Loading...
HomeMy WebLinkAboutResolution - 2000-R0077 - Grant Application - TX Department Of Health - Innovative Grant, Establish Fund - 03_23_2000Resolution No. 2000—R0077 March 23, 2000 Item No. 21 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 on behalf of the City of Lubbock a grant application for an Innovative Grant (Permanent Fund for Children and Public Health) and any associated documents, by and between the City of Lubbock and the Texas Department of Health, which grant application is attached hereto and which shall be a part of this Resolution as if fully copied herein in detail. Passed by the City Council this 23rdday of March , 2000. TDY SIT1 N, AYOR A ST: . Darnell, City Secretary APPROVED AS TO CONTENT: Tommy C e , Health Department Manager APPROVED AS TO DEdnald G. Vandiver, First Assistant City Attorney DDres/grantres March 2, 2000 . .J..A 1! ,. 1N .f. 1 *.. Resolution No. 2000-R00 77 March 23, 2000 Item No. 21 TDH. TEXAS DEPARTMENT Of HEALTH REQUEST FOR PROPOSALS Texas Department of Health Innovation Grants (Permanent Fund for Children and Public Health) 1100 W. 49th Street Austin, Texas 78766-3199 February 2000 Walter D. Wilkerson, Jr., M.D. William R. Archer Ill, M.D. Chair, Texas Board of Health Commissioner of Health Ali, .u. p„ �4.. ■ UkE OP Co t tws 1. INTRODUCTION........................................................... 4 2. BACKGROUND, LEGAL AUTHORITY, AND PURPOSE ............................. 5 3. FUNDING................................................................. 6 4. PROPOSALS.............................................................. 7 A. Part I. Grants for Developing and Demonstrating Cost-effective Prevention and Intervention Strategies for Improving Public Health Outcomes . .............. 7 B. Part II. Grants to Local Communities to Address Disparities in Health in Minority Populations........................................................9 C. Part III. Grants to Local Communities for Essential Public Health Services ..... 9 5. GENERAL REQUIREMENTS ................................................. 10 A. Eligible Applicants .................................................. 10 B. Budget Period ...................................................... 10 C. Schedule of Events ................................................. 11 D. Program Contact ................................................... 11 E. Applicant Conference ............................................. 12 F. Questions and Answers Document ..................................... 12 6. PROPOSAL REVIEW, SELECTION, AND NEGOTIATION .......................... 13 A. Screening Proposals ............................................... 13 B. Program Review Process ............................................ 13 C. Program Review Tools .............................................. 13 D. Selection and Contract Negotiation .................................... 15 7. TDH ADMINISTRATIVE INFORMATION ........................................ 16 A. Incurring Costs and Rejection of Proposals ............................. 16 B. Right to Amend or Withdraw RFP...................................... 16 C. Financial and Administrative Requirements .............................. 16 D. Authority to Bind TDH ............................................... 16 E. Contracting with Subcontractors and Vendors ........................... 17 F. Contract Information ................................................ 17 G. Protest of Application or Bid Denial .................................... 17 8. PROPOSAL CONTENT ..................................................... 18 A. Proposal Submission Information and Deadline .......................... 18 B. Assembly......................................................... 18 C. Confidential information ............................................. 19 D. Organization and Arrangement of the Proposal ........................... 20 1. Face Page - Proposal for Financial Assistance .................... 20 2. Proposal Checklist ............................................ 20 3. Contact Person Information .................................... 20 4. Project Abstract —no ........................................... 20 S. Assessment Narrative ......................................... 20 6. Organization Summary ........................................ 21 7. Project Description and Work Plan ............................... 21 8. Performance Measurement Requirements ......................... 23 9. Quality Assurance ............................................ 23 N i. x r 1. , ■ E. Financial Information ................................................ 23 1. Funding Information .......................................... 23 2. Budget ..................................................... 24 3. Child Support Regulations ..................................... 24 9. BLANK FORMS AND INSTRUCTIONS ......................................... 25 Form A - Face Page Proposal for Financial Assistance ............................26 Form B - Proposal Checklist .... ........................................... 28 FormC - Contact Person Information ........................................ 29 Form D - Funding Information Form ........................................... 30 Form E- Budget Summary ...................................................31 Form F - Budget Forms and instructions ...... ...... ..........................33 Form G - Child Support Certification...........................................48 Appendix A - Essential Public Health Services Appendix B - TDH Contract General Provisions (Sample) Appendix C - TDH Executive Order 0110, Protest of Application or Bid Denial 3 1. INTRODUCTION The Texas Department of Health (TDH) announces the expected availability of State General Revenue funding to provide grants for three goals which are referred to as "Parts." Part I. Grants for Developing and Demonstrating Cost-effective Prevention and Intervention Strategies for Improving Public Health Outcomes. Part 11. Grants to Local Communities to Address Disparities in Health in Minority Populations Part III. Grants to Local Communities for Essential Public Health Services Grants are limited and will be awarded on a competitive basis. This document, the Request for Proposal (RFP) contains the requirements that applicants must meet to be considered for funding. Applicants who wish to be considered for TDH Innovation Grants are required to submit proposals in accordance with the instructions contained in this RFP. Proposals that do not comply with the instructions in this RFP may be disqualified or downgraded. Applicants should submit proposals that are complete and written in clear, concise language. Certain forms that have been required in past TDH RFPs for other programs have been deferred until the contract negotiations phase. IMPORTANT: APPLICANTS SHOULD READ THIS RFP COMPLETELY BEFORE PREPARING THEIR PROPOSALS. 4 2. BACKGROUND, LEGAL AUTHORITY, AND PURPOSE The TDH Innovation Grants were created in 1999 by the 76th Texas Legislature (HB 1676). The Legislature determined that a significant portion of funds received by the State of Texas from the recent tobacco legislation should be appropriated to certain permanent funds. One of those permanent funds, called the Permanent Fund for Children and Public Health was established for "certain public health purposes" and was appropriated $100 million. The interest from the fund is available to TDH to accomplish the goals of the Fund. The legal authority for the grants is Government Code, §403.1055, relating to the Permanent Fund for Children and Public Health, and the Health and Safety Code, §121.0065, relating to Grants for Essential Public Health Services. The intent of the TDH Innovation Grants is to improve public health outcomes at the community level, using innovations that can be replicated in many places in Texas. To the maximum extent possible, the grants are intended to bring about improvements in health status that are demonstrable or measurable. No funds from the grants will be authorized to pay for direct health care services, except when providing direct health care services is incidental to addressing an essential public health service within the objectives of a grant. TDH maintains an Internet web site with information regarding this grant program http J/www.t d h. stat e.t x. u srin n ovat i o n Currently the web site contains: this RFP, the applicant conference information, the rules for the grant program, text of the two House bills related to the grant program (HB 1676 and HB 1444), and the report of and other documents related to the HCR 44 (75th Legislature) workgroup which studied local public health issues. TDH updates the web site on a routine basis. 5 3. FUNDING A. Approximately $8,400,000 is expected to be available to fund projects in all three parts. TDH intends to award grants of 33 1/3% (one-third) of the available grant funds to proposals in each part. However, if the funds for a part are not completely expended or allocated, TDH will have the authority to redistribute funds among the other two parts based on unfunded responses to a previous or subsequent request for proposals. B. Continued funding in future years will be based upon the availability of funds and documented progress of the project during the prior budget period. Funding may vary and is subject to change for each budget period. C. Funds may not be used to supplant local or State funds. D. The actual dollar amount awarded to each project will depend upon TDH's assessment of the merits of the proposal. E. Any single grantee may be awarded multiple contracts but may receive a maximum of $1,000,000 for the 14-month budget period. F. TDH intends to fund up to 30 projects. G. Grants made under Part III will be allocated in such a way so that the total amount of funds available is equally divided between services for rural and urban areas of the state. A rural area is a county that had a population in the most recent decennial United States census of 150,000 or less, or that part of a county with a population of greater than 150,000 that is not delineated as urbanized by the United States Census Bureau. An urban area is a county or part of a county that is not a rural area. Note that the determining factor in deciding whether a grant is for an urban or rural area is whether an urban or rural area is receiving the services. For example, a grantee may be located in an urban area but may be proposing to serve a rural area. In this example, the grant would be considered a rural grant. Applicants must specify whether a rural or urban area (or both) will be receiving the services proposed. C1 4. PROPOSALS In order to encourage creativity and innovation in proposals, TDH has left a large proportion of the grant funds available for uncategorized projects. A few categorized projects of particular interest to the agency are included as follows: A. Part I. Grants for Developing and Demonstrating Cost-effective Prevention and Intervention Strategies for Improving Public Health Outcomes. Research on the Epidemiology and Causes of Childhood Obesity in Texas Up to $450,000 is available for projects that will assess the problem of childhood obesity in Texas. The project(s) should include a plan to assess quantitatively the burden of obesity in Texas children using accepted epidemiological methods and scientific standards. The project(s) should assess the prevalence of obesity in Texas in various geographic and demographic groups. The project(s) should design a model for an ongoing surveillance system on childhood obesity and make recommendations about the frequency with which data should be collected on heights and weights of school -aged children. In addition, the project(s) should (a) seek to describe the detailed risk factors for obesity in Texas, and (b) to the extent possible, explore the underlying causes of childhood obesity and define the role of nutrition and the habits of daily life on the incidence of childhood obesity in this State. Proposals should describe in detail the method of study, data collection, analysis, and dissemination of results. If the proposal includes a sampling method, it should include details of the method and analysis, including statistical considerations. Dramatization of Public Health Problems and Community Action In Texas A total of $90,000 is available for projects that will dramatize the role of public health in Texas communities and in the lives of ordinary Texans. The goal of the project is to help educate community leaders and others about the importance of public health activities and the importance of their support and participation in those activities. Research indicates that only a tiny proportion of the Texas population understands the nature of public health and its role in their lives. In addition, the role of public health has evolved as the nature and understanding of health threats has evolved from a disease model toward an understanding of determinants of health such as risky behaviors. Proposed projects should aim to dramatize the day-to-day importance and potential for positive impact of public health activities in Texas communities through audio, visual, or written media. Projects should concentrate on public health problems and activities at the local or community level. The activities depicted may be iA those of local health departments, community organizations, individuals, schools and universities, or other public or private entities. In general, the project is not intended to promote the activities of TDH or other state or federal governmental entities, although, because of the important roles of these entities in the daily practice of public health in Texas communities, incidental mentions of such agencies may be appropriate within the context of the project. In addition to other requirements, proposals should describe the ability of the applicant to research and understand the nature of public health problems and actions in communities, details of the nature of the materials to be created, and how such materials can be used and distributed. A Comprehensive Descriptive Analysis of Morbidity and Mortality in Texas Up to $375,000 is available for intensive studies of morbidity and mortality in Texas. The study should analyze in detail the causes of morbidity and mortality in Texas for a period of up to 30 years by geography, age, race, ethnicity, and other demographic characteristics. The study should identify trends in overall Texas morbidity and mortality and specific causes of morbidity and mortality over the study period in various geographic and demographic categories, with an emphasis on Texas' minority populations. Wherever possible and appropriate, measures of morbidity should include quality -of -life adjustments. The project should be able to conclude whether morbidity and mortality have been higher or lower in various geographic, racial, and ethnic groups over time and should describe the differing major causes of morbidity and mortality in major population groups. Wherever feasible and appropriate, the project should utilize methods of geographic information systems and detailed maps of Texas that reflect trends in morbidity and mortality. In addition to other requirements, the proposal should specify the source(s) of the data to be used in the analysis, the scope of the analysis, the approach and methods to be used, and the expertise and experience of the analysts. Projects that propose to use morbidity or mortality datasets held by TDH will be expected to comply with TDH rules regarding the public or research use of such datasets. Other Innovation Grants A total of approximately $1,885,000 is available for other innovation grant proposals for developing and demonstrating cost-effective prevention and intervention strategies for improving public health outcomes. Within the limits set out in the rules governing these grants, projects may address any public health problem or issue within the State of Texas. The Department anticipates that few, if any, of these grants will be higher than $400,000 or lower than $25,000. 8 B. Part U. Grants to Local Communities to Address Disparities in Health in Minority Populations Minority populations are African -Americans, American Indians, Asians and Hispanics in Texas. Applicants may address subgroups within these classifications (for example, Korean -Americans, recent immigrants versus second -generation Texans) as appropriate. Prevention in the Minority Youth Population of Texas A total of $550,000 is available for projects that investigate and articulate the underlying causes of risky health behaviors among minority youths in Texas, including, but not limited to early sexual activity, substance abuse, and violence, or behaviors that lead to diseases that disproportionately affect minority populations. The inquiry should use accepted research methods, including but not limited to epidemiologic and demographic analyses of individuals, families or groups or methods of collecting detailed anecdotal information, such as focus groups or in-depth personal stories (through interviews) that may shed light on the underlying causes of risky behaviors in individuals. Projects are encouraged to use innovative methods of data collection and analysis. Proposals should explain the rationale and likely outcomes of the project in detail, including how the findings are likely to aid in the development of prevention principles and programs for the minority populations of Texas. Projects may involve large geographic areas such as the entire State, or smaller ones, such as a county or city. Projects should be conducted in areas of Texas that contain a significant proportion of minority population. Other Innovation Grants A total of approximately $2,250,000 is available for other innovation grant proposals under Part II for addressing specific public health priorities,. particularly to address disparities in health in minority populations. Within the limits set out in the rules governing these grants, projects may address any public health problem or issue within the State of Texas. The Department anticipates that few, if any, of these grants will be higher than $400,000 or lower than $25,000. Projects should be carried out in parts of Texas that contain a significant proportion of minority populations. C. Part 111. Grants to Local Communities for Essential Public Health Services A total of approximately $2,800,000 is available for other innovation grant proposals under Part III for essential public health services. Within the limits set out in the rules governing these grants, projects may seek to provide one or more essential public health service. The Department anticipates that few, if any, of these grants will be higher than $500,000 or lower than $25,000. C 5. GENERAL REQUIREMENTS A. Eligible Applicants Part I: Any person or other entity, public or private, except TDH Part II: Any county, municipality, public health district, or other political subdivision, including hospital districts, or local nonprofit organization in Texas Part III: Any county, municipality, public health district, or other political subdivision, including hospital districts, in Texas Applicants may submit proposals for grants under one, two, or all three parts, including proposals for funding one project under more than one part, or proposals for multiple projects under different parts. Such proposals should clearly specifythe parts) for which the proposal seeks funding and the specific amount of funding sought under each part. B. Budget Period TDH expects that the initial grants will be awarded beginning on or about July 1, 2000 for a 14-month period; that is, through the end of the State fiscal year ending on August 31, 2001. Some applicants may wish to submit proposals for projects that would extend beyond August 31, 2001. Such proposals will be considered for initial and continued funding into future years, with the following limitations: 1. Because the funding for future grants is dependent upon the biennial legislative appropriation process, TDH cannot contract for funding beyond August 31, 2001. Thus, any funding beyond August 31, 2001 will be contingent upon appropriations and further approval by TDH through contract negotiations. Applicants should take this into account in designing their proposals. 2. No proposals will be considered for funding beyond August 31, 2003. 10 C. Schedule of Events The following schedule is subject to revision at the discretion of TDH. Changes will be posted on the web site and published in the Texas Register. 1. Applicant conference in Austin (optional for applicants) .................... .... 03/10/00 2. Deadline for Submission of Proposal ................. 04/18/00 3. Written Notification to Applicants ...................... 06/02/00 4. Contract Development and Execution ............. 06105-06130100 5. Contract Begin Date ........................... 07/1/00 or later D. Program Contact The sole contact for questions or inquiries regarding this RFP is Gyl Kovalik. Ms. Kovalik, or other contacts authorized by the Commissioner, are the only TDH employees authorized to clarify, modify, amend, alter, or withdraw project requirements, terms, and conditions of the RFP. To ensure fairness in the competitive award process, other employees and representatives of TDH have been instructed not to communicate with potential applicants or their representatives regarding this RFP prior to the award date. Applicants who contact TDH employees or representatives other than the sole contact listed above on matters related to this RFP before the award date may be disqualified for current or future grants. However, potential applicants may contact TDH program and regional staff regarding potential projects in order to seek program or regional staff input on potential projects' design and/or to seek TDH program or regional staff collaboration in implementing the project if it is funded. All communications concerning this RFP must be addressed in writing to: Gyl Kovalik Office of Policy and Planning Texas Department of Health 1100 West 49th Street Austin, Texas 78756-3199 FAX (512) 458-7344 ayl.kovalik@tdh.state.tx.us 11 The physical address for overnight and personal deliveries is: Office of Policy and Planning Texas Department of Health 1100 West 49th Street, Room M-660 Austin, Texas 76756-3199 E. Applicant Conference An optional applicant conference will be held to provide technical assistance to applicants in preparing their responses. The conference will be held on Friday, March 10, 2000 from 10:00 a.m. to 4:00 p.m., at "The Meeting Place", 2100 Northland Drive, Austin, Texas. Registration will be from 9:00 to 10:00 a.m. Attendance is optional for interested applicants, but will be restricted to 150 participants because of space limitations. Any interested person must reserve a place by faxing a request to the department as outlined in the Applicant Conference Information which will be posted on the web site at http://www.tdh.state.tx.us/innovation. Attendance or non-attendance at the applicant conference will have no effect on the evaluation of applications. All questions during the conference must be written on index cards that will be handed out at the beginning of the conference. The cards will be collected throughout the day. Questions may be answered at the conference but no answer will be binding until it has been included in the "Questions and Answers" document. F. Questions and Answers Document In addition to the questions collected at the applicant conference, additional written inquiries concerning the RFP must be received no later than 5:00 P.M., C.S.T., March 31, 2000. Responses to inquiries of a general nature will be distributed in a "Questions and Answers" (Q&A) document to each organization that attends the applicant conference, sends in a written inquiry, requests the Q&A document, or requests this RFP. Responses to inquiries of a specific nature will be provided only to the requestor. TDH will be the sole judge of whether a request is of a general or specific nature. The Q&A document will also be put on the web site (http://www.tdh.state.tx.usAnnovation) and updated regularly. 12 6. PROPOSAL REVIEW, SELECTION, AND NEGOTIATION Proposals will be reviewed according to the criteria below. All proposals will remain with TDH and will not be returned to the applicant. A. Screening Proposals Proposals will be initially screened for eligibility and completeness. Proposals that do not meet the requirements in this RFP may not be considered for review or may receive lower scores at the discretion of TDH. Applicants not being considered for further review will be notified in writing. B. Program Review Process TDH will establish a panel(s) of TDH employees and persons from outside TDH who will review the responses to this RFP and make recommendations to the Commissioner for awards. Panel members from outside TDH will receive no compensation or reimbursement for expenses. No panel members will be a current applicant for a grant on which the panel member would be making recommendations. The Commissioner or his designee will make the final funding decision. C. Program Review Tools The Office of Policy and Planning will develop a review tool for use by the review committee. The review tool will award a maximum of 200 points. One hundred (100) points may be awarded for the general content requirements of this RFP, as described in section 8, Proposal Content. An additional 100 points may be awarded based on the following preferences: 1. demonstrates innovation(s) that are replicable in other parts of Texas. An innovation is defined as a solution, analysis, intervention, program design, evaluation method, or administrative method that is substantially new to the area where the innovation is being introduced. Replicable means that some aspect of the innovation proposed could reasonably be assumed to inform public health practices in another community in Texas. Part I - 20 points Part 11 - 10 points Part III - 10 points 13 2. documents the intent and ability of the applicant to communicate and collaborate with elements of the community that deliver essential public health services (see Appendix A for a list of the essential public health services), health care providers, consumers, businesses, educational institutions, governmental agencies, law enforcement agencies, or religious institutions and how community needs have been or will be determined and addressed; All applicants are encouraged to discuss their interests and ideas for developing projects with public and private sector partners throughout communities early in the planning stage. Community support should be assured by public and private participation in the planning, development, implementation, and assessment phases. Part I - 20 points Part II - 25 points Part III - 25 points 3. demonstrates a strong financial commitment on the part of the applicant toward the activities proposed including direct funding or significant in -kind contributions from the applicant, local entities, private donors, state agencies, federal grantors, or private foundations; Part I - 15 points Part II - 5 points Part III - 15 points 4. with respect to Part I and it grants, considers or inquires into one or more of the underlying causes of public health problems; Part I - 20 points Part II - 40 points Part III - 0 points 5. • addresses or demonstrates cost-effectiveness or cost benefit; Part I - 10 points Part II - 10 points Part III - 10 points 6. includes a plan for the dissemination of methods, findings or conclusions such as publication in the public health or medical literature, presentations locally and at statewide events, using the Internet, or other avenues; Part I - 15 points Part II - 10 points Part III - 10 points 14 7. with respect to Part III grants, demonstrates a contribution to strengthening the essential public health services infrastructure; Part 1- 0 points Part II - 0 points Part III - 25 points 8. with respect to Part III grants, demonstrates that the applicant has or will develop a local health board or other appropriate advisory group during the grant period. Part I - 0 points Part II - 0 points Part III - 5 points D. Selection and Contract Negotiation Once award decisions are made, TDH will negotiate contracts within the framework of the program goals and the funds available. The applicants selected for contract awards may be asked to revise the budgets, as well as the goals and objectives, ,of their proposals in order to achieve the program's goals within available funding limits. TDH funds for this grant program are dependent on the availability of the appropriations. Because of limitations on the timing of the obligation or expenditure of State monies, it may be necessary for TDH to negotiate different schedules for the actual transfer of the monies to each successful applicant or to place limits on the timing of the expenditures of the grants by each successful applicant. This will be part of the contract negotiation process. The applicant will submit written revisions reflecting negotiated changes. Once the contract negotiation process is complete, TDH will initiate the development of a contract. Each applicant whose proposal is selected for funding will receive written notification. This notice is an announcement of selection, and the receipt of the notice is not legally binding until there is a fully -executed contract. Each applicant not selected for a contract will also receive a timely written notification that its proposal will not be funded. 15 7. TDH ADMINISTRATIVE INFORMATION A. Incurring Costs and Rejection of Proposals Any costs incurred in the preparation of the proposal will be borne by the applicant and are not allowable costs. TDH reserves the right to reject any or all proposals and is not liable for any costs incurred by the applicant in the development, submission, or review of the proposal. B. Right to Amend or Withdraw RFP TDH reserves the right to alter, amend, or modify any provisions of this RFP or to withdraw this RFP at any time prior to the execution of a contract. The decision of TDH will be administratively final in this regard. C. Financial and Administrative Requirements If an applicant has not had a contract with TDH within the past 24 months, the applicant will submit with its proposal a copy of the applicant's most recent Balance Sheet and Statement of Income and Expenses. TDH will evaluate the financial statements and may, at its sole discretion, reject the proposal on the grounds of the applicant's financial capability. All current contractors and/or selected applicants administering two or more TDH contract attachments are required to maintain integrity between the transactions affecting each contract attachment by (1) maintaining a completely separate set of records for each contract attachment or (2) establishing within the chart of accounts and general ledger a separate set of accounts for each contract attachment. The applicant is encouraged to secure additional funds from other sources as necessary to strengthen the overall application. D. Authority to Bind TDH The Commissioner of Health, or the Chief, Bureau of Financial Services (or a designee), are the only individuals who may legally commit TDH to the expenditure of public funds. No costs chargeable to the proposed contract can be reimbursed before TDH receives a fully -executed contract. 16 E. Contracting with Subcontractors and Vendors A selected applicant may enter into contracts with subcontractors or procurement contracts with vendors. Applicants will be responsible to TDH for the performance of any subcontractor or vendor. If the applicant enters into contracts with subcontractors or procurement contracts with vendors, the documents will be in writing and will comply with the requirements specified in the General Provisions for Texas Department of Health Grant Contracts (see Appendix B: sample TDH Contract General Provisions). If an applicant plans to enter into a contract with a subcontractor or a procurement contract with a vendor that delegates a substantial portion of the scope of the project or exceeds $25,000 of the applicant's approved funding, the applicant must submit justification to TDH and receive prior written approval from TDH before entering into the contract. F. Contract Information After the proposal review process is completed, the final funding amount and the terms of the contract will be determined through negotiations between TDH and the applicant. The specific Scope of Work will be developed from information contained in the RFP and the proposal. TDH reserves the right to adjust the funding allocation during the term of the contract, pursuant to the terms of the contract. A selected applicant is subject to the General Provisions for TDH Grant Contracts. Any exceptions to any of the requirements in the RFP must be specifically noted and satisfactorily explained by the applicant in the proposal as a condition for allowing those exceptions in the contract. A sample of the TDH Contract General Provisions are included as Appendix B. G. Protest of Application or Bid Denial TDH has established a procedure for dispute resolution for any applicant that has responded to this RFP. An applicant may request review of a TDH action that denies the award of a contract to that applicant after response to this solicitation by following the procedures and time frames included in Appendix C: TDH Executive Order XO-0110, Protest of Application or Bid Denial. 17 8. PROPOSAL CONTENT A. Proposal Submission Information and Deadline Applications (original and five copies) must be received on or before 5:00 P.M., C.S.T., April 18, 2006. PROPOSALS RECEIVED AFTER THE PROPOSAL DEADLINE WILL NOT BE CONSIDERED. The original proposal and five copies must be submitted to: Gyl Kovalik Office of Policy and Planning Texas Department of Health 1100 West 49th Street Austin, Texas 78756-3199 TDH will not accept proposals by facsimile transmission or E-mail. Proposals may be mailed or hand -delivered to the TDH program address above on or before the proposal deadline. If a proposal is hand -delivered to the TDH program address above, be sure to request a receipt at the time of delivery to verify that the proposal was received by the Office of Policy and Planning on or before the proposal due date and time. If a proposal is mailed, it will be considered as meeting the deadline if it is: received on or before the due date, or postmarked on or before the due date and received in time for submission to the program review team. (Applicants must request a legibly -dated U.S. Postal Service postmark or obtain a legibly - dated receipt from a commercial carrier service or the U.S. Postal Service. Private metered postmarks will not be acceptable proof of postmark.) B. Assembly To facilitate review and processing of the proposals, each proposal should meet the following stylistic requirements: • a table of contents • all pages clearly and consecutively numbered • original and 5 copies, unbound original • typed by computer or typewriter W, • single-spaced • 12-point font on 8 1,120 x 110 paper with 1 ° margins • printed on one side only • signed in ink by an authorized official (copies need not bear an original signature) and • blank forms provided in section 9. Blank Forms and Instructions must be used (electronic reproduction of the forms is acceptable). Specific instructions for each required section are provided. During the contracting phase, TDH will require that all preliminarily selected applicants complete additional forms (e.g., assurances, certifications, administrative information). Those additional forms will be available for inspection on the innovation grants web site (http://www.tdh.state.txusAnnovation). C. Confidential Information The applicant must clearly designate any portion(s) of the proposal that contain(s) confidential information and state the reasons the information should be designated as such. Designations that mark the entire application as confidential will not be honored. If any information is marked as confidential in the application, TDH will determine whether the requested information is excepted from disclosure under the Open Records Act, Texas Government Code, Chapter 552, VTCA. If it constitutes an exception and if a request is made by any other entity for the information marked as confidential, the information shall be forwarded to the Texas Attorney General along with a request for a ruling on its confidentiality. The Attorney General's procedure includes obtaining input from the applicant. Applicants are advised to consult with their legal counsel regarding disclosure issues and to take the appropriate precautions to safeguard trade secrets or any other confidential information. Following the award of any contract, responses to this RFP are subject to release as public information unless any proposal or specific parts of any proposal can -be shown to be excepted from disclosure under the Open Records Act, Chapter 552, Texas Government Code. 19 D. Organization and Arrangement of the Proposal Note that points are designated for certain of the forms or other information required below. As described in section 6. E. Program Review Tools, applicants may be awarded a total of 100 points for the elements listed below according to the points listed. 1. Face Page - Proposal for Financial Assistance This form (see Form A) requests basic information about the applicant and the project, including the signature of the authorized representative. The face page is the cover page of the proposal and must be completed in its entirety. 2. Proposal Checklist This form (see Form B) is provided to ensure the proposal includes all of the information requested. The Proposal Checklist immediately follows the face page and must be completed. 3. Contact Person Information This form (see Form C) provides information to TDH about the appropriate contact persons in the applicant's organization. 4. Project Abstract —no longer than one page Provide an executive summary description of the project for reviewers. S. Assessment Narrative - no longer than three pages (10 points) The applicant is encouraged to utilize existing data sources and assessments when completing this portion of the application. Note that the community/target population being addressed by the proposal may be as large as the entire state of Texas or as small as is reasonable for the proposed project. Following are the required assessment items: a. A synopsis of the available data on the target population including: • geographic boundaries; (for Part III proposals, the applicant must include a designation of whether the target population is in a rural or urban area according to the definition in section 3. H.) • demographic data (age, gender, ethnicity, etc.); • socioeconomic data (per capita income, poverty levels, unemployment, occupational data, etc.); and P • general description of community -wide health status (e.g., key morbidity/mortality statistics). b. A description of gaps in resources and potential barriers to improving health status in the target population. 6. Organization Summary - no longer than three pages (10 points) The applicant must provide a narrative description including: a. the legal name of the applicant, b. the type of organization, for example, municipality, nonprofit corporation, etc., C. any affiliations, d. its overall purpose or mission statement, e. a brief history of its accomplishments, f. organizational structure (include an organizational chart. Make sure that the chart shows positions such as the board of directors, officers, advisory councils or committees, local health board and/or staff. Include existing filled positions, existing vacant positions, and proposed positions.), g. prior experience in the type of program proposed, h. organization's contracting experience, and i. • other detail that demonstrates the organization's qualifications. 7. Project Description and Work Plan (60 points) Applicants must submit a comprehensive plan. The plan must include a clear and concise discussion of each of the following topics: a. the goals and objectives of the project, b. the proposed activities with time lines for accomplishing the objectives, C. the population to be served, 21 d. how the project will address the needs and the problems identified in the community assessment and how the proposed project will overcome these problems/meet these needs, e. how and by whom the activities will be conducted (include a job description of the project director), f. with regard to Part III applications, whether a rural or urban area (or both) will be receiving the services proposed, g. whether the proposal seeks funding for Parts I, II, and/or III (as described in section 1. Introduction and section 5. A. Eligible Applicants) and the specific amount of funding sought under each part, h. how the proposal addresses one or more of the essential public health services, i. how improvements in health status that are demonstrable or measurable will be made, or, what specific positive outcomes will be reached, j. with regard to Part II applications, how the program addresses disparities in morbidity, mortality or health status in minority populations, k. whether and how each of the preferences in section 6. C. are addressed, With regard to Part III applications, applicants must demonstrate that they have a local health authority as defined under the Local Public Health Reorganization Act, Health and Safety Code, Chapter 121, prior to the grant funds being awarded. A TDH regional director cannot serve as the local health authority for Part III grants recipients. M. when applicable, the proposal must demonstrate how the applicant plans to use, collect and evaluate data. Describe: what baseline data will be used; • what data will be collected; • how the data will be collected and tabulated; • who will be responsible for data collection and reporting; • how often data collection activities will occur. 22 8. Performance Measurement Requirements (10 points) Applicants agree that in the event a contract is awarded, performance measure(s) will be used to assess, in part, the applicant's effectiveness in meeting the objectives for the project. The applicant must identify performance measures for project objectives and propose target levels of performance for each measure that are related to some baseline indicators. The proposed measures and levels of performance and the baseline indicators will be negotiated and agreed upon by the applicant and TDH if the applicant is selected to negotiate a contract. Performance measures are defined as outcome, output, efficiency, and explanatory measures. A well -written measure will include the following components: who will deliver the service(s) and their qualifications (as appropriate); a deliverable (a product or service and how much); schedulettime frame; and a standard of performance. 9. Quality Assurance (10 points) The proposal must contain the following information regarding quality assurance: • demonstrate how the applicant will ensure quality in every aspect of the program including the delivery of the program and the collection and interpretation of data, • describe the quality assurance plan and processes that will enable the project to meet standards and expectations, • describe the applicant's ability to provide services to culturally diverse populations, where applicable, • details about responsible personnel, staff credentials, performance review, and use of standards and protocols. E. Financial Information Funding Information. The funding information form (see Form D) requests information on funding from other non-TDH State of Texas agencies and projected federal expenditures. Letter(s) of good standing from other non-TDH state agency funding sources that validate the applicant's programmatic, administrative, and financial capability should be placed after this form. If the applicant is a state agency or an institution of higher education, letters of good standing are not required. 23 2. Budget. All applicants must complete the budget summary form (see Form E) and the detailed budget category forms (see Form F) which include space for a narrative justification for the budget request. Definitions of ,the cost categories and instructions for the forms are provided in Section 9. Blank Forms and Instructions. 3. Child Support Regulations. If the applicant is an individual or a for profit organization, a Child Support Certification must be completed (see Form G). The form requires the name and social security number of the individual or sole proprietor, or each partner, shareholder, or owner with an ownership interest of at least 25 percent, and certifications and acknowledgment of responsibilities regarding delinquent child support obligor(s) as specified by Section 231.006, Family Code. 24 9. BLANK FORMS AND INSTRUCTIONS Resolution No. 2000—R00 77 March 23. 2000 Item No. 21 25 Resolution No. 2000— R00 77 Form A Texas Department of Health Face Page - Proposal for Financial Assistance 1. APPLICANT INFORMATION Ia. Legal Name: lb. Address (include Street & Mailing Addresses, City, County, State and Zip Code): lc. PAYEE Name and Mailing Address (if different from Applicant): ld. Employer Identification No. or State of Texas Comptroller Vendor Identification No. (14 digit): le. Applicant's Legal Authority to Contract: 2. A. B. C. D. TYPE OF ENTITY (enter appropriate letter in box): ❑ If response is F. or G., is entity a HUB? Yes/No City E. Nonprofit Organization I. Other (specify) County F. Individual Other Political Subdivision G. For Profit Organization State Agency H. State Controlled Institution of Higher Learning 3. TYPE OF PROPOSAL (check one:) New Continuation 4. PROPOSED PROJECT PERIOD: Start Date End Date 5. COUNTIES AFFECTED BY PROJECT: 6. AMOUNT OF FUNDING REQUEST: 7. ALL DATA IN THIS PROPOSAL ARE TRUE AND CORRECT. THE DOCUMENT HAS BEEN DULY AUTHORIZED BYTHE GOVERNING BODY OF THE APPLICANT, AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED. 7a. Typed Name & Title of Authorized Representative 7b. Telephone Number 7c. I- Signature of Authorized Representative 7d. Date 26 Form A Face Page - Proposal for Financial Assistance Instructions This form provides information about the applicant and the proposed project with the Texas Department of Health (TDH). It is required to be completed and returned with the applicant's response to TDH's Request for Proposal. Please follow the instructions below to complete the face page form. 1. APPLICANT INFORMATION Ia. Enter the legal name of the applicant. lb. Enter the applicant's complete street and mailing addresses, city, county, state, and zip code. le. Enter the PAYEE's name and mailing address if PAYEE is different from the applicant. The PAYEE is the corporation, entity or vendor who will be receiving payments. Id. Enter the Federal Tax Identification Number (9-digits) or the Vendor Identification Number assigned by the State of Texas Comptroller (14-digits). le. Enter applicant's legal authority to contract. Examples of legal authority to contract include: 501(c)(3), Board resolution, letter of authority, sole proprietorship, partnership, statutory citation for a governmental entity (health department, local government, state agency, school district). 2. TYPE OF ENTITY The type of entity is defined by the Secretary of State and/or the Texas State Comptroller. Enter the appropriate letter in the box provided. If the response is F. Individual or G. For Profit, applicant must also respond to the question is the entity a HUB (historically underutilized business)? HUB is defined as a corporation, sole proprietorship, or joint venture formed for the purpose of making a profit in which at least 51 % of all classes of the shares of stock or other equitable securities are owned by one or more persons who have been historically underutilized (socially disadvantaged) because of their identification as members of certain groups: Black American, Hispanic American, Asian Pacific American, Native American, and Women. The HUB must be certified by the General Services Commission or another entity. 3. TYPE OF PROPOSAL Check the appropriate type proposal. "New" means a new assistance award. "Continuation" means an extension for an additional budget period for a contract awarded under a multi -year project period. 4. PROPOSED PROJECT PERIOD Enter project period for this proposal. For purposes of this form, the project period is defined as the total time for which support of a project has been authorized by TDH: A project period may consist of one or more budget periods. The total project period comprises the original project period and any extensions. 5. COUNTIES AFFECTED BY PROJECT List the counties that are affected by the project. 6. AMOUNT OF FUNDING REOUEST Enter the amount requested from TDH for the proposed budget period. For purposes of this form, the budget period is defined as the period of time to be funded by a TDH contract. 7. ALL DATA IN THIS PROPOSAL ARE TRUE AND CORRECT. THE DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES M THE ASSISTANCE IS AWARDED. 7a. Type in the name and title of the person authorized to represent the applicant. 7b. Enter the area code and telephone number of the person authorized to represent the applicant. 7c. The person authorized to represent the applicant must sign in this block. 7d. Enter the date the person authorized to represent the applicant signed this form. NOTE: Evidence of the persons authority to represent the applicant must be on file in the applicant's headquarters. A copy of the governing body's authorization for the person to sign this proposal as an official representative must be on file in the applicant's office. 27 Form B TEXAS DEPARTMENT OF HEALTH PROPOSAL CHECKLIST Legal Name of Applicant INSTRUCTIONS: This Checklist must be completed and submitted with the original proposal. It is provided to ensure that the proposal is complete, proper signatures are included, and the required assurances, certifications, and attachments have been submitted. The proposal is typed (computer or typewriter), single-spaced on 8 %11 x 11" white paper, and does not exceed page limits where specified. Confidential information is clearly marked in the proposal and reasons the information should be confidential are stated. APPLICATION CONTENT Included N/A A. Face Page is completed, and proper signature and date are included B. Application Checklist is completed and attached to original application C. Contact Person Information D. Administrative Information (with supplemental documentation) E. Applicant Background is included F. Assessment Narrative is included H. Project Description and Work Plan (goals, objectives, performance measure(s), capacity of organization including an organization chart, and service delivery plan) are included I. Financial Information 1. Funding Information Form is completed and letters of good standing and financial statements are attached if required 2. Budget: • Budget Summary Form is complete • Budget Category Detail Forms are included • Contractor's Bid Proposal Form is included (if applicable) and a functional program narrative is attached J. Other Required Forms and Documentation are attached and signed 1. Historically Underutilized Businesses [HUBs] 2. Assurances 3. Certifications 4. Disclosure of Lobbying Activities 5. Nonprofit Board of Directors and Executive Director Assurances Form 6. Certification Regarding License, Certificate or Permit 28 Form C Contact Person Information Legal Name of Applicant: The purpose of this form is to provide information to TDH about the appropriate contact person in the applicant's organization. Please type in complete information about each person authorized to perform the following responsibilities. If any of the following information changes during the term of the contract, please notify the Vendor Coordinator, Grants Management Division, TDH. Name of Applicant's Authorized Representative: Title: Address: E-Mail Address: Telephone Number: Fax Number: Name of Project Coordinator: Tittle: Address: E-Mail Address: Telephone Number: Fax Number: Name of contact person regarding this proposal: Title: Address: E-Mail Address: Telephone Number: Fax Number: Name of Financial Officer: Tittle: Address: E-Mail Address: Telephone Number: Fax Number: Name of person responsible for Project Quality Assurance (if applicable): Title: Address: E-Mail Address: Telephone Number: Fax Number: 29 Form D FUNDING INFORMATION FORM Legal Name of Applicant: Funding From Other State of Texas Agencies (Do not include TDH funding ) State of Texas Agency & Program Name Name of Contact Person at State Agency Telephone No. Period Funds Available Total Amount of Funding TOTAL. STATE AGENCY FUNDING $ A letter of good standing from each State agency providing funds to applicant (other than TDH) should be attached behind this form. Applicant's fiscal year ending month is: Applicant must enter the total projected amount of federal expenditures for applicant's current fiscal year. Projected amount should include funding for all activities including "pass through" funds from all State agencies. Do not include funds being requested in this proposal; however, any other TDH funds that have been awarded to the applicant that are pass -through federal funds should be included in the projection. $ Applicant must enter the total projected amount of State expenditures for applicant's current fiscal year. Projected amount should include funding for all activities, including TDH funds, except funds being requested in this proposal. $ w 0 Form E BUDGET SUMMARY Leeal Name of Annlicant: Cost Categories TDH Funds Requested (1) Direct Federal Funds (2) Other State Agency Funds (3) Local Funding Sources (4) Other Funds (5) Total (6) A. Personnel $ $ $ $ $ $ B. Fringe Benefits $ $ $ $ $ $ C. Travel $ $ $ $ $ $ D. Equipment $ S $ $ $ $ E. Supplies $ $ $ $ $ $ F. Contractual $ $ $ $ $ $ G. Construction N/A $ $ $ $ $ H. Other $ $ $ $ $ $ I. Total Direct Costs $ $ $ $ $ $ J. Indirect Costs $ $ $ $ $ $ K. Total (Sum of I and J) $ $ $ $ $ $ L. Program Income -- Projected Earnings $ $ $ $ $ $ M. Match --In-Kind —Other Match $ $ $ $ $ $ $ $ $ $ $ $ Indirect costs are based on (mark the statement which is accurate): ❑ ne applicant's most recently approved indirect cost rate %). A copy is attached behind the OTHER Budget Category Detail Form. ❑ Ile applicant's most recently approved indirect cost rate (_____%) which is on file with TDH's Fiscal Division. ❑ Uniform Grant Management Standards. w r Form E BUDGET SUMMARY INSTRUCTIONS This form should reflect funding from all sources that support the project described in this application. Itemize the amount of support for each finding source and sum columns A through M and sum rows 1-5. See "Budget Forms and Instructions" for definitions of cost categories. For purposes of this form, the column headings have the following meanings: Column 1: The amount of funds requested from the Texas Department of Health (TDH) for this project. Column 2: Federal funds awarded directly to applicant. Column 3: Funds awarded to applicant from other State of Texas governmental agencies. Column 4: Funds awarded to applicant by local governmental agencies (city, county, local health department, etc.). Column 5: Funds from other sources not previously addressed in columns 1-4 (third party reimbursements, private foundations, donations, fimd- raising). Column 6: The sum of columns 1-5. Program Income: Projected Earnings. Applicant must estimate the amount of program income that is expected to be generated during the budget period. Match: If applicant is required to provide a match with this application, applicant shall enter the amount of matching funds contributed from the appropriate finding column(s). Costs and third party in -kind contributions counting towards satisfying a cost sharing or matching requirement must be verifiable from the applicant's records. These records must show how the value placed on third party in -kind contributions was derived. To the extent feasible, volunteer services will be supported by the same methods that the applicant uses to support the allocability of regular personnel costs. Third party in -kind contributions count toward satisfying a cost sharing or matching requirement only where, if the party receiving the contributions were to pay for them, the payments would be allowable costs. In -Kind: The dollar value of in -kind contributions should be reflected in the appropriate line of row M. In -Kind Match and in the appropriate finding source column heading. The value placed on donated or volunteer services must be reasonable and must be documented to the satisfaction of TDH prior to being accepted as match. Documentation supporting the reasonableness and value of donated or volunteer services must be attached behind the BUDGET SUMMARY form. Other Match: Enter the dollar amount of finds which will be used to match TDH fiends for the proposed activity in row M. Other Match under the column heading which reflects the source of the other match. Match may come from sources such as local finds, other state grants, federal grants, private donations, or private foundations if not otherwise restricted. w N Form F BUDGET FORMS AND INSTRUCTIONS Application Requirements The application must include a detailed breakdown of budget cost categories and a narrative justification. Details of each cost category shall be expressed using the budget category detail forms which follow. Definitions of the cost categories and instructions and examples of how to itemize the contents of each cost category are included after the budget category detail forms. The budget narrative shall explain and justify the proposed budget request. The budget category detail forms have space for a narrative; however, if more space is needed, attach additional sheets of paper to the respective budget category detail form. Computer generated facsimiles may be substituted for any of the forms; however, the exact wording and format must be maintained. Allowable and Unallowable Costs Below is a brief listing of allowable and unallowable costs as prescribed by federal cost principles or TDH policy. Applicable federal cost principles provide additional information and guidance on allowable and unallowable costs. In addition, see Section I. item D. Use of Funds for allowable and unallowable costs specific to this RFP. An allowable cost, in accordance with federal cost principles, meets the following criteria: ✓ It is necessary and reasonable for proper and efficient administration of the funded program; ✓ It can be allocated to the funded program and is not a general expense needed to carry out the contractor's general responsibilities; ✓ It is authorized or is not prohibited under applicable laws or regulations; ✓ It conforms to applicable limitations or exclusions; ✓ It is consistent with applicable policies and procedures; ✓ It is treated consistently through the application of generally accepted accounting principles appropriate to the circumstances; ✓ It is not allocated or included as a cost of any other program; and ✓ It is the net sum of all applicable credits. Unallowable costs, i.e., costs that may not be paid with TDH funds include, but are not limited to: X Advertising and public relations costs other than those specifically allowed by terms of the contract attachment or those incurred for the purpose of personnel recruitment, solicitation of bids and disposal of surplus materials; X Bad debts; X Construction is not allowed without the prior written approval of TDH; X Contingency reserve funds; X Contributions and donations; X Entertainment costs including amusement/social activities and their related costs (meals, beverages, lodgings, rentals, transportation, and gratuities) are not allowed unless the costs are directly related to the program's purpose and TDH has reviewed and issued prior written approval of the work plan components that relate to entertainment costs; X Fines, penalties, late payment fees, bank overdraft charges; 33 x Fundraising; x Interest (unless specifically authorized by applicable cost principles or authorized by federal or state legislation); x Lobbying. J)irect Costs Direct costs are those that can be specifically identified with a particular award, project, service, scope of work or other direct objective of an organization. These costs may be charged directly to the TDH contract attachment (if applicant is awarded a contract). These costs may also be charged to cost objectives used to accumulate all costs pending distribution to specific contracts and other purposes. Direct cost categories include: personnel, fringe benefits, travel, equipment, supplies, contractual, and other. Indirect Costs Indirect costs are those that have been incurred for common or joint objectives and cannot be readily identified with a particular final cost objective. The amount of indirect costs that may be charged to any resulting TDH contract attachment is determined by negotiation and will be defined in the contract budget attachment. Audit Requirements If required by OMB Circular A-133 and/or UGMS, applicant or applicant's authorized contracting entity shall arrange for a financial and compliance audit (Single Audit). Applicant may include in the budget request an amount for TDH's proportionate share of costs. The audit must be conducted by an independent CPA and must be in accordance with applicable OMB Circulars, Government Auditing Standards, and UGMS. Audit services shall be procured in compliance with state procurement procedures, as well as the provisions of UGMS. 34 Form F PERSONNEL Budget Category Detail Form LEGAL NAME OF APPLICANT: FRINGE BENEFITS: Itemize the elements of fringe benefits in this space. Attach an III SALARY TOTAL II$ additional sheet of paper if more space is required. Fringe Benefits Rate % FRINGE BENEFITS TOTAL IL w Ln Form F TRAVEL Budget Category Detail Form LEGAL NAME OF APPLICANT: Local Travel Costs (Travel and Per Diem . . . . ........ ........nt+tyv i-00 #Y! . ...... In .. . ........... . . . ... . 6 W., t-0 W Ml rsem�caabu JR- . ....... .. . . ................... .... .... ........ ... 'MIT" ......... ......... A ... ... .. . ... . 4:x. . . . . ...... 0 V::V] ................... .. -X-:0 .......... ... .......... .......... .... ...... ... ............. 6: .... . ........... .. ......... .. . ... .......... . ....... ..... NOTE: All contracts with the Texas Department of Health require that a written travel policy be maintained by the contracting entity. Attach a copy of the travel policy as an appendix to the proposal. If a written travel policy is not in place, TDH's travel policy will be used. W ON Form F EQUIPMENT Budget Category Detail Form LEGAL NAME OF APPLICANT: Amount requested in budget for equipment: $ Itemize, describe and justify the list below. Attach complete specifications or a copy of the purchase order. Equipment is defined by TDH as non -expendable personal property with a unit cost of more than $1,000.00 and a useful life of more than one year, with the following exceptions: fax machines, stereo systems, cameras, video recorders/players, microcomputers, printers, software, medical and laboratory equipment which cost over $500. Medical and laboratory equipment in this classification are defined as microscopes, oscilloscopes, centrifuges, balances, and incubators. Medical and laboratory equipment not included in these five categories are not considered a capital asset unless the unit value w V Form F SUPPLIES Budget Category Detail Form LEGAL NAME OF APPLICANT: Amount requested in budget for supplies: $ w 00 Form F CONTRACTUAL Budget Category Detail Form LEGAL NAME OF APPLICANT: Amount requested in budget for contractual: $ , List only contracts for health or health -related services provided directly to applicant's clients by a third party. If a third -party is not yet identified, describe the service to be contracted and show contractor as "To be named." Justification for any contract that delegates a substantial portion of the scope of the protect i.e. $25,000 or 25% of the applicant's funding reauest whichever is Rreater, must be attached behind this form. . .. ......... ... ........ ... ---- - ----- .. ........ M ........ . ...... . ....... . ... .. ....... ................... M 0 . ......... ....... ........... . ....... ..... .. ... .......... . .............. .. U ZI W .0.. 1 . .. ......... ex WF ... .................. ..... .. . . . . . . . . . . . . . . . . . ...... Form F OTHER Budget Category Detail Form LEGAL NAME OF APPLICANT: Amount requested in budget for other. $ : ..... _ ... .... ��t.... ..................................... __.........:.........:.., ............. _ _ ............ fir .,.................................,...................:......... . DEFINITION OF COST CATEGORIES, INSTRUCTIONS AND EXAMPLES A. PERSONNEL DEFINITION: Actual salaries and wages for all staff positions in the proposed project that will provide direct care and administrative services (including clerical) to the project. TDH requires that the distribution of salaries and wages be supported by personnel activity reports (time sheets). These reports must be maintained for all staff members (professionals and non- professionals) whose compensation is charged, in whole or in part, directly to the TDH contract. The reports must reflect an after -the -fact determination of the actual activity of each employee. Budget estimates (i.e., estimates determined before the services are performed) do not qualify as support for charges to awards. Each report must account for the total activity for which employees are compensated and which is required in fulfillment of their obligations to the organization. The reports must be signed by the individual employee and by a responsible supervisory official having first-hand knowledge of the activities performed by the employee(s). INSTRUCTIONS: Enter the following information for each position on the PERSONNEL Budget Category Detail Form: functional title, whether the position is existing or proposed, % of time dedicated to the project, any certification or license an individual must possess to be qualified for the position, the total annual salary, the amount of TDH funds requested for this position's salary (% of time dedicated to the project multiplied by the annual salary), whether the position is vacant or filled, and the justification for the position. Justification may include a brief description of the position's primary responsibilities and an explanation for the % oftime dedicated to the project, why the position classification is appropriate (including license/certification requirements), and an explanation of reasonableness of the annual salary. B. FRINGE BENEFITS DEFINITION: Fringe benefits paid by the applicant on behalf of its employees. This includes employer contributions for social security, retirement, health and accident insurance, and workers' compensation insurance. Fringe benefits requested should represent actual benefits paid for employees. INSTRUCTION: Itemize the elements of fringe benefits and indicate the % rate on the PERSONNEL Budget Category Detail Form. C. TRAVEL DEFINITION: The costs of transportation, lodging, meals and related expenses incurred by the applicant's staff while traveling to perform duties required by the proposed project are classified as travel. This includes personal auto mileage for travel by employees. Costs related to client transportation and registration fees should be classified as "Other" not "Travel." 41 INSTRUCTIONS: The TRAVEL Budget Category Detail Form requires information on local travel costs (travel and per diem) and information on conferences/workshops for which TDH funding is being requested. For local travel, enter the reimbursement rate for automobile mileage and the estimated number of miles to be traveled for the budget period. To calculate the total estimated local travel costs, multiply the local reimbursement rate per mile by the total estimated number of automobile miles. Enter the estimated per diem costs which may be associated with local travel and show the basis for cost (IS partial days x $7 per partial day = $105). The justification should include who or what position classification(s) will be traveling and why local travel is necessary to accomplish the project. For conferences/workshops, the following must be included for all attending for whom TDH funds are being requested: the name and/or description of the conference/workshop, the location (city), the number of persons attending, estimated travel, per diem, other related travel costs (excluding registration fees) and total costs for all attending. The justification should include how attendance at the conference/workshop will directly benefit the project and why it is necessary to accomplish the project. All contracts with the Texas Department of Health require that a written travel policy be maintained by the contracting entity. Attach a copy of the travel policy as an appendix to the proposal. If a written travel policy is not in place, TDH's travel policy will be used. D. EQUIPMENT DEFINITION: Equipment is defined by TDH as non -expendable personal property with a unit cost of more than $1,000.00 and a useful life of more than one year, with the following exceptions: fax machines, stereo systems, cameras, video recorders/players, microcomputers, printers, software, medical and laboratory equipment. Medical and laboratory equipment in this category is defined as microscopes, oscilloscopes, centrifuges, balances, and incubators. Medical and laboratory equipment not included in these five categories are not considered a capital asset unless the unit value is over $1,000.00. The exception items listed will still be inventoried if their unit cost plus any items used with or attached to the unit is $500.00 or greater. For items with component parts (i.e., computers), the aggregate cost must be considered when applying the $500/$1,000 threshold. INSTRUCTIONS: Enter the following information on the EQUIPMENT Budget Category Detail Form for each type of equipment item: description of each item, the cost per unit, the number of units to be purchased, the total amount for the line item (multiply the cost per unit by the number of units), state the purpose for the item(s) and why the equipment is necessary and how the applicant determined or will determine that the cost is reasonable. Attach a complete specification or a copy of the purchase order. 42 EXAMPLES OF EQUIPMENT DESCRIPTIONS Remember: Equipment is priced per unit including freight. If you intend to purchase 10 @ $95 each, this would be considered a supply item not an equipment item. INCORRECT EXAMPLES Computer-166 Mh Pentium 1@ $2,150 (Insufficient description/specifcation) 1 @ $250 Laser Jet Printer (This item would be moved to supplies as it is less than $500.00). E. SUPPLIES CORRECT EXAMPLES Packard Bell Multimedia C-110, Hard Drive 1081.7 MB; 14.4 AMSP modem fax; .44 MB 3.5" diskette drive, CD ROM 4X CDR-173; Mouse, Color monitor; Keyboard, Windows `95 pre -installed. 1 @ $2,150 24" Zenith Portable TVNCR Combination; Model 4Z 12345 1 @ $750 DEFINITION: Costs for materials and supplies necessary to carry out the program. This includes medical supplies, drugs, janitorial supplies, office supplies, patient educational supplies, software less than $500, plus any equipment with a purchase price including freight not to exceed $1,000 per item, except those listed in the "equipment" category. INSTRUCTIONS: Enter the following information in the SUPPLIES Budget Category Detail Form for each general category or type of supplies: description of the items, the cost per unit, the number of units to be purchased, the total amount for the line item (multiply the cost per unit by the number of units), and state the purpose for the item(s), why the equipment is necessary and how the applicant determined or will determine that the cost is reasonable. F. CONTRACTUAL DEFINITION: The contractual section includes only costs incurred for health or health -related services rendered directly to the applicant's clients by a third party. Examples of the services that may be included in this category are: counseling, education, nursing, lab fees, physician's fees, radiology, pharmacy, therapy, etc. Travel by these individuals should be included in this category if they are delivering client services. Contracts for administrative services are not included in this category; they are properly classified in the Other category. 43 If the applicant enters into grant contracts with subrecipients or procurement contracts with vendors, the documents will be in writing and will comply with the requirements specified in the Contracts with Subrecipients and Contracts for Procurement articles in the General Provisions for Texas Department of Health Grant Contracts (see APPENDIX A: Sample General Provisions, Texas Department of Health Contracts, 1999 version). If an applicant plans to enter into a contract which delegates a substantial portion of the scope of the project i.e. $25,000 or 25% of the applicant's funding request whichever is greater, the applicant must submit justification to TDH and receive prior written approval from TDH before entering into the contract. INSTRUCTIONS: The CONTRACTUAL Budget Category Detail Form requires the names of the individuals or organizations performing the services, a description of the services being contracted, the number of hours or units of service to be purchased, the method of reimbursement (cost reimbursement or unit cost), unit cost if applicable and total amount of each subcontract. Justification should include why applicant intends to contract for the service, why the service is necessary to perform the scope of work and how the applicant will ensure that the cost of the service is reasonable. Justification for contracts that delegate a substantial portion of the scope of the project i.e. $25,000 or 25% of the applicant's funding request whichever is greater, must be attached behind the CONTRACTUAL Budget Category Detail Form. G. CONSTRUCTION - TDH does not fund construction projects. H. OTHER DEFINITION: All other allowable direct costs not listed in any of the above categories are to be included in this category. Some of the major costs that should be budgeted in this category are: * contracts for administrative services or non -medical services; * space and equipment rental; * utilities and telephone expenses; * data processing services; * printing and reproduction expenses; * postage and shipping; * contract clerical or other personnel services; * janitorial services; * exterminating services; * security services; * insurance and bonds; * equipment repairs or service maintenance agreements; * books, periodicals, pamphlets, and memberships; * advertising; * registration fees; 44 patient transportation; training costs, speakers fees and stipends. INSTRUCTIONS: The OTHER Budget Category Detail Form requires a general description of the service and the cost. The justification should include an explanation of the purpose of the service and how it is necessary for the completion of the activity. The justification should also include a statement of when services will be utilized if other than the full RFP budget period. I. TOTAL DIRECT CHARGES The amount to be entered on row I Total Direct Costs, of the BUDGET SUMMARY form, is the sum of all direct cost categories (A through M. J. INDIRECT COSTS DEFINITION: Those costs related to the project that are not included in direct costs. Indirect costs are those costs incurred for a common or joint purpose benefitting more than one cost objective and not readily identified with a particular cost center and which may be paid if allowable under the funding source, e.g., depreciation and use allowances, interest, operation and maintenance expenses (janitorial and utility services, repairs and normal alterations of buildings, furniture, equipment, care of grounds, security), general administration and general expenses (central offices such as director, office of finance, business services, budget and planning, personnel, general counsel, safety and risk management, management information services). The applicant may negotiate an indirect cost rate with its federal cognizant agency or state coordinating agency. If there is no assigned agency, TDH's Fiscal Division may provide guidance on how to have an agency assigned or TDH's Fiscal Division may review the applicant's cost allocation plan and negotiate an approved indirect cost rate. The TDH Fiscal Division will maintain a listing of agencies and their approved rates. To obtain information about cognizant agencies or negotiating an indirect cost rate, contact the TDH Fiscal Division at (512) 458-7435. If the applicant does not have an approved indirect cost rate and does not intend to negotiate one, then funds may be budgeted in accordance with Uniform Grant Management Standards (UGMS) which reads as follows: "In lieu of determining the actual indirect costs of the service for which a state award is made, a grantee may recover up to 10 percent of the direct salary and wage costs of providing the service (excluding overtime, shift premiums, and fringe benefits) as indirect costs, subject to adequate documentation [of direct salary and wage costs]. Applicants choosing this method of indirect cost recovery are prohibited from seeking recovery using a cost allocation plan, rate or other methods for the same period." 45 INSTRUCTIONS: A Budget Category Detail Form has not been developed for the Indirect Cost Category. Applicant should indicate the indirect cost rate (if applicable) on the BUDGET SUMMARY page and mark the box which contains the appropriate statement regarding the support for the indirect charge. If applicant attaches a copy of the most recently approved indirect cost rate, it should be placed behind the OTHER Budget Category Detail Form. K. TOTAL The amount to be entered on row K Total, of the BUDGET SUMMARY form, is the sum of Total Direct Costs and Indirect Costs (I + n. L. PROGRAM INCOME DEFINITION: All revenue directly generated by a TDH contract -supported activity or earned as a result of a TDH contract during the contract term (beginning and ending dates). This includes fees or charges made by the contractor in connection with activities supported in whole, or in part, by a federal/state contract. This income will be identified and reported quarterly and annually utilizing the report forms identified in the contract. For more information about program income, refer to APPENDIX A - TDH CONTRACT GENERAL PROVISIONS (Sample), and/or request a copy of TDH's Financial Administrative Procedures Manual. The TDH program will consider future funding levels of a contractor based in part upon their proficiency in identifying, billing, collecting, and reporting program income and in utilizing it for the purposes and conditions as specified in the contract attachment. INSTRUCTIONS: Projected Earnings. Applicant must enter on the BUDGET SUMMARY form the estimated amount of program income that is expected to be generated during the budget period. 46 M. MATCH DEFINITION: The portion of allowable costs incurred under the proposed project borne by unrestricted funding sources or the value of third party in -kind contributions applicable to the period to which the match requirement applies. Costs and third party in -kind contributions counting towards satisfying a cost sharing or matching requirement must be verifiable from the applicant's records. These records must show how the value placed on third party in -kind contributions was derived. To the extent feasible, donated or volunteer services will be supported by the same methods that the applicant uses to support the allocability of regular personnel costs. Applicant must provide supporting documentation of the reasonableness and value of donated and volunteer services. Third party in -kind contributions count toward satisfying a cost sharing or matching requirement only where, if the party receiving the contributions were to pay for them, the payments would be allowable costs. INSTRUCTIONS: If the applicant is required to provide a match with this application, applicant shall enter on the BUDGET SUMMARY form the amount of matching funds contributed under the appropriate funding column(s). In -Kind. Enter the dollar value of in -kind contributions in row M. In -Kind Match under the column heading which reflects the source of the in -kind contribution. The value placed on donated or volunteer services must be reasonable and must be documented to the satisfaction of TDH prior to being accepted as match. Documentation supporting the reasonableness and value of donated or volunteer services must be attached behind the BUDGET SUMMARY form. Other Match. Enter the dollar amount of funds which will be used to match TDH funds for the proposed activity in row M. Other Match under the column heading which reflects the source of the other match. 47 Form G Texas Department of Health Child Support Certification* The Texas Family Code, §231.006, VTCA places certain restrictions on child support obligors. Contracts with governmental entities or nonprofit corporations are not subject to §231.006. The contractor identified below is not a governmental entity or a nonprofit corporation and certifies to the following: 1. The contractor is: (check one) ❑ An individual or sole proprietor, or ❑ A business entity (corporation, partnership, joint venture, limited liability company, association, etc.) 2. The contractor certifies that the following is a complete list of the names and social security numbers of either (a) the individual or sole proprietor who is the contractor or (b) each partner, shareholder, or owner with an ownership interest of at least 25% of the contractor/business entity: (attach additional sheet if necessary). (A) Printed Name: Social Security Number: (B) Printed Name: Social Security Number: 3. Under the Texas Fanvly Code, §231.006, VTCA the contractor certifies that the individual or business entity named in this contract, bid, or application is not ineligible to receive the specified grant, loan, or payment and acknowledges that this contract may be terminated and payment withheld if this certification is inaccurate. A child support obligor who is more than 30 days delinquent in paying child support or a business entity in which the obligor (who is more than 30 days delinquent) is the sole proprietor, partner, shareholder, or owner with an ownership interest of at least 25% is not eligible to receive the specified grant, loan or payment. The contractor understands that it is the contractor's responsibility to verify whether a child support obligor who is more than 30 days delinquent is the sole proprietor, partner, shareholder or owner with an ownership interest of at least 25%. 4. Printed Name of Contractor: Printed Name of Authorized Representative Signing this Certification: Signature of Authorized Representative: Date: *For purposes of this form, the word "contractor" is referring to the organization responding to a TDH RFP and the word "contract" should be read as "any proposed contract that results from a TDH RFP." 48 Resolution No. 2000-R00 77 March 23, 2000 Item No. 21 APPENDIX A ESSENTIAL PUBLIC HEALTH SERVICES ESSENTIAL PUBLIC HEALTH SERVICES Monitor the health status of individuals in the community to identify community health problems. Diagnose and investigate community health problems and community health hazards. Inform, educate, and empower the community with respect to health issues. Mobilize community partnerships in identifying and solving community health problems. Develop policies and plans that support individual and community efforts to improve health. Enforce laws and rules that protect the public health and ensure safety in accordance with those laws and rules. Link individuals who have a need for community and personal health services to appropriate community and private providers. Ensure a competent workforce for the provision of essential public health services. Research new insights and innovative solutions to community health problems. Evaluate the effectiveness, accessibility, and quality of personal and population -based health services in a community. Resolution No. 2000-Roo 77 March 23, 2000 Item No. 21 APPENDIX B TDH CONTRACT GENERAL PROVISIONS (Sample) GENERAL PROVISIONS FOR TEXAS DEPARTMENT OF HEALTH GRANT CONTRACTS. T�ABEE OF CUNTENTS s r + r � s ARTICLE 1 'PREAMBLE 3 kUNDING s 4. Alrli'il\L1rir.LR L'U' > 6 'DEBARMENT: AND SJSPENSION r Y a a 7ASS Vitl'iNTELLECTU�y'�-a� �. W. 9 HIST0RICA*=- ibj bERU S w; REGARDIIVG > la '=IFTCATTal� IiTCENSE,CERTZiZZCAT'E, OR PERMIT r t ; 11 'CONFLIGTOFTI�TEREST X ; _ Yr ' :.ifP -' LGIiR�= LVV4 \.GLViJJI:iCAs . 13�`S'ANDARDS FOR FINANOT iL.AND PI OGRAI IMA IC 1�1ANAGEIVIENT 14 BONDIING r : >.15 FUNDING PARTICIPATTOl� REQiJ�][2EMEN'T 16 A7>ORtABLE.COSTS Ai1D Tr EMENTS 17 zMEWS ANDCONDTTiO �FPAYMF�1'P r . 18 - PAYNIEI�ITS ADVANCE 19 PROGRAM' INCOME i t OVERTIME COMPENSA'iiON � M� . Zl. EQUIPMENT AND SUPPLiE. . 22 - CONTRACTS QVITI'I STJBRECIPIENIS 23 `CONTRACTS FOR PROCUREMENT • 24 REPORTS b k -INSPECTIONS .. 26 _RECORDS RETENTION 27-,CIZENTRECORDS • •i; Y ZS `CONFIDENTIALITY: 29 - HOLD HARMLESS . ` 30 -: SANCITONS 31 - SANCTION REVIEW 32 - BREACH OF CONTRACT 33 = TERMINATION 34 - VOID CONTRACT :.. ,. 3S - SEVERABIIITY . 36 - SURVIVAL OF: TERMS 37 - NO -WAIVER OF SOVEREIGN AIMUNITY (Independent) 2000 GENERAL. PROVISIONS 4/99 Any alteration to this document constitutes a counter-offer and must be approved in writing by the Texas Department of Health. GENERAL PROVISIONS FOR TEXAS DEPARTMENT OF HEALTH GRANT CONTRACTS ARTICLE 1. Preamble PERFORMING AGENCY and RECEIVING AGENCY (the parties) hereby agree to make and enter into this grant contract (contract), to faithfully perform the duties prescribed by this contract and to uphold and abide by its terms and provisions. This contract consists of RECEIVING and PERFORMING AGENCY identifying data, Details of Attachment(s), authorized signatures, General Provisions, and Attachment(s) with detailed Scope(s) of Work, Special Provisions, budget(s), and exhibit(s) as applicable. This contract represents the complete and entire understanding and agreement of the parties. No prior agreement or understanding, oral or otherwise, of the parties or their agents will be valid or enforceable unless embodied in this contract. The person or persons signing and executing this contract on behalf of PERFORMING AGENCY, or representing themselves as signing and executing this contract on behalf of PERFORMING AGENCY, warrant and guarantee that he, she, or they have been duly authorized by PERFORMING AGENCY to execute this contract on behalf of PERFORMING AGENCY and to validly and legally bind PERFORMING AGENCY to all of its terms, performances, and provisions. PERFORMING AGENCY assures compliance with this contract, including these General Provisions unless otherwise specified in any Special Provisions of the Attachment(s) to this document. If these General Provisions are revised or replaced during the term of this contract, and PERFORMING AGENCY does not consent to comply with the modified General Provisions, PERFORMING AGENCY may exercise its termination options in accordance with the General Provisions, Termination Article. ARTICLE 2. Term The time period of this contract shall be governed by the term(s) of the Attachment(s). No commitment of contract funds is permitted prior to the first day or subsequent to the last day of the term. The term may be extended or shortened by amendment(s). ARTICLE 3. Fundinz This contract is contingent upon the availability of funding for each Attachment for the term of the Attachment. PERFORMING AGENCY shall have no right of action against the State of Texas or RECEIVING AGENCY in the event that RECEIVING AGENCY is unable to fulfill its obligations under this contract as a result of lack of sufficient funding of RECEIVING AGENCY for any Attachment(s) to this contract. If funds become unavailable, provisions of the Termination Article will apply. ARTICLE 4. Amendments This contract may be amended only if the amendment is in writing and signed by individuals with authority to bind all parties. PERFORMING AGENCY shall not perform and RECEIVING AGENCY shall not pay for the performance of different or additional services, work, or products except pursuant to an amendment of this contract that is executed (Independent) 2000 GENERAL PROVISIONS Page 1 4/99 in compliance with this Article. RECEIVING AGENCY may not waive any term, covenant, or condition of this contract unless by amendment executed in compliance with this Article. PERFORMING AGENCY shall plan expenditures so that any necessary budget revisions or amendments are executed no later than 90 days prior to the expiration of the Attachment term. PERFORMING AGENCY shall provide a written justification for any budget revisions and/or amendments. If a budget revision or amendment is requested during the last quarter of the Attachment term, the written justification must include a reason for the delay. ARTICLE 5. Applicable Laws and Standards This contract shall be interpreted under and in accordance with the laws of the State of Texas and enabling state rules. Where applicable, federal statutes and regulations, including federal grant requirements applicable to funding sources, will apply to this contract. The Uniform Grant and Contract Management Act (UGCMA), Texas Government Code, Chapter 783, Vernon's Texas Codes Annotated (VTCA), and the Uniform Grant Management Standards (UGMS) as amended by revised federal circulars and incorporated in UGMS by the Governor's Budget and Planning Office, apply as terms and conditions of this contract and are adopted by reference in their entirety. If a conflict arises between the provisions of this contract and the provisions of UGCMA and UGMS, the provisions of UGCMA and UGMS will prevail unless expressly stated otherwise. RECEIVING AGENCY must give prior approval for changes to contract Attachment(s) as specified by UGMS in "Part III -State Uniform Requirements for Grants and Cooperative Agreement, Subpart C-Post-Award Requirements, item _ 30-Changes" and applicable federal Office of Management and Budget (OMB) circulars. RECEIVING AGENCY will provide copies of applicable OMB circulars, Code of Federal Regulations, and UGMS to PERFORMING AGENCY upon request. These documents are incorporated by reference as a condition of this contract. PERFORMING AGENCY may not use funds granted under this contract to pay any person for influencing or attempting to influence an officer or employee of any agency; federal or state; a Member of Congress; an officer or employee of Congress; an employee of a Member of Congress in connection with the awarding of any contract or grant or the extension, continuation, renewal, amendment, or modification of any contract or grant (31 USC § 1352 and UGMS). If at any time this contract exceeds $100,000, regardless of funding source, PERFORMING AGENCY shall file with RECEIVING AGENCY a declaration containing the name of any registrant under the Lobbying Disclosure Act of 1995 who has made lobbying contacts on behalf of PERFORMING AGENCY in connection with that contract or grant, a certification that none of the funds provided by RECEIVING AGENCY have been or will be used for payment to lobbyists, and disclosure of the names of any and all registered lobbyists with whom PERFORMING AGENCY has an agreement. PERFORMING AGENCY shall require any person who receives a subgrant or subcontract to file the same declaration, certification and disclosure with RECEIVING AGENCY. PERFORMING AGENCY shall file the declaration, certification, and disclosure at the time of application for the contract or grant; upon execution of a contract or grant unless PERFORMING AGENCY previously filed a declaration, certification or disclosure form in connection with the award; and at the end of each calendar quarter in which there occurs any event that materially affects the accuracy of the information contained in any declaration, certification or disclosure previously filed. RECEIVING AGENCY will supply the certification form to PERFORMING AGENCY upon request. PERFORMING AGENCY, if a corporation, certifies by execution of this contract that its payment of franchise taxes is currently in "good standing" with the State of Texas or that it is exempt from payment of franchise taxes (Independent) 2000 GENERAL PROVISIONS Page 2 4/99 under Texas law (Tax Code, Chapter 171, VTCA). A false statement regarding franchise tax status is a material breach of this contract. If franchise tax payments become delinquent during the Attachment term, payments under this contract will be withheld until PERFORMING AGENCY's delinquent franchise tax is paid in full. ARTICLE 6. Debarment and Suspension PERFORMING AGENCY certifies by execution of this contract to the following: ► it is not ineligible for participation in federal or state assistance programs under Executive Order 12549, Debarment and Suspension; ► neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency; ► it has not knowingly failed to pay a single substantial debt or a number of outstanding debts to a federal or state agency; and ► it is not subject to an outstanding judgment in a suit against PERFORMING AGENCY for collection of the balance of a debt. Where PERFORMING AGENCY is unable to certify to any of the statements in this Article, PERFORMING AGENCY shall attach an explanation. PERFORMING AGENCY shall not contract with a subrecipient nor procure goods or services from a subcontractor, at any tier, which is debarred or suspended or is otherwise excluded from or ineligible for participation in federal assistance programs under Executive Order 12549. ARTICLE 7. Assurances PERFORMING AGENCY shall establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest or personal gain. To the extent such provisions are applicable to PERFORMING AGENCY, PERFORMING AGENCY agrees to fully comply with the following: ► Title VI of the Civil Rights Act of 1964, 42 USC §§2000d er seq. (P.L. 88-352), which prohibits discrimination on the basis of race, color or national origin, and includes the provision for effective communication and equal access to programs, services and activities to persons with Limited English Proficiency (LEP); ► Title IX of the Education Amendments of 1972, as amended, 20 USC §§ 1681-1683, and 1685-1686, which prohibits discrimination on the basis of sex; ► Section 504 of the Rehabilitation Act of 1973, 29 USC §794(a), which prohibits discrimination on the basis of disabilities and the Americans with Disabilities Act of 1990, 42 USC §§ 12101 er seq., including the provision for effective communication and equal access to programs, services and activities to persons with sensory and speech impairments; ► The Age Discrimination Act of 1975, as amended, 42 USC §§6101-6107, which prohibits discrimination on the basis of age; ► The Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (Independent) 2000 GENERAL PROVISIONS Page 3 4/99 ► The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to the nondiscrimination on the basis of alcohol abuse or alcoholism; • Public Health Service Act of 1912, §§523 and 527, 42 USC §290 dd-2, as amended, relating to confidentiality of alcohol and drug abuse patient records; ► Title VIII of the Civil Rights Act of 1968, 42 USC §§3601 et seq., as amended, relating to nondiscrimination in the sale, rental or financing of housing; and, ► The requirements of any other nondiscrimination statute(s). Collectively, such requirements obligate RECEIVING AGENCY to provide services without discrimination on the basis of race, color, national origin, age, sex, or disability. PERFORMING AGENCY shall carry out the terms of this contract in a manner which will assist RECEIVING AGENCY in complying with such obligations to the fullest extent of PERFORMING AGENCY's ability. PERFORMING AGENCY agrees to comply with all or part of the following, as applicable: A. Texas Labor Code, Chapter 21, VTCA, which requires that certain employers not discriminate on the basis of race, color, disability, religion, sex, national origin, or age. B. Immigration Reform and Control Act of 1986, 8 USC §§1324a et seq., as amended, regarding employment verification and retention of verification forms for any individual(s) hired on or after November 6, 1986, who will perform any labor or services under this contract. C. Pro -Children Act of 1994, 20 USC §§6081-6084, regarding the provision of a smoke -free workplace and promoting the non-use of all tobacco products. D. The National Research Service Award Act of 1971, as amended, 42 USC §§288 et seq. and 6601(P.L. 93-348 and P.L. 103-43) regarding the protection of human subjects involved in research, development, and related activities supported by any applicable award of federal assistance. E. The Clinical Laboratory Improvement Amendments of 1988, 42 USC §263a, which establish federal requirements for the regulation and certification of clinical laboratories. F. The Occupational Safety and Health Administration Regulations on Blood Borne Pathogens, 56 Fed. Reg. 64175 (1991), 29 CFR § 1910.1030, which set safety standards for those workers and facilities who may handle blood borne pathogens. G. Laboratory Animal Welfare Act of 1966, 7 USC §§2131 et seq. (P.L. 89-544), as amended, pertaining to the care, handling, and treatment of warm-blooded animals held for research, teaching, or other activities supported by this award of assistance. H. Article 9102, Texas Revised Civil Statutes (TRCS), as amended, pertaining to standards which eliminate architectural barriers for persons with disabilities. I. Health and Safety Code § 165.004 (Vernon's Supp. 1998), relating to the promotion of breast-feeding by providing information that encourages breast-feeding to program participants who are pregnant women or mothers with infants. Promotional material may be requested from RECEIVING AGENCY by calling (512) 406-0744. J. Environmental standards pursuant to the following: (1) Institution of environmental quality control measures under the National Environmental Policy Act of 1969, 42 USC §§4321-4347 (P.L. 91-90) and Executive Order 11514 "Protection and Enhancement of Environmental Quality." (2) Notification of violating facilities pursuant to Executive Order 11738 "Providing for Administration of the Clean Air Act and the Federal Water Pollution Control Act with Respect to Federal Contracts, Grants, or Loans." (3) Protection of wetlands pursuant to Executive Order 11990. (4) Evaluation of flood hazards in floodplains in accordance with Executive Order 11988. (Independent) 2000 GENERAL PROVISIONS Page 4 4/99 (5) Assurance of project consistency with the approved State Management program developed under the Coastal Zone Management Act of 1972, 16 USC §§1451 et seq. (6) Conformity of federal actions to state clean air implementation plans under the Clean Air Act of 1955, as amended, 42 USC §§7401 et seq. (7) Protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, 42 USC §§300f-300j (P.L. 93-523). (8) Protection of endangered species under the Endangered Species Act of 1973, as amended (P.L. 93- 205). K. The Hatch Political Activity Act, 5 USC §§7321-29, which limits the political activity of employees whose principal employment activities are funded in whole or in part with federal funds. L. The Federal Fair Labor Standards Act and the Intergovernmental Personnel Act of 1970, as applicable, concerning minimum wage and maximum hours. PERFORMING AGENCY shall ensure that the facilities under its ownership, lease or supervision which shall be utilized in the accomplishment of the project are not listed on the Environmental Protection Agency's (EPA) list of Violating Facilities and shall notify the Federal grantor agency of the receipt of any communication from the Director of the EPA Office of Federal Activities indicating that a facility to be used in the project is under consideration for listing by the EPA (Executive Order 11738). PERFORMING AGENCY shall comply with the flood insurance purchase requirements of 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234). Section 102 (a) requires the purchase of flood insurance in communities where the insurance is available as a condition for the receipt of any federal financial assistance for construction or acquisition proposed for use in any area that has been identified by the Secretary of the U.S. Department of Housing and Urban Development as an area having special flood hazards. As required by Texas Family Code, §231.006, VTCA, a child support obligor who is more than 30 days delinquent in paying child support and a business entity in which the obligor is a sole proprietor, partner, shareholder, or owner with an ownership interest of at least 25% is not eligible to receive payments from state funds under a contract to provide property, materials, or services or receive a state -funded grant or loan. If applicable, PERFORMING AGENCY agrees to comply with these provisions, certifies that it is not ineligible to receive the payments specified in this contract, and acknowledges that this contract may be terminated and payment may be withheld if this certification is inaccurate. PERFORMING AGENCY shall comply with the requirements of the Texas Workers' Compensation Act, Labor Code, Chapters 401-406, VTCA, and rules promulgated thereunder found at 28 Texas Administrative Code (TAC), Chapter 41, et seq., which cover compensation for employees' injuries. When incorporated into a contract, standard assurances contained in the application package, if any, become terms or conditions for receipt of RECEIVING AGENCY funds. PERFORMING AGENCY and its subrecipients shall maintain an appropriate contract administration system to insure that all terms, conditions, and specifications are met. PERFORMING AGENCY shall comply with all federal tax laws and is solely responsible for filing all required state and federal tax forms. PERFORMING AGENCY shall comply with all applicable requirements of federal and state laws, executive orders, regulations and policies governing the activity described in Attachment(s), and with the applicable standard conditions or assurances prescribed by UGMS in "Part III -State Uniform Requirements for Grants and Cooperative Agreement, Subpart B-Pre-Award Requirements, item ! 14-State Assurances." (bedependent) 2000 GENERAL PROVISIONS Page 5 4/99 PERFORMING AGENCY assures it shall not transfer, assign or sell its interest in this contract, or in any equipment purchased with funds from this contract, without the written consent of RECEIVING AGENCY. ARTICLE 8. Intellectual Property Texas Health and Safety Code § 12.020(a), VTCA, authorizes RECEIVING AGENCY to apply for, register, secure, hold, and protect a patent, copyright, trademark or other evidence of protection or exclusivity issued in or for intellectual property. "Intellectual property" consists of inventions; discoveries; improvements to any process, machine, manufacture, or composition of matter; products; technology; scientific information; trade secrets; computer software; literary works; musical works with any accompanying words; dramatic works with any accompanying music; pantomimes and choreographic works; pictorial, graphic, and sculptural works; motion pictures and other audiovisual works; sound recordings; architectural works; words, names, symbols, devices, slogans or any combination thereof which have been adopted and used by RECEIVING AGENCY to identify goods and/or services and distinguish them from those of others; and any other creative works if they may be protected by a patent, copyright, trademark, service mark, collective mark, or certification mark or other evidence of protection or exclusivity whether or not protection or exclusivity has been applied for or received. "Mark," for purposes of trademark and service mark, includes a word, name, symbol, device, slogan or any combination thereof which has been adopted and used by RECEIVING AGENCY to identify goods and/or services and distinguish them from those of others. Federal trademark law also provides for collective marks and certification marks. "Patent" protects any new and useful process, machine, manufacture, or composition of matter, or any new and useful improvement. "Work made for hire" is a work prepared by an employee within the scope of his or her employment; or a work specially ordered or commissioned for use as a contribution to a collective work, as a part of a motion picture or other audiovisual work, as a translation, as a supplementary work, as a compilation, as an instructional text, as a test, as answer material for a test, or as an atlas, and the parties expressly agree in a written instrument signed by them that the work shall be considered a work made for hire. The term "works," for purposes of federal copyright law, includes software; literary works; musical works with any accompanying words; dramatic works with any accompanying music; pantomimes and choreographic works; pictorial, graphic, and sculptural works; motion pictures and other audiovisual works, sound recordings and architectural works. All work performed that results in the production of original books, manuals, films, or other original material is the exclusive property of RECEIVING AGENCY. All right, title, and interest in and to said property shall vest in RECEIVING AGENCY upon creation. All work performed shall be deemed to be a "work made for hire" for copyright purposes and made in the course of the services rendered pursuant to this contract. To the extent that title to any such work may not, by operation of law, vest in RECEIVING AGENCY or such work may not be considered a work made for hire, all rights, title and interest therein are hereby irrevocably assigned to RECEIVING AGENCY. RECEIVING AGENCY shall have the right to obtain and to hold in its own name any and all patents, copyrights, trademarks, service marks, certification marks, collective marks, registrations, or such other protection as may be appropriate to the subject matter, and any extensions and renewals thereof. PERFORMING AGENCY shall ensure all rights, titles, and interest in and to the intellectual property are secured to RECEIVING AGENCY from (independent) 2000 GENERAL PROVISIONS Page 6 4/99 PERFORMING AGENCY and its subrecipients. PERFORMING AGENCY agrees to give RECEIVING AGENCY and agrees to require its subrecipients to give RECEIVING AGENCY, or any person designated by RECEIVING AGENCY, all assistance required to perfect the rights defined in this Article, without any charge or expense beyond those amounts payable to PERFORMING AGENCY for the services rendered under the contract. If federal funds are used to finance activities supported by the contract Attachment(s) that result in the production of original books, manuals, films, or other original material, the federal awarding agency reserves a royalty -free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use, for federal government purposes (1) the copyright in any work developed under a grant, subgrant, or contract under a grant or subgrant; and (2) any rights of copyright to which a PERFORMING AGENCY or its subrecipient purchases ownership with grant support. PERFORMING AGENCY shall place an acknowledgment of federal awarding agency grant support and a disclaimer, as appropriate, on any publication written or published with such support and, if feasible, on any publication reporting the results of or describing a grant -supported activity. An acknowledgment shall be to the effect that "This publication was made possible by grant number from (federal awarding a eg ncy)" or "The project described was supported by grant number from (federal awarding agency " and "Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the (federal awarding agency)." In the event the terms of a federal grant award the copyright to PERFORMING AGENCY, RECEIVING AGENCY reserves a royalty -free, nonexclusive, worldwide and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use, for RECEIVING AGENCY, public health, and state governmental noncommercial purposes (1) the copyright, mark, and patent on an invention, discovery, or improvement to any process, machine, manufacture, or composition of matter; products; technology; scientific information; trade secrets; and computer software, in any work developed under a grant, subgrant, or contract under a grant or subgrant; and (2) any rights of copyright, service or trade marks or patents to which a grantee, subgrantee or a contractor purchases ownership with grant support. PERFORMING AGENCY may publish the results of the contract performance if those results are subject to copyright law at its expense with prior RECEIVING AGENCY review and approval. RECEIVING AGENCY will not withhold the approval unreasonably. If RECEIVING AGENCY withholds approval, PERFORMING AGENCY may still publish the results of the contract performance but shall not reference the Texas Department of Health in any manner. If RECEIVING AGENCY approves and owns the copyright, any publication should include "© Texas Department of Health, 1100 West 49th Street, Austin, Texas, (the year of publication), All Rights Reserved." If PERFORMING AGENCY is the copyright holder, any publication shall include acknowledgment of the support received from RECEIVING AGENCY. At least six copies of any such publication must be provided to RECEIVING AGENCY. RECEIVING AGENCY reserves the right to require additional copies before or after the initial review. PERFORMING AGENCY and any subrecipient, as appropriate, must comply with the standard patent rights clauses in 37 Code of Federal Regulations §401.14 or Federal Acquisition Regulations 52.227.11. ARTICLE 9. Historically Underutilized Businesses RECEIVING AGENCY shall comply with Texas Government Code, Chapter 2161, VTCA, and 1 TAC §§ 111.11- 111.24 whereby state agencies are required to make a good faith effort to assist historically underutilized businesses (HUBS) in receiving contract awards issued by the state to purchase "goods," which are defined as "supplies, materials, or equipment," services, or public works. (Independent) 2000 GENERAL PROVISIONS Page 7 4199 If PERFORMING AGENCY subcontracts a portion of this contract, PERFORMING AGENCY agrees to make a good faith effort to subcontract with HUBs during the performance of its contract Attachments) with RECEIVING AGENCY and will report HUB subcontract activity on a quarterly basis to RECEIVING AGENCY. PERFORMING AGENCY and its subrecipient(s), if any, are encouraged to use minority banks (a bank which is owned at least 50 percent by minority group members). ARTICLE 10. Certification Regarding License. Certificate, or Permit RECEIVING AGENCY may pay PERFORMING AGENCY only for personnel who are duly licensed and/or qualified to perform required services. PERFORMING AGENCY certifies that no owner, operator, or administrator of PERFORMING AGENCY has had a license, certificate, or permit revoked by any of the Texas state agencies listed below: • Adjutant General's Department • Board of Private Investigators and Private Security Agencies • Interagency Council on Early Childhood Intervention • Texas Alcoholic Beverage Commission • Texas Cancer Council • Texas Children's Trust Fund of Texas Council • Texas Commission for the Deaf and Hard of Hearing • Texas Commission on Alcohol and Drug Abuse • Texas Commission on Jail Standards • Texas Commission on Law Enforcement Officers Standards & Education • Texas Commission on Fire Protection • Texas Council on Sex Offender Treatment • Texas Criminal Justice Policy Council • Texas Department of Criminal Justice • Texas Department of Human Services • Texas Department of Mental Health & Mental Retardation • Texas Department of Protective and Regulatory Services • Texas Department of Public Safety • Texas Department of Health • Texas Health & Human Services Commission • Texas National Guard Armory Board • Texas Polygraph Examiners Board • Texas Rehabilitation Commission • Texas Youth Commission ARTICLE 11. Conflict of Interest PERFORMING AGENCY does not have nor shall it knowingly acquire any interest that would conflict in any manner with the performance of its obligations under this contract. Potential conflicts of interest include an existing business or personal relationship between PERFORMING AGENCY, its principal, or any affiliate or subrecipient with RECEIVING AGENCY, its board members, officers or employees, or any other entity or person involved in any way in any project that is the subject of this contract. (Independent) 2000 GENERAL PROVISIONS Page 8 4/99 ARTICLE 12. Year-2000 Certification PERFORMING AGENCY certifies that any supplied or supported software, hardware, firmware and micro code products used individually or together as a system to comply with RECEIVING AGENCY contract requirements will be year-2000-compliant on or before the date such hardware, software, firmware and systems are to be impacted. Year-2000-compliant means that such product operates "accurately" in the manner in -which it was intended as it relates to date related operations when given a "valid date" containing century, year, month, and day. For purposes of this Article, "supplied or supported software, hardware, firmware and micro code products" does not include software supported by RECEIVING AGENCY or an agency of the federal government. PERFORMING AGENCY is responsible for installing and implementing year-2000-compliant versions of any software provided by RECEIVING AGENCY or an agency of the federal government which is used in performance of this contract. For purposes of this Article, 1) "accurately" is defined to include the following: a) calculations must be correctly performed using four -digit year processing; b) functionality -on-line, batch including entry, inquiry, maintenance and updates must support four -digit year processing; c) interfaces and reports must support four -digit year processing; d) successful translation into year-2000 with the correct system date (e.g., 01/01/2000) must occur without human intervention; e) processing with a four -digit year after transition to any date beyond the year 2000 must occur without human intervention; f) correct results in forward and backward date calculation spanning century boundaries must be provided; g) correct leap year calculations must be performed; and h) processing correct results in forward and backward date calculation spanning century boundaries must occur, including the conversion of previous years currently stored as two digits; 2) "date integrity" shall mean all manipulations of time -related data (dates, durations, days of week, etc.) will produce desired results for all valid date values within the application domain; 3) "explicit century" shall mean date elements in interfaces and data storage permit specifying century to eliminate date ambiguity; 4) "extraordinary actions" shall be defined to mean any action outside the normal documented processing steps identified in the product's reference documentation; 5) "general integrity" shall mean no value for current date will cause interruptions in desired operation - especially from the 20th to 21st centuries; 6) "implicit century" shall mean for any data element without century, the correct century is unambiguous for all manipulations involving that document; 7) "product" or "products" shall be defined to include, but is not limited to, any supplied or supported hardware, software, firmware and/or micro code; (Independent) 2000 GENERAL PROVISIONS Page 9 4/99 8) "valid date" shall contain a two -digit month, a two -digit day and a four -digit year. PERFORMING AGENCY and its subrecipient(s) must obtain a warranty from any vendor/licensor from which it obtains product(s) that product(s) delivered and installed under the contract/license shall be able to accurately process valid date data when used in accordance with the product documentation provided by the contractor/ licensor and require no extraordinary actions on the part of PERFORMING AGENCY, its personnel, or its subrecipient(s). Products under the contract/license possess general integrity, date integrity, explicit and implicit century capabilities. If the contract/license requires that specific products must perform as a system in accordance with the foregoing warranty, then the warranty shall apply to those listed products as a system. The duration of this warranty and the remedies available to PERFORMING AGENCY or its subrecipient(s) for breach of the warranty shall be defined in, and subject to, the terms and conditions of the contractor's standard commercial warranty or warranties contained in the contract/license; provided, that notwithstanding any provision to the contrary in such commercial warranty or warranties, the remedies available to PERFORMING AGENCY or its subrecipient(s) shall include repair or replacement of any supplied product whose noncompliance is discovered and made known to the contractor/licensor in writing within ninety (90) days after final acceptance. Nothing in the warranty shall be considered to limit any rights or remedies PERFORMING AGENCY or its subrecipient(s) may otherwise have under the contract/license with respect to defects other than Year-2000 performance. RECEIVING AGENCY will not hold PERFORMING AGENCY responsible if the information coming to PERFORMING AGENCY's product/software from RECEIVING AGENCY is inaccurate or corrupt. ARTICLE 13. Standards for Financial and Programmatic Management PERFORMING AGENCY shall develop, implement, and maintain financial management and control systems that meet or exceed the requirements of UGMS as detailed in RECEIVING AGENCY's Financial Administrative Procedures Manual. Those requirements shall include at a minimum: A. Financial planning, including the development of budgets that adequately reflect all functions and resources necessary to carry out authorized activities and the adequate determination of costs; B. Financial management systems including accurate, correct, and complete payroll, accounting, and financial reporting records; cost source documentation; effective internal and budgetary controls; determination of reasonableness, allowableness, and allocability of costs; and timely and appropriate audits and resolution of any findings; and, C. Billing and collection policies, including a fee schedule, a system for discounting or adjusting charges based on a person's income and family size, and a mechanism capable of billing and making reasonable efforts to collect from patients and third parties. PERFORMING AGENCY must bill all third party payers for services provided under the Attachment(s) before submitting any request for reimbursement to RECEIVING AGENCY. A third party payer is any person or entity who has the legal responsibility for paying all or part of the services provided, including commercial health or liability insurance carriers, Medicaid, or other federal, state, local and private funding sources. Third party billing functions will be provided by PERFORMING AGENCY at no cost to the client. PERFORMING AGENCY or its subrecipient must become a Medicaid provider if performing approved Texas Medicaid services authorized by the Attachment(s). PERFORMING AGENCY, if designated a 501(c)(3) organization as defined in the Internal Revenue Service Code or a for -profit organization, and its governing board, shall bear full responsibility for the integrity of the fiscal and (Independent) 2000 GENERAL PROVISIONS Page 10 4/99 programmatic management of the organization. Such responsibility shall include: accountability for all funds and materials received from RECEIVING AGENCY; compliance with RECEIVING AGENCY rules, policies, procedures, and applicable federal and state laws and regulations; and correction of fiscal and program deficiencies identified through self -evaluation and RECEIVING AGENCY's monitoring piocesses. Further; PERFORMING AGENCY's governing board shall ensure separation of powers, duties, and functions of board members and staff. Ignorance of any contract provisions or other requirements contained or referenced in this contract shall not constitute a defense or basis for waiving or appealing such provisions or requirements. ARTICLE 14. Bonding PERFORMING AGENCY is required to carry a fidelity bond or insurance coverage equal to the amount of funding provided under the contract Attachment(s) up to $100,000 that covers each employee of PERFORMING AGENCY handling funds under this contract, including person(s) authorizing payment of such funds. The fidelity bond or insurance will provide for indemnification of losses occasioned by: 1) any fraudulent or dishonest act or acts committed by any of PERFORMING AGENCY's employees, either individually or in concert with others, and/or 2) failure of PERFORMING AGENCY or any of its employees to perform faithfully his/her duties or to account properly for all monies and property received by virtue of his/her position or employment. ARTICLE 15. Funding Participation Requirement PERFORMING AGENCY agrees funds provided through this contract will not be used for matching purposes in securing other funding unless otherwise directed or approved by RECEIVING AGENCY. ARTICLE 16. Allowable Costs and Audit Requirements Only those costs allowable under UGMS and any revisions thereto plus any applicable federal cost principles are eligible for reimbursement under this contract. Applicable cost principles, audit requirements, and administrative requirements are as follows: Applicable Cost Principles* I Audit Requirements* I Administrative Requirements* OMB Circular A-87, State & Local Governments OMB Circular A-21, Educational Institutions OMB Circular A-122, Non -Profit Organizations 48 CFR Part 31, For -profit Organization other than a hospital and an organization named in OMB Circular A-122 as not subject to that circular OMB Circular A-133 OMB Circular A-133 OMB Circular A-133 and UGMS Program audit conducted by an independent certified public accountant must be in accordance with Governmental Auditing Standards. • OMB Circulars shall be applied with the modifications prescribed by UGMS. UGMS OMB Circular A-110 UGMS (Independent) 2000 GENERAL PROVISIONS Page 11 4/99 PERFORMING AGENCY must have incurred a cost within the applicable Attachment term to be eligible for reimbursement underthis contract. PERFORMING AGENCY must incur cost(s) prior to requesting reimbursement under this contract. No later than 90 days after the end of the applicable Attachment term, RECEIVING AGENCY must receive vouchers from PERFORMING AGENCY for costs encumbered on or before the last day of the applicable Attachment term. Reimbursement requests submitted and postmarked more than 90 days following the end of the applicable Attachment term may or may not be reimbursed, at the discretion of RECEIVING AGENCY. PERFORMING AGENCY or the AUTHORIZED CONTRACTING ENTITY shall arrange for a financial and compliance audit (Single Audit) if required by OMB Circular A-133 and/or UGMS. The audit shall be of PERFORMING AGENCY's or the AUTHORIZED CONTRACTING ENTITY's fiscal year. The audit must be conducted by an independent certified public accountant and in accordance with applicable OMB Circulars, Government Auditing Standards, and UGMS. PERFORMING AGENCY shall procure audit services in compliance with state procurement procedures, as well as with the provisions of UGMS. If PERFORMING AGENCY is not required to have a Single Audit, a limited scope audit may be required. RECEIVING AGENCY will provide PERFORMING AGENCY with written audit requirements if a limited scope audit is required. Within 30 days of receipt of the audit reports required by this section, PERFORMING AGENCY/AUTHORIZED CONTRACTING ENTITY shall submit a copy to RECEIVING AGENCY's Internal Audit Division. ARTICLE 17. Terms and Conditions of Payment For services satisfactorily performed pursuant to this contract, RECEIVING AGENCY will reimburse PERFORMING AGENCY for allowable costs. Reimbursements are contingent on a signed contract and will not exceed the total of each Attachment(s). PERFORMING AGENCY is entitled to payment only if the service, work, and/or product has been satisfactorily performed and authorized in accordance with this contract. PERFORMING AGENCY must submit requests for reimbursement on a State of Texas Purchase Voucher (TDH Form B-13) or any other form designated by RECEIVING AGENCY. PERFORMING AGENCY shall submit vouchers for reimbursement monthly within 30 days following the end of the month covered by the bill. PERFORMING AGENCY shall submit a reimbursement request as a final close-out bill not later than 90 days following the end of the applicable Attachment term(s). Reimbursement requests submitted and postmarked more than 90 days following the end of the applicable Attachment term may not be paid, at the discretion of RECEIVING AGENCY. For any contract Attachments beginning on or after September 1, 1999, PERFORMING AGENCY shall disburse program income, rebates, refunds, contract settlements, audit recoveries and interest earned on such funds before requesting cash payments including advance payments from RECEIVING AGENCY. RECEIVING AGENCY is required to place PERFORMING AGENCY on Direct Deposit status in accordance with Texas Government Code, §403.016(c), VTCA. PERFORMING AGENCY will no longer receive copies of vouchers. Funding from this contract may not be used to supplant state or local funds, but PERFORMING AGENCY shall use the funds from this contract to increase state or local funds currently available for a particular activity. PERFORMING AGENCY shall maintain its current level of support, if possible. (Independent) 2000 GENERAL PROVISIONS Page 12 4/99 RECEIVING AGENCY shall determine whether costs submitted by PERFORMING AGENCY are allowable and reimbursable. If RECEIVING AGENCY has paid funds to PERFORMING AGENCY for unallowable or ineligible costs, PERFORMING AGENCY shall return the funds to RECEIVING AGENCY within 30 days of written notice. RECEIVING AGENCY may withhold all or part of any payments to PERFORMING AGENCY to offset reimbursement for any ineligible expenditures that PERFORMING AGENCY has not refunded to RECEIVING AGENCY. RECEIVING AGENCY may take repayment from funds available under any contract Attachment, active or expired, in amounts necessary to fulfill PERFORMING AGENCY repayment obligations. ARTICLE 18. Advance Payments PERFORMING AGENCY may request a one-time advance for each Attachment only to meet immediate need for cash disbursement. PERFORMING AGENCY must make the request on State of Texas Purchase Voucher, accompanied by written justification and supporting documentation as specified in RECEIVING AGENCY's Financial Administrative Procedures Manual. The advance shall be requested at the beginning of the applicable Attachment period, or at a later time in the applicable Attachment period if circumstances so warrant. Approval of the request for advance will be at the discretion of RECEIVING AGENCY. If the request is approved, the voucher will be processed; if disapproved, RECEIVING AGENCY will provide written notification to PERFORMING AGENCY. RECEIVING AGENCY will determine the amount of the advance, if any, by the amount and term of the applicable Attachment(s). For each Attachment, the amount of the advance shall not exceed an amount equal to the amount of the Attachment divided by the number of months covered by the Attachment multiplied by two (2). Advance funds will be expended during the applicable Attachment term so that, after the final monthly billing, PERFORMING AGENCY will not have advance funds on hand. If the Attachment is amended to increase or decrease the total amount, RECEIVING AGENCY may make an upward or downward adjustment to the allowable advance in accordance with the above formula. If PERFORMING AGENCY is requesting an upward adjustment, PERFORMING AGENCY must submit a written justification and State of Texas Purchase Voucher in the amount necessary to correct the ratio. If the adjustment is downward, RECEIVING AGENCY will determine the amount of adjustment to the advance and the method of repayment. ARTICLE 19. Program Income PERFORMING AGENCY may develop a fee -for -service system and a schedule of fees for personal health services in accordance with the provisions of Chapter 12, Subchapter D, Health and Safety Code, VTCA; the Texas Board of Health rules covering Fees for Clinical Health Services, 25 TAC § 1.91; and other applicable laws. No patient may be denied a service due to inability to pay. All revenues directly generated by an Attachment(s) supported activity or earned only as a result of the Attachment(s) during the term of the Attachment(s) are considered program income. PERFORMING AGENCY shall identify and report this income utilizing the forms and time frames specified in the Reports Article of these provisions. PERFORMING AGENCY shall utilize one of the following methods for applying program income: 1. Additive method - add the program income to the funds already committed to the project by both parties. Program income will be used by PERFORMING AGENCY to further the program (Independent) 2000 GENERAL PROVISIONS Page 13 4/99 objectives of the state/federal statute under which the Attachment(s) wastwere made, and it shall be spent on the same project in which it was generated. 2. Deductive method - deduct the program income from the total allowable costs to determine the net allowable costs. PERFORMING AGENCY must expend program income during the Attachment term in which it is earned, and may not carry forward to the succeeding term. Program income not expended in the term in which it is earned shall be refunded to RECEIVING AGENCY. RECEIVING AGENCY may base future funding levels, in part, upon PERFORMING AGENCY's proficiency in identifying, billing, collecting, and reporting program income, and in utilizing it for the purposes and conditions of the applicable Attachment(s). ARTICLE 20. Overtime Compensation PERFORMING AGENCY shall not use any of the funds provided by the Attachment(s) hereto to pay the premium portion of overtime. PERFORMING AGENCY shall be responsible for any obligations of premium overtime pay due employees. Premium overtime pay is defined as any compensation paid to an individual in addition to the normal rate of pay for hours worked in excess of normal working hours. ARTICLE 21. Equipment and Supplies In accordance with Health & Safety Code, § 12.053, VTCA, title to all equipment and supplies purchased from funds from this contract will be in the name of PERFORMING AGENCY throughout the Attachment(s) term(s) or until the Attachment is terminated. Equipment is defined as tangible nonexpendable property with an acquisition cost of more than $1,000 and a useful life of more than, one year, with the following exceptions: fax machines, stereo systems, cameras, video recorder/players, microcomputers, software, medical equipment, laboratory equipment, and printers. If the unit cost of these exception items is more than $500, they will still be considered equipment, must be approved for purchase, and are considered capital assets for inventory purposes. Medical and laboratory equipment in this category is defined as microscopes, oscilloscopes, centrifuges, balances, and incubators. Medical and laboratory equipment not included in these five categories is not considered a capital asset unless the unit value is more than $1,000. Supplies which may be necessary to carry out the contract include medical supplies, drugs, janitorial supplies, office supplies, patient educational supplies, software less than $500, plus any equipment with a purchase price including freight not to exceed $1,000 per item, except those defined as "equipment." Unless initially listed and approved in the Attachment(s), prior written approval from RECEIVING AGENCY is required for any changes to approved equipment purchases meeting the above equipment definition. To receive approval to purchase data processing hardware and software or enhancements, PERFORMING AGENCY must submit a detailed justification and specification which include a description of features, make and model, and cost, etc. (Independent) 2000 GENERAL PROVISIONS Page 14 4/99 PERFORMING AGENCY shall maintain a property inventory and submit an annual cumulative report (TDH Form GC-11) to RECEIVING AGENCY no later than October 15th of each year. PERFORMING AGENCY shall administer a program of maintenance, repair, and protection of assets under this contract so as to assure their full availability and usefulness. In the event PERFORMING AGENCY is indemnified, reimbursed, or otherwise compensated for any loss of, destruction of, or damage to the assets provided under this contract, it shall use the proceeds to repair or replace said assets. In the event of bankruptcy, PERFORMING AGENCY shall sever RECEIVING AGENCY property, equipment, and supplies in possession of PERFORMING AGENCY from the bankruptcy, and title shall revert to RECEIVING AGENCY. Upon termination or expiration of applicable Attachment(s), title to any remaining equipment and supplies purchased from funds under this contract reverts to RECEIVING AGENCY. Title may be transferred to any other party designated by RECEIVING AGENCY. RECEIVING AGENCY may, at its option and to the extent allowed by law, transfer the reversionary interest to such property to PERFORMING AGENCY. ARTICLE 22. Contracts with Subrecinients PERFORMING AGENCY may enter into contracts with subrecipients unless restricted or otherwise prohibited in specific Attachment(s). PERFORMING AGENCY is responsible to RECEIVING AGENCY for the performance of any subrecipient. Contracts with subrecipients shall be in writing and must include the following: • name and address of all parties; • a detailed description of the services to be provided; • measurable method and rate of payment and total amount of the contract; • clearly defined and executable termination clause; • beginning and ending dates which coincide with the dates of the applicable contract Attachment(s) or cover a term within the beginning and ending dates of the applicable contract Attachment(s); • access to inspect the work and the premises on which any of the work is performed, in accordance with the Inspections Article contained in this contract; and • all clauses required by state/federal statutes, executive orders, and their implementing regulations. PERFORMING AGENCY agrees that all contracts with subrecipients containing a categorical budget shall include audit requirements referenced in the Allowable Costs and Audit Requirements Article of this contract, as appropriate. Prior to entering into an agreement equaling $25,000 or 25% of an Attachment, whichever is greater, PERFORMING AGENCY shall obtain written approval from RECEIVING AGENCY. PERFORMING AGENCY shall ensure that: subrecipients are fully aware of the requirements imposed upon them by state/federal statutes and regulations; subrecipients comply with all financial management requirements as defined by RECEIVING AGENCY and the applicable OMB circulars; subrecipients complete required audits; (Independent) 2000 GENERAL PROVISIONS Page 15 4199 an adequate tracking system is maintained to ensure timely receipt of any subrecipient's required audit reports and the resolution of any findings and questioned costs cited by these reports. ARTICLE 23. Contracts for Procurement PERFORMING AGENCY may enter into contracts for procurement unless restricted or otherwise prohibited in specific Attachment(s). PERFORMING AGENCY agrees that it shall be responsible to RECEIVING AGENCY for the performance of any subcontracted activity. , Contracts for procurement shall be in writing and must contain the following provisions: • Administrative, contractual, or legal remedies in instances where contractors violate or breach contract terms, and provide for such sanctions and penalties as may be appropriate (contracts other than small purchases). • Termination for cause and for convenience by PERFORMING AGENCY including the manner by which it will be effected and the basis for settlement (all contracts in excess of $10,000). • Compliance with the Copeland "Anti -Kickback" Act (18 USC 874) as supplemented in Department of Labor regulations (29 CFR Part 3) (all contracts and subgrants for construction or repair). • Compliance with §§ 103 and 107 of the Contract Work Hours and Safety Standards Act (40 USC 327-330) as supplemented by Department of Labor regulations (29 CFR Part 5) (construction contracts awarded by grantees and subgrantees in excess of $2,000, and in excess of $2,500 for other contracts which involve the employment of mechanics or laborers). • Notice of RECEIVING AGENCY requirements and regulations pertaining to reporting. • Notice of RECEIVING AGENCY requirements and regulations pertaining to patent rights with respect to any discovery or invention which arises or is developed in the course of or under such contract. • RECEIVING AGENCY requirements and regulations pertaining to copyrights and rights in data. • Access by the RECEIVING AGENCY, the federal grantor agency, the Comptroller General of the United States, the State of Texas or any of their duly authorized representatives to any books, documents, papers, and records of the contractor which are directly pertinent to that specific contract for the purpose of making audit, examination, excerpts, and transcriptions. • Retention of all required records for three years after RECEIVING AGENCY makes final payments and all other pending matters are closed. • Compliance with all applicable standards, orders, or requirements issued under §306 of the Clean AirAct (42 USC 1857(h)), §508 of the Clean Water Act (33 USC 1368), Executive Order 11738, and Environmental Protection Agency regulations (40 CFR Part 15) (contracts, subcontracts, and subgrants of amounts in excess of $100,000). • Mandatory standards and policies relating to efficiency which are contained in the state energy plan issued in compliance with the Energy Policy and Conservation Act (P. L. 94-163). ARTICLE 24. Reports Financial reports are required as provided in UGMS, and PERFORMING AGENCY shall file them regardless of whether expenses have been incurred. For each Attachment, PERFORMING AGENCY shall submit a Financial Status Report, State of Texas Supplemental Form 269a (TDH Form GC-4a) within 30 days following the end of each of the first three quarters. (Independent) 2000 GENERAL PROVISIONS Page 16 4/99 PERFORMING AGENCY shall submit a final financial report on State of Texas Supplemental Form 269a (TDH Form GC-4a), not later than 90 days following the end of the Attachment term(s). PERFORMING AGENCY shall submit a State of Texas Purchase Voucher if all costs have not been recovered, or PERFORMING AGENCY shall refund excess monies if costs incurred were less than funds received. Failure to file a purchase voucher in a timely manner may result in RECEIVING AGENCY disallowing payment. PERFORMING AGENCY shall submit program and progress reports required by RECEIVING AGENCY in the format agreed to by the parties. PERFORMING AGENCY shall provide RECEIVING AGENCY other reports including financial reports RECEIVING AGENCY determines necessary to accomplish the objectives of this contract. If PERFORMING AGENCY is legally prohibited from providing such reports, it shall immediately notify RECEIVING AGENCY. ARTICLE 25. Inspections RECEIVING AGENCY and, when federal funds are involved, any authorized representative(s) of the federal government have the right, at all reasonable times, to inspect or otherwise evaluate the work (including reviews of client or patient records and discussions with staff) performed by PERFORMING AGENCY and its subrecipient(s), if any, and the premises on which the work is being performed. PERFORMING AGENCY and its subrecipient(s) shall participate in inspections and provide reasonable access, facilities, and assistance to the representatives. All inspections and evaluations will be performed in such a manner as will not unduly interfere with the work. PERFORMING AGENCY and its subrecipient(s), if any, shall give RECEIVING AGENCY, the federal government, and the Texas State Auditor, or any of their duly authorized representatives, access to any pertinent books, documents, papers, and client or patient records, if any, for the purpose of making audit, examination, excerpts, and transcripts of transactions related to contract Attachment(s). RECEIVING AGENCY will have the right to audit billings both before and after payment. Payment under Attachment(s) will not foreclose the right of RECEIVING AGENCY to recover excessive or illegal payments. Any deficiencies identified by RECEIVING AGENCY upon examination of PERFORMING AGENCY's records will be conveyed in writing to PERFORMING AGENCY. PERFORMING AGENCY's resolution of findings will also be conveyed in writing to RECEIVING AGENCY within 30 days of receipt of RECEIVING AGENCY's findings. A RECEIVING AGENCY determination of either an inadequate or inappropriate resolution of the findings may result in sanctions which will remain in effect until RECEIVING AGENCY determines the deficiencies are properly remedied. ARTICLE 26. Records Retention PERFORMING AGENCY shall retain, preserve and make available all required records for a period of three years from the date of the last expenditure report submitted under contract Attachment(s) or until all audit questions are resolved, or until any court orders requiring record retention are dissolved, whichever time period is longer. Microfilm copies of records required to be kept under the Attachment(s) may be substituted for the originals in accordance with guidelines and procedures approved by RECEIVING AGENCY, provided that the microfilm procedures are reliable and are supported by an adequate retrieval system, unless otherwise ordered by a court of general jurisdiction. ARTICLE 27. Client Records (Independent) 2000 GENERAL PROVISIONS Page 17 4/99 Notwithstanding any other provision herein, if requested by RECEIVING AGENCY, PERFORMING AGENCY shall share all patient information with RECEIVING AGENCY when the contract involves patient care by the PERFORMING AGENCY. RECEIVING AGENCY may require PERFORMING AGENCY, or any subrecipient, to transfer a client or patient record to another agency or to RECEIVING AGENCY if the transfer is necessary to protect either the confidentiality of the record or the health and welfare of the client or patient. In the event of termination, RECEIVING AGENCY may require the transfer of client or patient records as authorized by law upon written notice to PERFORMING AGENCY, either to another entity that agrees to continue the service or to RECEIVING AGENCY. At the end of the Attachment term, PERFORMING AGENCY shall give RECEIVING AGENCY access to the records or provide copies for audit, examination, evaluation, inspection, litigation, or other circumstances that may arise, to the extent authorized by law. PERFORMING AGENCY, or any subrecipient, shall not otherwise transfer an identifiable client record, including a patient record, to another entity or person without written consent from the client or patient, or someone authorized to act on his or her behalf. Written consent must be given on a form provided by RECEIVING AGENCY or as otherwise authorized by law, including the Texas Medical Practice Act, Article 4495b, TRCS. ARTICLE 28. Confidentiality PERFORMING AGENCY shall have a system in effect to protect client or patient records and all other documents deemed confidential by law which are maintained in connection with the activities funded under this contract. PERFORMING AGENCY shall not disclose or transfer confidential client or patient information, including information required by the Reports Article, except in accordance with applicable law. If providing direct client care, services, or programs, PERFORMING AGENCY shall implement RECEIVING AGENCY's workplace policies based on the model guidelines, and PERFORMING AGENCY shall educate employees and clients concerning the human immunodeficiency virus (HIV) and its related conditions, including acquired immunodeficiency syndrome (AIDS), in accordance with the Health and Safety Code, §§85.112-114, VTCA. ARTICLE 29. Hold Harmless PERFORMING AGENCY, as an independent contractor, agrees to hold RECEIVING AGENCY and/or the federal government harmless and to indemnify them from any and all liability, suits, claims, losses, damages and judgments, and to pay all costs, fees, and damages to the extent that such costs, fees, and damages arise from performance or nonperformance of PERFORMING AGENCY under this contract. ARTICLE 30. Sanctions RECEIVING AGENCY may impose sanctions for any breach of contract, and will monitor PERFORMING AGENCY for both programmatic and financial compliance. RECEIVING AGENCY may, at its own discretion, impose one or more sanctions for each item of noncompliance and will determine sanctions on a case -by -case basis. A state or federal statute, rule, regulation, or federal guideline will prevail over the provisions of this Article unless the statute, rule, regulation, or guideline can be read together with the provision(s) of this Article to give effect to both. (Independent) 2000 GENERAL PROVISIONS Page 18 4/99 RECEIVING AGENCY may: A. terminate all or a part of the contract. Termination is the permanent withdrawal of PERFORMING AGENCY's authority to obligate previously awarded funds before that authority would otherwise expire or the voluntary relinquishment by PERFORMING AGENCY to obligate previously awarded funds. PERFORMING AGENCY costs resulting from obligations incurred by PERFORMING AGENCY after termination of an award are not allowable unless expressly authorized by the notice of termination. Termination does not include: (1) withdrawal of funds awarded on the basis of the PERFORMING AGENCY's underestimate of the unobligated balance in a prior period; (2) withdrawal of the unobligated balance as of the expiration of a contract; (3) refusal to extend a contract or award additional funds, to make a competing or noncompeting continuation, renewal, extension, or supplemental award; or (4) voiding of a contract upon determination that the award was obtained fraudulently, or was otherwise illegal or invalid from inception; B. suspend all or part of the contract. Suspension is, depending on the context, either (1) the temporary withdrawal of PERFORMING AGENCY's authority to obligate funds pending corrective action by PERFORMING AGENCY or its subrecipient(s) or pending a decision to terminate or amend the contract, or (2) an action taken by a suspending official in accordance with agency regulations implementing Executive Order 12549 to immediately exclude a person from participating in contract transactions for a period, pending completion of an investigation and such legal or debarment proceedings as may ensue. PERFORMING AGENCY costs resulting from obligations incurred by PERFORMING AGENCY during a suspension are not allowable unless expressly authorized by the notice of suspension; C. disallow (deny both use of funds and matching credit for) all or part of the activities or action not in compliance; D. temporarily withhold cash payments. Temporarily withholding cash payments means the temporary withholding of advances or reimbursements to PERFORMING AGENCY or its subrecipient(s) for proper charges or obligations incurred, pending resolution of issues of noncompliance with contract conditions or indebtedness to the United States or to the State of Texas; E. permanently withhold cash payments. Permanent withholding of cash payment means that RECEIVING AGENCY retains funds billed by PERFORMING AGENCY or its subrecipient(s) for a) unallowable, undocumented, disputed, inaccurate, improper, or erroneous billings; b) failure to comply with contract provisions; or c) indebtedness to the United States or to the State of Texas; F. deny contract renewal or future contract awards to a PERFORMING AGENCY for a certain period of time not to exceed five years; G. delay contract execution with PERFORMING AGENCY while other imposed or proposed sanctions are pending resolution; H. place PERFORMING AGENCY on probation. Probation means that PERFORMING AGENCY will be placed on accelerated monitoring for a period not to exceed six months at which time items of noncompliance must be resolved or substantial improvement shown by PERFORMING AGENCY; I. conduct accelerated monitoring of PERFORMING AGENCY. Accelerated monitoring means more frequent or more extensive monitoring will be performed by RECEIVING AGENCY than would routinely be accomplished; (Independenr) 2000 GENERAL PROVISIONS Page 19 4/99 J. require PERFORMING AGENCY to obtain technical or managerial assistance; K. disallow requests for reimbursement by disapproving costs or fees submitted for payment or reimbursement by PERFORMING AGENCY; L. establish additional prior approvals for expenditure of funds by PERFORMING AGENCY; M. require additional, more detailed, financial and/or programmatic reports to be submitted by PERFORMING AGENCY; N. demand repayment from PERFORMING AGENCY; O. reduce the contract funding amount for failure to achieve or maintain the proposed level of service, to expend funds appropriately and at a rate which will make full use of the award, or to provide services as set out in the contract; and P. impose other remedies provided by law. RECEIVING AGENCY will formally notify PERFORMING AGENCY in writing when a sanction is imposed (with the exception of accelerated monitoring, which may be unannounced), stating the nature of the sanction(s), the reasons for imposing them, the corrective actions which must be taken before they will be removed and the time allowed for completing the corrective actions, and the method, if any, of requesting reconsideration of the sanctions imposed. PERFORMING AGENCY is required to file, within 15 days of receipt of notice, a written response to RECEIVING AGENCY's program/division that sent the notice, acknowledging receipt of such notice and stating how PERFORMING AGENCY will correct the noncompliance or demonstrating in writing that the findings on which the sanctions are based are either invalid or do not warrant the sanction(s). If RECEIVING AGENCY determines that a sanction is warranted, and unless the sanction is subject to review (see Sanction Review Article), RECEIVING AGENCY's decision is final and PERFORMING AGENCY must take corrective action. In an emergency, RECEIVING AGENCY may immediately terminate or suspend all or part of the contract, temporarily or permanently withhold cash payments, deny contract renewal or future contract awards, or delay contract execution by delivering written notice to a PERFORMING AGENCY, by any verifiable method, stating the reason for the emergency action. An "emergency" is defined as the following: • PERFORMING AGENCY is noncompliant and the noncompliance has a direct adverse impact on the public or client health or safety. The direct adverse impact may be programmatic or financial, impacting health or safety by failing to provide services, providing inadequate services, providing unnecessary services, or utilizing resources so that the public or clients do not receive the benefits contemplated by the contract scope of work or performance measures; • PERFORMING AGENCY fails to achieve a performance measure; • PERFORMING AGENCY is reimbursed or requesting reimbursement for expenditures which are not in accordance with applicable federal or state laws and regulations or the provisions of the contract; or • PERFORMING AGENCY is expending funds inappropriately. Whether PERFORMING AGENCY's conduct or inaction is an emergency shall be determined by RECEIVING AGENCY on a case -by -case basis and shall be based upon the egregious nature of the noncompliance or conduct. (independent) 2000 GENERAL PROVISIONS Page 20 4/99 ARTICLE 31. Sanction Review PERFORMING AGENCY may request a review of the imposition of the following sanctions: termination of all or part of the contract, suspension of all or part of the contract, permanent withholding of cash payments, and denial of contract renewal or future contract awards. PERFORMING AGENCY must make the request for review in writing to RECEIVING AGENCY within fifteen (15) days from the date of notification by providing written notice of the dispute to the person who signed the notification. PERFORMING AGENCY's notice shall contain the following: (1) a copy of the letter from RECEIVING AGENCY notifying PERFORMING AGENCY of the sanction; (2) a specific description of each act that is the basis for the dispute; (3) the grounds upon which PERFORMING AGENCY bases the complaint; (4) an identification of the issue or issues to be resolved; (5) a precise statement of the relevant facts; (6) any documentation in support of PERFORMING AGENCY's position; and (7) a statement and authorities in support of PERFORMING AGENCY's position. Evidence that PERFORMING AGENCY properly notified RECEIVING AGENCY consists of any of the following documents: (1) signature on delivery card; (2) confirmation of a facsimile to the correct telephone number; or (3) signed acknowledgment of delivery. RECEIVING AGENCY's representative will schedule a meeting or a conference call to attempt to resolve the issues in dispute. If the dispute is resolved, any resolution will be in writing and will be signed by all parties. If the dispute is not resolved, RECEIVING AGENCY's representative will notify PERFORMING AGENCY in writing. RECEIVING AGENCY will appoint a reviewer(s), who will review the information, who may permit or require additional information and who may grant, deny, or modify all relief requested in the written notice of dispute. The reviewer(s)'s decision will be in writing and will contain a discussion of the reason for the decision and the remedial action, if any. The reviewer(s) will send copies of the decision to all parties by any verifiable means. The decision of the reviewer(s) is final and is the final action of RECEIVING AGENCY for purposes of further proceedings. A state statute or rule or a federal statute, regulation or guideline will prevail over the provisions of this Article unless the statute, rule, regulation or guideline can be read together with the provision or provisions of this Article to give effect to both. ARTICLE 32. Breach of Contract Any remedies set out in this contract are in addition to rights and remedies for breach of contract provided by law. ARTICLE 33. Termination Each Attachment shall terminate upon the expiration date of the Attachment unless extended by written amendment in accordance with the Amendments Article. Prior to completion of the contract term, all or a part of this contract may be terminated with or without cause as set out below. A. Termination without cause. (1) Either party may terminate this contract with at least 90 days prior written notice to the other party. (Independent) 2000 GENERAL PROVISIONS Page 21 4/99 (2) The parties may terminate this contract by mutual agreement. (3) Either party may terminate this contract with at least 30 days prior written notice to the other party in the event state and/or federal funding for this contract is terminated, limited, suspended, or withdrawn. (4) RECEIVING AGENCY may terminate this contract when, in the sole determination of RECEIVING AGENCY, termination is in the best interest of the State of Texas. B. Termination for cause. (1) Either party may terminate for material breach of contract with at least 30 days written notice to the other party. (2) RECEIVING AGENCY may terminate this contract, in whole or in part, for breach of contract or for risky conduct by giving at least 30 days written notice to PERFORMING AGENCY. "Risky conduct" may include one or more of the following - (a) A court of competent jurisdiction finds that PERFORMING AGENCY has failed to adhere to any laws, ordinances, rules, regulations or orders of any public authority having jurisdiction; (b) PERFORMING AGENCY fails to communicate with RECEIVING AGENCY or fails to allow its employees or those of its subrecipients to communicate with RECEIVING AGENCY as necessary to the performance of the contract; (c) PERFORMING AGENCY breaches a standard of confidentiality with respect to the services provided under this contract; (d) RECEIVING AGENCY determines that PERFORMING AGENCY is without the personnel or resources to perform under the contract; (e) RECEIVING AGENCY determines that PERFORMING AGENCY, its agent or another representative offered or gave a gratuity (e.g., an entertainment or gift) to an official or employee of RECEIVING AGENCY for the purpose of obtaining a contract or favorable treatment; (f) PERFORMING AGENCY's management system does not meet the UGMS management standards; or (g) PERFORMING AGENCY appears to be financially unstable. Indicators of financial instability may include one or more of the following: (i) PERFORMING AGENCY fails to make payments; (ii) PERFORMING AGENCY makes an assignment for the benefit of its creditors; (iii) PERFORMING AGENCY admits in writing its inability to pay its debts generally as they become due; (Independent) 2000 GENERAL PROVISIONS Page 22 4/99 (iv) If judgment for the payment of money in excess of $50,000 (which is not covered by insurance) is rendered by any court or governmental body against PERFORMING AGENCY, and PERFORMING AGENCY does not (a) discharge the judgment or (b) provide for its discharge in accordance with its terms, or (c) procure a stay of execution within 30 days from the date of entry thereof, and within the 30-day period or a longer period during which execution of the judgment shall have been stayed, appeal therefrom and cause the execution thereof to be stayed during such appeal while providing such reserves therefore as may be required under generally accepted accounting principles; (v) A writ or warrant of attachment or any similar process shall be issued by any court against all or any material portion of the property of PERFORMING AGENCY, and such writ or warrant of attachment or any similar process is not released or bonded within 30 days after its entry; (vi) PERFORMING AGENCY is adjudicated bankrupt or insolvent; (vii) PERFORMING AGENCY files a case under the Federal Bankruptcy Code or is seeking relief under any provision of any bankruptcy, reorganization, arrangement, insolvency, readjustment of debt, dissolution, receivership or liquidation law of any jurisdiction, whether now or hereafter in effect, or consents to the filing of any case or petition against it under any such law; (viii) Any property or portion of the property of PERFORMING AGENCY is sequestered by court order and the order remains in effect for more than 30 days after PERFORMING AGENCY obtains knowledge thereof, (ix) A petition is filed against PERFORMING AGENCY under any state reorganization, arrangement, insolvency, readjustment of debt, dissolution, liquidation, or receivership law of any jurisdiction, whether now or hereafter in effect, and such petition is not dismissed within 30 days; or (x) PERFORMING AGENCY consents to the appointment of a receiver, trustee, or liquidator of PERFORMING AGENCY or of all or any part of its property. C. Emergency termination. RECEIVING AGENCY may terminate the contract immediately upon notice to PERFORMING AGENCY in an emergency by any verifiable means. "Emergency" is defined in the Sanctions Article. Either party may deliver written notice of intent to terminate by any verifiable method. If either party gives notice of its intent to terminate all or a part of this contract, RECEIVING AGENCY and PERFORMING AGENCY will try to resolve any issues related to the anticipated termination in good faith during the notice period. Upon termination of all or part of this contract, RECEIVING AGENCY and PERFORMING AGENCY will be discharged from any further obligation created under the applicable terms of this contract except for the equitable settlement of the respective accrued interests or obligations incurred prior to termination. Termination does not, however, constitute a waiver of any remedies for breach of this contract. In addition, the obligations of PERFORMING AGENCY to retain records and maintain confidentiality of information shall survive this contract. ARTICLE 34. Void Contract (Independent) 2000 GENERAL PROVISIONS Page 23 4/99 RECEIVING AGENCY may hold a contract void upon determination that the contract award was obtained fraudulently or was otherwise illegal or invalid from its inception. ARTICLE 35. Severability If any provision of this contract is construed to be illegal or invalid, the illegal or invalid provision will be deemed stricken and deleted to the same extent and effect as if never incorporated, but all other provisions will continue. ARTICLE 36. Survival of Terms Termination or expiration of this contract for any reason shall not release either party from any liabilities or obligations set forth in this contract that (a) the parties have expressly agreed shall survive any such termination or expiration, or (b) remain to be performed or by their nature would be intended to be applicable following any such termination or expiration. ARTICLE 37. No Waiver of Sovereign Immunity THE PARTIES EXPRESSLY AGREE THAT NO PROVISION OF THIS CONTRACT IS IN ANY WAY INTENDED TO CONSTITUTE A WAIVER BY RECEIVING AGENCY OR THE STATE OF TEXAS OF ANY IMMUNITIES FROM SUITOR FROM LIABILITY THAT RECEIVING AGENCY OR THE STATE OF TEXAS MAY HAVE BY OPERATION OF LAW. (Independent) 2000 GENERAL PROVISIONS Page 24 4/99 Resolution No. 2000-R00 77 March 23, 2000 Item No. 21 APPENDIX C TDH EXECUTIVE ORDER 0110 PROTEST OF APPLICATION OR BID DENIAL Order Number: XO-0110 Subject: PROTEST OF APPLICATION OR BID DENIAL (a) Purpose. The purpose of this policy is to establish the procedure for dispute resolution for any applicant that has responded to a Texas Department of Health (department) solicitation such as a request for proposal [RFP] or a request for application [RFA] for client services. (b) Exceptions. A state statute or rule or a federal statute, regulation or guideline will prevail over the provisions of this policy unless the statute, rule, regulation, or guideline can be read together with the provision or provisions of this policy to give effect to both. (c) Definitions. (1) Client services contracts - Contracts with a subrecipient to carry out a department program to benefit eligible clients. A listing of TDH programs that have client services contracts is maintained in the Grants Management Division. (2) Contract - A legally enforceable agreement by which goods, services, property, or property rights are to be provided in return for consideration. (3) Financial services - The department office responsible for the function of assessing provider compliance with the financial requirements under a contract. (4) Representative - Person designated by a program or by the appropriate financial services office to negotiate with an applicant to resolve a dispute. (5) Reviewer(s) - A person designated by the Associate Commissioner of the Associateship that issued the solicitation, the Associate Commissioner for Human Resources and Support, and the Associate Commissioner for Information Resources and Business Management, or three persons, one appointed by each Associate Commissioner, who review information and reach a decision concerning intended action. Any questions during this process may be directed to the Office of General CounseL (6) Subrecipient - Any person, agency or establishment, government department, or nonprofit organization that receives federal or state assistance to carry out a program through a primary recipient such as a state or local government, or other subrecipient, but does not include an individual that is a beneficiary of such a program A subrecipient may also be a direct recipient of federal assistance under other agreements or programs. Distinguishing characteristics of a subrecipient include determining eligibility for assistance, measuring performance against meeting the objectives of the program, programmatic decision -making, and conforming with applicable program compliance requirements. Subrecipient is synonymous with subcontractor. (d) Request for Review. An applicant may request review of a department action that denies the award of a contract for client services to the applicant. (1) Notice of Dispute. (A) An applicant may dispute the denial by giving notice of the dispute in writing to the addressee to whom the original application was made. This notice may be faxed. (B) The department must receive the notice of dispute no later than the close of business three (3) working days after the daze the applicant knows or should have known of the action the applicant is disputing. (C) The notice is the basis for all further action and should contain the following information: (1) a copy of the letter from the department notifying the applicant of the action; (n) an identification of the issue or issues to be resolved. (iui) a precise statement of the relevant facts; (iv) a statement or argument in support of the action or actions requested; and (v) any documentation of the applicant's position. (2) Dispute Resolution Procedures. (A) The representative will schedule a meeting or conference call to attempt to resolve the issues in dispute. (B) The representative will give written notice of resolution of the dispute to the bureau chiefor division director, as appropriate, ofthe department office that issued the solicitation. (C) Any resolution will be reduced to writing and will be acknowledged by both applicant and representative. (D) If the dispute was not resolved, the program representative will notify in writing the other party and the bureau chief or the division director, as appropriate, of the department office that issued the solicitation that the dispute has not been resolved or that the resolution cannot be satisfactorily reduced to writing. (1) The bureau chief or division director, as appropriate, of the department office will contact the three associate commissioners, who will appoint a reviewer(s). (n) The bureau chief or division director, as appropriate, wffi forward the applicant's notice and the response of the representative to the reviewer(s). (ini) Ifthe reviewer(s) determine that additional infonmationis necessary or desirable, the reviewer(s) may permit or require additional information. (iv) The reviewer(s) may grant, deny, or modify all relief requested in the request for dispute resolution (v) The reviewer(s)'s decision wdi be in writing and will contain a discussion of the reason for the decision and the remedial action, if any. (vii) The reviewer(s) will send copies of the decision to the applicant, the representative, and any other interested parties when the decision has been reduced to writing. The decision may be faxed. (AD The decision of the reviewer(s) is finaL ISSUED BY: Patti J. Patterson, M.D. Commissioner of Health DATE: June 18, 1997 REVIEW/REVISION DATES: