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HomeMy WebLinkAboutResolution - 3501 - Agreement - TDOH - Health Services - 12_06_1990Resolution # 3501 December 6, 1990 Item #15 DGV:da RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock BE and is hereby authorized and directed to execute for and on behalf of the City of Lubbock Local Health Services Contract No. C1000285 by and between the City of Lubbock and the Texas Department of Health, attached herewith, and associated documents, which 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 6th day of December , 1990. B. C. McMINN, MAYOR ATTEST: ne to Boyd, City Secretary APPROVED AS TO CONTENT: Rita Harmon, Assistant City Manager APPROVED AS TO FORM: Do'Trald G. Van ever, 'First Assis ant City Attorney a .. Texas Department of Health Robert Bernstein, M.D., F.A.C.P. Commissioner September 25, 1990 Anthony B. Way, M.D., Director LUBBOCK CITY HEALTH DEPARTMENT P.O.Box 2548 Lubbock, TX 79408 0000 f Dear Doctor Way: 1100 West 49th Street Austin, Texas 78756-3199 (512) 458-7111 Robert A. MacLean, M.D. Deputy Commissioner Professional Services TDH Document No. C1000285 The 1991 contract for public health services is submitted for signature. Both copies should be completed and returned within 45 days of receipt. Final signature will be obtained and a fully executed copy returned for the record. The cover pages (3) contain blanks which require signature and data pertaining to the Performing Agency, Authorized Contracting Entity, and Vendor/Payee. Please verify the Vendor/Payee name and address as it relates to the vendor identification number. This information must be accurate and complete to ensure timely processing. The attached explanation sheet may be helpful. If adequate information is not filled in, the contract may be returned and/or payments delayed. The General Provisions contain articles which apply to all TDH contracts. If your contract is a renewal of prior fiscal year activities, please be aware of changes or additional requirements contained in Articles 6, 7, 9, 13, 15, 17, and 22. Any special requirements, restrictions, or deviations from the General Provisions will be found in the Special Provisions section of the appropriate Attachment. Each Attachment is numbered and has several sections, which include the term of the contract, legal authorization, special provisions, and the budget. The number of clients/units of service and service area should be entered, if applicable. Please read the Attachment carefully to make sure the data is accurate. The document and attachment numbers should be referenced in all future correspondence. Financial procedures are available upon request for the finance official responsible for accounting, billing, and reporting. Use of these procedures will facilitate claims processing and help avoid delay in your receipt of reimbursements. If you have any questions, please call us at 512/458-7470. Sincerely, Tirn kka" Julian M. Kosh, Jr., Director Grants Management Division JMK:wa Enclosure OCT o 4 1990 TEXAS DEPARTMENT OF HEALTH CONTRACTS COVER PAGE INFORMATION a. Performing Agency is defined as an entity that is performing services for the Texas Department of Health through a contractual agreement. b. Authorized Contracting Entity refers to the Performing Agency's governing body. C. The designation of Vendor/Payee organization is required. Please verify or fill in the blank with the appropriate classification (some examples are listed on cover page 1). d. Designate whether Performing Agency is a small business and/or minority/woman owned business. See definitions below. For this purpose, 'small business' is defined by using the criteria contained in 13 CFR Part 121. Generally, if no standard for an industry's field of operation is provided in the regulations, a small business concern means an independently owned and operated business that is not dominant in its field of operation. It may include, but is not limited to, an individual, a partnership, a corporation, a joint venture, an association, .or a cooperative. In addition, the concern must make a significant contribution to the U.S. economy through payment of taxes and/or use of .American products, materials. and labor. A minority -owned enterprise is a business, at least 50 percent of which is owned by minority group members, or in the case of publicly owned business, at least 51 percent of the stock of which is owned by minority group members. 'A women -owned business is defined as a business which is, at least. 51 percent owned, controlled and operated by a woman or women. e. Vendor/Payee Name, Vendor Address and State of Texas Vendor Identification No. Please verify/provide us with the vendor name. address and ZD No. to be used on billings submitted against this contract. This information must match exactly with the vendor record as on file with the State Comptroller's Office. f. Enter name and title of Financial Offiger/Contact person. g. Signature, Name and Title of Person Authorized to Sign Contracts must be completed. If authority to sign contracts has been delegated by the governing body to someone -other than the governing body, i.e., Performing Agency director, a letter from the governing body must be attached. h. The Performing Agency director must sign 'Recommended By" section if he/she is not the one authorized to sign the contract. Interim or acting, director/ administrator should sign if the director position is vacant. If you need assistance in determining status of an item, please call Grants Management Division at (512) 458-7470. Rev. 4190 TEXAS DEPARTMENT OF �iEALTH CONTRACT 1100 West 49t Street Austin, Texas 78756-3199 STATE OF TEXAS COUNTY OF TRAVIS TDH Document No. C1000285 This contract is -between the Texas Department of -Health, hereinafter referred to as RECEIVING AGENCY, and the- party listed below as PERFORMING AGENCY and _ includes general provisions and attachments detailing scope(s) of work and special provisions. _ PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT (PRINT or TYPE) { 1 Mailing Address: P.O.Box 2548 Lubbock TX 79408 0000' { y (st) P) 1 L Street Address: 1902 Texas Avenue Lubbock TX 79408 00001 1 eren i y s (st)(ZIP) { { Authorized { Contracting Entity: CITY OF LUBBOCK 6 1 --_-i- different from PERFORMING AGENCY) 1 Payee Name: CITY OF LUBBOCK HEALTH DEPARTMENT j +(Must match with vendor i en i ica ion number shown below) 1 Payee Address: P.O. BOX 2000 LUBBOCK TX 79457 0000' 1 us mac with vendor i en ifica ion number shown { Below { State of Texas Vendor Identification No. (14 digits): 17560005906037 f Finance Officer/Contact: Doug Goodman 1 1 r Type of Organization: Cit 1 1 Designate: Elementary/secondary school, junior college, senior college/university i { cityy, county, other political subdivision, council of governments, judicial district, community services program, individual, or other (define) y Is this a small business No (Yes/No) and/or minority/woman owned No (Yes/No) 4 Is this a non-profit business _ (Yes/No) PAYEE AGENCY Fiscal Year Ending Month: SEPTEMBER + SUMMARY OF TRANSACTION: Contract for public health services. 1 1 1 1 y 1 1 { � COVER - Page 1 • DETAILS OF ATiAL KENTS ., Financial Assistance : At. TD4 Term ! Source G D1T?Ct Total Assistance ! ' V:. Prodraa ! Begin ! End ; Funds* `. Ascnct Assistance Amount (TDB Share, ! ' '• CRE-`,9S 91 1190'. 813I191! STATE 13.268 yC9-L9 ! 9/ 1l90', 8/31191; STATE :3.994 _� .c .Is! 29.004.00! 217..594.00! . ` E1tcIH: ! 9/ 1l90! 813I191!'STATE, V .538.90! } • ', - ..,p 1 t . ' 1 , t 1 1 . - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - -- -- - •- -- • - -• - -- -- t .. a:r.t tic. CL(!CO285 f 544,514.00! fu-.s are indicated by a number =rca tF - ztalog of F_ e-a: - aes- c assistance (.CFDA.), .if appl. ^able. :? 0 BUDGET SECTION OF AKY ZERO AKOUVT AT'Al. E41 "OR DUALS. '- ED - P' a a. g. .. EXECUTED iN DUPLICATE ORIGIKAI,S OK THE BATES SHOlIN. CITY OF LUM%l TOR Document No.: C1000285 Authorized Coeracting Entity (type above if different frcm PERFORMING AGENCY) for and ti lwe►=_lf of: LUBBOCK CITY -FILTH DEPARTMENT TEXAS DEPARTMENT OF HEALTH PER,':%ulkG AGENCY RECEIVING AGENCY By: G✓e' By: (Sic,,aure cf person authorized .(Signature of person authorize: to si,, x;:racts) to sign contracts) Terry Faye Bleier, Chief B. C. McMINN, MAYOR Bureau of Financial Services (Nzce ari Title) (Name and Title) -Oate: December 6, 1990 -Date: RECCMMEN$E: APPROVED AS TO FORK: By: By: (PERFORMiKS AGEKCY Director, Office of General Counsel if di*fere--: fr.-m person - authorize: to sign contract) COVER - '=ye 3 GENERAL PROVISIONS FOR TEXAS DEPARTMENT OF HEALTH CONTRACTS PERFORMING AGENCY and 'RECEIVING AGENCY agree this contract, assurances, general and/or special provisions, and attachment(s) with detailed scope(s) of work and budget(s), as applicable. incorporate all covenants and agreements pertaining hereto. No prior agreement or understanding, oral or otherwise," of the parties'or their agents will be valid or enforceable unless embodied in this contract. The person or persons signing and executing this contract on behalf of PERFORMING AGENCY, or representing themselves as signing and executing this contract on behalf of PERFORMING AGENCY, do hereby warrant and guarantee that he, she, or they have been duly authorized by PERFORMING AGENCY to execute this contract on behalf of PERFORMING AGENCY and to validly and legally bind PERFORMING AGENCY to all terms, performances, and provisions.herein set forth. PERFORMING AGENCY hereby assures compliance with the following terms and conditions unless otherwise specified in the attachment(s) hereto: ARTICLE 1. Scone of Work PERFORMING AGENCY will perform the work outlined in the Scope(s) of Work contained in the attachment(s) hereto which is/are referenced in the Details of Attachments and hereby incorporated and made a part of this contract, plus amendments which may be added by additional attachment(s) from time to time as hereinafter provided._ Satisfactory performance of this contract will be measured in part by: (1).adherence to the contract; (2) results of CPA or State Auditor reports; and, 3) timeliness, completeness, and accuracy of required reports. ARTICLE 2. Term The time period of this contract will be governed by the _term(s) on the attachment(s). No commitment of contract funds is permitted prior to the first day nor subsequent to the last day of the term. The term may be extended by amendment(s). ARTICLE 3. Funding This contract is contingent upon funding being available for the term of the attachment(s) and PERFORMING AGENCY will have no, right of action against RECEIVING AGENCY in the event that RECEIVING AGENCY is unable to perform its obligations under this contract as a result of the suspension, termination, 'withdrawal, or failure of funding to RECEIVING AGENCY or lack of sufficient funding of RECEIVING AGENCY for any attachment(s) to this contract. If funds become unavailable, provisions of the Termination Article will apply. ARTICLE 4. Amendments This contract may be amended, and such amendments will be in writing and duly executed by the parties hereto. 1991 GENERAL PROVISIONS Page 1 ' (rev.5/90) ARTICLE 5. Severabilit If any provision of this contract will be construed to be illegal or invalid, this will not affect the legality or validity, of any of the other provisions hereof. The illegal or invalid provision will be deemed stricken and deleted herefrom;to the same extent and effect as if never incorporated herein, but all other provisions will continue. ARTICLE 6. Applicable Laws and Standards This contract will be governed by the laws of the State of Texas and enabling state/federal regulations, including federal grant requirements applicable to funding sources as set out in attachment(s) hereto, and Treasury Circular 1075 (31 -CFR Part 205) as applicable to advance of funds. If PERFORMING AGENCY is a local governmental public health entity, this contract will also be governed by the Local Public Health Reorganization Act, Chapter 121, Health and Safety Code. PERFORMING AGENCY agrees Article 4413 (32g), V.T.C.S., [Uniform Grant and Contract Management Standards Manual (UGCMS)], as may be amended by revised federal circulars to be incorporated in UGCMS by the Governor's Budget and Planning Office, applies as terms and conditions of this contract, and the standards are adopted by reference in,their entirety. If a conflict arises between the provisions of this contract and UGCMS, the provisions of UGCMS will prevail unless expressly stated otherwise. A copy of this manual and its references are provided to PERFORMING AGENCY by RECEIVING AGENCY upon request. PERFORMING AGENCY must obtain prior approval from RECEIVING AGENCY for major project changes which are specified in RECEIVING AGENCY's institutional prior approval procedures. These procedures are incorporated by reference as a condition of this contract. In accordance with Section 1352 of Public Law 101-121, effective December 22, 1989, PERFORMING AGENCY is prohibited from using funds. granted under this contract for lobbying Congress or any agency in connection with a particular contract. In addition, if at any time, the contract exceeds $100,000, the law requires certification that none of the funds provided by PERFORMING AGENCY to RECEIVING AGENCY have been used for payment to lobbyists. Regardless of funding source, and if a contract exceeds $100,0.00, disclosure form must be completed if PERFORMING AGENCY has any agreement with a lobbyist. This certification and/or form is available upon request and must be forwarded to RECEIVING AGENCY within 90 days of receipt PERFORMING AGENCY certifies by execution of this contract that its payment of franchise taxes is current or, if PERFORMING AGENCY is exempt from payment of franchise taxes, that it is not subject to the State of Texas franchise tax. A false statement regarding franchise tax status will be treated as a material breach of this contract and may be grounds for termination at the option of RECEIVING AGENCY. If franchise. tax payments become delinquent during the attachment term, payments under this contract will be held until PERFORMING AGENCY's delinquent franchise tax is paid in.full. 1991 GENERAL PROVISIONS = Page 2 (rev.5J90) PERFORMING AGENCY further certifies by execution of this contract that it is not ineligible for participation in federal or state assistance programs under Executive Order 12549, Debarment. and Suspension. PERFORMING AGENCY specifically asserts that it does not owe a single substantial debt or a number of outstanding debts to a federal or state agency. A false statement regarding PERFORMING AGENCY's status will be treated as a material breach of this contract and may be grounds for termination at the option of RECEIVING AGENCY. ARTICLE 7. Assurances PERFORMING AGENCY assures that no person will, on the grounds of race, creed, color, handicap, national origin, sex, political affiliation or beliefs, be excluded from, be denied the benefit of, or be subjected to discrimination under any program or activity funded in whole or in part under this agreement. Incorporated by reference the same as if specifically written herein are the rules, regulations, and all other requirements imposed by law including, but not limited to, compliance with those pertinent rules and regulations of the State of Texas and those of United States agencies providing funds to the State of Texas. PERFORMING AGENCY assures it will not transfer or assign its interest in this contract without written consent of the the RECEIVING AGENCY. ARTICLE 8. Standards For Financial Management PERFORMING AGENCY will develop, implement, and maintain financial management and control systems that meet or exceed the requirements of UGCMS. Those requirements include at a minimum: 1. Financial planning including the development of budgets that adequately reflect all functions and resources necessary to carry out authorized activities and the adequate determination of costs; 2. Financial management system including accurate, correct, and complete payroll, accounting, and financial reporting records, cost source documentation, effective internal and budgetary controls, determination of reasonableness, allowability, and allocability of costs, and timely and appropriate audits and resolution of any findings; and, 3. Billing and collection policies including a charge schedule, a system for discounting or adjusting charges based on a person's income and family size, and a mechanism capable of billing and making reasonable efforts to collect from patients and third parties. ARTICLE 9. Allowable Costs Only those costs allowable under UGCMS and OMB Circular A-110, and any revisions thereto, plus any applicable federal cost principles are eligible for reimbursement under this contract. Applicable cost principles and audit requirements are as follows: Circular Applicable Cost Principles Audit Requirement A-87 State & Local Governments Circular A-128 1991 GENERAL PROVISIONS - Page 3 (rev.5/90) To ,be eligible for reimbursement under this contract, a cost must have been incurred within the attachment term and paid by PERFORMING AGENCY prior to claiming reimbursement from RECEIVING AGENCY or encumbered by thelastday of the attachment term and liquidated no later than 45 days after the end of the attachment term. Each PERFORMING AGENCY/AUTHORIZED CONTRACTING ENTITY receiving $25,000 or more in total federal/state financial assistance during their fiscal year shall arrange for an agency -wide financial and compliance audit of the PERFORMING AGENCY'S/AUTHORIZED CONTRACTING ENTITY'S fiscal year. The audit must be conducted by an independent CPA and must be in accordance with the applicable OMB Circulars and Government AuditingStandards. Procurement of audit services will comply with state procurement procedures, as well as provisions of UGCMS . Within 30 days of receipt of audit report, PERFORMING AGENCY/AUTHORIZED CONTRACTING ENTITY will submit a copy to RECEIVING AGENCY'S Internal Audit Division. ARTICLE 10. Overtime Compensation None of the funds provided by attachment(s) will be used to pay overtime. PERFORMING AGENCY will be responsible for any obligations of overtime pay due employees. 'ARTICLE 11. Terms and Conditions of Payment For services satisfactorily performed pursuant to the Scope(s) of Work, PERFORMING AGENCY will receive reimbursement for allowable costs. Reimbursements will not exceed the total of each attachment(s) hereto and are contingent on a signed contract. Claims for reimbursement will be made.on a State of Texas Purchase Voucher (TDH Form 1AG-37). Vouchers for reimbursement of actual expenses will be submitted monthly within 20 days following the end of the month covered by the bill. A make-up claim may be submitted as a final close-out bill not later than 45 days following the end of attachment term(s). Advance payment may be requested in accordance with the applicable provisions of this contract. Payments made for approved claims or notice of denial of claims submitted against attachment(s) to this contract will be. mailed not later than 60 days after receipt of monthly vouchers. Payment is considered made on the date postmarked. Any reimbursements made by PERFORMING AGENCY to subcontractors will be made in accordance with Article 601f,.V.T.C.S. Funding from this contract will not be used to supplant state or local funds, but PERFORMING AGENCY will use such funds to increase state or local funds currently available to PERFORMING AGENCY for a particular activity. PERFORMING AGENCY further agrees to maintain to the best of its ability its current level of support, if any. PERFORMING AGENCY will refund to RECEIVING AGENCY any funds PERFORMING AGENCY claims and receives from RECEIVING AGENCY for the reimbursement of costs which are determined by RECEIVING AGENCY to be ineligible for reimbursement. 1991 GENERAL PROVISIONS —Page 4. (rev.5/90) RECEIVING AGENCY will have the right to withhold all or part of any future payments to PERFORMING AGENCY to offset any reimbursement made to PERFORMING AGENCY for any ineligible expenditures not refunded to RECEIVING AGENCY by PERFORMING AGENCY. - Payment may be denied for noncompliance if required financial reports are not on file for previous quarters or for the final period, or for failure to respond to financial compliance monitoring reports, or if program requirements are not met as specified in the Scope(s) of Work. ARTICLE 12. Advance Payments PERFORMING AGENCY may request. in writing, a one time advance with proper justification and the concurrence of RECEIVING AGENCY. Amount of advance will be determined by the amount and term of the attachment(s); however, for each attachment, the amount of the advance will not exceed - one- sixth (1/6th) of a twelve-month attachment. Advance will be requested on a State of Texas Purchase Voucher at the beginning of attachment period or at a_ single later time in the attachment period if circumstances so warrant and the request is approved. Advance funds will be liquidated during the attachment term so that, after final monthly billing, PERFORMING AGENCY will not have advance funds on hand. Advance funds may be drawn only to meet immediate cash needs for disbursement (UGCMS and federal circulars). Amendments to this contract may require upward or downward adjustment to the allowable advance until it equates 1/6th of a twelve-month attachment or approximates two months operating costs. In the case of a downward adjustment, PERFORMING AGENCY and RECEIVING AGENCY will agree on the amount of adjustment to the advance. RECEIVING AGENCY retains the option to reduce future claims by the required amount. In the case of an upward adjustment and PERFORMING AGENCY needs additional funds to meet immediateoperating expenses, PERFORMING AGENCY may submit to RECEIVING AGENCY a written justification and State of Texas Purchase Voucher in the amount necessary to correct the ratio. ARTICLE 13. Proeram Income PERFORMING AGENCY will develop a fee for service system and a schedule of fees for personal health services in accordance with the provisions of Article 4414c, V.T.C.S., and the Texas Board of Health rules covering Fees for Clinical Health Services (25 TAC, Sec. 1.91) and other applicable laws provided, however, that a patient may not be denied a service due to inability to pay. All revenues received from the delivery of contract services will be identified, reported, and utilized as provided in this article. Such program income will be retained by PERFORMING AGENCY and: (1) be used by PERFORMING AGENCY for any purposes which further the objectives of the program and the Scope of Work for the attachment(s) and be deducted from total project costs; or, (2) be deducted from total project costs. This is according to RECEIVING AGENCY policy interpreting UGCMS, a copy of policy is provided on request and is incorporated by reference as a condition of this contract. 1991'GENERAL PROVISIONS Page 5 (rev.5/90) ARTICLE 14. Financial Reports Financial reports are required as provided in UGCMS and will be filed regardless of whether or not expenses have been incurred. Quarterly Financial Status Report, State of Texas Supplemental Form 269a (TDH Form GC-4), will be submitted within 20 days following the end of each quarter. Annual/Final A final financial report, Request for Advance or Reimbursement, Form 270 (TDH- Form GC-10) will be submitted not later than 45 days following the end of attachment term(s).. An amended Form 269a will be submitted if the amount of expenditures reported in the last quarter changed. If necessary, a State of Texas Purchase Voucher will be submitted if all costs have not been recovered or a refund will be made of excess monies if costs incurred were less than funds received. ARTICLE 15. Reports and Inspections PERFORMING AGENCY will submit financial, program, progress, and other reports as requested by RECEIVING AGENCY in the format agreed to by the parties hereto. RECEIVING AGENCY and, when federal funds are involved, any authorized representatives) of the federal government have the right, at all reasonable times, to inspect or otherwise evaluate the work performed or being performed hereunder and the premises in which it is being performed, including subcontractors PERFORMING AGENCY will participate in and provide reasonable access, facilities, and assistance to the representatives. All inspections and evaluations will be performed in such a manner as will not unduly delay the work. PERFORMING AGENCY agrees that RECEIVING AGENCY and the federal government, or any of their duly authorized representatives, will have access to any pertinent books, documents, papers, and records of PERFORMING AGENCY for the purpose of making audit, examination, excerpts, and transcripts of transactions related to _contract attachment(s). RECEIVING AGENCY will have the right -to -audit billings both before and after payment. Payment under attachment(s) will not foreclose the right of RECEIVING AGENCY to recover excessive or illegal payments. Any deficiencies identified by RECEIVING AGENCY upon examination of PERFORMING AGENCY's records will be conveyed in writing to PERFORMING AGENCY. PERFORMING AGENCY's resolution of findings will also be conveyed in writing to RECEIVING AGENCY within 30 days of receipt of RECEIVING AGENCY's findings. A determination by RECEIVING AGENCY of either an inadequate or inappropriate resolution of the findings may result in the withholding of funds or .suspension of the contract attachment(s). Any such withholding of funds or suspension will remain in effect until the findings are properly remedied as determined by RECEIVING AGENCY. 1991 GENERAL PROVISIONS Page 6 (rev.5/90) PERFORMING AGENCY will retain all such records for a period of three years from the date of the last expenditure report submitted under contract attachment(s) or until resolution of all audit questions, whichever time period is longer. ARTICLE 16. Client Records At the end of the attachment term, all client records are the property of PERFORMING AGENCY. RECEIVING AGENCY retains the right to have access to the records or obtain copies for audit, litigation, or other circumstances. that may arise. If at any time during the attachment term(s), PERFORMING AGENCY and/or RECEIVING AGENCY should decide to terminate the agreement. RECEIVING AGENCY may require the transfer of client records upon written notice to PERFORMING AGENCY. Records may be transferred to another entity that agrees to continue the service or, at the option of RECEIVING AGENCY, the records may be transferred to RECEIVING AGENCY headquarters. ARTICLE 17. Confidentialit PERFORMING AGENCY will have a system in effect to protect from inappropriate disclosure of patient records and all other documents deemed confidential by law which are maintained in connection with the activities funded under contract attachment(s). Any disclosure of confidential patient information by PERFORMING AGENCY, including information required by the Reports and Inspections Article, will be in accordance with applicable law. If providing direct client services, PERFORMING AGENCY agrees to implement workplace guidelines similar to the guidelines adopted by RECEIVING AGENCY and to make available educational materials for employees concerning the human immunodeficiency virus (HIV) and its related conditions including acquired immunodeficiency syndrome (AIDS). Further, PERFORMING AGENCY agrees to develop and implement guidelinesregardingconfidentiality of AIDS and HIV - related medical information for employees of PERFORMING AGENCY and for clients, inmates, patients, and residents served by PERFORMING AGENCY. Such guidelines will be consistent with those published by RECEIVING AGENCY and with state and federal law and regulations. A PERFORMING AGENCY that does not adopt confidentiality guidelines as herein required is not legally eligible to receive state funds until the guidelines are developed and implemented. If PERFORMING AGENCY does not have workplace and/or confidentiality guidelines, PERFORMING AGENCY may use those which have been adopted by RECEIVING AGENCY'S Texas Board of Health and which areavailableupon request. ARTICLE 18. Equipment and Supplies Equipment is defined as tangible nonexpendable property with an acquisition cost of over $500 and a useful life of more than one year. In accordance with Article 601b, V.T.C.S., Section 8.02(c), title to all equipment purchased from funds provided herein will be in the name of PERFORMING AGENCY throughout the contract/attachment(s) term(s). Unless initially listed and approved in the contract/attachment(s) prior written approval from RECEIVING AGENCY is required for any _additions to or deletions of approved equipment purchases having an acquisition cost exceeding. 1991 GENERAL PROVISIONS Page 7 (rev.5/90) $500. To receive approval for data processing hardware and software purchases with an acquisition cost over $500, PERFORMING AGENCY must submit a detailed justification which includes description of features,make and model, and cost, etc. PERFORMING AGENCY will maintain an annual property and inventory, and submit a report to RECEIVING AGENCY at the end of the contract/attachment(s) term(s). PERFORMING AGENCYwilladminister a program of maintenance, repair, and protection of assets under this contract/attachment(s) so as to assure their. full availability and usefulness. In the event PERFORMING AGENCY is indemnified, reimbursed, or otherwise compensated for any loss of, destruction of, or damage to the assets provided under this contract /attachment(s), it will use the proceeds to repair or replace said assets. PERFORMING AGENCY agrees that upon termination of contract/ attachment (s), title to any remaining equipment purchased from funds as hereinabove provided will be transferred to the RECEIVING AGENCY or any other party designated by the RECEIVING AGENCY; provided, however, that RECEIVING AGENCY ,may, at its option and to the extent allowed bylaw, transfer title to such property to the PERFORMING AGENCY. ARTICLE 19. Subcontractin PERFORMING AGENCY may enter into agreements with subcontractors unless restricted or otherwise prohibited in specific'attachment(s). If PERFORMING 'AGENCY elects to enter into an agreement which subcontracts out a substantial portion of PERFORMING AGENCY's Scope of Work, prior writtenapproval must be obtained from RECEIVING AGENCY. Subcontracts, if any, entered into by PERFORMING AGENCY will be in writing and subject to the requirements of this contract. PERFORMING AGENCY agrees that it will be responsible to RECEIVING AGENCY for the performance of any subcontractor. ARTICLE 20. Copyrights and Publications PERFORMING AGENCY understands and agrees that where activities supported by the contract attachment(s)'produce original books, manuals, films, computer programs (including executable computer programs and supporting data in any form), or other original material, PERFORMING AGENCY may copyright such material subject to any rights to same reserved by or vested in the federal government or any agency thereof; however, RECEIVING AGENCY may grant to PERFORMING AGENCY limited rights to produce, publish, and use such materials as appropriate. PERFORMING AGENCY may publish at its. expense the results of contract performance with prior RECEIVING AGENCY review and approval. Any publication (written,- visual, or sound) should include acknowledgment of the _support received from RECEIVING AGENCY and the appropriate federal agency, if applicable. At 'least three copies of any such publication must be provided to RECEIVING AGENCY. RECEIVING AGENCY reserves the right to require additional copies before or after the initial review. ARTICLE 21. Hold Harmless PERFORMING AGENCY, which is not a state agency, assures that it is an independent contractor and not an agent, servant, or employee of the state. 1991 GENERAL PROVISIONS. Page 8 (rev.5/90) Except to the extent that Chapter 104 of the Texas Civil Practice and Remedies Code is applicable to this contract, PERFORMING AGENCY agrees to hold RECEIVING AGENCY and/or federal government harmless and to indemnify them from and against any and all claims, demands. and causes of action of every kind and character which may be asserted by any third party occurring or in any way incident to, arising out of, or in connection with the performance of services by PERFORMING AGENCY under this contract to the extent allowed by law. PERFORMING AGENCY, by acceptance of funds provided through contract attachment(s), agrees and ensures that personnel paid from these funds are duly licensed and/or qualified to perform the required services. ARTICLE 22. Bondintc Each person 'employed by PERFORMING AGENCY who handles funds under this contract, including persons authorizing payment of such funds, will be covered by the terms of a fidelity bond providing for indemnification of losses occasioned by:`(1) any fraudulent or dishonest act or acts committed by any of PERFORMING AGENCY's employees either individually or in concert with others, and/or, (2) failure of PERFORMING AGENCY or any of its employees to perform faithfully his/her duties or to account properly for all monies and property received by virtue of his/her position or employment. This fidelity bond will be in the amount of not less than Ten Thousand Dollars ($10,000). ARTICLE 23. Suspension/Termination If PERFORMING AGENCY fails to comply with RECEIVING AGENCY's reporting requirements, the program objectives, or the contract award conditions, RECEIVING AGENCY may withhold payments. RECEIVING AGENCY will provide advance written notice to PERFORMING AGENCY which will identify the deficiency and RECEIVING AGENCY's intent to withhold payments if the deficiency is not corrected within a specific number of days. When the deficiency is corrected, RECEIVING AGENCY will release any withheld payments with no further action. If PERFORMING AGENCY fails to comply with the terms, conditions, or standards of this contract, RECEIVING AGENCY may suspend the contract attachment(s) and prohibit PERFORMING AGENCY from incurring additional obligations of funds pending either corrective action or termination. RECEIVING AGENCY will provide written notice to PERFORMING AGENCY at least thirty (30) days in advance of the suspension date. Such notice will detail the nature of noncompliance and specify a correction date. PERFORMING AGENCY may request a hearing on the proposed suspension if such request is made in writing within ten (10) days from any final notification of suspension. This contract or any attachment(s) hereto may be terminated by either of the parties hereto for noncompliance by the other party. A party intending to terminate for noncompliance by the other party will provide written notice to the other party at least thirty (30) days prior to the intended date of termination. Such notice will include the reasons for the termination and will provide the other party an opportunity to rebut the reasons in writing. A hearing may be requested on the proposed termination if such request is made in writing within ten (10)-days fromanyfinal notification of termination. By such termination, neither party may nullify obligations already incurred for performance or failure to perform prior to the date of termination. Such _terminationwill not be an exclusive remedy but will be in addition to any other rights and remedies provided by law or under this contract.' 1991 GENERAL PROVISIONS Page 9 (rev.5/90) This contract or any attachment(s) hereto may be terminated in whole, or in part, when both parties agree that continuation would not produce results commensurate with further expenditure of funds.Both parties will agree on the effective date and, in the case of partial` termination, the portion to be terminated. RECEIVING AGENCY will immediately send PERFORMING AGENCY written notice of the terms agreed to and such notice will '`become 'a part of the contract. PERFORMING AGENCY will ,not incur new obligations for the terminated portion after the effective date of termination and will cancel as many outstanding obligations as possible. RECEIVING AGENCY will allow fullcredit to PERFORMING AGENCY for`noncancelable obligations which were _properly incurred prior to the termination date. This contract or any attachment(s) hereto may be terminated if funds allocated for any attachment(s) hereto should become reduced, depleted, or unavailable during any attachment(s) budget period, and RECEIVING AGENCY is unable to obtain additional funds for such purposes. RECEIVING AGENCY will immediately provide written notification to `PERFORMING AGENCY of such fact and such attachment(s) to this contract is/are terminated upon- receipt of that notification. PERFORMING AGENCY will not incur new obligations after the effective date of termination and will cancel as many outstanding obligations as possible. RECEIVING AGENCY will allow full credit to PERFORMING AGENCY for noncancelable obligations which were properly incurred prior to the termination date. 'This contract or any attachment(s) hereto may be terminated in the event that federal or state laws or other requirements should be amended or judicially interpreted so as to render continued fulfillment of this contract, on the part of either party, unreasonable or impossible. If the parties should be unable to agree upon amendment which would therefore be needed to enable the substantial continuation of the services contemplated herein, then, upon written notification by RECEIVING AGENCY to PERFORMING AGENCY, the parties will be discharged from any further obligations created under the terms of this contract, except for the equitable settlement of the respective accrued interests or obligations as of the date of termination. ARTICLE 24. Personnel All personnel funded by attachment(s) to this contract are employees of PERFORMING AGENCY which will be responsible for their direction and control and liable for any of their acts or omissions PERFORMING AGENCY will have in place legally sufficient Due Process Hearing Procedures for all of its employees filling state budgeted positions. PERFORMING AGENCY will have full authority to employ, promote, suspend, demote, discharge, and transfer within its organization any and all state budgeted personnel funded by attachment(s) to this contract provided, however, that any demotion, suspension, or discharge of such state budgeted employees will be in accordance with the Due Process Hearing Procedures as set out above. The only distinction between state budgeted and local paid employees is that employees on state budgeted positions receive state benefits and are subject to certain duties, obligations, and restrictions as state'employees as contained in state law. One such restriction,' as contained in the State Appropriations Act, is that no employee, paid on a state budgeted position may 1991 GENERAL PROVISIONS - Page 10 (rev.5/90) receive a salary supplement from any source unless specifically authorized in the Appropriations Act or other state law. This prohibition includes, but is not limited to, the payment to such employee of a so-called "flat rate" car allowance or travel allowance. Any such travel or per diem to these employees must be on a reimbursement basis, supported by appropriate records, and may not exceed the reimbursement for mileage and/or per diem allowed under the Appropriations Act and current state travel regulations. This restriction will apply whether travel funds are provided in attachment(s) under this contract or from any other source. PERFORMING AGENCY will utilize RECEIVING AGENCY4s policies and procedures for hiring and promoting individuals into state budgeted positions funded by attachment(s) to this contract. Qualifications of any individuals filling these positions will be subject to approval of RECEIVING AGENCY's Bureau of Personnel Management. The purpose of the approval is to ensure that individuals occupying these positions meet minimum educational and experience requirements. PERFORMING AGENCY will maintain required records and submit documents necessary to process personnel, payroll, leave and time records, and travel claims on state budgeted positions. PERFORMING AGENCY will be furnished by RECEIVING AGENCY state warrants for salary compensation or travel reimbursement for issuance to employees on state budgeted positions. An independent audit is not required as a condition of this contract if the attachment provides assistance through assignment of state budgeted positions and no funds are budgeted for local costs. PERFORMING AGENCY may be reimbursed for local personnel costs or other categories of expense used to fulfill the scope of work of attachment(s) in lieu of being furnished state payroll warrants after a state budgeted position becomes vacant. Reimbursement will not exceed the balance of funds on the state budgeted position after all benefits, obligations, and/or other entitlements are met. PERFORMING AGENCY's Director, or other person(s) authorized elsewhere in this contract, may submit a request for conversion. RECEIVING AGENCY will transmit formal approval. and a revised budget to PERFORMING AGENCY to complete the conversion. ARTICLE 25. Funding Participation Requirement PERFORMING AGENCY agrees funds provided through this contract will not be used for matching purposes in securing other funding. ARTICLE 26. Performance -Based Attachments History RECEIVING AGENCY is responsible for developing performance -based public health services contracts in response to the State Auditor's Report. This system will enhance service delivery and improve accountability and efficiency in the management of public health dollars. Plans for initial implementation were designed to use the model objectives format stemming from recommendations of the Committee on Model Objectives for Local Public Health in Texas. The committee was composed of representatives 1991 GENERAL PROVISIONS.- Page 11 (rev.5/90) of local health departmentsandRECEIVING, AGENCY'S central and public health region offices in consultation with the University of Texas School of Public Health ,in Houston. The concept was piloted in three local health departments and is being used by the public health regions in planning, managing, and evaluating selected public health services. Purpose The overall goal of performance -based contracts is improved public health practices in. Texas. The project is intended to: identify public health needs and establish priorities which provide a rational basis for resource allocation; project realistic outcomes based on activities which can be accomplished with current or planned resources, communicate needs, and build consensus at all levels regarding directions to be taken in specific programs; and, institute -a system for planning, implementing, managing, and evaluating programs and monitoring progress toward reducing and/or alleviating public health problems. Process PERFORMING AGENCY will prepare outcome and process objectives relative to local needs and resources in the following selected program areas, if applicable: -AIDS/HIV -Chronic Disease Prevention and Control -Food Protection -Immunization -Maternal and Child Health By the end of the current state fiscal year, PERFORMING AGENCY will show evidence of a monitoring system to evaluate progress towards the objectives. RECEIVING AGENCY will provide training, written documentation, and ongoing technical assistance to PERFORMING AGENCY in the development of objectives and a monitoring system. RECEIVING AGENCY contact for matters pertaining to the performance -based public health services project is the Office of the Associate Commissioner for Community and Rural Health. It is understood and agreed to by both parties that some objectives may not be met and achievement levels may be different than estimated. The objectives are recognized as test processes and achievement below the established levels will not affect the right of PERFORMING AGENCY to funds provided through Attachment(s) when the basic program scope of work has been fulfilled. Any disputes arising from procedures or actions taken as part of this project will be addressed and resolved to the mutual satisfaction of both parties. 1991 GENERAL PROVISIONS - Page 12 (rev.5/90) DOCUMENT NO. C1000285 ATTACHMENT NO. 0.1 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: COMMUNITY AND RURAL- HEALTH TERM: September 1, 1990 THROUGH August 31, 1991 SECTION I. SCOPE OF WORK: PERFORMING AGENCY will use direct assistance and/or financial assistance from RECEIVING AGENCY to supplement the delivery of comprehensive public health services. Comprehensive health services encompass a wide variety of personal health services, environmental health services, and other problems of the jurisdiction. Personal health services may include but are not limited to adult health/chronic disease, AIDS/HIV, chronically ill/disabled children, dental, immunization,.laboratory, maternal and child health, public health promotion/education, sexually transmitted disease control, and tuberculosis control. Environmental health services/inspections may include but are not limited to food, premise, swimming pool, vector control, and wastewater control. Other services may be provided as needed when agreed to by both parties. Reports of comprehensive health services performed will be submitted to RECEIVING AGENCY, Community and Rural Health, in a format and time frame agreed upon by both parties. Direct assistance will be provided by RECEIVING AGENCY to PERFORMING AGENCY for the implementation of an immunization program. The goal of the immunization program is to prevent, control, and eradicate vaccine -preventable disease by providing/administering biologicals, promoting immunization, and applying epidemiologic/outbreak controls within budgetary constraints. This will be accomplished by performing the following activities -and reports. A. Investigations/Control Measures PERFORMING AGENCY will investigate 100% of suspected cases of measles, rubella, pertussis, poliomyelitis, and diphtheria within 24 hours after a report is received. PERFORMING AGENCY will investigate 90% of suspected mumps - cases and 100% of suspected tetanus cases within 48 hours after a report is received. For the above diseases, PERFORMING AGENCY will implement the most current outbreak control procedures/measures and contact RECEIVING AGENCY, Immuniza- tion Division, within 48 hours after an investigation is initiated. B. Reporting Requirements PERFORMING AGENCY agrees to provide RECEIVING AGENCY, Immunization Division, by January 31st, of each year, a report detailing storage measures and methods used to control vaccine loss including method to monitor and record daily vaccine storage temperatures. The report shall be submitted in a format provided by RECEIVING AGENCY, Immunization Division. PERFORMING AGENCY agrees to provide RECEIVING AGENCY, Immunization Division, monthly reports of vaccine utilization/loss, within -ten working days after the end of each month, on forms provided by RECEIVING AGENCY (forms C5, C5A, C33, C33A)..PERFORMING AGENCY will obtain monthly biological reports from private physician offices and others who receive state,sopplied biologicals. PERFORMING AGENCY agrees to provide RECEIVING AGENCY, Immunization Division, by September 15th, of each year, a report on the number of people served with immunizations (unduplicated count) and the number of visits for immunizations in the preceding State Fiscal Year. In addition to support for the above activities, RECEIVING AGENCY, Bureau of Laboratories, agrees to provide direct assistance of laboratory supplies to PERFORMING AGENCY to execute laboratory analyses for the following RECEIVING AGENCY programs: water bacteriology, milk bacteriology, and chemistry, syphilis serology, gonorrhea testing, and other approved laboratory analyses. PERFORMING AGENCY agrees to meet standards for such analyses as set forth by RECEIVING AGENCY, Bureau of Laboratories, the Clinical Laboratories Improve- ment Act, the Safe Drinking Water_ Act, the National Conference of Interstate Milk Shippers, and/or the Public Health Service Grade A Pasteurized Milk Ordinance. PERFORMING AGENCY agrees to comply with the following: Texas Immunization Laws, Rules and Regulations; Human'Resources Code, Chapter 42; Texas Education Code, Section 2.09, 2.09A; U.S. Department of Heatlh and Human Services, Childhood Immunization Grant. PERFORMING AGENCY will provide an estimated 12,500 clients with services/units of service in or benefiting the county(ies)/area defined as: LUBBOCK. SECTION II. LEGAL AUTHORITY TO CONTRACT: Chapters 12 and 121, Health and Safety Code. SECTION III. SPECIAL PROVISIONS: None. -2- SECTION IV. BUDGET: FINANCIAL ASSISTANCE Financial assistance involves payment of funds to PERFORMING AGENCY for costs incurred in carrying out approved activities. - Personnel $53,698.00 Fringe Benefits 13,416.00 Travel .00 Equipment .00 Supplies .00 Contractual 24,000.00 Other .00 Total Direct Costs $91,114.00 Indirect .00 TOTAL $91,114.00 Financial reports are due the 20th of.December, March, June and September and the 15th of October. RECEIVING AGENCY financial assistance will not exceed $ 91,114.00 3 DIRECT ASSISTANCE Direct assistance involves the assignment of state funded positions or the provision of materials or supplies such as vaccines in lieu of cash. Personnel [03 position(s)] $63,204.00 Laboratory Support 14,000.00 Vaccine 91,064.00 TOTAL $168,268.00 Direct assistance for personnel in the amount of $63,204.00 is shown on the attached list of positions and budgetary amounts which is an integral part of this attachment. State salary warrants for net earnings will be issued in accordance with state regulations. Direct assistance for public health laboratory services is provided by RECEIVING AGENCY, Bureau of Laboratories, through requisition for supplies processed in accordance with RECEIVING AGENCY guidelines. 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 attachment(s) benefitting from this assistance. RECEIVING AGENCY direct assistance will not exceed $168,268.00. Total RECEIVING AGENCY assistance will not exceed $259,382.00. 4 LUBBOCK CITY HEALTH DEPARTMENT PAGE 634 TEXAS DEPARTMENT OF HEALTH PHR 2 OPERATING BUDGET FOR YEAR ENDING AUGUST 31, 1991 AS OF JUTE 30, 1990 BUDGET NO. LC000 H21311/K13028 CATE- DESCRIPTION OR TITLE FUND END ITEM JOB PAY PAY EFFECTIVE MONTHLY BUDGETED AMT GORY DESC. MONTH NO. CLASS GP_STP DATE RATE _ 1 NURSE II STATE AUG 018 4385 14 01 SEP 90 1,995.00 23,940.00_ LIC VOCATIONAL -NURSE II STATE -AUG- 083 4412 10 03 SEP 90 - 1,662.00 19,944.00 ADMINISTRATIVE TECH I STATE AUG 104 1501 08'06 SEP 90 1,610.00 19,320.06 63,204.00 r ` + DOCUMENT NO. C1000285 ATTACHMENT NO 02 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: BUREAU OF MATERNAL AND CHILD HEALTH TERM-0-September .1, 1990 -THROUGH August 31, 1991 SECTION I. SCOPE OF WORK: PERFORMING AGENCY will use direct assistance and/or financial assistance from RECEIVING AGENCY to provide clinical health services to women and children. Emphasis will be placed.on prenatal care for pregnant women, family planning services, and preventive child health services, especially for low income women and children. Services will be performed in accordance with the standards for maternity, family planning, and child health services as promulgated by the RECEIVING AGENCY, Bureau of Maternal and Child Health. Maternity/Family Planning and Child Health Clinic reports will be submitted to RECEIVING AGENCY, Bureau of Maternal and Child Health, in a format and time frame to be agreed upon by both parties. PERFORMING AGENCY will provide an estimated 7,500 clients with services/units of service in or benefiting the county(ies)/area defined as: LUBBOCK. SECTION II. LEGAL AUTHORITY TO CONTRACT: Chapters 12 and 121, Health and Safety Code, SECTION III. SPECIAL PROVISIONS: The General Provisions Program Income Article requires that a fee for services system and a schedule of fees be developed. Low income mothers and children provided health services under this attachment will not be charges a fee. The term "low income" refers to an individual or family with an income determined to be below the nonfarm income official poverty line defined by the Office of Management and Budget and revised annually in accordance with Section 624 of the. Economic Opportunity Act of 1964. No Text DIRECT ASSISTANCE Direct assistance involves the assignment of state funded positions or the provision of materials or supplies such as vaccines in lieu of cash. Personnel [02 position(s)] $29,004.00 TOTAL, $2-9,004.00 Direct assistance for personnel in the amount of $29,004.00 is shown on the attached list of positions and budgetary amounts which is an integral part of this attachment. State salary warrants for net earnings will be issued in accordance with state regulations. 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 attachment(s) benefitting from this assistance. RECEIVING AGENCY direct assistance will not exceed $29,004.00. Total RECEIVING AGENCY assistance will not exceed $217,594.00. EXECUTED IN D'u?IICATE ORIGINALS ON THE DATES SHOWN. CITY OF LLBBOCC Authorized W'racting Entity (type above if different from PERFORMING AGENCY) for and is bEF=if of: LUBBOCK CITY HEALTH DEPARTMENT PERPE=WING AGENCY By:�C , �r�✓'. (Sig :tune person authorized to siza ,.n4racts} B. C. McMINN, MAYOR (N ee an: Title) -Date: December 6, 1990 RECOMMENCE. 8y: : &___ x0p.- (PERFORM I NS AGENCY Director, if diffe.ev: from person authorize: to sign contract) TOO Document No,: C1000285 TEXAS DEPARTMENT OF HEALTH RECEIVING AGENCY B�.. Y: (Signature of arson uthori,:es to sign coat cts) Terry Faye Bleier, Chief Bureau of Financial Services (Name and Title) -Date: DEC 2 0 1990 APPROVED AS TO FORM: B y : Office General Counse COYER - ace 3 ~ DETAILS OF -ATTA-CHMENTS Attl; 11 11 Financial Assistance Am. TDH ; Tern ; Source of Direct Total Assistance No. Program ; Begin ; End ; Funds* ; Amount Assistance ; Amount (.TDH Share4 01 CH-LHS 9/ 1/90: 8/31/91: STATE 13.268 91,114.00; 168,268.00; 259,382.00: f ! 1 1 1 t 11 1 i 1 ! i ! 1 I 02 NCH-LHS 9/ 1/90, 8/31/91; STATE 13,994 188,590.00: 29,004.00: 217,594.00 03 ; BIV-LHS 9/ 1/90; 8/31/91: STATE 67,538.00; .00; 67,538.00; I I I ! I ± ! t I I I I ! 1 ! 1 t ! I 1 ! ! 1 ± ! 1 ! 1 ! ! ! I I I 1 t 1 I I f I 1 1 I 1 ! t I ! I 1 ! 1 I 1 ± t I t I 11 I I 1 1 ! 1 i ± I 1 1 ! I 1 1 1 1 1 1 1 ± I I ! 1 I 1 ! 1 1 I I 1 1 t 1 t t 1 I 1 { I I f 1 1 ! t ! t { 1 I I I 1 ! ! I I I ! I I 1 I ! I 1 1 ! 1 I I I I I I t I t I I } I I 1 t f ! 1 I I ! I I 1 I 1 1 1 t ! t I I I t i 1 t 1 I I I I 1 t t t 1 t 1 I I 1 I 1 1 f t 1 I I 1 I I ! 1 I ! t 1 ! I I I 1 ! ! I ! 1 1 I 1 ! 1 ± 1 t P 1 I 1 f i I I I ! I I I I 1 1 1 I I 1 t I 1 1 1 t 1 ! t t ! I I 1 I I 1 I 1 I I 1 1 1 ---------------------------------------------------------------------------------------------------------------- ocument No, C1000285 TOTALS ; $ 347.242.0011 $ 197,272.00; $ 544,514.00; ------ —-------- ---------------------- !---------! --- 1--- *Federal funds are indicated by a number from the Catalog of Federal Domestic Assistance ICFDAI, if applicable, REFER TO BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS. COVER - Page 2 STATE OF TEXAS COUNTY OF TRAVIS TEXAS D1P100TWest 49thEStreetONTRACT Austin, Texas 78756-3199 TDH Document No. C1000285 This contract is -between the Texas Department of -Health, hereinafter referred to as RECEIVING AGENCY, and the- party listed below as PERFORMING AGENCY and includes general provisions and_ attachments detailing scope(s) of work and special provisions. PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT t I (PRINT or TYPE) Mailing Address: P.O.Box 2548 Lubbock TX 79408 0000' Street Address: 1902 Texas Avenue Lubbock TX 79408 00001 different) (city) (st)-(zip)t Authorized Contracting Entity: CITY OF LUBBOCK I -(If differentfrom t i Payee Name: CITY OF LUBBOCK HEALTH DEPARTMENT j (Must match with vendor identification num er shown below) I Payee Address: P.O. BOX 2000 LUBBOCK TX 79457 00001 TRust match with vendor identification number shown b_elow t State of Texas Vendor Identification No. (14 digits): 17560005906037 1 Finance Officer/Contact: Doug Goodman i Type of Organization: City I Designate: Elementary secon ary school, junior college, senior co ege universe y city, county, other political subdivision, council of governments, judicial I disttrict, community services program, individual, or other (define) Is this a small business No (Yes/No) and/or minority/woman owned No (Yes/No) i Is this a non-profit business yP., (Yes/No) t t PAYEE AGENCY Fiscal Year Ending Month: SEPTEMBER t 1 SUMMARY OF TRANSACTION: t t Contract for public health services. I f COVER - Page 1 Texas Department of Health Robert Bernstein, M.D., F.A.C.P. 1100 West 49th Street Robert A. MacLean, M.D. Commissioner Austin, Texas 78756-3199 Deputy Commissioner (512) 458-7111 December 20, 1990 Anthony B. Way, M.D. Director LUBBOCK CITY HEALTH DEPARTMENT P.O.Box 2548 Lubbock, TX 79408 0000 TDH Document No. C1000285 Dear Doctor Way: Enclosed is an approved copy of the above referenced document. Please file it with the office of record for your agency. If we may be of assistance, please call us at 512/458-7470. Sincerely, 4 Julia M. Kosh, Jr., Director Grants Management Division JMK: wa RECEIVED JAN 4 1991 LUBBOCK CITY HEALTH DEPT. LEGAL DOCUMENTS PROCESSING INSTRUCTIONS ONE INSTRUCTION SHEET PER ITEM, PLEASE. All documents need to be signed by Staff and Attorney Signed originals of all documents must be kept in the City Secretary's Office for permanent files. Please specify if additional originals or certified copies of originals are needed. Date for Council consideration: 12 06 90 Item no. on agenda (if known): Attached: Ordinance Resolution x Contract x Agreement Other (Please specify): Special handling/routing instructions: For filing only -- City Secretary's Office. Return 2 original(s) copy(ies) to Doug Goodman, Health Department V) M Doug Goodman Health 2900 Name Department Extension Other disposition: Signed:' Date: 11/27/90 2. If a client elects to have a confidential file made for the testing and counseling, this file will be maintained in a fashion consistent with RECEIVING AGENCY's HIV Testing Guidelines which are incorporated by reference and made a part hereof. If confidential testing is needed, then the lab slip containing the test results may be provided to the client if requested. 3. No log containing personal information or identifiers or HIV status will be maintained in anonymous or confidential testing situations. PERFORMING AGENCY will submit required programmatic reports quarterly on the same cycle as financial status reports. PERFORMING AGENCY will authorize their staff to attend in -state and out-of- state training, conferences, and meetings for which funds were budgeted and approved by. RECEIVING AGENCY. SECTION IV. BUDGET: Personnel $47,660.00 Fringe Benefits 11,916.00 Travel 1,300.00 Equipment .00 Supplies 2,000.00 Contractual .00 Other 2,300.00 Total Direct Costs $65,176.00 Indirect 2,362.00 TOTAL $67,538.00 Financial status reports (FSRs) are due the 20th of December, March, June, September and the 15th of October. Total reimbursements will not exceed $67,538.00. Total reimbursements for Counseling, Testing, Referral, and Partner Notification services will not exceed $32,488.00. Total reimbursements for Education, Prevention, and Risk Reduction services will not exceed $32,688.00. Indirect cost based on UGCMS, Table 1. Indirect costs may be claimed based on total direct costs in accordance with UGCMS, Table 1, and will not exceed $ 2,362.00. -4- performed by staff who have approved by RECEIVING AGENCY. received.counseling training from a course 2. PERFORMING AGENCY will conduct monthly monitoring of counseling, testing, referral, and partner notification sessions and give performance feedback to counselors. 3. PERFORMING AGENCY agrees to facilitate RECEIVING AGENCY review of scheduled counseling, testing, referral, and partner notification sessions. PERFORMING AGENCY agrees to comply with the following: Chapter 81, Health and Safety Code. . Article 4419b-4, V.T.C.S., Human Immunodeficiency Virus Service Act. PERFORMING AGENCY will provide an estimated 1,000 clients with services/units of service in or benefiting the county(ies)/area defined as: LUBBOCK. SECTION II. LEGAL AUTHORITY TO CONTRACT: Chapters_12, and 121, Health and Safety Code. SECTION III. SPECIAL PROVISIONS: RECEIVING AGENCY will supply PERFORMING AGENCY with the most current version of the document entitled "Content of AIDS -Related Written Materials, Pictorials, Audiovisuals, Questionnaires, Survey Instruments, and Education Sessions in Centers for Disease Control Assistance Programs," and its preface which is written by RECEIVING AGENCY. Said document and its preface are incorporated as part of this attachment as though it were written herein verbatim. PERFORMING AGENCY will provide to RECEIVING AGENCY written acknowledgment of receipt and acceptance of this document and its preface and will comply with the guidelines contained in this document and its preface. Due to the sensitive and highly personal nature of AIDS/HIV-related information, strict adherence to the General Provisions Confidentiality Article and RECEIVING AGENCY program rules regarding confidentiality is required. PERFORMING AGENCY success depends upon whether persons at risk believe that the program observes this principle. In addition to these conditions, PERFORMING AGENCY will comply with the following specific requirements regarding individual patient information/data when conducting counseling, testing, referral,and partner notification activities. 1. If a client chooses to be anonymous when the mandatory offer of anonymity is made, then: a. no record will be maintained linking the person's identity with his/her real name or pseudonym or other identifiers; and b. upon notice to the client, the lab slip(s) containing the test results will be shredded/destroyed. Originals and copies of test results will not be maintained longer than 30 days. .. y may want to be tested. 2. Provide culturally sensitive and effective pretest and posttest counseling based on Centers for disease Control (CDC) approved model. 3. Publicize HIV counseling and testing services so that potential clients will know where and when services are available. 4. Offer HIV counseling and testing services at a location that is convenient for the majority of the target population and during hours established to reach these clients. 5. Use scannable forms supplied by RECEIVING AGENCY for collection of demo- graphic information and blinded test result data. 6. Utilize RECEIVING AGENCY'S laboratory for all ELISA and Western Blot testing. 7. PERFORMING AGENCY will develop and maintain a referral plan by which reciprocal linkages are established with other service providers (especially other RECEIVING AGENCY funded providers) for the purpose of: a. ensuring that behavior changes occur and are sustained; b. providing psychosocial services; c. medical intervention; d. substance abuse treatment; e. family planning services; f. financial and legal assistance; g. case management; h. long term care; Partner Notification 1. All partner notification services are to be consistent with RECEIVING AGENCY'S Serologic Test Counseling and Partner Notification Techniques guidelines which are incorporated by reference and made a part hereof. 2. Encourage HIV+ clients to voluntarily refer their sexual and/or needle sharing partners for HIV counseling and testing. 3. Encourage intravenous drug users (IVDU) to voluntarily refer their sexual and/or needle sharing partners for HIV counseling and testing. 4. If the client wishes to make the partner notification personally, provide guidance in making contact. 5. If the client does not want to make the partner notification, but wishes partners to be notified, elicit adequate information for RECEIVING AGENCY STD clinic personnel to make the notification. CTRPN Quality Assurance Guidelines 1. PERFORMING AGENCY assures that pretest and posttest counseling sessions are -2- DOCUMENT NO. C1000285 ATTACHMENT NO. 03 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: HIV DIVISION TERM: September 1, 1990 THROUGH August 31, 1991 SECTION I. SCOPE OF WORK: PERFORMING AGENCY agrees toconduct program activities to help reduce the spread of AIDS/HIV (acquired immunodeficiency syndrome/human immunodeficiency virus). PERFORMING AGENCY will: 1. Establish and/or maintain AIDS/HIV health education/risk reduction programs for the targeted populations and/or the general public; and, 2. Perform counseling, testing, referral, and partner notification (CTRPN) activities which include establishing and/or maintaining anonymous or confidential HIV testing programs for persons at increased risk of HIV infection due to individual sexual behavior, intravenous drug abuse, or other risk behaviors. All information and education materials developed and provided by PERFORMING AGENCY will be accurate, comprehensive, and consistent with current findings of the United States Public Health Service. PERFORMING AGENCY agrees that all activities will be performed in accordance with applicable RECEIVING AGENCY current program rules and guidelines, PERFORMING AGENCY'S continuation objectives, activities work plans, and detailed budget as approved by RECEIVING AGENCY. RECEIVING AGENCY will supply the PERFORMING AGENCY with the most current version of the program rules. PERFORMING AGENCY will submit to RECEIVING AGENCY written acknowledgment of receipt and acceptance of the document. All of the above named documents are adopted by reference as part of this attachment. PERFORMING AGENCY assures that expenditure of funds will be in accordance with the respective activity's detailed budget. PERFORMING AGENCY will provide CTRPN services to the target population defined as: 1. Males who routinely have sex with other males. 2. Males who occasionally have sex with other males. 3. Males who have sex with males and females. 4. Males and females with multiple sex partners. 5. Persons with a history of sexually transmitted diseases. 6. Persons with a history of high risk behavior. Counseling and Testing 1. Offer voluntary anonymous and/or confidential HIV testing to clients who -1 _ LUBBOCK CITY/FAMILY HEALTH SERVICES PAGE 635 TEXAS DEPARTMENT OF HEALTH PHR 2 OPERATING BUDGET FOR YEAR ENDING AUGUST 31., 1991 AS OF JUNE 30, 1990 BUDGET NO. LC301 H21311/K13028 CATE- DESCRIPTION OR TITLE FUND END ITEM JOB PAY PAY EFFECTIVE MONTHLY BUDGETED AMT GORY DESC. MONTH NO. -CLASS GP STP DATE - RATE 1 CLERICAL SUPERVISOR II MCH-LT SEP 088 0063 07 01 SEP 90 1.300.00 CLERICAL SUPERVISOR, -II STATE AUG 088 0063 OCT- 90 1.300.00 15,600.00 COMMUNITY SERV AIDE II MCH-LT SEP 131 5502 04 01 SEP 90 1117.00 COMMUNITY SERV AIDE II STATE AUG 131 5502 OCT 90 1:117.00 13,404.00 29,004.00 z GENERAL PROVISIONS FOR TEAS DEPARTMENT OF HEALTH CONTRACTS PERFORMING AGENCY and RECEIVING AGENCY agree this contract, assurances, general and/or special provisions, and attachment(s) with detailed scope(s) of work and budget(s), as applicable, incorporate all covenants and agreements pertaining hereto. No prior agreement or understanding, oral or otherwise, of the parties or their agents will be valid or enforceable unless embodied in this contract. The person or persons signing and executing this contract on behalf of PERFORMING AGENCY, or representing themselves as signing and executing this contract on behalf of PERFORMING AGENCY, do hereby warrant and guarantee that he, she, or they have been duly authorized by PERFORMING AGENCY to execute this contract on behalf of PERFORMING AGENCY and to validly and legally bind PERFORMING AGENCY to all terms, performances, and provisions herein set forth. PERFORMING AGENCY hereby assures compliance with the following terms and conditions unless otherwise specified in the attachment(s) hereto: ARTICLE 1. Scope of Work PERFORMING AGENCY will perform the work outlined in the Scope(s) of Work contained in the attachment(s) hereto which is/are referenced in the Details of Attachments and hereby incorporated and made a part of this contract, plus amendments which may be added by additional attachment(s) from time to time as hereinafter provided. Satisfactory performance of this contract will be measured in part by: (1) adherence to the contract; (2) results of CPA or State Auditor reports; and, 3) timeliness, completeness, and accuracy of required reports. ARTICLE 2. Term The time period of this contract will be governed by the term(s) on the attachment(s). No commitment of contract funds is permitted prior to the first day nor subsequent to the last day of the term. The term may be extended by amendment(s). ARTICLE 3. Funding This contract is contingent upon funding being available for the term of the attachment(s) and PERFORMING AGENCY will have no right of action against RECEIVING AGENCY in the event that RECEIVING AGENCY is unable to perform its obligations under this contract as a result of the suspension, termination, withdrawal, or failure of funding to RECEIVING AGENCY or lack of sufficient funding of RECEIVING AGENCY for any attachment(s) to this contract. If funds become unavailable, provisions of the Termination Article will apply. ARTICLE 4. Amendments This contract may be amended, and such amendments will be in writing and duly executed by the parties hereto. 1991 GENERAL PROVISIONS - Page 1 (rev.5/90) ARTICLE 5. Severability If any provision of this contract will be construed to be illegal or invalid, this will not affect the legality or validity of any of the other provisions hereof. The illegal or invalid provision will be deemed stricken and deleted herefrom to the same extent and effect as if never incorporated herein, but all other provisions will continue. ARTICLE 6. Applicable Laws and Standards This contract will be governed by the laws of the State of Texas and enabling state/federal regulations, including federal grant requirements applicable to funding sources as set out in attachment(s) hereto, and Treasury Circular 1075 (31 CFR Part 205) as applicable to advance of funds. If PERFORMING AGENCY is a local governmental public health entity, this contract will also be governed by the Local Public Health Reorganization Act, Chapter 121, Health and Safety Code. PERFORMING AGENCY agrees Article 4413 (32g), V.T.C.S., [Uniform Grant and Contract Management Standards Manual (UGCMS)], as may be amended by revised federal circulars to be incorporated in UGCMS by the Governor's Budget and Planning Office, applies as terms and conditions of this contract, and the standards are adopted by reference in their entirety. If a conflict arises between the provisions of this contract and UGCMS, the provisions of UGCMS will prevail unless expressly stated otherwise. A copy of this manual and its references are provided to PERFORMING AGENCY by RECEIVING AGENCY upon request. PERFORMING AGENCY must obtain prior approval from RECEIVING AGENCY for major project changes which are specified in RECEIVING AGENCY's institutional prior approval procedures. These procedures are incorporated by reference as a condition of this contract. In accordance with Section 1352 of Public Law 101-121. effective December 22, 1959, PERFORMING AGENCY is prohibited from using funds granted under this contract for lobbying Congress or any agency in connection with a particular contract. In addition, if at any time, the contract exceeds $100,000, the law requires certification that none of the funds provided by PERFORMING AGENCY to RECEIVING AGENCY have been used for payment to lobbyists. Regardless of funding source, and if a contract exceeds $100,000, disclosure form must be completed if PERFORMING AGENCY has any agreement with a lobbyist. This certification and/or form is available upon request and must be forwarded to RECEIVING AGENCY within 90 days of receipt. PERFORMING AGENCY certifies by execution of this contract that its payment of franchise taxes is current or, if PERFORMING AGENCY is exempt from payment of franchise taxes, that it is not subject to the State of Texas franchise tax. A false statement regarding franchise tax status will be treated as a material breach of this contract and may be grounds for termination at the option of RECEIVING AGENCY. If franchise tax payments become delinquent during the attachment term, payments under this contract will be held until PERFORMING AGENCY's delinquent franchise tax is paid in full. 1991 GENERAL PROVISIONS - Page 2 (rev.5/90) PERFORMING AGENCY further certifies by execution of this contract that it is not ineligible for participation in federal or state assistance programs under Executive Order 12549, Debarment and Suspension. PERFORMING AGENCY specifically asserts that it does not owe a single substantial debt or a number of outstanding debts to a federal or state agency. A false statement regarding PERFORMING AGENCY's status will be treated as a material breach of this contract and may be grounds for termination at the option of RECEIVING AGENCY. ARTICLE 7. Assurances PERFORMING AGENCY assures that no person will, on the grounds of race, creed, color, handicap, national origin, sex, political affiliation or beliefs, be excluded from, be denied the benefit of, or be subjected to discrimination under any program or activity funded in whole or in part under this agreement. Incorporated by reference the same as if specifically written herein are the rules, regulations, and all other requirements imposed by law including, but not limited to, compliance with those pertinent rules and regulations of the State of Texas and those of United States agencies providing funds to the State of Texas. PERFORMING AGENCY assures it will not transfer or assign its interest in this contract without written consent of the the RECEIVING AGENCY. ARTICLE 8. Standards For Financial Management PERFORMING AGENCY will develop, implement, and maintain financial management and control systems that meet or exceed the requirements of UGCMS. Those requirements include at a minimum: 1. Financial planning including the development of budgets that adequately reflect all functions and resources necessary to carry out authorized activities and the adequate determination of costs; 2. Financial management system including accurate, correct, and complete payroll, accounting, and financial reporting records, cost source documentation, effective internal and budgetary controls, determination of reasonableness, allowability, and allocability of costs, and timely and appropriate audits and resolution of any findings; and, 3. Billing and collection policies including a charge schedule, a system for discounting or adjusting charges based on a person's income and family size, and a mechanism capable of billing and making reasonable efforts to collect from patients and third parties. ARTICLE 9. Allowable Costs Only those costs allowable under UGCMS and OMB Circular A-110, and any revisions thereto, plus any applicable federal cost principles are eligible for reimbursement under this contract. Applicable cost principles and audit requirements are as follows; Circular Applicable Cost Principles Audit Requirement A-87 State & Local Governments Circular A-128 1991 GENERAL PROVISIONS - Page 3 (rev.5/90) To be eligible for reimbursement under this contract, a cost must have been incurred within the attachment term and paid by PERFORMING AGENCY prior to claiming reimbursement from RECEIVING AGENCY or encumbered by the last day of the attachment term and liquidated no later than 45 days after the end of the attachment term. Each PERFORMING AGENCY/AUTHORIZED CONTRACTING ENTITY receiving $25,000 or more in total federal/state financial assistance during their fiscal year shall arrange for an agency -wide financial and compliance audit of the PERFORMING AGENCY'S/AUTHORIZED CONTRACTING ENTITY'S fiscal year. The audit must be conducted by an independent CPA and must be in accordance with the applicable OMB Circulars and Government Auditing Standards. Procurement of audit services will comply with state procurement procedures, as well as provisions of UGCMS . Within 30 days of receipt of audit report, PERFORMING AGENCY/AUTHORIZED CONTRACTING ENTITY will submit a copy to RECEIVING AGENCY'S Internal Audit Division. ARTICLE 10. Overtime Compensation None of the funds provided by attachment(s) will be used to pay overtime. PERFORMING AGENCY will be responsible for any obligations of overtime pay due employees. ARTICLE 11. Terms and Conditions of Payment For services satisfactorily performed pursuant to the Scope(s) of Work, PERFORMING AGENCY will receive reimbursement for allowable costs. Reimbursements will not exceed the total of each attachment(s) hereto and are contingent on a signed contract. Claims for reimbursement will be made on a State of Texas Purchase Voucher (TDH Form SAG-37). Vouchers for reimbursement of actual expenses will be submitted monthly within 20 days following the end of the month covered by the bill. A make-up claim may be submitted as a final close-out bill not later than 45 days following the end of attachment term(s). Advance payment may be requested in accordance with the applicable provisions of this contract. Payments made for approved claims or notice of denial of claims submitted against attachment(s) to this contract will be mailed not later than 60 days after receipt of monthly vouchers. Payment is considered made on the date postmarked. Any reimbursements made by PERFORMING AGENCY to subcontractors will be made in accordance with Article 601f, V.T.C.S. Funding from this contract will not be used to supplant state or local funds, but PERFORMING AGENCY will use such funds to increase state or local funds currently available to PERFORMING AGENCY for a particular activity. PERFORMING AGENCY further agrees to maintain to the best of its ability its current level of support, if any. PERFORMING AGENCY will refund to RECEIVING AGENCY any funds PERFORMING AGENCY claims and receives from RECEIVING AGENCY for the reimbursement of costs which are determined by RECEIVING AGENCY to be ineligible for reimbursement. 1991 GENERAL PROVISIONS - Page 4 (rev.5/90) RECEIVING AGENCY will have the right to withhold all or part of any future payments to PERFORMING AGENCY to offset any reimbursement made to PERFORMING AGENCY for any ineligible expenditures not refunded to RECEIVING AGENCY by PERFORMING AGENCY. Payment may be denied for noncompliance if required financial reports are not on file for previous quarters or for the final period, or for failure to respond to financial compliance monitoring reports, or if program requirements are not met as specified in the Scope(s) of Work. ARTICLE 12. Advance Payments PERFORMING AGENCY may request, in writing, a one time advance with proper justification and the concurrence of RECEIVING AGENCY. Amount of advance will be determined by the amount and term of the attachment(s); however, for each attachment, the amount of the advance will not exceed one -sixth (1/6th) of a twelve-month attachment. Advance will be requested on a State of Texas Purchase Voucher at the beginning of attachment period or at a single later time in the attachment period if circumstances so warrant and the request is approved. Advance funds will be liquidated during the attachment term so that, after final monthly billing, PERFORMING AGENCY will not have advance funds on hand. Advance funds may be drawn only to meet immediate cash needs for disbursement (UGCMS and federal circulars). Amendments to this contract may require upward or downward adjustment to the allowable advance until it equates 1/6th of a twelve-month attachment or approximates two months operating costs. In the case of a downward adjustment, PERFORMING AGENCY and RECEIVING AGENCY will agree on the amount of adjustment to the advance. RECEIVING AGENCY retains the option to reduce future claims by the required amount. In the case of an upward adjustment and PERFORMING AGENCY needs additional funds to meet immediate operating expenses, PERFORMING AGENCY may submit to RECEIVING AGENCY a written justification and State of Texas Purchase Voucher in the amount necessary to correct the ratio. ARTICLE 13. Proaram Income PERFORMING AGENCY will develop a fee for service system and a schedule of fees for personal health services in accordance with the provisions of Article 4414c, V.T.C.S., and the Texas Board of Health rules covering Fees for Clinical Health Services (25 TAC, Sec. 1.91) and other applicable laws provided, however, that a patient may not be denied a service due to inability to pay. All revenues received from the delivery of contract services will be identified, reported, and utilized as provided in this article. Such program income will be retained by PERFORMING AGENCY and: (1) be used by PERFORMING AGENCY for any purposes which further the objectives of the program and the Scope of Work for the attachment(s) and be deducted from total project costs; or, (2) be deducted from total project costs. This is according to RECEIVING AGENCY policy interpreting UGCMS, a copy of policy is provided on request and is incorporated by reference as a condition of this contract. 1991 GENERAL PROVISIONS - Page 5 (rev.5/90) ARTICLE 14. Financial Reports Financial reports are required as provided in UGCMS and will be filed regardless of whether or not expenses have been incurred. Quarterly Financial Status Report, State of Texas Supplemental Form 269a (TDH Form GC-4), will be submitted within 20 days following the end of each quarter. AnnuallFinal A final financial report, Request for Advance or Reimbursement, Form 270 (TDH Form GC-10) will be submitted not later than 45 days following the end of attachment term(s). An amended Form 269a will be submitted if the amount of expenditures reported in the last quarter changed. If necessary, a State of Texas Purchase Voucher will be submitted if all costs have not been recovered or a refund will be made of excess monies if costs incurred were less than funds received. ARTICLE 15. Reports and Inspections PERFORMING AGENCY will submit financial, program, progress, and other reports as requested by RECEIVING AGENCY in the format agreed to by the parties hereto. RECEIVING AGENCY and, when federal funds are involved, any authorized representatives) of the federal government have the right, at all reasonable times, to inspect or otherwise evaluate the work performed or being performed hereunder and the premises in which it is being performed, including subcontractors. PERFORMING AGENCY will participate in and provide reasonable access, facilities, and assistance to the representatives. All inspections and evaluations will be performed in such a manner as will not unduly delay the work. PERFORMING AGENCY agrees that RECEIVING AGENCY and the federal government, or any of their duly authorized representatives, will have access to any pertinent books, documents, papers, and records of PERFORMING AGENCY for the purpose of making audit, examination, excerpts, and transcripts of transactions related to contract attachment(s). RECEIVING AGENCY will have the right to audit billings both before and after payment. Payment under attachment(s) will not foreclose the right of RECEIVING AGENCY to recover excessive or illegal payments. Any deficiencies identified by RECEIVING AGENCY upon examination of PERFORMING AGENCY's records will be conveyed in writing to PERFORMING AGENCY. PERFORMING AGENCY's resolution of findings will also be conveyed in writing to RECEIVING AGENCY within 30 days of receipt of RECEIVING AGENCY's findings. A determination by RECEIVING AGENCY of either an inadequate or inappropriate resolution of the findings may result in the withholding of funds or suspension of the contract attachment(s). Any such withholding of funds or suspension will remain in effect until the findings are properly remedied as determined by RECEIVING AGENCY. 1991 GENERAL PROVISIONS - Page 6 (rev.5/90) PERFORMING AGENCY will retain all such records for a period of three years from the date of the last expenditure report submitted under contract attachment(s) or until resolution of all audit questions, whichever time period is longer. ARTICLE 16. Client Records At the end of the attachment term, all client records are the property of PERFORMING AGENCY. RECEIVING AGENCY retains the right to have access to the records or obtain copies for audit, litigation, or other circumstances. that may arise. If at any time during the attachment term(s), PERFORMING AGENCY and/or RECEIVING AGENCY should decide to terminate the agreement, RECEIVING AGENCY may require the transfer of client records upon written notice to PERFORMING AGENCY. Records may be transferred to another entity that agrees to continue the service or, at the option of RECEIVING AGENCY, the records may be transferred to RECEIVING AGENCY headquarters. ARTICLE 17. Confidentiality PERFORMING AGENCY will have a system in effect to protect from inappropriate disclosure of patient records and all other documents deemed confidential by law which are maintained in connection with the activities funded under contract attachment(s). Any disclosure of confidential patient information by PERFORMING AGENCY, including information required by the Reports and Inspections Article, will be in accordance with applicable law. If providing direct client services, PERFORMING AGENCY agrees to implement workplace guidelines similar to the guidelines adopted by RECEIVING AGENCY and to make available educational materials for employees concerning the human immunodeficiency virus (HIV) and its related conditions including acquired immunodeficiency syndrome (AIDS). Further, PERFORMING AGENCY agrees to develop and implement guidelines regarding confidentiality of AIDS and HIV - related medical information for employees of PERFORMING AGENCY and for clients, inmates, patients, and residents served by PERFORMING AGENCY. Such guidelines will be consistent with those published by RECEIVING AGENCY and with state and federal law and regulations. A PERFORMING AGENCY that does not adopt confidentiality guidelines as herein required is not legally eligible to receive state funds until the guidelines are developed and implemented. If PERFORMING AGENCY does not have workplace and/or confidentiality guidelines, PERFORMING AGENCY may use those which have been adopted by RECEIVING AGENCY'S Texas Board of Health and which are available upon request. ARTICLE 18. Equipment and Supplies Equipment is defined as tangible nonexpendable property with an acquisition cost of over $500 and a useful life of more than one year. In accordance with Article 601b, V.T.C.S., Section 8.02(c), title to all equipment purchased from funds provided herein will be in the name of PERFORMING AGENCY throughout the contract/attachment(s) term(s). Unless initially listed and approved in the contract/ attachment (s), prior written approval from RECEIVING AGENCY is required for any additions to or deletions of approved equipment purchases having an acquisition cost exceeding 1991 GENERAL PROVISIONS - Page 7 (rev.5/90) $500. To receive approval for data processing hardware and software purchases with an acquisition cost over $500, PERFORMING AGENCY must submit a detailed justification which includes description of features, make and model, and cost, etc. PERFORMING AGENCY will maintain an annual property and inventory and submit a report to RECEIVING AGENCY at the end of the contract/attachment(s) term(s). PERFORMING AGENCY will administer a program of maintenance, repair, and protection of assets under this contract/attachment(s) so as to assure their full availability and usefulness. In the event PERFORMING AGENCY is indemnified, reimbursed, or otherwise compensated for any loss of, destruction of, or damage to the assets provided under this contract /attachment(s), it will use the proceeds to repair or replace said assets. PERFORMING AGENCY agrees that upon termination of contract /attachment(s), title to any remaining equipment purchased from funds as hereinabove provided will be transferred to the RECEIVING AGENCY or any other party designated by the RECEIVING AGENCY; provided, however, that RECEIVING AGENCY may, at its option and to the extent allowed by law, transfer title to such property to the PERFORMING AGENCY. ARTICLE 19. Subcontracting PERFORMING AGENCY may enter into agreements with subcontractors unless restricted or otherwise prohibited in specific attachment(s). If PERFORMING AGENCY elects to enter into an agreement which subcontracts out a substantial portion of PERFORMING AGENCY's Scope of Work, prior written approval must be obtained from RECEIVING AGENCY. Subcontracts, if any, entered into by PERFORMING AGENCY will be in writing and subject to the requirements of this contract. PERFORMING AGENCY agrees that it will be responsible to RECEIVING AGENCY for the performance of any subcontractor. ARTICLE 20. Copyrights and Publications PERFORMING AGENCY understands and agrees that where activities supported by the contract attachment(s) produce original books, manuals, films, computer programs (including executable computer programs and supporting data in any form), or other original material, PERFORMING AGENCY may copyright such material subject to any rights to same reserved by or vested in the federal government or any agency thereof; however, RECEIVING AGENCY may grant to PERFORMING AGENCY limited rights to produce, publish, and use such materials as appropriate. PERFORMING AGENCY may publish at its expense the results of contract performance with prior RECEIVING AGENCY review and approval. Any publication (written, visual, or sound) should include acknowledgment of the support received from RECEIVING AGENCY and the appropriate federal agency, if applicable. At least three copies of any such publication must be provided to RECEIVING AGENCY. RECEIVING AGENCY reserves the right to require additional copies before or after the initial review. ARTICLE 21. Hold Harmless PERFORMING AGENCY, which is not a state agency, assures that it is an independent contractor and not an agent, servant, or employee of the state. 1991 GENERAL PROVISIONS Page 8 (rev.5/90) Except to the extent that Chapter 104 of the Texas Civil Practice and Remedies Code is applicable to this contract, PERFORMING AGENCY agrees to hold RECEIVING AGENCY and/or federal government harmless and to indemnify them from and against any and all claims, demands. and causes of action of every kind and character which may be asserted by any third party occurring or in any way incident to, arising out of, or in connection with the performance of services by PERFORMING AGENCY under this contract to the extent allowed by law. PERFORMING AGENCY, by acceptance of funds provided through contract attachment(s), agrees and ensures that personnel paid from these funds are duly licensed and/or qualified to perform the required services. ARTICLE 22. Bonding Each person employed by PERFORMING AGENCY who handles funds under this contract, including persons authorizing payment of such funds, will be covered by the terms of a fidelity bond providing for indemnification of losses occasioned by: (1) any fraudulent or dishonest act or acts committed by any of PERFORMING AGENCY's employees either individually or in concert with others, and/or, (2) failure of PERFORMING AGENCY or any of its employees to perform faithfully his/her duties or to account properly for all monies and property received by virtue of his/her position or employment. This fidelity bond will be in the amount of not less than Ten Thousand Dollars ($10,000). ARTICLE 23. Suspension/Termination If PERFORMING AGENCY fails to comply with RECEIVING AGENCY's reporting requirements. the program objectives, or the contract award conditions, RECEIVING AGENCY may withhold payments. RECEIVING AGENCY will provide advance written notice to PERFORMING AGENCY which will identify the deficiency and RECEIVING AGENCY's intent to withhold payments if the deficiency is not corrected within a specific number of days. When the deficiency is corrected, RECEIVING AGENCY will release any withheld payments with no further action. If PERFORMING AGENCY fails to comply with the terms, conditions, or standards of this contract, RECEIVING AGENCY may suspend the contract attachment(s) and prohibit PERFORMING AGENCY from incurring additional obligations of funds pending either corrective action or termination. RECEIVING AGENCY will provide written notice to PERFORMING AGENCY at least thirty (30) days in advance of the suspension date. Such notice will detail the nature of noncompliance and specify a correction date. PERFORMING AGENCY may request a hearing on the proposed suspension if such request is made in writing within ten (10) days from any final notification of suspension. This contract or any attachment(s) hereto may be terminated by either of the parties hereto for noncompliance by the other party. IA party intending to terminate for noncompliance by the other party will provide written notice to the other party at least thirty (30) days prior to the intended date of termination. Such notice will include the reasons for the termination and will provide the other party an opportunity to rebut the reasons in writing. A hearing may be requested on the proposed termination if such request is made in writing within ten (10) days from any final notification of termination. By such termination, neither party may nullify obligations already incurred for performance or failure to perform prior to the date of termination. Such termination will not be an exclusive remedy but will be in addition to any other rights and remedies provided by law or under this contract. 1991 GENERAL PROVISIONS - Page 9 (rev.5/90) This contract or any attachment(s) hereto may be terminated in whole, or in part, when both parties agree that continuation would not produce results commensurate with further expenditure of funds. Both parties will agree on the effective date and, in the case of partial termination, the portion to be terminated. RECEIVING AGENCY will immediately send PERFORMING AGENCY written notice of the terms agreed to and such notice will become a part of the contract. PERFORMING AGENCY will not incur new obligations for the terminated portion after the effective date of termination and will cancel as many outstanding obligations as possible. RECEIVING AGENCY will allow full credit to PERFORMING AGENCY for noncancelable obligations which were properly incurred prior to the termination date. This contract or any attachment(s) hereto may be terminated if funds allocated for any attachment(s) hereto should become reduced, depleted, or unavailable during any attachment(s) budget period, and RECEIVING AGENCY is unable to obtain additional funds for such purposes. RECEIVING AGENCY will immediately provide written notification to PERFORMING AGENCY of such fact and such attachment(s) to this contract is/are terminated upon receipt of that notification. PERFORMING AGENCY will not incur new obligations after the effective date of termination and will cancel as many outstanding obligations as possible. RECEIVING AGENCY will allow full credit to PERFORMING AGENCY for noncancelable obligations which were properly incurred prior to the termination date. This contract or any attachment(s) hereto may be terminated in the event that federal or state laws or other requirements should be amended or judicially interpreted so as to render continued fulfillment of this contract, on the part of either party, unreasonable or impossible. If the parties should be unable to agree upon amendment which would therefore be needed to enable the substantial continuation of the services contemplated herein, then, upon written notification by RECEIVING AGENCY to PERFORMING AGENCY, the parties will be discharged from any further obligations created under the terms of this contract, except for the equitable settlement of the respective accrued interests or obligations as of the date of termination. ARTICLE 24. Personnel All personnel funded by attachment(s) to this contract are employees of PERFORMING AGENCY which will be responsible for their direction and control and liable for any of their acts or omissions. PERFORMING AGENCY will have in place legally sufficient Due Process Hearing Procedures for all of its employees filling state budgeted positions. PERFORMING AGENCY will have full authority to employ, promote, suspend, demote, discharge, and transfer within its organization any and all state budgeted personnel funded by attachment(s) to this contract provided, however, that any demotion, suspension, or discharge of such state budgeted employees will be in accordance with the Due Process Hearing Procedures as set out above. The only distinction between state budgeted and local paid employees is that employees on state budgeted positions receive state benefits and are subject to certain duties, obligations, and restrictions as state employees as contained in state law. One such restriction, as contained in the State Appropriations Act, is that no employee paid on a state budgeted position may 1991 GENERAL PROVISIONS - Page 10 (rev.5/90) receive a salary supplement from any source unless specifically authorized in the Appropriations Act or other state law. This prohibition includes, but is not limited to, the payment to such employee of a so-called "flat rate" car allowance or travel allowance. Any such travel or per diem to these employees must be on a reimbursement basis, supported by appropriate records, and may not exceed the reimbursement for mileage and/or per diem allowed under the Appropriations Act and current state travel regulations. This restriction will apply whether travel funds are provided in attachment(s) under this contract or from any other source. PERFORMING AGENCY will utilize RECEIVING AGENCY's policies and procedures for hiring and promoting individuals into state budgeted positions funded by attachment(s) to this contract. Qualifications of any individuals filling these positions will be subject to approval of RECEIVING AGENCY's Bureau of Personnel Management. The purpose of the approval is to ensure that individuals occupying these positions meet minimum educational and experience requirements. PERFORMING AGENCY will maintain required records and submit documents necessary to process personnel, payroll, leave and time records, and travel claims on state budgeted positions. PERFORMING AGENCY will be furnished by RECEIVING AGENCY state warrants for salary compensation or travel reimbursement for issuance to employees on state budgeted positions. An independent audit is not required as a condition of this contract if the attachment provides assistance through assignment of state budgeted positions and no funds are budgeted for local costs. PERFORMING AGENCY may be reimbursed for local personnel costs or other categories of expense used to fulfill the scope of work of attachment(s) in lieu of being furnished state payroll warrants after a state budgeted position becomes vacant. Reimbursement will not exceed the balance of funds on the state budgeted position after all benefits, obligations, and/or other entitlements are met. PERFORMING AGENCY's Director, or other person(s) authorized elsewhere in this contract, may submit a request for conversion. RECEIVING AGENCY will transmit formal approval and a revised budget to PERFORMING AGENCY to complete the conversion. ARTICLE 25. Funding Participation Requirement PERFORMING AGENCY agrees funds provided through this contract will not be used for matching purposes in securing other funding. ARTICLE 26. Performance -Based Attacbments History RECEIVING AGENCY is responsible for developing performance -based public health services contracts in response to the State Auditor's Report. This system will enhance service delivery and improve accountability and efficiency in the management of public health dollars. Plans for initial implementation were designed to use the model objectives format stemming from recommendations of the Committee on Model Objectives for Local Public Health in Texas. The committee was composed of representatives 1991 GENERAL PROVISIONS - Page 11 (rev.5/90) of local health departments and RECEIVING AGENCY'S central and public health region offices in consultation with the University of Texas School of Public Health in Houston. The concept was piloted in three local health departments and is being used by the public health regions in planning, managing, and evaluating selected public health services. Purpose The overall goal of performance -based contracts is improved public health practices in Texas. The project is intended to: -identify public health needs and establish priorities which provide a rational basis for resource allocation; -project realistic outcomes based on activities which can be accomplished with current or planned resources, communicate needs, and build consensus at all levels regarding directions to be taken in specific programs; and, -institute a system for planning, implementing, managing, and evaluating programs and monitoring progress toward reducing and/or alleviating public health problems. Process PERFORMING AGENCY will prepare outcome and process objectives relative to local needs and resources in the following selected program areas, if applicable; -AIDS/HIV -Chronic Disease Prevention and Control -Food Protection -Immunization -Maternal and Child Health By the end of the current state fiscal year, PERFORMING AGENCY will show evidence of a.monitoring system to evaluate progress towards the objectives. RECEIVING AGENCY will provide training, written documentation, and ongoing technical assistance to PERFORMING AGENCY in the development of objectives and a monitoring system. RECEIVING AGENCY contact for matters pertaining to the performance -based public health services project is the Office of the Associate Commissioner for Community and Rural Health. It is understood and agreed to by both parties that some objectives may not be met and achievement levels may be different than estimated. The objectives are recognized as test processes and achievement below the established levels will not affect the right of PERFORMING AGENCY to funds provided through Attachment(s) when the basic program scope of work has been fulfilled. Any disputes arising from procedures or actions taken as part of this project will be addressed and resolved to the mutual satisfaction of both parties.. 1991 GENERAL PROVISIONS - Page 12 (rev.5/90) DOCUMENT NO. C1000285 ATTACHMENT NO. 01 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: COMMUNITY AND RURAL- HEALTH TERM: September 1, 1990 THROUGH August 31, 1991 SECTION I. SCOPE OF WORK: PERFORMING AGENCY will use direct assistance and/or financial assistance from RECEIVING AGENCY to supplement the delivery of comprehensive public health services. Comprehensive health services encompass a wide variety of personal health services, environmental health services, and other problems of the jurisdiction. Personal health services may include but are not limited to adult health/chronic disease, AIDS/HIV, chronically ill/disabled children, dental, immunization, laboratory, maternal and child health, public health promotion/education, sexually transmitted disease control, and tuberculosis control. Environmental health services/inspections may include but are not limited to food, premise, swimming pool, vector control, and wastewater control. Other services may be provided as needed when agreed to by both parties. Reports of comprehensive health services performed will be submitted to RECEIVING AGENCY, Community and Rural Health, in a format and time frame agreed upon by both parties. Direct assistance will be provided by RECEIVING AGENCY to PERFORMING AGENCY for the implementation of an immunization program. The goal of the immunization program is to prevent, control, and eradicate vaccine -preventable disease by providing/administering biologicals, promoting immunization, and applying epidemiologic/outbreak controls within budgetary constraints. This will be accomplished by performing the following activities and reports. A. Investigations/Control Measures PERFORMING AGENCY will investigate 100% of suspected cases of measles, rubella, pertussis, poliomyelitis, and diphtheria within 24 hours after a report is received. PERFORMING AGENCY will investigate 90% of suspected mumps cases and 100% of suspected tetanus cases within 48 hours after a report is received. For the above diseases, PERFORMING AGENCY will implement the most current outbreak control procedures/measures and contact RECEIVING AGENCY, Immuniza- tion Division, within 48 hours after an investigation is initiated. B. Reporting Requirements PERFORMING AGENCY agrees to provide RECEIVING AGENCY, Immunization Division, by January 31st, of each year, a report detailing storage measures and methods used to control vaccine loss including method to monitor and record daily vaccine storage temperatures. The report shall be submitted in a format provided by RECEIVING AGENCY, Immunization Division. PERFORMING AGENCY agrees to provide REC-EIVING AGENCY, Immunization Division, monthly -reports of vaccine utilization/loss, within -ten working days after the end of each month, on forms provided by RECEIVING AGENCY (forms-05, C5A, C33, C33A)-._PERFORMING AGENCY will obtain monthly biological reports from private physician offices and others who receive state,sopplied biologicals. PERFORMING AGENCY agrees to provide RECEIVING AGENCY, Immunization Division, by September 15th, of each year, a report on the number of people served with immunizations (unduplicated count) and the number of visits for immunizations in the preceding State Fiscal Year. In addition to support for the above activities, RECEIVING AGENCY, Bureau of Laboratories, agrees to provide direct assistance of laboratory supplies to PERFORMING AGENCY to execute laboratory analyses for the following RECEIVING AGENCY programs: water bacteriology, milk bacteriology, and chemistry, syphilis serology, gonorrhea testing, and other approved laboratory analyses. PERFORMING AGENCY agrees to meet standards for such analyses as set forth by RECEIVING AGENCY, Bureau of Laboratories, the Clinical Laboratories Improve- ment Act, the Safe Drinking Water_ Act, the National Conference of Interstate Milk Shippers, and/or the Public Health Service Grade A Pasteurized Milk Ordinance. PERFORMING AGENCY agrees to comply with the following: Texas Immunization Laws, Rules and Regulations; Human Resources Code, Chapter 42; Texas Education Code, Section 2.09, 2.09A; U.S. Department of Heatlh and Human Services, Childhood Immunization Grant. PERFORMING AGENCY will provide an estimated 12,500 clients with services/units of service in or benefiting the county(ies)/area defined as: SECTION II. LEGAL AUTHORITY TO CONTRACT: Chapters 12 and 121, Health and Safety Code. SECTION III. SPECIAL PROVISIONS: None. -2- SECTION IV. BUDGET: FINANCIAL ASSISTANCE Financial assistance involves payment of funds to PERFORMING AGENCY for costs incurred in carrying out approved activities. Personnel $53,698.00 Fringe Benefits 13,416.00 Travel .00 Equipment .00 Supplies .00 Contractual 24,000.00 Other .00 Total Direct Costs $91,114.00 Indirect .00 TOTAL $91,114.00 Financial reports are due the 20th of December, March, June and September and the 15th of October. RECEIVING AGENCY financial assistance will not exceed $ 91,114.00 3 DIRECT ASSISTANCE Direct assistance involves the assignment of state funded positions or the provision of materials or supplies such as vaccines in lieu of cash. Personnel [03 position(s)] $63,204.00 Laboratory Support 14,000.00 Vaccine 91,064.00 TOTAL $168,268.00 Direct assistance for personnel in the amount of $63,204.00 is shown on the attached list of positions and budgetary amounts which is an integral part of this attachment. State salary warrants for net earnings will be issued in accordance with state regulations. Direct assistance for public health laboratory services is provided by RECEIVING AGENCY, Bureau of Laboratories, through requisition for supplies processed in accordance with RECEIVING AGENCY guidelines. 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 attachment(s) benefitting from this assistance. RECEIVING AGENCY direct assistance will not exceed $168,268.00. Total RECEIVING AGENCY assistance will not exceed $259,382.00. 4 LUBBOCK CITY HEALTH DEPARTMENT PAGE 634 TEXAS DEPARTMENT OF HEALTH PHR 2 OPERATING BUDGET FOR YEAR ENDING AUGUST 31, 1991 AS OF JUNE 30, 1990 BUDGET NO. LC000 H21311^13028 CATE- DESCRIPTION OR TITLE FUND END ITEM JOB PAY PAY EFFECTIVE MONTHLY BUDGETED AMT GORY DESC. MONTH NO. CLASS GP_STP DATE RATE._ 1 NURSE II STATE AUG 018 4385 14 01 SEP 90 1,995.00 23,940.00, LIC VOCATIONAL -NURSE II -STATE -AUG_ 083 4412 10 03 SEP 90 1,662.00 19,944.00 ADMINISTRATIVE TECH I STATE AUG 104 1501 08-06 SEP 90 1,610.00 19,320.00 63,204.00 DOCUMENT NO. C1000285 ATTACHMENT NO. 02 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: .BUREAU OF MATERNAL AND CHILD HEALTH -TERM,,-September 1, 1990 THROUGH August 31, 1991 SECTION I. SCOPE OF WORK: PERFORMING AGENCY will use direct assistance and/or financial assistance from RECEIVING AGENCY to provide clinical health services to women and children. Emphasis will be placed on prenatal care for pregnant women, family planning services, and preventive child health services, especially for low income women and children. Services will be performed in accordance with the standards for maternity, family planning, and child health services as promulgated by the RECEIVING AGENCY, Bureau of Maternal and Child Health. Maternity/Family Planning and Child Health Clinic reports will be submitted to RECEIVING AGENCY, Bureau of Maternal and Child Health, in a format and time frame to be agreed upon by both parties. PERFORMING AGENCY will provide an estimated 7,500 clients with services/units of service in or benefiting the county(ies)%area defined as: LUBBOCK. SECTION II. LEGAL AUTHORITY TO CONTRACT: Chapters 12 and 121, Health and Safety Code. SECTION III. SPECIAL PROVISIONS: The General Provisions Program Income Article requires that a fee for services system and a schedule of fees be developed. Low income mothers and children provided health services under this attachment will not be charges a fee. The term low income" refers to an individual or family with an income determined to be below the nonfarm income official poverty line defined by the Office of Management and Budget and revised annually in accordance with Section 624 of the Economic Opportunity Act of 1964. -1- SECTION IV. BUDGET: FINANCIAL ASSISTANCE Financial assistance involves payment of funds to PERFORMING AGENCY for costs incurred in carrying out approved activities. DIRECT ASSISTANCE Direct assistance involves the assignment of state funded positions or the provision of materials or supplies such as vaccines in lieu of cash. Personnel (02 position(s)] $29,004.00 - TOTAL - $219 , 004. 00 Direct assistance for personnel in the amount of $29,004.00 is shown on the attached list of positions and budgetary amounts which is an integral part of this attachment. State salary warrants for net earnings will be issued in accordance with state regulations. 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 attachment(s) benefitting from this assistance. RECEIVING AGENCY direct assistance will not exceed $29,004.00. Total RECEIVING AGENCY assistance will not exceed $217,594.00. 3 LUBBOCK CITY/FAMILY HEALTH SERVICES PAGE 635 TEXAS DEPARTMENT OF HEALTH PHR 2 OPERATING BUDGET FOR YEAR ENDING AUGUST 31, 1991 AS OF JUNE 30, 1990 BUDGET NO. LC301 H21311/K13028 CATE- DESCRIPTION OR TITLE FUND END ITEM JOB- PAY PAY EFFECTIVE MONTHLY BUDGETED AMT GORY DESC. MONTH NO.- -CLASS GP STP DATE. RATE 1 CLERICAL SUPERVISOR II MCH-LT SEP 088 0063 07 01 SEP 90 1,300.00 CLERICAL SUPERVISOR I STATE AUG 088.. 0063 OCT_ 90 1,300.00 15,600.00 COMMUNITY SERV AIDE -II MCH-LT SEP 131 5502 04 01 SEP 90 1,117.00 COMMUNITY SERV AIDE II STATE AUG 131 5502 OCT 90 1,117.00 13,404.00 29,004.00 't- DOCUMENT NO. C1000285 ATTACHMENT NO. 03 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: HIV DIVISION TERM: September 1, 1990 THROUGH August 31, 1991 SECTION I. SCOPE OF WORK: PERFORMING AGENCY agrees to conduct program activities to help reduce the spread of AIDS/HIV (acquired immunodeficiency syndrome/human immunodeficiency virus). PERFORMING AGENCY will: 1. Establish and/or maintain AIDS/HIV health education/risk reduction programs for the targeted populations and/or the general public; and, 2. Perform counseling, testing, referral, and partner notification (CTRPN) activities which include establishing and/or maintaining anonymous or confidential HIV testing programs for persons at increased risk of HIV infection due to individual sexual behavior, intravenous drug abuse, or other risk behaviors. All information and education materials developed and provided by PERFORMING AGENCY will be accurate, comprehensive, and consistent with current findings of the United States Public Health Service. PERFORMING AGENCY agrees that all activities will be performed in accordance with applicable RECEIVING AGENCY current program rules and guidelines, PERFORMING AGENCY'S continuation objectives, activities work plans, and detailed budget as approved by RECEIVING AGENCY. RECEIVING AGENCY will supply the PERFORMING AGENCY with the most current version of the program rules. PERFORMING AGENCY will submit to RECEIVING AGENCY written acknowledgment of receipt and acceptance of the document. All of the above named documents are adopted by reference as part of this attachment. PERFORMING AGENCY assures that expenditure of funds will be in accordance with the respective activity's detailed budget. PERFORMING AGENCY will provide CTRPN services to the target population defined as: 1. Males who routinely have sex with other males. 2. Males who occasionally have sex with other males. 3. Males who have sex with males and females. 4. Males and females with multiple sex partners. 5. Persons with a history of sexually transmitted diseases. 6. Persons with a history of high risk behavior. Counseling and Testing 1. Offer voluntary anonymous and/or confidential HIV testing to clients who -1- may want to be tested. 2. Provide culturally sensitive and effective pretest and posttest counseling based on Centers for disease Control (CDC) approved model. 3. Publicize HIV counseling and testing services so that potential clients will know where and when services are available. 4. Offer HIV counseling and testing services at a location that is convenient for the majority of the target population and during hours established to reach these clients. 5. Use scannable forms supplied by RECEIVING AGENCY for collection of demo- graphic information and blinded test result data. - 6. Utilize RECEIVING AGENCY'S laboratory for all ELISA and Western Blot testing. 7. PERFORMING AGENCY will develop and maintain a referral plan by which reciprocal linkages are established with other service providers (especially other RECEIVING AGENCY funded providers) for the purpose of: a. ensuring that behavior changes occur and are sustained; b. providing psychosocial services; c. medical intervention; d, substance abuse treatment; e. family planning services; f. financial and legal assistance; g. case management; h. long term care; Partner Notification 1. All partner notification services are to be consistent with RECEIVING AGENCY'S Serologic Test Counseling and Partner Notification Techniques guidelines which are incorporated by reference and made a part hereof. 2. Encourage HIV+ clients to voluntarily refer their sexual and/or needle sharing partners for HIV counseling and testing. 3. Encourage intravenous drug users (IVDU) to voluntarily refer their sexual and/or needle sharing partners for HIV counseling and testing. 4. If the client wishes to make the partner notification personally, provide guidance in making contact. 5. If the client does not want to make the partner notification, but wishes partners to be notified, elicit adequate information for RECEIVING AGENCY STD clinic personnel to make the notification. CTRPN Quality Assurance Guidelines 1. PERFORMING AGENCY assures that pretest and posttest counseling sessions are -2- performed by staff who have received counseling training from a course approved by RECEIVING AGENCY. 2. PERFORMING AGENCY will conduct monthly monitoring of counseling, testing, referral, and partner notification sessions and give performance feedback to counselors. 3. PERFORMING AGENCY agrees to facilitate RECEIVING AGENCY review of scheduled counseling, testing, referral, and partner notification sessions. PERFORMING AGENCY agrees to comply with the following: Chapter 81, Health and Safety Code. Article 4419b-4, V.T.C.S., Human Immunodeficiency Virus Service Act. PERFORMING AGENCY will provide an estimated 1,000 clients with services/units of service in or benefiting the county(ies)/area defined as: LUBBOCK. SECTION II. LEGAL AUTHORITY TO CONTRACT: Chapters 12, and 121, Health and Safety Code. SECTION III. SPECIAL PROVISIONS: RECEIVING AGENCY will supply PERFORMING AGENCY with the most current version of the document entitled "Content of AIDS -Related Written Materials, Pictorials, Audiovisuals, Questionnaires, Survey Instruments, and Education Sessions in Centers for Disease Control Assistance Programs," and its preface which is written by RECEIVING AGENCY. Said document and its preface are incorporated as part of this attachment as though it were written herein verbatim. PERFORMING AGENCY will provide to RECEIVING AGENCY written acknowledgment of receipt and acceptance of this document and its preface and will comply with the guidelines contained in this document and its preface. Due to the sensitive and highly personal nature of AIDS/HIV-related information, strict adherence to the General Provisions Confidentiality Article and RECEIVING AGENCY program rules regarding confidentiality is required. PERFORMING AGENCY success depends upon whether persons at risk believe that the program observes this principle. In addition to these conditions, PERFORMING AGENCY will comply with the following specific requirements regarding individual patient information/data when conducting counseling, testing, referral,and partner notification activities. 1. If a client chooses to be anonymous when the mandatory offer of anonymity is made, then: a. no record will be maintained linking the person's identity with his/her real name or pseudonym or other identifiers; and b. upon notice to the client, the lab slip(s) containing the test results will be shredded/destroyed. Originals and copies of test results will not be maintained longer than 30 days. -3- 2. If a client elects to have a confidential file made for the testing and counseling, this file will be maintained in a fashion consistent with RECEIVING AGENCY's HIV Testing Guidelines which are incorporated by reference and made a part hereof. If confidential testing is needed, then the lab slip containing the test results may be provided to the client if requested. 3. No log containing personal information or identifiers or HIV status will be maintained in anonymous or confidential testing situations. PERFORMING AGENCY will submit required programmatic reports quarterly on the same cycle as financial status reports. PERFORMING AGENCY will authorize their staff to attend in -state and out-of- state training, conferences, and meetings for which funds were budgeted and approved by RECEIVING AGENCY. SECTION IV. BUDGET: Personnel $47,660.00 Fringe Benefits 11,916.00 Travel 1,300.00 Equipment .00 Supplies 2,000.00 Contractual .00 Other 2,300.00 Total Direct Costs $65,176.00 Indirect 2,362.00 TOTAL $67,538.00 Financial status reports (FSRs) are due the 20th of December, March, June, September and the 15th of October. Total reimbursements will not exceed $67,538.00. Total reimbursements for Counseling, Testing, Referral, and Partner Notification services will not exceed $32,488.00. Total reimbursements for Education, Prevention, and Risk Reduction services will not exceed $32,688.00. Indirect cost based on UGCMS, Table 1. Indirect costs may be claimed based on total direct costs in accordance with UGCMS, Table 1, and will not exceed $ 2,362.00. -4-