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HomeMy WebLinkAboutResolution - 2010-R0563 - Amendment 2 To Medical Transportation Services Agreement 529-08-0196-00016F - 11/04/2010Resolution No. 2010-RO563 November 4, 2010 Item No. 5.13 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock is hereby authorized and directed to execute for and on behalf of the City of Lubbock, an Amendment to the Medical Transportation Services Agreement to extend the terms of the agreement for an additional eighteen (18) months, by and between the City of Lubbock and Texas Health and Human Services Commission, and related documents. Said Amendment is attached hereto and incorporated in this resolution as if fully set forth herein and shall be included in the minutes of the City Council. Passed by the City Council on November 4, 2010 TOM MARTIN, MAYOR ATTEST: Rebe a Garza, City Secretary APPROVED AS TO CONTENT: 01�QQLZ, Bill Howe on, Community evelopment Citibus APPROVED AS TO FORM: Chad Weaver, Assistant City Attorney vwxcdocs RES.Citibus Amendment -Tx Health & HSC August 26, 2010 Resolution No. 2010—RO563 STATE OF TEXAS § HHSC 529-08-0196-00016G COUNTY OF TRAVIS HHSC AMENDMENT TWO TO THE MEDICAL TRANSPORTATION SERVICES AGREEMENT BETWEEN THE TEXAS HEALTH AND HUMAN SERVICES COMMISSION AND CITIBUS Article I. Background and Objectives Section 1.01 Background This HHSC Amendment TWO ("Amendment") to HHSC contract 529-08-0196-00016 ("Agreement") is entered into between the Texas Health and Human Services Commission ("HHSC"), an administrative agency within the executive department of the State of Texas, with its principal place of business at 4900 North Lamar Boulevard, Austin, Texas, 78751 and Citibus ("CONTRACTOR"), 801 Texas Ave., Lubbock TX 79401, organized under the laws of Texas, and having its principal offices at 801 Texas Ave., Lubbock TX 79401. HHSC and the CONTRACTOR may be referred to in this Amendment individually as "Party" and collectively as the "Parties." The Texas Department of Transportation ("TxDOT") issued its solicitation entitled "Request for Proposal ("RFP"), Medical Transportation Program, Statewide Transportation Services," Solicitation Number B442006073000 October 2005 with an initial term of 36 months of performance beginning June 26, 2006 and ending June 25, 2009. TxDOT assigned the contract to HHSC effective May 1, 2008 pursuant to S.B. 10, 80"' Legislature, Regular Session, 2007. HHSC assigned contract number 529-08-0196-00016 to the contract. Section 1.02 Authority This Amendment is executed under the authority granted in §531.02414 of the Tex GV. Code and the Human Resource Code, Section 22.002 and in compliance with Articles 7 and 11 of the HHSC Uniform Contract Terms and Conditions (UTC) v. 1.4. Section 1.03 Objectives The objectives of this Amendment are to extend the term of the agreement to procure continued services, provide for payment of costs for those continued services, and incorporate disclosures mandated by state or federal law that were previously identified in HHSC Amendment One Number 529-08-0196-00016F and in the July 31, 2009 written responses to Transportation Service Area Providers (TSAP) Teleconference Questions. (Attached for reference as Exhibit A to this HHSC Amendment Two.) pj�C�L��C�1L� HHSC Contract No. 529-08-0196-00016G Page 1 11111 NOV 0 9 2010 Article H. Amendment to the Obligations of the Parties Section 2.01 Modification of Term HHSC, under the Uniform contract Terms and Conditions (UTC) Section 11.03, may extend the term in accordance with the Agreement. Section 2.01 of HHSC Amendment One provides an option to renew the current agreement for an additional 18 months. The Agreement's current term expires on August 31, 2010. Under this Amendment Two, the additional term will commence on September 1, 2010 and expire February 29, 2012 unless extended to complete the intended purpose of the agreement or terminated earlier pursuant to UTC 11.03. Section 2.02 Medicaid Assurance and Certification As noted in Amendment Number One, Section 2.05 submittal of disclosure information will commence as of September 1, 2010. Disclosure information must be received by HHSC on or before October 1, 2010. Section 2.03 Rates TxDOT P.O. Number 13442006510897000, Revision #4, dated October 26, 2007, is modified to adjust the cost per trip amounts. A reduction of one percent in all unit rates is made as part of the agency's cost savings initiative for state fiscal year 2010-2011. An additional 3.68 percent reduction was made based on the "unit price" adjustment correlated with the price index for Petroleum Price Index (PPI) number WPU0571, gasoline, for those rates that were increased since June of 2006 (relative to increases in the price index for WPU0571, gasoline, during that time). The rates become effective on September 1, 2010. The price adjustment for the trip cost of each line item is as follows: Section 2.04 Effective date The modifications to the Agreement provided in this Amendment Two will take effect upon execution and will terminate on the Expiration Date of this Amended Contract unless extended or terminated sooner by HHSC in accordance with the Agreement. FNOVR 9 -010 I, HHSC Contract No. 529-08-0196-00016G Page 2 ! In Out -of- Attendant Attendant TSA TSAP Name County County In County Out -of - Rate Rate Rate County 2 Citibus 1 $26.72 1 $44.54 1 $26.72 $44.54 Section 2.04 Effective date The modifications to the Agreement provided in this Amendment Two will take effect upon execution and will terminate on the Expiration Date of this Amended Contract unless extended or terminated sooner by HHSC in accordance with the Agreement. FNOVR 9 -010 I, HHSC Contract No. 529-08-0196-00016G Page 2 ! Article M. Representations and Agreements of the Parties Section 3.01 Continuing effect of the Agreement The Parties contract and agree that the terms of the Agreement shall remain in effect and continue to govern except to the extent modified in this Amendment. Section 3.02 Incorporation of the terms of the Amendment By signing this Amendment, the Parties expressly understand and agree that this Amendment is hereby made a part of the Agreement as though it were set out word for word in the Agreement. IN WITNESS HEREOF, HHSC AND CONTRACTOR have each caused this Amendment to be signed and delivered by its duly authorized representative. Health & Human Services Commission By: r '( �1111-11-i Thoml M. Suehs Executive Commissioner Date: 1 HHSC Contract No. 529-08-0196-00016G Page 3 Citibus By: Print Name: TOM MARTIN Job Title: Mayor Date: November 4, 2010 B Print Name: JOHN WILSON Job Title: General Manager Citibus 1TPT,0T � NOV 0 9 wo APPROVED RECIPIENT ATTEST: Rebe&d Garza City Secretary Date: November 4, 2010 APPROVED AS TO CONTENT: --P,a f & Bill Ho on Comm ity Development rector APPROVED AS TO FORM: i Chad Weaver Assistant City Attorney NOV 08Z0f0 U CITY OF LUBBOCK AGENDA ITEM SUMMARY II. CONSENT AGENDA ITEM #/SUBJECT: #Consider a resolution authorizing the Mayor to sign an amendment for the Medical Transportation Services Agreement between the Texas Health and human Services Commission and the City of Lubbock/Citibus. HHSC 529-08-0196-00016G (Citibus) BACKGROUND DISCUSSION: The amendment for the Medical Transportation Services Agreement between the Texas Health and Human Services Commission and the City of Lubbock/Citibus (HHSC 529- 08-0196-00016G) extends the term of the Medical Transportation Contract for an additional eighteen (18) months. Under Amendment Two the additional term will commence on September 1, 2010 and expire on February 29, 2012 unless extended to complete the intended purpose of the agreement or terminated earlier. Under this agreement Citibus' paratransit service provides non -emergency medical transportation for Lubbock and the surrounding counties. The non -emergency medical transportation contract allows Citibus to partner with other communities to provide regional transportation. Citibus is the lead agency and sub -contracts with SPARTAN, a rural transportation provider, to provide trips outside of Lubbock. The amendment includes a price adjustment for the trip cost as follows: TSA TSAP In County Out -of- Attendant In Attendant Name Rate County Rate County Rate Out -of - County 2 Citibus $26.72 $44.54 $26.72 $44.54 The original purchase order/contract was approved by City Council on June 26, 2006. FISCAL IMPACT: With this amendment Citibus will receive $26.72 per non -emergency medical transportation trip, a decrease of 4.68% from the current rate of $28.02. Based on the number of trips provided in 2009 this reduction in price per trip will mean approximately a $33,000 drop in revenue for this contract in FY 2011. It is estimated that the City of Lubbock will receive $780,000 in revenues for FY 2011 from the non -emergency medical transportation contract. This revenue will be available for local match for other Citibus grants, making this a valuable asset for the FY 2011 budget. SUMMARY/RECOMMENDATION: Citibus recommends the approval of the amendment for the Medical Transportation Services Agreement between the Texas Health and Human Services Commission and the City of Lubbock/Citibus. HHSC 529-08-0196-00016G HHSC Contract No. 529-08-0196-00016F STATE OF TEXAS COUNTY OF TRAVIS AMENDMENT ONE TO THE MEDICAL TRANSPORTATION SERVICES AGREEMENT BETWEEN THE TEXAS HEALTH AND HUMAN SERVICES COMMISSION AND Citibus Article 1. Background and Objectives Section 1.01 Background The Health and Human Services Commission ("HHSC"), an administrative agency within the executive department of the State of Texas with its principal place of business at 4900 North Lamar Boulevard, Austin, Texas, 78751, and Citibus, organized under the laws of the State of Texas and having its principal offices at 801 Texas Avenue, Lubbock, TX 79401. HHSC and TSAP may be referred to in this Agreement individually as a "Party" and collectively as the "Parties." The Parties hereby contract and agree to extend the existing Agreement and that the following terms, and conditions apply to the transportation services to be provided by the TSAP. The Texas Department of Transportation ("TxDOT") issued its solicitation entitled "Request for Proposal, Medical Transportation Program, Statewide Transportation Services," Solicitation No. B442006073000 ("RFP") October, 2005 with an initial term of thirty-six (36) months of performance beginning June 26, 2006 until June 25, 2009. TxDOT assigned the contract to HHSC, effective May 1, 2008, pursuant to S.B. 10, 80`h Legislature, Regular Session, 2007. Section 1.02 Authority This Amendment is executed by the authority granted in §531.02414 of the Tex. Gov Code and the Human Resource Code, Section 22.002. Section 1.03 Objectives This Amendment is necessary to reflect changes in the program as mandated by state or federal law and to promote and foster statewide transportation services by further developing and maintaining a network of transportation providers to coordinate services that shall allow maximum service availability to all eligible recipients requiring transportation. The TSAP Page 1 of 9 TSAP Contracts HHSC Contract No. 529-08-0196-00016 TxDOT P.O. No: B442008510885000 understands that HHSC has amended certain compliance requirements pertaining to several Sections of the Agreement. These new requirements are the result of revisions in federal and state laws that the TSAP is obligated to follow in accordance with Article 3, Applicable Laws and Standards, of the Agreement. HHSC has sought to require compliance with these legal changes in all of its vendor agreements. The Parties agree that it is prudent and efficient to modify the Agreement to include these changes to federal and state laws. There are no new financial payments required or additional costs incurred by the Parties in the execution of this Amendment. Article 2. Amendment to the Obligations of the Parties Section 2.01 Modification of Term HHSC, under the Uniform Contract Terms and Conditions, Section 11.03, may terminate the Agreement, or extend the term when, at its sole discretion HHSC determines the term extension is in the best interest of the State of Texas. HHSC seeks to clarify the requirement for all of its TSAP agreements. The language in the TxDOT Purchase Order calls for transportation services to commence on June 26, 2006 for a period of 36 months with the option to renew two additional terms of 36 month periods. The Purchase Order is hereby modified to read as follows. Term of Service: Service shall commence on June 26, 2009 until August 31, 2010 with the option to renew for one additional term of 18 months. Section 2.02 Medicaid Assurance and Certification The U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS), revealed requirements resulting from revisions in federal law. CMS requires certain application and disclosure infonmation'as required under Title 42, Public Health 455.1 Basis and Scope, to include but not limited to: • requirements for a State fraud detection, and • investigation program, and for disclosure of information on ownership and control. HHSC seeks to require compliance with these legal changes in all of its vendor agreements. Section 2.03 Relating to Texas Safety Restraint Laws Section 3, Applicable Laws and Standards, Item 3.6 and Section 10.4, Operator Requirements, Item 10.4.13 of the Agreement allude to Texas safety restraints. HHSC seeks to clarify and comply with legal changes in all of its vendor agreements and hereby modifies and replaces language to Section 10.4.13 to read as follows: Page 2 of 9 TSAP Contracts HHSC Contract No. 529-08-0196-00016) TxDOT P.O. No: B442008510885000 "Ensure that operators and passengers observe all applicable Texas safety restraint laws, including the Child Passenger Safety Seat System requirements contained in Texas Transportation Code Chapter 545." Section 2.04 Criminal Background Checks (CBC) Section 10.4, Operation Requirements, Item 10.4.6,2 and Item 10.4.6.3 relating to criminal background checks, is hereby modified and replaced by the following. 10.4.6.2 The criminal history background check shall include at a minimum, but not limited to, felony or misdemeanor conviction of an act of abuse, neglect or exploitation of children, the elderly or persons with disabilities as defined in Texas Family Code, as amended, Chapter 261 and Texas Human Resources Code, as amended, Chapter 48; an offense under the Texas Penal Code, as amended, against the person; against the family; against public order or decency; against public health, safety or morals; against property; an offense under Chapter 481 of the Texas Health and Safety Code, as amended, (Texas Controlled Substances Act). The Transportation Service Area Provider (TSAP) certifies the TSAP shall, prior to any individual performing work under this contract, conduct or cause to be conducted for each new employee, employee, subcontractor, subcontractor employee who works directly with clients under this Contract, or who have direct access to client records, an Internet Computerized Criminal History file (CCH) background check and a National and State Sex Offender Registry check, which shall be maintained by the TSAP, available for review by the HHSC. The TSAP shall check for felony and misdemeanor convictions for the seven years prior to the hire date and annually thereafter. Individuals with any criminal conviction that falls within the aforementioned categories shall not be allowed to participate . in providing requirements of the purchase order. Information on CCH can be found at: The Texas Department of Public Safety https://records.txdgs.state.tx.us/DPS WEB/Portal/index.aspx National and State Offender Registries can be found at: National: http://www.nsopw.gov State: haps://records.txdns.state.tx.us/DPS WEB/SorNew/index.aspx 10.4.6.2.1 The TSAP shall require each employee, subcontractor, subcontractor employee who works directly with clients or has access to client records, under this Contract to notify the TSAP in writing, within 10 business- days, of criminal convictions (felony or misdemeanor) and or Page 3 of 9 TSAP Contracts TxDOT P.O. No: B442008510885000 HHSC Contract No. 529-08-0196-00016 pending felony charges or placement on a Registry as a perpetrator. This is an ongoing requirement during the term of the contract. 10.4.6.2.2 The TSAP shall require each new employee, employee, subcontractor, subcontractor employee who works directly with clients or has access to client records under this Contract who has not resided or lived in Texas to sign a waiver attesting to the fact they have never been convicted of a felony or misdemeanor referenced in the above paragraph 10.4.6.2 or identified as a perpetrator. If they have been convicted, the nature and conviction date of the felony or misdemeanor must be disclosed. 10.4.6.2.3 The TSAP shall certify that TSAP shall not submit claims for or assign to duties under this Contract, any employee, subcontractor, subcontractor employee based on a determination by the TSAP that the results of a positive CCH and or Registry response make the individual ineligible to provide the service. 10.4.6.2.4 The TSAP shall have a written policy describing the criteria on which the determination was made and must document the basis for each determination. Additionally, the TSAP shall have a written policy regarding acceptable screening practices of new employees who have direct access to client and or client records, which serve to protect the organization and its clients that is clearly defined. The TSAP shall ensure that any subcontractors have this written policy in force. 10.4.6.2.5 If HHSC determines that an employee, subcontractor or subcontractor employee provided services under this Contract for any period prior to completion of the required checks as described above, HHSC may require repayment for the expenditures claimed for the period the required checks had not been completed. Section 2.05 Provider Financial and Criminal Disclosure Requirements The U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS), revealed requirements resulting from revisions in federal law. CMS requires certain application and disclosure information as required under 42 CFR Part 455, Program Integrity: Medicaid; 42 CFR Part 455.104 Disclosure by providers and fiscal agents: Information on ownership and control; 42 CFR Part 455.105 Disclosure by providers: Information related to business transactions. HHSC seeks to require compliance with these legal changes in all of its vendor agreements. Page 4 of 9 TSAP Contracts HHSC Contract No. 529-08-0196-00016 TxDOT P.O. No: B442008510885000 The contract is hereby amended to add the following sections. 10.8.12 Provider agrees to disclose information on ownership and control, information related to business transactions and information on persons convicted of crimes in accordance with 42 CFR Part 455, Subpart B, and provide such information on request to the Texas Health and Human Services Commission (HHSC), Department of State Health Services (DSHS), Texas Attorney General's Medicaid Fraud Control Unit, and the United States Department of Health and Human Services. This disclosure is required of all Providers. Provider agrees to keep its application for participation in the Medicaid program current at all times by informing HHSC or its agent in writing of any changes to the information contained in its application, including, but not limited to, changes in ownership or control, federal tax identification number, phone number, or provider business addresses, at least 10 business days before making such changes. Provider also agrees to notify HHSC or its agent within 10 business days of any restriction placed on or suspension of the Provider's license or certificate to provide medical services, and Provider must provide to HHSC complete information related to any such suspension or restriction. 10.8.13 Provider agrees to disclose all convictions of Provider or Provider's principals within 10 business days of the date of conviction. For purposes of this disclosure, Provider must use the definition of "Convicted" contained in 42 CFR 1001.2, which includes all convictions, deferred adjudications, and all types of pretrial diversion program. Fully explain the details, including the offense, the date and state and county where the conviction occurred and the cause number(s). Section 2.06 Communication Requirements Section 10.2.8 specifies the communications requirements the TSAP shall provide and maintain throughout the contract term. Electronic communication must be compliant with Health Insurance Portability and Accountability Act (HIPAA) security requirements concerning electronic transport of client information. HHSC seeks to clarify this requirement for all of its vendor agreements and hereby incorporates Section 10.2.8.7 language as follows. 10.2.8.7 An operational electronic mail system to receive and respond to encrypted transportation requests from the MTP staff 24 hours a day/7 days a week. The TSAP shall provide notice of any e-mail address or phone number changes. The TSAP must also submit a confirmation e-mail that client trip information has been received within one hour of receipt of client trip requests. Section 2.07 Recordkeeping Section 10.8.1.1 Specifies requirements stipulated by HHSC record retention policies and HHSC's Uniform Contract Terms and Conditions requires a record retention period for all records. HHSC seeks to clarify the requirement for all of its vendor agreements. Page 5 of 9 TSAP Contracts HHSC Contract No. 529-08-0196-00016 TxDOT P.O. No: B442008510885000 10.8.1.1.1 Records related to the Medicaid program for recipients through the age of twenty (20), must be retained indefinitely in accordance with the litigation hold in the class action lawsuit, Frew v. Hawkins related to the THSteps Medicaid program, until MTP notifies the TSAP that the litigation hold is released. Upon such notification, the TSAP shall continue to hold the records according to the usual retention period thereafter. 10.8.1.1.2 Records for non -Medicaid recipients, or Medicaid recipients whom at the time of service were twenty-one (21) years of age or older, must be retained for seven years, after the conclusion of the contract. Section 2.08 Client and Attendant Signature Section 10.2.4 requirements specify that the vendor shall secure a recipient's or responsible party's signature to acknowledge their acceptance for each segment of a trip. HHSC seeks to clarify this requirement for all of its vendor agreements and is hereby modifying and replacing the following language to read as follows: "Obtain recipient and attend"ant signature for documentation of provision of each segment of a trip. Inability to obtain a recipient's or attendant's signature must be documented. Service must not be denied to the recipient or their attendant on the basis of refusal to Sign." Section 2.09 Insertion of time on Driver log Section 10.7.2 specifies the conditions to be satisfied for a TSAP's financial management system. HHSC seeks to clarify this requirement for all of its vendor agreements and is hereby modifying and replacing Section 10.7.2.2 language to read as follows. "Provide records that contain all pertinent documentation, including operator's logs for each service billed to MTP. The operator logs must include the recipient's and the attendant's (if applicable) signatures, and the time that the recipient or their attendant were picked up and dropped off for each segment of a trip." Section 2.010 Calling Card Section 10.3 specifies scheduling and dispatching processes the TSAP shall have in place. HHSC seeks to clarify this requirement for all of its vendor agreements and hereby modifies and replaces Section 10.3.3.2 language to read as follows. "Is responsible for leaving a calling card should a recipient or their attendant fail to appear at the scheduled pick up location. The calling card is left to verify that the TSAP arrived Page 6 of 9 TSAP Contracts HHSC Contract No. 529-08-0196-00016" TxDOT P.O. No: B442008510885000 and left the pick up location. The drive will note the time the card was left on their driver log as verification." Section 2.011 Use of Alternate Transportation Services via Spot Purchase Section 10. 1.3 specifies the type of services the TSAP shall provide to eligible recipients as authorized by HHSC. HHSC seeks to modify the Agreement to allow greater flexibility to the TSAP to respond to exceptional transportation needs. The Agreement is hereby modified to add the following sections following 10.1.3.4. 10.1.3.5 Exceptional Transportation Exceptional transportation service, under extraordinary medical circumstances, defined as non -emergency, same-day travel on -demand transportation, for an unscheduled episodic situation, when the recipient must be seen on the day of the request and treatment cannot be delayed until the next day. 10.1.3.5.1 If a TSAP or a TSAP's subcontracted vehicle is not available for recipient transportation at the time required, the TSAP shall provide an alternate means of transportation services, which may include taxicab services secured via TSAP's spot purchase processes. The vehicle standards specified in Section 10.5, Vehicle Requirements, shall apply to the service procured. In all cases, the TSAP must use the most appropriate service available, which meets the recipient's health care needs and shall not exceed a 5% threshold cumulative of trip(s) services rendered for the preceding service month, without securing HHSC approval. 10.1.3.5.2 Valid requests for exceptional transportation needs shall be honored within three (3) hours of the time the request is made. Section 2.012 Reimbursement of Alternate Transportation Services Section 10.7.1 specifies the terms for payment. HHSC seeks to modify the Agreement to add the following sections following 10.7.1.9. 10.7.1.10 The TSAP shall be reimbursed only for the actual cost of services, as shown by the vendor receipt. No additional administrative or indirect charges will be paid to the TSAP for the use of alternate transportation services. The TSAP shall invoice HHSC. The invoice along with copies of taxicab vendor receipt shall be mailed to: • Texas Health and Human Services Commission Medical Transportation Program, MC 0209 Attn: Accounting P O Box 149030 Austin, TX 78714-9030 Page 7 of 9 TSAP Contracts HHSC Contract No. 529-08-0196-00016 TxDOT P.O. No: BU2008510885000 Section 2.013 HHSC Uniform Terms and Conditions, Version 1.4 a The term "Contract" means the contract awarded as a result of the TxDOT Solicitation and includes all exhibits to the Solicitation. The following documents in order of priority will be incorporated into the Contract: • the Contract document (s); • the TxDOT Solicitation and all addenda, attachments and exhibits; • any modifications, addendum or amendments issued in conjunction with the TxDOT Solicitation; • HHSC's Uniform Contract Terms and Conditions (UTCs). Version 1.4; and • the successful Respondent's proposal. The HHSC UTCs, Version 1.4, are located on the internet at: http://www.hhsc.state.tx.us/about hhsc/Contractingtrfp_attch/General TC.pdf One or more of the "Special Terms" located in Article 16 of the UTCs may apply to the Contract, and HHSC reserves the right to negotiate additional contract terms and conditions, prior to contract execution. Respondents are responsible for reviewing the UTCs and noting any exceptions, reservations, and limitations on the Vendor Information and Disclosures form. Article 3. General Terms and Conditions Section 3.01 Effective date and term of the Amendment This Amendment is effective June 26, 2009 until August 31, 2010 upon execution by the Parties. Section 3.02 Continuing effect of Agreement. The Parties contract and agree that all of the terms and conditions of the Agreement will remain in effect and continue to govern except to the extent modified by this Amendment. Section 3.03 Incorporation ofAmendment By signing this Amendment, the Parties expressly understand and agree that Amendment is hereby made a part of the Agreement as though it were set out word for word herein. The Parties have executed this Amendment, and in their capacities as stated below with authority to bind their organizations on the dates set forth by their signatures. Page 8 of 9 TSAP Contracts HHSC Contract No. 529-08-0196-00016f- TxDOT 29-08-0196-000161 TxDOT P.O. No: B442008510885000 IN WITNESS HEREOF, HHSC and TSAP have each caused this Amendment to be signed and delivered by its duly authorized representative. HEALTH & HUMAN SERVICES COMMISSION By: Albert Hawkins Executive Commissioner Date: 7-13- Z) TSAP NAM ". r Print Name/4t,) L ' W1 �•S° Job Title Cal PXAg Date: . Page 9 of 9 TSAP Contracts TxDOT P.O. No: B442008510885000 HHSC Contract No. 529-08-0196-00016