HomeMy WebLinkAboutResolution - 2023-R0327 - DSHS Contract No. HHS001331300015 Immunization Locals Grant Program 6.27.23Resolution No. 2023-RO327
Item No. 0327
June 27, 2023
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the Mayor of the City of Lubbock is hereby authorized and directed to execute
for and on behalf of the City of Lubbock, Department of State Health Services Contract No.
HHS001331300015 under the Immunization Locals Grant Program, by and between the City
of Lubbock and the State of Texas' Department of State Health Services (DSHS), and all
related documents. Said Contract is attached hereto and incorporated in this resolution as if
fully set forth herein and shall be included in the minutes of the City Council.
Passed by the City Council on June 27, 2023
APPROVED AS TO
Bill HowAorl, Deputy City
APPROVED AS TO FORM:
Foster, A sdsiant City Attorney
RESMI-IS-1-11-IS001331300015 Immunization Locals Grant Program
6.5.23
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TEXAS
• Texas Department of State Health Services
`t. Health and Human
Services Jennifer A. Shuford, M.D., M.P.H.
Commissioner
Resolution No. 2023-RO327
The Honorable Tray Payne, Mayor
City of Lubbock
PO Box 2000
Lubbock, Texas 79408
Subject: IMM/LOCALS
Contract Number: HHS001331300015
Contract Amount: $232,115.00
Contract Term: September 1, 2023, through August 31, 2024
Dear Mayor Payne:
Enclosed is the IMM/LOCALS contract between the Department of State Health
Services and City of Lubbock.
The purpose of this contract is to prevent and control the transmission of vaccine -
preventable diseases in children and adults, with emphasis on accelerating strategic
interventions to improve their vaccine coverage levels.
Please let me know if you have any questions or need additional information.
Sincerely,
Shelva Mays, CTCM
Contract Manager
Shelva.mays@dshs.texas.gov
P.O. Box 149347 • Austin, Texas 78714-9347 • Phone: 888-963-7111 • TTY: 800-735-2989 • dshs.texas.gov
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Total State Funds: $128,839.00
All expenditures under the Grant Agreement will be in accordance with ATTACHMENT B,
BUDGET.
VI. REPORTING REQUIREMENTS
Grantee shall submit reports in accordance with the requirements specified in ATTACHMENT A,
STATEMENT OF WORK.
VII. CONTRACT REPRESENTATIVES
The following will act as the representative authorized to administer activities under this Grant
Agreement on behalf of their respective Party.
System Auncy Grantee
Shelva Mays Katherine Wells
Department of State Health Services City of Lubbock
P.O. Box 149347 — Mail Code 1990 PO Box 2000
Austin, Texas 78714-9347 Lubbock, Texas 79408
cros covidimm(Rdshs.texas. gov kwells(@mylubbock.us
VIII. NOTICE REQUIREMENTS
A. All notices given by Grantee shall be in writing, include the Grant Agreement contract
number, comply with all terms and conditions of the Grant Agreement, and be delivered to
the System Agency's Contract Representative identified above.
B. Grantee shall send legal notices to System Agency at the address below and provide a copy
to the System Agency's Contract Representative:
Health and Human Services Commission
4601 W. Guadalupe, Mail Code 1100
Austin, Texas 78751
Attn: Office of Chief Counsel
With a copy to:
Department of State Health Services
1100 W. 49th Street, Mail Code 1919
Austin, Texas 78756
Attention: Office of General Counsel
C. Notices given by System Agency to Grantee may be emailed, mailed or sent by common
carrier. Email notices shall be deemed delivered when sent by System Agency. Notices sent
System Agency Grant Agreement, Contract # HHS001331300015
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ATTACHMENT A —STATEMENT OF WORK
ATTACHMENT B — BUDGET
ATTACHMENT C — HHS CONTRACT AFFIRMATIONS V. 2.2 (MAY 2022)
ATTACHMENT D — HHS UNIFORM TERMS AND CONDITIONS — GRANT V. 3.2
(JULY 2022)
ATTACHMENT E — DATA USE AGREEMENT-TACCHO VERSION (OCTOBER 23,
2019)
ATTACHMENT E-1 DATA USE AGREEMENT -SECURITY AND PRIVACY INQUIRY
ATTACHMENT F — ADDITIONAL PROVISIONS
ATTACHMENT G — FEDERAL ASSURANCES
ATTACHMENT H — CERTIFICATION REGARDING LOBBYING
ATTACHMENT I — DISCLOSURE OF LOBBYING ACTIVITIES (SF-LLL)
ATTACHMENT J — FFATA CERTIFICATION FORM
XI. SIGNATURE AUTHORITY
Each Party represents and warrants that the person executing this Grant Agreement on its
behalf has full power and authority to enter into this Grant Agreement. Any services or work
performed by Grantee before this Grant Agreement is effective or after it ceases to be effective
is performed at the sole risk of Grantee.
SIGNATURE PAGE FOLLOWS
System Agency Grant Agreement, Contract # HHS001331300015
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ATTACHMENT A
STATEMENT OF WORK
I. GRANTEE RESPONSIBILITIES
Grantee shall:
A. Implement and operate an immunization program for children, adolescents, and adults,
with special emphasis on accelerating interventions to improve the immunization
coverage of children three (3) years of age or younger (birth to 35 months of age).
Grantee shall incorporate traditional and non-traditional systematic approaches
designed to eliminate barriers, expand immunization capacity, and establish uniform
operating policies, as described herein.
B. Be enrolled as a provider in the Texas Vaccines for Children (TVFC) and the Adult
Safety Net (ASN) Programs by the effective date of this Contract. This includes a
signed Deputization Addendum Form (EFI1-13999).
C. Maintain staffing levels to meet required activities of the Contract and ensure staff
funded by this Contract attend required training.
D. Report all notifiable conditions as specified in Texas Administrative Code (TAC) Title
25, Part I § § 97.1-97.6, as amended, and as otherwise required by law.
E. Report all vaccine adverse event occurrences in accordance with the 1986 National
Childhood Vaccine Injury Act (NCVIA) 42 U.S.C. § 300aa-25 (located at
http://vaers.hhs.gov/ or 1-800-822-7967, as amended.
F. Sustain a network of TVFC/ASN providers to administer vaccines to program -eligible
populations by conducting the following activities:
1. Ensuring New Provider Checklist is completed;
2. Conducting quality assurance reviews;
3. Ensuring annual influenza pre -book survey is completed;
4. Conducting compliance site visits;
5. Conducting unannounced storage and handling visits; and
6. Ensuring providers adhere to the vaccine borrowing procedure.
G. Participate in audits and assessments through the following activities:
1. Completing and submitting through Child Health Reporting System (CHRS) all
audits and assessments conducted on childcare facilities and Head Start
Centers;
2. Completing audits, assessments and retrospective surveys of public and private
schools;
3. Reviewing monthly reports to ensure data quality;
4. Reviewing the monthly Provider Activity Reports;
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A. Report the number of doses administered to underinsured children monthly, as directed by
DSHS.
B. Report the number of unduplicated underinsured clients served, as directed by DSHS.
C. Complete and submit Immunization Inter -Local Agreement (ILA) Quarterly Report form,
utilizing the format provided by the DSHS Immunization Section and available at
https://dshs.texas.gov immunize/lhd.shtm by the report due date. If the due date falls on a
weekend or state approved holiday, the report is due the next business day.
Report Type
Reporting Period
Report Due Date
Programmatic
09/01/2023 to 11/30/2023
12/31/2023
Programmatic
12/01/2023 to 02/29/2024
03/31/2024
Programmatic
03/01/2024 to 05/31/2024
06/30/2024
Programmatic
06/01/2024 to 08/31/2024
09/30/2024
Submit quarterly reports electronically through an online tool according to the
timeframes stated above. DSHS Immunization Section will provide instructions at the
beginning of each state fiscal year through CMS. Supplemental report documents
(PEAR and AFIX reports, vacancy letters, etc.) should be sent to
dshsimmunizationcontracts@,dshs.texas.gov.
D. Submit the Financial Status Report (FSR-269A) biannually as outlined
below. Grantee shall email the Financial Status Report (FSR-269A) to the following
email address: FSR rg ants(@dshs.texas.gov.
Period Covered
Due Date
September 1, 2023 — February 29, 2024
February 29, 2024
March 1, 2024 - August 31, 2024
September 31, 2024
E. Maintain an inventory of equipment, supplies defined as Controlled Assets, and real
property. Submit an annual cumulative report of the equipment and other property on HHS
System Agency Grantee's Property Inventory Report to the designated DSHS Contract
Manager and fsoequip(@dshs.texas.gov by email not later than October 15 of each year.
Controlled Assets include firearms, regardless of the acquisition cost, and the following
assets with an acquisition cost of $500 or more, but less than $5,000: desktop and laptop
computers (including notebooks, tablets and similar devices), non -portable printers and
copiers, emergency management equipment, communication devices and systems, medical
and laboratory equipment, and media equipment. Controlled Assets are considered
Supplies.
F. Provide written notification of budget transfers by submission of a revised Categorical
Budget Form to the designated DSHS Contract Manager, highlighting the areas affected
by the budget transfer. Grantee is advised as follows:
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close-out invoice and final financial status report no later than 45 days following the end
of the Contract term. Invoices received more than 45 days after the end of the Contract
term are subject to denial of payment. Grantee shall electronically submit all invoices with
supporting documentation to: invoices()dshs.texas. gov and
CMSinvoices(a,dshs.texas.gov and a copy to the assigned DSHS Contract Representative
identified in the Signature Document.
A. At a minimum, voucher should include:
1. Grantee name, address, email address, vendor identification number, and
telephone number;
2. DSHS Contract or Purchase Order number;
3. Dates services were completed and/or products were delivered;
4. The total invoice amount; and
5. Any additional supporting documentation which is required by the Statement
of Work or as requested by DSHS.
Failure to submit required information may result in delay of payment or return of
invoice. Billing invoices must be legible. Illegible or incomplete invoices which
cannot be verified will be disallowed for payment.
B. DSHS will pay Grantee monthly on a cost reimbursement basis and in accordance
with ATTACHMENT B, BUDGET, of this Contract. DSHS will reimburse Grantee
only for allowable and reported expenses incurred within the grant term.
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HEALTH AND HUMAN SERVICES
Contract Number HHS001331300015
Attachment C CONTRACT AFFIRMATIONS
For purposes of these Contract Affirmations, HHS includes both the Health and Human Services
Commission (HHSC) and the Department of State Health Services (DSHS). System Agency
refers to HHSC, DSHS, or both, that will be a party to this Contract. These Contract
Affirmations apply to all Contractors and Grantees (referred to as "Contractor") regardless of
their business form (e.g., individual, partnership, corporation).
By entering into this Contract, Contractor affirms, without exception, understands, and agrees to
comply with the following items through the life of the Contract:
1. Contractor represents and warrants that these Contract Affirmations apply to Contractor
and all of Contractor's principals, officers, directors, shareholders, partners, owners,
agents, employees, subcontractors, independent contractors, and any other representatives
who may provide services under, who have a financial interest in, or otherwise are
interested in this Contract and any related Solicitation.
2. Complete and Accurate Information
Contractor represents and warrants that all statements and information provided to HHS
are current, complete, and accurate. This includes all statements and information in this
Contract and any related Solicitation Response.
3. Public Information Act
Contractor understands that HHS will comply with the Texas Public Information Act
(Chapter 552 of the Texas Government Code) as interpreted by judicial rulings and
opinions of the Attorney General of the State of Texas. Information, documentation, and
other material prepared and submitted in connection with this Contract or any related
Solicitation may be subject to public disclosure pursuant to the Texas Public Information
Act. In accordance with Section 2252.907 of the Texas Government Code, Contractor is
required to make any information created or exchanged with the State pursuant to the
Contract, and not otherwise excepted from disclosure under the Texas Public Information
Act, available in a format that is accessible by the public at no additional charge to the
State.
4. Contracting Information Requirements
Contractor represents and warrants that it will comply with the requirements of Section
552.372(a) of the Texas Government Code. Except as provided by Section 552.374(c) of
the Texas Government Code, the requirements of Subchapter J (Additional Provisions
Related to Contracting Information), Chapter 552 of the Government Code, may apply to
the Contract and the Contractor agrees that the Contract can be terminated if the
Contractor knowingly or intentionally fails to comply with a requirement of that
subchapter.
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and acknowledges that this Contract may be terminated and payment withheld if this
certification is inaccurate.
12. Child Support Obligation
Under Section 231.006(d) of the Texas Family Code regarding child support, Contractor
certifies that the individual or business entity named in this Contract and any related
Solicitation Response is not ineligible to receive the specified payment and acknowledges
that the Contract may be terminated and payment may be withheld if this certification is
inaccurate. If the certification is shown to be false, Contractor may be liable for additional
costs and damages set out in 231.006(f).
13. Suspension and Debarment
Contractor certifies that it and its principals are not suspended or debarred from doing
business with the state or federal government as listed on the State of Texas Debarred
Vendor List maintained by the Texas Comptroller of Public Accounts and the System for
Award Management (SAM) maintained by the General Services Administration. This
certification is made pursuant to the regulations implementing Executive Order 12549 and
Executive Order 12689, Debarment and Suspension, 2 C.F.R. Part 376, and any relevant
regulations promulgated by the Department or Agency funding this project. This
provision shall be included in its entirety in Contractor's subcontracts, if any, if payment
in whole or in part is from federal funds.
14. Excluded Parties
Contractor certifies that it is not listed in the prohibited vendors list authorized by
Executive Order 13224, "Blocking Property and Prohibiting Transactions with Persons
Who Commit, Threaten to Commit, or Support Terrorism, " published by the United States
Department of the Treasury, Office of Foreign Assets Control.'
15. Foreign Terrorist Organizations
Contractor represents and warrants that it is not engaged in business with Iran, Sudan, or a
foreign terrorist organization, as prohibited by Section 2252.152 of the Texas Government
Code.
16. Executive Head of a State Agency
In accordance with Section 669.003 of the Texas Government Code, relating to
contracting with the executive head of a state agency, Contractor certifies that it is not (1)
the executive head of an HHS agency, (2) a person who at any time during the four years
before the date of this Contract was the executive head of an HHS agency, or (3) a person
who employs a current or former executive head of an HHS agency.
17. Human Trafficking Prohibition
Under Section 2155.0061 of the Texas Government Code, Contractor certifies that the
individual or business entity named in this Contract is not ineligible to receive this
Contract and acknowledges that this Contract may be terminated and payment withheld if
this certification is inaccurate.
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26. Restricted Employment for Certain State Personnel
Contractor acknowledges that, pursuant to Section 572.069 of the Texas Government
Code, a former state officer or employee of a state agency who during the period of state
service or employment participated on behalf of a state agency in a procurement or
contract negotiation involving Contractor may not accept employment from Contractor
before the second anniversary of the date the Contract is signed or the procurement is
terminated or withdrawn.
27. No Conflicts of Interest
A. Contractor represents and warrants that it has no actual or potential conflicts of
interest in providing the requested goods or services to System Agency under this
Contract or any related Solicitation and that Contractor's provision of the requested
goods and/or services under this Contract and any related Solicitation will not
constitute an actual or potential conflict of interest or reasonably create an appearance
of impropriety.
B. Contractor agrees that, if after execution of the Contract, Contractor discovers or is
made aware of a Conflict of Interest, Contractor will immediately and fully disclose
such interest in writing to System Agency. In addition, Contractor will promptly and
fully disclose any relationship that might be perceived or represented as a conflict
after its discovery by Contractor or by System Agency as a potential conflict. System
Agency reserves the right to make a final determination regarding the existence of
Conflicts of Interest, and Contractor agrees to abide by System Agency's decision.
28. Fraud, Waste, and Abuse
Contractor understands that HHS does not tolerate any type of fraud, waste, or abuse.
Violations of law, agency policies, or standards of ethical conduct will be investigated,
and appropriate actions will be taken. Pursuant to Texas Government Code, Section
321.022, if the administrative head of a department or entity that is subject to audit by the
state auditor has reasonable cause to believe that money received from the state by the
department or entity or by a client or contractor of the department or entity may have
been lost, misappropriated, or misused, or that other fraudulent or unlawful conduct has
occurred in relation to the operation of the department or entity, the administrative head
shall report the reason and basis for the belief to the Texas State Auditor's Office (SAO).
All employees or contractors who have reasonable cause to believe that fraud, waste, or
abuse has occurred (including misconduct by any HHS employee, Grantee officer, agent,
employee, or subcontractor that would constitute fraud, waste, or abuse) are required to
immediately report the questioned activity to the Health and Human Services
Commission's Office of Inspector General. Contractor agrees to comply with all
applicable laws, rules, regulations, and System Agency policies regarding fraud, waste,
and abuse including, but not limited to, HHS Circular C-027.
A report to the SAO must be made through one of the following avenues:
• SAO Toll Free Hotline: 1-800-TX-AUDIT
• SAO website: http://sao.fraud.state.tx.us
All reports made to the OIG must be made through one of the following avenues:
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31. No Felony Criminal Convictions
Contractor represents that neither Contractor nor any of its employees, agents, or
representatives, including any subcontractors and employees, agents, or representative of
such subcontractors, have been convicted of a felony criminal offense or that if such a
conviction has occurred Contractor has fully advised System Agency in writing of the
facts and circumstances surrounding the convictions.
32. Unfair Business Practices
Contractor represents and warrants that it has not been the subject of allegations of
Deceptive Trade Practices violations under Chapter 17 of the Texas Business and
Commerce Code, or allegations of any unfair business practice in any administrative
hearing or court suit and that Contractor has not been found to be liable for such practices
in such proceedings. Contractor certifies that it has no officers who have served as
officers of other entities who have been the subject of allegations of Deceptive Trade
Practices violations or allegations of any unfair business practices in an administrative
hearing or court suit and that such officers have not been found to be liable for such
practices in such proceedings.
33. Entities that Boycott Israel
Contractor represents and warrants that (1) it does not, and shall not for the duration of
the Contract, boycott Israel or (2) the verification required by Section 2271.002 of the
Texas Government Code does not apply to the Contract. If circumstances relevant to this
provision change during the course of the Contract, Contractor shall promptly notify
System Agency.
34. E-Verify
Contractor certifies that for contracts for services, Contractor shall utilize the U.S.
Department of Homeland Security's E-Verify system during the term of this Contract to
determine the eligibility of:
1. all persons employed by Contractor to perform duties within Texas; and
2. all persons, including subcontractors, assigned by Contractor to perform work
pursuant to this Contract within the United States of America.
35. Former Agency Employees — Certain Contracts
If this Contract is an employment contract, a professional services contract under Chapter
2254 of the Texas Government Code, or a consulting services contract under Chapter
2254 of the Texas Government Code, in accordance with Section 2252.901 of the Texas
Government Code, Contractor represents and warrants that neither Contractor nor any of
Contractor's employees including, but not limited to, those authorized to provide services
under the Contract, were former employees of an HHS Agency during the twelve (12)
month period immediately prior to the date of the execution of the Contract.
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39. Prohibition on Certain Telecommunications and Video Surveillance Services or
Equipment (2 CFR 200.216)
Contractor certifies that the individual or business entity named in this Response or
Contract is not ineligible to receive the specified Contract or funding pursuant to 2 CFR
200.216.
40. COVID-19 Vaccine Passports
Pursuant to Texas Health and Safety Code, Section 161.0085(c), Contractor certifies that
it does not require its customers to provide any documentation certifying the customer's
COVID-19 vaccination or post -transmission recovery on entry to, to gain access to, or to
receive service from the Contractor's business. Contractor acknowledges that such a
vaccine or recovery requirement would make Contractor ineligible for a state -funded
contract.
41. Entities that Boycott Energy Companies
In accordance with Senate Bill 13, Acts 2021, 87th Leg., R.S., pursuant to Section
2274.002 of the Texas Government Code (relating to prohibition on contracts with
companies boycotting certain energy companies), Contractor represents and warrants
that: (1) it does not, and will not for the duration of the Contract, boycott energy
companies or (2) the verification required by Section 2274.002 of the Texas Government
Code does not apply to the Contract. If circumstances relevant to this provision change
during the course of the Contract, Contractor shall promptly notify System Agency.
42. Entities that Discriminate Against Firearm and Ammunition Industries
In accordance with Senate Bill 19, Acts 2021, 87th Leg., R.S., pursuant to Section
2274.002 of the Texas Government Code (relating to prohibition on contracts with
companies that discriminate against firearm and ammunition industries), Contractor
verifies that: (1) it does not, and will not for the duration of the Contract, have a practice,
policy, guidance, or directive that discriminates against a firearm entity or firearm trade
association or (2) the verification required by Section 2274.002 of the Texas Government
Code does not apply to the Contract. If circumstances relevant to this provision change
during the course of the Contract, Contractor shall promptly notify System Agency.
43. Security Controls for State Agency Data
In accordance with Senate Bill 475, Acts 2021, 87th Leg., R.S., pursuant to Texas
Government Code, Section 2054.138, Contractor understands, acknowledges, and agrees
that if, pursuant to this Contract, Contractor is or will be authorized to access, transmit,
use, or store data for System Agency, Contractor is required to meet the security controls
the System Agency determines are proportionate with System Agency's risk under the
Contract based on the sensitivity of System Agency's data and that Contractor must
periodically provide to System Agency evidence that Contractor meets the security
controls required under the Contract.
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access to or control of critical infrastructure, as defined by Section 113.001 of the Texas
Business & Commerce Code, in this state.
49. Enforcement of Certain Federal Firearms Laws Prohibited
In accordance with House Bill 957, Acts 2021, 87th Leg., R.S., if Texas Government
Code, Section 2.101 is applicable to Contractor, Contractor certifies that it is not
ineligible to receive state grant funds pursuant to Texas Government Code, Section
2.103.
50. Prohibition on Abortions
Contractor understands, acknowledges, and agrees that, pursuant to Article II of the
General Appropriations Act, (1) no funds shall be used to pay the direct or indirect costs
(including marketing, overhead, rent, phones, and utilities) of abortion procedures
provided by contractors of HHSC; and (2) no funds appropriated for Medicaid Family
Planning, Healthy Texas Women Program, or the Family Planning Program shall be
distributed to individuals or entities that perform elective abortion procedures or that
contract with or provide funds to individuals or entities for the performance of elective
abortion procedures. Contractor represents and warrants that it is not ineligible, nor will it
be ineligible during the term of this Contract, to receive appropriated funding pursuant to
Article 11.
51. False Representation
Contractor understands, acknowledges, and agrees that any false representation or any
failure to comply with a representation, warranty, or certification made by Contractor is
subject to all civil and criminal consequences provided at law or in equity including, but
not limited to, immediate termination of this Contract.
52. False Statements
Contractor represents and warrants that all statements and information prepared and
submitted by Contractor in this Contract and any related Solicitation Response are
current, complete, true, and accurate. Contractor acknowledges any false statement or
material misrepresentation made by Contractor during the performance of this Contract
or any related Solicitation is a material breach of contract and may void this Contract.
Further, Contractor understands, acknowledges, and agrees that any false representation
or any failure to comply with a representation, warranty, or certification made by
Contractor is subject to all civil and criminal consequences provided at law or in equity
including, but not limited to, immediate termination of this Contract.
53. Permits and License
Contractor represents and warrants that it will comply with all applicable laws and
maintain all permits and licenses required by applicable city, county, state, and federal
rules, regulations, statutes, codes, and other laws that pertain to this Contract.
54. Equal Employment Opportunity
Contractor represents and warrants its compliance with all applicable duly enacted state
and federal laws governing equal employment opportunities.
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Authorized representative on behalf of Contractor must complete and sign the following:
Legal Name of Contractor
Assumed Business Name of Contractor, if applicable (d/b/a or `doing business as')
Texas County(s) for Assumed Business Name (d/b/a or `doing business as')
Attach Assumed Name Certificate(s) filed with the Texas Secretary of State and Assumed
Name Certificate(s), if any, for each Texas County Where Assumed Name Certificate(s) has
been filed.
Signature of Authorized Representative Date Signed
Printed Name of Authorized Representative Title of Authorized Representative
First, Middle Name or Initial, and Last Name
Physical Street Address City, State, Zip Code
Mailing Address, if different City, State, Zip Code
Phone Number Fax Number
Email Address DUNS Number
Federal Employer Identification Number Texas Identification Number (TIN)
Texas Franchise Tax Number Texas Secretary of State Filing
Number
SAM.gov Unique Entity Identifier (UEI)
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ABOUT THIS DOCUMENT
In this document, Grantees (also referred to in this document as subrecipients or contractors) will find
requirements and conditions applicable to grant funds administered and passed -through by both the Texas Health
and Human Services Commission (HHSC) and the Department of State Health Services (DSHS). These
requirements and conditions are incorporated into the Grant Agreement through acceptance by Grantee of any
funding award by HHSC or DSHS.
The terms and conditions in this document are in addition to all requirements listed in the RFA, if any, under
which applications for this grant award are accepted, as well as all applicable federal and state laws and
regulations. Applicable federal and state laws and regulations may include, but are not limited to: 2 CFR Part 200,
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards;
requirements of the entity that awarded the funds to HHS; Chapter 783 of the Texas Government Code; Texas
Comptroller of Public Accounts' agency rules (including Uniform Grant and Contract Standards set forth in Title
34, Part 1, Chapter 20, Subchapter E, Division 4 of the Texas Administrative Code); the Texas Grant
Management Standards (TxGMS) developed by the Texas Comptroller of Public Accounts; and the Funding
Announcement, Solicitation, or other instrument/documentation under which HHS was awarded funds. HHS, in
its sole discretion, reserves the right to add requirements, terms, or conditions.
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ARTICLE VI. INTELLECTUAL PROPERTY.............................................................
13
6.1
OWNERSHIP OF WORK PRODUCT.......................................................................
13
6.2
GRANTEE'S PRE-EXISTING WORKS...................................................................
14
6.3
THIRD PARTY IP.................................................................................................
14
6.4
AGREEMENTS WITH EMPLOYEES AND SUBCONTRACTORS ...............................
14
6.5
DELIVERY UPON TERMINATION OR EXPIRATION ..............................................
15
6.6
SURVIVAL............................................................................................................15
6.7
SYSTEM AGENCY DATA......................................................................................
15
ARTICLE VII. PROPERTY............................................................................................
15
7.1
USE OF STATE PROPERTY...................................................................................
15
7.2
DAMAGE TO STATE PROPERTY..........................................................................
16
7.3
PROPERTY RIGHTS UPON TERMINATION OR EXPIRATION OF CONTRACT .......
16
7.4
EQUIPMENT AND PROPERTY...............................................................................
16
ARTICLE VIII. RECORD RETENTION, AUDIT, AND CONFIDENTIALITY .....
17
8.1
RECORD MAINTENANCE AND RETENTION.........................................................
17
8.2
AGENCY'S RIGHT TO AUDIT...............................................................................
17
8.3
RESPONSE/COMPLIANCE WITH AUDIT OR INSPECTION FINDINGS ...................
18
8.4
STATE AUDITOR'S RIGHT TO AUDIT..................................................................
18
8.5
CONFIDENTIALITY..............................................................................................
18
ARTICLE IX. GRANT REMEDIES, TERMINATION AND PROHIBITED
ACTIVITIES......................................................................................................................19
9.1
REMEDIES............................................................................................................19
9.2
TERMINATION FOR CONVENIENCE....................................................................
19
9.3
TERMINATION FOR CAUSE ................................... :.............................................
19
9.4
GRANTEE RESPONSIBILITY FOR SYSTEM AGENCY'S TERMINATION COSTS....
20
9.5
INHERENTLY RELIGIOUS ACTIVITIES................................................................
20
9.6
POLITICAL ACTIVITIES.......................................................................................
20
ARTICLE X. INDEMNITY..............................................................................................
21
10.1
GENERAL INDEMNITY.........................................................................................
21
10.2
INTELLECTUAL PROPERTY.................................................................................
21
10.3
ADDITIONAL INDEMNITY PROVISIONS...............................................................
22
ARTICLE XI. GENERAL PROVISIONS......................................................................
22
11.1
AMENDMENTS.....................................................................................................
22
11.2
NO QUANTITY GUARANTEES..............................................................................
22
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ARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS
1.1 DEFINITIONS
As used in this Grant Agreement, unless a different definition is specified, or the context
clearly indicates otherwise, the following terms and conditions have the meanings assigned
below:
"Amendment" means a written agreement, signed by the Parties, which documents
changes to the Grant Agreement.
"Contract" or "Grant Agreement" means the agreement entered into by the Parties,
including the Signature Document, these Uniform Terms and Conditions, along with any
attachments and amendments that may be issued by the System Agency.
"Deliverables" means the goods, services, and work product, including all reports and
project documentation, required to be provided by Grantee to the System Agency.
"DSHS" means the Department of State Health Services.
"Effective Date" means the date on which the Grant Agreement takes effect.
"Federal Fiscal Year" means the period beginning October 1 and ending September 30
each year, which is the annual accounting period for the United States government.
" (;AAP" means Generally Accepted Accounting Principles.
"GASB" means the Governmental Accounting Standards Board.
"Grantee" means the Party receiving funds under this Grant Agreement. May also be
referred to as "subrecipient" or "contractor" in this document.
"HHSC" means the Texas Health and Human Services Commission.
"Health and Human Services" or "HHS" includes HHSC and DSHS.
"Intellectual Property Rights" means the worldwide proprietary rights or interests,
including patent, copyright, trade secret, and trademark rights, as such right may be
evidenced by or embodied in:
i. any idea, design, concept, personality right, method, process, technique,
apparatus, invention, discovery, or improvement;
ii. any work of authorship, including any compilation, computer code, website or
web page design, literary work, pictorial work, or graphic work;
iii. any trademark, service mark, trade dress, trade name, branding, or other indicia
of source or origin;
iv. domain name registrations; and
v. any other proprietary or similar rights. The Intellectual Property Rights of a Party
include all worldwide proprietary rights or interests that the Party may have
acquired by assignment, by exclusive license, or by license with the right to grant
sublicenses.
"Parties" means the System Agency and Grantee, collectively.
"Party" means either the System Agency or Grantee, individually.
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(including this Grant Agreement) and other contractual instruments shall be deemed to
include all subsequent Amendments and other modifications, but only to the extent that
such Amendments and other modifications are not prohibited by the terms of this Grant
Agreement, and (ii) references to any statute or regulation are to be construed as
including all statutory and regulatory provisions consolidating, amending, replacing,
supplementing, or interpreting the statute or regulation.
D. Any references to agreements, contracts, statutes, or administrative rules or regulations
in the Grant Agreement are references to these documents as amended, modified, or
supplemented during the term of the Grant Agreement.
E. The captions and headings of this Grant Agreement are for convenience of reference
only and do not affect the interpretation of this Grant Agreement.
F. All attachments, including those incorporated by reference, and any Amendments are
considered part of the terms of this Grant Agreement.
G. This Grant Agreement may use several different limitations, regulations, or policies to
regulate the same or similar matters. All such limitations, regulations, and policies are
cumulative.
H. Unless otherwise expressly provided, reference to any action of the System Agency or
by the System Agency by way of consent, approval, or waiver will be deemed modified
by the phrase "in its sole discretion."
I. Time is of the essence in this Grant Agreement.
J. Prior to execution of the Grant Agreement, Grantee must notify System Agency's
designated contact in writing of any ambiguity, conflict, discrepancy, omission, or other
error. If Grantee fails to notify the System Agency designated contact of any ambiguity,
conflict, discrepancy, omission or other error in the Grant Agreement prior to Grantee's
execution of the Grant Agreement, Grantee:
i. Shall have waived any claim of error or ambiguity in the Grant Agreement; and
ii. Shall not contest the interpretation by the System Agency of such provision(s).
No grantee will be entitled to additional reimbursement, relief, or time by reason of any
ambiguity, conflict, discrepancy, exclusionary specification, omission, or other error or
its later correction.
ARTICLE II. PAYMENT PROVISIONS
2.1 PROMPT PAYMENT
Payment shall be made in accordance with Chapter 2251 of the Texas Government Code,
commonly known as the Texas Prompt Payment Act. Chapter 2251 of the Texas
Government Code shall govern remittance of payment and remedies for late payment and
non-payment.
2.2 TAXES
Grantee represents and warrants that it shall pay all taxes or similar amounts resulting from
the Grant Agreement, including, but not limited to, any federal, State, or local income, sales
or excise taxes of Grantee or its employees. System Agency shall not be liable for any taxes
resulting from the Grant Agreement.
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2.9 INDIRECT COST RATES
The System Agency may acknowledge an indirect cost rate for Grantees that is utilized for
all applicable Grant Agreements. For subrecipients receiving federal funds, indirect cost
rates will be determined in accordance with applicable law including, but not limited to, 2
CFR 200.414(f). For recipients receiving state funds, indirect costs will be determined in
accordance with applicable law including, but not limited to, TxGMS. Grantees funded with
blended federal and state funding will be subject to both state and federal requirements when
determining indirect costs. In the event of a conflict between TxGMS and applicable federal
law or regulation, the provisions of federal law or regulation will apply. Grantee will provide
any necessary financial documents to determine the indirect cost rate in accordance with the
Uniform Grant Guidance (UGG) and TxGMS.
ARTICLE III. STATE AND FEDERAL FUNDING
3.1 EXCESS OBLIGATIONS PROHIBITED
This Grant Agreement is subject to termination or cancellation, without penalty to System
Agency, either in whole or in part, subject to the availability and actual receipt by System
Agency of state or federal funds. System Agency is a state agency whose authority and
appropriations are subject to actions of the Texas Legislature. If System Agency becomes
subject to a legislative change, revocation of statutory authority, or lack of appropriated
funds that would render either System Agency's or Grantee's delivery or performance under
the Grant Agreement impossible or unnecessary, the Grant Agreement will be terminated or
cancelled and be deemed null and void. In the event of a termination or cancellation under
this Section, System Agency will not be liable to Grantee for any damages that are caused or
associated with such termination or cancellation, and System Agency will not be required to
give prior notice. Additionally, System Agency will not be liable to Grantee for any
remaining unpaid funds under this Grant Agreement at time of termination.
3.2 NO DEBT AGAINST THE STATE
This Grant Agreement will not be construed as creating any debt by or on behalf of the State
of Texas.
3.3 DEBTS AND DELINQUENCIES
Grantee agrees that any payments due under the Grant Agreement shall be directly applied
towards eliminating any debt or delinquency it has to the State of Texas including, but not
limited to, delinquent taxes, delinquent student loan payments, and delinquent child support
during the entirety of the Grant Agreement term.
3.4 REFUNDS AND OVERPAYMENTS
A. At its sole discretion, the System Agency may (i) withhold all or part of any payments to
Grantee to offset overpayments, unallowable or ineligible costs made to the Grantee, or
if any required financial status report(s) is not submitted by the due date(s); or (ii) require
Grantee to promptly refund or credit - within thirty (30) calendar days of written notice —
to System Agency any funds erroneously paid by System Agency which are not expressly
authorized under the Grant Agreement.
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threshold amount includes federal funds passed through by way of state agency
awards.
iv. If Grantee, within Grantee's fiscal year, expends at least SEVEN HUNDRED FIFTY
THOUSAND DOLLARS ($750,000) in state funds awarded, Grantee shall have a
single audit or program -specific audit in accordance with TxGMS. The audit must be
conducted by an independent certified public accountant and in accordance with 2
CFR 200, Government Auditing Standards, and TxGMS.
v. For -profit Grantees whose expenditures meet or exceed the federal or state
expenditure thresholds stated above shall follow the guidelines in 2 CFR 200 or
TxGMS, as applicable, for their program -specific audits.
vi. Each Grantee required to obtain a single audit must competitively re -procure single
audit services once every six years. Grantee shall procure audit services in
compliance with this section, state procurement procedures, as well as with
applicable provisions of 2 CFR 200 and TxGMS.
B. Financial Statements.
Each Grantee that does not meet the expenditure threshold for a single audit or program -
specific audit, must provide financial statements for the audit period.
4.3 SUBMISSION OF AUDITS AND FINANCIAL STATEMENTS
A. Audits.
Due the earlier of 30 days after receipt of the independent certified public accountant's
report or nine months after the end of the fiscal year, Grantee shall submit one electronic
copy of the single audit or program -specific audit to the System Agency via:
i. HHS portal at https:Hhhsportal.hhs.state.tx.us/heartwebextr/hhscSau or,
ii. Email to: single audit rgporQahhsc.state.tx.us.
B. Financial Statements.
Due no later than nine months after the Grantee's fiscal year-end, Grantees not required
to submit an audit, shall submit one electronic copy of their financial statements via:
i. HHS portal at httl2s:Hhhsportal.hhs.state.tx.us/heartwebextr/hhscSau; or,
ii. Email to: single audit report(d) hhsc. state. tx.us.
ARTICLE V. WARRANTY, AFFIRMATIONS, ASSURANCES AND
CERTIFICATIONS
5.1 WARRANTY
Grantee warrants that all work under this Grant Agreement shall be completed in a manner
consistent with standards under the terms of this Grant Agreement, in the applicable trade,
profession, or industry; shall conform to or exceed the specifications set forth in the Grant
Agreement; and all deliverables shall be fit for ordinary use, of good quality, and with no
material defects. If System Agency, in its sole discretion, determines Grantee has failed to
complete work timely or to perform satisfactorily under conditions required by this Grant
Agreement, the System Agency may require Grantee, at its sole expense, to:
i. Repair or replace all defective or damaged work;
ii. Refund any payment Grantee received from System Agency for all defective or
damaged work and, in conjunction therewith, require Grantee to accept the return of
such work; and,
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D. In the event that Grantee has any rights in and to the Work Product that cannot be
assigned to System Agency, Grantee hereby grants to System Agency an exclusive,
worldwide, royalty -free, transferable, irrevocable, and perpetual license, with the right to
sublicense, to reproduce, distribute, modify, create derivative works of, publicly perform
and publicly display, make, have made, use, sell and offer for sale the Work Product and
any products developed by practicing such rights.
E. The foregoing does not apply to Incorporated Pre-existing Works or Third Party IP that
are incorporated in the Work Product by Grantee. Grantee shall provide System Agency
access during normal business hours to all Grantee materials, premises, and computer
files containing the Work Product.
6.2 GRANTEE'S PRE-EXISTING WORKS
A. To the extent that Grantee incorporates into the Work Product any works of Grantee that
were created by Grantee or that Grantee acquired rights in prior to the Effective Date of
this Grant Agreement ("Incorporated Pre-existing Works"), Grantee retains ownership
of such Incorporated Pre-existing Works.
B. Grantee hereby grants to System Agency an irrevocable, perpetual, non-exclusive,
royalty -free, transferable, worldwide right and license, with the right to sublicense, to
use, reproduce, modify, copy, create derivative works of, publish, publicly perform and
display, sell, offer to sell, make and have made, the Incorporated Pre-existing Works, in
any medium, with or without the associated Work Product.
C. Grantee represents, warrants, and covenants to System Agency that Grantee has all
necessary right and authority to grant the foregoing license in the Incorporated Pre-
existing Works to System Agency.
6.3 THIRD PARTY IP
A. To the extent that any Third Party IP is included or incorporated in the Work Product by
Grantee, Grantee hereby grants to System Agency, or shall obtain from the applicable
third party for System Agency's benefit, the irrevocable, perpetual, non-exclusive,
worldwide, royalty -free right and license, for System Agency's internal business or
governmental purposes only, to use, reproduce, display, perform, distribute copies of,
and prepare derivative works based upon such Third Party IP and any derivative works
thereof embodied in or delivered to System Agency in conjunction with the Work
Product, and to authorize others to do any or all of the foregoing.
B. Grantee shall obtain System Agency's advance written approval prior to incorporating
any Third Party IP into the Work Product, and Grantee shall notify System Agency on
delivery of the Work Product if such materials include any -Third Party IP.
C. Grantee shall provide System Agency all supporting documentation demonstrating
Grantee's compliance with this Section 6.3, including without limitation documentation
indicating a third party's written approval for Grantee to use any Third Party IP that may
be incorporated in the Work Product.
6.4 AGREEMENTS WITH EMPLOYEES AND SUBCONTRACTORS
Grantee shall have written, binding agreements with its employees and subcontractors that
include provisions sufficient to give effect to and enable Grantee's compliance with
Grantee's obligations under this Article VI, Intellectual Property.
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C. Grantee shall not remove State Property from the continental United States. In addition,
Grantee may not use any computing device to access System Agency's network or e-
mail while outside of the continental United States.
D. Grantee shall not perform any maintenance services on State Property unless the Grant
Agreement expressly authorizes such Services.
E. During the time that State Property is in the possession of Grantee, Grantee shall be
responsible for:
i. all repair and replacement charges incurred by State Agency that are associated with
loss of State Property or damage beyond normal wear and tear, and
ii. all charges attributable to Grantee's use of State Property that exceeds the Grant
Agreement scope. Grantee shall fully reimburse such charges to System Agency
within ten (10) calendar days of Grantee's receipt of System Agency's notice of
amount due. Use of State Property for a purpose not authorized by the Grant
Agreement shall constitute breach of contract and may result in termination of the
Grant Agreement and the pursuit of other remedies available to System Agency
under contract, at law, or in equity.
7.2 DAMAGE TO STATE PROPERTY
A. In the event of loss, destruction, or damage to any System Agency or State of Texas
owned, leased, or occupied property or equipment by Grantee or Grantee's employees,
agents, Subcontractors, or suppliers, Grantee shall be liable to System Agency and the
State of Texas for the full cost of repair, reconstruction, or replacement of the lost,
destroyed, or damaged property.
B. Grantee shall notify System Agency of the loss, destruction, or damage of equipment or
property within one (1) business day. Grantee shall reimburse System Agency and the
State of Texas for such property damage within ten (10) calendar days after Grantee's
receipt of System Agency's notice of amount due.
7.3 PROPERTY RIGHTS UPON TERMINATION OR EXPIRATION OF CONTRACT
In the event the Grant Agreement is terminated for any reason or expires, State Property
remains the property of the System Agency and must be returned to the System Agency by
the earlier of the end date of the Grant Agreement or upon System Agency's request.
7.4 EQUIPMENT AND PROPERTY
A The Grantee must ensure equipment with a per -unit cost of $5,000 or greater purchased
with grant funds under this award is used solely for the purpose of this Grant or is
properly pro -rated for use under this Grant. Grantee must have control systems to
prevent loss, damage, or theft of property funded under this Grant. Grantee shall
maintain equipment management and inventory procedures for equipment, whether
acquired in part or whole with grant funds, until disposition occurs.
B. When equipment acquired by Grantee under this Grant Agreement is no longer needed
for the original project or for other activities currently supported by System Agency, the
Grantee must properly dispose of the equipment pursuant to 2 CFR and/or TxGMS, as
applicable. Upon termination of this Grant Agreement, use and disposal of equipment by
the Grantee shall conform with TxGMS requirements.
C. Grantee shall initiate the purchase of all equipment approved in writing by the System
Agency in accordance with the schedule approved by System Agency, as applicable.
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representatives. In addition, agencies of the State of Texas that shall have a right of
access to records as described in this section include: the System Agency, HHS's
contracted examiners, the State Auditor's Office, the Office of the Texas Attorney
General, and any successor agencies. Each of these entities may be a duly authorized
authority.
C. If deemed necessary by the System Agency or any duly authorized authority, for the
purpose of investigation or hearing, Grantee shall produce original documents related to
this Grant Agreement.
D. The System Agency and any duly authorized authority shall have the right to audit
billings both before and after payment, and all documentation that substantiates the
billings.
E. Grantee shall include this provision concerning the right of access to, and examination
of, sites and information related to this Grant Agreement in any Subcontract it awards.
8.3 RESPONSE/COMPLIANCE WITH AUDIT OR INSPECTION FINDINGS
A. Grantee must act to ensure its and its Subcontractors' compliance with all corrections
necessary to address any finding of noncompliance with any law, regulation, audit
requirement, or generally accepted accounting principle, or any other deficiency
identified in any audit, review, or inspection of the Grant Agreement and the services
and Deliverables provided. Any such correction will be at Grantee's or its
Subcontractor's sole expense. Whether Grantee's action corrects the noncompliance shall
be solely the decision of the System Agency.
B. As part of the services, Grantee must provide to HHS upon request a copy of those
portions of Grantee's and its Subcontractors' internal audit reports relating to the services
and Deliverables provided to the State under the Grant Agreement.
8.4 STATE AUDITOR'S RIGHT TO AUDIT
The state auditor may conduct an audit or investigation of any entity receiving funds from the
state directly under the Grant Agreement or indirectly through a subcontract under the Grant
Agreement. The acceptance of funds directly under the Grant Agreement or indirectly
through a subcontract under the Grant Agreement acts as acceptance of the authority of the
state auditor, under the direction of the legislative audit committee, to conduct an audit or
investigation in connection with those funds. Under the direction of the legislative audit
committee, an entity that is the subject of an audit or investigation by the state auditor must
provide the state auditor with access to any information the state auditor considers relevant
to the investigation or audit.
8.5 CONFIDENTIALITY
Grantee shall maintain as confidential and shall not disclose to third parties without System
Agency's prior written consent, any System Agency information including but not limited to
System Agency's business activities, practices, systems, conditions and services. This
section will survive termination or expiration of this Grant Agreement. This requirement
must be included in all subcontracts awarded by Grantee.
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i. Material Breach
The System Agency may terminate the Grant Agreement, in whole or in part, if
the System Agency determines, in its sole discretion, that Grantee has materially
breached the Grant Agreement or has failed to adhere to any laws, ordinances,
rules, regulations or orders of any public authority having jurisdiction, whether or
not such violation prevents or substantially impairs performance of Grantee's duties
under the Grant Agreement. Grantee's misrepresentation in any aspect including,
but not limited to, of Grantee's Solicitation Application, if any, or Grantee's
addition to the SAM exclusion list (identification in SAM as an excluded entity)
may also constitute a material breach of the Grant Agreement.
ii. Failure to Maintain Financial Viability
The System Agency may terminate the Grant Agreement if the System Agency, in
its sole discretion, determines that Grantee no longer maintains the financial
viability required to complete the services and deliverables, or otherwise fully
perform its responsibilities under the Grant Agreement.
B. System Agency will specify the effective date of such termination in the notice to
Grantee. If no effective date is specified, the Grant Agreement will terminate on the
date of the notification.
9.4 GRANTEE RESPONSIBILITY FOR SYSTEM AGENCY'S TERMINATION COSTS
If the System Agency terminates the Grant Agreement for cause, the Grantee shall be
responsibleto the System Agency for all costs incurred by the System Agency and the State
of Texas to replace the Grantee. These costs include, but are not limited to, the costs of
procuring a substitute grantee and the cost of any claim or litigation attributable to Grantee's
failure to perform any work in accordance with the terms of the Grant Agreement.
9.5 INHERENTLY RELIGIOUS ACTIVITIES
Grantee may not use grant funding to engage in inherently religious activities, such as
proselytizing, scripture study, or worship. Grantees may engage in inherently religious
activities; however, these activities must be separate in time or location from the grant -
funded program. Moreover, grantees must not compel program beneficiaries to participate in
inherently religious activities. These requirements apply to all grantees, not just faith -based
organizations.
9.6 POLITICAL ACTIVITIES
Grant funds cannot be used for the following activities:
A. Grantees and their relevant sub -grantees or subcontractors are prohibited from using
grant funds directly or indirectly for political purposes, including lobbying, advocating
for legislation, campaigning for, endorsing, contributing to, or otherwise supporting
political candidates or parties, and voter registration campaigns. Grantees may use
private, or non -System Agency money or contributions for political purposes but may
not charge to, or be reimbursed from, System Agency contracts or grants for the costs of
such activities.
B. Grant -funded employees may not use official authority or influence to achieve any
political purpose and grant funds cannot be used for the salary, benefits, or any other
compensation of an elected official.
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AGENCY HAS ACCESS AS A RESULT OF GRANTEE'S PERFORMANCE
UNDER THE GRANT AGREEMENT.
10.3 ADDITIONAL INDEMNITY PROVISIONS
A. GRANTEE AND SYSTEM AGENCY AGREE TO FURNISH TIMELY
WRITTEN NOTICE TO EACH OTHER OF ANY INDEMNITY CLAIM.
GRANTEE SHALL BE LIABLE TO PAY ALL COSTS OF DEFENSE,
INCLUDING ATTORNEYS' FEES.
B. THE DEFENSE SHALL BE COORDINATED BY THE GRANTEE WITH THE
OFFICE OF THE TEXAS ATTORNEY GENERAL WHEN TEXAS STATE
AGENCIES ARE NAMED DEFENDANTS IN ANY LAWSUIT AND GRANTEE
MAY NOT AGREE TO ANY SETTLEMENT WITHOUT FIRST OBTAINING
THE CONCURRENCE FROM THE OFFICE OF THE TEXAS ATTORNEY
GENERAL.
C. GRANTEE SHALL REIMBURSE SYSTEM AGENCY AND THE STATE OF
TEXAS FOR ANY CLAIMS, DAMAGES, COSTS, EXPENSES OR OTHER
AMOUNTS, INCLUDING, BUT NOT LIMITED TO, ATTORNEYS' FEES AND
COURT COSTS, ARISING FROM ANY SUCH CLAIM. IF THE SYSTEM
AGENCY DETERMINES THAT A CONFLICT EXISTS BETWEEN ITS
INTERESTS AND THOSE OF GRANTEE OR IF SYSTEM AGENCY IS
REQUIRED BY APPLICABLE LAW TO SELECT SEPARATE COUNSEL,
SYSTEM AGENCY WILL BE PERMITTED TO SELECT SEPARATE
COUNSEL AND GRANTEE SHALL PAY ALL REASONABLE COSTS OF
SYSTEM AGENCY'S COUNSEL.
ARTICLE XI. GENERAL PROVISIONS
11.1 AMENDMENTS
Except as otherwise expressly provided, the Grant Agreement may only be amended by a
written Amendment executed by both Parties.
11.2 NO QUANTITY GUARANTEES
The System Agency makes no guarantee of volume or usage of work under this Grant
Agreement. All work requested may be on an irregular and as needed basis throughout the
Grant Agreement term.
11.3 CHILD ABUSE REPORTING REQUIREMENTS
A. Grantees shall comply with child abuse and neglect reporting requirements in Texas
Family Code Chapter 261. This section is in addition to and does not supersede any
other legal obligation of the Grantee to report child abuse.
B. Grantee shall use the Texas Abuse Hotline Website located at
https: www.txabusehotline.org Login/Default.aspx as required by the System
Agency. Grantee shall retain reporting documentation on site and make it available for
inspection by the System Agency.
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obligation, expense, or liability of any kind on behalf of System Agency or the State of
Texas.
B. Grantee may not rely upon implied authority and is not granted authority under the Grant
Agreement to:
i. Make public policy on behalf of the System Agency;
ii. Promulgate, amend, or disregard administrative regulations or program policy
decisions made by State and federal agencies responsible for administration of a
System Agency program; or
iii. Unilaterally communicate or negotiate with any federal or state agency or the Texas
Legislature on behalf of the System Agency regarding System Agency programs or
the Grant Agreement. However, upon System Agency request and with reasonable
notice from System Agency to the Grantee, the Grantee shall assist the System
Agency in communications and negotiations regarding the Work under the Grant
Agreement with state and federal governments.
11.7 CHANGE IN LAWS AND COMPLIANCE WITH LAWS
Grantee shall comply with all laws, regulations, requirements and guidelines applicable to a
Grantee providing services and products required by the Grant Agreement to the State of
Texas, as these laws, regulations, requirements and guidelines currently exist and as amended
throughout the term of the Grant Agreement. Notwithstanding Section 11.1, Amendments,
above, System Agency reserves the right, in its sole discretion, to unilaterally amend the Grant
Agreement to incorporate any modifications necessary for System Agency's compliance, as
an agency of the State of Texas, with all applicable state and federal laws, regulations,
requirements and guidelines.
11.8 SUBCONTRACTORS
Grantee may not subcontract any or all of the Work and/or obligations under the Grant
Agreement without prior written approval of the System Agency. Subcontracts, if any,
entered into by the Grantee shall be in writing and be subject to the requirements of the
Grant Agreement. Should Grantee subcontract any of the services required in the Grant
Agreement, Grantee expressly understands and acknowledges System Agency is in no
manner liable to any subcontractor(s) of Grantee. In no event shall this provision relieve
Grantee of the responsibility for ensuring that the services performed under all subcontracts
are rendered in compliance with the Grant Agreement.
11.9 PERMITTING AND LICENSURE
At Grantee's sole expense, Grantee shall procure and maintain for the duration of this Grant
Agreement any state, county, city, or federal license, authorization, insurance, waiver,
permit, qualification or certification required by statute, ordinance, law, or regulation to be
held by Grantee to provide the goods or services required by this Grant Agreement. Grantee
shall be responsible for payment of all taxes, assessments, fees, premiums, permits, and
licenses required by law. Grantee shall be responsible for payment of any such government
obligations not paid by its Subcontractors during performance of this Grant Agreement.
11.10 INDEPENDENT CONTRACTOR
Grantee and Grantee's employees, representatives, agents, Subcontractors, suppliers, and
third -party service providers shall serve as independent contractors in providing the services
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11.15 NO IMPLIED WAIVER OF PROVISIONS
The failure of the System Agency to object to or to take affirmative action with respect to
any conduct of the Grantee which is in violation or breach of the terms of the Grant
Agreement shall not be construed as a waiver of the violation or breach, or of any future
violation or breach.
11.16 FUNDING DISCLAIMERS AND LABELING
A. Grantee shall not use System Agency's name or refer to System Agency directly or
indirectly in any media appearance, public service announcement, or disclosure relating
to this Grant Agreement including any promotional material without first obtaining
written consent from System Agency. The foregoing prohibition includes, without
limitation, the placement of banners, pop-up ads, or other advertisements promoting
Grantee's or a third party's products, services, workshops, trainings, or other commercial
offerings on any website portal or internet-based service or software application hosted
or managed by Grantee. This does not limit the Grantee's responsibility to comply with
obligations related to the Texas Public Information Act or Texas Open Meetings Act.
B. In general, no publication (including websites, reports, projects, etc.) may convey
System Agency's recognition or endorsement of the Grantee's project without prior
written approval from System Agency. Publications funded in part or wholly by HHS
grant funding must include a statement that "HHS and neither any of its components
operate, control, are responsible for, or necessarily endorse, this publication (including,
without limitation, its content, technical infrastructure, and policies, and any services or
tools provided)" at HHS's request.
11.17 MEDIA RELEASES
A. Grantee shall not use System Agency's name, logo, or other likeness in any press
release, marketing material or other announcement without System Agency's prior
written approval. System Agency does not endorse any vendor, commodity, or service.
Grantee is not authorized to make or participate in any media releases or public
announcements pertaining to this Grant Agreement or the Services to which they relate
without System Agency's prior written consent, and then only in accordance with
explicit written instruction from System Agency.
B. Grantee may publish, at its sole expense, results of Grantee performance under the Grant
Agreement with the System Agency's prior review and approval, which the System
Agency may exercise at its sole discretion. Any publication (written, visual, or sound)
will acknowledge the support received from the System Agency and any Federal agency,
as appropriate.
11.18 PROHIBITION ON NON -COMPETE RESTRICTIONS
Grantee shall not require any employees or Subcontractors to agree to any conditions, such
as non -compete clauses or other contractual arrangements, that would limit or restrict such
persons or entities from employment or contracting with the State ofTexas.
11.19 SOVEREIGN IMMUNITY
Nothing in the Grant Agreement will be construed as a waiver of the System Agency's or
the State's sovereign immunity. This Grant Agreement shall not constitute or be construed as
a waiver of any of the privileges, rights, defenses, remedies, or immunities available to the
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participation in or denied any aid, care, service or other benefits provided by Federal or
State funding, or otherwise be subjected to discrimination.
C. Grantee agrees to comply with Title VI of the Civil Rights Act of 1964, and its
implementing regulations at 45 C.F.R. Part 80 or 7 C.F.R. Part 15, prohibiting a
contractor from adopting and implementing policies and procedures that exclude or have
the effect of excluding or limiting the participation of clients in its programs, benefits, or
activities on the basis of national origin. State and federal civil rights laws require
contractors to provide alternative methods for ensuring access to services for applicants
and recipients who cannot express themselves fluently in English. Grantee agrees to take
reasonable steps to provide services and information, both orally and in writing, in
appropriate languages other than English, in order to ensure that persons with limited
English proficiency are effectively informed and can have meaningful access to
programs, benefits, and activities.
D. Grantee agrees to post applicable civil rights posters in areas open to the public
informing clients of their civil rights and including contact information for the HHS
Civil Rights Office. The posters are available on the HHS website at:
https:/ihhs.texas.gov about-hhs our -rights. civil-rights-office/civil-rights-posters.
E. Grantee agrees to comply with Executive Order 13279, and its implementing regulations
at 45 C.F.R. Part 87 or 7 C.F.R. Part 16. These provide in part that any organization that
participates in programs funded by direct financial assistance from the United States
Department of Agriculture or the United States Department of Health and Human
Services shall not discriminate against a program beneficiary or prospective program
beneficiary on the basis of religion or religious belief.
F. Upon request, Grantee shall provide HHSC's Civil Rights Office with copies of the
Grantee's civil rights policies and procedures.
G. Grantee must notify HHSC's Civil Rights Office of any complaints of discrimination
received relating to its performance under this Grant Agreement. This notice must be
delivered no more than ten (10) calendar days after receipt of a complaint. Notice
provided pursuant to this section must be directed to:
HHSC Civil Rights Office
701 W. 51 st Street, Mail CodeW206
Austin, Texas 78751
Phone Toll Free: (888) 388-6332
Phone: (512) 438-4313
Fax: (512) 438-5885
Email: HHSCivilRightsOffice@hhsc.state.tx.us.
11.25 ENTERPRISE INFORMATION MANAGEMENT STANDARDS
Grantee shall conform to HHS standards for data management as described by the policies
of the HHS Office of Data, Analytics, and Performance. These include, but are not limited
to, standards for documentation and communication of data models, metadata, and other
data definition methods that are required by HHS for ongoing data governance, strategic
portfolio analysis, interoperability planning, and valuation of HHS System data assets.
11.26 DISCLOSURE OF LITIGATION
A. The Grantee must disclose in writing to the contract manager assigned to this Grant
Agreement any material civil or criminal litigation or indictment either threatened or
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ATTACHMENT E
HITS DATA USE AGREEMENT
This Data Use Agreement ("DUA"), effective as of the date the Base Contract into which
it is incorporated is signed ("Effective Date"), is entered into by and between a Texas Health and
Human Services Enterprise agency ("HHS"), and the Contractor identified in the Base Contract, a
political subdivision of the State of Texas ("CONTRACTOR.
ARTICLE 1.
PURPOSE; APPLICABILITY; ORDER OF PRECEDENCE
The purpose of this DUA is to facilitate creation, receipt, maintenance, use, disclosure or
access to Confidential Information with CONTRACTOR, and describe CONTRACTOR's rights
and obligations with respect to the Confidential Information. 45 CFR 164.504(e)(1)-Q). This DUA
also describes HHS's remedies in the event of CONTRACTOR's noncompliance with its
obligations under this DUA. This DUA applies to both Business Associates and contractors who
are not Business Associates who create, receive, maintain, use, disclose or have access to
Confidential Information on behalf of HHS, its programs or clients as described in the Base
Contract.
As of the Effective Date of this DUA, if any provision of the Base Contract, including any
General Provisions or Uniform Terms and Conditions, conflicts with this DUA, this DUA controls.
ARTICLE 2.
DEFINITIONS
For the purposes of this DUA, capitalized, underlined terms have the meanings set forth in
the following: Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 (42
U.S.C. §1320d, et seq.) and regulations thereunder in 45 CFR Parts 160 and 164, including all
amendments, regulations and guidance issued thereafter; The Social Security Act, including Section
1137 (42 U.S.C. §§ 1320b-7), Title XVI of the Act; The Privacy Act of 1974, as amended by the
Computer Matching and Privacy Protection Act of 1988, 5 U.S.C. § 552a and regulations and
guidance thereunder; Internal Revenue Code, Title 26 of the United States Code and regulations and
publications adopted under that code, including IRS Publication 1075; OMB Memorandum 07-18;
Texas Business and Commerce Code Ch. 521; Texas Government Code, Ch. 552, and Texas
Government Code §2054.1125. In addition, the following terms in this DUA are defined as follows:
"Authorized Purpose" means the specific purpose or purposes described in the Statement
of Work of the Base Contract for CONTRACTOR to fulfill its obligations under the Base Contract,
or any other purpose expressly authorized by HHS in writing in advance.
"Authorized User" means a Person:
(1) Who is authorized to create, receive, maintain, have access to, process, view,
handle, examine, interpret, or analyze Confidential Information pursuant to this DUA;
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a manner that is not expressly an Authorized Purpose under this DUA or as Required by Law.
45 CFR 164.502(b)(1); 45 CFR 164.514(d)
(B) Except as Required by Law, CONTRACTOR will not disclose or allow access
to any portion of the Confidential Information to any Person or other entity, other than
Authorized User's Workforce or Subcontractors (as defined in 45 C.F.R. 160.103) of
CONTRACTOR who have completed training in confidentiality, privacy, security and the
importance of promptly reporting any Event or Breach to CONTRACTOR's management, to
carry out CONTRACTOR's obligations in connection with the Authorized Purpose.
HHS, at its election, may assist CONTRACTOR in training and education on specific or
unique HHS processes, systems and/or requirements. CONTRACTOR will produce
evidence of completed training to HHS upon request. 45 C.F.R. 164.308(a)(5)(i); Texas
Health & Safety Code §181.101
All of CONTRACTOR's Authorized Users, Workforce and Subcontractors with access to a state
computer system or database will complete a cybersecurity training program certified under Texas
Government Code Section 2054.519 by the Texas Department of Information Resources.
(C) CONTRACTOR will establish, implement and maintain appropriate
sanctions against any member of its Workforce or Subcontractor who fails to comply with this
DUA, the Base Contract or applicable law. CONTRACTOR will maintain evidence of
sanctions and produce it to HHS upon request.45 C.F.R. 164.308(a)(1)(ii)(C); 164.530(e);
164.410(b); 164.530(b)(1)
(D) CONTRACTOR will not, except as otherwise permitted by this DUA,
disclose or provide access to any Confidential Information on the basis that such act is
Required by Law without notifying either HHS or CONTRACTOR's own legal counsel to
determine whether CONTRACTOR should object to the disclosure or access and seek
appropriate relief. CONTRACTOR will maintain an accounting of all such requests for
disclosure and responses and provide such accounting to HHS within 48 hours of HHS'
request. 45 CFR 164.504(e)(2)(ii)(A)
(E) CONTRACTOR will not attempt to re -identify or further identify
Confidential Information or De -identified Information, or attempt to contact any Individuals
whose records are contained in the Confidential Information, except for an Authorized
Purpose, without express written authorization from HHS or as expressly permitted by the
Base Contract. 45 CFR 164.502(d)(2)(i) and (ii) CONTRACTOR will not engage in
prohibited marketing or sale of Confidential Information. 45 CFR 164.501, 164.508(a)(3)
and (4); Texas Health & Safety Code Ch. 181.002
(F) CONTRACTOR will not permit, or enter into any agreement with a
Subcontractor to, create, receive, maintain, use, disclose, have access to or transmit
Confidential Information to carry out CONTRACTOR's obligations in connection with the
Authorized Purpose on behalf of CONTRACTOR, unless Subcontractor agrees to comply
with all applicable laws, rules and regulations. 45 CFR 164.502(e)(1)(ii); 164.504(e)(1)(i)
and (2).
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proper management and administration of CONTRACTOR, or to carry out
CONTRACTOR's legal responsibilities, if: 45 CFR 164.504(e)(4)(A).
(1) Disclosure is Required by Law, provided that CONTRACTOR complies with
Section 3.01(D); or
(2) CONTRACTOR obtains reasonable assurances from the person or entity to
which the information is disclosed that the person or entity will:
(a)Maintain the confidentiality of the Confidential Information in accordance
with this DUA;
(b) Use or further disclose the information only as Required by Law or for
the Authorized Purpose for which it was disclosed to the Person; and
(c)Notify CONTRACTOR in accordance with Section 4.01 of any Event or
Breach of Confidential Information of which the Person discovers or should have
discovered with the exercise of reasonable diligence. 45 CFR
164.504(e)(4)(ii)(B).
(N) Except as otherwise limited by this DUA, CONTRACTOR will, if required
by law and requested by HHS, use commercially reasonable efforts to use PHI to provide data
aggregation services to HHS, as that term is defined in the HIPAA, 45 C.F.R. § 164.501 and
permitted by HIPAA. 45 CFR 164.504(e)(2)(i)(B)
(0) CONTRACTOR will, on the termination or expiration of this DUA or the
Base Contract, at its expense, send to HHS or Destroy, at HHS's election and to the extent
reasonably feasible and permissible by law, all Confidential Information received from HHS
or created or maintained by CONTRACTOR or any of CONTRACTOR's agents or
Subcontractors on HHS's behalf if that data contains Confidential Information.
CONTRACTOR will certify in writing to HHS that all the Confidential Information that has
been created, received, maintained, used by or disclosed to CONTRACTOR, has been
Destroyed or sent to HHS, and that CONTRACTOR and its agents and Subcontractors have
retained no copies thereof. Notwithstanding the foregoing, HHS acknowledges and agrees
that CONTRACTOR is not obligated to send to HHSC and/or Destroy any Confidential
Information if federal law, state law, the Texas State Library and Archives Commission
records retention schedule, and/or a litigation hold notice prohibit such delivery or
Destruction. If such delivery or Destruction is not reasonably feasible, or is impermissible by
law, CONTRACTOR will immediately notify HHS of the reasons such delivery or
Destruction is not feasible, and agree to extend indefinitely the protections of this DUA to the
Confidential Information and limit its further uses and disclosures to the purposes that make
the return delivery or Destruction of the Confidential Information not feasible for as long as
CONTRACTOR maintains such Confidential Information. 45 CFR 164.504(e)(2)(ii)(J)
(P) CONTRACTOR will create, maintain, use, disclose, transmit or Destroy
Confidential Information in a secure fashion that protects against any reasonably anticipated
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agreed to be bound by the terms of this DUA, at all times and supply it to HHS, as directed,
upon request.
(V) CONTRACTOR will implement, update as necessary, and document
reasonable and appropriate policies and procedures for privacy, security and Breach of
Confidential Information and an incident response plan for an Event or Breach, to comply
with the privacy, security and breach notice requirements of this DUA prior to conducting
work under the Statement of Work. 45 CFR 164.308; 164.316; 164.514(d); 164.530(i)(1).
(W) CONTRACTOR will produce copies of its information security and privacy
policies and procedures and records relating to the use or disclosure of Confidential
Information received from, created by, or received, used or disclosed by CONTRACTOR for
an Authorized Purpose for HHS's review and approval within 30 days of execution of this
DUA and upon request by HHS the following business day or other agreed upon time frame.
45 CFR 164.308; 164.514(d).
(X) CONTRACTOR will make available to HHS any information HHS requires
to fulfill HHS's obligations to provide access to, or copies of, PHI in accordance with HIPAA
and other applicable laws and regulations relating to Confidential Information.
CONTRACTOR will provide such information in a time and manner reasonably agreed upon
or as designated by the Secretary of the U.S. Department of Health and Human Services, or
other federal or state law. 45 CFR 164.504(e)(2)(i)(I).
(Y) CONTRACTOR will only conduct secure transmissions of Confidential
Information whether in paper, oral or electronic form, in accordance with applicable rules,
regulations and laws. A secure transmission of electronic Confidential Information in motion
includes, but is not limited to, Secure File Transfer Protocol (SFTP) or Encryption at an
appropriate level. If required by rule, regulation or law, HHS Confidential Information at rest
requires Encryption unless there is other adequate administrative, technical, and physical
security. All electronic data transfer and communications of Confidential Information will be
through secure systems. Proof of system, media or device security and/or Encryption must be
produced to HHS no later than 48 hours after HHS's written request in response to a
compliance investigation, audit or the Discovery of an Event or Breach. Otherwise, requested
production of such proof will be made as agreed upon by the parties. De -identification of HHS
Confidential Information is a means of security. With respect to de -identification of PHI,
"secure" means de -identified according to HIPAA Privacy standards and regulatory guidance.
45 CFR 164.312, 164.530(d).
(Z) For each type of Confidential Information CONTRACTOR creates, receives,
maintains, uses, discloses, has access to or transmits in the performance of the Statement of
Work, CONTRACTOR will comply with the following laws rules and regulations, only to
the extent applicable and required by law:
Title 1, Part 10, Chapter 202, Subchapter B, Texas Administrative Code;
• The Privacy Act of 1974;
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(B) CONTRACTOR'S obligation begins at the Discovery of an Event or Breach
and continues as long as related activity continues, until all effects of the Event are mitigated
to HHS's reasonable satisfaction (the "incident response period"). 45 CFR 164.404.
(C) Breach Notice:
(1) Initial Notice.
(a) For federal information, including without limitation, Federal
Tax Information, Social Security Administration Data, and Medicaid Client
Information, within the first, consecutive clock hour of Discovery, and for
all other types of Confidential Information not more than 24 hours after
Discovery, or in a timeframe otherwise approved by HHS in writing, initially
report to HHS's Privacy and Security Officers via email at:
privacy@HHSC.state.tx.us and to the HHS division responsible for this
DUA; and IRS Publication 1075; Privacy Act of 1974, as amended by the
Computer Matching and Privacy Protection Act of 1988, 5 U.S.C. § 552a;
OMB Memorandum 07-16 as cited in HHSC-CMS Contracts for
information exchange.
(b) Report all information reasonably available to
CONTRACTOR about the Event or Breach of the privacy or security of
Confidential Information. 45 CFR 164.410.
(c) Name, and provide contact information to HHS for,
CONTRACTOR' single point of contact who will communicate with HHS
both on and off business hours during the incident response period.
(2) Formal Notice. No later than two business days after the Initial Notice
above, provide formal notification to privacy@HHSC.state.tx.us and to the HHS
division responsible for this DUA, including all reasonably available information
about the Event or Breach, and CONTRACTOR's investigation, including without
limitation and to the extent available: For (a) - (m) below: 45 CFR 164.400-414.
(a) The date the Event or Breach occurred;
(b) The date of CONTRACTOR's and, if applicable,
Subcontractor's Discovery;
(c) A brief description of the Event or Breach; including how it
occurred and who is responsible (or hypotheses, if not yet determined);
(d) A brief description of CONTRACTOR' investigation and the
status of the investigation;
(e) A description of the types and amount of Confidential
Information involved;
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expeditiously respond, and report as required to and by HHS for incident response purposes
and for purposes of HHS's compliance with report and notification requirements, to the
reasonable satisfaction of HHS.
(B) CONTRACTOR will complete or participate in a risk assessment as directed
by HHS following an Event or Breach, and provide the final assessment, corrective actions
and mitigations to HHS for review and approval.
(C) CONTRACTOR will fully cooperate with HHS to respond to inquiries and/or
proceedings by state and federal authorities, Persons and/or Individuals about the Event or
Breach.
(D) CONTRACTOR will fully cooperate with HHS's efforts to seek appropriate
injunctive relief or otherwise prevent or curtail such Event or Breach, or to recover or protect
any Confidential Information, including complying with reasonable corrective action or
measures, as specified by HHS in a Corrective Action Plan if directed by HHS under the Base
Contract.
4.03 Breach Notification to Individuals and Reporting to Authorities. Tex. Bus. &
Comm. Code §521.053; 45 CFR 164.404 (Individuals), 164.406 (Media); 164.408
(Authorities)
(A) HHS may direct CONTRACTOR to provide Breach notification to
Individuals, regulators or third -parties, as specified by HHS following a Breach.
(B) CONTRACTOR shall give HHS an opportunity to review and provide
feedback to CONTRACTOR and to confirm that CONTRACTOR's notice meets all
regulatory requirements regarding the time, manner and content of any notification to
Individuals, regulators or third -parties, or any notice required by other state or federal
authorities, including without limitation, notifications required by Texas Business and
Commerce Code, Chapter 521.053(b) and HIPAA. HHS shall have ten (10) business days to
provide said feedback to CONTRACTOR. Notice letters will be in CONTRACTOR's name
and on CONTRACTOR's letterhead, unless otherwise directed by HHS, and will contain
contact information, including the name and title of CONTRACTOR's representative, an
email address and a toll -free telephone number, if required by applicable law, rule, or
regulation, for the Individual to obtain additional information.
(C) CONTRACTOR will provide HHS with copies of distributed and approved
communications.
(D) CONTRACTOR will have the burden of demonstrating to the reasonable
satisfaction of HHS that any notification required by HHS was timely made. If there are delays
outside of CONTRACTOR's control, CONTRACTOR will provide written documentation of
the reasons for the delay.
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(B) Termination or Expiration of this DUA will not relieve CONTRACTOR of its
obligation to return or Destroy the Confidential Information as set forth in this DUA and to
continue to safeguard the Confidential Information until such time as determined by HHS.
(C) If HHS determines that CONTRACTOR has violated a material term of this
DUA; HHS may in its sole discretion:
(1) Exercise any of its rights including but not limited to reports, access
and inspection under this DUA and/or the Base Contract; or
(2) Require CONTRACTOR to submit to a Corrective Action Plan,
including a plan for monitoring and plan for reporting, as HHS may determine
necessary to maintain compliance with this DUA; or
(3) Provide CONTRACTOR with a reasonable period to cure the
violation as determined by HHS; or
(4) Terminate the DUA and Base Contract immediately, and seek relief in
a court of competent jurisdiction in Texas.
Before exercising any of these options, HHS will provide written notice to
CONTRACTOR describing the violation, the requested corrective action CONTRACTOR
may take to cure the alleged violation, and the action HHS intends to take if the alleged
violated is not timely cured by CONTRACTOR.
(D) If neither termination nor cure is feasible, HHS shall report the violation to the
Secretary of the U.S. Department of Health and Human Services.
(E) The duties of CONTRACTOR or its Subcontractor under this DUA survive
the expiration or termination of this DUA until all the Confidential Information is Destroyed
or returned to HHS, as required by this DUA.
6.05 Governing Law, Venue and Litigation
(A) The validity, construction and performance of this DUA and the legal relations
among the Parties to this DUA will be governed by and construed in accordance with the laws
of the State of Texas.
(B) The Parties agree that the courts of Texas, will be the exclusive venue for any
litigation, special proceeding or other proceeding as between the parties that may be brought,
or arise out of, or in connection with, or by reason of this DUA.
6.06 Injunctive Relief
(A) CONTRACTOR acknowledges and agrees that HHS may suffer irreparable
injury if CONTRACTOR or its Subcontractor fails to comply with any of the terms of this
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6.10 Automatic Amendment and Interpretation
If there is (i) a change in any law, regulation or rule, state or federal, applicable to HIPPA and/or
Confidential Information, or (ii) any change in the judicial or administrative interpretation of any
such law, regulation or rule„ upon the effective date of such change, this DUA shall be deemed to
have been automatically amended, interpreted and read so that the obligations imposed on HHS
and/or CONTRACTOR remain in compliance with such changes. Any ambiguity in this DUA will
be resolved in favor of a meaning that permits HHS and CONTRACTOR to comply with HIPAA
or any other law applicable to Confidential Information.
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6. Type(s) of Texas HHS Confidential Information the
HIPAA
CIS
IRS FTI
CMS
SSA
PII
Applicant/Bidder will create, receive, maintain, use,
❑
❑
❑
❑
❑
❑
disclose or have access to: (Check all that apply)
Other (Please List)
• Health Insurance Portability and Accountability Act (HIPAA) data
• Criminal Justice Information Services (CIIS) data
• Internal Revenue Service Federal Tax Information (IRS FTI) data
• Centers for Medicare & Medicaid Services (CMS)
• Social Security Administration (SSA)
• Personally Identifiable Information (PII)
7. Number of Storage Devices for Texas HHS Confidential Information (as defined in the
Total #
Texas HHS System Data Use Agreement (DUA))
(Sum a-d)
Cloud Services involve using a network of remote servers hosted on the Internet to store,
0
manage, and process data, rather than a local server or a personal computer.
A Data Center is a centralized repository, either physical or virtual, for the storage,
management, and dissemination of data and information organized around a particular body
of knowledge or pertaining to a particular business.
a. Devices. Number of personal user computers, devices or drives, including mobile
devices and mobile drives.
b. Servers. Number of Servers that are not in a data center or using Cloud Services.
c. Cloud Services. Number of Cloud Services in use.
d. Data Centers. Number of Data Centers in use.
S. Number of unduplicated individuals for whom Applicant/Bidder reasonably expects to
Select Option
handle Texas HHS Confidential Information during one year:
(a-d)
a. 499 individuals or less
() a.
b. 500 to 999 individuals
0 b.
c. 1,000 to 99,999 individuals
0 C.
d. 100,000 individuals or more
d.
9. HIPAA Business Associate Agreement
a. Will Applicant/Bidder use, disclose, create, receive, transmit or maintain protected
o Yes
health information on behalf of a HIPAA-covered Texas HHS agency for a HIPAA-
No
covered function?
b. Does Applicant/Bidder have a Privacy Notice prominently displayed on a Webpage or a
0 Yes
Public Office of Applicant/Bidder's business open to or that serves the public? (This is a
C) No
HIPAA requirement. Answer "N/A" if not applicable, such as for agencies not covered
O N/A
by HIPAA.)
Action Plan for Compliance with a Timeline:
Compliance Date:
10. Subcontractors. If the Applicant/Bidder responded "0" to Question 4 (indicating no
subcontractors), check "N/A" for both 'a.' and 'b.'
a. Does Applicant/Bidder require subcontractors to execute the DUA Attachment 1
0 Yes
Subcontractor Agreement Form?
0 No
N/A
Action Plan for Compliance with a Timeline:
Compliance Date:
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SECURITY AND PRIVACY INQUIRY (SPI)
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SECTION B: PRIVACY RISK ANALYSIS AND ASSESSMENT (To be completed by Applicant/Bidder)
For any questions answered "No," an Action Plan for Compliance with a Timeline must be documented in
the designated area below the question. The timeline for compliance with HIPAA-related requirements for
safeguarding Protected Health Information is 30 calendar days from the date this form is signed.
Compliance with requirements related to other types of Confidential Information must be confirmed within
90 calendar days from the date the form is signed.
1. Written Policies & Procedures. Does Applicant/Bidder have current written privacy and
Yes or No
security policies and procedures that, at a minimum:
a. Does Applicant/Bidder have current written privacy and security policies and
0 Yes
procedures that identify Authorized Users and Authorized Purposes (as defined in the
0 No
DUA) relating to creation, receipt, maintenance, use, disclosure, access or transmission
of Texas HHS Confidential Information?
Action Plan for Compliance with a Timeline:
Compliance Date:
b. Does Applicant/Bidder have current written privacy and security policies and
0 Yes
procedures that require Applicant/Bidder and its Workforce to comply with the
0 No
applicable provisions of HIPAA and other laws referenced in the DUA, relating
to creation, receipt, maintenance, use, disclosure, access or transmission of
Texas HHS Confidential Information on behalf of a Texas HHS agency?
Action Plan for Compliance with a Timeline:
Compliance Date:
c. Does Applicant/Bidder have current written privacy and security policies and procedures
0 Yes
that limit use or disclosure of Texas HHS Confidential Information to the minimum that is
0 No
necessary to fulfill the Authorized Purposes?
Action Plan for Compliance with a Timeline:
Compliance Date:
d. Does Applicant/Bidder have current written privacy and security policies and procedures
0 Yes
that respond to an actual or suspected breach of Texas HHS Confidential Information, to
"No" "No"
0No
include at a minimum (if any responses are check for all three):
i. Immediate breach notification to the Texas HHS agency, regulatory authorities, and
other required Individuals or Authorities, in accordance with Article 4 of the DUA;
ii. Following a documented breach response plan, in accordance with the DUA
and applicable law; &
iii. Notifying Individuals and Reporting Authorities whose Texas HHS Confidential
Information has been breached, as directed by the Texas HHS agency?
SPI Version 2.1 (06/2018) Texas HHS System - Data Use Agreement - Attachment 2: Page 4 of 18
SECURITY AND PRIVACY INQUIRY (SPI)
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j. Does Applicant/Bidder have current written privacy and security policies and
0 Yes
procedures that restrict permissions or attempts to re -identify or further identify
0 No
de -identified Texas HHS Confidential Information, or attempt to contact any Individuals
whose records are contained in the Texas HHS Confidential Information, except for an
Authorized Purpose, without express written authorization from a Texas HHS agency or
as expressly permitted by the Base Contract?
Action Plan for Compliance with a Timeline:
Compliance Date:
k. If Applicant/Bidder intends to use, disclose, create, maintain, store or transmit Texas HHS
0 Yes
Confidential Information outside of the United States, will Applicant/Bidder obtain the
0 No
express prior written permission from the Texas HHS agency and comply with the Texas
HHS agency conditions for safeguarding offshore Texas HHS Confidential Information?
Action Plan for Compliance with a Timeline:
Compliance Date:
Does Applicant/Bidder have current written privacy and security policies and procedures
0 Yes
that require cooperation with Texas HHS agencies' or federal regulatory inspections,
0 No
audits or investigations related to compliance with the DUA or applicable law?
Action Plan for Compliance with a Timeline:
Compliance Date:
m. Does Applicant/Bidder have current written privacy and security policies and
0 Yes
procedures that require appropriate standards and methods to destroy or dispose of
0 No
Texas HHS Confidential Information?
Action Plan for Compliance with a Timeline:
Compliance Date:
n. Does Applicant/Bidder have current written privacy and security policies and procedures
0 Yes
that prohibit disclosure of Applicant/Bidder's work product done on behalf of Texas HHS
0 No
pursuant to the DUA, or to publish Texas HHS Confidential Information without express
prior approval of the Texas HHS agency?
Action Plan for Compliance with a Timeline:
Compliance Date:
2. Does Applicant/Bidder have a current Workforce training program?
0 Yes
Training of Workforce must occur at least once every year, and within 30 days of date of hiring a new
0 No
Workforce member who will handle Texas HHS Confidential Information. Training must include: (1) privacy and
security policies, procedures, plans and applicable requirements for handling Texas HHS Confidential
Information, (2) a requirement to complete training before access is given to Texas HHS Confidential
Information, and (3) written proof of training and a procedure for monitoring timely completion of training.
SPI Version 2.1 (06/2018) Texas HHS System - Data Use Agreement - Attachment 2: Page 6 of 18
SECURITY AND PRIVACY INQUIRY (SPI)
n.._.. Q:-- Cn. clnnen— ff^4^ — e7 A
This section is about your electronic system. If your business DOES NOT store, access, or
No Electronic ctransmit
Texas HHS Confidential Information in electronic systems (e.g., laptop, personal
Systems
use computer, mobile device, database, server, etc.) select the box to the right, and
❑
"YES" will be entered for all questions in this section.
For any questions answered "No," an Action Plan for Compliance with a Timeline must be documented in the
designated area below the question. The timeline for compliance with HIPAA-related items is 30 calendar
days, PII-related items is 90 calendar days.
1. Does the Applicant/Bidder ensure that services which access, create, disclose, receive,
Yes
transmit, maintain, or store Texas HHS Confidential Information are maintained IN the
C) No
United States (no offshoring) unless All of the following requirements are met?
a. The data is encrypted with FIPS 140-2 validated encryption
b. The offshore provider does not have access to the encryption keys
c. The Applicant/Bidder maintains the encryption key within the United States
d. The Application/Bidder has obtained the express prior written permission of the
Texas HHS agency
For more information regarding FIP5140-2 encryption products, please refer to:
h ttp://csrc. nist. aov/publications/figs
Action Plan for Compliance with a Timeline:
Compliance Date:
2. Does Applicant/Bidder utilize an IT security -knowledgeable person or company to maintain
O Yes
or oversee the configurations of Applicant/Bidder's computing systems and devices?
() No
Action Plan for Compliance with a Timeline:
Compliance Date:
3. Does Applicant/Bidder monitor and manage access to Texas HHS Confidential Information
o Yes
(e.g., a formal process exists for granting access and validating the need for users to access
No
Texas HHS Confidential Information, and access is limited to Authorized Users)?
Action Plan for Compliance with a Timeline:
Compliance Date:
4. Does Applicant/Bidder a) have a system for changing default passwords, b) require user
()Yes
password changes at least every 90 calendar days, and c) prohibit the creation of weak
C) No
passwords (e.g., require a minimum of 8 characters with a combination of uppercase,
lowercase, special characters, and numerals, where possible) for all computer systems
that access or store Texas HHS Confidential Information.
If yes, upon request must provide evidence such as a screen shot or a system report.
Action Plan for Compliance with a Timeline:
Compliance Date:
SPI Version 2.1 (06/2018) Texas HHS System - Data Use Agreement - Attachment 2: Page 8 of 18
SECURITY AND PRIVACY INQUIRY (SPI)
DocuSign Envelope ID: 840D3DFE-E9l9-447C-871D-17373C8C6C32
10. Does Applicant/Bidder use encryption products to protect Texas HHS Confidential
Yes
Information that is transmitted over a public network (e.g., the Internet, WiFi, etc.)?
O No
If yes, upon request must provide evidence such as a screen shot or a system report.
Encryption is required for all HHS Confidential Information. Additionally, FIPS 140-2 validated encryption is required for
Health Insurance Portability and Accountability Act (HIPAA) data, Criminal Justice Information Services (CJIS) data, Internal
Revenue Service Federal Tax Information (IRS FTI) data, and Centers for Medicare & Medicaid Services (CMS) data.
For more information regarding FIPS 140-2 encryption products, please refer to:
http://csrc. nist. aov/publications/figs
Action Plan for Compliance with a Timeline:
Compliance Date:
11. Does Applicant/Bidder use encryption products to protect Texas HHS Confidential
() Yes
Information stored on end user devices (e.g., laptops, USBS, tablets, smartphones, external
O No
hard drives, desktops, etc.)?
If yes, upon request must provide evidence such as a screen shot or a system report.
Encryption is required for all Texas HHS Confidential Information. Additionally, FIPS 140-2 validated encryption is required
for Health Insurance Portability and Accountability Act (H/PAA) data, Criminal Justice Information Services (CJ/S) data,
Internal Revenue Service Federal Tax Information (IRS FTI) data, and Centers for Medicare & Medicaid Services (CMS) data.
For more information regarding FIPS 140-2 encryption products, please refer to:
http://csrc. nist. gov/publ ications/fips
Action Plan for Compliance with a Timeline:
Compliance Date:
12. Does Applicant/Bidder require Workforce members to formally acknowledge rules outlining
0 Yes
their responsibilities for protecting Texas HHS Confidential Information and associated
0 No
systems containing HHS Confidential Information before their access is provided?
Action Plan for Compliance with a Timeline:
Compliance Date:
13. Is Applicant/Bidder willing to perform or submit to a criminal background check on
Q Yes
Authorized Users?
0 No
Action Plan for Compliance with a Timeline:
Compliance Date:
14. Does Applicant/Bidder prohibit the access, creation, disclosure, reception, transmission,
Q Yes
maintenance, and storage of Texas HHS Confidential Information with a subcontractor
0 No
(e.g., cloud services, social media, etc.) unless Texas HHS has approved the subcontractor
agreement which must include compliance and liability clauses with the same
requirements as the Applicant/Bidder?
Action Plan for Compliance with a Timeline:
Compliance Date:
SPI Version 2.1 (06/2018) Texas HHS System - Data Use Agreement - Attachment 2: Page 10 of 18
SECURITY AND PRIVACY INQUIRY (SPI)
DocuSign Envelope ID: 840D3DFE-E919-447C-871 D-1 7373C8C6C32
SECTION D: SIGNATURE AND SUBMISSION (to be completed by Applicant/Bidder)
Please sign the form digitally, if possible. If you can't, provide a handwritten signature.
1.1 certify that all of the information provided in this form is truthful and correct to the best of my knowledge.
If I learn that any such information was not correct, I agree to notify Texas HHS of this immediately.
2. Signature 3. Title . Date:
To submit the completed, signed form:
• Email the form as an attachment to the appropriate Texas HHS Contract Manager(s).
SectionTo Be Completed by
Agency(s): Requesting De artment(s):
HHSC: � DFPS: � DSHS: 1-3
Legal Entity Tax Identification Number (TIN) (Last four Only):
PO/Contract(s) #:
Contract Manager:
Contract Manager Email Address:
Contract Manager Telephone #:
Contract Manager:
Contract Manager Email Address:
Contract Manager Telephone #:
Contract Manager:
Contract Manager Email Address:
Contract Manager Telephone #:
Contract Manager:
Contract Manager Email Address:
Contract Manager Telephone #:
Contract Manager:
Contract Manager Email Address:
Contract Manager Telephone #:
Contract Manager:
Contract Manager Email Address:
Contract Manager Telephone #:
Contract Manager:
Contract Manager Email Address:
Contract Manager Telephone #:
Contract Manager:
Contract Manager Email Address:
Contract Manager Telephone #:
SPI Version 2.1 (06/2018) Texas HHS System - Data Use Agreement - Attachment 2: Page 12 of 18
SECURITY AND PRIVACY INQUIRY (SPI)
DocuSign Envelope ID: 840D3DFE-E919-447C-871D-17373C8C6C32
141 reaerai lax ►nlormavon;
(5) Personally Identifiable Information;
(6) Social Security Administration Data, including, without limitation, Medicaid information;
(7) All privileged work product,
(8) All information designated as confidential under the constitution and laws of the State of
Texas and of the United States, including the Texas Health & Safety Code and the Texas Public
Information Act, Texas Government Code, Chapter 552.
Definitions for the following types of confidential information can be found the following sites:
• Health Insurance Portability and Accountability Act (HIPAA) - http://www.hhs.gov/hipaa/index.html
• Criminal Justice Information Services (C11S) - https.11www.fbi.gov/serviceslciislciis-security-policy-resource-center
• Internal Revenue Service Federal Tax Information (IRS FTI) - https://www.irs.gov/pub/irs-pdflplo75.pdf
• Centers for Medicare & Medicaid Services (CMS) - https://www.cros.gov/Regulations-and-Guidance/Regulations-and-
Guidance.html
• Social Security Administration (SSA) - https://www.ssa.gov/regulations/
• Personally Identifiable Information (Pll) - http://Csrc.nist.govlpublicationslnistpubsl800-l221sp800-l22.pdf
Item #7. Number of Storage devices for Texas HHS Confidential Information. The total number of devices is
automatically calculated by exiting the fields in lines a - d. Use the <Tab> key when exiting the field to prompt
calculation, if it doesn't otherwise sum correctly.
• Item 7a. Devices. Provide the number of personal user computers, devices, and drives (including mobile
devices, laptops, USB drives, and external drives) on which your business stores or will store Texas HHS
Confidential Information.
• Item 7b. Servers. Provide the number of servers not housed in a data center or "in the cloud, "on which Texas HHS
Confidential Information is stored or will be stored. A server is a dedicated computer that provides data or services to other
computers. It may provide services or data to systems on a local area network (LAN) or a wide area network (WAN) over the
Internet. If none, answer "0" (zero).
• Item 7c. Cloud Services. Provide the number of cloud services to which Texas HHS Confidential Information is stored. Cloud
Services involve using a network of remote servers hosted on the Internet to store, manage, and process data, rather than
on a local server or a personal computer. If none, answer "0" (zero.)
• Item 7d. Data Centers. Provide the number of data centers in which you store Texas HHS Confidential Information. A
Data Center is a centralized repository, either physical or virtual, for the storage, management, and
dissemination of data and information organized around a particular body of knowledge or pertaining to a
particular business. If none, answer "0" (zero).
Item #8. Number of unduplicated individuals for whom the Applicant/Bidder reasonably expects to handle Texas HHS
Confidential Information during one year. Select the radio button that corresponds with the number of clients/consumers for
whom you expect to handle Confidential Information during a year. Only count clients/consumers once, no matter how many
direct services the client receives during a year.
Item #9. HIPAA Business Associate Agreement.
• Item #9a. Answer "Yes" if your business will use, disclose, create, receive, transmit, or store information relating to a
client/consumer's healthcare on behalf of the Department of State Health Services, the Department of Disability and Aging
Services, or the Health and Human Services Commission for treatment, payment, or operation of Medicaid or Medicaid
clients. If your contract does not include HIPAA covered information, respond "no."If "no,"a compliance plan is not required.
• Item #9b. Answer "Yes" if your business has a notice of privacy practices (a document that explains how you protect and
use a client/consumer's healthcare information) displayed either on a website (if one exists for your business) or in your
place of business (if that location is open to clients/consumers or the public). If your contract does not include HIPAA
covered information, respond "N/A."
Item #10. Subcontractors. If your business responded "0" to question 4 (number of subcontractors), Answer "N/A" to Items 10a
and 1Ob to indicate not applicable.
• Item #10a. Answer "Yes" if your business requires that all subcontractors sign Attachment 1 of the DUA.
• Item #10b. Answer "Yes" if your business obtains Texas HHS approval before permitting subcontractors to handle Texas HHS
Confidential Information on your business's behalf.
Item #11. Optional Insurance. Answer "yes" if applicant has optional insurance in place to provide coverage for a Breach or any
g
SPI Version 2.1 (06/2018)
Texas HHS System - Data Use Agreement - Attachment 2: Page 14 of 18
SECURITY AND PRIVACY INQUIRY (SPI)
DocuSign Envelope ID: 840D3DFE-E919-447C-871D-17373C8C6C32
• Item W. Answer "Yes" if your business has written policies and procedures requiring you to allow individuals
(clients/consumers) to access their individual record of Texas HHS Confidential Information, and allow them to
amend or correct that information, if applicable.
• Item #1g. Answer "Yes" if your business has written policies and procedures restricting access to Texas HHS Confidential
Information to only persons who have been authorized and trained on how to handle Texas HHS Confidential Information
• Item #1h. Answer "Yes" if your business has written policies and procedures requiring sanctioning of any subcontractor,
employee, trainee, volunteer, or anyone whose work you direct when they have accessed Texas HHS Confidential
Information but are not authorized to do so, and that you have a method of proving that you have sanctioned such an
individuals. If you are the only employee, you must demonstrate how you will document the noncompliance, update
policies and procedures if needed, and seek additional training or education to prevent future occurrences.
• Item #1i. Answer "Yes" if your business has written policies and procedures requiring you to update your policies within
60 days after you have made changes to how you use or disclose Texas HHS Confidential Information.
• Item #1j. Answer "Yes" if your business has written policies and procedures requiring you to restrict attempts to take
de -identified data and re -identify it or restrict any subcontractor, employee, trainee, volunteer, or anyone whose work
you direct, from contacting any individuals for whom you have Texas HHS Confidential Information except to perform
obligations under the contract, or with written permission from Texas HHS.
• Item #1k. Answer "Yes" if your business has written policies and procedures prohibiting you from using, disclosing,
creating, maintaining, storing or transmitting Texas HHS Confidential Information outside of the United States.
• Item #11. Answer "Yes" if your business has written policies and procedures requiring your business to cooperate with
HHS agencies or federal regulatory entities for inspections, audits, or investigations related to compliance with the DUA or
applicable law.
• Item #1m. Answer "Yes" if your business has written policies and procedures requiring your business to use appropriate
standards and methods to destroy or dispose of Texas HHS Confidential Information. Policies and procedures should
comply with Texas HHS requirements for retention of records and methods of disposal.
• Item #1n. Answer "Yes" if your business has written policies and procedures prohibiting the publication of the
work you created or performed on behalf of Texas HHS pursuant to the DUA, or other Texas HHS Confidential
Information, without express prior written approval of the HHS agency.
Item #2. Answer "Yes" if your business has a current training program that meets the requirements specified in the SPI
for you, your employees, your subcontractors, your volunteers, your trainees, and any other persons under you direct
supervision.
Item #3. Answer "Yes" if your business has privacy safeguards to protect Texas HHS Confidential Information as described
in the SPI.
Item #4. Answer "Yes" if your business maintains current lists of persons in your workforce, including subcontractors
(if applicable), who are authorized to access Texas HHS Confidential Information. If you are the only person with
access to Texas HHS Confidential Information, please answer "yes."
Item #5. Answer "Yes" if your business and subcontractors (if applicable) monitor for and remove from the list of
Authorized Users, members of the workforce who are terminated or are no longer authorized to handle Texas HHS
Confidential Information. If you are the only one with access to Texas HHS Confidential Information, please answer "Yes."
SECTION C. SECURITY RISK ANALYSIS AND ASSESSMENT
This section is about your electronic systems. If you DO NOT store Texas HHS Confidential Information in electronic systems
(e.g., laptop, personal computer, mobile device, database, server, etc.), select the "No Electronic Systems" box and respond
"Yes" for all questions in this section.
Item #1. Answer "Yes" if your business does not "offshore" or use, disclose, create, receive, transmit or maintain
Texas HHS Confidential Information outside of the United States. If you are not certain, contact your provider of
technology services (application, cloud, data center, network, etc.) and request confirmation that they do not off-
shore their data.
SPI Version 2.1 (06/2018) Texas HHS System - Data Use Agreement - Attachment 2: Page 16 of 18
SECURITY AND PRIVACY INQUIRY (SPI)
DocuSign Envelope ID: 840D3DFE-E919-447C-871D-17373C8C6C32
Item #12. Answer "Yes" if your business requires employees, volunteers, trainees and other workforce members to sign a
document that clearly outlines their responsibilities for protecting Texas HHS Confidential Information and associated
systems containing Texas HHS Confidential Information before they can obtain access. If you are the only employee answer
"Yes" if you have signed or are willing to sign the DUA, acknowledging your adherence to requirements and responsibilities.
Item #13. Answer "Yes" if your business is willing to perform a criminal background check on employees, subcontractors,
volunteers, or trainees who access Texas HHS Confidential Information. If you are the only employee, answer "Yes" if you
are willing to submit to a background check.
Item #14. Answer "Yes" if your business prohibits the access, creation, disclosure, reception, transmission, maintenance,
and storage of Texas HHS Confidential Information on Cloud Services or social media sites if you use such services or sites,
and there is a Texas HHS approved subcontractor agreement that includes compliance and liability clauses with the same
requirements as the Applicant/Bidder. If you do not utilize Cloud Services or media sites for storing Texas HHS Confidential
Information, answer "Yes."
Item #15. Answer "Yes" if your business keeps current on security updates/patches (including firmware, software and
applications) for computing systems that use, disclose, access, create, transmit, maintain or store Texas HHS Confidential
Information. If you use a Microsoft Windows system, refer to the Microsoft website on how to ensure your system is
automatically updating, see example:
h ttps://portal. msrc. microsoft. com/en-us/
Item #16. Answer "Yes" if your business's computing systems that use, disclose, access, create, transmit, maintain or store
Texas HHS Confidential Information contain up-to-date anti-malware and antivirus protection. If you use a Microsoft
Windows system, refer to the Microsoft website on how to ensure your system is automatically updating, see example:
https.11docs. microsoft.com/en-us/windows/security/threat-protection/
Item #17. Answer "Yes" if your business reviews system security logs on computing systems that access or store Texas HHS
Confidential Information for abnormal activity or security concerns on a regular basis. If you use a Microsoft Windows system,
refer to the Microsoft website for ensuring your system is logging security events, see example:
https://docs. microsoft. com/en-us/windows/security/threat-protection/auditing/basic-security-audit-policies
Item #18. Answer "Yes" if your business disposal processes for Texas HHS Confidential Information ensures that Texas
HHS Confidential Information is destroyed so that it is unreadable or undecipherable. Simply deleting data or formatting
the hard drive is not enough; ensure you use products that perform a secure disk wipe. Please see NIST SP 800-88 R1,
Guidelines for Media Sanitization and the applicable laws and regulations for the information type for further guidance.
Item #19. Answer "Yes" if your business ensures that all public facing websites and mobile applications containing HHS
Confidential Information meet security testing standards set forth within the Texas Government Code (TGC), Section
2054.516
SECTION D. SIGNATURE AND SUBMISSION
Click on the signature area to digitally sign the document. Email the form as an attachment to the appropriate
Texas HHS Contract Manager.
SPI Version 2.1 (06/2018) Texas HHS System - Data Use Agreement - Attachment 2: Page 18 of 18
SECURITY AND PRIVACY INQUIRY (SPI)
DocuSign Envelope ID: 840D3DFE-E919-447C-871D-17373C8C6C32
TABLE OF CONTENTS
1.
ELECTRICAL ITEMS........................................................................................................ 3
2.
DISASTER SERVICES........................................................................................................ 3
3.
NOTICE OF A LICENSE ACTION................................................................................... 3
4.
SERVICES AND INFORMATION FOR PERSONS WITH LIMITED ENGLISH
PROFICIENCY..............................................................................................4
5.
THIRD PARTY PAYORS................................................................................................... 4
6.
MEDICAL RECORDS RETENTION................................................................................ 4
7.
INTERIM EXTENSION AMENDMENT.......................................................................... 5
8.
NOTICE OF CRIMINAL ACTIVITY AND DISCIPLINARY ACTIONS .................... 5
9.
NOTICE OF GRANT AGREEMENT/CONTRACT ACTION ....................................... 5
10.
NOTICE OF BANKRUPTCY............................................................................................. 6
11.
NOTICE OF CHANGE OF CONTACT PERSON OR KEY PERSONNEL ................. 6
12.
BYRD ANTI -LOBBYING AMENDMENT....................................................................... 6
13.
CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT .......... 6
14.
COMPLIANCE WITH LAWS, RULES, AND REQUIREMENTS ................................ 6
15.
DISCLOSURE OF VIOLATIONS OF FEDERAL CRIMINAL LAW .......................... 7
16.
EXCLUDED PARTIES........................................................................................................ 7
17.
NO CONFLICTS OF INTEREST (FEDERAL)................................................................ 8
18.
OPEN MEETINGS............................................................................................................... 8
19.
RECORDS RETENTION (FEDERAL)............................................................................. 8
Health and Human Services
Additional Provisions V.1.0 — Grant Funding
Effective: February 2021
Page 2 of 8
DocuSign Envelope ID: 840D3DFE-E919-447C-871D-17373C8C6C32
4. SERVICES AND INFORMATION FOR PERSONS WITH LIMITED ENGLISH PROFICIENCY
A. Grantee/Contractor shall take reasonable steps to provide services and information both
orally and in writing, in appropriate languages other than English, to ensure that persons
with limited English proficiency are effectively informed and can have meaningful access
to programs, benefits and activities. Meaningful access may entail providing language
assistance services, including oral interpretation and written translation, if necessary.
More information can be found at https://www.lep.gov/.
B. Grantee/Contractor shall identify and document on the client records the primary
language/dialect of a client who has limited English proficiency and the need for
translation or interpretation services and shall not require a client to provide or pay for
the services of a translator or interpreter.
C. Grantee/Contractor shall make every effort to avoid use of any persons under the age of
18 or any family member or friend of the client as an interpreter for essential
communications with a client with limited English proficiency, unless the client has
requested that person and using the person would not compromise the effectiveness of
services or violate the client's confidentiality and the client is advised that a free
interpreter is available.
5. THIRD PARTY PAYORS
A. Except as provided in this Grant Agreement/Contract, Grantee/Contractor shall screen all
clients and may not bill the System Agency for services eligible for reimbursement from
third party payors, who are any person or entity who has the legal responsibility for paying
for all or part of the services provided, including commercial health or liability insurance
carriers, Medicaid, or other federal, state, local and private funding sources.
B. As applicable, the Grantee/Contractor shall:
i. Enroll as a provider in Children's Health Insurance Program and Medicaid if providing
approved services authorized under this Grant Agreement/Contract that may be covered
by those programs and bill those programs for the covered services;
ii. Provide assistance to individuals to enroll in such programs when the screening process
indicates possible eligibility for such programs;
iii. Allow clients that are otherwise eligible for System Agency services, but cannot pay a
deductible required by a third party payor, to receive services and bill the System
Agency for the deductible;
iv. Not bill the System Agency for any services eligible for third party reimbursement until
all appeals to third party payors have been exhausted;
v. Maintain appropriate documentation from the third party payor reflecting attempts to
obtain reimbursement;
vi. Bill all third party payors for services provided under this Grant Agreement/Contract
before submitting any request for reimbursement to System Agency; and
vii. Provide third party billing functions at no cost to the client.
6. MEDICAL RECORDS RETENTION
Grantee/Contractor shall retain medical records in accordance with 22 TAC § 165.1(b) or other
applicable statutes, rules and regulations governing medical information.
Health and Human Services
Additional Provisions V.1.0 - Grant Funding
Effective: February 2021
Page 4 of 8
DocuSign Envelope ID: 840D3DFE-E919-447C-871 D-1 7373C8C6C32
10. NOTICE OF BANKRUPTCY
Grantee Contractor shall notify in writing the assigned System Agency contract manager
of its plan to seek bankruptcy protection within five business days of such action by
Grantee./Contractor.
11. NOTICE OF CHANGE OF CONTACT PERSON OR KEY PERSONNEL
The Grantee;Contractor shall notify in writing the assigned System Agency contract
manager within ten business days of any change to the Grantee/Contractor's Contact Person
or Key Personnel.
12. BYRD ANTI -LOBBYING AMENDMENT
Grantee certifies that no federal appropriated funds have been paid or will be paid to any
persons or organization for influencing or attempting to influence an officer or employee
of any agency, a member of Congress, an officer or employee of Congress, or an
employee of a member of Congress on its behalf to obtain, extend, or modify this
contract or grant. If non-federal funds are used by Grantee to conduct such lobbying
activities, Grantee shall promptly file the prescribed disclosure form. In accordance with
31 U.S.C. § 1352(b)(5), Grantee acknowledges and agrees that it is responsible for
ensuring that each subrecipient and subcontractor certifies its compliance with the
expenditures prohibition and the declaration requirement.
13. CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT
Grantee represents and warrants that it will comply with all applicable standards, orders,
or regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401-7671q) and the
Federal Water Pollution Control Act as amended (33 U.S.C. 1251-1387).
14. COMPLIANCE WITH LAWS, RULES, AND REQUIREMENTS
Grantee represents and warrants that it will comply, and assure the compliance of all its
subrecipients and contractors, with all applicable federal and state laws, rules,
regulations, and policies in effect or hereafter established. In addition, Grantee
represents and warrants that it will comply with all requirements imposed by the
awarding agency concerning special requirements of law, program requirements, and
other administrative requirements. In instances where multiple requirements apply to
Grantee, the more restrictive requirement applies.
Health and Human Services
Additional Provisions V.1.0 Grant Funding
Effective: February 2021
Page 6 of 8
DocuSign Envelope ID: 840D3DFE-E919-447C-871 D-1 7373C8C6C32
17. NO CONFLICTS OF INTEREST (FEDERAL)
Grantee represents and warrants its compliance with the Federal awarding agency's
conflict of interest policies in accordance with 2 CFR § 200.112.
18. OPEN MEETINGS
If the Grantee is a governmental entity, Grantee represents and warrants its compliance
with Chapter 551 of the Texas Government Code which requires all regular, special, and
called meetings of a governmental body to be open to the public, except as otherwise
provided by law.
19. RECORDS RETENTION (FEDERAL)
Grantee represents and warrants its compliance with the records retention requirements
of 2 CFR §200.333. System Agency reserves the right to direct Grantee to retain
documents for a longer period of time or transfer certain records to System Agency's
custody when it is determined the records possess longer term retention value. Grantee
must include the substance of this clause in all subaward and subcontracts.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
Health and Human Services
Additional Provisions V.1.0 — Grant Funding
Effective: February 2021
Page 8 of 8
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9. Will comply, as applicable, with the provisions of the Davis- 13. Will assist the awarding agency in assuring compliance
Bacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act with Section 106 of the National Historic Preservation
(40 U.S.C. §276c and 18 U.S.C. §874), and the Contract Act of 1966, as amended (16 U.S.C. §470), EO 11593
Work Hours and Safety Standards Act (40 U.S.C. §§327- (identification and protection of historic properties), and
333), regarding labor standards for federally -assisted the Archaeological and Historic Preservation Act of
construction subagreements. 1974 (16 U.S.C. §§469a-1 et seq.).
10. Will comply, if applicable, with flood insurance purchase
requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires
recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of
insurable construction and acquisition is $10,000 or more.
11. Will comply with environmental standards which may be
prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National
Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating
facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in
floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management
program developed under the Coastal Zone Management
Act of 1972 (16 U.S.C. §§1451 et seq.); (f) conformity of
Federal actions to State (Clean Air) Implementation Plans
under Section 176(c) of the Clean Air Act of 1955, as
amended (42 U.S.C. §§7401 et seq.); (g) protection of
underground sources of drinking water under the Safe
Drinking Water Act of 1974, as amended (P.L. 93-523);
and, (h) protection of endangered species under the
Endangered Species Act of 1973, as amended (P.L. 93-
205).
12. Will comply with the Wild and Scenic Rivers Act of
1968 (16 U.S.C. §§1271 et seq.) related to protecting
components or potential components of the national
wild and scenic rivers system.
14. Will comply with P.L. 93-348 regarding the protection of
human subjects involved in research, development, and
related activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of
1966 (P.L. 89-544, as amended, 7 U.S.C. §§2131 et
seq.) pertaining to the care, handling, and treatment of
warm blooded animals held for research, teaching, or
other activities supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning
Prevention Act (42 U.S.C. §§4801 et seq.) which
prohibits the use of lead -based paint in construction or
rehabilitation of residence structures.
17. Will cause to be performed the required financial and
compliance audits in accordance with the Single Audit
Act Amendments of 1996 and OMB Circular No. A-133,
"Audits of States. Local Governments, and Non -Profit
Organizations."
18. Will comply with all applicable requirements of all other
Federal laws. executive orders, regulations, and policies
governing this program.
19. Will comply with the requirements of Section 106(g) of
the Trafficking Victims Protection Act (TVPA) of 2000, as
amended (22 U.S.C. 7104) which prohibits grant award
recipients or a sub -recipient from (1) Engaging in severe
forms of trafficking in persons during the period of time
that the award is in effect (2) Procuring a commercial
sex act during the penod of time that the award is in
effect or (3) Using forced labor in the performance of the
award or subawards under the award.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
TITLE
APPLICANT ORGANIZATION
DATE SUBMITTED
Standard Form 424B (Rev. 7-97) Back
DocuSign Envelope ID: 840D3DFE-E919-447C-871 D-1 7373C8C6C32
DISCLOSURE OF LOBBYING ACTIVITIES
Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352 OMB Number: 4040-0013
Expiration Date: 02/28/2025
1. * Type of Federal Action:
2. * Status of Federal Action:
3. * Report Type:
a. contract
a. bid/offer/applicabon
® a. initial filing
® b. grant
® b initial award
❑ b. material change
❑ c. cooperative agreement
C. post -award
❑ d. loan
e. loan guarantee
f loan insurance
4. Name and Address of Reporting Entity:
®prime ❑ SubAwardee
Name
Street 1 Street 2
' Ciry Slate Zip
Congressional District, if known:
S. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime:
6. * Federal Department/Agency:
7. * Federal Program Name/Description:
CFDA Number if applicable
8. Federal Action Number, ifknown:
9. Award Amount, ifknown:
10. a. Name and Address of Lobbying Registrant:
Prefix First Name Middle Name
' Last Name Suffix
Street 1 Street 2
City State F Zip
b. Individual Performing Services (including address If different from No. 10a)
Prefix First Name Middle Name
' Last Name Suffix
Street 1 Street 2
City State Zip
11. Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fad upon which
reliance was placed by the tier above when the transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to
the Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than
$10.000 and not more than $100 000 for each such failure
' Signature:
'Name: Prefix • Frst Name Middle Name
' Last Name Suffix F
Title: Telephone No.: Date:
Federal Use Only:
s ndardoFonoL LLLI (Rev.7 n�
DocuSign Envelope ID: 840D3DFE-E919-447C-871D-17373C8C6C32
Fiscal Federal Funding Accountability and Transparency Act
(FFATA) CERTIFICATION
As the duly authorized representative (Signor) of the Contractor, I hereby certify that the
statements made by me in this certification form are true, complete, and correct to the best of
my knowledge.
Did your organization have a gross income, from all sources, of less than $300,000 in your previous tax
year? Yes No
If your answer is "Yes", skip questions "A", "B", and "C" and finish the certification. If your answer is "No
answer questions "A" and "B".
A. Certification Regarding % of Annual Gross from Federal Awards.
Did your organization receive 80% or more of its annual gross revenue from federal awards during the
preceding fiscal year? Yes ❑ No ❑
B. Certification Regarding Amount of Annual Gross from Federal Awards.
Did your organization receive $25 million or more in annual gross revenues from federal awards in the
preceding fiscal year? Yes No
If your answer is "Yes" to both question "A" and "B", you must answer question "C".
If your answer is "No" to either question "A" or "B", skip question "C" and finish the certification.
C. Certification Regarding Public Access to Compensation Information.
Does the public have access to information about the compensation of the senior executives in your
business or organization (including parent organization, all branches, and all affiliates worldwide) through
periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C.
78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? Yes ❑ No ❑
If your answer is "Yes" to this question, where can this information be accessed?
If your answer is "No" to this question, you must provide the names and total compensation of
the top five highly compensated officers below.
Provide compensation information here:
Department of State Health Services Form 4734 — April 2022
Contract Management Section
Carbon Copy Events Status Timestamp
Gloria Diaz Sent: 5/18/2023 10:37:45 AM
COPIED
gdiaz@mylubbock.us Viewed: 5/18/2023 10:51:22 AM
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Shelva Mays
shelva.mays@dshs.texas.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
CMS Inbox
cmucontracts@dshs.texas.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 5/18/2023 10:37:45 AM
Payment Events Status Timestamps
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