HomeMy WebLinkAboutResolution - 2023-R0437 - HHSC Contract No. HHS000779500003, Treatment For Youth (TRY) Funding - 09/12/2023Resolution No. 2023-R0437
Item No. 5.32
September 12, 2023
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF TI IE CITY OF LUBBOCK:
THAT the acts of the Mayor of the City of Lubbock in executing, on behalf of the City of
Lubbock, Amendment No. 3 to the Health and IIuman Services Commission Contract No.
HHS000779500003, under the Substance Use Yrevention, Treatment and Recovery Services
Block Grant, to provide 'I'reatment for Youth (TRY) funding, by and between the City of Lubbock
and the State of Texas' Health and IIuman Services Commission, and related documents are
hereby ratified in full. Said Amendment is attached hereto and incorporated in this resolution as
if fully set forth herein and shall be included in the minutes of the City Council.
Passed by the City Council on September 12, 2023
1' �z7:�i
ATTEST:
Courtney Paz, City retary
APPROVED AS TO CONTEN"1':
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Bill Ha erton, Depu ity Manager
APPROVED AS TO FORM:
Foster, Assistant City Attorney
RES.HHSC Contract No. I�HS000779500003 Amendment No.3 Ratification
8.25.23
DocuSign Envelope ID: EA9F2883-AO39-4030-9A95-3175B5DOE388
Resolution No. 2023-RO437
HEALTH AND HUMAN SERVICES COMMISSION
CONTRACT No. HHS000779500003
AMENDMENT No. 3
The HEALTH AND HUMAN SERVICES COMMISSION ("HHSC" or "System Agency") and CITY
OF LUBBOCK ("Grantee"), collectively referred to as the "Parties" to that certain Treatment for
Youth (TRY) Contract effective August 1, 2020, and denominated HHSC Contract No.
HHS000779500003 ("Contract"), as amended, now desire to further amend the Contract.
WHEREAS, HHSC desires to revise the Statement of Work to update references and reporting
requirements; and
WHEREAS, the desires to update the block grant title to comply with U.S. Health and Human
Services revision of the block grant, and make other modifications as stated herein.
NOW, THEREFORE, the Parties amend and modify the Contract as follows:
1. ATTACHMENT A, STATEMENT OF WORK (APRIL 2021), is deleted in its entirety and replaced
with ATTACHMENT A, REVISED STATEMENT OF WORK (AUGUST 2023), which is attached to
this Amendment and incorporated into the Contract for all purposes.
2. ATTACHMENT B, PROGRAM SERVICES AND UNIT RATES (OCTOBER 2022), is deleted in its
entirety and replaced with ATTACHMENT B, REVISED PROGRAM SERVICES AND UNIT RATES
(AUGUST 2023), which is attached to this Amendment and incorporated into the Contract for
all purposes.
3. ATTACHMENT H, FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT
(FFATA) FORM, is attached to this Amendment and incorporated into the Contract and
Grantee is required submit a completed certification to meet the federal requirement.
4. All references to Substance Abuse (SABG) Block Grant or Substance Abuse Prevention and
Treatment (SAPT) Block Grant in the Contract and all attachments and exhibits, as amended,
are replaced with Substance Use Prevention, Treatment and Recovery Services (SUPTRS)
Block Grant without the need for modifying each Contract document.
5. This Amendment shall be effective on August 31, 2023.
6. Except as amended and modified by this Amendment, all terms and conditions of the Contract,
as amended, shall remain in full force and effect.
7. Any further revisions to the Contract shall be by written agreement of the Parties.
8. Each Party represents and warrants that the person executing this Amendment on its behalf has
full power and authority to enter into this Amendment.
SIGNATURE PAGE FOLLOWS
SIGNATURE PAGE FOR AMENDMENT NO.3
HHSC Solicitation No: HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Page 1 of 2
DocuSign Envelope ID: EA9F2883-AO39-4030-9A95-3175B5DOE388
HHSC CONTRACT No. HHS000779500003
HEALTH AND HUMAN SERVICES
COMMISSION
Un
[Docu3igned by:
� sWPJA,
E79F19B7A71B4AD
Roderick Swan
Associate Commissioner
August 28, 2023
Date of Signature:
CITY OF LUBBOCK
EI
igned by:
peyL&�-
E32C1148D
By:
Tray Payne
Mayor
August 28, 2023
Date of Signature:
HHSC Solicitation No: HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Page 2 of 2
DocuSign Envelope ID: EA9F2883-AO39-4030-9A95-3175B5DOE388
A. Grantee shall provide substance use disorder treatment services to the target population at
one or more of the following service types. levels of care. The below service types levels
of care are based on Texas Administrative Code (TAC) requirements, as referenced in the
Substance Use Disorder (SUD) Program Guide (currently available at:
https:i/www.hhs.texas.gov. providers/behavioral-health-services-providers/substance-use-
service-providers) and the American Society of Addiction Medicine (ASAM) criteria
(currently available at: www.asam.orv-), which is a collection of objective guidelines that
give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services
(ASAM Level 1 Outpatient Services)
2. Supportive Residential Treatment Services
(ASAM Level 3.1 Clinically Managed Low -Intensity Residential Services)
3. Intensive Residential Treatment Services
(ASAM Level 3.5 Clinically Managed High Intensity Residential Services)
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Youth Texas residents who meet client eligibility requirements for HHSC-funded
substance use disorder services as stated in the SUD Program Guide.
A. Administrative Requirements
1. Grantee shall adhere to the most current SUD Program Guide.
2. Grantee shall provide age -appropriate medical and psychological therapeutic
services designed to treat an individual's SUD and restore functions while
promoting recovery.
3. Grantee shall adhere to Level of Care; Service Type licensure requirements.
4. Grantee shall comply with all applicable Texas Administrative Code (TAC) rules
related to SUD treatment.
5. Grantee shall document all specified required activities and services in the Clinical
Management of Behavioral Health Services (CMBHS) system. Documents that
require client or staff signature must be maintained according to TAC requirements
and made available to HHSC for review upon request.
6. In addition to TAC and SUD Program Guide required policies and procedures,
Grantee shall develop and implement organizational policies and procedures, which
must be provided to System Agency upon request, for the following:
i. A marketing plan to engage local referral sources and provide information to
these sources regarding the availability of SUD treatment and the Client
Eligibility criteria for admissions;
ii. All published marketing materials, which must include state and federal
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment A
Page I
DocuSign Envelope ID: EA9F2883-A039-4030-9A95-3175B5DOE388
priority populations for Treatment Programs admissions; and
iii. Client retention in services, including protocols for addressing clients absent
from treatment and policies defining treatment non-compliance.
7. Grantee shall ensure that its Program Directors participate in their specific program
and service type conference calls as scheduled by HHSC. Program Directors shall
participate unless otherwise agreed to by HHSC in writing. Grantee executive
management may participate in the conference calls.
8. Grantee shall actively attend and share representative knowledge about Grantee's
system and services at the Outreach, Screening, Assessment, and Referrals (OSAR)
quarterly regional collaborative meetings.
9. Grantee shall adhere to Youth Program and Adult Program requirements and
provisions as provided in the SUD Program Guide.
10. Grantee shall ensure compliance with Client Eligibility requirements which
includes Texas residence eligibility, Financial Eligibility, and clinical eligibility as
specified in SUD Program Guide.
11. Grantee shall develop a local agreement with the Department of Family and
Protective Services (DFPS) local offices to address referral process, coordination
of services, and sharing of information in accordance with the consent form.
12. Grantee shall adhere to Memorandums of Understanding requirements as stated in
the SUD Program Guide.
B. Service Delivery
1. Grantee shall adhere to the requirements in the Federal Priority Populations for
Treatment Programs and State Priority Populations for Treatment Programs
section of the SUD Program Guide.
2. Grantee shall maintain Daily Capacity Management Report in CMBHS as required
in the SUD Program Guide.
3. Grantee shall maintain a wait list to track all eligible individuals who have been
screened but cannot be admitted to SUD treatment immediately and:
i. If there is an individual identified as a federal and State priority population on
the wait list, then Grantee that has shall confirm this in the Daily Capacity
Management Report;
ii. Grantee shall arrange for appropriate services in another treatment facility or
provide access to interim services as indicated within 48 hours from when
efforts to refer to other appropriate services are exhausted;
iii. Grantee shall offer services directly or through referral interim services to
waitlisted individuals;
iv. Establish a wait list that includes priority populations and interim services that
are available while awaiting admission to treatment services; and
v. Develop a mechanism for maintaining contact with individuals awaiting
admission.
4. If unable to provide admissions to individuals within Federal Priority Populations
for Treatment Programs and State Priority Populations for Treatment Programs
according to the SUD Program Guide, then Grantee shall:
i. Implement written procedures that address maintaining weekly contact with
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment A
Page 2
DocuSign Envelope ID: EA9F2883-A039-4030-9A95-3175B5DOE388
individuals waiting for admissions as well as what referrals are made when a
client cannot be admitted for services immediately;
ii. When Grantee cannot admit a client, who is at risk for dangerous withdrawal,
Grantee shall ensure that an emergency medical care provider is notified;
iii. Coordinate with an alternate provider for admission within forty-eight hours;
iv. Notify Substance Use Disorder (Substance _Use_Disorder@hhsc.state. tx.us) so
that assistance can be provided that ensures immediate admission to other
appropriate services and proper coordination when appropriate;
v. Provide pre -admission service coordination to reduce barriers to treatment,
enhance motivation, stabilize life situations, and facilitate engagement in
treatment;
vi. Adhere to Informed Consent Document for Opioid Use Disorder applicable to
individual as stated in the SUD Program Guide; and
vii. When an individual is placed on a Wait list, Grantee shall screen and document
interim services as referrals that provides applicable testing, counseling, and
treatment for Human Immunodeficiency Virus (HIV), tuberculosis (TB) and
sexually transmitted infections (STIs).
C. Screening and Assessment
1. Grantee shall comply with all applicable rules for SUD programs in the TAC
regarding Screening and Assessment and the State Information, Rules, and
Regulations section of the SUD Program Guide.
2. Grantee shall conduct the screening in a confidential, face-to-face interview.
3. Grantee shall document assessment in CMBHS.
4. Grantee shall document Financial Eligibility in CMBHS as required in the SUD
Program Guide.
5. Grantee shall conduct and document a CMBHS SUD initial assessment with the
client to determine the appropriate levels of care for SUD treatment. The CMBHS
assessment will identify the impact of substances on the physical, mental health,
and other identified issues including Tuberculosis, Hepatitis B and C, sexually
transmitted infection (STI), Human Immunodeficiency Virus (HIV). If the client:
i. Indicates risk for these communicable diseases, Grantee shall refer the client to
the appropriate community resources for further testing and counseling; and
ii. Is at risk for HIV, Grantee shall refer the client to pre- and post-test counseling
on HIV; and
iii. Is living with HIV, Grantee must refer the client to the appropriate community
resources to complete the necessary referrals and health related paperwork.
6. The Initial Screening or Initial Assessment must be signed by a Qualified Credential
Counselor (QCC) and fled in the client record within 3 Service Days of admission
or Grantee may accept an evaluation from an outside entity if it meets the criteria
for admission and was completed during the thirty (30) calendar days preceding
admission.
D. Treatment Planning, Implementation, and Review
1. Grantee shall comply with all applicable rules for SUD programs in the TAC
regarding Treatment Planning, Implementation and Review.
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment A
Page 3
DocuSign Envelope ID: EA9F2883-A039-4030-9A95-3175B5DOE388
2. Grantee shall collaborate actively with clients and family, when appropriate, to
develop and implement an individualized, written treatment plan that identifies
services and support needed to address problems and needs identified in the
assessment. The treatment plan must document the expected length of stay and
treatment intensity. Grantee shall use clinical judgment to assign a projected length
of stay for each client.
3. Grantee shall document referral and referral follow-up in CMBHS to the
appropriate community resources based on the individual need of the client.
4. The treatment plan must be signed by a QCC and filed in the client record within 5
service days of admission.
E. Discharge
1. Grantee shall comply with all applicable rules in the TAC for SUD Programs
regarding Discharge.
2. Grantee shall develop and implement an individualized discharge plan with the
client to assist in sustaining recovery.
3. Grantee shall document in CMBHS the client -specific information that supports the
reason for discharge listed on the discharge report. A QCC shall sign the discharge
summary. Grantee must make appropriate referrals and document in the client
record. A client's treatment is considered successfully completed if the following
criteria are met:
i. Client has completed the clinically recommended number of treatment units
(either initially Projected or modified with clinical justification) as indicated in
CMBHS;
ii. All problems on the treatment plan have been addressed; and
iii. Treatment plan component of CMBHS is used to create a final and completed
treatment plan version.
4. Problems designated as "treat" or "case manage" status in the client record must
have all objectives resolved prior to discharge. Problems further flagged as:
i. "Referred" must have associated documented referrals in CMBHS;
ii. "Deferred" must be reassessed. All deferred problems must be resolved prior to
successful discharge, either through referral, withdrawal, treatment, or case
management with clinical justification reflected in CMBHS, through the
Progress Note and Treatment Plan Review Components; and
iii. "Withdrawn" must have clinical justification reflected in CMBHS through the
Progress Note and Treatment Plan Review Components.
F. Additional Service Requirements
1. Grantee shall comply with all applicable rules in the TAC for SUD programs and
the State Information, Rules, and Regulations section of the SUD Program Guide.
2. Grantee shall deliver and provide access to services at times and locations that meet
the needs of the target population. Provide or arrange for transportation to all
required services not provided at Grantee's facility.
3. Grantee shall accept referrals from the OSAR.
4. Grantee shall provide evidenced -based education at minimum on the following
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment A
Page 4
DocuSign Envelope ID: EA9F2883-A039-4030-9A95-3175B5DOE388
topics: Tuberculosis, HIV, Hepatitis B and C, Sexually Transmitted
Infections/Diseases, and health risks of tobacco and nicotine product use.
5. As needed, Grantee shall conduct and record an assessment, including relevant
documentation, in CMBHS, to aid the ultimate success of the client.
6. Grantee shall ensure client access to the full continuum of treatment services and
shall provide sufficient treatment intensity to achieve treatment plan goals.
7. Grantee shall provide all services in a culturally, linguistically, non -threatening,
respectful and developmentally appropriate manner for clients, families, and/or
significant others.
8. Grantee shall provide trauma -informed services that address the multiple and
complex issues related to violence, trauma, and substance use disorders.
9. Grantee shall ensure that clients have the right to define their "families" broadly to
include biological relatives, and significant others to be included in the SUD
treatment process, which includes family counseling and family group of the
Family Support Network components of the curriculum.
10. Grantee shall ensure that clients and their family are referred to community support
services.
11. Grantee shall provide overdose prevention education to all clients.
12. Grantee shall conduct specific overdose prevention activities with clients with
opioid use disorders and those clients that use drugs intravenously.
13. Grantee shall directly provide or refer to community support services for overdose
prevention and reversal education to all identified at risk clients prior to discharge.
Grantee will document all overdose prevention and reversal education in CMBHS.
14. Grantee shall ensure access to adequate and appropriate medical and psychosocial
tobacco cessation treatment by:
i. Assessing all clients for tobacco use and clients seeking to cut back or quit.
ii. If the client indicates wanting assistance with cutting back or quitting, referring
client to appropriate tobacco cessation treatment.
iii. Obtaining parental consent, if applicable, to refer client for tobacco cessation
materials.
15. Grantee shall utilize System Agency as the payer of last resort if the Client has other
or outside funding available (i.e., wages, insurance, etc.).
A. All personnel must receive the training and supervision necessary to ensure compliance
with: (1) System Agency rules, (2) standards regarding provision of appropriate and
individualized treatment, and (3) standards regarding protection of client health, safety, and
welfare.
B. Grantee shall ensure that all direct care staff receive a copy of this Statement of Work and
SUD Program Guide.
C. Grantee shall ensure that all direct care staff review all policies and procedures related to
the Program or organization on an annual basis.
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment A
Page 5
DocuSign Envelope ID: EA9F2883-A039-4030-9A95-3175B5DOE388
D. Grantee shall ensure compliance with all applicable rules in the TAC for SUD Programs
regarding Personnel Practices and Development and the Personnel Requirements and
Documentation section of the SUD Program Guide.
E. Within 90 business days of hire and prior to service delivery, all direct care staff must have
specific documented training on the following topics:
1. Motivational Interviewing Techniques or Motivational Enhancement Therapy;
2. Trauma -informed care;
3. Cultural competency;
4. Harm reduction trainings;
5. HIPAA and 42 CFR Part 2 training; and
6. State of Texas co-occurring psychiatric and substance use disorder (COPSD)
training, available at: www.centralizedtraininiz.com.
F. Grantee shall ensure all direct care staff complete annual education on HIPAA and 42 CFR
Part 2 training.
G. Grantee shall ensure all direct care staff complete a minimum of cumulative 10 hours of
training each FY in any of the following areas:
1. Motivational Interviewing Techniques;
2. Cultural competencies;
3. Reproductive health education;
4. Risk and harm reduction strategies;
5. Trauma Informed Care; or
6. Suicide prevention and intervention.
H. QCCs are individuals in the Grantee staff responsible for planning, directing, or
supervising treatment services.
I. Grantee shall have a clinical Program Director known as a "Program Director" with at least
two (2) years of post-QCC licensure experience providing SUD treatment.
J. SUD counseling must be provided by a QCC, or Chemical Dependency Counselor Intern.
SUD education and life skills training must be provided by counselors or individuals who
have appropriate specialized education and expertise. All counselor interns shall work
under the direct Supervision of a QCC.
K. Licensed Counselors shall not provide services outside the scope of practice of the
counselor's licensure or use techniques that exceed the counselor's license authorization or
professional competence.
L. Grantee shall develop a policy and procedure on staff training, available for System
Agency review, to ensure that information is gathered from clients in a respectful,
nonthreatening, and culturally competent manner.
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment A
Page 6
DocuSign Envelope ID: EA9F2883-A039-4030-9A95-3175B5DOE388
M. Grantee shall adapt services and accommodate persons as appropriate to meet the needs of
special populations.
N. Grantee shall adhere to 25 TAC Rule 448.804 (Treatment Planning, Implementation and
Review) regarding direct care staff knowledge, skills, and abilities.
O. Grantee shall ensure direct care staff in youth programs have the knowledge, skills, and
abilities to provide services to youth, as they relate to the individual's job duties.
P. Grantee shall demonstrate through documented training, credentials, and/or experience that
all direct care staff are proficient in areas pertaining to youth services, including but not
limited to areas regarding substance use, misuse and substance use disorder treatment
specific to youth treatment, and appropriate treatment strategies, including family
engagement strategies, and emotional, developmental, and mental health issues foryouth.
Q. Grantee shall choose and implement one of the following evidence -based models:
1. Cannabis Youth Treatment Series (CYT);
2. Seeking Safety Treatment Series;
3. The Seven Challenges; or
4. Grantee may choose to use, with prior written approval by System Agency,
additional models, practices, or curricula that are evidence -based.
A. OUTPATIENT TREATMENT SERVICES
(ASAM Level 1 Outpatient Services)
1. Grantee shall adhere to applicable TAC requirements, including requirements for
adolescent programs, and SUD Program Guide for outpatient treatment services.
2. Grantee shall provide one hour of group or individual counseling services for every
six hours of educational activities. Grantee shall document said services in
CMBHS.
3. Grantee shall document in CMBHS a discharge follow-up no sooner than sixty
calendar days and before ninety calendar days after discharge from the outpatient
treatment services.
B. SUPPORTIVE RESIDENTIAL TREATMENT SERVICES
(ASAM Level 3.1 Clinically Managed Low -Intensity Residential Services)
1. Grantee shall adhere to applicable TAC requirements for supportive residential
services requirements and additional requirements for adolescent programs.
Additionally, Grantee shall adhere to SUD Program Guide for residential services.
2. Grantee shall document a discharge follow-up no sooner than sixty calendar day
and before ninety calendar days after discharge from the residential treatment
services in CMBHS.
3. Grantee shall facilitate regular communication between a youth client and the
client's family and shall not arbitrarily restrict any communications without clear
individualized clinical justification documented in the client record.
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment A
Page 7
DocuSign Envelope ID: EA9F2883-AO39-4030-9A95-3175B5DOE388
4. Grantee shall develop and implement written policy and procedures addressing
notification of parents or guardians in the event a youth client leaves a residential
Program without authorization and have available for HHSC review.
5. For pregnant and parenting clients, Grantee shall address the needs of parents on
the treatment plan either directly or through referral including but not limited to the
following:
i. Gender -specific parenting education;
ii. Reproductive health education and pregnancy planning;
iii. DFPS coordination;
iv. Family violence and safety;
v. Fetal and child development;
vi. Current infant and child safety guidelines;
vii. Financial resource needs; and
viii. And any other needs of the client's children.
C. INTENSIVE RESIDENTIAL TREATMENT SERVICES
(ASAM Level 3.5 Clinically Managed High -Intensity Residential Services)
1. Grantee shall adhere to applicable TAC requirements for intensive residential
services and additional adolescent programs. Additionally, Grantee shall adhere to
SUD Program Guide for residential services.
2. Grantee shall document a discharge follow-up no sooner than sixty calendar days
and before ninety calendar days after discharge from the residential treatment
services in CMBHS.
3. Grantee shall facilitate regular communication between a youth client and the
client's family and shall not arbitrarily restrict any communications without clear
individualized clinical justification documented in the client record.
4. Grantee shall develop and implement written policy and procedures addressing
notification of parents or guardians in the event a youth client leaves a residential
program without authorization. Upon System Agency request, policies and
procedures must be made available for System Agency to review.
5. For pregnant and parenting clients, Grantee shall address the needs of parents on
the treatment plan either directly or through referral including but not limited to the
following:
i. Gender -specific parenting education;
ii. Reproductive health education and pregnancy planning;
iii. DFPS coordination;
iv. Family violence and safety;
v. Fetal and child development;
vi. Current infant and child safety guidelines;
vii. Financial resource needs; and
viii. And any other needs of the client's children.
A. Grantee shall submit required reports of monitoring activities to System Agency by the
applicable due date(s) and the submission methods outlined in Table I. Submiasion
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment A
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RRe uirements. If the due date falls on a weekend or holiday, then due date is the following
business day.
B. All reports being submitted to the SUD Mailbox must utilize the following naming
convention in the subject line: [FY for Deliverable] Deliverable [Name of Deliverable]
TRY [Contract No.]
C. Grantee shall submit a Quarterly Match Report on System Agency -approved template, to
document Grantee's compliance to contribute five percent match.
D. Grantee's document submission obligations and requirements will survive the termination
or expiration of this Contract.
Requirement
Deliverable
Due Date
Submission System
(Report Name
Section V
Quarterly Match
Each FY. Ouarterlr•:
SUD Mailbox:
Ql: December 15th
Report
SUD.Contracts@hhs.texas.gov
Q2: March 15th
Q3: June 15th
Q4: September 15th
Attachment B
FY Closeout
Each FY:
SUD Mailbox:
October 15`h
SUD.Contracts@hhs.texas.gov
Attachment B
Final Closeout
Env 45 calendar days
SUD Mailbox:
after contract end
SUD.Contracts@hhs.texas.gov
ddt
Section VI
CMBHS Security
Each FY:
SUD Mailbox:
Attestation Form
September 15`h &
SUD.Contracts@hhs.texas.gov
and list of
March 151h
authorized users
SECTION VI: CLINICAL MANAGEMENT FOR BEHAVIORAL HEALTH SERVICES
(CMBHS) SYSTEM MINIMUM REQUIREMENTS
A. Grantee shall comply with all CMBHS requirements for the TRY program as detailed in
the System of Record section of the SUD Program Guide, which includes the following:
1. Designation of Security Administrator and backup Security Administrator.
2. Establishment of Security Policy.
3. Notifications to CMBHS Help -desk within 10 business days of any changes to Security
Administrator.
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment A
Page 9
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4. CMBHS user access, including removal of user access within 24 hours for those who are
no longer authorized to have access to secure data.
B. Grantee is required to maintain access to CMBHS for the entire duration of the Contract.
C. In addition to CMBHS Helpdesk notification, Grantee shall submit a signed CMBHS Security
Attestation Form and a list of Grantee's employees and contracted laborers authorized to have
access to secure data. The CMBHS Security Attestation Form and list must be submitted
electronically on or before the September 15th and March 15th of each FY.
D. Grantee shall attend HHSC training on documentation and recordkeeping in CMBHS.
A.
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment A
Page 10
DocuSign Envelope ID: EA9F2883-AO394030-9A95-3175B500E388
ATTACHMENT B
REVISED PROGRAM SERVICES AND UNIT RATES
(AUGUST 2023)
A. Contract is funded by the United States Health and Human Services (HHS), the Substance
Abuse and Mental Health Services Administration (SAMSHA), Substance Use Prevention
Treatment Recovery Services (SUPTRS) Block Grant, Assistance Listing Number (ALN)
93.959, and System Agency General Revenue.
B. Grantee shall comply with the following Code of Federal Regulation (CFR):
1. SUPTRS Block Grant: 45 CFR Part 96, Subpart C, currently available at:,
https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-96?toc=l; and
2. 2 CFR 200, currently available at: https://www.ecfr.gov/current/title-2/subtitle-A/chapter-
II/part-200?toc=1.
C. Grantee shall comply with Texas Grant Management Standards, currently available at:
https:Hcomptroller.texas. og_v/purchasing/grant-mana eg ment/
D. Funding
1. System Agency's share of total reimbursements is not to exceed $229,988.00 for the
Contract term of August 01, 2020 through August 31, 2025, as further specified and
allocated by state fiscal year in ARTICLE IV, BUDGET, of the Contract.
2. The required Grantee match for the same period is $11,496.00. Grantee is required to
contribute five percent matching of funds. Funding from the SUPTRS Supplemental
funding (HR133 and/or COVID-19) does not require matching of funds and is excluded
from the match calculations.
E. Claims and Payment Requirements:
1. Grantee shall submit claims in CMBHS no later than a month after services are rendered.
2. At the closure of each state fiscal year ("FY"), System Agency will conduct Contract
closeout activities. As part of the FY closeout activities, Grantee shall ensure all claims for
each FY are submitted in CMBHS by October 15 and System Agency may deny claims
submitted after October 15.
3. Additionally, Grantee shall submit all claims for the September service period of the
current FY by October 15, and any such claims that are submitted after October 15 may be
denied due to the grant budget period being closed.
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment B
Page I
DocuSign Envelope ID: EA9F2883-AO39-4030-9A95-3175B5DOE388
4. Final closeout activities will be conducted after the end of the Contract term and Grantee
shall submit final closeout documentation 45 calendar days from the end of the Contract
term.
5. System Agency may request additional supportive documentation to support the claims.
All requests for additional information must be provided by the deadline requested
F. Except as indicated by the CMBHS financial eligibility assessment, Grantee shall accept
reimbursement or payment from System Agency as payment in full for services or goods
provided to clients or participants. Grantee shall not seek additional reimbursement or payment
for services or goods, to include benefits received from federal, state, or local sources, from
clients or participants.
G. Budget Program Adjustment (BPA) Requirements
Grantee may request revisions to the approved service group distribution of funds budgeted
in the Service Type/Numbers Served/Capacity/Funding Amounts Chart by completing a
Budget Program Adjustment (BPA) Form and submitting the form to SUD Mailbox at
SUD. Contracts(a-)hhs.texas. gov with copy to the System Agency Contract Representative.
BPA Form must be completed correctly and completely to be accepted. System Agency
may reject the BPA Form if it is incomplete or incorrectly filled out.
2. System Agency will review the accepted BPA Form to determine if the request is allowable
under the Contract and RFA, if applicable. The estimated timeline for System Agency to
review and provide written communication regarding approval or denial of the request is
thirty calendar days from receiving an accepted BPA form.
Any revisions to the distribution of funds will result in revised numbers served and/or
capacity requirements.
4. The annual deadline to submit the BPA Form is March 1 st.
H. Any unexpended balance associated with any other System Agency Contract may not be
applied to this System Agency Contract.
I. System Agency funded capacity is defined as the number of clients who will be served as stated
under this Contract.
I Service Unit Rates
1. The unit rates for the service charts referenced in Section N are currently available at:
https:Hhhs.texas.izov/doing-business-hhs/provider-portals/behavioral-health-services-
providers/substance-use-disorder-service-providers. The document is titled "Treatment
Rate Sheet" and found under "Forms".
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment B
Page 2
DocuSign Envelope ID: EA9F2883-AO39-4030-9A95-3175B5DOE388
2. If the link to the webpage and/or location of the applicable unit rate document changes,
System Agency will provide Grantee notice through a broadcast message by email.
3. All unit rates are subject to change and contingent on available funding. If unit rates are
adjusted, System Agency will provide Grantee notice through a broadcast message by
email. All broadcast messages will be maintained in Grantee Contract file, and document
the following:
a. Treatment Program/Service Type unit rate adjustments;
b. Treatment Program/Service Type unit rate adjustments effective date; and
c. Treatment Program/Service Type method for receiving payments for the unit rate
adjustment.
4. There may be a delay between the effective date of the updated rate adjustment and the
such rate adjustment being reflected in CMBHS. In the event of a difference in the updated
adjusted rate and the rate reflected in CMBHS, the updated rate controls and payment will
be adjusted as described in Section J(5).
The method(s) by which the rate adjustment is implemented is determined by the effective
date of the rate adjustment. The methods are as follows:
a. If effective date is during the FY closeout period, then System Agency may conduct
reconciliation to extract paid claims data for services provided by Grantee during the
unit rate adjustment approval period. System Agency may calculate the difference
between Grantee's payment utilizing the unit rate in CMBHS versus the revised unit
rate. System Agency will thereafter issue Grantee a final reconciliation payment for the
difference between the two service unit rates. Grantee's fiscal year payment may not
exceed the total fiscal year allocation set forth in budget for the corresponding FY under
this Contract.
b. System Agency may revise the service unit rates manually in CMBHS to ensure all
service claims during the approved service period may be reimbursed at the revised
rate.
c. System Agency reserves the right to utilize different method(s) to process unit rate
adjustments.
d. Method(s) used to process the unit rate adjustment will be described in the System
Agency broadcast message.
K. Clinic numbers must be approved by the System Agency Contract Representative before
billing can occur. The Clinic Change Request Form is currently available at:
https:Hhhs.texas.gov/doing-business-hhs/provider-portals/behavioral-health-services-
providers/substance-use-disorder-service-providers. The document is titled "Clinic Request
Form" and found under "Forms".
L. Service Types with no associated amount will be paid from the preceding Service Type having
an associated amount.
M. Reimbursement of Allowable Costs for FY 2022 and FY 2023
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment B
Page 3
DocuSign Envelope ID: EA9F2883-AO39-4030-9A95-3175B5DOE388
Grantees may be eligible to receive additional payments for FY 2022 and 2023 for COVID-
19-related costs incurred for covered services that were not included under the fee for
service payment reimbursement mechanism.
2. Additional payments will only be made upon written approval from System Agency.
System Agency does not guarantee that additional payments will cover all COVID 19-
related costs. In no event will the total amount paid to any Grantee exceed the budget under
this Contract for the associated FY.
3. At its sole discretion, System Agency will determine additional payment amounts by
applying inflationary and/or market adjustment factors, such as the Consumer Price Index.
Additional payments will be based on Grantee's actual services provided and submitted to
System Agency for reimbursement through CMBHS no later than October 15 each year
for the FY.
4. Additional payments must comply with applicable provisions within 2 CFR 200 (Uniform
Administrative Requirements, Cost Principles, and Audit Requirements for Federal
Awards), Title 45 of the Code of Federal Regulations Part 96 (Block Grants), and the Texas
Grant Management Standards (TxGMS).
5. Additional payments will be made at the sole discretion of System Agency and are subject
to availability.
N. The Service Types, Numbers Served, Capacity, and Funding Amounts in the table below are
approved by System Agency. Grantee shall perform the required services set forth in the
Statement of Work of this Contract in accordance with the following cost categories:
SERVICE TYPE/NUMBERS SERVED/CAPACITY/FUNDING AMOUNTS
FY 2023 SERVICE CHART
Service Type
Number
Served
Capacity
Amount
Youth Intensive Residential
0
0
$0.00
Youth Intensive Residential Wraparound
Services - Room & Board Medicaid Youth
Youth Supportive Residential
0
0
$0.00
Youth Outpatient Services
26
3
$57,497.00
Youth Outpatient Group Counseling
Youth Outpatient Group Education
Youth Outpatient Individual
Youth Adolescent Support
Youth Adolescent Support — Medicaid Youth
Wraparound
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment B
Page 4
DocuSign Envelope ID: EA9F2883-A039-4030-9A95-3175B5DOE388
Youth Family Counseling
Youth Family Counseling - Medicaid Youth
Wraparound - Parent Education Sessions
Youth Family Support
Youth Family Support - Medicaid Youth
Wraparound
Youth Psychiatrist Consultation
Total
26
$57,497.00
FY 2024 SERVICE CHART
Service Type
Number
Served
Capacity
Amount
Youth Intensive Residential
0
0
$0.00
Youth Intensive Residential Wraparound
Services - Room & Board Medicaid Youth
Youth Supportive Residential
0
0
$0.00
Youth Outpatient Services
26
3
$57,497.00
Youth Outpatient Group Counseling
Youth Outpatient Group Education
Youth Outpatient Individual
Youth Adolescent Support
Youth Adolescent Support Medicaid Youth
Wraparound
Youth Family Counseling
Youth Family Counseling - Medicaid Youth
Wraparound - Parent Education Sessions
Youth Family Support
Youth Family Support Medicaid Youth
Wraparound
Youth Psychiatrist Consultation
Total
26
$57,497.00
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment B
Page 5
DocuSign Envelope ID: EA9F2883-AO394030-9A95-3175B5DOE388
FY 2025 SERVICE CHART
Service Type
Number
Served
Capacity
Amount
Youth Intensive Residential
0
0
$0.00
Youth Intensive Residential Wraparound
Services - Room & Board Medicaid Youth
Youth Supportive Residential
0
0
$0.00
Youth Outpatient Services
0
0
$0.00
Youth Outpatient Group Counseling
Youth Outpatient Group Education
Youth Outpatient Individual
Youth Adolescent Support
Youth Adolescent Support — Medicaid Youth
Wraparound
Youth Family Counseling
Youth Family Counseling — Medicaid Youth
Wraparound — Parent Education Sessions
Youth Family Support
Youth Family Support — Medicaid Youth
Wraparound
Youth Psychiatrist Consultation
Total
0
$0.00
HHSC Solicitation No. HHS0007795
HHSC Contract No. HHS000779500003
Amendment No. 3
Attachment B
Page 6
DocuSign Envelope ID: EA9F2883-A039-4030-9A95-317585DOE388
TENS Form 8040-A
August 2022-E
L� Health and Human Federal Funding Accountability and Transparency Act FFATA
Services 9 tY P Y ( )
Certification Form
The certifications enumerated below represent material facts upon which HHSC relies when reporting information to the federal government
required under federal law. If HHSC later determines that the contractor knowingly rendered an erroneous certification, HHSC may pursue all
available remedies in accordance with Texas and U.S. laws. The signer further agrees that they will provide immediate written notice to HHSC
if at any time they learn that any of the certifications provided for below were erroneous when submitted or have since become erroneous by
reason of changed circumstances. Note: If the signer cannot certify all of the statements contained in this section, they must provide written
notice to HHSC detailing which of the below statements they cannot certify and why.
Did your organization have a gross income, from all sources, of less than $300,000 in your previous tax year?
p Yes — Skip questions A, B and C and continue to section D. ® No — Answer questions A and B.
A. Certification Regarding Percent 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?
Q Yes ® No — Skip question C.
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 p No — Skip question C.
If your answer is Yes to both questions A and B, you must answer question C.
If your answer is No to either question A or B, skip question C and continue to section D.
C. Certification Regarding Public Access to Compensation Information
Does the public have access to information about the highly compensated officers/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?
0 Yes Q No — Provide the names and total compensation of the top five highly compensated officers/senior executives.
Name of Officer or Senior Executive
Total Compensation
1.
2.
3.
4.
5.
D. Signatures
As the duly authorized representative (signer) 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.
EDocuSlflned by:
�, VX August 28, 2023
3781 FE32� 46D...
Signature of Authorized Representative Date
Printed Name of Authorized Representative
Tray Payne
Title of Authorized Representative
Mayor
Legal Name of Contractor
Unique Entity Identifier
City of Lubbock
Applicable HHSC Contract No.(s):
DocuSign Envelope ID: EA9F2883-AO39-4030-9A95-3175B5DOE388
TEXAS
o PCS 515 CONTRACT ROUTING AND APPROVAL REQUEST Health and Human
U. Services
SectionContract
New Contract Number
❑ HHS000779500003
Amendment Number
3
New Work Order Number
Amendment Number
Contractor Legal Business Name:
CITY OF LUBBOCK
Total Contract Value (Including Renewals)
241,484.00
Note: Contract value is defined as the estimated dollar amount that the agency may be obligated to pay
pursuant to the contract and all executed and proposed amendments, extensions and renewals of the contract.
Requesting Agency/Program
HHSC MSS-SUDCMU
Contract Manager Name
Cristina Bunyard
Contract Manager Email Contract Manager Phone
cristina.bunyard@hhs.texas.gov N/A
Purchaser/Buyer Name
Section.. •
required approvers listed in Section 2 must include
approvers,This section contains all contract -specific approvers
contracts. All contract -specific
Financials. CAPPS approvals must occur in
Purchaser/Buyer Email Purchaser/Buyer Phone
as designated by Program. These individuals will be inserted into the CAPPS Financials approval process. The mimmurn
the contract manager, program staff, and legal approval; legal approval may be provided by email for boilerplate template
DocuSign, must be listed in this section to approve the contract in
the order below.
listedCAPPS
Is this a legal approved boilerplate template? ® Yes ❑ No If "Yes" attach Proof of Approval
Approver Title
Approver Name
Approver E-mail Address
1.
Contract Analyst
Ecrtina Bunyard
cristina.bunyard@hhs.texas.gov
2. Contract Administration M
Flames Driscoll
james.driscoll@hhs.texas.gov
3.
Legal
FharaniAmbreen
Ambreen.Dharani@hhs.texas.gov
4.
F_
5.
6.
1
F
7.
1
F
8.
1
F I
F
9.
10.1
11.1
1 1
F
Effective 10/23/2017 - 1 - Revised 01/13/2022
DocuSign Envelope ID: EA9F2883-AO39-4030-9A95-3175B5DOE388
TEXAS
o PCS 515 CONTRACT ROUTING AND APPROVAL REQUEST Health and Human
U. Services
DocuSign Routing Path Begins
Section 3: Internal Required D.Approvals
In addition to the approvals in Section 2 the following approvers are needed consistent with the chart below.
HHSC Contracts
Approver
Name
E-mail Address
Chief Financial Officer
Trey Wood
Trey.Wood@hhs.texas.gov
System Contracting Director
Andy Marker
Edward.Marker@hhs.texas.gov
Chief Financial Officer
Trey Wood
Trey.Wood@hhs.texas.gov
System Contracting Director
Andy Marker
Edward. Marker@hhs.texas.gov
Office of Chief Counsel
Karen Ray
Karen.Ray@hhs.texas.gov
OIG Contracts
$10,000,000 up to $19,999,999
Approver
Name
E-mail Address
Chief Financial Officer
Trey Wood
Trey.Wood@hhs.texas.gov
Chief Financial Officer
Trey Wood
Trey.Wood@hhs.texas.gov
System Contracting Director
Andy Marker
Edward. Marker@hhs.texas.gov
Office of Chief Counsel
Karen Ray
Karen.Ray@hhs.texas.gov
DSHS Contracts
$20,000,000 up to $49,999,999
Approver
Name
E-mail Address
System Contracting Director
Andy Marker
Edward.Marker@hhs.texas.gov
DSHS General Counsel
Cynthia Hernandez
Cynthia.Hernandez3@hhs.texas.gov
System Contracting Director
Andy Marker
Edward.Marker@hhs.texas.gov
Office of Chief Counsel
Karen Ray
Karen. Ray@hhs.texas.gov
Effective 10/23/2017 - 2 - Revised 01/13/2022
DocuSign Envelope ID: EA9F2883-A039-4030-9A95-3175B5DOE388
TEXAS
PCS 515 CONTRACT ROUTING AND APPROVAL REQUEST U. servl�esndHuman
Section 4: DocuSign Signatories
Signatory
Name
E-mail Address
Contractor Signature Authority
Tray Payne
TrayPayne@mylubbock.us
Additional Contractor Signature
Authority*
Contractor Signature cc
Gloria Diaz
Fgdlaz@mylubbock.us
HHS Signature Authority
[SwanRoderick
Roderick.Swan@hhs.texas.gov
HHS Signature Authority cc
SA Mailbox
SUD.Contracts@hhs.texas.gov
General Inbox cc
Cristina Bunyard
Fcristina.bunyard@hhs.texas.gov
* If adding an additional contractor signature authority, please provide instructions on which documents need to be completed by this individual.
Please cc: Katherine Wells at: kwells@mylubbock.us
Effective 10/23/2017 - 3 - Revised O1/13/2022
DocuSign Envelope ID: EA9F2883-AO39-4030-9A95-3175B500E388
TEXAS
o PCS 515 CONTRACT ROUTING AND APPROVAL REQUEST Health and Human
U.Services
INSTRUCTIONS
PURPOSE
To direct HHS contracts, work orders, amendments, renewals, and extensions through the routing and approval process.
WHEN TO PREPARE THIS FORM
This form shall be completed for any document requiring CAPPS Financials approval routing and for DocuSign contract signature routing.
Program area shall adhere to any HHS Circular-046 requirements to complete the form prior to submission to Procurement and
Contracting Services Quality Assurance ("PCS QA").
PROCEDURE TO COMPLET_E.. PCS 515
Section 1: To be completed by Program.
This section contains necessary contract information.
Section 2: To be completed by Program.
This section contains all contract -specific approvers as designated by Program. These individuals will be inserted into the CAPPS
Financials approval process. The minimum required approvers listed in Section 2 must include the contract manager, program staff, and
legal approval. All contract -specific approvers, except for the contract signatory who will review and approve in DocuSign, must
be listed in this section to approve the contract in CAPPS Financials. CAPPS approvals must occur in the order listed in Section 2.
DocuSign Routing Path Begins
Section 3: Required Approvals.
This section contains all required Office of Chief Counsel and Chief Financial Officer approvals based on contract value.
Section 4: To be completed by Program.
This section shall contain all required contract signatory information. These individuals will be inserted into the DocuSign routing path.
Effective 10/23/2017 - 4 - Revised 01/13/2022
DocuSign'
Certificate Of Completion
Envelope Id: EA9F2883A03940309A953175B5DOE388 Status: Completed
Subject: Amending $241,484.00; HHS000779500003; CITY OF LUBBOCK A-3;HHSC MSS-SUDCMU
Procurement Number:
Source Envelope:
Document Pages: 27 Signatures: 3 Envelope Originator:
Certificate Pages: 2 Initials: 0 Texas Health and Human Services Commission
AutoNav: Enabled 1100 W. 49th St.
Envelopeld Stamping: Enabled Austin, TX 78756
Time Zone: (UTC-06.00) Central Time (US & Canada) PCS_DocuSign@hhsc.state.tx.us
IP Address: 168.60.133.247
Record Tracking
Status: Original Holder: Texas Health and Human Services Location: DocuSign
8/10/2023 2-59-08 PM Commission
PCS DocuSign@hhsc.state.tx.us
Security Appliance Status Connected Pool- FedRamp
Storage Appliance Status: Connected Pool- Texas Health and Human Services Location: DocuSign
Commission
Signer Events Signature Timestamp
Tray Payne bySent: 8/10/2023 3:29:22 PM
TrayPayne@mylubbock.us [DOCUS'g-d
I^uM PA�In t Viewed: 8/25/2023 2:26:50 PM
Mayor 3M FE32CI I49D Signed: 8/28/2023 8:52:54 AM
City of Lubbock
Security Level: Email, Account Authentication Signature Adoption: Pre -selected Style
(None) Using IP Address: 208.84.91.41
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Roderick Swan bl Sent: 8/28/2023 8:52:56 AM
Roderick.Swan@hhs.texas.gov E011"S191*d
U SWAB Viewed: 8/28/2023 8:57:39 AM
Associate Commissioner E79FI967A71B4A . Signed: 8/28/2023 8:57:55 AM
Security Level: Email, Account Authentication
(None) Signature Adoption: Pre -selected Style
Using IP Address: 72.179.41.247
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
SA Mailbox COPIED Sent: 8/10/2023 3:29:21 PM
SUD.Contracts@hhs.texas.gov Viewed: 8/21/2023 8:57:30 PM
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Carbon Copy Events Status Timestamp
Not Offered via DocuSign
Cristina Bunyard
cristina.bunyard@hhs.texas.gov
Contract Specialist IV
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
COPIED
--]
Gloria Diaz COPIED
gdiaz@mylubbock.us
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Katherine Wells COPIED
kwells@mylubbock.us
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Sent: 8/10/2023 3:29:21 PM
Viewed: 8/28/2023 10:06:17 AM
Sent: 8/24/2023 11:30:26 PM
Viewed: 8/25/2023 8:20:39 AM
Sent: 8/24/2023 11:30:26 PM
Witness Events
Signature
Timestamp
Notary Events
Signature
Timestamp
Envelope Summary Events
Status
Timestamps
Envelope Sent
Hashed/Encrypted
8/10/2023 3:29:21 PM
Envelope Updated
Security Checked
8/24/2023 11:30:25 PM
Envelope Updated
Security Checked
8/24/2023 11:30:25 PM
Envelope Updated
Security Checked
8/24/2023 11:30:25 PM
Certified Delivered
Security Checked
8/28/2023 8:57:39 AM
Signing Complete
Security Checked
8/28/2023 8:57:55 AM
Completed
Security Checked
8/28/2023 8:57:55 AM
Payment Events
Status
Timestamps
No Text