HomeMy WebLinkAbout15623 ORD - 07/02/1980•kh :7-1-80;]st
AN ORDINANCE
AUTHORIZING EXECUTION OF A CONTRACT WITH THE TEXAS
DEPARTMENT OF HUMAN RESOURCES TO PROVIDE A TITLE XX
GRANT FOR $52,530 TO PAY FOR FAMILY PLANNING SERVICES
FOR INCOME ELIGIBLE PARTICIPANTS FROM SEPTEMBER 1,
1980 THROUGH AUGUST 31, 1981, ALL AS MORE FULLY SET
FORTH IN THE CONTRACT, A SUBSTANTIAL COPY OF WHICH IS
ATTACHED HERETO AND MADE A PART HEREOF, MARKED EXHIBIT
"A"; AND DECLARING AN EMERGENCY.
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CORPUS CHRISTI,
TEXAS:
SECTION 1. That the City Manager be authorized to execute a contract
with the Texas Department of Human Resources to provide a Title XX grant for
$52,530 to pay for family planning services for income eligible participants
from September 1, 1980 through August 31, 1981, all as more fully set forth
in the contract, a substantial copy of which is attached hereto and made a
part hereof, marked Exhibit "A".
SECTION 2. The necessity to authorize execution of the aforesaid
contract at the earliest practicable date creates a public emergency and an
imperative public necessity requiring the suspension of the Charter rule that
no ordinance or resolution shall be passed finally on the date of its intro-
duction but that such ordinance or resolution shall be read at three several
meetings of the City Council, and the Mayor having declared that such emergency
and necessity exist, having requested the suspension of the Charter rule and
that this ordinance be passed finally on the date of its introduction and take
effect and be in full force and effect from and after its passage, IT IS
ACCORDINGLY SO ORDAINED, this the` p)(;Qday of July, 1980.
ATTEST:
APPROVED:
DAY OF JULY, 1980:
J. BRUCE AYCOCK, CITY ATTORNEY
By
41;
Assistant Cit iprney
THITY OF CORPUS CHRISTI, TEXAS
156P3
MICROFILMED
\WG 91980
•
axes De- nent
' of H
'Contract
081-40—P-00
SECTION 1 — Prime Contractor Data
INFORMATION SHEET
PURCHASE OF SERVICE CONTRACT
v01-4u—r—Uu
Effective 09-01-80
2029
1978
'Replan No.
08
(County No.
178
Legal Name' -
City of Corpus Christi
Commonly Used Name d
�Comract ENeetive Data
09-01-80
(' Brent
4' ff few Nueces County—City of Corpus
Christi Department of Public Health and Welfare
Address
�ComractTermination Date
08-31-81
P.O. Box 9277, Corpus Christi, TX 78408
Person Authorized
Telephone No.
512/884-3011
to Sign Contract
R. Marvin Townsend
Charter No.
Title
City Manager
Term of Ownership (Check one)
(IP,ddle ❑Prnrate
N/A 1Employer I.D. No.
17460005741
Contact Person
C.M.G. Buttery, M.D., M.P.H.
Telephone No.
r 512/855-4051
SECTION 1I —Summary of
•
EFFECTIVE PAYMENT DATES
BUDGET NAME
BUDGET
NUMBER
UNIT
RATE
NUMBER
ELIG. UNITS
MAXIMUM
REIMBURSABLE
•
Less fees from eligible clients (trait rate payment only)
—
Total Regional Allocation foithls contract
SECTION III — Funding
LOCAL FUNDS
$ 5,253.00
CONTRACT
Matching } -'
2.426 50
$ 7.879.50
Administrative Overhead
Total Local Fund
$ 5 253.00
State Funds
Federal Funds
47,277.00
Contract Total
$ 52,530.00
Effective 09-01-80
02029
SECTION IV — Service and/or Subcontractor Data (complete a separate sheet (SECTION nil for each different service or for each different
subcontract)
Program Activity Name Code
Family Planning 591
Service Activity Name Social and Educational Family Planning Services;code
Medical Family Planning Services , 16E, 16K
Name
of Subcontracting Agency 16 applicable) Name of Contac Person
N/A
Address of Subcontracting Agency Telephone No.
1. Client categories to be served (check all applicable):
® Current AFDC
® Current SSI
® MAO Income Eligible
®Other Income Eligible
❑Without Regard to Income
® Ineligible
2. Total Number of Clients to be Served. 0 per day 0 per week 0 per month
3. Number of Eligible Clients to be Served: 0 per day 0 per week 0 per month
4. Unit of Service•
5. Number of Units of Service to All Clients:
6. Number of Units of Service to Eligible Clients:
7. A.
IS
ADDRESSIES) OF
PROVIDING FACILITY(IES)
HOURS OF
OPERATION
•••••-- . .wulpiom .....y am vim: .s cal wren 5 clay care)
NUMBER OF CHILDREN IN EACH AGE GROUP
0-2 YRS.
3-6 YRS.
6-14 YRS.
0-5 YRS.
0-14 YRS.
0.17 YAS.•
1702 Horne Road
Corpus Christi, TX
78416
Also see attachment
TOTALS
Physically, or Emotionally Handicapped
8. Geographic Area Served: Nueces County
9. Goals (check all applicable):
01 ®II ❑III .01V ❑V
10. Source of Federal Funds (check all applicable):
LI1XX ❑IV -B
11. Basis of Payment (check one):
❑Fixed Unit Rate of $
❑Cost Reimbursement
X Fee Schedule (Local Match)
per
12. Fundine:
TOTAL AMOUNT OF
STATE FUNDS
$ —0—
MATCH AMOUNT OF
LOCAL FUNDS
5,253.00
TOTAL AMOUNT OF
FEDERAL FUNDS
47,277.00
GRAND TOTAL
$52,530 00
i
Teras Department
'of Human Resources
081-40—P-00
Effective 09-01-80
' Form 2040
September 1980
FAMILY PLANNING CONTRACT PLAN OF OPERATION: PROGRAM
DESCRIPTION
I. Goals
Pursuant to the mandate of PL 93-647, the Family Planning Program defined
by the terms of this document shall operate toward the achievement of the
following goals:
A. Achieving or maintaining economic self-support to prevent, reduce, or
eliminate dependency.
B. Achieving or maintaining self-sufficiency, including reduction or preven-
tion of dependency.
C. Preventing or remedying neglect, abuse, or exploitation of children and
adults unable to protect their own interests, or preserving, rehabilitating,
or reuniting families.
II. Objectives and Measures
A. To offer social and educational family planning services to Its current
recipients of AFDC, SSI, and MAO within the contract period.
B. To offer social and educational family planning services tc2.5.110_income
eligible persons within the contract period.
C. To offer medical family planning services to 2500 income eligible per-
sons within the contract period.
D. Measure. The number of current recipients and income eligible persons
who receive family planning services within the contract period.
10. Services to be Covered
A. Office or Clinic Visits (Physician Directed)
The Department will provide reimbursement for the following services
and procedures when prescribed, furnished, directed, or supervised by a
physician.
1. Complete Health History and Physical Examination (Code 01) to
consist of:
a. Complete obstetric and gynecologic history (including
menarche, menstrual, gravidity, parity, pregnancy outcomes,
and complications of pregnancy/delivery).
•
081-40-9-00
Effective 09-01-80
• Fmm 2040
Page 2
b. History of significant illness-morbidiry, hospitalization, and
previous medical care, including particularly information about
thromboembolic disease, hepato -renal disease, breast and
genital neoplasm, diabetic and prediabetic conditions,
cephalgia and migraine, hematologic phenomena, pelvic
inflamatroy disease, visual disturbances, and mental depression -
c. History of problems relating to previous contraceptive use.
d. Family, social, physical, and mental health history.
e. Physical examination- Recommended procedures for examina-
tion include, but are not limited to:
(1) Thyroid palpatation
(2) Examination of breasts and auxiliary glands
(3) Ausculation of heart and lungs
(4) Blood pressure
(5) Weight and height
(6) Abdominal examination
(7) Pelvic examination
(8) Examination of extremities
f. Patient consultation. Consultation includes:
(1) Instruction of reproductive anatomy and physiology.
(2) Overview of available methods of contraception includ-
ing consultation on the use of a natural family planning
method if chosen by the patient.
Duration or frequency
There is a limit of one annual comprehensive examination and
evaluation for each eligible patient per Stare fiscal year (Sep-
tember 1 through August 31), excepting that a second com-
prehensive examination may be provided where a user of a
temporary contraceptive method elects surgical sterilization, in
which case a second comprehensive examination may be billed.
2. Follow-up Visits
a. There may be follow-up visits (Code 02) or examinations
when medically necessary including home visits as required.
b. A medical home visit (Code 34) is one made in response to an
acute medical circumstance, requiring a medically -trained pro-
fessional. It must be conducted under the standing orders of a
physician or performed by a physician.
8.
•
Effective 09-01-80
, Form2040
Page 3
B. Laboratory Services
1. The following laboratory services are reimbursable as routine pro-
cedures covered under family planning services:
a. Hematocrit (Code 03) and/or hemoglobin (Code 04)
b. Urinalysis (for sugar and protein) (Code 05)
c. Papanicolaou smear (including cervical and vaginal) (Code 06)
d. Miscellaneous culture for venereal disease (if indicated)
(Code 07)
e. Syphilis serology (if indicated) (Code 08)
f. Bacteria smear (e.g., bacterial study of Trichomoniasis, yeast,
etc.) (Code 09)
g. Trigycerides fasting level confirmation test for patients 40
years of age and over (Code 55)
h. Cholesterol/glucose fasting level confirmation test for patients
40 years of age and over (Code 56)
2. The special laboratory services and procedures noted below will be
covered if needed as a result of positive history or if deemed
medically necessary at the time of examination:
a. Tuberculosis skin rest (Code 10)
b. Microscopic analysis of urine (Code 11)
c. Sickle cell screening (Code 12)
d. Hemoglobin electrophoresis (Code 32)
e. Post-prandial blood glucose (blood sugar) (Code 13)
f. Rubella hemaglutinarion test (antibody screen) (Code 14)
g. Pregnancy testing upon patient's request, including drop -ins
(Code 15)
h. Blood type and/or Rh factor determination (Code 45)
i. Triglycerides fasting level confirmation rest for patients under
40 years of age (Code 55)
j. Cholesterol/glucose fasting level confirmation test for patients
under 40 years of age (Code 56)
k. Urine culture (Code 57)
•
081-40–P-00
Effective 09-01-80 •
Form 2040
Page 4
3. Duration or Frequency
a. In connection with the annual examination and evaluation, the
procedures listed as routine will be covered immediately.
b. Additonal laboratory procedures noted as special will be
covered if indicated as the result of positive history or if
deemed medically necessary at the time of examination by the
attending physician or medical director in charge.
c. The follow-up visits and subsequent laboratory procedures will
be covered if deemed necessary by the attending physician or
medical director and if considered an integral parr of family
planning services.
d. These services and procedures must be provided in the context
of medical judgment using policies and practices that con-
stitute high quality family planning services.
C. Contraceptive Methods and Devices.
Reimbursement will be made by DHR for these services:
1. Voluntary female sceriliz<ation: Tubal ligation (Code 16) — The
single surgical component covered by the fee is the primary physi-
cian. Hospital charges must be billed to Code 00, Complete In -
Patient Hospital Care, except hospital charges for complications
which must be billed to Code 44, Treatment of Complications.
Sterilization claims mime be accompanied by a written informed con-
sent document and must comply with Federal sterilization regula-
tions (42CFR, Parr 441, Subpart F).
2. Voluntary male sterilization: Vasectomy (Code 17) — Componenrs
covered by this fee include physician services, procedure room,
equipment, supplies, anesthesia, one sperm count, and tissue
analysis. If performed in a free-standing facility, any subsequent hos-
pital charges must be billed to Code 44, Treatment of Complica-
tions. If performed in a hospital -connected facility, the only specific
hospital charges allowed are for Code 53, Post -Operative Iii -Patient
Hospital Care, except hospital charges for complications which must
be billed to Code 44, Treatment of Complications. Sterilization
claims must be accompanied by a written informed consent docu-
ment and must comply with Federal sterilization regulations (42
CFR, Part 441, Subpart F).
081-40–P-00
Effective 09-01-80
F01'4 12040
Page5
3. Contraceptive menstrual aspiration (Code 48) — Components
covered by the fee include, physician services, procedure room,
equipment, supplies, anesthesia, and tissue analysis. This procedure
is allowed only prior to the definitive determination of the existence
of pregnancy. Documentation of the uncertain status of pregnancy
must be included in the patient's record. If performed in a free-
standing facility, any subsequent hospital charges must be billed on
Code 44, Treatment of Complications. If performed in a hospital
facility, the'only hospital charges allowed are Code 53, Post -Opera-
tive In -Patient Hospital Care, except hospital charges for complica-
tions which must be billed to Code 44, Treatment of Complications.
4. Furnishing and insertion of intrauterine (IUD) contraceptive
devices (Code 20).
5. The fitting and furnishing of diaphragms when furnished by the
clinic and not by prescription (Code 21).
6. When furnished by prescription, payment will be made for the
following contraceptive supplies.
a. Oral contraceptives (Code 40) and compact containers. In addi-
tion, payment will be made for dispensing oral contraceptives
in quantities of three or more cycles (Code 46).
b. Jellies (Code 36), creams (Code 35), suppositories (Code 37),
and foams (Code 38).
c. Diaphragms (Code 41).
d. Condoms (Code 42).
e. Natural family planning supplies (Code 43) (e.g., instruction
books, charts, thermometers).
f Medications for treatment of genital infections (Code 39). The
agency will be reimbursed the standard amount for one treat-
ment period of one disease per patient regardless of the
quantity or brand name of the medication.
When the medication is prescribed for the patient as well as
his/her partner (e.g. oral Flagyl tablets), the claim for the
medication for the partner must be billed on a separate Family
Planning Patient Visit Report (Form 2017). One Form 2017
must be completed for each person. However, the patient's
partner need not apply separately for services (Form 2050) if
he/she resides in the same household and is married legally or
common-law to the patient. When the patient's partner does
not reside in the same household or is not legally or common-
law married to the patient, he/she needs to apply for separate
certification of eligibility for services (Form 2050) before a
separate Form 2017 can be completed to claim reimbursement
for medication dispensed to him/her.
•
- -VV
Effective 09-01-80
•Form 2040
Page 6
D. Localization of Intrauterine Device (Codes 22, 23, and 24) — Reim-
bursement will be made by DHR for X-rays plus interpretation, and/or
for sonography, to localize an intrauterine device not otherwise detecta-
ble.
E. Social Services Counseling — These services are purchased from family
planning agency providers.
I. Initial Patient Education and Counseling (pre -exam counseling)
(Code 25)
a. Education of patient concerning the various contraceptive tech-
niques from which the patient may choose a method most per-
sonally suitable.
b. Education of the patient regarding elementary reproductive
anatomy in order to facilitate more effective use of the method
chosen.
c. Allowable as a reimbursable expense once during each period
of active patient status with any one provider agency, with the
exception chat this service can be reimbursed a second time for
the same patient during the same period of active status when
the patient is an adolescent or when the patient is receiving
contraceptive services following an abortion. A patient's chart
must have been closed for at least one year before this benefit
can be billed again for a reactivated patient with the same agen-
cy.
2. Specific Education/Counseling on Method Chosen (Code 26)
a. After the patient has been examined by the physician and has
chosen the most personally suitable contraceptive method,
which is not contraindicated, education and counseling are
given to the patient about proper use, possible side effects,
reliability, reversibility, etc.
b. This service will be paid for when provided after an initial
exam, annual exam, or when the patient changes method or
experiences difficulty with a contraceptive method.
3. Follow-up Home Visit, Non -Medical (Code 27)
a. Social services home visit follow-up consists of contacting
patients for such reasons as having missed medical appoint-
ments, reporting Pap smear results, reporting other significant
laboratory findings, or instructing about natural family plan-
ning, if the patient has not responded to telephone or mail con-
tacts. •
•
081-40–P-00
Effective 09-01-80
•
Form 2040
Page 7
b. This service will be paid for as often as the program director
deems it necessary to serve a patient.
c. This benefit includes personal visits only. Telephone and mail
contacts are not reimbursable nor are home visits for con-
traceptive supply delivery (these can be mailed).
4. Problem counseling (Code 28) includes counseling with patients
(with or without referrals to other agencies) for such as pregnancy,
venereal disease, social/marital problems, nutritional deficiency,
suspected cancer, genetic disorder, or human sexuality concerns (e.g.
of the handicapped and adolescents). This service will be paid for
each rime it is deemed necessary by the physician. Allowable once
for each counseling session, whether counseling an individual, a
couple, or a large group.
S. Introduction to family planning/hospital setting (Cade 30), consists
of a general overview to an individual of the benefits of family plan-
ning. Allowable only once for each person individually introduced
to family planning within a hospital setting.
6. Instruction in natural family planning methods (Code 47) consists
of two sessions for complete instruction of a couple or an individual
in one or more methods of natural family planning (defined as
methods for determining the fertile and infertile periods in a
woman's cycle by such approaches as calendar record keeping,
monitoring basal body temperature, and/or analyzing the woman's
cervical mucus). This instruction is allowable as a reimbursable
expense once during each period of active patient status with any
single provider agency.
F. Complete In-patient Hospital Care for Female Sterilization Per-
formed in a Hospital Only (Code 00) — An individual is considered to
have inpatient status if the following criteria are met:
a. Patient is formally admitted to a certified hospital.
b. Patient is assigned a bed. This bed may be either a recovery room
bed or a hospital room bed. Length of stay is unimportant- (patient
need not stay overnight).
Reimbursement under Title XX will be made by the Department
for all inpatient expenses actually incurred in the performance of
tubal ligations to a maximum of five days hospital confinement. In-
patient expenses are considered to include but are not limited to
room, meals, supplies, and laboratory and radiology out-patient
work-ups (related to in-patient hospital care in connection with a
female sterilization) prior to admission to the hospital, provided not
more than 30 days prior to hospital admission for the sterilization or
the planned period of admission in cases where the sterilization was
never performed.
•
uts1-40—P-00
Effective 09-01-80
Form 2040
Page 8
Code 00 claims for laboratory and radiology provided under out-
patient circumstances and related to in-patient hospital care in con-
nection with a female sterilization must only be for those services
not otherwise specifically included in the Plan for Operation of the
Contract (Form 2040).
The our -patient laboratory and radiology services must not be repe-
ated upon hospital admission unless justified as medically indicated
by medical record information. In addition to the required derailed
itemized statement, there must be an explanation accompanying
each billing of the reasons for the laboratory/radiology services, their
medical necessity, and their relevancy to the female sterilization -
If a patient is admitted to the hospital but decides against the family
planning surgery which is scheduled, the provider may be reim-
bursed under Title XX for the in-patient cost associated with this
case. In such instances, a letter of explanation must accompany the
billing sent to Fiscal Division.
When billing the Department for any in-patienr hospital procedure,
the provider must include the professional surgical fee as well as the
hospital charges on the same bill. They must not be billed separately.
When a patient enters the hospital at the end of one month and is
discharged at the beginning of the next month, the entire procedure
must be billed during the month of discharge. The hospital detail of
charges, consent form, etc., must be attached to the appropriate
Form 2017, Family Planning Patient Visit Report For hospitaliza-
tion multiple surgical procedures, 65% of the in-patient care must
be charged to the non -family planning procedure (e.g. delivery) and
35% to the family planning procedure (e.g. sterilization). Reimbur-
sement for hospital charges on two consecutive family planning pro-
cedures, such as an abortion and a sterilization, is based on a 50%
split to each procedure. In billing for family planning hospital care
which extends beyond the five-day limit, the following formula
should be used: total hospital cost divided by number of days, times
5 equals maximum amount reimbursable by DI -IR for the Title XX
family planning hospital care in conettion with sterilization surgery
(minus 15% if State match is used.) The entire bill (not a summary)
must be submitted. Expenses incurred in the treatment of complica-
tions are not to be included when billing on this code.
Note: See Treatment of Complication (Code 44) for procedures
when billing for complications arising during the client's in-patient
hospitalization.
•
081-40–P-00
Effective 09-01-80
•
• Form 2040
Page 9
G. Post-operative In-patient Hospital Care for Contraceptive
Menstrual Aspiration and Vasectomy Performed in a Hospital Only
(Code 53) — Reimbursement for all expenses actually incurred for post-
operative care, including bedroom, meals, attendant care, and incidental
services and supplies while recovering post-operatively. At least one
night's stay must have occurred post-operatively. A maximum of five
days confinement is allowed. A copy of the derailed hospital bill must be
submitted which itemizes in detail the services rendered. These services
must not be billed separately from the billing for the surgery to which
they relate. Expenses incurred in the treatment of complications must
not be billed on this code.
H. Treatment of Complications from Family Planning Surgery or IUD
Insertion (Code 44) — Reimbursement will be made by the Depart-
ment for all expenses actually incurred in the care and treatment of com-
plications from family planning surgery (sterilization or contraceptive
menstrual aspiration) or IUD insertion, to the maximum dollar amount
per occurrence as set forth in the fee schedule.
An explanation of the type of complication and circumstances of occur-
rence of the complication must accompany such a claim for reimburse-
ment of treatment of complications. A detailed itemization of services
must be attached to the claims form to document services rendered.
Examples of treatment of complications include medication for treat-
ment of post-surgical infections, and medication for treatment of swell-
ing after a vasectomy.
When the complications are related to a sterilization procedure per-
formed subsequent to another procedure the complication treatment
costs must be separated our as follows:
1. For complications of sterilization performed subsequent to another
family planning procedure (e.g. abortion) split the complications
treatment 50% — 50%.
2. For complications of sterilization performed subsequent to a non -
family planning procedure (e.g. delivery) split the costs 65% —
35%.
Provider agencies are obligated to treat complications (either on an in-
patient or our -patient basis) that arise from surgical procedures per-
formed under the contract even if the cost exceeds the amount reimbur-
sable through the Title XX contract. The agency must absorb the cost. A
contingency fund to cover these costs is recommended to be set up.
Agencies are not required to perform requested family planning pro-
cedures when the likelihood of complications appears subsrantiaL
Anesthesiologist fees (Code 33) — Reimbursement will be made for
anesthesiologist fees incurred for female sterilizations. An itemized bill
from the anesthesiologist must be submitted with the sterilization claim
as supportive documentation.
•
Texas Department
of Human Resources
STATE OF TEXAS
, COUNTY OF TRAVIS
Form 2034
September 1980
TITLE XX
FAMILY PLANNING CONTRACT NO. P3 081-40—P—OO
The Texas Department of Human Resources, hereinafter referred to as the Department, and
CITY OH CORPUS CAR/STI
hereinafter referred to as the Contractor, which has been certified by the Departments Title XIX fiscal
intermediary agent as a Title XIX family planning vendor, do hereby make and enter into this contract,
which constitutes the entire agreement between the Contractor and the Department.
The Department is the single Texas state agency responsible for administering the public welfare program under
the Social Security Act. Federal law and regulations, as well as State law, in Chapter 22 of the Human Resources
Code, permit and authorize the Department, subject to certain limitations, to enter into agreements with public
or private agencies for the purposes of providing social and/or other services for the benefit of eligible
individuals. Since the Contractor desires to provide services for the benefit of certain eligible individuals, as
described herein, the Department and the Contractor make this contract.
The parties hereto mutually agree:
A. The scope of the services to be provided by the Contractor and/or subcontracting agency(ies) under this
contract, is limited to those services listed in the Plan of Operation which is attached ro this contract and
incorporated into this contract in its entirety by specific reference. Any change, modification, or amendment
thereto. must be made with the prior written approval of the Department except as otherwise provided in
this contract and any such change, modification, or amendment to such Plan of Operation is not effective
until approved by the Department. Such original Plan of Operation, currently effective fee schedule attached
ro this contract, and any approved amendment as maintained on file by the Department will be o. nsidered to
be the controlling instruments in case any disputes arise relative to the wording of any portion of such Plan
of Operation fee schedule or amendment thereto.
B. Medical and social services under this contract are extended to income eligible individuals. Social
services under this contract are extended to current AFDC and SSI recipients. Services offered to current
AFDC recipients, current SSI recipients, and income eligible individuals must be fully integrated with
those offered to patients not subsidized by the Department.
C. The basis for payment for services rendered under this contract is indicated in the fee schedule approved by
the Board of Human Resources. The Department may revise the fee schedule at any time by giving the Con-
tractor written notice of such revision. The fee schedule is effective upon adoption by the Board of Ituman
Resources. Any contractor -initiated amendment to the fee schedule is subject to prior written Department
approval.
•
Form 20•
Page 2
Rev_ 9-80
D. The Department, the Contractor and all subcontractors, if any, will carry out the requirements for the pro-
vision of services as set forth in Chapter II, Title 45 of the Code of Federal Regulations, as amended, will
monitor and conduct fiscal and/or program audits at reasonable times artd will provide consultative and
technical assistance for the continuous development of the services contemplated by this contract. The
Department shall have authority to monitor and conduct fiscal and/or program audits of both the contrac-
tor and its subcontractor(s) to the extent of services provided under the terms of this contract. On site visits
as welLas.accessatreasonable times to all books and records will be granted State or Federal auditing agen-
cies, representatives of the United States Department of Health and Human Services and/or the Department
when it is deemed necessary by such agencies for purposes of inspection, monitoring, auditing, or -evaluating
said materials.
E.
This contract is subject to the availability of State and Federal funds and if such funds become unavailable,
or if the total amount of funds allocated for this contract should become depleted during any budget period
and the Department is unable to obtain additional funds for such purposes, then this contract will be termi-
nated by written notice.
In the event that the Contractor fails to provide services in accordance with the provisions of this contract,
the Department may, upon wrirten notice of default to the Contractor, immediately terminate the whole
or any parr of this contract, and such termination shall not be an exclusive remedy but shall be in addition
to any other rights and remedies provided by law or under this contract.
Furthermore, in the event that Federal or State laws or other requirements should be amended or judicially
interpreted so as to render continued fulfillment of this contract, on the part of either party, substantially
unreasonable or impossible, or if the parties should be unable to agree upon any amendment which would
therefore be needed co enable the substantial continuation of the services contemplated herein, then, and
in that event, the parties shall be discharged from any further obligations created under the terms of this
contract, except for the equitable settlement of the respective accrued interests or obligations incurred up to
the date of termination.
F. This contract may be canceled by mutual consent; however, if such mutual consent cannot be attained, then,
and in that event, either party to this contract may consider it to be canceled by the giving of thirty (30)
days notice in writing to the other party and this contract shall thereupon be canceled upon the expiration of
such thirty (30) day period.
The Contractor agrees to. and will require its subcontractor(s) if any, to agree to:
A. Provide services in accordance
monitor same.
B.
C.
Provide to the Department, in
and proper monthly statement
rendered under this contract.
with the aforementioned Plan of Operation and allow the Department to
accordance with the procedures prescribed by the Department, a verified
of charges, or certification of expenditures, for services which have been
Refrain from entering into any subcontract(s) for services without prior approval or waiver of the right
of approval to subcontract, from the Department.
All subcontracts, if any, entered into by the Contractor shall be in written form Any subcontract entered
into by the Contractor shall be subject to the requirements of Title XX of the Social Security Act, as
amended, and of this contract. The Contractor agrees that it shall be responsible to rhe Department for the
performance of any subcontractor.
Form 2034•
Page 3
Rev. 9-80
D. Comply with all applicable State licensing requirements and/or Federal certification requirements.
E. Furnish the Department with various statistical reports as required by the Department in the format
prescribed by the Department.
F. Make available at reasonable times and for reasonable periods those client records, books, and
supporting documents kept current by the Contractor and its subcontractors) pertaining to provided
services for purposes of inspection, monitoring, auditing, or evaluating by Department personnel or
their representatives.
G. Participate fully in any evaluation study of chis program authorized by the Department.
H. Comply with Department rules and regulations pertaining to hearings concerning applicants for and
recipients of services and to abide by the decisions rendered by the Department in such hearings_ The
Contractor shall inform all individuals of their right to such fair hearing.
Comply with the Federal Civil Rights Act of 1964, as amended, and The Rehabilitation Act of 1973
Subsection 504, as amended, and TEX. REV. ,CIV. STAT. ANN. arr. 6252-16, as amended, and Executive
Order No, 11246, entitled "Equal Employment Opportunity" as supplemented in 41 C.F.R. Part 60, in-
cluding but not limited to, giving equal opportunity both to those seeking employment and those seeking
services without regard to age, race, color, religion, sex, or national origin. The Contractor further agrees
not to discriminate on the basis of handicap against any qualified person seeking employment or services.
Establish a method to secure the confidentiality of records and other information relating to clients in
accordance with the applicable Federal law, rules, and regulations, as well as the applicable State law and
regulations. The provision shall not be construed as limiting the Departments right of access to recipient
case records or other information relating to Title XX clients.
K. Maintain and retain case information concerning those individuals and families who received services
and supporting fiscal documents adequate co ensure that claims for Federal matching funds are in accord
with applicable Federal requirements. Said documents shall be maintained and retained by the
Contractor and all subcontractors, if any, for a period of five (5) years after the date of submission of the
billing to the Department, or until an audit has been concluded, whichever time period is greater.
L Be primarily responsible for any audit exception or other payment deficiency in the program covered by
this contract which is found to exist after monitoring or auditing by the Department or the United States
Department of Health and Human Services, and be primarily responsible for the collection and proper
reimbursement to the Department of any amount paid in excess of the proper billing amount.
M. Submit billings and statistical documentation, except for bills previously filed with insurance companies for
family planning surgical billings, as required by the Department, no later than the ninetieth (90th) day fol
lowing the last day of the month in which service was provided. Family planning surgical billings may b.
submitted within 120 days. Deadline for family planning bills which are submitted subsequent to insurance
claims payment may be exceeded upon the Department's policy. Failure TO do so will be considered failure
co comply with the contract. Such failure to comply is valid justification for immediate termination of this
contract and/or refusal to pay the billings that are not submitted within the aforestated time limits.
N. Offer family planning services without regard to maternity, marital status. parenthood. handicap or age;
with respect for the dignity of the individual; upon referral from any source including the patient's own
application; on a voluntary basis, ensuring the patient complete choice of provider and choice of con-
traceptive method which is medically feasible. The contractor must provide directly services aimed princi-
pally at family size limitation, spacing of pregnancies, and problems of infertility, nut by referral, to at
least 50% of all persons seen for individual family planning services. Patients may accept or reject contra-
ceptive services and supplies under this program with complete freedom from coercion or pressure of mind
and conscience. Family Planning services must be provided to minors without the requirement of parental
consent by the Contractor.
• •Form . •
Page 4
Rev. 9$0
O. Use money received through this contract specifically for family planning services.
P. Accept reimbursement from the Department up to the maximum amount allowed by the Department as set
forth in the currently effective fee schedule as payment in full for services listed in the Plan of Operation
rendered to individuals eligible under this contract, and to make no charge to the patient, any member of
his family, or to any other source excepting insurance companies for such services.
The Contractor must bill the client's insurance company before it bills the Department. The Contactor
may accept reimbursement from insurance companies, and must deduct that amount from the amount
to be reimbursed to the Contractor by the Department. The Contractor further agrees to secure agree-
ments to ensure that all physicians and any others participating in the Contractor's family planning -pro-
gram make no additional charge to any source other than to the Contractor for covered services rendered to
persons eligible under this contract for such services.
Q Attempt to serve an increasing number of those estimated to be eligible individuals in the area served by
the agency, through outreach services, child care services, night and weekend clinics, etc.
R. Abide by Department program guidelines as the Department develops them for purposes of clarifying, ex-
panding, and improving family planning services. • •
S. Determine eligibility of individuals according to policies and procedures promulgated by the Department as •
set forth in the Plan of Operation.
T. Designate and file with the Department the name of the contractor's current medical director. The medical
director must be either a licensed medical physician or a licensed osteopath.
U. Comply with the requirements of Title 45 Code of Federal Regulations concerning the submission of infor-
mation about ownership or control, past business transactions, and certain other disclosing entities.
V. Disclose upon request to the Department or to the Department of Health and Human Services the name of
any person who has an ownership or control, interest in, or is an agent or managing employee of the con-
tractor who has been convicted of a criminal offense related to the person's involvement in any program
under Titles XVIII, XIX, or XX of the Social Security Act since the inception of these programs.
W. Place in all literature describing services covered under their contract prominent notices acknowledging the
Department as a source of funding to the contractor. Such notice shall also be placed in the contractor's
annual reports.
IV.
This Article IV Is:
111 Applicable 0 Inapplicable
The Contractor further agrees:
A. To provide the Department with detailed statements of charges each month developed in the Format
prescribed by the Department, and to promptly forward such bill to the Department along with a
statement certifying that the Contractor has provided each and every. service for which billing is
rendered.
Form 20
Page%41,
Rev. 9-80
B. That funds certified by the Contractor for marching purposes in accordance with the terms of this
contract, will be funds which can be used to match Federal funds under the Social Security Act and
appropriate Federal rules and regulations. Records will be maintained to verify the source and amount
of funds certified by the Contractor for matching purposes for a period of five (5) years after submission
of the certification statement, or until an audit has been concluded, whichever is greater.
C. That to reimburse the Department for administrative and other operational costs incurred in procuring
federal funds, the Department shall be entitled to retain from any allowable reimbursement due the
Contractor an amount equal to five
terrified to rhe Department as having been expended.
V.
The Department agrees to:
percent (__5_%) of rhe total amount
A. Pay the Contractor_$% (percent) of the approved monthly billings for services which have been
rendered in accordance with the terms of this contract and its attached set fee schedule.
B. Recognize the fiscal policies and procedures of the Contractor and its subcontractor(s), if any, except
where they are in conflict with Federal and/or State law, policies, rules, and regulations.
C. Perform such evaluation studies that the Department determines to be necessary and report to the
appropriate officers of the Contractor and its subcontractor(s), if any, the preliminary results of the
study before the evaluation is concluded and the findings made a matter of record.
For the faithful performance of the terms of this contract, the parties hereto in their capacities as stated, affix
their signatures and bind themselves effective the let day of September
1980 , and continuing through August 31 1981
TEXAS DEPARTMENT OF HUMAN RESOURCES
CITY OF CORPUS CHRISTI
BY BY
Commissioner
Title
Agency Name
R. Marvin Townsend
City Manager
Title
Corpus Christi, Texas
Ajh(%_day of
TO THE MEMBERS OF THE CITY COUNCIL
Corpus Christi, Texas
For the reasons set forth in the emergency clause of the foregoing ordinance, a
public emergency and imperative necessity exist for the suspension of the Charter
rule or requirement that no ordinance or resolution shall be passed finally on
the date it is introduced, and that such ordinance or resolution shall be read
at three meetings of the City Council; I, therefore, request that you suspend
said Charter rule or requirement and pass this ordinance finally,on the date it
is introduced, or at the present meeting of the City Council.
Respectfully,
,//,/
MAYOR
HE CI OF CORPUS CHRISTI, TEXAS
The Charter rule was suspended by the following vote:
Luther Jones
Edward L. Sample
Dr. Jack Best
David Diaz
Jack K. Dumphy
Betty N. Turner
Cliff Zarsky
The above ordinance was
Luther Jones
Edward L. Sample
Dr. Jack Best
David Diaz
Jack K. Dunphy
Betty N. Turner
Cliff Zarsky
passed by the following vote:
I5