the State of Texas or RECEIVING AGENCY in the event that RECEIVING AGENCY is unable to fulfill its obligations under this contract as a result of 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 This contract may be amended only if the amendment is in writing and signed by individuals with authority to bind all parties. PERFORMING AGENCY shall not perform and RECEIVING AGENCY shall not pay for the performance of different or additional services, work, or products except pursuant to an amendment of this contract that is executed (LGS) 2000 GENERAL PROVISIONS Page 1 4/99 in compliance with this Article. RECEIVING AGENCY may not waive any term, covenant, or condition of this contract unless by amendment executed in compliance with this Article. PERFORMING AGENCY shall plan expenditures so that any necessary budget revisions or amendments are executed no later than 90 days prior to the expiration of the Attachment term. PERFORMING AGENCY shall provide a written justification for any budget revisions and/or amendments. If a budget revision or amendment is requested during the last quarter of the Attachment term, the written justification must include a reason for the delay. ARTICLE 5. AnDlicable Laws and Stands This contract shall be interpreted under and in accordance with the laws of the State of Texas and enabling state rules. Where applicable, federal statutes and regulations, including federal grant requirements applicable to funding sources, will apply to this contract. The Uniform Grant and Contract Management Act (UGCMA), Texas Government Code, Chapter 783, Vernon's Texas Codes Annotated (VTCA), and the Uniform Grant Management Standards (UGMS) as amended by revised federal circulars and incorporated in UGMS by the Governor's Budget and Planning Office, apply as terms and conditions of this contract and are adopted by reference in their entirety. If a conflict arises between the provisions of this contract and the provisions of UGCMA and UGMS, the provisions of UGCMA and UGMS will prevail unless expressly stated otherwise. RECEIVING AGENCY must give prior approval for changes to contract Attachment(s) as specified by UGMS in "Part III -State Uniform Requirements for Grants and Cooperative Agreement, Subpart C-Post-Award Requirements, item _.30-Changes" and applicable federal Office of Management and Budget (OMB) circulars. RECEIVING AGENCY will provide copies of applicable OMB circulars and UGMS to PERFORMING AGENCY upon request. These documents are incorporated by reference as a condition of this contract. PERFORMING AGENCY may not use funds granted under this contract to pay any person for influencing or attempting to influence an officer or employee of any agency; federal or state; a Member of Congress; an officer or employee of Congress; or an employee of a Member of Congress in connection with the awarding of any contract or grant or the extension, continuation, renewal, amendment, or modification of any contract or grant (31 USC § 1352 and UGMS). If at anytime this contract exceeds $100,000, regardless of funding source, PERFORMING AGENCY shall file with RECEIVING AGENCY a declaration containing the name of any registrant under the Lobbying Disclosure Act of 1995 who has made lobbying contacts on behalf of PERFORMING AGENCY in connection with that contract or grant, a certification that none of the funds provided by RECEIVING AGENCY have been or will be used for payment to lobbyists and shall disclosure of the names of any and all registered lobbyists with whom PERFORMING AGENCY has an agreement. PERFORMING AGENCY shall require any person who receives a subgrant or subcontract to file the same declaration, certification and disclosure with RECEIVING AGENCY. PERFORMING AGENCY shall file the declaration, certification, and disclosure at the time of application for the contract or grant; upon execution of a contract or grant unless PERFORMING AGENCY previously filed a declaration, certification or disclosure form in connection with the award; and at the end of each calendar quarter in which there occurs any event that materially affects the accuracy of the information contained in any declaration, certification or disclosure previously filed. RECEIVING AGENCY will supply the certification form to PERFORMING AGENCY upon request. (LGS) 2000 GENERAL PROVISIONS Page 2 4/99 ARTICLE 6. Debarment and Suspension PERFORMING AGENCY certifies by execution of this contract to the following: ► it is not ineligible for participation in federal or state assistance programs under Executive Order 12549, Debarment and Suspension; ► neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency; ► it has not knowingly failed to pay a single substantial debt or a number of outstanding debts to a federal or state agency; and ► it is not subject to an outstanding judgment in a suit against PERFORMING AGENCY for collection of the balance of a debt. Where PERFORMING AGENCY is unable to certify to any of the statements in this Article, PERFORMING AGENCY shall attach an explanation. PERFORMING AGENCY shall not contract with a subrecipient nor procure goods or services from a subcontractor, at any tier, which is debarred or suspended or is otherwise excluded from or ineligible for participation in federal assistance programs under Executive Order 12549. ARTICLE 7. Assurances PERFORMING AGENCY shall 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. To the extent such provisions are applicable to PERFORMING AGENCY, PERFORMING AGENCY agrees to fully comply with the following: ► Title VI of the Civil Rights Act of 1964, 42 USC §§2000d et seq. (P.L. 88-352), which prohibits discrimination on the basis of race, color or national origin, and includes the provision for effective communication and equal access to programs, services and activities to persons with Limited English Proficiency (LEP); ► Title IX of the Education Amendments of 1972, as amended, 20 USC §§ 1681-1683, and 1685-1686, which prohibits discrimination on the basis of sex; ► Section 504 of the Rehabilitation Act of 1973, 29 USC §794(a), which prohibits discrimination on the basis of disabilities and the Americans with Disabilities Act of 1990, 42 USC §§ 12101 et seq., including the provision for effective communication and equal access to programs, services and activities to persons with sensory and speech impairments; ► The Age Discrimination Act of 1975, as amended, 42 USC §§6101-6107, which prohibits discrimination on the basis of age; ► The Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; ► The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to the nondiscrimination on the basis of alcohol abuse or alcoholism; ► Public Health Service Act of 1912, §§523 and 527, 42 USC §290 dd-2, as amended, relating to confidentiality of alcohol and drug abuse patient records; (LGS) 2000 GENERAL PROVISIONS Page 3 4/99 Title VIII of the Civil Rights Act of 1968, 42 USC §§3601 et seq., as amended, relating to nondiscrimination in the sale, rental or financing of housing; and, The requirements of any other nondiscrimination statute(s). Collectively, such requirements obligate RECEIVING AGENCY to provide services without discrimination on the basis of race, color, national origin, age, sex, or disability. PERFORMING AGENCY shall carry out the terms of this contract in a manner which will assist RECEIVING AGENCY in complying with such obligations to the fullest extent of PERFORMING AGENCY's ability. PERFORMING AGENCY agrees to comply with all or part of the following, as applicable: A. Texas Labor Code, Chapter 21, VTCA, which requires that certain employers not discriminate on the basis of race, color, disability, religion, sex, national origin, or age. B. Immigration Reform and Control Act of 1986, 8 USC §§1324a et seq., as amended, regarding employment verification and retention of verification forms for any individual(s) hired on or after November 6, 1986, who will perform any labor or services under this contract. C. Pro -Children Act of 1994,20 USC §§6081-6084, regarding the provision of a smoke -free workplace and promoting the non-use of all tobacco products. D. The National Research Service Award Act of 1971, as amended, 42 USC §§288 et seq. and 6601 (P.L. 93-348 and P.L. 103-43) regarding the protection of human subjects involved in research, development, and related activities supported by any applicable award of federal assistance. E. The Clinical Laboratory Improvement Amendments of 1988, 42 USC §263a, which establish federal requirements for the regulation and certification of clinical laboratories. F. The Occupational Safety and Health Administration Regulations on Blood Borne Pathogens, 56 Fed. Reg. 64175 (1991� 29 CFR § 1910.1030, which set safety standards for those workers and facilities who may handle blood borne pathogens. G. Laboratory Animal Welfare Act of 1966, 7 USC §§2131 et seq. (P.L. 89-544), as amended, pertaining to the care, handling, and treatment of warm-blooded animals held for research, teaching, or other activities supported by this award of assistance. H. Article 9102, Texas Revised Civil Statutes (TRCS), as amended, pertaining to standards which eliminate architectural barriers for persons with disabilities. I. Health and Safety Code § 165.004 (Vernon's Supp. 1998), relating to the promotion of breast-feeding by providing information that encourages breast-feeding to program participants who are pregnant women or mothers with infants. Promotional material may be requested from RECEIVING AGENCY by calling (512) 406-0744. J. Environmental standards pursuant to the following: (1) Institution of environmental quality control measures under the National Environmental Policy Act of 1969, 42 USC §§43214347 (P.L. 91-90) and Executive Order 11514 "Protection and Enhancement of Environmental Quality." (2) Notification of violating facilities pursuant to Executive Order 11738 "Providing for Administration of the Clean Air Act and the Federal Water Pollution Control Act with Respect to Federal Contracts, Grants, or Loans." (3) Protection of wetlands pursuant to Executive Order 11990. (4) Evaluation of flood hazards in floodplains in accordance with Executive Order 11988. (5) Assurance of project consistency with the approved State Management program developed under the Coastal Zone Management Act of 1972, 16 USC §§ 1451 et seq. (6) Conformity of federal actions to state clean air implementation plans under the Clean Air Act of 1955, as amended, 42 USC §§7401 et seq. (LGS) 2000 GENERAL PROVISIONS Page 4 4/99 (7) Protection of underground sodrees of drinking�water under the Safe Drinking Water Act of 1974, as amended, 42 USC §§300f-300j (P.L. 93-523). (8) Protection of endangered species under the Endangered Species Act of 1973, as amended (P.L. 93- 205). K. The Hatch Political Activity Act, 5 USC §§7321-29, which limits the political activity of employees whose principal employment activities are funded in whole or in part with federal funds. L. The Federal Fair Labor Standards Act and the Intergovernmental Personnel Act of 1970, as applicable, concerning minimum wage and maximum hours. M. General Appropriations Act, Regular Session, 75th Legislature, 1997, Article IX, §33 "Limitation on Grants to Units of Local Government." For the purpose of §33, "unit of local government" shall mean a council of governments, a regional planning commission, or a similar regional planning agency created under Chapter 391, Local Government Code; a Local Workforce Development Board; or an MHMR community center. N. Texas Government Code, Chapter 573,.Vemon's 1994, relating to nepotism. O. Texas Government Code, Chapter 552, Vernon's 1994, relating to open records and public information. P. Texas Government Code, Chapter 551, Vernon's 1994, relating to open meetings. Q. Texas Government Code, Chapter 415, and all rules adopted by the Texas Commission on Law Enforcement Officer Standards and Education pursuant to Chapter 415, Texas Government Code, relating to regulated law enforcement agencies. PERFORMING AGENCY shall ensure that the facilities under its ownership, lease or supervision which shall be utilized in the accomplishment of the project are not listed on the Environmental Protection Agency's (EPA) list of Violating Facilities and shall notify the Federal grantor agency of the receipt of any communication from the Director of the EPA Office of Federal Activities indicating that a facility to be used in the project is under consideration for listing by the EPA (Executive Order 11738). PERFORMING AGENCY shall comply with the flood insurance purchase requirements of 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234). Section 102 (a) requires the purchase of flood insurance in communities where the insurance is available as a condition for the receipt of any Federal financial assistance for construction or acquisition proposed for use in any area that has been identified by the Secretary of the U. S. Department of Housing and Urban Development as an area having special flood hazards. PERFORMING AGENCY shall comply with the requirements of the Texas Workers' Compensation Act, Labor Code, Chapters 401-406, VTCA, and rules promulgated thereunder found at 28 Texas Administrative Code (TAC), Chapter 41, et seq., which cover compensation for employees' injuries. When incorporated into a contract, standard assurances contained in the application package, if any, become terms or conditions for receipt of RECEIVING AGENCY funds. PERFORMING AGENCY and its subrecipients shall maintain an appropriate contract administration system to ensure that all terms, conditions, and specifications are met. PERFORMING AGENCY shall comply with all federal tax laws and is solely responsible for filing all required state and federal tax forms. PERFORMING AGENCY shall comply with all applicable requirements of federal and state laws, executive orders, regulations and policies governing the activity described in Attachment(s), and with the applicable standard conditions or assurances prescribed by UGMS in "Part III -State Uniform Requirements for Grants and Cooperative Agreement, Subpart B -Pre-Award Requirements, _. 14-State Assurances." (LGS) 2000 GENERAL PROVISIONS Page 5 4/99 PERFORMING AGENCY assures it shall not transfer, assign or sell its interest in this contract, or in any equipment purchased with funds from this contract, without the written consent of RECEIVING AGENCY. ARTICLE 8. Intellectual Texas Health and Safety Code § I2.020(a), VTCA, authorizes RECEIVING AGENCY to apply for, register, secure, hold, and protect a patent, copyright, trademark or other evidence of protection or exclusivity issued in or for intellectual property. "Intellectual property" consists of inventions; discoveries; improvements to any process, machine, manufacture, or composition of matter; products; technology; scientific information; trade secrets; computer software; literary works; musical works with any accompanying words; dramatic works with any accompanying music; pantomimes and choreographic works; pictorial, graphic, and sculptural works; motion pictures and other audiovisual works; sound recordings; architectural works; words, names, symbols, devices, slogans or any combination thereof which have been adopted and used by RECEIVING AGENCY to identify goods and/or services and distinguish them from those of others; and any other creative works if they may be protected by a patent, copyright, trademark, service mark, collective mark, or certification mark or other evidence of protection or exclusivity whether or not protection or exclusivity has been applied for or received. "Mark," for purposes of trademark and service mark, includes a word, name, symbol, device, slogan or any combination thereof which has been adopted and used by RECEIVING AGENCY to identify goods and/or services and distinguish them from those of others. Federal trademark law also provides for collective marks and certification marks. "Patent" protects any new and useful process, machine, manufacture, or composition of matter, or any new and useful improvement. "Work made for hire" is a work prepared by an employee within the scope of his or her employment; or a work specially ordered or commissioned for use as a contribution to a collective work, as a part of a motion picture or other audiovisual work, as a translation, as a supplementary work, as a compilation, as an instructional text, as a test, as answer material for a test, or as an atlas, and the parties expressly agree in a written instrument signed by them that the work shall be considered a work made for hire. The term "works," for purposes of federal copyright law, includes software; literary works; musical works with any accompanying words; dramatic works with any accompanying music; pantomimes and choreographic works; pictorial, graphic, and sculptural works; motion pictures and other audiovisual works, sound recordings and architectural works. All work performed that results in the production of original books, manuals, films, or other original material is the exclusive property of RECEIVING AGENCY. All right, title, and interest in and to said property shall vest in RECEIVING AGENCY upon creation. All work performed shall be deemed to be a "work made for hire" for copyright purposes and made in the course of the services rendered pursuant to this contract. To the extent that title to any such work may not, by operation of law, vest in RECEIVING AGENCY or such work may not be considered a work made for hire, all rights, title and interest therein are hereby irrevocably assigned to RECEIVING AGENCY. RECEIVING AGENCY shall have the right to obtain and to hold in its own name any and all patents, copyrights, trademarks, service marks, certification marks, collective marks, registrations, or such other protection as may be appropriate to the subject matter, and any extensions and renewals thereof. PERFORMING AGENCY (LGS) 2000 GENERAL PROVISIONS Page 6 4/99 III 1 11 1 1 4 d ■ shall ensure all rights, titles, and interest in and to the intellectual property are secured to RECEIVING AGENCY from PERFORMING AGENCY and its subrecipients. PERFORMING AGENCY agrees to give RECEIVING AGENCY and agrees to require its subrecipients to give RECEIVING AGENCY, or any person designated by RECEIVING AGENCY, all assistance required to perfect the rights defined in this Article, without any charge or expense beyond those amounts payable to PERFORMING AGENCY for the services rendered under the contract. If federal funds are used to finance activities supported by the contract Attachment(s) that result in the production of original books, manuals, films, or other original material, the federal awarding agency reserves a royalty -free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use, for federal government purposes (1) the copyright in any work developed under a grant, subgrant, or contract under a grant or subgrant; and (2) any rights of copyright to which a PERFORMING AGENCY or its subrecipient purchases ownership with grant support. PERFORMING AGENCY shall place an acknowledgment of federal awarding agency grant support and a disclaimer, as appropriate, on any publication written or published with such support and, if feasible, on any publication reporting the results of or describing a grant -supported activity. An acknowledgment shall be to the effect that "This publication was made possible by grant number from (federal awardinggencv)" or "The project described was supported by grant number from (federal awarding a eg, W" and "Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the (federal awarding agenW." In the event the terms of a federal grant award the copyright to PERFORMING AGENCY, RECEIVING AGENCY reserves a royalty -free, nonexclusive, worldwide and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use, for RECEIVING AGENCY, public health, and state governmental noncommercial purposes (1) the copyright, trade mark, service mark, and patent on an invention, discovery, or improvement to any process, machine, manufacture, or composition of matter, products; technology; scientific information; trade secrets; and computer software, in any work developed under a grant, subgrant, or contract under a grant or subgrant; and (2) any rights of copyright, service or trade marks or patents to which a grantee, subgrantee or a contractor purchases ownership with grant support. PERFORMING AGENCY may publish the results of the contract performance if those results are subject to copyright law at its expense with prior RECEIVING AGENCY review and approval. RECEIVING AGENCY will not withhold the approval unreasonably. If RECEIVING AGENCY withholds approval, PERFORMING AGENCY may still publish the results of the contract performance but shall not reference the Texas Department of Health in any manner. If RECEIVING AGENCY approves and owns the copyright, any publication should include "© Texas Department of Health, 1100 West 49th Street, Austin, Texas, (the year of publication), All Rights Reserved" If PERFORMING AGENCY is the copyright holder, any publication shall include acknowledgment of the support received from RECEIVING AGENCY. At least six 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 subrecipient, as appropriate, must comply with the standard patent rights clauses in 37 Code of Federal Regulations §401.14 or Federal Acquisition Regulations 52.227.11. ARTICLE 9. Historically Underutilized Businesses RECEIVING AGENCY shall comply with Texas Government Code, Chapter 2161, VTCA, and 1 TAC §§ 111.11- 111.24 whereby state agencies are required to make a good faith effort to assist historically underutilized businesses (HUBs) in receiving contract awards issued by the state to purchase "goods," which are defined as "supplies, materials, or equipment," services, or public works. (LGS) 2000 GENERAL PROVISIONS Page 7 4/99 If PERFORMING AGENCY subcontracts a portion of this contract, PERFORMING AGENCY agrees to make a good faith effort to subcontract with HUBS during the performance of its contract Attachment(s) with RECEIVING AGENCY and will report HUB subcontract activity on a quarterly basis to RECEIVING AGENCY. PERFORMING AGENCY and its subrecipient(s), if any, are encouraged to use minority banks (a bank which is owned at least 50 percent by minority group members). ARTICLE 10. Certification Regarding License. Certificate. or Permit RECEIVING AGENCY may pay PERFORMING AGENCY only for personnel who are duly licensed and/or qualified to perform required services. PERFORMING AGENCY certifies that no owner, operator, or administrator of PERFORMING AGENCY has had a license, certificate, or permit revoked by any of the Texas state agencies listed below: • Adjutant General's Department • Board of Private Investigators and Private Security Agencies • Interagency Council on Early Childhood Intervention • Texas Alcoholic Beverage Commission • Texas Cancer Council • Texas Children's Trust Fund of Texas Council • Texas Commission for the Deaf and Hard of Hearing • Texas Commission on Alcohol and Drug Abuse • Texas Commission on Jail Standards • Texas Commission on Law Enforcement Officers Standards & Education • Texas Commission on Fire Protection • Texas Council on Sex Offender Treatment • Texas Criminal Justice Policy Council • Texas Department of Criminal Justice • Texas Department of Human Services • Texas Department of Mental Health & Mental Retardation • Texas Department of Protective and Regulatory Services • Texas Department of Public Safety • Texas Department of Health • Texas Health & Human Services Commission • Texas National Guard Armory Board • Texas Polygraph Examiners Board • Texas Rehabilitation Commission • Texas Youth Commission ARTICLE 11. Conflict of Interest PERFORMING AGENCY does not have nor shall it knowingly acquire any interest that would conflict in any manner with the performance of its obligations under this contract. Potential conflicts of interest include an existing business or personal relationship between PERFORMING AGENCY, its principal, or any affiliate or subrecipient with RECEIVING AGENCY, its board members, officers or employees, or any other entity or person involved in any way in any project that is the subject of this contract. (LGS) 2000 GENERAL PROVISIONS Page 8 4/99 ARTICLE 12. Year-2000 Certification PERFORMING AGENCY certifies that any supplied or supported software, hardware, firmware and micro code products used individually or together as a system to comply with RECEIVING AGENCY contract requirements will be year-2000-compliant on or before the date such hardware, software, firmware and systems are to be impacted. Year-2000-compliant means that such product operates "accurately" in the manner in which it was intended as it relates to date related operations when given a "valid date" containing century, year, month, and day. For purposes of this Article, "supplied or supported software, hardware, firmware and micro code products" does not include software supported by RECEIVING AGENCY or an agency of the federal government. PERFORMING AGENCY is responsible for installing and implementing year-2000-compliant versions of any software provided by RECEIVING AGENCY . or an agency of the federal government which is used in performance of this contract. For purposes of this Article, 1) "accurately" is defined to include the following: a) calculations must be correctly performed using four -digit year processing; b) functionality -on-line, batch including entry, inquiry, maintenance and updates must support four -digit year processing; c) interfaces and reports must support four -digit year processing; d) successful translation into year-2000 with the correct system date (e.g., 01/01/2000) must occur without human intervention; e) processing with a four -digit year after transition to any date beyond the year 2000 must occur without human intervention; f) correct results in forward and backward date calculation spanning century boundaries must be provided; g) correct leap year calculations must be performed; and h) processing correct results in forward and backward date calculation spanning century boundaries must occur, including the conversion of previous years currently stored as two digits; 2) "date integrity" shall mean all manipulations of time -related data (dates, durations, days of week, etc.) will produce desired results for all valid date values within the application domain; 3) "explicit century" shall mean date elements in interfaces and data storage permit specifying century to eliminate date ambiguity; 4) "extraordinary actions" shall be defined to mean any action outside the normal documented processing steps identified in the product's reference documentation; 5) "general integrity" shall mean no value for current date will cause interruptions in desired operation - especially from the 20th to 21st centuries; 6) "implicit century" shall mean for any data element without century, the correct century is unambiguous for all manipulations involving that document; (GGS) 2000 GENERAL PROVISIONS Page 9 4/99 7) "product" or "products" shall be defined to include, but is not limited to, any supplied or supported hardware, software, firmware and/or micro code; 8) "valid date" shall contain a two -digit month, a two -digit day and a four -digit year. PERFORMING AGENCY and its subrecipient(s) must obtain a warranty from any vendor/licensor from which it obtains product(s) that product(s) delivered and installed under the contract/license shall be able to accurately process valid date data when used in accordance with the product documentation provided by the contractor/ licensor and require no extraordinary actions on the part of PERFORMING AGENCY, its personnel, or its subrecipient(s). Products under the contract/license possess general integrity, date integrity, explicit and implicit century capabilities. If the contract/license requires that specific products must perform as a system in accordance with the foregoing warranty, then the warranty shall apply to those listed products as a system. The duration of this warranty and the remedies available to PERFORMING AGENCY or its subrecipient(s) for breach of the warranty shall be defined in, and subject to, the terms and conditions of the contractor's standard commercial warranty or warranties contained in the contract/license; provided, that notwithstanding any provision to the contrary in such commercial warranty or warranties, the remedies available to PERFORMING AGENCY or its subrecipient(s) shall include repair or replacement of any supplied product whose noncompliance is discovered and made known to the contractor/licensor in writing within ninety (90) days after final acceptance. Nothing in the warranty shall be considered to limit any rights or remedies PERFORMING AGENCY or its subrecipient(s) may otherwise have under the contract/license with respect to defects other than Year-2000 performance. RECEIVING AGENCY will not hold PERFORMING AGENCY responsible if the information coming to PERFORMING AGENCY's product/software from RECEIVING AGENCY is inaccurate or corrupt. ARTICLE 13. Standards for Financial and Programmatic Management PERFORMING AGENCY shall develop, implement, and maintain financial management and control systems that meet or exceed the requirements of UGMS as detailed in RECEIVING AGENCY's Financial Administrative Procedures Manual. Those requirements shall include at a minimum: A. 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; B. Financial management systems including accurate, correct, and complete payroll, accounting, and financial reporting records; cost source documentation; effective internal and budgetary controls; determination of reasonableness, allowableness, and allocability of costs; and timely and appropriate audits and resolution of any findings; and, C. Billing and collection policies, including a fee 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. PERFORMING AGENCY must bill all third party payers for services provided under the Attachment(s) before submitting any request for reimbursement to RECEIVING AGENCY. A third party payer is any person or entity who has the legal responsibility for paying all or part of the services provided, including commercial health or liability insurance carriers, Medicaid, or other federal, state, local and private funding sources. Third party billing functions will be provided by PERFORMING AGENCY at no cost to the client. PERFORMING (LGS) 2000 GENERAL PROVISIONS Page 10 4/99 AGENCY or its subrecipient must become a Medicaid provider if performing approved Texas Medicaid services authorized by the Attachment(s). PERFORMING AGENCY and its governing body shall bear full responsibility for the integrity of the fiscal and programmatic management. Such responsibility shall include: accountability for all funds and materials received from RECEIVING AGENCY; compliance with RECEIVING AGENCY rules, policies, procedures, and applicable federal and state laws and regulations; and correction of fiscal and program deficiencies identified through self - evaluation and RECEIVING AGENCY's monitoring processes. Ignorance of any contract provisions or other requirements contained or referenced in this contract shall not constitute a defense or basis for waiving or appealing such provisions or requirements. ARTICLE 14. 13ondin� PERFORMING AGENCY is required to carry a ,fidelity bond, insurance coverage or self-insurance equal to the amount of funding provided under the contract Attachment(s) up to $ 100,000 that covers each employee of PERFORMING AGENCY handling funds under this contract, including person(s) authorizing payment of such funds. The fidelity bond, insurance, or self-insurance will provide 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. ARTICLE 15. Funding Participa ion 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. ARTICLE 16. Allowable Costs and Audit Requirements Only those costs allowable under UGMS and any revisions thereto plus any applicable federal cost principles are eligible for reimbursement under this contract. Applicable cost principles, audit requirements, and administrative requirements are as follows: Applicable Cost Principles* I Audit Requirements* I Administrative Requirements* OMB Circular A-87, State & OMB Circular A-133 UGMS Local Governments • OMB Circulars shall be applied with the modifications prescribed by UGMS. PERFORMING AGENCY must have incurred a cost within the applicable Attachment term to be eligible for reimbursement under this contract. PERFORMING AGENCY must incur cost(s) prior to requesting reimbursement under this contract. No later than 90 days after the end of the applicable Attachment term, RECEIVING AGENCY must receive vouchers from PERFORMING AGENCY for costs encumbered by the last day of the applicable Attachment term. Reimbursement requests submitted and postmarked more than 90 days following the end of the applicable Attachment term may or may not be reimbursed, at the discretion of RECEIVING AGENCY. (LGS) 2600 GENERAL PROVISIONS Page 11 4/99 PERFORMING AGENCY or the AUTHORIZED CONTRACTING ENTITY shall arrange for a financial and compliance audit (Single Audit) if required by OMB Circular A-133 and/or UGMS. The audit shall be of PERFORMING AGENCY's or the AUTHORIZED CONTRACTING ENTITY's fiscal year. The audit must be conducted by an independent certified public accountant and in accordance with applicable OMB Circulars, Government Auditing Standards, and UGMS. PERFORMING AGENCY shall procure audit services in compliance with state procurement procedures, as well as with the provisions of UGMS. If PERFORMING AGENCY is not required to have a Single Audit, a limited scope audit may be required. RECEIVING AGENCY will provide PERFORMING AGENCY with written audit requirements if a limited scope audit is required. Within 30 days of receipt of the audit reports required by this section, PERFORMING AGENCY/AUTHORIZED CONTRACTING ENTITY shall submit a copy to RECEIVING AGENCY's Internal Audit Division. ARTICLE 17. Terms and Conditions of Payment For services satisfactorily performed pursuant to this contract, RECEIVING AGENCY will reimburse PERFORMING AGENCY for allowable costs. Reimbursements are contingent on a signed contract and will not exceed the total of each Attachment(s). PERFORMING AGENCY is entitled to payment only if the service, work, and/or product has been satisfactorily performed and authorized in accordance with this contract. PERFORMING AGENCY must submit requests for reimbursement on a State of Texas Purchase Voucher (TDH Form 13-13) or any other form designated by RECEIVING AGENCY. PERFORMING AGENCY shall submit vouchers for reimbursement monthly within 30 days following the end of the month covered by the bill. PERFORMING AGENCY shall submit a reimbursement request as a final close-out bill not later than 90 days following the end of the applicable Attachment term(s). Reimbursement requests submitted and postmarked more than 90 days following the end of the applicable Attachment term may not be paid, at the discretion of RECEIVING AGENCY. For any contract Attachment(s) beginning on or after September 1, 1999, PERFORMING AGENCY shall disburse program income, rebates, refunds, contract settlements, audit recoveries and interest earned on such funds before requesting cash payments including advance payments from RECEIVING AGENCY. RECEIVING AGENCY is required to place PERFORMING AGENCY on Direct Deposit status in accordance with Texas Government Code, §403.016(c), VTCA. PERFORMING AGENCY will no longer receive copies of vouchers. Funding from this contract may not be used to supplant state or local funds, but PERFORMING AGENCY shall use the funds from this contract to increase state or local funds currently available for a particular activity. PERFORMING AGENCY shall maintain its current level of support, if possible. RECEIVING AGENCY shall determine whether costs submitted by PERFORMING AGENCY are allowable and reimbursable. If RECEIVING AGENCY has paid funds to PERFORMING AGENCY for unallowable or ineligible costs, PERFORMING AGENCY shall return the funds to RECEIVING AGENCY within 30 days of written notice. RECEIVING AGENCY may withhold all or part of any payments to PERFORMING AGENCY to offset reimbursement for any ineligible expenditures that PERFORMING AGENCY has not refunded to RECEIVING (LGS) 2000 GENERAL PROVISIONS Page 12 4/99 AGENCY. RECEIVING AGENCY may take repayment from funds available under any contract Attachment, active or expired, in amounts necessary to fulfill PERFORMING AGENCY repayment obligations. ARTICLE 18. Advance Pants PERFORMING AGENCY may request a one-time advance for each Attachment only to meet immediate need for cash disbursement. PERFORMING AGENCY must make the request on a State of Texas Purchase Voucher, accompanied by written justification and supporting documentation as specified in RECEIVING AGENCY's Financial Administrative Procedures Manual. The advance shall be requested at the beginning of the applicable Attachment period or at a later time in the applicable Attachment period if circumstances so warrant. Approval of the request for advance will be at the discretion of RECEIVING AGENCY. If the request is approved, the voucher will be processed; if disapproved, RECEIVING AGENCY will provide written notification to PERFORMING AGENCY. RECEIVING AGENCY will determine the amount of the advance, if any, by the amount and term of the applicable Attachment(s). For each Attachment, the amount of the advance shall not exceed an amount equal to the amount of the Attachment divided by the number of months covered by the Attachment multiplied by two (2). Advance funds will be expended during the applicable Attachment term so that, after the final monthly billing, PERFORMING AGENCY will not have advance funds on hand. If the Attachment is amended to increase or decrease the total amount, RECEIVING AGENCY may make an upward or downward adjustment to the allowable advance in accordance with the above formula. If PERFORMING AGENCY is requesting an upward adjustment, PERFORMING AGENCY must submit a written justification and State of Texas Purchase Voucher in the amount necessary to correct the ratio. If the adjustment is downward, RECEIVING AGENCY will determine the amount of adjustment to the advance and the method of repayment. ARTICLE 19. Program Income PERFORMING AGENCY may, but if a local health department shall, develop a fee -for -service system and a schedule of fees for personal health services in accordance with the provisions of Chapter 12, Subchapter D, Health and Safety Code, VTCA; the Texas Board of Health rules covering Fees for Clinical Health Services, 25 TAC §1.91; and other applicable laws. No patient may be denied a service due to inability to pay. 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. PERFORMING AGENCY shall identify and report this income utilizing the forms and time frames specified in the Reports Article of these provisions. PERFORMING AGENCY shall utilize one of the following methods for applying program income: 1. Additive method - add the program income to the funds already committed to the project by both parties. Program income will be used by PERFORMING AGENCY to further the program objectives of the state/federal statute under which the Attachment(s) was/were made, and it shall be spent on the same project in which it was generated. 2. Deductive method - deduct the program income from the total allowable costs to determine the net allowable costs. (LGS) 20bO GENERAL PROVISIONS Page 13 4/99 PERFORMING AGENCY must expend program income during the Attachment term in which it is earned, and may not carry forward to the succeeding term. Program income not expended in the term in which it is earned shall be refunded to RECEIVING AGENCY. RECEIVING AGENCY may base future funding levels, in part, upon PERFORMING AGENCY's proficiency in identifying, billing, collecting, and reporting program income, and in utilizing it for the purposes and conditions of the applicable Attachment(s). ARTICLE 20. Overtime Compensation PERFORMING AGENCY shall not use any of the funds provided by the Attachment(s) hereto to pay the premium portion of overtime. PERFORMING AGENCY shall be responsible for any obligations of premium overtime pay due employees. Premium overtime pay is defined as any compensation paid to an individual in addition to the normal rate of pay for hours worked in excess of normal working hours. ARTICLE 21. Equipment and Supplies In accordance with Health & Safety Code, § 12.053, VTCA, title to all equipment and supplies purchased from funds from this contract will be in the name of PERFORMING AGENCY throughout the Attachment(s) term(s) or until the Attachment is terminated. Equipment is defined as tangible nonexpendable property with an acquisition cost of more than $1,000 and a useful life of more than one year, with the following exceptions: fax machines, stereo systems, cameras, video recorder/players, microcomputers, software, medical equipment, laboratory equipment, and printers. If the unit cost of these exception items is more than $500, they will still be considered equipment, must be approved for purchase, and are considered capital assets for inventory purposes. Medical and laboratory equipment in this category is defined as microscopes, oscilloscopes, centrifuges, balances, and incubators. Medical and laboratory equipment not included in these five categories is not considered a capital asset unless the unit value is more than $1,000. Supplies which may be necessary to cant' out the contract include medical supplies, drugs, janitorial supplies, office supplies, patient educational supplies, software less than $500, plus any equipment with a purchase price including freight not to exceed $1,000 per item, except those defined as "equipment." Unless initially listed and approved in the Attachment(s), prior written approval from RECEIVING AGENCY is required for any changes to approved equipment purchases meeting the above equipment definition. To receive approval to purchase data processing hardware and software or enhancements, PERFORMING AGENCY must submit a detailed justification and specification which include a description of features, make and model, and cost, etc. PERFORMING AGENCY shall maintain a property inventory and submit an annual cumulative report (TDH Form GC- l 1) to RECEIVING AGENCY no later than October 15th of each year. PERFORMING AGENCY shall administer a program of maintenance, repair, and protection of assets under this contract 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 contract, it shall use the proceeds to repair or replace said assets. Upon termination or expiration of applicable Attachment(s), title to any remaining equipment and supplies purchased from funds under this contract reverts to RECEIVING AGENCY. Title may be transferred to any other (LGS) 2000 GENERAL PROVISIONS Page 14 4/99 .1 4 party designated by RECEIVING AGENCY. RECEIVING AGENCY may, at its option and to the extent allowed by law, transfer the reversionary interest to such property to PERFORMING AGENCY. ARTICLE 22. Contracts with Subrecipients PERFORMING AGENCY may enter into contracts with subrecipients unless restricted or otherwise prohibited in specific Attachment(s). PERFORMING AGENCY is responsible to RECEIVING AGENCY for the performance of any subrecipient. Contracts with subrecipients shall be in writing and must include the following: • name and address of all parties; • a detailed description of the services to be provided; • measurable method and rate of payment and total amount of the contract; • clearly defined and executable termination clause; • beginning and ending dates which coincide with the dates of the applicable contract Attachment(s) or cover a term within the beginning and ending dates of the applicable contract Attachment(s); • access to inspect the work and the premises on which any of the work is performed, in accordance with the Inspections Article contained in this contract; and • all clauses required by statelfederal statutes, executive orders, and their implementing regulations. PERFORMING AGENCY agrees that all contracts with subrecipients containing a categorical budget shall include audit requirements referenced in the Allowable Costs and Audit Requirements Article of this contract, as appropriate. Prior to entering into an agreement equaling $25,000 or 25% of an Attachment, whichever is greater, PERFORMING AGENCY shall obtain written approval from RECEIVING AGENCY. PERFORMING AGENCY shall ensure that: • subrecipients are fully aware of the requirements imposed upon them by state/federal statutes and regulations; • subrecipients comply with all financial management requirements as defined by RECEIVING AGENCY and the applicable OMB circulars; • subrecipients complete required audits; • an adequate tracking system is maintained to ensure timely receipt of any subrecipient's required audit reports and the resolution of any findings and questioned costs cited by these reports. ARTICLE 23. Contracts for Procurement PERFORMING AGENCY may enter into contracts for procurement unless restricted or otherwise prohibited in specific Attachment(s). PERFORMING AGENCY agrees that it shall be responsible to RECEIVING AGENCY for the performance of any subcontracted activity. Contracts for procurement shall be in writing and must contain the following provisions: (LGS) 2000 GENERAL PROVISIONS Page 15 4/99 • Administrative, contractual, or legal remedies in instances where contractors violate or breach contract terms, and provide for such sanctions and penalties as may be appropriate (contracts other than small purchases). • Termination for cause and for convenience by PERFORMING AGENCY including the manner by which it will be effected and the basis for settlement (all contracts in excess of $10,000). • Compliance with the Copeland "Anti -Kickback" Act (18 USC §874) as supplemented in Department of Labor regulations (29 CFR Part 3) (all contracts and subgrants for construction or repair). • Compliance with §§103 and 107 of the Contract Work Hours and Safety Standards Act (40 USC §§327-330) as supplemented by Department of Labor regulations (29 CFR Part 5) (construction contracts awarded by grantees and subgrantees in excess of $2,000, and in excess of $2,500 for other contracts which involve the employment of mechanics or laborers). • Notice of RECEIVING AGENCY requirements and regulations pertaining to reporting. • Notice of RECEIVING AGENCY requirements and regulations pertaining to patent rights with respect to any discovery or invention which arises or is developed in the course of or under such contract. • RECEIVING AGENCY requirements and regulations pertaining to copyrights and rights in data. • Access by RECEIVING AGENCY, the federal grantor agency, the Comptroller General of the United States, the State of Texas or any of their duly authorized representatives to any books, documents, papers, and records of the contractor which are directly pertinent to that specific contract for the purpose of making audit, examination, excerpts, and transcriptions. • Retention of all required records for three years after RECEIVING AGENCY make final payments and all other pending matters are closed. • Compliance with all applicable standards, orders, or requirements issued under §306 of the Clean Air Act (42 USC § 1857(h)), §508 of the Clean Water Act (33 USC § 1368), Executive Order 11738, and Environmental Protection Agency regulations (40 CFR Part 15) (contracts, subcontracts, and subgrants of amounts in excess of $100,000). • Mandatory standards and policies relating to efficiency which are contained in the state energy plan issued in compliance with the Energy Policy and Conservation Act (P. L. 94-163). ARTICLE 24. Reports Financial reports are required as provided in UGMS, and PERFORMING AGENCY shall file them regardless of whether expenses have been incurred. For each Attachment, PERFORMING AGENCY shall submit a Financial Status Report, State of Texas Supplemental Form 269a (TDH Form GC-4a) within 30 days following the end of each of the first three quarters. PERFORMING AGENCY shall submit a final financial report on State of Texas Supplemental Form 269a (TDH Form GC-4a), not later than 90 days following the end of the Attachment term(s). PERFORMING AGENCY shall submit a State of Texas Purchase Voucher if all costs have not been recovered, or PERFORMING AGENCY shall refund excess monies if costs incurred were less than funds received. Failure to file a purchase voucher in a timely manner may result in RECEIVING AGENCY disallowing payment. PERFORMING AGENCY shall submit the financial, program, and progress reports required by RECEIVING AGENCY in the format agreed to by the parties. PERFORMING AGENCY shall provide RECEIVING AGENCY other reports including financial reports RECEIVING AGENCY determines to be necessary to accomplish the (LGS) 26M GENERAL PROVISIONS Page 16 4/99 objectives of this contract. If PERFORMING AGENCY is legally prohibited from providing such reports, it shall immediately notify RECEIVING AGENCY. ARTICLE 25. Inspections 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 reviews of client or patient records and discussions with staff) performed by PERFORMING AGENCY and its subrecipient(s), if any, and the premises on which the work is being performed. PERFORMING AGENCY and its subrecipient(s) shall participate in inspections 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 interfere with the work. PERFORMING AGENCY and its subrecipient(s), if any, shall give RECEIVING AGENCY, the federal government, and the Texas State Auditor, or any of their duly authorized representatives, access to any pertinent books, documents, papers, and client or patient records, if any, 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 RECEIVING AGENCY determination of either an inadequate or inappropriate resolution of the findings may result in sanctions which will remain in effect until RECEIVING AGENCY determines the deficiencies are properly remedied. ARTICLE 26. Records Retention PERFORMING AGENCY shall retain, preserve and make available all required records for a period of three years from the date of the last expenditure report submitted under contract Attachment(s) or until all audit questions are resolved, or until any court orders requiring record retention are dissolved, whichever time period is longer. Microfilm copies of records required to be kept under the Attachment(s) may be substituted for the originals in accordance with guidelines and procedures approved by RECEIVING AGENCY, provided that the microfilm procedures are reliable and are supported by an adequate retrieval system, unless otherwise ordered by a court of general jurisdiction. ARTICLE 27. Client Records Notwithstanding any other provision herein, if requested by RECEIVING AGENCY, PERFORMING AGENCY shall share all patient information with RECEIVING AGENCY when the contract involves patient care by the PERFORMING AGENCY. RECEIVING AGENCY may require PERFORMING AGENCY, or any subrecipient, to transfer a client or patient record to another agency or to RECEIVING AGENCY if the transfer is necessary to protect either the confidentiality of the record or the health and welfare of the client or patient. (LGS) 2000 GENERAL PROVISIONS Page 17 4/99 In the event of termination, RECEIVING AGENCY may require the transfer of client or patient records as authorized by law upon written notice to PERFORMING AGENCY, either to another entity that agrees to continue the service or to RECEIVING AGENCY. At the end of the Attachment term, PERFORMING AGENCY shall give RECEIVING AGENCY access to the records or provide copies for audit, examination, evaluation, inspection, litigation, or other circumstances that may arise, to the extent authorized by law. PERFORMING AGENCY, or any subrecipient, shall not otherwise transfer an identifiable 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. Written consent must be given on a form provided by RECEIVING AGENCY or as otherwise authorized by law, including the Texas Medical Practice Act, Article 4495b, TRCS. ARTICLE 28. Confidentiality PERFORMING AGENCY shall 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 this contract. PERFORMING AGENCY shall not disclose or transfer confidential client or patient information, including information required by the Reports Article, except in accordance with applicable law. If providing direct client care, services, or programs, PERFORMING AGENCY shall implement RECEIVING AGENCY's workplace policies based on the model guidelines, and PERFORMING AGENCY shall educate employees and clients concerning the human immunodeficiency virus (HIV) and its related conditions, including acquired immunodeficiency syndrome (AIDS), in accordance with the Health and Safety Code, §§85.112-114, VTCA. ARTICLE 29. Sanctions RECEIVING AGENCY may impose sanctions for any breach of contract, and will monitor PERFORMING AGENCY for both programmatic and financial compliance. RECEIVING AGENCY may, at its own discretion, impose one or more sanctions for each item of noncompliance and will determine sanctions on a case -by -case basis. A state or federal statute, rule, regulation, or federal guideline will prevail over the provisions of this Article unless the statute, rule, regulation, or guideline can be read together with the provision(s) of this Article to give effect to both. RECEIVING AGENCY may: A. terminate all or a part of the contract. Termination is the permanent withdrawal of PERFORMING AGENCY's authority to obligate previously awarded funds before that authority would otherwise expire or the voluntary relinquishment by PERFORMING AGENCY to obligate previously awarded funds. PERFORMING AGENCY costs resulting from obligations incurred by PERFORMING AGENCY after termination of an award are not allowable unless expressly authorized by the notice of termination. Termination does not include: (1) withdrawal of funds awarded on the basis of PERFORMING AGENCY's underestimate of the unobligated balance in a prior period; (2) withdrawal of the unobligated balance as of the expiration of a contract; (3) refusal to extend a contract or award additional funds, to make a competing or noncompeting continuation, renewal, extension, or supplemental award; or (4) voiding of a contract upon determination that the award was obtained fraudulently, or was otherwise illegal or invalid from inception; (LGS) 2000 GENERAL PROVISIONS Page 18 4/99 I.:.. I I 1 I. a 1 B. suspend all or part of the contract. Suspension is, depending on the context, either (1) the temporary withdrawal of PERFORMING AGENCY's authority to obligate funds pending corrective action by PERFORMING AGENCY or its subrecipient(s) or pending a decision to terminate or amend the contract, or (2) an action taken by a suspending official in accordance with agency regulations implementing Executive Order 12549 to immediately exclude a person from participating in contract transactions for a period, pending completion of an investigation and such legal or debarment proceedings as may ensue. PERFORMING AGENCY costs resulting from obligations incurred by PERFORMING AGENCY during a suspension are not allowable unless expressly authorized by the notice of suspension; C. disallow (deny both use of funds and matching credit for) all or part of the activities or action not in compliance; D. temporarily withhold cash payments. Temporarily withholding cash payments means the temporary withholding of advances or reimbursements to PERFORMING AGENCY or its subrecipient(s) for proper charges or obligations incurred, pending resolution of issues of noncompliance with contract conditions or indebtedness to the United States or to the State of Texas; E. permanently withhold cash payments. Permanently withholding of cash payment means that RECEIVING AGENCY retains funds billed by PERFORMING AGENCY or its subrecipient(s) for a) unallowable, undocumented, disputed, inaccurate, improper, or erroneous claims; b) failure to comply with contract provisions; or c) indebtedness to the United States or to the State of Texas; F. deny contract renewal or future contract awards to a PERFORMING AGENCY for a certain period of time not to exceed five years; G. delay contract execution with PERFORMING AGENCY while other imposed or proposed sanctions are pending resolution; H. place PERFORMING AGENCY on probation. Probation means that PERFORMING AGENCY will be placed on accelerated monitoring for a period not to exceed six months at which time items of noncompliance must be resolved or substantial improvement shown by PERFORMING AGENCY; I. conduct accelerated monitoring of PERFORMING AGENCY. Accelerated monitoring means more frequent or more extensive monitoring will be performed by RECEIVING AGENCY than would routinely be accomplished; J. require PERFORMING AGENCY to obtain technical or managerial assistance; K. disallow requests for reimbursement by disapproving costs or fees submitted for payment or reimbursement by PERFORMING AGENCY; L. establish additional prior approvals for expenditure of funds by PERFORMING AGENCY; M. require additional, more detailed, financial and/or programmatic reports to be submitted by PERFORMING AGENCY; N. demand repayment from PERFORMING AGENCY; (LGS) 2000 GENERAL PROVISIONS Page 19 4/99 O. reduce the contract funding amount for failure to achieve or maintain the proposed level of service, to expend funds appropriately and at a rate which will make full use of the award, or to provide services as set out in the contract; and P. impose other remedies provided by law. RECEIVING AGENCY will formally notify PERFORMING AGENCY in writing when a sanction is imposed (with the exception of accelerated monitoring, which may be unannounced), stating the nature of the sanction(s), the reasons for imposing them, the corrective actions which must be taken before they will be removed and the time allowed for completing the corrective actions, and the method, if any, of requesting reconsideration of the sanctions imposed. PERFORMING AGENCY is required to file, within 1S days of receipt of notice, a written response to RECEIVING AGENCY's program/division that sent the notice, acknowledging receipt of such notice and stating how PERFORMING AGENCY will correct the noncompliance or demonstrating in writing that the findings on which the sanctions are based are either invalid or do not warrant the sanction(s). If RECEIVING AGENCY determines that a sanction is warranted, and unless the sanction is subject to review (see Sanction Review Article) RECEIVING AGENCY's decision is final and PERFORMING AGENCY must take corrective action. In an emergency, RECEIVING AGENCY may immediately terminate or suspend all or part of the contract, temporarily or permanently withhold cash payments, deny contract renewal or future contract awards, or delay contract execution by delivering written notice to PERFORMING AGENCY, by any verifiable method, stating the reason for the emergency action. An "emergency" is defined as the following: • PERFORMING AGENCY is noncompliant and the noncompliance has a direct adverse impact on the public or client health or safety. The direct adverse impact may be programmatic or financial, impacting health or safety by failing to provide services, providing inadequate services, providing unnecessary services, or utilizing resources so that the public or clients do not receive the benefits contemplated by the contract scope of work or performance measures; • PERFORMING AGENCY fails to achieve a performance measure; • PERFORMING AGENCY is reimbursed or requesting reimbursement for expenditures which are not in accordance with applicable federal or state laws and regulations or the provisions of the contract; or • PERFORMING AGENCY is expending funds inappropriately. Whether PERFORMING AGENCY's conduct or inaction is an emergency shall be determined by RECEIVING AGENCY on a case -by -case basis and shall be based upon the egregious nature of the noncompliance or conduct. ARTICLE 30. Sanction Review PERFORMING AGENCY may request a review of the imposition of the following sanctions: termination of all or part of the contract, suspension of all or part of the contract, permanent withholding of cash payments, and denial of contract renewal or future contract awards. PERFORMING AGENCY must make the request for review in writing to RECEIVING AGENCY within fifteen (1 S) days from the date of notification by providing written notice of the dispute to the person who signed the notification. (LGS) 2060 GENERAL PROVISIONS Page 20 4/99 PERFORMING AGENCY's notice shall contain the following: (1) a copy of the letter from RECEIVING AGENCY notifying PERFORMING AGENCY of the sanction; (2) a specific description of each act that is the basis for the dispute; (3) the grounds upon which PERFORMING AGENCY bases the complaint; (4) an identification of the issue or issues to be resolved; (5) a precise statement of the relevant facts; (6) any documentation in support of PERFORMING AGENCY's position; and (7) a statement and authorities in support of PERFORMING AGENCY's position. Evidence that PERFORMING AGENCY properly notified RECEIVING AGENCY consists of any of the following documents: (1) signature on delivery card; (2) confirmation of a facsimile to the correct telephone number, or (3) signed acknowledgment of delivery. RECEIVING AGENCY's representative will schedule a meeting or a conference call to attempt to resolve the issues in dispute. If the dispute is resolved, any resolution will be in writing and will be signed by all parties. If the dispute is not resolved, RECEIVING AGENCY's representative will notify PERFORMING AGENCY in writing. RECEIVING AGENCY will appoint a reviewer(s), who will review the information, who may permit or require additional information and who may grant, deny, or modify all relief requested in the written notice of dispute. The reviewer(s)'s decision will be in writing and will contain a discussion of the reason for the decision and the remedial action, if any. The reviewer(s) will send copies of the decision to all parties by any verifiable means. The decision of the reviewer(s) is final and is the final action of RECEIVING AGENCY for purposes of further proceedings. A state statute or rule or a federal statute, regulation or guideline will prevail over the provisions of this Article unless the statute, rule, regulation or guideline can be read together with the provision or provisions of this Article to give effect to both. ARTICLE 31. Breach of Contract Any remedies set out in this contract are in addition to rights and remedies for breach of contract provided by law. ARTICLE 32. Termination Each Attachment shall terminate upon the expiration date of the Attachment unless extended by written amendment in accordance with the Amendments Article. Prior to completion of the contract term, all or a part of this contract may be terminated with or without cause as set out below. A. Termination without cause. (1) Either party may terminate this contract with at least 90 days prior written notice to the other Ply (2) The parties may terminate this contract by mutual agreement. (3) Either party may terminate this contract with at least 30 days prior written notice to the other party in the event state and/or federal funding for this contract is terminated, limited, suspended, or withdrawn. (4) RECEIVING AGENCY may terminate this contract when, in the sole determination of RECEIVING AGENCY, termination is in the best interest of the State of Texas. aGS) 2000 GENERAL PROVISIONS Page 21 4/99 B. Termination for cause. (1) Either party may terminate for material breach of contract with at least 30 days written notice to the other party. (2) RECEIVING AGENCY may terminate this contract, in whole or in part, for breach of contract or for risky conduct by giving at least 30 days written notice to PERFORMING AGENCY. "Risky conduct" may include one or more of the following: (a) A court of competent jurisdiction finds that PERFORMING AGENCY has failed to adhere to any laws, ordinances, rules, regulations or orders of any public authority having jurisdiction; (b) PERFORMING AGENCY fails to communicate with RECEIVING AGENCY or fails to allow its employees or those of its subrecipients to communicate with RECEIVING AGENCY as necessary to the performance of the contract; (c) PERFORMING AGENCY breaches a standard of confidentiality with respect to the services provided under this contract; (d) RECEIVING AGENCY determines that PERFORMING AGENCY is without the personnel or resources to perform under the contract; (e) RECEIVING AGENCY determines that PERFORMING AGENCY, its agent or another representative offered or gave a gratuity (e.g., an entertainment or gift) to an official or employee of RECEIVING AGENCY for the purpose of obtaining a contract or favorable treatment; (f) PERFORMING AGENCY's management system does not meet the UGMS management standards; or (g) PERFORMING AGENCY appears to be financially unstable. Indicators of fmancial instability may include one or more of the following: (i) PERFORMING AGENCY fails to make payments; (ii) PERFORMING AGENCY makes an assignment for the benefit of its creditors; (iii) PERFORMING AGENCY admits in writing its inability to pay its debts generally as they become due; or (iv) If judgment for the payment of money in excess of $50,000 (which is not covered by insurance) is rendered by any court or governmental body against PERFORMING AGENCY, and PERFORMING AGENCY does not (a) discharge the judgment or (b) provide for its discharge in accordance with its terms, or (c) procure a stay of execution within 30 days from the date of entry thereof, and within the 30-day period or a longer period during which execution of the judgment shall have been stayed, appeal therefrom and cause the execution (LGS) 2000 GENERAL PROVISIONS Page 22 4/99 thereof to be stayed during such appeal while providing such reserves therefore as may be required under generally accepted accounting principles. C. Emergency termination. RECEIVING AGENCY may terminate the contract immediately upon notice to PERFORMING AGENCY in an emergency by any verifiable means. "Emergency" is defined in the Sanctions Article. Either party may deliver written notice of intent to terminate by any verifiable method. If either party gives notice of its intent to terminate all or a part of this contract, RECEIVING AGENCY and PERFORMING AGENCY will try to resolve any issues related to the anticipated termination in good faith during the notice period. Upon termination of all or part of this contract, RECEIVING AGENCY and PERFORMING AGENCY will be discharged from any further obligation created under the applicable terms of this contract except for the equitable settlement of the respective accrued interests or obligations incurred prior to termination. Termination does not, however, constitute a waiver of any remedies .for breach of this contract. In addition, the obligations of PERFORMING AGENCY to retain records and maintain confidentiality of information shall survive this contract. ARTICLE 33. Void Contract RECEIVING AGENCY may hold a contract void upon its determination that the contract award was obtained fraudulently or was otherwise illegal or invalid from its inception. ARTICLE 34. Severability If any provision of this contract is construed to be illegal or invalid, the illegal or invalid provision will be deemed stricken and deleted to the same extent and effect as if never incorporated, but all other provisions will continue. ARTICLE 35. Local Health Department Personnel All local health department 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 the payment to such employee of a so-called "flat rate" car allowance or travel allowance. Any travel or per diem allowance 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. (LGS) 2000 GENERAL PROVISIONS Page 23 4/99 PERFORMING AGENCY will utilize RECEIVING AGENCY's policies and procedures for hiring and promoting individuals into state -budgeted positions funded by this contract. Qualifications of any individuals filling these positions will be subject to approval of RECEIVING AGENCY's Bureau of Human Resources. 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 costs on state -budgeted positions. RECEIVING AGENCY will furnish documentation regarding salary compensation or travel reimbursement for 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 applicable 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 if the request is granted. ARTICLE 36. Survival of Terms Termination or expiration of this contract for any reason shall not release either party from any liabilities or obligations set forth in this contract that (a) the parties have expressly agreed shall survive any such termination or expiration, or (b) remain to be performed or by their nature would be intended to be applicable following any such termination or expiration. ARTICLE 37. No Waiver of Sovereign Immunity THE PARTIES EXPRESSLY AGREE THAT NO PROVISION OF THIS CONTRACT IS IN ANY WAY INTENDED TO CONSTITUTE A WAIVER OF ANY IMMUNITIES FROM SUIT OR FROM LIABILITY THAT THE PARTIES OR THE STATE OF TEXAS MAY HAVE BY OPERATION OF LAW. ARTICLE 38. Certifications The governing body of each party has authorized this contract. RECEIVING AGENCY is paying for the performance of governmental functions and services from current revenues available to RECEIVING AGENCY. The payment is in an amount that fairly compensates PERFORMING AGENCY for the services or functions performed under the contract. (LGS) 2000 GENERAL PROVISIONS Page 24 4/99 DOCUMENT NO. 7560005906-00 ATTACHMENT NO. 02 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: IMMUNIZATION DMSION TERM: September 01, 1999 THRU: August 31, 2000 SECTION I. SCOPE OF WORK: The goal of RECEIVING AGENCY Program is to prevent, control, and eliminate indigenous vaccine -preventable diseases by providing and administering biologicals, promoting immunizations, conducting vaccine -preventable disease surveillance, and applying principles of epidemiology and outbreak control measures within budgetary constraints. PERFORMING AGENCY shall implement an immunization program for children, with special emphasis on children two years of age or younger (less than 36 months of age). PERFORMING AGENCY will incorporate traditional and nontraditional, systematic approaches designed to eliminate barriers, expand immunization delivery, and establish uniform policies to immunize children and adolescents appropriately. PERFORMING AGENCY shall formulate and implement a comprehensive immunization policy for all employees according to the most current Advisory Committee on Immunization Practices (ACID) statement: "Immunization of Health -Care Workers." PERFORMING AGENCY shall submit a detailed personnel report by the first working day of the fifth month of this contract Attachment term to RECEIVING AGENCY Program, outlining positions funded through this contract Attachment. The report will contain the following information: • Position Title and Classification • Monthly and Yearly Salary • Job Description • Percent of time allocated to each major job task PERFORMING AGENCY will attend and participate in at least one seminar or training session addressing the immunization requirements for children and students enrolled in Texas public and private schools and licensed child-care facilities. PERFORMING AGENCY shall investigate all suspected cases of invasive Haemophilus influenzae disease in children less than 5 years of age and all suspected cases of measles, rubella, pertussis, paralytic poliomyelitis, diphtheria, and all suspected deaths due to varicella (chickenpox) within 24 hours of receipt of the initial case report. PERFORMING AGENCY shall investigate all suspected cases of mumps, tetanus, and hepatitis B infection in pregnant women and in children less than 7 years of age within 48 hours of receipt of the initial case report. ATTACHMENT - Page 1 PERFORMING AGENCY shall complete all case investigation forms and provide completed epidemiologic data and completed investigation forms to RECIVING AGENCY Program, within 30 days of the initial case report, on the following: • All reported cases of invasive Haemophilus influenzae disease in children less than five (5) years of age; • All reported cases of hepatitis B infection in pregnant women and in children less than seven (7) years of age; • All deaths due to varicella (chickenpox); and, • All reported cases of measles, mumps, rubella, congenital rubella syndrome, pertussis, diphtheria, and paralytic poliomyelitis. PERFORMING AGENCY shall adhere to the Vaccine -Preventable Disease Surveillance Guidelines provided by RECEIVING AGENCY Program and shall implement the most current outbreak control procedures and measures as recommended in those guidelines. PERFORMING AGENCY shall implement an immunization reminder and recall system to notify parents or guardians of children when immunizations are due. The notifications may be automated or manual and may include mailed or telephone contacts. Extra efforts shall be made to notify parents or guardians of children at high -risk of failure to complete the vaccines on schedule (e.g., children who start their vaccines late). PERFORMING AGENCY shall provide immunization services outside usual clinic hours (which are 8:00 a.m. to 5:00 p.m., Monday through Friday) at least once each month or as needed to insure barrier -free access to immunization clinics. PERFORMING AGENCY residency requirements are not applicable under this contract Attachment. PERFORMING AGENCY shall not deny vaccinations to recipients because they do not reside within PERFORMING AGENCY'S jurisdiction. PERFORMING AGENCY will maintain an accurate, up-to-date list of clinics and sites where public sector (free or low cost) immunization services are offered in PERFORMING AGENCY'S local area. PERFORMING AGENCY will update the clinic list monthly and provide the updates to local area Temporary Aid to Needy Families (TANF) offices and to the Immunization Communication and Training Program of RECEIVING AGENCY. No fee may be charged for vaccines provided by RECEIVING AGENCY Program. All vaccines obtained from RECEIVING AGENCY Program shall be used solely for purposes of this contract Attachment and shall not be sold to agencies or individuals. PERFORMING AGENCY shall not collect vaccine administration fees from Medicaid recipients. Vaccine administration fees collected from non -Medicaid patients shall be kept within guidelines established by RECEIVING AGENCY. In accordance with 25 TAC §1.91, no one may be denied immunization services in public clinics because of inability to pay the administration fee. Fee schedules shall not be based on vaccine type, formulation, or dose in series. A copy of PERFORMING AGENCY'S fee schedule shall be submitted to RECEIVING AGENCY Program by the first working day of the fifth month of this contract Attachment term. ATTACHMENT - Page 2 All equipment and vaccine used by PERFORMING AGENCY ,,which are provided by RECEIVING AGENCY Program shall be accounted for as public property. RECEIVING AGENCY Program may investigate equipment or vaccine loss, destruction, spoilage, or other waste and may then require PERFORMING AGENCY to replace or reimburse RECEIVING AGENCY Program for them. PERFORMING AGENCY shall record vaccine lot numbers on all vaccine storage records and in individual clinic immunization records to ensure a vaccine audit trail. PERFORMING AGENCY shall provide RECEIVING AGENCY Program with a copy of any local agency audit of immunization program funds and vaccines. PERFORMING AGENCY shall submit a report to RECEIVING AGENCY Program for the previous calendar year that details storage measures and methods used to control vaccine loss, including methods to monitor and record daily vaccine storage temperatures. The report shall be submitted by the first working day of the fifth month of this contract Attachment term in a format provided by RECEIVING AGENCY Program. PERFORMING AGENCY will assist in distributing state -supplied vaccines to "Texas Health Steps" providers, Medicaid providers, physicians, and other providers and organizations within PERFORMING AGENCY'S local area. PERFORMING AGENCY shall provide the parent, managing conservator, or guardian of each patient with a form, developed by RECEIVING AGENCY Program in compliance with 25 TAC, Chapter 100. This form will allow the parent, managing conservator, or guardian to authorize participation in the Immunization Tracking System (ImmTrac). When this form is signed and returned to PERFORMING AGENCY, PERFORMING AGENCY shall comply with the requirements of 25 TAC, Chapter 100 and provide an immunization history to RECEIVING AGENCY Program. PERFORMING AGENCY shall provide RECEIVING AGENCY Program weekly data transfers of all vaccines administered, detailed by client name, demographics, and dose information. The data shall be submitted in a format provided by RECEIVING AGENCY Program for inclusion in the state's immunization registry (ImmTrac). PERFORMING AGENCY shall comply with all applicable federal and state laws, rules, regulations, standards, and guidelines in effect on the beginning date of this contract Attachment unless replaced by subsequent amendment. The following documents are incorporated by reference and made a part of this contract Attachment. These include: • Human Resources Code §42.043, VTCA; • Education Code §§38.001-38.002, VTCA; • Health and Safety Code §§81.023 and 161.001-161.009, VTCA; • 25 TAC §§97.61-97.77 and 97.101-97.102; • 25 TAC, Chapter 100; • 42 USC §§247b and 300 as-25; • Omnibus Budget Reconciliation Act of 1993, 26 USC §4980B; • RECEIVING AGENCY'S Client Services Standards for Public Health and Community Clinics, revised June 1997; and ATTACHMENT - Page 3 Standards for Pediatric Immunization Practices, February 1996, recommended by the National Vaccine Advisory Committee, approved by the United States Public Health Service, and endorsed by the American Academy of Pediatrics. Any amended guidelines will become effective within thirty (30) days of receipt by PERFORMING AGENCY. If PERFORMING AGENCY does not consent to comply with these guidelines, PERFORMING AGENCY may exercise the termination option set out in the General Provisions. The following performance measure(s) will be used, in part, to assess PERFORMING AGENCY'S effectiveness in providing the services described in this contract Attachment, without waiving the enforceability of any of the terms of the contract. PERFORMING AGENCY shall provide an estimated 20,929 doses of vaccine to clients who live or receive services in the following county(ies)/area defined as: Lubbock, and surrounding counties. PERFORMING AGENCY shall provide RECEIVING AGENCY Program monthly reports of doses administered by vaccines and age group and vaccine utilization/loss. Reports shall be submitted by the fifteenth calendar day of each month for the previous calendar month, on forms provided by RECEIVING AGENCY Program (forms C5, C33, C33A). If automated reports are used by PERFORMING AGENCY, the report shall be similar to and include the same information as the C5, C33, C33A forms. PERFORMING AGENCY shall provide copies of each Biological Transfer Form (C-68) used to transfer vaccines to another agency or private provider. Vaccine lot numbers shall be included on all Biological Transfer Forms used to transfer vaccines. PERFORMING AGENCY shall endeavor to achieve and maintain the following vaccine coverage levels: 90% for diphtheria and tetanus toxoids and pertussis vaccine (DTP), diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP), diphtheria and tetanus toxoids (DT), polio, measles/mumps/rubella (MMR)-, and Haemophilus influenzae type b conjugate (HibCV) vaccines in preschool age children (24-35 months of age); and 80% for hepatitis B and varicella vaccine. PERFORMING AGENCY will implement and participate in RECEIVING AGENCY'S Perinatal Hepatitis B Prevention Program following program protocol and providing program services when HBsAg-positive pregnant women are identified in their service area. PERFORMING AGENCY will assist licensed child care facilities and registered family homes in achieving and maintaining 90% immunization levels. ATTACHMENT - Page 4 PERFORMING AGENCY will assist accredited public and private schools in achieving and maintaining 95 l immunization levels. PERFORMING AGENCY shall assess the clinical records of preschool -age children to determine immunization levels. PERFORMING AGENCY shall use the Assessment Feedback Initiative Exchange (AF1X) methodology to assess immunization records using the Texas Windows version of Clinic Assessment Software Application (TexWin CASA) available from RECEIVING AGENCY Program. PERFORMING AGENCY shall complete one (1) annual on -site assessments of all its facilities and one (1) assessment on at least twelve (12) Texas Vaccines for Children (TVFC) private providers within their jurisdiction during the term of this contract Attachment, using the criteria specified in the attached Exhibit "A." RECEIVING AGENCY Program must approve the 12 TVFC private providers selected, prior to assessment. Assessment results shall be reported to RECEIVING AGENCY Program not more than two weeks after the assessments are complete. SECTION 11. SPECIAL PROVISIONS Travel funds are provided for use only by persons assigned to RECEIVING AGENCY Program. All out-of-state travel and travel for persons not assigned through this contract Attachment require prior approval by RECEIVING AGENCY Program. Travel expenses shall be reimbursed in accordance with PERFORMING AGENCY'S written travel policy; if PERFORMING AGENCY does not have a travel policy in place, travel expenses shall be reimbursed according to State of Texas travel regulations. For immunization activities performed under this contract Attachment, General Provisions, OVERTIME COMPENSATION Article, is not applicable, and PERFORMING AGENCY shall comply with the following paragraphs: PERFORMING AGENCY is authorized to pay employees who are not exempt under the Fair Labor Standards Act (FLSA), 29 USC, Chapter 8, §201 et seq., for overtime or compensatory time at the rate of time and one-half per FLSA. PERFORMING AGENCY is authorized to pay employees who are exempt under FLSA on a straight time basis for work performed on a holiday or for regular compensatory time hours when the taking of regular compensatory time off would be disruptive to normal business operations. Authorization for payment under this provision is limited to work directly related to immunization activities and shall be in accordance with the amount budgeted in this contract Attachment. PERFORMING AGENCY shall document proper authorization or approval for any work performed by exempt or non-exempt employees in excess of 40 hours in a workweek. ATTACHMENT - Page 5 SECTION III. BUDGET: PERSONNEL $51,236.00 FRINGE BENEFITS 17,120.00 TRAVEL 0.00 EQUIPMENT 0.00 SUPPLIES 0.00 CONTRACTUAL 0.00 OTHER 0.00 TOTAL $68,356.00 Total reimbursements will not exceed $ 68,356.00. Financial status reports are due the 30th of December, 30th of March, 30th of June, and the 30th of November. ., 9XHIBIT A IMMUNIZATIONASSESSMENT CRITERIA AND REPORTING REQUIREMENTS ,Assessment Criteria: Methbdolo% used for an automated assessment must be approved by RECEIVING AGENCY as meeting contractual requirements. The assessment criteria below is to be used for conducting/reporting all immunization assessments. CASA Clinic/Provider Site Requirements i CASA Client Information Date Hof Assessment FULL Last and First Name Common Review Date Date of Birth Provider Type Moved or Gone Elsewhere Name of Clinic/Provider Site VFC Status/Documentation Address Shot Type City, State, Zip Code, County Code Shot Date Reviewer Initials (XPR if electronic frle) Estimated 'Active" Client Population and Sample Size for 12-35 months of age Reporting Requirements: TexWin CASA clinic data files should be submitted to the Regional AFIX Coordinator and to the Texas Department of Health Immunization Division -Central Office within two weeks of completion of the assessment. Please contact the Immunization Division if you need the latest version of TexWin CASA or assistance with data file transfer. Please include the following information with your electronic files for each clinic'lassessment: Name', of assessment site and address (including County and TDH Region) Mailing address (if different from above) Site contact name, title, phone and fax number Type of site(s) (e.g., LHD, TDH, WIC, etc.) Date of assessment Description of files (e.g., card files, medical records. ICES, TexWin, other electronic) Exclusive criteria (must be approved by RECEIVING AGENCI) Name, address, and phone number of individual that performed the assessment Detailed explanation of reminder/recall criteria: DOCUMENT NO. 7560005906 -00 ATTACHMENT NO. 03 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: BUREAU OF HIV AND STD PREVENTION TERM: September 01, 1999 THRU: August 31, 2000 SECTION I. SCOPE OF WORK: PERFORMING AGENCY shall conduct active surveillance and reporting activities for human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). PERFORMING AGENCY shall comply with all applicable federal and state laws, rules, regulations, standards, and guidelines in effect on the beginning date of this contract Attachment unless replaced by subsequent amendment. The following documents are incorporated by reference and made a part of this contract Attachment. These include: • Chapters 81 and 85 of the Health and Safety Code; • Relevant portions of Chapter 6A (Public Health Service) of Title 42 (The Public Health and Welfare) of the United States Code, as amended; • 25 TAC Chapter 97; and • RECEIVING AGENCY Client Services Standards for Public Health and Community Clinics, revised June 1997. PERFORMING AGENCY shall perform all activities in accordance with PERFORMING AGENCY'S application, activities work plan and any revisions, and detailed budget as approved by RECEIVING AGENCY Program. All of the above -named documents are incorporated herein by reference and made a part of this contract Attachment. Before any revisions to the documents are effective, PERFORMING AGENCY shall request and obtain RECEIVING AGENCY approval of them in writing. The activities required to carry out these projects are outlined in the Centers for Disease Control and Prevention (CDC) Guidelines for HIV/AIDS Surveillance and RECEIVING AGENCY Program's grant applications and awards by CDC which are the bases for this contract Attachment. Copies have been provided to RECEIVING AGENCY Program. Any amended guidelines will become effective within thirty (30) days of receipt by PERFORMING AGENCY. If PERFORMING AGENCY does not consent to comply with these guidelines, PERFORMING AGENCY may exercise the termination option set out in the General Provisions. PERFORMING AGENCY shall be responsible to RECEIVING AGENCY Program for the design, maintenance and evaluation of an active surveillance system for AIDS cases. For the purposes of this contract Attachment, HIV infection and AIDS are as defined by the Centers for Disease Control and Prevention of the United States Public Health Service in accordance with the Health and Safety Code §81.101. The publication designating the most current definition may be requested from the RECEIVING AGENCY. ATTACHMENT - Page 1 PERFORMING AGENCY shall perform the following: 1. REPORTING a. Establish and maintain communications with key community and medical groups, individuals, and laboratories within PERFORMING AGENCY'S geographic jurisdiction. b. Collect reports of HIV infections and AIDS cases diagnosed and/or treated within PERFORMING AGENCY'S geographic jurisdiction. C. Report cases to RECEIVING AGENCY Program on a weekly basis. 2. REGISTRY MAINTENANCE a. Maintain a case file on all confirmed and suspected cases of HIV infections and AIDS diagnosed and/or treated within PERFORMING AGENCY'S geographic jurisdiction. b. Maintain a current list of key reporting sources. 3. SYSTEM EVALUATION a. Review and provide thorough follow-up on a minimum of eighty percent (80%) of suspected cases identified by RECEIVING AGENCY Program's alternate record review systems in order to enhance case ascertainment and validate the effectiveness of local surveillance efforts. b. Track reporting by local sources in order to monitor the level of compliance to reporting laws and level of case ascertainment. 4. EPIDEMIOLOGIC INVESTIGATIONS a. Initiate epidemiologic investigations on newly reported No Identified Risk (NIR) cases within five (5) days of receipt of case report through contact with appropriate health care provider or the review of medical records. b. Assist RECEIVING AGENCY Program with other epidemiologic investigations as deemed necessary by RECEIVING AGENCY Program or CDC. 5. CONFIDENTIALITY a. Store all case files and computer diskettes containing patient information in a locked file cabinet when not in use. The locked file cabinet and surveillance computer shall be kept in a locked room with limited, controlled access. b. Utilize passwords to access computer databases containing HIV/AIDS case data. Passwords shall be changed monthly and known only to surveillance personnel. ATTACHMENT - Page 2 C. Limit the number of persons who have keys to registry files to persons directly involved in case reporting. d. Require a statement of confidentiality to be signed by all personnel having access to HIV/AIDS case files and computer diskettes and kept on file by PERFORMING AGENCY. e. PERFORMING AGENCY may release demographic analyses of local data as public information as long as it could not lead to the identity of an individual. RECEIVING AGENCY Program will monitor PERFORMING AGENCY'S expenditures on a quarterly basis. If expenditures are above or below those projected in SECTION III: BUDGET, PERFORMING AGENCY'S contract Attachment amount may be subject to increase or decrease for the remainder of the contract Attachment period. The following performance measure(s) will be used to assess, in part, PERFORMING AGENCY'S effectiveness in providing the services described in this contract Attachment, without waiving the enforceability of any of the other terms of the contract. 1. PERFORMING AGENCY shall collect case information for an estimated 5Q cases and information shall be entered into the computerized HIV/AIDS Reporting System (HARS). PERFORMING AGENCY shall transfer the collected information on a weekly basis to RECEIVING AGENCY Program. PERFORMING AGENCY may request RECEIVING AGENCY Program to extend the timetable for transferring data to monthly. Any agreement shall be in writing and signed by both parties. 2. RECEIVING AGENCY Program will provide HIV/AIDS case reporting activities for cases diagnosed in the following geographic area(s): Lubbock. 3. PERFORMING AGENCY shall complete and submit a quarterly activity report demonstrating PERFORMING AGENCY'S conduct of HIV/AIDS case -finding activities. The report shall be submitted to RECEIVING AGENCY Program within twenty (20) calendar days after the end of each calendar year quarter in a format provided by RECEIVING AGENCY Program. SECTION II. SPECIAL PROVISIONS: Neither PERFORMING AGENCY, nor any subrecipient, shall 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, RECEIVING AGENCY (Texas Department of Health [TDH]) may require PERFORMING AGENCY, or any subrecipient, to transfer a client or patient record to RECEIVING AGENCY (TDH) if the transfer is necessary to protect either the confidentiality of the record or the health and welfare of the client or patient. ATTACHMENT - Page 3 RECEIVING AGENCY (TDH) shall have access to a client record (including a patient record) in the possession of PERFORMING AGENCY, or any subrecipient, under authority of the Health and Safety Code, Chapters 81 and 85, VTCA, and the Medical Practice Act, Article 4495b, VTCS. In such cases, RECEIVING AGENCY (TDH) shall keep confidential any information obtained from the client or patient record, as required by the Health and Safety Code, Chapter 81, and by Article 4495b, VTCS. Due to the sensitive and highly personal nature of HIV/AIDS-related information, PERFORMING AGENCY shall require its personnel to adhere strictly to the General Provisions, Confidentiality Article. PERFORMING AGENCY shall authorize its staff to attend training, conferences, and meetings for which funds were budgeted and approved by RECEIVING AGENCY Program. ATTACHMENT - Page 4 SECTION III. BUDGET: PERSONNEL $29,494.00 FRINGE BENEFITS 11,020.00 TRAVEL 2,500.00 EQUIPMENT 0.00 SUPPLIES 750.00 CONTRACTUAL 0.00 OTHER 0.00 TOTAL DIRECT CHARGES $43,764.00 INDIRECT CHARGES 2,949.00 TOTAL $46,713.00 Total reimbursements will not exceed $ 46,713.00. Financial status reports are due the 30th of December, 30th of March, 30th of June, and the 30th of November. Based on UGMS, indirect cost may be recovered up to 10% of the direct salary and wage costs of providing the service (excluding overtime, shift premiums, and fringe benefits). ATTACHMENT - Page 5 DOCUMENT NO. 7560005906-00 ATTACHMENT NO. 04 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: BUREAU OF REGIONAL/LOCAL HEALTH OPERATIONS TERM: September O1, 1999 THRU: August 31, 2000 SECTION I. SCOPE OF WORK: ESSENTIAL PUBLIC HEALTH SERVICES PERFORMING AGENCY shall use direct assistance and/or financial assistance, as specified in SECTION III., BUDGET, from RECEIVING AGENCY to deliver one or more of the following essential public health services as specified in PERFORMING AGENCY'S FY 2000 Service Delivery Plan which is adopted by reference: • Monitor health status to identify community health problems; • Diagnose and investigate health problems and health hazards in the community; • Inform, educate, and empower clients about health status; • Mobilize community partnerships to identify and solve health problems; • Develop policies and plans that support individual and community health efforts; • Enforce laws, rules, regulations, and ordinances, where applicable, that protect health and ensure safety; • Link clients to needed personal health services and assure the provision of health care when otherwise unavailable; • Assure a competent public health and personal health care work force; • Evaluate effectiveness, accessibility, and quality of personal and population -based health services; and • Research for new insights and innovative solutions to health problems. Two types of support are provided under this program: (1) direct assistance in the form of state -paid positions and/or (2) financial assistance from General Revenue funds and the Preventive Health and Health Services Block Grant. STATE -PAID POSITIONS State -paid positions under this contract Attachment shall perform activities as specified in PERFORMING AGENCY'S FY 00 Service Delivery Plan. Activities shall be specific to one of the ten essential public health services or cardiovascular and cancer activities. FINANCIAL ASSISTANCE PERFORMING AGENCY shall direct 73.5 % of the General Revenue funds toward the delivery of a broad range of essential public health services and 26.5 % of the Preventive Health and Health ATTACHMENT - Page 1 Services Block Grant funds for activities designed to reduce the incidence of cancer and cardiovascular disease. The following performance measures(s) will be used to assess, in part, PERFORMING AGENCY'S effectiveness in providing the services described in this contract Attachment, without waiving the enforceability of any of the other terms of the contract. PERFORMING AGENCY shall submit quarterly progress reports which describe accomplishments, challenges, barriers, impact and progress toward achieving the work plan goals and objectives contained in PERFORMING AGENCY'S FY 2000 Service Delivery Plan. These reports shall include the progress and activities of the employees in state -paid positions under the "000" budget. SECTION II. SPECIAL PROVISIONS General Provisions, Reports Article, is amended to include the following paragraph: PERFORMING AGENCY shall submit quarterly reports and an Annual Expenditures Report to the appropriate Public Health Regional Director in the format specified by RECEIVING AGENCY Program within thirty (30) days following the end of each quarter and sixty (60) days following the end of PERFORMING AGENCY'S fiscal year. ATTACHMENT - Page 2 ■ SECTION III. BUDGET: DIRECT ASSISTANCE Direct assistance involves the assignment of state funded positions in lieu of cash. State salary warrants for net earnings will be issued in accordance with state regulations. PERSONNEL $249192.00 TRAVEL 0.00 LABORATORY SUPPORT 0.00 OTHER 0.00 TOTAL $249192.00 Financial status reports (FSRs) are not required on direct assistance. Program income generated from activities supported with direct assistance will be reported on FSRs required for financial assistance provided through this Attachment, if applicable, or through other program Attachments(s) benefitting from this assistance. RECEIVING AGENCY direct assistance will not exceed $ 24,192.00. ATTACHMENT - Page 3 FINANCIAL ASSISTANCE Financial assistance involves payment of funds to Performing Agency for costs incurred in carrying out approved activities. PERSONNEL $689861.00 . FRINGE BENEFITS 239257.00 TRAVEL 0.00 EQUIPMENT 0.00 SUPPLIES 2,000.00 CONTRACTUAL 0.00 OTHER 0.00 TOTAL $94,118.00 RECEIVING AGENCY financial assistance will not exceed $94,118.00. TOTAL RECEIVING AGENCY assistance will not exceed $118,310.00. Financial status reports are due the 30th of December, 30th of March, 30th of June, and the 30th of November. ATTACHMENT - Page 4 The undersigned certifies, to the best of his or her knowledge and belief that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or an employee of any agency, a member of congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-111, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty ofjw"ess than $10,000 and not more than $100,000 for each Aug. 12, 1999 Date W11* Sit tan, lIyor AuthorizedPrint Name of • Applicationor •Number OrganizationLUBBOCK CITY HEALTH DEPARTMENT •• BOX 2548 LUBBOCK, TX • • 0000 �) s DOCUMENT NO. 7560005906-00 ATTACHMENT NO. 05 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: BUREAU OF CHILDREN'S HEALTH TERM: September 01, 1999 THRU: August 31, 2000 SECTION I. SCOPE OF WORK: PERFORMING AGENCY shall perform public health preventive services related to women, children, and their families in order to address local health needs; to build the local public health infrastructure; and to improve the health status of women, children, and families. PERFORMING AGENCY shall comply with all applicable federal and state laws, rules, regulations, standards, and guidelines in effect on the beginning date of this contract Attachment unless replaced by subsequent amendment. The following documents are incorporated by reference and made a part of this contract Attachment. These include: • RECEIVING AGENCY FY97 Title V Competitive Request for Proposal (RFP), Part B; • PERFORMING AGENCY FY97 Title V Competitive Application, Part B, and any revisions; • RECEIVING AGENCY FY98 Title V Continuation RFP, Part B; • PERFORMING AGENCY FY98 Title V Continuation Application, Part B, and any revisions; • RECEIVING AGENCY FY99 Title V Consolidated Continuation RFP, Part B, issued April 20, 1998; • PERFORMING AGENCY FY99 Title V Consolidated Continuation Application, Part B, and any revisions; • RECEIVING AGENCY FY00 Title V Population -Based Consolidated Continuation RFP issued March 31, 1999; and • PERFORMING AGENCY FY00 Title V Consolidated Continuation Application, and any revisions; • RECEIVING AGENCY'S current Title V Policy and Procedures Manual; • RECEIVING AGENCY'S Client Services Standards for Public Health and Community Clinics, revised June, 1997; and • RECEIVING AGENCY'S Quality Assurance (QA)Title V - Population Based On -Site Evaluation Report (designed to be used with QA Core Tool), which requires monthly time sheets to document staff time on work plan activities, invoices of all expenditures, logs of dated activities with sign -in sheets for public presentations. Any amended guidelines will become effective within thirty (30) days of receipt by PERFORMING AGENCY. If PERFORMING AGENCY does not consent to comply with these guidelines, PERFORMING AGENCY may exercise the termination option set out in the General Provisions. PERFORMING AGENCY shall implement its approved work plan in consultation with ATTACHMENT - Page 1 RECEIVING AGENCY'S Public Health Region (PHR) Title V Manager and Central Office Coordinator for public health preventive services. RECEIVING AGENCY'S PHR Director, as coordinator of regional services, will assist RECEIVING AGENCY staff in providing direction to PERFORMING AGENCY. RECEIVING AGENCY personnel will provide technical assistance and training to PERFORMING AGENCY, as needed. PERFORMING AGENCY shall cooperate with RECEIVING AGENCY staff to attain the goals of unified community health.assessment, policy development, coordinated services, and quality assurance and to prevent unnecessary duplication of services. The following performance measure(s) will be used to assess, in part, PERFORMING AGENCY'S effectiveness in providing the services described in this contract Attachment, without waiving the enforceability of any of the other terms of this contract. PERFORMING AGENCY shall submit quarterly reports on project activities to RECEIVING AGENCY'S PHR Title V Manager for review, assessment, and transmission to Central Office Coordinator within thirty (30) days of the end of each quarter. Quarterly reports shall describe accomplishments, challenges, barriers, impact, and progress in achieving the goals and objectives contained in PERFORMING AGENCY'S FY2000 Title V Consolidated Continuation Application's work plan, and any revisions. The quarterly progress report will be in the format specified by RECEIVING AGENCY Program, the Title V Policy and Procedures Manual, and through any amended guidelines. PERFORMING AGENCY shall submit a comprehensive final report on FY97 - FY00 work plan activities on or before September 30, 2000. This final report shall include the findings of an evaluation to determine the effectiveness of project activities in addressing local health needs, in building the local public health infrastructure, and in improving public health status. PERFORMING AGENCY shall provide population -based maternal and child health services to clients who live or receive services in the following county(ies)/area: Hale, Lubbock. SECTION II. SPECIAL PROVISIONS: General Provisions, Reports Article, is revised to include the following: PERFORMING AGENCY shall submit quarterly and year-end financial reports, in the format specified by RECEIVING AGENCY Program, within thirty (30) days of the end of each quarter and within ninety (90) days of the end of the contract Attachment term detailing the activities performed and the objectives achieved with the funding provided under this contract Attachment. PERFORMING AGENCY shall submit other reports as deemed necessary by RECEIVING AGENCY Program. General Provisions, Inspections Article, is revised to include the following: ATTACHMENT - Page 2 r� •Y � In addition to the site visits authorized by the Inspections Article of the General Provisions, PERFORMING AGENCY shall allow RECEIVING AGENCY to conduct on - site quality assurance reviews as deemed necessary by RECEIVING AGENCY. Unsatisfactory review findings may result in implementation of General Provisions, Sanctions Article. PERFORMING AGENCY shall notify RECEIVING AGENCY Program immediately in the event of any significant change affecting PERFORMING AGENCY'S identity, ownership or control, name, governing board membership, vendor identification, medical or program director, or address. Failure to disclose the required information or inaccurate disclosure by PERFORMING AGENCY may be treated as a material breach of this contract Attachment and may be grounds for termination. ATTACHMENT - Page 3 SECTION III. BUDGET: PERSONNEL $41,995.00 FRINGE BENEFITS 17,913.00 TRAVEL 3,263.00 EQUIPMENT * 11,731.00 SUPPLIES 8,249.00 CONTRACTUAL 0.00 OTHER 34,429.00 TOTAL $117,580.00 Total reimbursements will not exceed $ 117,580.00. Financial status reports are due the 30th of December, 30th of March, 30th of June, and the 30th of November. * Equipment list attached. ATTACHMENT - Page 4 cl PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT .. J:..: • .1. Qw1 I:." Vol TDH DOC. NO: 7560005906 00 ATTACHMENT NO:05 CHANGE NO: 02 EQUIPMENT LIST NO. OF UNIT ITEM DESCRIPTION UNITS COST EXTENSION 001 Intel Pentium II Processor, 450Mhz, Hard 2 $1,598.00 $3,196.00 Drive Type: Smart II eide, RAM-64MB, 384-MB, 24X max, Cache 512-KB, 1.44MB, ATI Rage Pro Turbo AGP 2x intergrated, Audio, Video Memory 4MB SGRAM, Microsoft Windows 95. 002 Intel Mobile Pentium II with MMX 1 $4,810.00 $4,810.00 Technology 366 MHz processor, 512KB level two write -back cache, 256K Integrated Memory, 64 MB CDRAM, 14.OGB Smart Hard Drive, 14.1 color TFT, Multibay Devices, 56K V.90 Modem, DVD drive, U-Ion Battery, 16-bit Stereo Sound, AC Adapter, Microsoft Windows 95, 3 year limited warranty. 003 HP Color Laser Jet 4500 Printer. 1 $3,725.00 $3,725.00 TOTAL $11,731.00 Items may be brand name, if specified, or equivalent. Equipment List - Page 1 a Deprtment of Health and Human Services Form Approved Health Care Financing Administration OMB 0938-0086/HCFA-1513 INSTRUCTIONS FOR COMPLETING DISCLOSURE OF OWNERSHIP AND CONTROL INTEREST STATEMENT (HCFA-1513) Completion and submission of this form is a condition of participation, certification, or recertification under any of the programs established by titles V, XVIII, XIX, and XX, or as a condition of approval or renewal of a contractor agreement between the disclosing entity and the secretary of appropriate state agency under any of the above''titled programs, a full and accurate disclosure of ownership and financial interest is required. Failure to submit requested information may result in a refusal by the Secretary or appropriate State agency to enter into an agreement or contract with any such institution or in termination of existing agreements. SPECIAL INSTRUCTIONS FOR TITLE XX PROVIDERS All Title XX providers must complete Part II(a) and (b) of this form. Only those Title XX providers rendering medical, remedial, or health -related homemaker services must complete Parts II and III. Title V providers must complete Parts II and III. GENERAL INSTRUCTIONS For definitions, procedures and requirements, refer to the appropriate Regulations: Title V 42CFR 51a.144 Title XVIII 42CFR 420.200-206 Title=42CFR 455.100-106 Title XX 45CFR 228.72-73 Please answer all questions as of the current date. If the yes block for any item is checked, list requested additional information under Remarks on Page 2, referencing the item. If additional space is needed use an attached sheet. Return the original to the State agency; retain a copy for your files. This form is to be completed annually. Any substantial delay in completing the form should be reported to the State survey agency. DETAILED INSTRUCTION These instructions are designed to clarify certain questions on the form. Instructions are listed in question order for easy reference. No instructions have been given for questions considered self-explanatory. IT IS ESSENTIAL THAT ALL APPLICABLE QUESTIONS BE ANSWERED ACCURATELY AND THAT ALL INFORMATION BE CURRENT. Item I (a) Under identifying information specify in what capacity the entity is doing business as (DBA), example, name of trade or corporation. Item I (b) For Regional Office Use Only. If the yes box is checked for Item VII the Regional Office will enter the 5-digit number assigned by HCFA to chain organizations. Item H Self-explanatory. Item III List the names of all individuals and organizations having direct or indirect ownership interests, or controlling interest separately or in combination, amounting to an ownership interest of 5 % or more in the disclosing entity. Direct ownership interest is defined as the possession of stock, equity in capital or any interest in the profits of the disclosing entity. A disclosing entity is defined as a Medicare provider or supplier, or other entity that furnishes services or arranges for furnishing services under Medicaid or the Maternal and Child Health Department of Health and Human Services Health Care Financing Administration program, or health related services under the social service program. Indirect ownership interest is defined as ownership interest in an entity that has direct or indirect ownership interest in the disclosing entity. The amount of indirect ownership in the disclosing entity that is held by any other entity is determined by multiplying the percentage of ownership interest at each level. An indirect ownership interest must be reported if it equates to an ownership interest of 5 % or more in the disclosing entity. Example: If A owns 10% of the stock in a corporation that owns 80% of the stock of the disclosing entity, A's interest equates to an 8 % indirect ownership and must be reported. Controlling interest is defined as the operational direction or management of a disclosing entity which may be maintained by any or all of the following devices: the ability or authority, expressed or reserved, to amend or change the corporate identity (i.e. joint venture agreement, unincorporated business status) of the disclosing entity; the ability or authority to nominate or name members of the Board of Directors or Trustees of the disclosing entity; the ability or authority, expressed or reserved, to amend or change the by-laws, constitution, or other operating or management direction of the disclosing entity; the right to control any or all of the assets or other property of the disclosing entity upon the sale or dissolution of that entity; the ability or authority, expressed or reserved, to control the sale of any or all of the assets, to encumber such assets by way of mortgage or other indebtedness, to dissolve the entity, or to arrange for the sale or transfer of the disclosing entity to new ownership or control. Items IV-VII Changes in Provider Status Change in provider status is defined as any change in management control. Examples of such changes would include: a change in Medical or Nursing Director, a new Administrator, contracting the operation of the facility to a management corporation, a change in the composition of the owning partnership which under applicable State law is not considered a change in ownership, or the hiring or dismissing of any employees with 5 % or more financial interest in the facility or in an owning corporation, or any change of ownership. Items IV-VII If the yes box is checked, list additional information requested under Remarks. Clearly identify which item is being continued. -- -1 0 r Form Approved OMB 0938-0086JHCFA-1513 Item IV (a and b) If there has been a change in ownership within the last year or if you anticipate a change, indicate the date in the appropriate space. Item V If the answer is yes, list name of the management firm and employer identification number (Elm, or the name of the leasing organization. A management company is defined as any organization that operates and manages a business on behalf of the owner of that business, with the owner retaining ultimate legal responsibility for operation of the facility. Item VI If the answer is yes, identify which has changed (Administrator, Medical Director, or Director of Nursing) and the date the change was made. Be sure to include name of the new Administrator, Director of Nursing or Medical Director, as appropriate. Item VII A chain affiliate is any free-standing health care facility that is either owned, controlled, or operated under lease or contract by an organization consisting of two or more free-standing health care facilities organized within or across State lines which is under the ownership, or through any other device, control and direction of a common party. Chain affiliates include such facilities whether public, private, charitable or proprietary. They also include subsidiary organizations and holding corporations. Provider -based facilities, such as hospital - based home health agencies, are not considered to be chain affiliates. Item VIII If yes, list the actual number of beds in the facility now and the previous number. It Dekrtment of Health and Human Services Form Approved . Health Care Financing Administration OMB No. 0938-0086/HCFA-1513 DISCLOSURE OF OWNERSHIP AND CONTROL INTEREST STATEMENT 1. IDENTIFYING INFORMATION (a) Name of Entity City of Dock H3alth DepmUmt DBA Provider No. Vendor No. 17560005906034 Phone (806) 775-2899 Street Address 19M Texas Avent- City bkbodz County Ilabbock State TX Zip 79405 (b) (To be completed by HCFA Regional Office) Chain Affiliate No. II. Answer the following questions by marking "Yes" or 'No." If any of the questions are answered 'Yes,' list names and addresses of Individuals or corporations under Remarks on Page 2. Identify each item number to be continued. (a) Are there any individuals or organizations having a direct or indirect ownership or control interest of 5 % or more in the institution, organization, or agency that have been convicted of a criminal offense related to the ' ement of such persons, or organizations in any of the programs established by Titles XVM, M, or XX? Yes o (b) Are there any directors, officers, agents, or managing employees of the institution, agency or organization who have ever been convict f a criminal offense related to their involvement in such programs established by Title XVIII, XIX, or XX? Yes No (c) Are there any individuals currently employed by the institution, agency, or organization in a managerial, accounting, auditing, or similar capacity who were employed by the institution's, organ!or agency's fiscal intermediary or carrier within the previous 12 months? (Title XVIII providers only.) Yes No III. (a) List names, addresses for individuals, or the EIN for organizations having direct or indirect ownership or a controlling interest in the entity. (See instructions for definition of ownership and controlling interest.) List any additional names and addresses under Remarks on Page 2. If more than one individual is reported and any of these persons are related to each other, this must be reported under Remarks on Page 2. NAME ADDRESS EIN (b) Type of Entity: Sole Proprietorship _ Partnersht�'pp _ Unincorporated Associations _ Corporation 7Other (specify) �oe�L FsOVFJPNIM; T (c) If the disclosing entity is a corporation, list names, addresses of the Directors, and EINS for corporations under Remarks on Page 2. o Mark appropriate answer for each of the following questions: (d) Are any owners of the disclosing entity also owners of MedicarelMedicaid facilities? (Example, sole proprietor, partnership or members of Board of Directors.) Yes No _ If yes, list names, addresses of individuals and provider numbers. NAME ADDRESS PROVIDER NUMBER 1 �r Form Approved OMB No. 0938-M6/HCFA-1513 i bepartment of Health and Human Services Health Care Financing Administration IV. (a) Has there b= a change in ownership or control within the last year? Yes No If yes, give date. (b) Do you 'ate any change of ownership or control within the year? Yes No If yes, when? (c) , Do you ' ate filing for bankruptcy within the year? Yes No If yes, when? V. Is this facility operated by a management company, or leased in whole or part by another organization? Yes No If yes, give date of change in operation. VI. Has there been a change in Administrator, Director of Nursing or Medical Director within the last year? Yes No VII. (a) Is this facility chain affiliated? If yes, list name, address of Corporation, and EIN. AA) Name EIN Address (b) If the answer to question VII (a) is No, was the facility ever affiliated with a chain? If Yes, list name, address of Corporation, and EIN. No Name F.IId Address VM. Have you increased your bed capacity by 10% or more or by 10 beds, whichever is greater, within the last 2 years: Yes No If yes, give year of change: Current bed space: Prior bed space: Whoever knowingly and willfully makes or causes to be made a false statement or representation of this statement, may be prosecuted under applicable federal or state laws. In addition, knowingly and willfully failing to fully and accurately disclose the information requested may result in denial of a request to participate or where the entity already participates, a termination of its agreement or contract with the state agency or the secretary, as appropriate. Name of Authorized Representative (Typed) Tide Tctr W Carden Public Health Signature Date Remarks: 2 DOCUMENT NO. 7560005906 -00 ATTACHMENT NO. 06 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: TUBERCULOSIS ELIMINATION DIVISION TERM: September 01, 1999 THRU: August 31, 2000 SECTION I. SCOPE OF WORK: PERFORMING AGENCY shall develop and provide: (1) basic services for tuberculosis (TB) prevention and control and (2) expanded outreach services to individuals of identified sub -groups who have TB or who are at high risk of developing TB throughout PERFORMING AGENCY'S defined service area. PERFORMING AGENCY shall comply with all applicable federal and state laws, rules, regulations, standards, and guidelines in effect on the beginning date of this contract Attachment unless replaced by subsequent amendment. All documents referenced herein are incorporated by reference and made a part of this Attachment. PERFORMING AGENCY shall perform the following activities: A. Provide basic and expanded outreach services in compliance with RECEIVING AGENCY'S Standard of Performance (Second Edition, May 1997) and the following series of American Thoracic Society (ATS) and Centers for Disease Control and Prevention (CDC) "Joint Statements" on diagnosis, treatment and control of tuberculosis: • Treatment of Tuberculosis and Tuberculosis Infection in Adults and Children (American Journal Respiratory Critical Care Medicine, Vol. 149, pp 1359-1374, 1994) • Control of Tuberculosis (American Review Respiratory Disease, Vol. 146, pp.1623- 33, 1992) • Diagnostic Standards and Classification of Tuberculosis (American Review Respiratory Disease, Vol. 142, pp. 725-35, 1990) • Centers for Disease Control and Prevention Screening for Tuberculosis and Tuberculosis in High Risk Populations ( Morbidity and Mortality Weekly Report [MMWR], September 8, 1995, Vol. 44, No. RR-1 1) Any amended guidelines will become effective within thirty (30) days of receipt by PERFORMING AGENCY. If PERFORMING AGENCY does not consent to comply with these guidelines, PERFORMING AGENCY may exercise the termination option set out in the General Provisions. B. Accomplish the following objectives during the period of this Attachment in accordance with PERFORMING AGENCY'S approved service delivery plan. 1. Management of Cases and Suspected cases. PERFORMING AGENCY shall assure that the following basic case management components are conducted for all confirmed and suspected TB cases: ATTACHMENT - Page 1 • patient isolation - coordinate until patient rendered non-infectious and educate patient; • ATS/CDC recommended four -drug therapy - initiate treatment of all TB cases with this therapy unless contraindicated, and follow ATS/CDC treatment guidelines until therapy is completed; • directly observed therapy (DOT) - document all TB cases not placed on DOT in patient's medical record explaining deviation if record is maintained at PERFORMING AGENCY; • drug susceptibility testing - perform testing and adjust treatment if drug resistance is found; • consult with RECEIVING AGENCY'S designated TB expert on all drug resistant cases - provide written documentation in patient's medical record indicating that the consult occurred and that PERFORMING AGENCY adhered to advice or justification for deviations from the advice; • consult with RECEIVING AGENCY'S designated pediatric TB expert on all complicated TB cases in children less than 15 years of age - provide written documentation in patient's medical record indicating that the consult occurred and that PERFORMING AGENCY adhered to advice or justification for deviations from this advice; • monitoring - perform monthly monitoring for drug toxicity; and, • testing - provide human immunodeficiency virus (HIV) testing for all patients at high risk for HIV. 2. Management of Contacts and Positive Reactors. PERFORMING AGENCY shall assure that the following minimal patient management procedures will be conducted: • examine all household and other close contacts to suspected infectious TB cases within 7 to 10 days of initial notification/diagnosis; • evaluate all contacts who are positive reactors for evidence of active disease. Additional positive reactors may be evaluated as resources permit with emphasis on high risk groups; • assure the use of directly observed preventive therapy (DOPT) for household contacts, especially children under 15 years of age requiring preventive treatment; and, • perform monthly monitoring for drug toxicity. ATTACHMENT - Page 2 3. Surveillance. PERFORMING AGENC' programs with health care providers throe service area to ensure that all TB cases, su: of age with TB infection are reported to the AGENCY'S Regional Director in the ab identification. PERFORMING AGEN( AGENCY'S Report of Cases and Patient shall design and implement surveillance lout PERFORMING AGENCY'S defined acted cases, and children less than 15 years cal health authority (LHA) or RECEIVING ice of a LHA within one working day of shall submit reports on RECEIVING rvices Form (TB400). 4. Infection Control. PERFORMING AGENCY shall have policies, procedures, and facilities to prevent transmission of mycobacterium tuberculosis in accordance with CDC's "Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health -Care Facilities," 1994 (Morbidity and Mortality Weekly Report, [MMWR] Vol. 43, No. RR-13, pp. I-132 and revisions hereof). Prevention measures shall consist of a hierarchy of controls, as specified in RECEIVING AGENCY'S Standard of Performance, including administrative, environmental and personal protection. 5. Screening High Risk Populations. PERFORMING AGENCY shall implement TB screening activities in identified high risk populations including: • foreign -born persons from areas of high TB incidence; • medically underserved, low-income populations, including high risk racial and ethnic groups; • persons with HIV infection or acquired immune deficiency syndrome (AIDS), and individuals at high risk for contracting HIV (e.g. injecting drug users, sex for drugs); or, • locally identified high prevalence groups (e.g. migrant farm workers, homeless persons). These screening programs shall be linked to appropriate follow-up efforts, as described in CDC's "Screening for Tuberculosis land Tuberculosis Infection in High -Risk Populations," 1995 (MMWR, Vol. 44, No. RR-11 and revisions hereof). Effective working relationships shall be developed and maintained with drug treatment centers, homeless shelters, and community -based o'Fganizations, jails and prisons, and agencies providing services for migrants, foreign born, and HIV/AIDS high -risk groups. 6. Professional Education. PERFORMIN personnel will receive 40 hours of tubercd within 60 days of employment. Each continuing TB education or training rele, Modules on Tuberculosis shall be utilized training shall be retained and made avail Program. AGENCY shall assure that all new TB s program training relevant to their position ar, employees shall receive 16 hours of t to their position. The CDC's Self -Study the initial training. Documentation of this upon request by RECEIVING AGENCY RECEIVING AGENCY Program will provide administrative and technical assistance for the implementation and operation of the service delivery plan. I i ATTACHMENTS - Page 3 '[I H 1 PERFORMING AGENCY shall comply with the following: • Texas Tuberculosis Code, Health and Safety Code, Chapter 13, Subchapter B, VTCA; • Communicable Disease Prevention and Control Act, Health and Safety Code, Chapter 81, VTCA; • Communicable Disease, 25 TAC, Chapter 97; and • RECEIVING AGENCY'S Quality Care: Client Services Standards for Public Health and Community Clinics, revised June 1997. The following key outcome performance measures will be used to assess, in part, PERFORMING AGENCY'S effectiveness in providing the services described in this contract Attachment, without waiving the enforceability of any of the other terms of the contract. • 90% of Cases/Suspects on DOT • 90% of Cases Completing Therapy • 90% of Patients on Physician Ordered DOPT • 0% of Patients Completing Prescribed Preventive Therapy • 0 % of contacts Initially Evaluated • 0 % of Contacts Receiving 2nd Purified Protein Derivative (PPD) Test PERFORMING AGENCY shall report on these measures monthly in the format provided by RECEIVING AGENCY Program. In addition, PERFORMING AGENCY shall maintain documentation and report monthly on the support measures defined in the reporting format, which are used to calculate key outcome performance measures. Reports are due the 30th day of the month following the report period. Reports shall be mailed to your Regional TB Program Manager. SECTION H. SPECIAL PROVISIONS: General Provisions, Reports Article, is revised to include the following: PERFORMING AGENCY shall develop and submit a service delivery plan and detailed budget justification for continuation of this Attachment during the next fiscal year. The plan and budget shall be prepared in the format approved by RECEIVING AGENCY Program; one copy shall be submitted to RECEIVING AGENCY Program and one copy shall be submitted to the Regional Director, no later than 120 days prior to the end of this Attachment term. The plan shall describe PERFORMING AGENCY'S service delivery and activities toward meeting the objectives outlined in SECTION I.B. above, including updated key outcome performance measure targets and a detailed line -item budget justification. ATTACHMENT - Page 4 PERFORMING AGENCY shall mail all initial reports of confirmed TB cases, suspected TB cases, and TB infection in children less than 15 years of age to RECEIVING AGENCY Program within five (5) working days of identification or notification. Any updates to initial RECEIVING AGENCY'S Report of Cases and Patient Services Form (TB400) (e.g., diagnosis, medication changes, x-rays, and bacteriology) and case closures shall be mailed to RECEIVING AGENCY Program. PERFORMING AGENCY shall mail reports of contacts on all Class 3 TB cases and smear positive Class 5 TB suspects within four (4) weeks of identification of Class 3 and 5 and submit information using RECEIVING AGENCY'S Report of Contacts Form (TB340). All subsequent contacts shall be mailed as contacts are identified. General Provisions, Terms and Conditions of Payment Article, is revised to include the following: Funding from this Attachment shall not be used to supplant state or local funds, but PERFORMING AGENCY shall use such funds to increase state or local funds currently available to PERFORMING AGENCY under this Attachment. PERFORMING AGENCY shall maintain local funding at a sufficient rate to support the local program. If the total costs of the project are greater than RECEIVING AGENCY share set out in SECTION III. BUDGET, PERFORMING AGENCY shall obtain funds for the remaining costs in order to accomplish the objectives set forth in this Attachment. General Provisions, Program Income Article, is revised to include the following: All revenue generated by this Attachment or earned as a result of this Attachment during the term of this Attachment is considered program income, including income generated through Medicaid billings for TB -related clinic services. PERFORMING AGENCY may use the program income, excluding program income earned from Medicaid billings for TB drugs, to further the scope of work detailed in this Attachment. This program income may not be used to supplant existing local, state or federal program funds. Program income earned from Medicaid billings for TB drugs, which have been provided by RECEIVING AGENCY Program to PERFORMING AGENCY, must be reported and reimbursed to RECEIVING AGENCY Program on a quarterly basis as follows: Due Date-W Period(s) Covered December 31 September -November March 31 December -February June 30 March -May September 30 June -August RECEIVING AGENCY Program has provided PERFORMING AGENCY with the format to be used for reporting. All reimbursements from PERFORMING AGENCY shall be mailed to: Texas Department of Health Attention: Tuberculosis Elimination Division ATTACHMENT - Page 5 1100 West 49th Street Austin, Texas 787576-3199 RECEIVING AGENCY Program will verify reimbursements received from PERFORMING AGENCY with the amounts paid by its Medicaid Contractor to PERFORMING AGENCY. Below are the set drug portion rates for the Medicaid billing codes to be utilized during the term of this Attachment. Rate Medicaid Billing Code $173.86 1-8137X, 1-8237X, 1-8437X, and 1- 8432X $1.09 1-8118X, 1-8218X, 1-8413X, and 1-8418X $31.25 1-8439X and 1-8434X $748.94 1-8450X and 1-8435X A final settlement of the reimbursements to RECEIVING AGENCY for TB drugs will be completed no later than 45 days after the Attachment term. Outreach workers employed under this Attachment should be recruited from the same racial/ethnic, cultural, and social groups as the patients for whom outreach activities are directed, whenever practical. RECEIVING AGENCY Program must distribute funds in a way that will maximize the delivery of authorized services to eligible clients. RECEIVING AGENCY Program will monitor PERFORMING AGENCY'S expenditures on a quarterly basis. If expenditures are below that projected in PERFORMING AGENCY'S total contract amount as shown in Section III. BUDGET, PERFORMING AGENCY'S budget may be subject to a decrease for the remainder of the Attachment term. Vacant positions existing after ninety (90) days may result in a decrease in funds. ATTACHMENT - Page 6 ., SECTION III. BUDGET: PERSONNEL $16,582.00 FRINGE BENEFITS 0.00 TRAVEL 1,152.00 EQUIPMENT 0.00 SUPPLIES 403.00 CONTRACTUAL 0.00 OTHER 1,107.00 TOTAL DIRECT CHARGES $19,244.00 INDIRECT CHARGES 829.00 TOTAL $20,073.00 Total reimbursements will not exceed $ 20,073.00. Financial status reports are due the 30th of December, 30th of March, 30th of June, and the 30th of November. The negotiated indirect cost amount shown above is less than the maximum allowed by UGMS. Indirect charges to this contract may not exceed the amount shown above, except by prior written approval of RECEIVING AGENCY. ATTACHMENT - Page 7