HomeMy WebLinkAboutC2010-321 - 8/24/2010 - Approvedq'
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DEPARTMENT OF STATE HEALTH SERVICES
This contract, number 2011-035293 (Contract), is entered into by and between the Department
of State Health Services {DSHS or the Department), an agency of the State of Texas, and
CORPUS CHRISTI-NUECES COUNTY PUBLIC HEALTH DISTRICT (Contractor), a
Government Entit (collectively, the Parties).
1. ose of the Contract. DSHS agrees to purchase, and Contractor agrees to provide,
services or goods to the eligible populations as described in the Program Attachments.
2. Total Amount of the Contract and Pa ment Methods . The total amount of this Contract
is $76.658.00, and the payment method(s) shall be as specified in the Program Attachments.
3. Funding OhliQation. This Contract is contingent upon the continued availability of funding.
If funds become unavailable through lack of appropriations, budget cuts, transfer of funds
between programs or health and human services agencies, amendment to the Appropriations Act,
health and human services agency consolidation, or any other disruptions of current appropriated
funding for this Contract, DSHS may restrict, reduce, or terminate funding under this Contract.
4. Term of the Contract. This Contract begins on 09/01/2010 and ends on 0813 1120 1 1. DSHS
has the option, in its sole discretion, to renew the Contract as provided in each Program
Attachment. DSHS is not responsible for payment under this Contract before both parties have
signed the Contract or before the start date of the Contract, whichever is later.
5. Authority. DSHS enters into this Contract under the authority of Health and Safety Code,
Chapter 1001.
b. Documents Formin~,Contract. The Contract consists of the following:
a. Core Contract (this document)
b. Program Attachments:
2011-035293-001 Tuberculosis Prevention and Control -State
c. General Provisions (Sub-recipient}
d. Solicitation Document(s), and
e. Contractor's response(s) to the Solicitation Document(s).
f. Exhibits
Any changes made to the Contract, whether by edit or attachment, do not farm part of the
Contract unless expressly agreed to in writing by DSHS and Contractor and incorporated herein.
2010-321
Res. 028730
08/24/10
Tx. Dept. Of State Health Svcs. ~N~~~~
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7. Conflictin Terms. In the event of conflicting terms among the documents forming this
Contract, the order of control is first the Core Contract, then the Program Attachment(s), then the
General Provisions, then the Solicitation Document, if any, and then Contractor's response to the
Solicitation Document, if any.
8. Payee. The Parties agree that the following payee is entitled to receive payment for services
rendered by Contractor or goads received under this Contract:
Name: CITY OF CORPUS CHRISTI
Address: PO BOX 9277
CORPUS CHRISTI, TX 784b9-9277
Vendor Identification Number: 17460005741027
9. Entire A Bement. The Parties acknowledge that this Contract is the entire agreement of
the Parties and that there are no agreements or understandings, written or oral, between them
with respect to the subject matter of this Contract, other than as set forth in this Contract.
By signing below, the Parties acknowledge that they have read the Contract and agree to its
terms, and that the persons whose signatures appear below have the requisite authority to execute
this Contract on behalf of the named party.
DEPARTMENT OF STATE HEALTH SERVICES
BY:- ~~
Signature of Authorized Official
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Date
CORPCIS CHRISTI-NUECES COUNTY PUBLIC
HEALTH DISTRICT
By:
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Date
Bob Barnette, C.P.M., CTPM
Director, Client Services Contracting Unit
1100 WEST 49TH STREET
AUSTIN, TEXAS 7$75b
(512)458-7470
Bob.Burnette @ dshs. state.tx. us
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CONTRACT NO. 2011-035293
PROGRAM ATTACHMENT NO.001
PURCHASE ORDER N0.0000364456
CONTRACTOR: CORPUS CHRISTI-NUECES COUNTY PUBLIC HEALTH DISTRICT
DSHS PROGRAM: Tuberculosis Prevention and Control -State
TERM:09/01/2010 THRU: 0$/31/2011
SECTION I. STATEMENT OF WORK:
A. PROVISION OF SERVICES
Throughout the Contractor's defined service area ofNueces, Contractor shall provide basic services
and associated activities for tuberculosis (TB) prevention and control, as well as conducting
additional activities to target special populations with individuals wha have TB or who are at high
risk of developing TB.
Contractor shall provide these services in compliance with the following:
• DSHS' most current version of the Standards of Performance for the Prevention and
Control of Tuberculosis, available at
htt ://www.dshs.state.tx.us/idculdisease/tb/ ublicationsldefault.as ;
• DSHS' TB Policy and Procedures Manual, available at
htt :llwww.dshs.state.tx.us/idcu/disease/tb/ ublications/default.as ,
• DSHS Standards for Public Health Clinic Services, Revised August 31, 2004 available at
http://www.dshs.state.tx.uslamb/r3shsstndrds4clinicservs.pdf ;
* American Thoracic Society (ATS) and Centers for Disease Control and Prevention
(CDC) joint statements on diagnosis, treatment and control of TB available at
http:llwww.cdc.govlmrrawr/preview/mmwrhtmUrr521 l al .htm
• Diagnostic Standards and Classification of Tuberculosis in Adults and Children,
{American Journal of Respiratory and Critical Care Medicine, Val. 161, pp. 1376-1395,
2000) at http:l/ajrccm.atsjoui~nals.org/c~i/contey~t/fu_ill161/4/1376 ;
• Treatment of Tuberculosis, (ATS/CDC/IDSA), 2003 available at
httpl/www.cdc.gov/nan~wrlpreview/minwrht~nl/rr5211a1.htm ;
• Targeted Tuberculin Testing and Treatment of Latent TB Infection (LTBI), Morbidity and
Mortality Weekly Report, Vol. 49, No. RR-6, 2000 at
http:l/www.cclc.gov/inmwr/previewlmmwrhtmllrr490fial.htrn ;
• Updated: Adverse Event Data and Revised American Thoracic Society/CDC
Recommendations Against the Use of Rifampin and Pyrazinamide for Treatment of
Latent Tuberculosis Infection -United States, 2003, MMWR 52 {No. 31) at
http :ll www. eclipsconsultcom/eclips/article/Pulmonary%20Di,sease/S 8756-
3452f0$)70243-3 ;and
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Controlling Tuberculosis in the United States, MMWR, Vol. 54, No. RR-12, 2445 at
httt~://www.cdc. Gov/mmwr/preview/mmwrhtmllrrS412a1.htm
Contractor shall comply with all applicable federal and state regulations and statues, including, but
not limited to, the following:
• Texas Tuberculosis Code, Health and Safety Code, Chapter 13, subchapter B
• Communicable Disease Prevention and Control Act, Health and Safety Code, Chapter 81
• Screening and Treatment fox Tuberculosis in Jails and Other Correctional Facilities,
Health anal Safety Code, Chapter 89;
• Texas Administrative Code TAC, Title 25, Part 1, Chapter 97, Subchapter A, Contrrol of
Communicable Diseases; and
# Texas Administrative Code TAC, Title 25, Part 1, Chapter 97, Subchapter H,
Tuberculosis Screening for Jails and Other Correctional Facilities.
B. REPORTING
Because of the inherent time to complete treatment for tuberculosis disease and latent tuberculosis
infection in relation to the period of this Program Attachment, required reporting under this Program
Attachment will show results for work performed under previous Program Attachments under the
overall DSHS Contract.
Contractor shall provide a narrative report, in the format provided by DSHS, on their performance
goals, objectives, and screening activities, including how Contractor has complied with all the
requirements of this Program Attachment. That report shall include a detailed analysis of
performance related to the performance measures listed below and a progress report of activities in
January through December. The narrative program report shall be sent to the Texas Department of
State Health Services, TB Services Branch, Mail Code 1939,1140 West 49'~ Street, PO Box 149347,
Austin, Texas 78714-9347 via regular mail, fax, or a-mail. Contractor shall maintain the
documentation used to calculate performance measures as required by the General Provisions
Records Retention Article and by the Texas Administrative Code Title 22, Part 9 Chapter 165,
§ 165.1 regarding the retention of medical records. Report periods and due dates are as follows:
PERIOD COVERED DUE DATE
Janu -December 2010 March 1, 2011
Contractor shall send all initial reports of confirmed and suspected TB cases to DSHS within seven
(7} working days of identification or notification. Any updates to initial DSHS' Report of Cases and
Patient Services Form (TB-400) (e.g., diagnosis, medication changes, x-rays, and bacteriology) and
case closures shall be sent within thirty (30) calendar days from when the change occurred to DSHS
at 1100 West 49`x' Street, Mail Code 1939, PO Box 149347, Austin, Texas 78714-9347.
Contractor shall send an initial report of contacts on all Class 3 TB cases and smear-positive Class 5
TB suspects within thirty (30) days of identification using DSHS' Report of Contacts Form (TB-340
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and TB-341). Any new follow-up information (not included in the initial report) related to the
evaluation and treatment of contacts shall be sent to DSHS on the TB-340and TB-341 at intervals of
90 days, 120 days, and 2 years after the day Contractor became aware of the TB case.
Electronic reporting to DSHS for Class 3 TB cases, smear positive Class 5 TB suspects, and their
contacts may become available during the term. of this Program Attachment. Once notified of this
option by DSHS, Contractor may avail itself of this option if it adheres to all the electronic reporting
requirements (including system requirements) provided at that time.
Contractor shall collect information to determine the number of persons who received from the
Contractor at least one TB service, including but not limited to; tuberculin skin tests; chest
radiographs; health care worker services; or treatment with one or more anti-tuberculosis
medications.
Contractor shall perform all activities under this Contract in accordance with Contractor's work
plans (attached as Exhibit A), and the detailed budget as approved by DSHS. Contractor must
receive written approval from DSHS before varying from applicable policies, procedures, protocols,
and the final approved work plan, and must update its implementation documentation within forty-
eight (48) hours of making approved changes so that staff working on activities under this contract
know of the change(s).
DSHS reserves the right, where allowed by legal authority, to redirect funds in the event of financial
shortfalls. DSHS will monitor Contractor's expenditures on a quarterly basis. If expenditures are
below that projected in Contractor's total Contract amount, as shown in SECTION VI, BUDGET,
Contractor's budget may be subject to a decrease for the remainder of the Contract term. Vacant
positions existing after ninety (90) days may result in a decrease in funds.
SECTION II. PERFORMANCE MEASURES:
The following performance measures will be used to assess, in part, Contractor's effectiveness in
providing the services described in this Contract, without waiving the enforceability of any of the
other terms of the Contract or any other method of determining compliance.
1. Cases, and suspected cases, of TB under treatment by Contractor shall be placed on
timely and appropriate Direct Observed Therapy (DOT);
2. Newly diagnosed TB cases that are eligible* to complete treatment within 12 months
shall complete therapy within 365 days or less; *Exclude TB cases 1) diagnosed at death,
2) wha die during therapy, 3) who are resistant to rifampin, 4) who have meningeal
disease, and/or 5} who are younger than 15 years with either rniliary disease or a
positive blood culture far TB, If data indicates that fewer than 83% of TB cases eligible
to complete treatment within 12 rrionths actually complete that therapy in a timely and
appropriate manner, then DSHS may (at its sole discretion) require additional measures
be taken by Contractor to improve that percentage on a timeline set by DSHS.
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3. TB cases with initial cultures positive for Mycobacterium tuberculosis complex shall be
tested for and have drug susceptibility results documented in their medical record. If data
indicates a compliance rate far this Performance Measure of less than 97%, then DSHS
may {at its sole discretion) require additional measures be taken by Contractor to improve
that percentage on a timeline set by DSHS.
4. Newly-reported cases of TB cases with Acid-fast Bacillis (AFB) positive sputum culture
results will have documented conversion to sputum culture-negative within 60 days of
initiation of treatment. If data indicates a compliance rate for this Performance Measure
of less than 43%, then DSHS may (at its sole discretion) require additional measures be
taken by Contractor to improve that percentage on a timeline set by DSHS.
5. Newly-reported TB cases shall have an HN test performed (unless they are known HIV-
positive, or if the patient refuses) and shall have positive or negative HIV test results
reported to DSHS according to the schedule provided herein. If fewer than 78°Io of newly
reported TB cases have a result of an HIV test reported, then DSHS may (at its sole
discretion) require additional measures betaken by Contractor to improve that percentage
on a timeline set by DSHS.
6. Newly-reported suspected cases of TB disease shall be started in a timely manner on the
recommended initial 4-drug regimen. If fewer than 93% of newly-reported TB cases are
started on an initial 4-drug regimen, then DSHS may (at its sole discretion) require
additional measures be taken by Contractor to improve that percentage on a timeline set
by DSHS.
7. Newly-reported TB patients with a positive AFB sputum-smear result shall have at Ieast
three contacts identified as part of the contact investigation that must be pursued for each
case. If data indicates a compliance rate for this Performance Measure of less than 90%,
then DSHS may (at its sole discretion) require additional measures be taken by Contractor
to improve that percentage on a timeline set by DSHS.
8. Newly-identified contacts, identified through the contact investigation, that are associated
with a sputum AFB smear-positive TB case shall be evaluated for TB infection and
disease. If data indicates a compliance rate for this Performance Measure of less than
80.5%, then DSHS may (at its sole discretion) require additional measures be taken by
Contractor to improve that percentage on a timeline set by DSHS.
9. Contacts, identified through the contact investigation, that are associated with a sputum
AFB smear-positive case and that are newly diagnosed with latent TB infection (LTBI)
shall be started on timely and appropriate treatment. If data indicates a compliance rate
for this Performance Measure of less than b0%, then DSHS may (at its sole discretion)
require additional measures be taken by Contractor to improve that percentage on a
timeline set by DSHS.
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10. Contacts, identified through the contact investigation, that are associated with a sputum
AFB smear-positive case that are newly diagnosed with LTBI and that were started on
treatment shall complete treatment for LTBI. If data indicates a compliance rate for this
Performance Measure of less than 40%, then DSHS may {at its sole discretion) require
additional measures be taken by Contractor to improve that percentage on a timeline set
by DSHS.
11.Newly-reported TB patients that are older than 12-years-old and that have a pleural or
respiratory site of disease shall have sputum AFB-culture results reported to DSHS. If
data indicates a compliance rate for this Performance Measure of less than $8.5%, then
DSHS may (at its sole discretion) require additional measures be taken by Contractor to
improve that percentage an a timeline set by DSHS.
12. All reporting to DSHS shall be completed as described herein and submitted by the
deadlines given.
If Contractor fails to meet any of the performance measures, Contractor shall furnish in the narrative
report due March 1, 2011, a written explanation including a plan to meet those measures and to
prevent recurrence of such a situation. Nothing in this provision acts to constrain enforcement
options for DSHS regarding any contract breach.
SECTION III. SOLICFTATION DOCUMENT:
Exempt Governmental Entity
SECTION IV. RENEWALS:
None
SECTION V. PAYMENT METHOD:
Cost Reimbursement
Funding is further detailed in the attached Categorical Budget and if applicable, Equipment List.
SECTION VI. BILLING INSTRUCTIONS:
Contractor shall request payment using the State of Texas Purchase Voucher (Form B-13) and
acceptable supporting documentation for reimbursement of the required services/deliverables. The
B-13 can be found at the following link http:l/www,dshs.state.tx.us/ ants/forrnslbl3form.doc.
Vouchers and supporting documentation should be mailed or submitted by fax ar electronic mail to
the addresses/number below.
Department of State Health Services
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Claims Processing Unit, MC 1940
1100 West 49~' Street
PO BOX 149347
Austin, Texas 78714-9347
The fax number for submitting State of Texas Purchase Voucher (Form B-13} to the Claims
Processing Unit is (512) 458-7442. The email address is invoices@dshs.state.tx.us.
SECTION VII. BUDGET:
SOURCE OF FUNDS: STATE
SECTION VIII. SPECIAL PROVISIONS:
General Provisions, Article I COMPLIANE AND REPORTING, Section I.47' Statutes anal
Standards of General Applicability, is amended to include the following:
Contractor, as a subrecipient of federal grant funds, is prohibited from texting while driving a
federal government owned vehicle and from texting while using government furnished electronic
equipment while driving any vehicle, including any privately owned or governmental owned
vehicle. "Texting" means reading from or entering data into any handheld or other electronic
device, including SMS texting, e-mailing, instant messaging, obtaining navigational information,
or engaging in any other form. of electronic data retrieval or electronic data communication.
"Driving" means operating a motor vehicle on an active roadway with the motor running,
including while temporarily stationary due to traffic, a traffic light, stop sign or otherwise.
"Driving" does not include operating a motor vehicle with or without the motor running when
one has pulled over to the side of, or off, an active roadway and has halted in a location where
one can safely remain stationary. "Government furnished electronic equipment" means any
electronic equipment that maybe used for texting and for which any payment is made, in part or
in whole, under this program attachment. The Contractor is responsible for ensuring its
employees are aware of this prohibition and adhere to this prohibition.
General Provisions, Article III. Funding, Section 3.06 Nonsupplanting, is revised to include the
following:,
Funding from this Contract shall not be used to supplant (i.e., used in place of funds dedicated,
appropriated or expended for activities funded through this Contract) state or local funds, but
Contractor shall use such funds to increase state or local funds currently available for a particular
activity. Contractor shall maintain local funding at a sufficient rate to support the local program.
If the total cost of the project is greater than DSHS' share set out in SECTION VII. BUDGET,
Contractor shall supply funds for the remaining costs in order to accomplish the objectives set
forth in this Contract.
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All revenues directly generated by this Contract or earned as a result of this Contract during the
term of this Contract are considered program. income; including income generated through
Medicaid billings for TB related clinic services. Contractor may use the program income to
further the scope of work detailed in this Contract, and must keep documentation to demonstrate
such to DSHS's satisfaction. This program income may not be used to take the place of existing
local, state, or federal program funds.
General Provisions, Article N. Payment Methods and Restrictions, Section 4.Q2, Billing
Submission, is hereby revised to include:
Quarterly Financial Status Reports (Form 269A) from Contractor shall be provided to DSHS in
the format provided by the DSHS. These reports shall be mailed to Texas Department of State
Health Services, Attention: Accounting Section, Claims Processing Unit, 1100 West 49`s Street,
PO Box 149347, Austin, Texas 7$714-9347. One (1} copy of each quarterly financial status
report shall be mailed to the Texas Department of State Health Services, Attention: TB Services
Branch, Mail Code 1939, 1100 West 49`~ Street, PO Box 149347, Austin, Texas 78714-9347.
These reports shall be submitted on a quarterly basis as follows:
PERIOD COVERED DUE DATE
Se tember, October, November December 31, 2010
December, Janu , Febx-u March 31, 2p11
March, A ril, Ma June 30, 2011
June, Jul , Au st Se tember 30, 2011
General Provisions, Article XIII. General Terms, Section 13.15 Amendrt~ent, is amended to
include the following:
Contractor must submit all amendment and revision requests in writing to the Division
Contract Management Unit at least 90 days prior to the end of the term of this Program
Attachment.
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2011-035293-001
Categorical- Budget:
Total reimbursements wil! not exceed $75,658.00
Financial status reports are due: 12/30/2010, 03/30/2011, D6/30/2011, iD/31/2Q11
Fiscal Year 2011 Department o£ State Health Services Contract
General Provisions
(Core/Subrecipient)
ARTICLE I COMPLIANCE AND REPORTING ......................................................................1
Section 1.01 Compliance with Statutes and Rules .................................................................1
Section 1.02 Compliance with Requirements of Solicitation Document . ............................1
Section 1.03 Reporting . ............................................................................................................1
Section 1.04 Client Financial Eligibility . ................................................................................1
Section 1.05 Applicable Contracts Law and Venue for Disputes .........................................1
Section 1.06 Applicable Laws and Regulations Regarding Funding Sources . ...........:.......1
Section 1.07 Statutes and Standards of General Applicability ..............................................2
Section 1.0$ Applicability of General Provisions to Interagency and Interlocal Contracts.
.................................................................................................................................4
Section 1.09 Civil Rights Policies and Complaints . ...............................................................5
Section 1.10 Licenses, Certifications, Permits, Registrations and Approvals .....................5
ARTICLE II SERVICES .................................................................................................................5
Section 2.01 Education to Persons in Residential Facilities ..................................................5
Section 2.02 Disaster Services ..................................................................................................5
Section 2.03 Consent to Medical Care of a Minor . ................................................................5
Section 2.04 TeIemedicine Medical Services . .........................................................................6
Section 2.05 Fees for Personal Health Services . ....................................................................6
Section 2.06 Cost Effective Purchasing of Medications . .......................................................6
Section 2.07 Services and Information for Persons with Limited English Proficiency. ....6
ARTICLE III FUNDING ..................................................................................................................7
Section 3.01 Debt to State and Corporate Status . ..................:..............................................7
Section 3.02 Application of Payment Due . .............................................................................7
Section 3.03 Use of Funds . .......................................................................................................7
Section 3.04 Use for Match Prohibited . ...................................................................:..............7
Section 3.05 Program Income ..................................................................................................7
Section 3.06 Nonsupplanting ...................................................................................................7
ARTICLE IV PAYMENT METHODS AND RESTRICTIONS ..................................................5
Section 4.01 ~ Payment Methods ................................................................................................8
Section 4.02 Billing Submission .....................................................................~.........................8
Section 4A3 Final Billing Submission . .............................................................................
.......8
Section 4.04 Working Capital Advance ..................................................................................5
Section 4.05 Financial Status Reports (FSRs) ........................................................................8
Section 4.06 Third Party Payors . ............................................................................................9
ARTICLE V TERMS AND CONDITIONS OF PAYMENT ......................................................9
Section 5.01 Prompt Payment . ................................................................................................9
Section 5.02 Withholding Payments . ......................................................................................9
Section 5.03 Condition Precedent to Requesting Payment . ..................................................9
Section 5.04 Acceptance as Payment in Full . ......................................................................10
ARTICLE VI ALLOWABLE COSTS AND AUDIT REQUIREMENTS .................................10
General Provisions. (Core Subrecipient) 2011
Fiscal Year 201.1. Department of State Health Services Contract
General Provisions
(Core/Subrecipient)
ection 1 Allowable Costs . ................................................................................................10
Section 6.02 Independent Single or Program-Specific Audit . ............................................11
Section 6.03 Submission of Audit . ........................................................................................12
ARTICLE VII CONFIDENTIALITY ........................................................................................12
Section 7.01 Maintenance of Confidentiality . ......................................................................12
Section 7.02 Department Access to PHI and Other Confidential Information . ...............12
Section 7.03 Exchange of Client-Identifying Information . .................................................12
Section 7.04 Security of Patient or Client Recards ..............................................................13
Section 7.05 HIV/AIDS Model Workplace Guidelines .........................................................13
ARTICLE VIII RECORDS RETENTION ..................................................................................13
Section 8.01 Retention . ...........................................................................................................13
ARTICLE IX ACCESS AND INSPECTION ...............................................................................14
Section 9.01 Access. .............................................................................................................. 14
Section 9.02 State Auditor's Office . ...................................................................................... 14
Section 9.03 Responding to Deficiencies . .............................................................................. 14
ARTICLE X NOTICE REQUIREMENTS ................................................................................. 14
Sectian 10.01 Child Abuse Reporting Requirement ...........:......... .... 14
Section 10.02 Significant Incidents . ........................................................................................ 15
Section 10.03 Litigation ............................................................................................................ 15
Section 10.04 Action Against the Contractor ......................................................................... 15
Section 10.05 Insolvency . ......................................................................................................... 15
Section 10.05 Misuse of Funds and Performance Malfeasance ............................................ 15
Sectian 14.07 Criminal Activity and Disciplinary Action ..................................................... 16
Section 10.0$ Retaliation Prohibited . ..................................................................................... 16
Section 10.09 Dacumentation . ................................................................................................. I6
ARTICLE XI ASSURANCES AND CERTIFICATIONS ..........................................................16
Section 11.01 Certification . ......................................................................................................16
Section 1L02 Child Support Delinquencies . ..........................................................................17
Sectian 11.03 Authorization .....................................................................................................18
Section 11.04 Gifts and Benefits Prohibited ...........................................................................18
Section 11.05 Ineligibility to Receive the Contract . ...............................................................18
Section 11.06 Antitrust .............................................................................................................18
Section 11.07 Initiation and Completion of Work ................................................................18
ARTICLE XII GENERAL BUSINESS OPERATIONS OF CONTRACTOR .......................18
Section 12.01 Responsibilities and Restrictions Concerning Governing Body, Officers and
Employees ...........................................:..............................................................18
Section 12.02 Management and Control Systems ..................................................................19
Section 12.03 Insurance . ..........................................................................................................19
Section 12.04 Fidelity Bond . ....................................................................................................20
Section 12.05 Liability Coverage . ............................................................................................20
General Provisions (Core Subrecipient) 2011 2
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Fiscal Year 2011 Department of State Health Services Contract
General Provisions
{Core/Subrecipient)
Section 12.06
Section 12.07
Section 12.08
Section 12.09
Section 1210
Section 12.11
Section 12.12
Section 12.13
Section 12.14
Section 12.15
Section 12.16
Section 7.2.17
Section 12.1$
Section 12.19
Section 12.20
Section 12.21
Section 12.22
Section 12.23
Section 7.2.24
Section 12.25
Section 12.26
Section 12.27
Section 12.28
Section 12.29
Overtime Compensation ..........................
Program Site ......................................................................................................20
Cost Allocation Plan . ............................................................ ............................21
Employee/Volunteer Background Screening . .................... ..........................:.21
Historically Underutilized Businesses {HUBs) ..................... ............................21
Buy Texas ............................................................................... ............................21
Contracts with Subrecipient and Vendor Subcontractors . ...........................21
Status of Subcontractors . ..................................................... ............................22
Incorporation of Terms in Subrecipient Subcontracts ...... ............................22
Independent Contractor . ...................................................... ............................22
Authority to Bind . .......................................:......................... ............................22
Tax Liability . ......................................................................... ............................23
Notice of Organizational Change . ....................................... ............................23
Quality Management . .......................................................................................23
Equipment (including Controlled Assets) Purchases . ...................................23
Supplies . ................................................................................:............................23
Changes to Equipment List . .............................................................................23
Property inventory and Protection of Assets . ................................................24
Bankruptcy . .......................................................................................................24
Title to Property . ...............................................................................................24
Property Acquisitions . ....................:.................................................................24
Disposition of Property .....................................................................................24
Closeout of Equipment . ....................................................................................25
Assets as Collateral Prohibited ........................................................................25
ARTICLE XIII GENERAL TERMS ............................................................................................25
Section 13.01 Assignment ......................................................................................................... 25
Section 13.02 Lnbbying . ........................................................................................................... 25
Section 13.03 Conflict of Interest . ........................................................................................... 26
Section 13.04 Transactions Between Related Parties . ........................................................... 2G
Section 13.05 Intellectual Property . ........................................................................................ 26
Section 13.06 Other Intangible Property ................................................................................. 27
Section 13.07 Severability and Ambiguity . ............................................................................ 27
Section 13.08 Legal Notice . ...................................................................................................... 27
Section 13.09 Successors . ......................................................................................................... 28
Section 13.10 Headings ............................................................................................................. 28
Section 13.11 Parties ................................................................................................................. 28
Section 13.12 Survivability of Terms . ..................................................................................... 2$
Section 13.13 Direct Operation . .............................................................................................. 28
Section 13.14 Customer Service Information . ....................................................................... 28
Section 13.15 Amendment . ...................................................................................................... 28
Section 13.16 Contractor's Notification of Change to Certain Contract Provisions. ........ 29
Section 13.17 Contractor's Request for Revision of Certain Contract Provisions. ........... 29
Section 13.18 Immunity Not Waived . ..................................................................................... 30
Section 13.19 Hold Harmless and Indemnification . .............................................................. 30
General Provisions (Core Subrecipient) 2011
.........................................................20 .
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Fiscal Year 2011 Department of State Health Services Contract
General Provisions
(Core/Subrecipient)
Section 13.20 Waiver . ...............................................................................................................30
Section 13.21 Electronic and Information Resources Accessibility and Security Standards.
...............................................................................................................................30
Section 13.22 Force Majeure . ..................................................................................................31
Section 13.23 Interim Contracts ..............................................................................................31
ARTICLE XIV BREACH OF CONTRACT AND REMEDIES FOR NON-COMPLIANCE...
...............................................................................................................................31
Section 14.01 Actions Constituting Breach of Coz~tract . ................:.....................................31
Section 14.02 General Remedies and Sanctions . ...................................................................32
Section 14.03 Notice of Remedies or Sanctions . .....................................................................33
Section 1.4.04 Emergency Action . ............................................................................................34
ARTICLE XV CLAIMS AGAINST THE DEPARTMENT ....................................................34
Section 15.01 Breach of Contract Claim . ...............................................................................34
Section 15.02 Notice ..................................................................................................................34
Section 15.03 Sole Rexnedy . .....................................................................................................35
Section 15.04 Condition Precedent to Suit . ............................................................................35
Section 15.05 Performance Nat Suspended ............................................................................35
ARTICLE XVI TERMINATION .................................................................................................35
Section 16.01 Expiration of Contract or Program Attachment(s) . ......................................35
Section 16.02 Effect of Termination .......................................................................................35
Section 16.03 Acts Not Constituting Termination . ................................................................35
Section 16.04 Termination Without Cause ..............................................................................36
Section 16.05 Termination For Cause ......................................................................................36
Section 16.06 Notice of Ternnunation . ......................................................................................37
ARTICLE XVII VOID, SUSPENDED, AND TERMINATED CONTRACTS .........................37
Section 17.01 Void Contracts . .................................................................................................37
Section 17.02 Effect of Void, Suspended, or Involuntarily Terminated Contract . ............37
Section 17.03 Appeals Rights ...................................................................................................38
ARTICLE XVIII CLOSEOUT .........................................
.................................. 3 $
Section 18.01 Cessation of Services At Closeout .................................................................... 38
Section 18.02 Administrative Offset . ...................................................................................... 38
Section 18.03 Deadline for Closeout . ...................................................................................... 38
Section 18.04 Payment of Refunds . ......................................................................................... 3$
Section 18.05 Disallowances and Adjustments . ..................................................................... 38
General Provisions (Core Subrecipient) 2011
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ARTICLE Y COMPLFANCE AND REPORTING
Section 1.01 Compliance with Statutes and Rules. Contractor shall comply, and shall require its
subcontractor(s) to comply, with the requirements of the Department's rules of general applicability
and other applicable state and federal statutes, regulations, rules, and executive orders, as such
statutes, regulations, rules, and executive orders currently exist and as they maybe lawfully amended.
The Department rules are located in the Texas Administrative Code, Title 25 {Rules). To the extent
this Contract impales a higher standard, or additional requirements beyond those required by
applicable statutes, regulations, rules or executive orders, the terms of this Contract will control.
Contractor further. agrees that, upon notification from DSHS, Contractor shall comply with the terms
of any contract provisions DSHS is required to include in its contracts under legislation effective at
the time of the effective date of this Contract or during the term of this Contract.
Section I.D2 Compliance with Requirements of Solicitation Document. Except as specified in
these General Provisions or the Program Attachment(s), Contractor shall comply with the
requirements, eligibility conditions, assurances, certifications and program requirern.ents of the
Solicitation Document, if any, (including any revised or additional terms agreed to in writing by
Contractor and DSHS prior to execution of this Contract) for the duration of this Contract or any
subsequent renewals. The Parties agree that the Department has relied upon Contractor's response to
the Solicitation Document. The Parties agree that any misrepresentation contained in Contractor's
response to the Solicitation Document constitutes a breach of this Contract.
Section 1.03 Reporting. Contractor shall submit reports in accordance with the reporting
requirements established by the Department and shall provide any other information requested by the
Department in the format required by DSHS. Failure to submit a required report or additional
requested information by the due date specified in the Program Attachrxzent(s) ox upon request
constitutes a breach of contract, may result in delayed payment and/or the imposition of sanctions and
remedies, and, if appropriate, emergency action; and may adversely affect evaluation of Contractor's
future contracting opportunities with the Department.
Section 1.04 Client financial Eligibility. Where applicable, Contractor shall use financial
eligibility criteria, financial assessment procedures and standards developed by the Department to
determine client eligibility.
Section 1.05 Applicable Contracts Law and Venue for Disputes. Regarding all issues related to
contract formation, performance, interpretation, and any issues that may arise in any dispute between
the Parties, this Contract will be governed by, and construed in accordance with, the laws of the State
of Texas. In the event of a dispute between the Parties, venue for any suit will be Travis County,
Texas.
Section 1.06 Applicable Laws and Regulations Regarding Funding Sources. Where applicable,
federal statutes and regulations, including federal grant requirements applicable to funding sources,
will apply to this Contract. Contractor agrees to comply with applicable laws, executive orders,
regulations and policies, as well as Office of Management and Budget (OMB) Circulars, the Uniform
Grant and Contract Management Act of 1981 (UGMA), Tex. Gov. Code Chapter 783, and Uniform
Grant Management Standards (UGMS), as revised by federal circulars and incorporated in UGMS by
the Governor's Budget, Planning and Policy Division. UGMA and UGMS can be located through
General Provisions {Core Subrecipient) 2011
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web links an the DSHS website at http:/lwww.dshs.state.tx.us/contracts/links,shtm. Contractor also
shall comply with all applicable federal and state assurances contained in UGMS, Part III, State
Uniform Administrative Requirements for Grants and Caaperative Agreements. §_.14. If applicable,
Contractor shall comply with the Federal awarding agency's Common Rule, and the U.S. Health and
Human Services Grants Palicy Statement, both of which may be located through weblinks on the
DSHS website at http:/lwww.dshs.state.tx.uslcontractsllinks.shtm. For contracts funded by block
grants, Contractor shall comply with Tex. Gov. Code Chapter 2105.
Section 1.07 Statutes and Standards of General Applicability. Contractor is responsible far
reviewing and complying with all applicable statutes, rules, regulations, executive orders and
policies. To the extent applicable to Contractor, Contractor shall comply with the following:
a) the following statutes, rules, regulations, and DSHS policy (and any of their subsequent
amendments) that collectively prohibit discrimination on the basis of race, color, national
origin, limited English proficiency, sex, sexual orientation (where applicable), disabilities,
age, substance abuse, political belief or religion: 1}Title VI of the Civil Rights Act of 1964,
42 USC §§ 2000d et seq.; 2) Title IX of the Education Amendments of 1972, 20 USC §§
1681-1683., and 1685-1686; 3) Section 544 of the Rehabilitation Act of 1973, 29 USC §
794(a}; 4) the Americans with Disabilities Act of 1990, 42 USC §§ 12101 et seq.; 5) Age
Discrimination Act of 1975, 42 USC §§ 6101-6107; 6} Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation Act of 1970, 42 USC § 290dd (b)(1); 7)
45 CFR Parts 80, 84, 86 and 91; 8) U.S. Department of Labor, Equal Employment
Opportunity E.O. 11246; 9) Tex. Lab. Code Chapter 21; 10) Food Stamp. Act of 1977 {7 USC
§ 204 et seq.; 11) Executive Order 13279, 45 CFR Part 87 or 7 CFR Part 16 regarding equal
treatment and opportunity for religious organizations; and 12) DSHS Policy AA-5018, Non-
discrimination Policy for DSHS Programs;
b) Drug Abuse Office and Treatment Act of 1972, 21 USC §§ 110T et seq., relating to drug
abuse;
c) Public Health Service Act of 1912, §§ 523 and 527, 42 USC § 290dd-2, and 42 CFR Part 2,
relating to confidentiality of alcohol and drug abuse patient records;
d) Title VIII of the Civil Rights Act of 1968, 42 USC §§ 3601 et seq., relating to
nondiscrimination in housing;.
e) Immigration Reform and Control Act of 1986, $USC § 1324a, regarding employment
verification;
f) Pro-Children Act of 1994, 20 USC §§ 6081-6084, and the Pro-Children Act of 2001, 20 USC
§ 7183, regarding the non-use of all tobacco products;
g} National Research Service Award Act of 1971, 42 USC §§ 289a-1 et seq., and 6601 (PL 93-
348 and PL 103-43}, regarding human subjects involved in research;
h) Hatch Political Activity Act, 5 USC §§ 1541-1508 and 7321-26, which limits the political
activity of employees whose employment is funded with federal funds;
i) Fair Labor Standards Act, 29 USC §§ 201 et seq., and the Intergovernmental Personnel Act of
1970, 42 USC §§ 4701 et seq., as applicable, concerning miniznum,wage and maximum
hours;
j) Tex. Gov. Code Chapter 469, pertaining to eliminating architectural barriers for persons with
disabilities;
k) Texas Workers' Compensation Act, Tex. Lab. Cade Chapters 401-406 and 2$ Tex. Admin.
Code Part 2, regarding compensation for employees' injuries;
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1) The Clinical Laboratory Improvement Amendments of 1988, 42 USC § 263a, regarding the
regulation and certification of clinical laboratories;
m} The Occupational Safety and Health Administration Regulations on Blood Borne Pathogens,
29 CFR § 1910.1030, or Title 25 Tex. Admin. Code Chapter 96 regarding safety standards for
handling blood borne pathogens;
n) Laboratory Animal Welfare Act of 1966, 7 USC §§ 2131 et seq., pertaining to the treatment
of laboxatoxy animals;
o) environmental standards pursuant to the following: 1) Institution of environmental quality
control measures under the National Environmental Policy Act of 1969, 42 USC §§ 4321-
4347 and Executive Order 11514 (35 Fed. Reg. 4247}, "Protection and Enhancement of
Environmental Quality;" 2) Notification of violating facilities pursuant to Executive Oxder
11738 (40 CFR Part 32}, "Providing for Administration of the Clean Air Act and the Federal
Water Pollution Control Act with respect to Federal Contracts, Grants, or Loans;" 3)
Protection of wetlands pursuant to Executive Order 11990, 42 Fed. Reg. 26961; 4} Evaluation
of flood hazards in floodplains in accordance with Executive Order 11988, 42 Fed. Reg.
26951 and, if applicable, flood insurance purchase requirements of Section 102(a) of the
Flood Disaster Protection Act of 1973 (PL 93-234); 5) Assurance of project consistency with
the approved State Management program developed under the Coastal Zone Management Act
of 1972, 16 USC §§ 1451 et seq.; 6} Federal Water Pollution Control Act, 33 USC § 1281 et
seq.; 7) Protection of underground sources of drinking water under the Safe Drinking Water
Act of 1974, 42 USC §§ 300f-300j; 8) Protection of endangered species under the Endangered
Species Act of 1973, 16 USC §§ 1531 et seq.; 9) Conformity of federal actions to state clean
air implementation plans under the Clean Air Act of 1955, 42 USC §§7401 et seq.; 10) Wild
and Scenic Rivers Act of 1968 (T6 USC §§ 1271 et seq.} related to protecting certain rivers
system; and 11) Lead-Based Paint Poisoning Prevention Act {42 USC §§'4801 et seq.}
prohibiting the use of lead-based paint in residential construction or rehabilitation;
p) Intergovernmental Personnel Act of 1970 (42 USC §§4278-4763} regarding personnel merit
systems far programs specified in Appendix A of the federal Office of Program
Management's Standards for a Merit System of Personnel Administration (5 CFR Part 900,
Subpart F);
q) Titles II and III of the Uniform Relocation Assistance and Real Property Acquisition Policies
Act of 197D (PL 91-646), relating to fair treatment of persons displaced or whale property is
acquired as a result of Federal ar federally-assisted programs;
r) Davis-Bacon Act (40 USC §§ 276a to 276a-7), the Copeland Act (40 U.S.C. § 276c and 18
USC § 874), and the Contract Work Hours and Safety Standards Act (40 USC §§ 327-333),
regarding lobar standards for federally-assisted construction subagreements;
s} National Historic Preservation Act of 1966, § 106 (16 USC § 470), Executive Order 11593,
and the Archaeological and Historic Preservation Act of 1974 (16 USC §§ 469a-1 et seq.}
regarding historic progeny to the extent necessary to assist DSHS in complying with the Acts;
t} financial and compliance audits in accordance with Single Audit Act Amendments of 1996
and OMB Circular No. A-133, "Audits of States, Local Governments, and Non-Profit
Organizations;"
u) Trafficking Victims Protection Act of 2000, Section 106(g) (22 USC § 7104); and
v) requirements of any other applicable state and federal statutes, executive orders, regulations,
rules and policies.
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If this Contract is funded by a grant or cooperative agreement, additional state or federal
requirements found in the Notice of Grant Award are imposed on Contractor and incorporated herein
by reference.
Section 1 A8 Applicability of General Provisions to Interagency and Interlocal Contracts.
Certain sections or portions of sections of these General Provisions will not apply to Contractors that
are State agencies or units of local government; and certain additional provisions will apply to such
Contractors.
a} The following sections or portions of sections of these General Provisions will not apply to
interagency or interlocal contracts:
1) Hold Harmless and Indemnification, Section 13.19;
2) Independent Contractor, Section 12.15 (delete the third sentence in its entirety; delete the
word "employees" in the fourth sentence; the remainder of the section applies);
3) Insurance, Section 12.03;
4) Liability Coverage, Section 12.05;
5} Fidelity Bond, Section 12.04;
6} Historically Underutilized Businesses, Section 12.10 (Contractor, however, shall comply
with HUB requirements of other statutes and rules specif tally applicable to that entity};
7) Debt to State and Corporate Status, Section 3A1;
8) Application of Payment Due, Section 3.02; and
9) Article XV Claims against the Department (This Article is inapplicable to interagency
contracts only}.
b) The following additional provisions will apply to interagency contracts:
1) This Contract is entered into pursuant to the authority granted and incompliance with the
provisions of the Interagency Cooperation Act, Tex. Gov. Code Chapter 771;
2} The Parties hereby certify that (1) the services specified are necessary and essential for the
activities that are properly within the statutory functions and programs of the affected
agencies of State government; (2) the proposed arrangements serve the interest of efficient
and economical administration of the State government; and (3) the services, supplies or
materials contracted for are not required by Section 21 of Article 16 of the Constitution of
the State of Texas to be supplied under contract given to the lowest responsible bidder;
and
3) DSHS certifies that it has the authority to enter into this Contract granted in Tex. Health &
Safety Code Chapter 1001, and Contractor certifies that it has specific statutory authority
to enter into and perform this Contract.
c) The following additional provisions will apply to interlocal contracts:
1} This Contract is entered into pursuant to the authority granted and in compliance with the
provisions of the Interlocal Cooperation Act, Tex. Gov. Code Chapter 791;
2) Payments made by DSHS to Contractor will be from current revenues available to DSHS;
and
3) Each Party represents that it has been authorized to enter into this Contract.
d) Contractor agrees that Contract Revision Requests {pursuant to the Contractor's Request for
Revision to Certain Contract Provisions section), when signed by a duly authorized
representative of Contractor, will be effective as of the effective date specified by the
Department, whether that date is prior to or after the date of any ratification by Contractor's
governing body.
General Provisions (Core Subrecipient) 2011 4
Section 1.09 Civil Rights Policies and Complaints. Upvn request, Contactor shall provide-the
Health and Human Services Commission (HHSC) Civil Rights Office with copies of all Contractor's
civil rights policies and procedures. Contractor shall notify HHSC's Office of Civil Rights of any
civil rights complaints received relating to performance under this Contract no more than ten (10)
calendar days after Contractor's receipt of the clairri. Notice must be directed to -
HHSC Civil Rights Office
701 W. 51st St., Mail Cade W20b
Austin, Texas 78751
Toll-free phone (888) 3$8-6332
Phone (512) 438-4313
TTY Toll-free (877) 432-7232
Fax (512) 438-5885
Section 1,10 Licenses, Certifications, Permits, Registrations and Approvals. Contractor shall
obtain and maintain all applicable licenses, certifications, permits, registrations and approvals to
conduct its business and to perform the services under this Contract. Failure to obtain or any
revocation, surrender, expiration, non-renewal, inactivation or suspension of any such license,
certification, permit, registration or approval constitutes grounds for termination of this Contract or
other remedies the Department deems appropriate. Contractor shall ensure that all its employees,
staff and volunteers obtain and maintain in active status all licenses, certifications, pei~nits,
registrations and approvals required to perform their duties under this Contract and shall prohibit any
person who does not hold a current, active required license, certification, permit, registration ar
approval from performing services under this Contract.
ARTICLE II SERVICES
Section 2.01 Education to Persons in Residential Facilities. If applicable, Contractor shall ensure
that all persons, who are housed in Department-licensed and/or -funded residential facilities and who
are twenty-two (22) years of age or younger, have access to educational services as required by Tex.
Educ. Code § 29.012. Contractor shall notify the local education agency or local early intervention
program as prescribed by Tex. Educ. Code § 29.012 not later than the third calendar day after the date
a person who is twenty-two (22) years of age or younger is placed in Contractor's residential facility,
Section 2.02 Disaster Services. In the event of a local, state, or federal emergency, including
natural, man-made, criminal, terrorist, and/or bioterrorism events, declared as a state disaster by the
Governor, or as a federal disaster by the appropriate federal official, Contractor may be called upon
to assist DSHS in providing services, as appropriate, in the following areas: community evacuation;
health and medical assistance; assessment of health and medical needs; health surveillance; medical
care personnel; health and medical equipment and supplies; patient evacuation; in-hospital care and
hospital facility status; food, drug, and medical device safety; worker health and safety; mental health
and substance abuse; public health information; vector control and veterinary services; and victim
identification and mortuary services. Contractor shall carry out disaster services in the manner mast
responsive to the needs of the emergency, be cost-effective, and be least intrusive on Contractor's
primary services.
Section 2.03 Consent to Medical Care of a Minor. If Contractor provides medical, dental,
psychological or surgical treatment to a minor under this Contract, either directly or through contracts
General Provisions (Core Subrecipient} 2011 5
with subcontractors, Contractor shall not provide treatment of a minor unless informed consent to
treatment is obtained pursuant to Tex. Farn. Code Chapter 32, relating to consent to treatment of a
child by anon-parent or child or pursuant to other state law. If requirements of federal law relating to
consent directly conflict with Tex. Fam. Code Chapter 32, federal law supersedes state law.
Section 2.04 Telemedicine Medical Services. Contractor shall ensure that if Contractor or its
subcontractor uses telemedicine/telepsychiatry that the services are implemented in accordance with
written procedures and using a protocol approved by Contractor's medical director and using
equipment that complies with the equipment standards as required by the Department. Procedures for
providing telemedicine service must include the following requirements:
a) clinical oversight by Contractor's medical director ar designated physician responsible for
medical leadership;
b) contraindication considerations far telemedicine use;
c) qualified staff members to ensure the safety of the individual being served by telemedicine at
the remote site;
d) safeguards to ensure confidentiality and privacy in accordance with state and federal laws;
e) use by credentialed licensed providers providing clinical care within the scope of their
licenses;
f) demonstrated competency in the operations of the system by all staff members who are
involved in the operation of the system and provision of the services prior to initiating the
protocol;
g) priority in scheduling the system for clinical care of individuals;
h) quality oversight and monitoring of satisfaction of the individuals served; and
i) management of information and documentation far telenr~edzcine services that ensures timely
access to accurate information between the two sites.
Telemedicine Medical Services does not include chemical dependency treatment services provided
by electronic means under Rule § 448.911.
Section 2.45 Fees for Personal Health Services. Contractor may develop a system and schedule
of fees for personal health services in accordance with the provisions of Tex. Health & Safety Code §
12.032, DSHS Rule § 1.91 covering Fees far Personal Health Services, and other applicable laws or
grant xequirements. The amount of a fee must not exceed the actual cast of providing the services.
No client maybe denied a service due to inability to pay.
Section 2.06 Cost Effective Purchasing of Medications. If medications are funded under this
Contract, Contractor shall make needed medications available to clients at the lowest possible prices
and use the most cost effective medications purchasing arrangement possible.
Section 2.47 Services and Information for Persons with Limited English Proficiency.
Contractor shall take reasonable steps to provide services and information, both orally and in writing,
in appropriate languages other than English, to ensure that persons with limited English proficiency
are effectively informed and can have meaningful access to programs, benefits, and activities.
Contractor shall identify and document an the client records the primary language/dialect of a client
who has limited English proficiency and the need for translation or interpretation services and shall
not require a client to provide or pay far the services of a translator or interpreter. Contractor shall
make every effort to avoid use of any persons under the age of eighteen (18) or any family member or
friend of the client as an interpreter for essential communications with a client with limited English
General Provisions (Core Subrecipient) 2011 6
proficiency, unless the client has requested that person and using the person would not compromise
the effectiveness of services or violate the client's confidentiality and the client is advised that a free
interpreter is available.
ARTICLE III FUNDING
Section 3.01 Debt to State and Corporate Status. Pursuant to Tex. Gov. Code § 403.OSS, the
Department will not approve and the State Comptroller will not issue payment to Contractor if
Contractor is indebted to the State for any reason, including a tax delinquency. Contractor, if a
corporation, certifies by execution of this Contract that it is current and will remain currentrn its
payment of franchise taxes to the State of Texas or that it is exempt from payment of franchise taxes
under Texas law {Tex. Tax Cade §§ 171.001 et seq.). Contractor, if a corporation, further certifies
that it is and will remain in good standing with the Secretary of State's office. A false statement
regarding franchise tax or corporate status is a material breach of this Contract. If franchise tax
payments become delinquent during the Contract term, all or part of the payments under this Contract
maybe withheld until Contractor's delinquent franchise tax is paid in full.
Section 3.02 Application of Payment Due. Contractor agrees that any payments due under this
Contract will be applied towards any debt of Contractor, including but not limited to delinquent taxes
and child support that is owed to the State of Texas.
Section 3.03 Use of Funds. Contractor shall expend Department funds only for the provision of
approved services and for reasonable and allowable expenses directly related to those services.
Section 3.04 Use for Match Prohibited. Contractor shall not use funds provided through this
Contract for matching purposes in securing other funding unless directed or approved by the
Department in writing.
Section 3.05 Program Income. Gross income directly generated from Department funds through a
project or activity performed under a Program Attachment and/or earned only as a result of a
Program Attachment during the term of the Program Attachment are considered program income.
Unless otherwise required under the terms of the grant funding this Contract, Contractor shall use the
addition alternative, as provided in UGMS § _.25(g)(2), for the use of program income to further the
program objectives of the state or federal statute under which the Program Attachment was made, and
Contractor shall spend the program income on the same Program Attachment project in which it was
generated. Contractor shall identify and report this income in accordance with the Compliance and
Reporting Article of these General Provisions, the Contractor's Financial Procedures Manual located
at http:/Iwww,dshs.state.tx.us/contracts/cf~m.shtm and the provisions of the Program Attachment(s).
Contractor shall expend program income during the Program Attachment term and may not carry
forward to any succeeding term. Contractor shall refund program income not expended in the term in
which it is earned to DSHS. DSHS nnay base future funding levels, in part, upon Contractor's
proficiency in identifying, billing, collecting, and reporting program income, and in using it for the
purposes and under the conditions specified in this Contract.
Section 3.Ofi Nonsupplanting. Contractor shall not supplant (i.e., use funds from this Contract to
replace or substitute existing funding from other sources that also supports the activities that are the
subject of this Contract) but rather shall use funds from this Contract to supplement existing state or
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local funds currently available for a particular activity. Contractor shall make a good faith effort to
maintain its current level of support. Contractor may be required to submit documentation
substantiating that a reduction in state or local funding, if any, resulted for reasons other than receipt
or expected receipt of funding under this Contract.
ARTICLE IV PAYMENT. METHODS AND RESTRICTIONS
Section 4.D1 Payment Methods. Except as otherwise provided by the provisions of the Program
Attachment(s), the payment method for each Program Attachment will be one of the following
methods:
a) cost reimbursement. This payment method is based on an approved budget in the Program
Attachment(s) and acceptable submission of a request far reimbursement; or
b) unit rate/fee-for-service. This payment method is based an a fixed price or a specified rate{s)
or fee(s) for delivery of a specified unit(s) of service, as stated in the Program Attachment(s)
and acceptable submission of all required documentation, forms and/or reports.
Section 4.02 Billing Submission. Contractors shall bill the Department in accordance with the
Program Attachment(s) in the form and format prescribed by DSHS. Unless otherwise specified in
the Program Attachments} or permitted under the Third Party Payors section of this Article,
Contractor shall submit requests for reimbursement or payment monthly within thirty (30) calendar
days following the end of the month covered by the bill.
Section 4.03 Final Billing Submission. Unless otherwise provided by the Department, Contractor
shall submit a reimbursement or payment request as a final close-out bill not later than sixty (60)
calendar days following the end of the term of the Program Attachment for goods received and
services rendered during the term. If necessary to meet this deadline, Contractor may submit
reimbursement ar payment requests by facsimile transmission. Reimbursement or payment requests
received in DSHS's offices more than sixty (60) calendar days following the end of the applicable
term will not be paid. Consideration of requests for an exception will be made on a case-by-case
basis, subject to the availability of funding, and only for an extenuating circumstance, such as a
catastrophic event, natural disaster, or criminal activity that substantially interferes with normal
business operations or causes damage or destruction of a place of business and/or records. A written
statement describing the extenuating circumstance and the last request for reimbursement must be
submitted for review and approval to the DSHS Accounting Section.
Section 4.04 Working Capital Advance. If allowed under this Contract, a single one-time
working capital advance per term of the Program Attachment may be granted at the Department's
dzscretian. Contractor must submit documentation to the contract manager assigned to the Program
Attachment to justify the need for a working capital advance. Contractor shall liquidate the working
capital advance as duected by the Department. The requirements for the documentation justifying
the need far an advance and the directions for liquidating the advance are found in the Contractor's
Financial Procedures Manual located at http://www.dshs.state.tx.us/contractslcfpm.shtrn.
Section 4.05 Financial Status Reports {FSRs). Except as otherwise provided in these General
Provisions or in the terms of the Program Attachment(s), for contracts with categorical budgets,
Contractor shall submit quarterly FSRs to Accounts Payable by the thirtieth calendar day of the
nrionth following the end of each quarter of the Program Attachment term for Department review and
General Provisions (Core Subrecipient) 2011
financial assessment. Contractor shall submit•the final FSR no Later than sixty (60) days following
the end of the applicable term.
Section 4.06 Third Party Payors. A third party payor is any person or entity who has the legal
responsibility for paying for all yr part of the services provided. Third party Payors include, but are
not limited to, commercial health or liability insurance carriers, Medicaid, or other federal, state,
local, and private funding sources. Except as provided in this Contract, Contractor shall screen all
clients and shall not bill the Department for services eligible for reimbursement from third party
Payors. Contractor shall (a) enroll as a provider in Children's Health Insurance Program and
Medicaid if providing approved services authorized under this Contract that maybe covered by those
programs, and bill those programs for the covered services; {b) provide assistance to individuals to
enroll in such programs when the screening process indicates possible eligibility for such programs;
(c) allow clients who are otherwise eligible for Department services, but cannot pay a deductible
required by a third party payor, to receive services up to the amount of the deductible and to bill the
Department for the deductible; (d) not bill the Department for any services eligible for third party
reimbursement until all appeals to third party Payors have been exhausted, in which case the thirty
{30)-day requirement in the Billing Submission section will be extended until all such appeals have
been exhausted; (e) maintain appropriate documentation from the third party payor reflecting
attempts to obtain reimbursement; (f} bill all third party Payors for services provided under this
Contract before submitting any request for reimbursement to Department; and (g} provide third party
billing functions at no cost to the client.
ARTICLE V TERMS AND CONDITIONS OF PAYMENT
Section 5.01 Prompt Payment. Upon receipt of a timely, undisputed invoice pursuant to this
Contract, Department will pay Contractor. Payments and reimbursements are contingent upon a
signed Contract and will not exceed the total amount of authorized funds under this Contract.
Contractor is entitled to payment or reimbursement only if the service, work, and/or product has been
authorized by the Department and performed or provided pursuant tv this Contract. If those
conditions are met, Department will make payment in accordance with the Texas prompt payment
law (Tex. Gov. Code Chapter 2251). Contractor shall comply with Tex. Gov. Code Chapter 2251
regarding its prompt payment obligations to subcontractors. Payment of invoices by the Department
will not constitute acceptance or approval of Contractor's performance, and all invoices and
Contractor's performance are subject to audit or review by the Department.
Section SA2 Withholding Payments. Department may withhold all or part of any payments to
Contractor to offset reimbursement for any ineligible expenditures, disallowed costs, or
overpayments that Contractor has not refunded to Department, or if financial status report(s) required
by the Department are not submitted by the date(s) due. Department may take repayment (recoup}
from funds available under this Contract in amounts necessary to fulfill Contractor's repayment
obligations.
Section 5.03 Condition Precedent to Requesting Payment. Contractor shah disburse program
income, rebates, refunds, contract settlements, audit recoveries, and interest earned on such funds
before requesting cash payments including any advance payments from Department.
General Provisions (Care Subrecipient) 2011 9
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Section 5.04 Acceptance as Payment in Full. Except as permitted in the Fees for Personal Health
Services section of the Services Article of these General Provisions or undex 25 Tex. Admin. Code §
444.413, Contractor shall accept reimbursement or payment from DSHS as payment in full for
services or goods provided to clients or participants, and Contractor shall not seek additional
reimbursement or payrizent for services or goods from clients or participants or charge a fee or make a
profit with respect to the Contract. A fee or profit is considered to be an amount in excess of actual
allowable costs that are incurred in conducting an assistance program.
ARTICLE VI ALLOWABLE COSTS AND AUDIT REQUIREMENTS
Section 6.01 Allowable Costs. For services satisfactorily performed, and sufficiently documented,
pursuant to this Contract, DSHS will reimburse Contractor for allowable costs. Contractor must have
incurred a cost pxior to claiming reimbursement and within the applicable term to be eligible for
reimbursement under this Contract. DSHS will determine whether costs submitted by Contractor are
allowable and eligible for reimbursement. If DSHS has paid funds to Contractor for unallowable or
ineligible costs, DSHS will notify Contractor in writing, and Contractor shall return the funds to
DSHS within thirty {30) calendar days of the date of this wxitten notice. DSHS may withhold all or
part of any payments to Contractor to offset reimbursement for any unallowable or ineligible
expenditures that Contractor has not refunded to DSHS, or if financial status report(s) required undex
the Financial Status Reports section are not submitted by the due date(s). DSHS may take repayment .
(recoup) from funds available under this Contract in amounts necessary to fulfill Contractor's
repayment obligations. Applicable cost principles, audit requirements, and administrative
requirements include-
Applicable Entity Applicable Cost Audit Administrative
Princi les Re uirements Re uirements
State, Local and OMB Circular OMB Circular UGMS, OMB
Tribal Governments A-87 (2 CFR, Part A-133 and UGMS Circular A-102, and
225) applicable Federal
awarding agency
common -rule
Educational OMB Circular OMB Circular OMB Circular A-110
Institutions A-21 (2 CFR, Part A-133 (2 CFR, Part 215) and
220); and UGMS, applicable Federal
as applicable awarding agency
common rule; and
UGMS, as a licable
Non-Profit OMB Circular OMB Circular UGMS; OMB
Organizations A-122 (2 CFR, A-133 and UGMS Circular A-110 (2
Part 230} CFR, Part 215) and
applicable Federal
awarding agency
common rule
For-profit 48 CFR Part 31, OMB Circular A- UGMS and applicable
Qr anization other Contract Cost 133 and UGMS Federal awarding
General Provisions (Core Subrecipient) 2011 10
+, ~ ,,~
than a hospital and an Principles agency common rule
organization named in Procedures, or
OMB Circular A-122 uniform cost
(2 CFR Part, 234) as accounting
not subject to that standards that
circular. comply with cost
principles
acceptable to the
federal or state
awardin a enc
A chart of applicable Federal awarding agency common rules is located through a weblink on the
DSHS website at http://www.dshs.state.tx.us/contractsllinks.shtm. OMB Circulars will be applied
with the modifications prescribed by UGMS with effect given to whichever provision imposes the
more stringent requirement in the event of a conflict.
Section 6.02 Independent Single or Program-Specific Audit. If Contractor within Contractor's
fiscal year expends a total amount of at least $500,000 in federal funds awarded, Contractor shall
have a single audit orprogram-specific audit in accordance with the Office of Management and
Budget (OMB) Cire. No. A-133, the Single Audit Act of 1984, P L 98-502, 98 Stat. 2327, and the
Single Audit Act Amendments of 1996, P L 104-156, 110 Stat. 1396. The $500,000 federal
threshold amount includes federal funds passed through by way of state agency awards. If Contractor
within Contractor's fiscal year expends a total amount of at Ieast $SOD,DOD in state funds awarded,
Contractor must have a single audit or program-specific audit in accordance with UGMS, State of
Texas Single Audit Circular. For-profit Contractors whose expenditures meet or exceed the federal
and/or state expenditure thresholds stated above shall follow the guidelines in OMB Circular A-133
or UGMS, as applicable, for their program-specific audits. The HHSC Office of Inspector General
(OIG) will notify Contractor to complete the Single Audit Determination Registration Form. If
Contractor fails to complete the Single Audit Determination Form within thirty {30) calendar days
after notification by OIG to do so, Contractor shall be subject to DSHS sanctions and remedies for
non-compliance with this Contract. The audit must be conducted by an independent certified public
accountant and in accordance with. applicable OMB Circulars, Government Auditing Standards, and
UGMS, which is accessible through a web link on the DSHS website at
httpa/vc~ww.dshs.state.tx.us/contracts/links.shtm. Contractor shall procure audit services in
compliance with this section, state procurement procedures, as well as with the provisions of UGMS.
Contractor, unless Contractor is a state governmental entity, shall competitively re-procure
independent single audit services at least every five (5) years. Incumbent audit firms may participate
in the re-procurement process; however, Contractor shall not procure services of the same audit firm
for more than ten {10) consecutive years and shall require that the audit firm limit the amount of time
the lead or coordinating audit partner {having primary responsibility for the audit) conducts the
independent audit to a maximum of five (5) years within aten-year period. Contractor may request,
in writing to the DSHS Contract Oversight and Support Section, an exception from lead partner
rotation for years six (6) through ten (10} of a ten-year period if the audit firm has only one lead
partner. If the request is approved, Contractor shall require the audit firm to provide certification
annually 'for years six through ten that the audit firm has no more than one partner and shall require
the audit firm to contract with an independent audit firm to perform a second partner review of the
General Provisions {Core Subrecipient) 2011 11
single orprogram-specific audit work performed for Contractor. Procurement of audit services must
comply with the procurement standards of 45 CFR Part 74 or 92, as applicable, including obtaining
competition and making positive efforts to use small, minority-owned, and women-owned business
enterprises.
Section 6.03 Submission of Audit. Within thirty {30) calendar days of receipt of the audit reports
required by the Independent Single arProgram-Specific Audit section, Contractor shall submit one
copy to the Department's Contract Oversight and Support Section, and one copy to the OIG, at the
following addresses:
Department of State Health Services
Contract Oversight and Support, Mail Code 1326
P.O. Box 149347
Austin, Texas 78714-9347
Health and Human Services Commission
Office of Inspector General
Compliance/Audit, Mail Code 1326
P.O. Box 85240
Austin, Texas 78708-5200
If Contractor fails to submit the audit report as required by the Independent Single or Program-
Specific Audit section within thirty (30) calendar days of receipt by Contractor of an audit report,
Contractor shall be subject to DSHS sanctions and remedies for non-compliance with this Contract.
ARTICLE VII CONFIDENTIALITY
Section 7.01 Maintenance of Confidentiality. Contractor must maintain the privacy and
confidentiality of information and records received during or related to the performance of this
Contract, including patient and client records that contain protected health information (PHI), and any
other information that discloses confidential personal information or identifies any client served by
DSHS, in accordance with applicable federal and state laws, rules and regulations, including but not
limited to 7 CFR Part 246; 42 CFR Part 2; 45 CFR Parts 160 and 164 (Health Insurance Portability
and Accountability Act [HIPAA]); Tex. Health & Safety Cade Chapters 12, 47, 81, 82, 85, 88, 92,
161, 181, 241, 245, 251, 534, 576, 577, 596, 611, and 773; and Tex. Occ. Code Chapters 56 and 159
and all applicable rules and regulations.
Section 7.02 Department Access to PHI and Other Confidential Information. Contractor shall
cooperate with Department to allow Department to request, collect and receive PHI and other
confidential information under this Contract, without the consent of the individual to whom the PHI
relates, for funding, payment and administration of the grant program, and for puzposes permitted
under applicable state and federal confidentiality and privacy laws.
Section 7.03 Exchange of Client-Identifying Information. Except as prohibited by other law,
Contractor and DSHS shall exchange PHI without the consent of clients in accordance with 45 CFR §
164.504(e)(3)(i)(B), Tex. Health & Safety Cade § 533.009 and Rule Chapeex 414, Subchapter A or
General Provisions (Core Subrecipient) 2011 12
„ ~ ~ ~~
other applicable laws or rules. Contractor shall disclose information described in Tex. Health &
Safety Code § 614A17(a)(2) relating to special needs offenders, to an agency described in Tex.
Health & Safety Cade § 614.017(c) upon request of that agency, unless Contractor documents that
the information is not allowed to be disclosed under 45 CFR Part 164 or other applicable law.
Section 7.04 Security of Patient or Client Records. Contractor shall maintain patient and client
records in compliance with state and federal law relating to security and retention of medical or
mental health and substance abuse patient and client records. Department may require Contractor to
transfer original or copies of patient and client records to Department, without the consent ar
authorization of the patient or client, upon termination of this Contract or a Program Attachment to
this Contract, as applicable, or if the care and treatment of the individual patient or client is
transferred to another entity. Prior to providing services funded under this Contract to a patient ox
client, Contractor shall attempt to obtain consent from the patient or client to transfer copies of
patient ar client records to another entity funded by DSHS upon termination of this Contract or a
Program Attachment to this Contract, as applicable, or if care or treatment is transferred to another
DSHS-funded contractor.
Section 7.05 HN/AIDS Model Workplace Guidelines. If providing direct client care, services,
ar programs, Contractor shall implement Department's policies based on the HIV/AIDS (human
immunodeficiency virus/acquired immunodef ciency syndrome) Model Workplace Guidelines for
Businesses, State Agencies, and State Contractors, Policy No. 090.021, and Contractor shall educate
employees and clients concerning HN and its related conditions, including AIDS, in accordance with
the Tex. Health & Safety Code § 85.112-114. A link to the Model Workplace Guidelines can be
found at htt ://www.dshs.state.tx.us/hivstdl olic / olicies.shtm.
ARTICLE VIII RECORDS RETENTION
Section 8.01 Retention. Contractor shall retain records in accordance with applicable state and
federal statutes, rules and regulations. At a minimum, Contractor shall retain and preserve all other
records, including financial records that are generated or collected by Contractor under the provisions
of this Contract, for a period of four (4) years after the termination of this Contract. If services are
funded through Medicaid, the federal retention period, if more than four (4) years, will apply.
Contractox shall retain alI records pertaining to this Cantract that are the subject of litigation or an
audit until the litigation has ended or aTl questions pertaining to the audit are resolved. Legal
requirements for Contractor may extend beyond the retention schedules established in this section.
Cantractor shall retain medical records in accordance with Tex. Admin. Code Title 22, Part 9, §
165.1(b) and (c) or other applicable statutes, rules and regulations governing medical information,
Contractor shall include this provision concerning records retention in any subcontract it awards. If
Contractor ceases business operations, it shall ensure that records relating to this Contract are
securely stored and are accessible by the Department upon Department's request for at least four (4)
years from the date Contractor ceases business or from the date this Contract terminates, whichever is
sooner. Contractor shall provide the name and address of the party responsible for storage of records
to the contract manager assigned to the Program Attachment.
General Provisions (Core Subrecipient) 2011 13
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ARTICLE IX ACCESS AND INSPECTION
Section 9.01 Access. In addition to any right of access arising by operation of law, Contractor, and
any of Contractor's affiliate or subsidiary organizations or subcontractors shall permit the
Department or any of its duly authorized representatives, as well as duly authorized federal, state or
local authorities, including the Comptroller General of the United States, OIG, and the State
Auditor's Office (SAO), unrestricted access to and the right to examine any site where business is
conducted or client services are performed, and all records (including client and patient records, if
any, and Contractor's personnel records and governing body personnel records), books, papers or
documents related to this Contract; and the right to interview members of Contractor's governing
body, staff, volunteers, participants and clients concerning the Contract, Contractor's business and
client services. If deemed necessary by the Department or the OIG, for the purpose of investigation
or hearing, Contractor shall produce original documents related to this Contract. The Department and
HHSC will have the right to audit billings both before and after payment, and all documentation that
substantiates the billings. Payments will not foreclose the right of Department and HHSC. to recover
excessive or illegal payments. Contractor shall make available to the Department information
collected, assembled or maintained by Contractor relative to this Contract for the Department to
respond to requests that it receives under the Public Information Act. Contractor shall include this
provision concerning the right of access to, and examination of, sites and information related to this
Contract in any subcontract it awards.
Section 9.02 State Auditor's Office. Contractor shall, upon request, make all records, books,
papers, documents, or recordings related to this Contract available for inspection, audit, or
reproduction during normal business hours to any authorized representative of the SAO. Contractor
understands that the acceptance of funds under this Contract acts as acceptance of the authority of the
SAO, or any successor agency, to conduct an audit or investigation in connection with those funds.
Contractor shall cooperate fully with the SAO or its successor in the conduct of the audit or
investigation, including providing all records requested, and providing access to any information the
SAO considers relevant to the investigation or audit. The SAO's authority to audit funds will apply
to Contract funds disbursed by Contractor to its subcontractors, and Contractor shall include this
provision concerning the SAO's authority to audit and the requirement to cooperate, in any
subcontract Contractor awards.
Section 9.03 Responding tQ Deficiencies. Any deficiencies identified by DSHS or HHSC upon
examination of Contractor's records or during an inspection of Contractor's site{s) will be conveyed
in writing to Contractor. Contractor shall submit, by the date prescribed by DSHS, a resolution to the
deficiency identified in a site inspection, program review or management or financial audit to the
satisfaction of DSHS or, if directed by DSHS, a corrective action plan to resolve the deficiency. A
DSHS or HHSC determination of either an inadequate or inappropriate resolution of the findings may
result in contract remedies or sanctions under the Breach of Contract and Remedies for Non-
compliance Article of these General Provisions.
ARTICLE X NOTICE REQUIREMENTS
Section 10.01 Child Abuse Reporting Reduirement. This section applies to mental health and
substance abuse contractors and contractors for the following public health programs: Human
Immunodeficiency Virus/Sexually Transmitted Diseases (HIVISTD); Family Planning (Titles V, X
and XX); Primary Health Care; Maternal and Child Health; and Women, Infants and Children (WIC)
General Provisions (Core Subrecipient) 2011 14
Nutrition Services. Contractor shall make a good faith effort to comply with child abuse reporting
guidelines and requirements in Tex. Fam. Code Chapter 2fi1 relating to investigations of reports of
child abuse and neglect. Contractor shall develop, implement and enforce a written policy that
includes at a minimum-the Department's Child Abuse Screening, Documenting, and Reporting Policy
for ContractorslProviders and train all staff on reporting xequirements. Contractor shall use the
DSHS Child Abuse Reporting Form as required by the Department located at
www.dshs.state.tx.uslchildabusere ortin .Contractor shall retain reporting documentation an site
and make it available for inspection by DSHS.
Section 10.02 Significant Incidents. In addition to notifying the appropriate authorities, Contractor
shall report to the contract manager assigned to the Program Attachment significant incidents
involving substantial disruption of Contractor's program operation, or affecting or potentially
affecting the health, safety or welfare of Department-funded clients or participants within seventy-
two (72) hours of discovery.
Section 10.03 Litigation. Contractor shall notify the contract manager assigned to the Program
Attachment of litigation related to or affecting this Contract and to which Contractor is a party within
seven (7} calendar days of becoming aware of such a proceeding. This includes, but is not limited to
an action, suit .or proceeding before any court or governmental body, including environmental and
civil rights matters, professional liability, and employee litigation. Notification must include the
names of the parties, nature of the litigation and remedy sought, including amount of damages, if any.
Section 10.04 Action Against the Contractor. Contractor shall notify the contract manager
assigned to the Program Attachment if Contractor has had a contract suspended or terminated for
cause by any local, state or federal department or agency or nonprofit entity within three (3) working
days of the suspension or termination. Such notification must include the reason for such action; the
name and contact information of the local, state or federal department or agency or entity; the date of
the contract; and the contract or case reference number. If Contractor, as an organization, has
surrendered its license or has had its license suspended or revoked by any local, state or federal
department or agency or non-profit entity, it shall disclose this information within three (3) working
days of the suzxender, suspension or revocation to the contract manager assigned to the Program
Attachment by submitting cone-page description that includes the reason{s) fox such action; the
Warne and contact information of the local, state or federal department or agency or entity; the date of
the license action; and a license or case reference number.
Section 10.05 Insolvency. Contractor shall notify in writing the contract manager assigned to the
Program Attachment of Contractor's insolvency, incapacity, or outstanding unpaid obligations to the
Intexnal Revenue Sex~ice (IRS) or Texas Workforce Commission (TWC} within three (3) working
days of the date of determination that Contractor is insolvent or incapacitated, ox the date Contractor
discovered an unpaid obligation to the IRS or TWC, Contractor shall notify in writing the contract
manager assigned to the Program Attachment of its plan to seek bankruptcy protection within three
(3) working days of such action by Contractor's governing body.
Section 10.06 Misuse of Funds and Performance Maifeasance. Contractor shall report to the
contract manager assigned to the Program Attachment, any knowledge of debarment, suspected
fraud, program abuse, possible illegal expenditures, unlawful activity, or violation of financial laws,
rules, policies, and procedures related to performance under this Contract. Contractor shall make
General Provisions {Core Subrecipient) 2011 15
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such report no later than three (3) working days from the date that Contractor has knowledge or
reason to believe such activity has taken place. Additionally, if this Contract is federally funded by
the Department of Health and Human Services (HHS), Contractor shall report any credible evidence
that a principal, employee, subcontractor or agent of Contractor, or any other person, has submitted a
false claim under the False Claims Act or has committed a criminal or civil violation of laws
t
pertaining to fraud, conflict of interest, bribery, gratuity, or similar misconduct involving those funds.
Contractor shall make this report to the HHS Office of Inspector General at
http://www.oig hhs.govlfraud/hotline/ no later than three (3) working days from the date that
Contractor has knowledge or reason to believe such activity has taken place.
Section 10.07 Criminal Activity and Disciplinary Action. Contractor affirms that no person who
has an ownership or controlling interest in the organization or who is an agent or managing employee
of the organization has been placed on community supervision, received deferred adjudication, is
presently indicted for or has been convicted of a criminal offense related to any financial matter,
federal or state program or felony sex crime. Contractor shall notify in writing the contract manager
assigned to the Program Attachment if it has reason to believe Contractor, or a person with ownership
or controlling interest in the organization or who is an agent or managing employee of the
organization, an employee or volunteer of Contractor, or a subcontractor providing services under
this Contract has engaged in any activity that would constitute a criminal offense equal to or greater
than a Class A misdemeanor or if such activity would reasonably constitute grounds for disciplinary
action by a state or federal regulatory authority, or has been placed on community supervision,
received deferred adjudication, or been indicted for or convicted of a criminal offense relating to
involvement in any financial matter, federal or state program or felony sex crime. Contractor shall
make the reports required by this section no later than three (3) working days from the date that
Contractor has knowledge or reason to believe such activity has taken place. Contractor shall not
permit any person who engaged, or was alleged to have engaged, in an activity subject to reporting
under this section to perform direct client services or have direct contact with. clients, unless
otherwise directed by DSHS.
Section 1.0.08 Retaliation Prohibited. Contractor shall not retaliate against any person who reports
a violation of, or cooperates with an investigation regarding, any applicable law, rule, regulation or
standard to the Department; another state agency, or any federal, state or local law enforcement
official.
Section 1D.D9 Documentation. Contractor shall maintain appropriate documentation of all notices
required under these General Provisions.
ARTICLE XI ASSURANCES AND. CERTIFICATIONS
Section 11.01 Certification. Contractor certifies by execution of this Contract to the following:
a) it is not disqualified under 2 CFR §376.935 or ineligible for participation in federal or state
assistance programs;
b) neither it, nor its principals, are presently debarred, suspended, proposed for debarment,
declared ineligible, or excluded from participation in this transaction by any federal or state
department or agency;
General Provisions (Core Subrecipient) 2411 16
1 i ~ ~ ~
c} it has not knowingly failed to pay a single substantial debt or a number of outstanding debts to
a federal or state agency;
d) it is not subject to an outstanding judgment in a suit against Contractor for collection of the
balance of a debt;
e) it is in good standing with all state and/or federal agencies that have a contracting or
regulatory relationship with Contractor;
f) that no person who has an ownership or controlling interest in Contractor or who is an agent
or managing employee of Contractor has been convicted of a criminal offense related to
involvement in any program established under Medicare, Medicaid, or a federal block grant;
g) neither it, nor its principals have within the three(3)-year period preceding this Contract, has
been convicted of or had a civil judgment rendered against them for commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or performing a private or
public (federal, state or local) transaction or contract under a private or public transaction,
violation of federal or state antitrust statutes (including those proscribing price-fixing between
competitors, allocation of customers between competitors and bid-rigging), or commission of
embezzlement, theft, forgery, bribery, falsification or destruction of records, making false
statements or false claims, tax evasion, obstruction of justice, receiving stolen property or any
other offense indicating a lack of business integrity or business honesty that seriously and
directly affects the present responsibility of Contactor or its principals;
h) neither it, nor its principals is presently indicted or otherwise criminally or civilly charged by
a governmental entity (federal, state or local) with the commission of any of the offenses
enumerated in subsection g) of this section; and
i) neither it, nor its principals within a three(3)-year period preceding this Contract has had one
or more public transaction (federal, state or local) terminated for cause or default.
Contractor shall include the certifications in this Article, without modification (except as required to
make applicable to the subcontractor), in all subcontracts and solicitations for subcontracts. Where
Contractor is unable to certify to any of the statements in this Article, Contractor shall submit an
explanation to the contract manager assigned to the Program Attachment. if Contractor's status with
respect to the items certified in this Article changes during the term of this Contract, Contractor shall
immediately notify the contract manager assigned to the Program Attachment.
Section 11.02 Child Support Delinquencies. As required by Tex. Fam. Code § 231.006, a child
support obligor who is more than thirty (30) calendar days delinquent in paying child support and a
business entity in which the obligor is a sole proprietor, partner, shareholder, or owner with an
ownership interest of at least twenty-five percent (2S%) is not eligible to receive payments from state
funds under a contract to provide property, materials, or services orreceive astate-funded grant or
loan. if applicable, Contractor shall maintain its eligibility to receive payments under this Contract,
certifies that it is not ineligible to receive the payments specified in this Contract, and acknowledges
that this Contract maybe terminated and payment maybe withheld if this certification is inaccurate.
General Provisions {Core Subrecipient) 2011 ~ 17
~. ,
Section 11.03 Authorization. Contractor certifies that it possesses legal authority to contract for the
services described in this Contract and that a resolution, motion or similar action has been duly
adopted or passed as an official act of Contractor's governing body, authorizing the binding of the
organization under this Contract including all understandings and assurances contained in this
Contract, and directing and authorizing the person identified as the authorized representative of
Contractor to act in connection with this Contract and to provide such additional information.as may
be required.
Section 11.04 Gifts and Benefits Prohibited. Contractor certifies that it has not given, offered to
give, nor intends to give at any time hereafter, any economic opportunity, present or future
employment, gift, loan, gratuity, special discount, trip, favor, service or anything of monetary value
to a DSHS or HHSC official or employee in connection with this Contract.
Section 11.05 Ineligibility to Receive the Contract. (a) Pursuant to Tex. Gov. Code § 2155.004
and federal law, Contractor is ineligible to receive this Contract if this Contract includes financial
participation by a person who received compensation from DSHS to participate in developing,
drafting or preparing the specifications, requirements, statement(s) of work or Solicitation Document
on which this Contract is based. Contractor certifies that neither Contractor, nor its employees, nor
anyone acting for Contractor has received compensation from DSHS for participation in the
development, drafting or preparation of specifications, requirements or statement(s) of work for this
Contract or in the Solicitation Document on which this Contract is based; {b) pursuant to Tex. Gov.
Code §§ 2155.006 and 2261.053, Contractor is ineligible to receive this Contract, if Contractor or any
person who would have financial participation in this Contract has been convicted of violating federal
law, or been assessed a federal civil or administrative penalty, in connection with a contract awarded
by the federal government for relief, recovery or reconstruction efforts as a result of Hurricanes Rita
or Katrina or any other disaster occurring after September 24, 2005; (c) Contractor certifies that the
individual or business entity named in this Contract is not ineligible to receive the specified Contract
under Tex. Gov. Code §§ 2155.004, 2155A06 or 2251.053, and acknowledges that this Contract may
be terminated and payment withheld if these certifications are inaccurate.
Section 11.06 Antitrust. Pursuant to 15 USC § 1, et seq. and Tex. Bus. & Comm. Code § 15.01, et
seq. Contractor certifies that neither Contractor, nor anyone acting for Contractor has violated the
antitrust laws of this state or federal antitrust laws, nor communicated directly or indirectly regarding
a bid with any competitor or any other person engaged in Contractor's line of business for the
purpose of substantially lessening competition in such line of business.
Section 11.07 Initiation and Completion of Work. Contractor certifies that it shall initiate and
complete the work under this Contract within the applicable time frame prescribed in this Contract.
ARTICLE XTI GENERAL BUSINESS OPERATIONS OF CONTRACTOR
Section 12.01 Responsibilities and Restrictions Concerning Governing Body, Officers and
Employees. Contractor and its governing body shall bear full responsibility for the integrity of the
fiscal and programmatic management of the organization. This provision applies to all organizations,
including Section 501(c)(3) organizations as defined in the Internal Revenue Service Code as not-for-
General Provisions {Core Subrecipient) 2011 1 S
profit organizations, Each member of Contractor's governing body shall be accountable for all funds
and materials received from Department. The responsibility of Contractor's governing body shall
also include accountability for compliance with Department Rules, policies, procedures, and
applicable federal and state laws and regulations; and correction of f scat and program deficiencies
identified through self-evaluation and Department's monitoring processes. Further, Contractor's
governing body shall ensure separation of powers, duties, and functions of governing body members
and staff. Staff members, including the executive director, shall not serve as voting members of
Contractor's governing body. No member of Contractor's governing body, or officer or employee of
Contractor shall vote for, confirm or act to influence the employment, compensation or change in
status of any person related within the second degree of affinity or the third degree of consanguinity
(as defined in Tex. Gov. Code Chapter 573) to the member of the governing body or the officer or
any employee authorized to employ or supervise such person. This prohibition does not prohibit the
continued employment of a person who has been continuously employed for a period of two {2) years
prior to the .election, appointment or employment of the officer, employee, or governing body
member related to such person in the prohibited degree. These restrictions also apply to the
governing body, officers and employees of Contractor's subcontractors. Ignorance of any Contract
provisions or other requirements contained or referred to in this Contract will not constitute a defense
or basis for waiving or appealing such provisions or requirements.
Section 12.02 Management and Control Systems. Contractor shall comply with, all the
requirements of the Department's Contractor's Financial Procedures Manual, and any of its
subsequent amendments, which is available at the Department's web site:
htt~_//www.dshs.state.tx.us/contracts/cftam.shtm. Contractor shall maintain an appropriate contract
administration system to ensure that all terms, conditions, and specifications are met. Contractor
shall develop, implement, and maintain financial management and control systems that meet or
exceed the requirements of UGMS and adhere to procedures detailed in Department's Contractor's
Financial Procedures Manual. Those requirements and procedures include, at a minimum, the
following:
a) financial planning, including the development of budgets that adequately reflect all functions
and resources necessary to carry out authorized activities and the adequate determination of
Costs;
b) financial management systems that include accurate accounting records that are accessible
and identify the source and application of funds provided under each Program Attachment of
this Contract, and original source documentation substantiating that costs are specifically and
solely allocable to the Program Attachment and are traceable from the transaction to the
general ledger; and
c) effective internal and budgetary controls; comparison of actual costs to budget; determination
of reasonableness, allowableness, and allocability of costs; timely and appropriate audits and
resolution of any findings; billing and collection policies; and a mechanism capable of billing
and making reasonable efforts to collect from clients and third parties.
Section 12.03 Insurance. Contractor shall maintain insurance or other means of repairing or
replacing assets purchased with Department funds. Contractor shall repair or replace with
comparable equipment any such equipment not covered by insurance that is lost, stolen, damaged or
destroyed. If any insured equipment purchased with DSHS funds is Iost, stolen, damaged or
destroyed, Contractor shall notify the contract manager assigned to the Program Attachment to obtain
instructions whether to submit and pursue an insurance claim. Contractor shall use any insurance
General Provisions (Core Subrecipient) 2011 19
proceeds to repair the equipment or replace the equipment with comparable equipment or remit the
insurance proceeds to DSHS.
Section 12.04 Fidelity Bond. For the benefit of DSHS, Contractor is required to carry a fidelity
bond ar insurance coverage equal to the amount of funding provided under this Contract up to
$100,000 that covers each employee of Contractor handling funds under this Contract, including
persons} authorizing payment of such funds. The fidelity bond or insurance must provide for
indemnification of losses occasioned by (1) any fraudulent or dishonest act or acts committed by any
of Contractor's employees, either individually or in concert with others, andlor (2} failure of
Contractor or any of its employees to perform faithfully his/her duties or to account properly for all
monies and property received by virtue of his/her position or employment. The bond or insurance
acquired under this section must include coverage for third party property and include DSHS as a loss
payee or equivalent designation. Contractor shall notify, and obtain prior approval from, the DSHS
Contract Oversight and Support Section before settling a claim on the fidelity bond or insurance.
Section 12.05 Liability Coverage. For the benefit of DSHS, Contractor shall also maintain liability
insurance coverage, referred to in Tex. Gov. Code § 2261.102, as "director and officer liability
coverage" or similar coverage for all persons in management or governing positions within
Contractor's organization or with management or governing authority over Contractor's organization
(collectively "responsible persons"). Contractor shall ensure that the policy includes Property of
Others coverage with respect to funds and other property of the State related to this Contract, and
includes DSHS as a loss payee on the policy. Contractor shall maintain copies of liability policies on
site fox inspection by DSHS and shall submit copies of policies to DSHS upon request. This section
applies to entities that are organized as non-profit corporations under the Texas Non-Profit
Corporation Act; for-profit corporations organized under the Texas Business Corporations Act; and
any other legal entity. Contractor shall maintain liability insurance coverage in an amount not less
than the total value of this Contract and that is sufficient to protect the interests of Department in the
event an actionable act ar omission by a responsible person damages Department's interests.
Contractor shall notify, and obtain prior approval from, the DSHS Contract Oversight and Support
Section before settling a claim an the insurance.
Section 12.06 Overtime Compensation. Except as provided in this section, Contractor shall not use
any of the funds provided by this Contract to pay the premium portion of overtime. Contractor shall
be responsible for any obligations of premium overtime pay due employees. Premium overtime pay
is defined as any compensation paid to an individual in addition to the employee's normal rate of pay
for hours worked in excess of normal working hours. Funds provided under this Contract maybe
used to pay the premium portion of overtime only under the following conditions: 1) with the prior
written approval of DSHS; 2) temporarily, in the case of an emergency or an occasional operational
bottleneck; 3) when employees are performing indirect functions, such as administration,
maintenance, or accounting; 4) in performance of tests, laboratory procedures, or similar operations
that are continuous in nature and cannot reasonably be interrupted or otherwise completed; or 5)
when lower overall cost to DSHS will result.
Section 12.07 Program Site. Contractor shall provide services only in locations that are in
compliance with all applicable local, state and federal zoning, building, health, fire, and safety
standards.
General Provisions (Core Subrecipient) 2011 20
Section 12.08 Cost Allocation Plan. Contractor shall submit a Cost Allocation Plan in the format
provided in the Department's Contractor's Financial Procedures Manual to the Department's
Contract Oversight and Support Section, at Mail Cade 1326, P.O. Box 149347, Austin, Texas 7$714-
9347, or by email to mailto:coscap@dshs.state.tx.us no later than the 60~' calendar day after the
effective date of the Contract, except when a Contractor has a current Cost Allocation Plan on file
with the Department. Contractor shall implement and follow the applicable Cost Allocation Plan. If
Contractor's plan is the same as in the previous year, by signing this Contract, Contractor certifies
that its current Cost Allocation Plan for the current year is the same as that submitted to DSHS for the
previous year. If the Cost Allocation Plan changes during the Contract term, Contractor shall submit
a new Cost Allocation Flan to the Contract Oversight and Support Section within thirty (30) calendar
days after the effective date of the change. Cost Allocation Plans must comply with the guidelines
provided in the Department's Contractor's Financial Procedures Manual located at
http:l/www. dshs. state. tx . us/contractslcf~m. shtm.
Section 12.09 EmployeeNolunteer Background Screening. Contractor shall comply with
employee/volunteer background screening standards established by the Department.
Section 12.10 Historically Underutilized Businesses (HUBS). If Contractor was not required to
submit a HUB subcontracting plan and if subcontracting is permitted under this Program Attachment,
Contractor is encouraged to make a good faith effort to consider subcontracting with HUBS in
accordance with Tex. Gov. Code Chapter 2161 and 34 Tex. Admin. Code § 20.14 et seq. Contractors
may obtain a list of HUBS at httpalwww.window.state.tx.uslprocurernent_/ rau ~/Y~ub. If Contractor has
filed a HUB subcontracting plan, the plan is incorporated by reference in this Contract. If Contractor
desires to make a change in the plan, Contractor must obtain prior approval from the Department's
H1JB Coordinator of the revised plan before proposed changes will be effective under this Contract.
Contractor shall make a good faith effort to subcontract with HUBS during the performance of this
Contract and shall report HUB subcontract activity to the Department's HUB Coordinator by the 15th
day of each month for the prior month's activity, if there was any such activity, in accordance with 34
Tex. Admin. Cade § 20.1C(c).
Section 12.11 Buy Texas. Contractor shall purchase products and materials produced in Texas when
the products and materials are available at a price and time comparable to products and materials
produced outside of Texas as required by Tex. Gov. Code § 2155.4441.
Section 12.12 Contracts with subrecipient and Vendor Subcontractors. Contractor may enter
into contracts with subrecipient subcontractors unless restricted or otherwise prohibited in a specific
Program Attachment(s). Prior to entering into a subrecipient agreement equaling or exceeding
$100,000, Contractor shall obtain written approval from DSHS. Contractor shall establish written
polices and procedures for procurement and monitoring of subcontracts and shall produce a
subcontracting monitoring plan. Contractor shall monitor subrecipient subcontractors for both
financial and programmatic performance and shall maintain pertinent records that must be available
far inspection by DSHS. Contractor shall ensure that subcontractors are fully aware of the
requirements placed upon them by state/federal statutes, rules, and regulations and by the provisions
of this Contract.
Contracts with all subcontractors, whether vendor or subrecipient, must be in writing and include the
following:
General Provisions (Core Subrecipient) 2011 21
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a) name and address of all parties and the subcontractor's Vendor Identification Number (VIN);
b) a detailed description of the services to be provided;
c} measurable method and rate of payment and total not-to-exceed amount of the contract;
d) clearly defined and executable termination clause; and
e} beginning and ending dates that coincide with the dates of the applicable Program
Attachment(s) or that cover a term within the beginning and ending dates of the applicable
Program Attachment(s).
Contractor is responsible to DSHS for the performance of any subcontractor. Contractor shall not
contract with a subcontractor, at any tier, that is debarred, suspended, or excluded from or ineligible
for participation in federal assistance programs; or if the subcontractor would be ineligible under the
following sections of these General Provisions: Ineligibility to Receive the Contract section
(Assurances and Certifications Article}; ar the Conflict of Interest of Transactions Between Related
Parties sections (General Terms Article).
Section 12.13 Status of Subcontractors. Contractor shall require alI subcontractors to certify that
they are not delinquent on any repayment agreements; have not had a required license or certification
revoked; and have not had a contract terminated by the Department. Contractors shall further require
that subcontractors certify that they have not voluntarily surrendered within the past three (3) years
any license issued by the Department.
Section 12.14 Incorporation of Terrns in subrecipient Subcontracts. Contractor shall include in
all its contracts with subrecipient subcontractors and solicitations for subrecipient subcontracts,
without rnadification (except as required to make applicable to the subcontractor), (1) the
certifications stated in the Assurances and Certifications Article; (2) the requirements in the Conflicts
of Interest section and the Transaction Between Related Parties section of the General Terms Article;
and (3) a provision granting to DSHS, SAO, OIG, and the Comptroller General of the United States,
and any of their representatives, the right of access to inspect the work and the premises on which
any work is performed, and the right to audit the subcontractor in accordance with the Access and
Inspection Article in these General Provisions. Each subrecipient subcontract contract must also
include a copy of these General Provisions and a copy of the Statement of Work and any other
provisions in the Program Attachment(s) applicable to the subcontract. Contractor shall ensure that
all written agreements with subrecipient subcontractors incorporate the terms of this Contract so that
all terms, conditions, provisions, requirements, duties and liabilities under this Contract applicable to
the services provided or activities conducted by a subcontractor are passed down to that
subcontractor. No provision of this Contract creates privity of contract between DSHS and any
subcontractor of Contractor.
Section 12.1 S Independent Contractor. Contractor is an independent contractor. Contractor shall
direct and be responsible for the performance of its employees, subcontractors, joint venture
participants or agents. Contractor is not an agent or employee of the Department or the State of
Texas for any purpose whatsoever. For purposes of this Contract, Contractor acknowledges that its
employees, subcontractors, joint venture participants or agents will not be eligible for unemployment
compensation from the Department or the State of Texas. ,
Section 12.16 Authority to Bind. The person or persons signing this Contract on behalf of
Contractor, or representing themselves as signing this Contract on behalf of Contractor, warrant and
General Provisions (Core subrecipient} 2fl11 22
guarantee that they have been duly authorized by Contractor to execute this Contract for Contractor
and to validly and legally bind Contractor to all of its terms.
Section 12.17 Tax Liability. Contractor shall comply with all state and federal tax laws and is
solely responsible for filing all required state and federal tax forms and making all tax payments. If
the Department discovers that Contractor has failed to remain current on a liability to the IRS, this
Contract will be subject to remedies and sanctions under this Contract, including immediate
termination at the Department's discretion. If the Contract is terminated under this section, the
Department will not enter into a contract with Contractor for three (3) years from the date of
termination.
Section 12.18 Notice of Organizational Change. Contractor shall submit written notice to the
contract manager assigned to the Program Attachment within ten (10) business days of any change to
the Contractor's name; contact information; key personnel, officer, director or partner; organizational
structure, such as merger, acquisition or change in form of business; legal standing; or authority to do
business in Texas. A change in Contractor's name and certain changes in organizational structure
require an amendment to this Contract in accordance with the Amendments section of these General
Provisions.
Section 12.19 Quality Management. Contractor shall comply with quality management
requirements as directed by the Department.
Section 12.20 Equipment {Including Controlled Assets) Purchases. Equipment means an article
of nonexpendable, tangible personal property having a useful lifetime of more than one year and an
acquisition cost of $5,000 or more, and "controlled assets." Controlled assets include firearms
regardless of the acquisition cast, and the following assets with an acquisition cost of $500 or more:
desktop and laptop computers, non-portable printers and copiers, emergency management equipment,
communication devices and systems, medical and laboratory equipment, and media equipment.
Contractors on a cost reimbursement payment method shall inventory all equipment. If the purchase
of equipment is approved in writing by the Department, Contractor shall initiate the purchase of that
equipment in the first quarter of the Contract ar Program Attachment term, as applicable. Failure to
timely initiate the purchase of equipment may result in loss of availability of funds for the purchase
of equipment. Requests to purchase previously approved equipment after the first quarter of the
Program Attachment must be submitted to the contract manager assigned to the Program Attachment.
Section 12.21 Supplies. Supplies are defined as consumable items necessary to carry out the
services under this Contract including medical supplies, drugs, janitorial supplies, office supplies,
patient educational supplies, software, and any items of tangible personal property other than those
defined as equipment above.
Section 12.22 Changes to Equipment List. Ail items of equipment purchased with funds under this
Contract must be itemized in Contractor's equipment list as finally approved by the Department in
the executed Contract. Any changes to the approved equipment list in the executed Contract must be
approved in writing by Department prior to the purchase of equipment. Contractor shall submit to the
contract manager assigned to the Program Attachment, a written description including complete
product specifications and need justification prior to purchasing any item of unapproved equipment.
General Provisions (Core Subrecipient} 2011 23
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If approved, Department will acknowledge its approval by means of a written amendment or by
written acceptance of Contractor's Contract Revision Request, as appropriate.
Section 12.23 Property Inventory and Protection of Assets. Contractor shall maintain an
inventory of equipment and property described in the Other Intangible Property section of Article
XIII and submit an annual cumulative report of the equipment and other property on Form GC-11
{Contractor's Property Inventory Report) to the Department's Contract Oversight and Support
Section, Mail Code 1326, P.Q. Box 149347, Austin, Texas 78714-9347, no Iatez than October 15`h of
each year. The report is located on the DSHS website at
http;//www.dshs.state.tx.uslcontracts/forms.shtm. Contractor shall maintain, repair, and protect
assets under this Contract to assure their full availability and usefulness. If Contractor is indemnified,
reimbursed, or otherwise compensated for any loss of, destruction of, or damage to the assets
provided or obtained under this Contract, Contractor shall use the proceeds to repair or replace those
assets.
Section 12.24 Bankruptcy. In the event of bankruptcy, Contractor shall sever Department property,
equipment, and supplies in possession of Contractor from the bankruptcy, and title must revert to
Department. If directed by DSHS, Contractor shall return all such property, equipment and supplies
to DSHS. Contractor shall ensure that its subcontracts, if any, contain a specific provision requiring
that in the event the subcontractor's bankruptcy, the subcontractor must sever Department property,
equipment, and supplies in possession of the subcontractor from the bankruptcy, and title must revert
to Department, who may require that the property, equipment and supplies be returned to DSHS.
Section 12.25 Title to Property. At the conclusion of the contractual relationship between the
Department and Contractor, for any reason, title to any remaining equipment and supplies purchased
with funds under this Contract reverts to Department. Title may be transferred to any other party
designated by Department. The Department may, at its option and to the extent allowed by law,
transfer the reversionary interest to such property to Contractor.
Section 12.26 Property Acquisitions. Department funds must not be used to purchase buildings or
real property. Any costs related to the initial acquisition of the buildings or real property are not
allowable.
Section 12.27 Disposition of Property. Contractor shall follow the procedures in the American
Hospital Association's (AHA's) "Estimated Useful Lives of Depreciable Hospital Assets" in
disposing, at any time during or after the Contract term, of equipment purchased with the Department
funds, except when federal or state statutory requirements supersede or when the equipment requires
licensure or registration by the state, or when the acquisition price of the equipment is equal to or
greater than $5,000. All other equipment not listed in the AHA reference (other than equipment that
requires licensure or registration or that has an acquisition cost equal to or greater than $5,000) will
be controlled by the requirements of UGMS. If, prior to the end of the useful life, any item of
equipment is no longer needed to perform services under this Contract, or becomes inoperable, or if
the equipment requires licensure or registration or had an acquisition price equal to or greater than
$S,ODO, Contractor shall request disposition approval and instructions in writing from the contract
manager assigned to the Program Attachment. After an item reaches the end of its useful life,
Contractor shall ensure that disposition of any equipment is in accordance with Generally Accepted
Accounting Principles, and any applicable federal guidance.
General Provisions (Core Subrecipient) 2011 24
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Section 12.28 Closeout of Equipment. At the end of the term of a Program Attachment that has no
additional renewals or that will not be renewed (Closeout) or when a Program Attachment is
otherwise terminated, Contractor shall submit to the contract manager assigned to the Program
Attachment, an inventory of equipment purchased with Department funds and request disposition
instructions for such equipment. All equipment purchased with Department funds must be secured
by Contractor at the time of Closeout or termination of the Program Attachment and must be
disposed of according to the Department's disposition instructions, which may include return of the
equipment to DSHS or transfer of possession to another DSHS contractor, at Contractor's expense.
Section 12.29 Assets as Collateral Prohibited. Contractors on a cost reimbursement payment
method shall not encumber equipment purchased with Department funds without prior written
approval from the Department.
ARTICLE XIII GENERAL TERMS
Section 13A1 Assignment. Contractor shall not transfer, assign, or sell its interest, in whole or in
part,.in this Contract, or in any equipment purchased with funds from this Contract, without the prior
written consent of the Department.
Section 13.02 Lobbping. Contractor shall comply with Tex. Gov. Code § 556.0055, which prohibits
contractors who receive state funds from using those funds to pay lobbying expenses. Further,
Contractor shall not use funds paid under this Contract, either directly or indirectly, to support the
enactment, repeal, modification, or adoption of any Iaw, regulation or policy at any level of
government, or to pay the salary or expenses of any person related to any activity designed to
influence legislation, regulation, policy or appropriations pending before Congress or the state
legislature, or for influencing or attempting to influence an officer or employee of any federal or state
agency, a member of Congress, an officer or employee of Congress, or an employee of a member of
Congress in connection with the awarding of any contract or the extension, continuation, renewal,
amendment, or modification of any contract (31 USC § 1352 and UGMS). If at any time this
Contract exceeds $100,000 of federal funds, Contractor shall file with the contract manager assigned
to the Program Attachment a declaration containing the name of any registrant under the Lobbying
Disclosure Act of 1995 who has made lobbying contacts on behalf of Contractor in connection with
this Contract, a certification that none of the funds provided by Department have been or will be used
for payment to lobbyists, and disclosure of the names of any and all registered lobbyists with whom
Contractor has an agreement. Contractor shall file the declaration, certification, and disclosure at the
time of application for this Contract; upon execution of this Contract unless Contractor previously
filed a declaration, certification, or disclosure form in connection with the award; and at the end of
each calendar quarter in which any event occurs that materially affects the accuracy of the
information contained in any declaration, certification, or disclosure previously filed. Contractor
shall require any person who requests or receives a subcontract to file the same declaration,
certification, and disclosure with the contract manager assigned to the Program Attachment.
Contractor shall also comply, as applicable, with the lobbying restrictions and requirements in OMB
Circulars A-122 Attachment B paragraph 25; A-87 Attachment B section 27; A-110 section_.27 and
A-21 paragraphs 17 and 28. Contractor shall include this provision in any subcontracts.
General Provisions (Core Subrecipient) 2011 25
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Section 13.03 Conflict of interest. Contractor represents to the Department that it and its -
subcontractors, if any, do not have nor shall Contractor or its subcontractors knowingly acquire or
retain, any financial or other interest that would conflict in any manner with the performance of their
obligations under this Contract. Potential conflicts of interest include, but are not limited to, an
existing or potential business or personal relationship between Contractor (or subcontractor), its
principal (or a member of the principal's immediate family), or any affiliate or subcontractor and the
Department or HHSC, their commissioners or employees, or any other entity or person involved in
any way in any project that is the subject of this Contract. Contractor shall establish safeguards to
prohibit employees and subcontractors and their employees from using their positions for a purpose
that constitutes or presents the appearance of personal or organizational conflict of interest or
personal gain. If, at any time,during the term of this Contract, Contractor or any of its subcontractors
has a conflict of interest or potential conflict of interest, Contractor shall disclose the actual or
potential conflict of interest to the contract manager assigned to the Program Attachment within ten
(10) days of when Contractor becomes aware of the existence of the actual or potential conflict of
interest.' Contractor shall require each of its subcontractors to report to Contractor any conflict of
interest or potential conflict of interest the subcontractor has or may have within ten {10) days of
when. the subcontractor becomes aware of the actual or potential conflict of interest.
Section 13.04 Transactions Between Related Parties. Contractor shall identify and report to
DSHS any transactions between Contractor and a related party that is part of the work that the
Department is purchasing under this Contract before entering into the transaction or immediately
upon discovery. Contractor shall submit to the contract manager assigned to the Program Attachment
the name, address and telephone number of the related party, how the party is related to Contractor
and the work the related party will perform under this Contract. A related party is a person or entity
related to Contractor by blood or marriage, common ownership or any association that permits either
to significantly influence or direct the actions or policies of the other. Contractor, far purposes of
reporting transactions between related parties, includes the entity contracting with the Department
under this Contract as well as the chief executive officer, chief financial officer and program director
of Contractor. Contractor shall comply with Tex. Gov. Code Chapter 573. Contractor shall maintain
records and supply any additional information requested by the Department, regarding a transaction
between related parties, needed to enable the Department to determine the appropriateness of the
transaction pursuant to applicable state or federal law, regulations or circulars, which may include 4S
CFR part 74, OMB Circ. No. A-110, 2 CFR § 215.42, and UGMS.
Section 13.05 Intellectual Property. Tex. Health & Safety Code § 12.020 authorizes DSHS to
protect intellectual property developed as a result of this Contract.
a) "Intellectual property" means created property that may be protected under copyright, patent,
or trademark/service mark law.
b) For purposes of this Contract intellectual property prepared for DSHS use, or a work specially
ordered or commissioned through a contract for DSHS use is "work made for hire." DSHS
owns works made for hire unless it agrees otherwise by contract. To the extent that title and
interest to any such work may not, by operation of law, vest in DSHS, or such work may not
be considered a work made for hire, Contractor izxevocably assigns the rights, title and
interest therein to DSHS. DSHS has the right to obtain and hold in its name any and all
patents, copyrights, registrations or other such protections as maybe appropriate to the subject
matter, and any extensions and renewals thereof. Contractor shall give DSHS and the State of
Texas, as well as any person designated by DSHS and the State of Texas, all assistance
General Provisions {Core Subrecipient) 2011 26
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required to perfect the rights defined herein without charge or expense beyond those amounts
payable to Contractor for goods provided or services rendered under this Contract.
c) If federal funds are used to finance activities supported by this Contract that result in the
production of intellectual property, the federal awarding agency reserves aroyalty-free,
nonexclusive, and irrevocable license to reproduce, publish, or otherwise use, and to authorize
others to use, for federal government purposes (1) the copyright in any intellectual property
developed under this Contract, including any subcontract; and {2} any rights of copyright to
which a Contractor purchases ownership with contract funds. Contractor shall place an
acknowledgment of federal awarding agency grant support and a disclaimer, as appropriate,
on any publication written or published with such support and, if feasible, on any publication
reporting the results of or describing agrant-supported activity. An acknowledgment must be
to the effect that "This publication was made possible by grant number from federal
awarding a eg ncy)" or "The project described was supported by grant number from
(federal awarding agency}" and "Its contents are solely the responsibility of the authors and
do not necessarily represent the official views of the (federal awarding_agency)."
d) If the terms of a federal grant award the copyright to Contractor, DSHS reserves aroyalty-
free, nonexclusive, worldwide and irrevocable license to reproduce, publish or otherwise use,
and to authorize others to use, for DSHS, public health, and state governmental
noncommercial purposes (1) the copyright, trademark, service mark, and/or patent on an
invention, discovery, or improvement to any process, machine, manufacture, or composition
of matter; products; technology; scientific information; trade secrets; and computer software,
in any work developed under a grant, subgrant, or contract under a grant or subgrant; and (2)
any rights of copyright, service or trade marks or patents to which a grantee, subgrantee or a
Contractor purchases ownership with contract funds.
e} If the results of the contract performance are subject to copyright law, Contractor cannot
publish those results without prior review and approval of DSHS. Contractor shall submit
requests for review and approval to the contract manager assigned to the Program
Attachment.
Section 13.06 Other Intangible Property. At the conclusion of the contractual relationship
between Department and Contractor, for any reason, Department shall have the sole ownership rights
and interest in all non-copyrightable intangible property that was developed, produced or obtained by
Contractor as a specific requirement under this Contract or under any grant that funds this Contract,
such as domain names, UIZLs, etc. Contractor shall inventory all such non-copyrightable intangible
property. Contractor shall cooperate with Department and perform all actions necessary to transfer
ownership of such property to the Department or its designee, or otherwise affirm Department's
ownership rights and interest in such property. This provision will survive the termination or
expiration of this Contract.
Section 13.07 Severability and Ambiguity. If any provision of this Contract is construed to be
illegal or invalid, the illegal or invalid provision will be deemed stricken and deleted to the same
extent and effect as if never incorporated, but all other provisions will continue. The Parties
represent and agree that the language contained in this Contract is to be construed as jointly drafted,
proposed and accepted.
Section 13.08 Legal Notice. Any notice required or permitted to be given by the provisions of this
Contract will be deemed to have been received by a Party on the third business day after the date on
General Provisions (Core Subrecipient) 2011 27
which it was mailed to the Party at the address specified by the Party to the other Party in writing or,
if sent by certified mail, on the date of receipt.
Section 13.09 Successors. This Contract will be binding upon the Parties and their successors and
assignees, except as expressly provided in this Contract.
Section 13.10 Headings. The articles and section headings used in this Contract are for convenience
of reference only and will not be construed in any way to define, limit or describe the scope or intent
of any provisions.
Section 13. i 1 Parties. The Parties represent to each other that they are entities fully familiar with
transactions of the kind reflected by the contract documents, and are capable of understanding the
terrnunology and meaning of their terms and conditions and of obtaining independent legal advice
pertaining to this Contract.
Section 13.12 Survivability of Terrris. Termination or expiration of this Contract or a Program
Attachment far any reason will not release either Party from any liabilities or obligations in this
Contract that (a) the Parties have expressly agreed will survive any such termination or expiration, or
{b} remain to be performed or (c) by their nature would be intended to be applicable following any
such termination or expiration.
Section 13.13 Direct Operation. At the Department's discretion, the Department may temporarily
assume operations of a Contractor's program or programs funded under this Contract when the
continued operation of the program by Contractor puts at risk the health or safety of clients and/or
participants served by Contractor,
Section 13..14 Customer Service Information. If requested, Contractor shall supply such
information as required by the Department to comply with the provisions of Tex. Gov. Code Chapter
2114 regarding Customer Service surveys.
Section 13.15 Amendment. The Parties agree that the Department may unilaterally reduce funds
pursuant to the terms of this Contract without the written agreement of Contractor. All other
amendments to this Contract must be in writing and agreed to by both Parties, except as otherwise
specified in the Contractor's Notification of Change to Certain Contract Provisions section or the
Contractor's Request for Revision to Certain Contract Provisions section of this Article. Contractor's
request for certain budget revisions or other amendments must be submitted in writing, including a
justification for the request, to the contract manager assigned to the Program Attachment; and if a
budget revision or amendment is requested during the last quarter of the Contract or Program
Attachment term, as applicable, Contractor's written justification must include a reason for the delay
in making the request. Revision or other amendment requests maybe granted at the discretion of
DSHS. Except as otherwise provided in this Article, Contractor shall not perform or produce, and
DSHS will not pay for the performance or production of, different or additional goods, services, work
or products except pursuant to an amendment of this Contract that is executed in compliance with this
section; and DSHS will not waive any term, covenant, or condition of this Contract unless by
amendment or otherwise in compliance with this Article.
General Provisions {Core Subrecipient} 2011. 28
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Section 13.16 Contractor's Notification of Change to Certain Contract Provisions. The
following changes maybe made to this Contract without a written amendment or the Department's
prior approval:
a) contractor's contact person and contact information;
b) contact information for key personnel, as stated in Contractor's response to the Solicitation
Document, if any;
c) cumulative budget line item transfers that exceed 10% among direct cost categories, other
than the equipment category, of cost reimbursement contract Program Attachments of less
than $100,000, provided that the total budget amount is unchanged;
d) minor corrections or clarifications to the Contract language that in no way alter the scope of
work, objectives or performance measures;
e) a change in Contractor's share of the budget concerning non-DSHS funding other than
program income and match, regardless of the amount of the change, provided that in changing
the budget, Contractor is not supplanting DSHS funds; and.
fl a change to remove community sites, independent school districts or schools, in substance
abuse Program Attachments in accordance with an Implementation Plan that must be
submitted along with the notification of the change to the contract manager assigned to the
Program Attachment.
Contractor within ten (10) calendar days shall notify in writing the contract manager assigned to the
Program Attachment of any change enumerated in this section. The notification maybe by letter, fax
or email. Cumulative budget line item transfers of 10% or less among direct cost categories, other
than equipment, of cost reimbursement contracts of any amount do not require written amendment ar
prior approval or notification.
Section 13.17 Contractor's Request for Revision of Certain Contract Provisions. A Contractor's
Revision Request is an alternative method for amending certain specified provisions of this Contract
that is initiated by Contractor, but must be approved by DSHS: The following amendments to this
Contract may be made through a Contractor's Revision Request, rather than through the amendment
process described in the Amendment section of this Article:
a) cumulative budget line item transfers among direct cost categories, other than the equipment
category, that exceed 10% of Program Attachments of $100,000 or more, provided that the
total budget amount is unchanged;
b) line item transfer to other categories of funds for direct payment to trainees for training
allowances;
c) change in clinic hours or location;
d} change in the equipment list substituting an item of equipment equivalent to an item of
equipment on the approved budget;
e) changes in the equipment category of a previously approved equipment budget {other than
acquisition of additional equipment, which requires an amendment to this Contract); and
f) changes specified in applicable OMB Circular cost principles as requiring prior approval,
regardless of dollar threshold (e.g., foreign travel expenses, overtime premiums, membership
fees); and
g) changes to add community sites, independent school districts or schools, in substance abuse
Program Attachments.
In order to request a revision of any of the enumerated provisions, Contractor shall obtain a Contract
Revision Request form from the DSHS website available at
General Provisions (Core Subrecipient) 2011 29
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htt ://www.dshs.state.tx.us/ rantslfonns.shtm, and complete the form as directed by the Department.
Two copies of the completed form must be signed by Contractor's representative who is authorized to
sign contracts on behalf of Contractor, and both original, signed forms must be submitted to the
contract manager assigned to the Program Attachment. Any approved revision will not be effective
unless signed by the DSHS Director of the Client Services Contracting Unit. A separate Contractor
Revision Request is required for each Program Attachment to be revised. Circumstances of a
requested contract revision may indicate the need for an amendment described in the Amendment
section of this Article rather than a contract revision amendment under this section.
Section 13.18 Immunity Not Waived. THE PARTIES EXPRESSLY AGREE THAT NO
PROVISION OF THIS CONTRACT IS IN ANY WAY INTENDED TO CONSTITUTE A
WAIVER BY DEPARTMENT OR THE STATE OF TEXAS OF ANY IMMUNITIES FROM SUIT
OR FROM LIABILITY THAT DEPARTMENT OR THE STATE OF TEXAS MAY HAVE BY
OPERATION OF LAW.
Section 13.19 Hold Harmless and Indemnification. Contractor, as an independent contractor,
agrees to hold Department, the State of Texas, individual state employees and officers, and the
federal government harmless and to indemnify them from any and all liability, suits, claims, losses,.
damages and judgments; and to pay all costs, fees, and damages to the extent that such costs, fees,
and damages arise from performance or nonperformance of Contractor, its employees,
subcontractors, joint venture participants or agents under this Contract.
Section 13.20 Waiver. Acceptance by either Party of partial performance or failure to complain of
any action, non-action or default undex this Contract will not constitute a waiver of either Party's
rights under this Contract.
Section 13.21 Electronic and Information Resources Accessibility and Security Standards. As
required by 1 Tex. Admin. Cade Chapter 213, as a state agency, DSHS must procure products that
comply with the State of Texas Accessibility requirements for Electronic and Information Resources
specified in 1 Tex. Admin. Code Chapter 213 when such products are available in the commercial
marketplace or when such products are developed in response to a procurement solicitation. If
performance under this Contract includes the development, modification or maintenance of a website
or other electronic and information resources for DSHS or far the public on behalf of DSHS,
Contractor shall provide the Department of Information Resources (DlR) with the URL to its
Voluntary Product Accessibility Template (VPAT) for reviewing compliance with the State of Texas
Accessibility requirements (rased on the federal standards established under Section 50$ of the
Rehabilitation Act}, or indicate that the pxoduct/service accessibility information is available from the
General Services Administration "Buy Accessible Wizard" (http:l/www.buyaccessible.gov}.
Contractors not listed with the "Buy Accessible Wizard" or supplying a URL to their VFAT must
provide DIR with a report that addresses the same accessibility criteria in substantively the same
format. Additional infoxmation regarding the "Buy Accessible Wizard". or obtaining a copy of the
VPAT is located at http:/Iwww.section508.~ov/. Contractor certifies that any network hardware or
software purchased or provided under this Contract has undergone independent certification testing
for known and relevant vulnerabilities, in accordance with rules adopted by DIR.
General Provisions (Core Subrecipient) 2011 30
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Section 13.22 Force Majeure. Neither Party will be liable for any failure or delay in performing all
or some of its obligations, as applicable, under this Contract if such failure or delay is due to any
cause beyond the reasonable control of such Party, including, but not limited to, extraordinarily
severe weather, strikes, natural disasters, fire, civil disturbance, epidemic, war, court order, or acts of
God'. The existence of any such cause of delay or failure will extend the period of performance in the
exercise of reasonable diligence until after ttze cause of the delay or failure has been removed and, if
applicable, for any reasonable period of time thereafter required to resume performance. A Party,
within a period of time reasonable under the circumstances, must inform the other by any reasonable
method (phone, email, etc.) and, as soon as practicable, must submit written notice with proof of
receipt, of the existence of a force majeure event or otherwise waive the right as a defense to non-
performance.
Section 13.23' Interim Contracts. The Parties agree that the Contract and/or any of its Program
Attachments will automatically continue as an "interim Contract" beyond the expiration date of the
term of the Contract or Program Attachment(s), as applicable, under the following circumstances: (l)
on or shortly prior to the expiration date of the Contract or Program Attachment, there is a state of
disaster declared by the Governor that affects the ability or resources of the DSHS contract or
program staff managing the Contract to complete in a timely manner the extension, renewal, or other
standard contract process for the Contract or Program Attachment; and (2) DSHS makes the
determination in its sole discretion that an Interim Contract is appropriate under the circumstances.
DSHS will notify Contractor promptly in writing if such a determination is made. The notice will
specify whether DSHS is extending the Contract or Program Attachment for additional time for
Contractor to perform or complete the previously contracted goods and services {with no new or
additional funding) or is purchasing additional goods and services as described in the Program
Attachment far the term of the Interim Contract, or both. The notice will include billing instructions
and detailed information on how DSHS will fund the goods or services to be procured during the
Interim Contract term. The Interim Contract will terminate thirty (30) days after the disaster
declaration is terminated unless the Parties agree to a shorter period of time.
ARTICLE XIV BREACH OF CONTRACT AND REMEDIES FOR NON-
COMPLIANCE
Section 14.01 Actions Constituting Breach of Contract. Actions or inactions that constitute
breach of contract include, but are not limited to, the following:
a) failure to properly provide the services and/or goods purchased under this Contract;
b) failure to comply with any provision of this Contract, including failure to comply with all
applicable statutes, rules or regulations;
c) failure to pay refunds or penalties owed to the Department;
d) failure to comply with a repayment agreement with the Department or agreed order issued by
the Department;
e) failure by Contractor to provide a full accounting of funds expended under this Contract;
f) discovery of a material misrepresentation in any aspect of Contractor's application or
response to the Solicitation Document;
g) any misrepresentation in the assurances and certifications in Contractor's application or
response to the Solicitation Document or in this Contract; or
h) Contractor is on or is added to the Excluded Parties List System (EPLS).
General Provisions {Core Subrecipient) 2011 31
Section 14.02 General Remedies and Sanctions. The Department will monitor Contractor for both
programmatic and financial compliance. The:remedies and sanctions in this sectioir are available to
the Department against Contractor and any entity that subcontracts with Contractor for provision of
services or goods. HHSC OIG may investigate, audit and impose or recommend imposition of
remedies ar sanctions to Department for any breach of this Contract and may monitor Contractor for
financial compliance. The Department may impose one or more remedies or sanctions for each item
of noncompliance and will determine remedies or sanctions on a case-by-case basis. Contractor is
responsible for complying with all of the terms of this Contract. The listing of or use of one or more
of the remedies or sanctions in this section does not relieve Contractor of any obligations under this
Contract. A state or federal statute, rule or regulation, or federal guideline will prevail over the
provisions of this Article unless the statute, rule, regulation, or guideline can be read together with the
provision{s) of this Article to give effect to both. If Contractor breaches this Contract by failing to
comply with one or more of the terms of this Contract, including but not limited to compliance with
applicable statutes, rules or regulations, the Department may take one or more of the following
actions:
a) terminate this Contract or a Program Attachment of this Contract as it relates to a specific
program type. In the case of termination, the Department will inform Contractor of the
termination no less than thirty (30) calendar days before the effective date of the termination
in a notice of termination, except for circumstances that require innnaediate termination as
described in the Emergency Action section of this Article. The notice of termination will
state the effective date of the termination, the reasons for the termination, and, if applicable,
alert Contractor of the opportunity to request a hearing an the termination pursuant to Tex.
Gov. Code Chapter 2105 regarding administration of Block Grants. Contractor shall not mare
any claim for payment or reimbursement for services provided from the effective date of
termination;
b} suspend all or part of this Contract. Suspension is, depending on the context, either (1) the
temporary withdrawal of Contractor's authority to obligate funds pending corrective action by
.Contractor or its subcontractor(s) or pending a decision to terminate or amend this Contract,
ar (2) an action taken by the Department to immediately exclude a person from participating
in contract transactions for a period of time, pending completion of an investigation and such
legal or debarment proceedings as may ensue. Contractor shall not bill DSHS far services
performed during suspension, and Contractor's costs resulting from obligations incurred by
Contractor during a suspension are not allowable unless expressly authorized by the notice of
suspension;
c) deny additional or future contracts with Contractor;
d) reduce the funding amount for failure to 1) provide goods and services as described in this
Contract or consistent with Contract performance expectations, 2} achieve ar maintain the
proposed level of service, 3) expend funds appropriately and at a rate that will make full use
of the award, or 4) achieve local match, if required;
e) disallow costs and credit for matching funds, if any, fox all or part of the activities or action
not in compliance;
f) temporarily withhold cash payments. Temporarily withholding cash payments means the
temporary withholding of a working capital advance, if applicable, ar reimbursements or
payments to Contractor for proper charges ar obligations incurred, pending resolution of
issues of noncompliance with conditions of this Contract or indebtedness to the United States
or to the State of Texas;
General Provisions {Core Subrecipient) 2011
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g) permanently withhold cash payments. Permanent withholding of cash payment means that
Department retains funds billed by Contractor for (1) unallowable, undocumented, disputed,
inaccurate, improper, or erroneous billings; (2) material failure to comply with Contract
provisions; or (3} indebtedness to the United States or to the State of Texas;
h) declare this Contract void upon the Department's determination that this Contract was
obtained fraudulently or upon the Department's determination that this Contract was illegal or
invalid from this Contract's inception and demand repayrent of any funds paid under this
Contract;
i) request that Contractor be removed from the Centralized Master Bidders List (CMBL) or any
other state bid list, and barred from participating in future contracting opportunities with the
State of Texas;
j) delay execution of a new contract or contract renewal with Contractor while other imposed or
proposed sanctions are pending resolution;
k) place Contractor on probation. Probation means drat Contractor will be placed on accelerated
monitoring for a period not to exceed six {6) months at which time items of noncompliance
must be resolved or substantial improvement shown by Contractor. Accelerated monitoring
means more frequent or more extensive monitoring will be performed by Department than
would routinely be conducted;
1) require Contractor to obtain technical or managerial assistance;
m) establish additional prior approvals for expenditure of funds by Contractor;
n) require additional or more detailed, financial and/or programmatic reports to be submitted by
Contractor;
o) demand repayment from Contractor when it is verified that Contractor has been overpaid, e.g.,
because of disallowed costs, payments not supported by proper documentation, improper
billing or accounting practices, or failure to comply with Contract terms;
p) pursue a claim far damages as a result of breach of contract;
q) require Contractor to prohibit any employee or volunteer of Contractor from performing
under this Contrast or having direct contact with DSHS-funded clients or participants, or
require removal of any employee, volunteer, officer or governing body member, if the
employee, volunteer, officer or member of the governing body has been indicted ar convicted
of the misuse of state or federal funds, fraud or illegal acts that are in contraindication to
continued obligations under this Contract, as reasonably determined by DSHS;
r} withhold any payments to Contractor to satisfy any recoupment, liquidated damages, match
insufficiency, or any penalty {if the penalty is permitted by statute} imposed by DSHS, and
take repayment from funds available under this Contract in amounts necessary to fulfill
Contractor's payment or repayment obligations;
s) reduce the Contract term;
t) recoup improper payments when it is verified that Contractor has been overpaid, e.g., because
of disallowed costs, payments not supported by proper documentation, improper billing or
accounting practices or failure to comply with Contract terms;
u) assess liquidated damages;
v) demand repayment of an amount equal to the amount of any match Contractor failed to
provide, as determined by DSHS;
w} impose other remedies, sanctions or penalties permitted by statute.
Section -14.03 Notice of Remedies or Sanctions. Department will formally notify Contractor in
writing when a remedy or sanction is imposed (with the exception of accelerated monitoring, which
General Provisions (Core Subrecipient) 2011 33
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may be unannounced), stating the nature of the remedies and sanction(s), the reasons for imposing
them, the corrective actions, if any, that must be taken before the actions will be removed and the
time allowed for completing the corrective actions, and the method, if any, of requesting
reconsideration of the remedies and sanctions imposed. Other than in the case of repayment or
recoupment, Contractor is required to file, within fifteen (15) calendar days of receipt of notice, a
written response to Department acknowledging receipt of such notice. If requested by the
Department, the written response must state how Contractor shall correct the noncompliance
(corrective action plan) or demonstrate in writing that the findings on which the remedies or
sanction(s) are based are either invalid or do not warrant the remedies or sanction(s). If Department
determines that a remedy or sanction is warranted, unless the remedy or sanction is subject to review
under a federal or state statute, regulation, rule, or guideline, Department's decision is final.
Department will provide written notice to Contractor of Department's decision. If required by the
Department, Contractor shall submit a corrective action plan for DSHS approval and take corrective
action as stated in the approved corrective action plan. if DSHS determines that repayment is
warranted, DSHS will issue a demand letter to Contractor for repayment. If full repayment is not
received within the time limit stated in the demand letter, and if recoupment is available, DSHS will
recoup the amount due to DSHS from funds otherwise due to Contractor under this Contract.
Section 14:04 Emergency Action. In an emergency, Department may immediately terminate or
suspend all or part of this Contract, temporarily or permanently withhold cash payments, deny future
contract awards, or delay contract execution by delivering written notice to Contractor, by any
verifiable method, stating the reason for the emergency action. An "emergency" is defined as the
following;
a} Contractor is noncompliant and the noncompliance has a direct adverse effect on the public or
client health, welfare or safety. The direct adverse effect may be programmatic or financial
and may include failing to provide services, providing inadequate services, providing
unnecessary services, or using resources so that the public or clients do not receive the
benefits contemplated by the scope of work or performance measures; or
b) Contractor is expending funds inappropriately.
Whether Contractor's conduct ar noncompliance is an emergency will be determined by Department
on a case-by-case basis and will be based upon the nature of the noncompliance or conduct.
ARTICLE XV CLAIMS AGAINST THE DEPARTMENT
Section 15.01 Breach of-Contract Claim. The process for a breach of contract claim against the
.Department provided for in Tex. Gov. Code Chapter 2260 and implemented in Department Rules §§
1.431-1.447 will be used by DSHS and Contractor to attempt to resolve any breach of contract claizxa
against DSHS.
Section I5.02 Notice. Contractor's claims for breach of this Contract that the Parties cannot resolve
in the ordinary course of business must be submitted to the negotiation process provided in Tex. Gov
Code Chapter 2260, subchapter B. To initiate the process, Contractor shall submit written notice, as
required by subchapter B, to DSHS's Office of General Counscl. The notice must specifically state
that the provisions of Chapter 2260, subchapter B, are being invoked. A copy of the notice must also
be given to all other representatives of DSHS and Contractor. Subchapter B is a condition precedent
to the filing of a contested case proceeding under Tex. Gov. Code Chapter 2260, subchapter C.
General Provisions (Core Subrecipient) 201 I 34
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Section 15.03 Sole Remedy. The contested case process pravided in Tex. Gov. Code Chapter 2260,
subchapter C, is Contractor's sole and exclusive process for seeking a remedy for any and alI alleged
breaches of contract by DSHS if the Parties are unable to resolve their disputes under this Article.
Section 15.04 Condition Precedent to Suit. Compliance with the contested case process provided
in Tex. Gov. Code Chapter 2260, subchapter C, is a condition precedent to seeking consent to sue
from the Legislature under Tex. Civ. Prac. & Rem. Code Chapter 107. Neither the execution of this
Contract by DSHS nor any other conduct of any representative of DSHS relating to this Contract will
be considered a waiver of sovereign immunity to suit.
Section 15.05 Performance Not Suspended. Neither the occurrence of an event nor the pendency
of a claim constitutes grounds for the suspension of performance by Contractor, in whole or in part.
ARTICLE XVI TERMINATION
Section 16A1 Expiration of Contract or Program Attachment{s). Except as pravided in the
Survivability of Terms section of the General Terms Article, Contractor's service obligations stated
in each Program Attachment wilt end upon the expiration date of that Program Attachment unless
extended or renewed by written amendment. Prior to completion of the term of all Program
Attachments, all or a part of this Contract may be terminated with or without cause under this Article.
Section 16.02 Effect of Termination. Termination is the permanentwithdrawai of Contractor's
authority tv obligate previously awarded funds before that authority would otherwise expire or the
voluntary relinquishment by Contractor of the authority to obligate previously awarded funds.
Contractor's costs resulting from obligations incurred by Contractor after termination of an award are
not allowable unless expressly authorized by the notice of termination. Upon termination of this
Contract or Program Attachment, as applicable, Contractor shall cooperate with DSHS to the fullest
extent possible to ensure the orderly and safe transfer of responsibilities under this Contract or
Program Attachment, as applicable, to DSHS or another entity designated by DSHS. Upon
termination of all or part of this Contract, Department and Contractor will be discharged from any
further obligation created under the applicable terms of this Contract or the Program Attachment, as
applicable, except for the equitable settlement of the respective accrued interests or obligations
incuzxed prior to termination and for Contractor's duty to cooperate with DSHS, and except as
provided in the Survivability of Terms section of the General Terms Article. Termination does not,
however, constitute. a waiver of any remedies for breach of this Contract. In addition, C_ontractor's
obli_~ations to retain records 'and maintain confidentiality of information will survive this Contract.
Section 16.03 Acts Not Constituting Termination. Termination does not include the Department's
(1) withdrawal of funds awarded on the basis of Contractor's underestimate of the unobligated
balance in a prior period; (2) withdrawal of the unobligated balance at the expiration of the term of a
program attachment; (3) refusal to extend a program attachment or award additional funds to make a
competing or noncompeting continuatign, renewal, extension, or supplemental award; (4} non-
renewal of a contract or program attachment at Department's sole discretion; or (S) voiding of a
contract upon determination that the award was obtained fraudulently, or was, otherwise illegal or
invalid from inception.
General Provisions (Core Subrecipient} 201 i 35
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Section 16.0 Termination Without Cause.
a) Either Party may terminate this Contract or a Program Attachment, as applicable, with at least
thirty (30) calendar days prior written notice to the other Party, except that if Contractor seeks
to terminate a Contract or Program Attachment that involves residential client services,
Contractor shall give the Department at least ninety (90) calendar days prior written notice
and shall submit a transition plan to ensure client services are not disrupted.
b) The Parties may terminate this Contract or a Program Attachment by mutual agreement.
c) Either Party may terminate this Contract or a Program Attachment with at least thirty (30)
calendar days prior written notice to the other Party if funds become unavailable through lack
of appropriations, budget cuts, transfer of funds between programs or health and human
services agencies, ainendments to the Appropriations Act, health and human services
consolidations, or any disruption of current appropriated funding for this Contract or Program
Attachment.
d} Department may terminate this Contract or a Program Attachment immediately when, in the
sole determination of Department, termination is in the best interest of the State of Texas.
Section 16.DS Termination For Cause. Either Party may terminate for material breach of this
Contract with at least thirty (30) calendar days written notice to the other Party. Department may
terminate this Contract, in whole or in part, far breach of contract or for any other conduct that
jeopardizes the Contract objectives, by giving at least thirty (30) calendar days written notice to
Contractor. Such conduct may include one or more of the following:
a) Contractor has failed to adhere to any laws, ordinances, rules, regulations or orders of any
public authority having jurisdiction;
b) Contractor fails to communicate with Department or fails to allow its employees or those of
its subcontractor to communicate with Department as necessary for the performance or
oversight of this Contract;
c) Contractor breaches a standard of confidentiality with respect to the services provided under
this Contract;
d) Department determines that Contractor is without sufficient personnel or resources to perform
under this Contract or that Contractor is otherwise unable or unwilling to fulfill any of its
requirements under this Contract or exercise adequate control over expenditures or assets;
e) Department determines that Contractor, its agent or another representative offered or gave a
gratuity (e.g., entertainment or gift)-to-an official or employee of DSHS or HHSC for the
purpose of obtaining a contract or favorable treatment;
f) Department determines that this Contract includes financial participation by a person who
received compensation from DSHS to participate in developing, drafting or preparing the
specifications, requirements or statement(s) of work or Solicitation Document on which this
Contract is based in violation of Tex. Gvv. Code § 2155.004; or Department determines that
Contractor was ineligible to receive this Contract under Tex. Gov. Code §§ 2155.006 or
2261.053 related to certain disaster response contracts;
g) Contractor appears to be financially unstable. Indicators of financial instability may include
one or more of the following:
1) Contractor fails to make payments;
2) Contractor makes an assignment far the benefit of its creditors;
3) Contractor admits in writing its inability to pay its debts generally as they become due;
General Provisions (Core Subrecipient) 2011
36
4} if judgment for the payment of money in excess of $50,000 (that is not covered by
insurance) is rendered by any court or governmental body against Contractor, and
Contractor does not (a) discharge the judgment, or (b) provide far its discharge in
accordance with its terms, or (c) procure a stay of execution within thirty (30) calendar
days from the date of entry of the judgment, or (d} if the execution is stayed, within the
thirty (30)-day period or a longer period during which execution of the judgment has been
stayed, appeal from the judgment and cause the execution to be stayed during such appeal
while providing such reserves for the judgment as maybe required under Generally
Accepted Accounting Principles;
5} a writ or warrant of attachment or any similar process is issued by any court against all or
any material portion of the property of Contractor, and such writ or warrant of attachment
or any similar process is not released or bonded within thirty {30) calendar days after its
issuance;
6} Contractor is adjudicated bankrupt or insolvent;
7) Contractor files a case under the Federal Bankruptcy Code or seeks relief under any
provision of any bankruptcy, reorganization, arrangement, insolvency, readjustment of
debt, dissolution, receivership or liquidation law of any jurisdiction then in effect, or
consents to the filing of any case or petition against it under any such law;
8) any property or portion of the property of Contractor is sequestered by court order and the
order remains in effect for more than thirty (30) calendar days after Contractor obtains
knowledge of the sequestration;
9) a petition is filed against Contractor under any state reorganization, arrangement,
insolvency, readjustment of debt, dissolution, receivership or liquidation law of any
jurisdiction then in effect, and the petition is not dismissed within thirty (30) calendar
days; or
10) Contractor consents to the appointment of a receiver, trustee, or liquidator of Contractor ar
of all or any part of its property;
h) Contractor's management system does not meet the UGMS management standards; or
i) Any required license, certification, permit, registration or approval required to conduct
Contractor's business or to perform services under this Contract is not obtained or is revoked,
is surrendered, expires, is not renewed, is inactivated or is suspended.
Section 16.06 Notice of Termination. Either Party may deliver written notice of intent to terminate
by any verifiable method. If either Party gives notice of its intent to terminate all or a part of this
Contract, Department and Contractor shall attempt to resolve any issues related to the anticipated
termination in good faith during the notice period.
ARTICLE XVII VOID, SUSPENDED, AND TERMINATED CONTRACTS
Section 17,01 Void Contracts. Department may void this Contract upon determination that the
award was obtained fraudulently.or was otherwise illegal or invalid from its inception.
Section 17.02 Effect of Void, Suspended, or Involuntarily Terminated Contract. A Contractor
who has been a party to a contract with DSHS that has been found to be void, or is suspended, or is
terminated for cause is not eligible for expansion of current contracts, if any, or new contracts or
renewals until, in the case of suspension or termination, the Department has determined that
General Provisions {Core Subrecipient) 20I i 37
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Contractor has satisfactorily resolved the issues underlying the suspension or termination.
Additionally, if this Contract is found to be void, any amount paid is subject to repayment.
Section 17.03 Appeals Rights. Pursuant to Tex. Gov. Code § 2105.302, after receiving notice from
the Department of termination of a contract with DSHS funded by block grant funds, Contractor may
request an administrative hearing under Tex. Gov. Code Chapter 2001.
ARTICLE XVIII CLOSEOUT
Section 18.01 Cessation of Services At Closeout. Upon expiration of this Contract or Program
Attachment, as applicable, (and any renewals of this Contract or Program Attachment) on its own
terms, Contractor shall cease services under this Contract or Program Attachment; and shall
cooperate with DSHS to the fullest extent possible upon expiration or prior to expiration, as
necessary, to ensure the orderly and safe transfer of responsibilities under this Contract to DSHS ar
another entity designated by DSHS. Upon receiving notice of Contract or Program Attachment
termination or non-renewal, Contractor shall immediately begin to effect an orderly and safe
transition of recipients of services to alternative service providers, as needed. Contractor also shall
completely cease providing services under this Contract or Program Attachment by the date specified
in the termination or non-renewal notice. Contractor shall not bill DSHS for services performed after
termination or expiration of this Contract or Program Attachrr~ent, or incur any additional expenses
once this Contract or Program Attachment is terminated or has expired. Upon termination, expiration
(with no renewal) or non-renewal of this Contract or a Program Attachment, Contractor shall
immediately initiate Closeout activities described in this Article.
Section 18.02 Administrative Offset. The Department has the right to administratively offset
amounts owed by Contractor against billings.
Section 18.03 Deadline for Closeout. Contractor shall submit all financial, performance, and other
Closeout reports required under this Contract within sixty (60) calendar days after the Contract or
Program Attachment end date. Unless otherwise provided under the Final Billing Submission section
of the Payment Methods and Restrictions Article, the Department is not liable for any claims that are
not received within sixty (60) calendar days after the Contract or Program Attachment end date.
Section 1$.OA~ Payment of Refunds. Any funds paid to Contractor in excess of the amount to which
Contractor is finally determined to be entitled under the terms of this Contract constitute a debt to the
Department and will result in a refund due, which Contractor shall pay within the time period
established by the Department.
Section 18.05 Disallowances and Adjustments. The Closeout of this Contract or Program
Attachment does not affect the Department's right to disallow costs and recover funds on the basis of
a later audit or other review or Contractor's obligation to return any funds due as a result of later
refunds, corrections, or other transactions.
General Provisions (Core Subrecipient) 2011 38
2011-035293
CORPUS CHRISTI-NUECES COUNTY PUBLIC HEALTH DISTRICT
Exhibit A/Work Plans
TBIPC -STATE
1. Summarize the proposed Services, service area, population to be served, location
{counties to be served), etc. List subcontractors you will work with in your area. Also,
address if and how you will serve individuals from counties outside your stated service
area.
The service area for the Corpus Christi-Nueces County Tuberculosis Eliminatien Program is
approximately 836 square miles. The Gulf of Mexico is the border for 331 square miles to the
east, San Patricio County to the north, Jim Wells County to the west, Kleberg County to the south
and CCTBC is approximately 150 miles form the Mexico border. The total population in Nueces
is 323,046. Ethnicity is as follows: Hispanics, 59.5%, White, 34.2%, Black,4.4% and 2% are
categorized as "other". This is a 2D09 population estimate for Nueces County from the US
Census Bureau Quick Facts.
The Corpus Christi-Nueces County Tuberculosis Elimination Program {CCNCTEP) provides basic
services for tuberculosis control and prevention in Carpus Christi, and surrounding counties as
needed. Services are provided in compliance with the Corpus Christi-Nueces County
Tuberculosis Elimination Division Standards of Performance, American Thoracic Society, Center
for Disease Control {ATS/CDC) joint statements. The Corpus Christi-Nueces County
Tuberculosis Elimination Program idea#ified 11 countable TB cases for Corpus Christi-Christi-
Nueces County Public Health District far 2009. This is 3.46 cases per hundred thousand of the
population.
Clinical and outreach services target the identification of Tuberculosis cases/suspects, contacts,
evaluation of those individuals seeking to immigrate to this country with Bi and B2 waivers.
Outreach services target those individuals in correctional facilities, both residential and day only
shelters for the homeless, alcoholics
2. Describe delivery systems, work#orce (attach organizational chart)., policies, support
systems {i.e., training, research, technical assistance, information, financial and
administrative systems) and other infrastructure available to achieve service delivery and
policy-making activities. What resources do you have to perform the project, who will
deliver services and how will they be delivered?
The City of Corpus Christi provides the office space, utilities, administrative support and computer
maintenance far the Internet based programs, TWICES and PICS, utilized by CCNCTBEP. Both
the State and Federal Grants have been decreasing yearly. The financial management~is now
assigned to an accountant at City Hall to oversee the expenditures and send in the FR5 to the
state for payment. CCTBCTBEP initiated a program in 20D3 to earn money by selling PPD's to
the general public for a cash fee. The PPD and supplies are purchased with program income.
This has kept our clinic viable as the amount of the grants decrease.
CCNCTBEP has been fortunate to be able to retain the core staff of one (1) multipurpose RN for
16 yrs {Patricia Otta, BSN, RN) paid by City of Christi. She works clinic, DOT, ou#reach,
transports to Texas Center for Infec#ious Diseases, works on the grants and any other assigned
#ask by her supervisor. One {1) RN for 13 yrs (Barbara Cavazos, RN) in the Federal Grant,
r
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She works in clinic, DOT and contact investigation. One (1} outreach worker for 15 yrs {Gabriel
Duran, CSA) in the Federal
Grant that does DOT/DOPY, contact investigation, outreach ppd's for the homeless at 11 different
homeless shelters, locates missing clients and helps locate individuals on alien waivers for
evaluation. One (1) receptionist for 15 yrs (Brenda Hinojosa}
In the State Grant, who manages the LTBI records, sends missed appointment letters and is
responsible fior program income
bank deposits. One {1} medical records tech for 13 years (Veronica Karen Rodriguez) who is
responsible far the case registry, data entry of TB cases/suspects, monthly sputum collection,
DOT/DOPT,works with all staff to help initiate contact investigations, prepares monthly clinic data
reports, takes over the duties of the outreach worker and the duties of the receptionist if they are
out. All staff work in the office and in the fiield as needed to do contact investigations, DOT/DOPY
and tracking of patients. The TB clinic staff (except for the receptionist) rotate weekends/holidays
to deliver DOTIDOPT, missing DOT clients are located by the outreach worker if passible, a
female employee will be utilized when needed, i.e. to bring in a female for evaluation ar work-up.
All staff members are licensedlcertified to drive the ou#reach van for DOTIDOPT or to transport a
client to the Texas Center for infectious Diseases in San Antonio, Texas for admission.
CCNCTBEP is very fortunate to have a vehicle at their disposal 100% of the time for TB outreach.
We are also very fortunate that the City of Corpus Christi provides the use of a city vehicle when
our van is being serviced.
The main objective for CCNCTBEP is 100% DOT resulting in prevention and Dore and all policies
and activities are based
on this objective.
3. Describe how you will determine the number of persons who received from the
CONTRACTOR in 2010 at least one TB sen+ice including but not limited to tuberculin skin
tests, chest radiographs, health care worker services, or treatment with one or more anti-
tuberculosis medications
Daily sign-in logs are kept of all. clients utilizing daily services provided by the TB clinic, i.e., TB
skin tests, TB skin test readings, medication refills, monthly workups, chest x-rays, DOT/DOPY
and nurse consultation. The number of services provided is pulled from the sign-in log.
4. Describe haw data is collected and tabulated, who will be responsible for data collection
and reporting, and how often data collection activities will occur. Describe how you will
conduct community surveillance to identify unreported cases of TB including active
surveillance activities for laboratories (specify names of labs) in your service area that
perform acid-fast bacilli smears and cultures far Mycobacterium tuberculosis complex.
Describe how you will maintain a record ofi outbreaks, in your area, with a description of
the outbreak and how it was managed.
Identify and examine all household, social, occupational and other close contacts to the
suspected infectious TB suspects
within seven (7) days of notification utilizing the concentric circle and send the preliminary TB 340
to DSHS-TB in Austin. All close household contacts to a smear positive TB suspect/case will
have achesty-ray regardless of their TB skin test result. The final TB 3401341 (contact report} is
to be forwarded to Austin T8 Elimination within 90 days. All children with a negative chest x-ray
that live in the house with a smear positive TB suspect/case will be placed on directly observed
preventive therapy on INH. Those with a positive ppd are continued for nine (9) months on INH
and those that nave a negative ppd at three months may discontinue INH if the ppd is negative
and the TB case is na longer smear positive or no longer in the home. All household contacts
five {5) years and under are placed on DOPY. Older household contacts are placed on DOPY as
resources allow.
i ~ r
All patients on DOTIDOPT are assessed for drug toxicity prior to each dose of medication and
must come into the clinic once a month for a workup that includes a drug toxicity check, age
appropriate lab and a visual acuity.
AIf positive reactors referred to CCTBC by private physicians are questioned as to who infected
them. They are provided a chest x-ray or given a referral for a chest x-ray privately. The x-rays
are read by Dr. William W. Burgin, Jr. and INH is ordered if the chest x-ray is normal. Positive
reactors picking up medication monthly must have a drug toxicity check and age appropriate lab
with their monthly work-up. Treatment far latent TB infection is provided without cost to the
patient.
Describe how the accuracy, timeliness and completeness of data collected will be
assessed and verified. If not already in place, describe how you will develop a written
plan to assess the quality of data collected.
Identify and examine all household, social, occupational and other close contacts to the
suspected infectious TB suspects
within seven (7} days of notification utilizing the concentric circle and send the preliminary TB 34d
to DSHS-TB in Austin. All close household contacts to a smear positive TB suspect/case will
have a chest x-ray regardless of their TB skin test result. The final TB 340/34 (contact report} is
to be forwarded to Austin TB Elimination within 90 days. AEI children with a negative chest x-ray
that live in the house with a smear positive TB suspect/case will be placed on directly observed
preventive therapy on INH. Those with a positive ppd are continued for nine (9) months on INH
and those that have a negative ppd at three months may discontinue INH if the ppd is negative
and the TB case is na longer smear positive or no longer in the home. All household contacts
five (5} years and under are placed on DOPT. Older household contacts are placed on DOPT as
resources allow.
8. Describe coordination with the other health and human services providers in the service
area(s) and delineate how duplication of services is to be avoided. List other community
programs you will be working with in your jurisdiction (substance abuse programs,
programs for homeless persons, other community based organizations, private providers,,
hospitals, and service organizations). Describe plans for TB educational opportunities to
be offered to community health-care providers and community-based organizations that
serve populations at high risk for TB.
The TB clinic staff coordinates monthly with the homeless shelters the testing andlor evaluation of
those clients that utilize
their facilities, Data gathered monthly indicates the number of clients tested andlor evaluated
from the homeless shelters, drug/alcohol abuse programs, county jail .and federak detention
center.
In-services and educational materials are prodded to community health-care providers and
community-based organizations
that serve in the Nueces County area. Health fairs are attended at intervals throughout the
calendar year.
7. Describe ability to provide services to culturally diverse populations (e.g., use of
interpreter services, use of field outreach staff who are trained to present information
appropriately #o diverse cultures, language translation, compliance with ADA
requirements, location, hours of service delivery, and other means to ensure accessibility
for the defined population).
e~ r
CCNCTBEP has two bilingual employees, Brenda Hinojosa and Gabriel Duran. Both speak
English and Spanish fluently.
Mr. Duran is able to read and write both languages and translate English to Spanish and Spanish
to English, including chart forms that the client needs to fill out. He writes client instructions per
the physician and directions when needed. He converted the hurricane instructions CCNCTBEP
provides the client to let them know what locating information is needed from them in the event of
a hurricane andbr disaster. CCNCTBEP is planning to work with the language line as Spanish
only individuals are not our only non-English speaking clients. CCNCTBEP works closely with all
community based organizations and often assists TB programs in other counties with the
management of the TB suspects/cases.
8. Describe your strategy for the management of TB cases and suspects, with emphasis on
provision of directly observed therapy (DOT); and use of incentives and enablers.
All TB suspectslcases are placed on ~-drug therapies given by DOT per the American Thoracic
Society (ATS), Center- for Disease Control {CDC) and Infectious Diseases Society of America
{IDSA) guidelines. Private physicians are provided current information related to TB
management to ensure the correct medication and DOT is ordered. If a private physician does
not place a patient on 4-drug therapy or DOT, a consultation is requested for that physician with
Dr. Wllliam W. Burgin, Jr. or
Dr. Barbara 5eaworth, Dr. David Griffith or Dr. Starke. CCNCTBEP delivers DOT/DOPY seven
(7) days a week in Nueces County.
Alf patients on DOT/DOPY are assessed for drug toxicity prior to each dose of medicotion and
must come into the clinic once a month for a workup that includes a drug toxicity check, age
appropriate lab and a visual acuity.
Dr. William W. Burgin, Jr., MD, FAP, FACCP, is the Health Authority for Corpus Christi-Nueces
County Public Health District. He reviews lab, chest x-rays, orders and reviews drug levels, signs
all quarantine orders and speaks to the presiding judge at quarantine hearings. Dr. Burgin sees
clients as needed and writes al! orders for LTBI, TB suspects and cases. He monitors for missed
doses and the length of treatment. All staff attends x-ray clinics with Dr. Burgin to discuss any
problems that have developed and to report client or staff issues, good or problematic.
9. Describe your process for review of cases under management.
TB suspects/cases determined to be infectious by smear are placed on home isolation until they
are no longer able to transmit disease. Control orders are utilized at the start of care #o establish
parameters and prevent the need for quarantine. Control orders are given in the patient's
language or an interpreter may read the Fetter #o the patient or guardian of the patient. Court
ordered management would be initiated for those that are non-compliant.
brag susceptibility is done on ail initial specimens and treatment is adjusted if drug resistance is
identified. Sputum is collected bi-weekly for three {3) consecutive days anti! the patient is smear
negative. When the patient is smear negative sputum collection continues monthly for three {3)
consecutive days until the end of treatment. If the patient remains smear and culture positive on
adequate doses of medication, then new susceptibilities are requested. Drug levels are done on
an as-needed basis for those patients that continue to be smear and culture positive longer than
the guidelines address. Those patients identified as drug resistant or with low drug levels require
a consultation with a state paid consultant.
10. Describe your strategy for the implementation of cohort analysis of cases at least
quarterly.
Internal audit reviews are performed quarterly on TB suspects/cases. Documentation becomes a
part of the patient's medical record.
i ~f 1 y p
11. Describe your strategy for the management of contacts and positive reactors, with
emphasis on directly observed preventive therapy (DOPY) #or all contacts diagnosed with
LTBI who are less than five years of age or HIV-infected or live in the same residence as
a case receiving directly observed therapy. DOPY may be provided to other persons at
high risk far progression to TB disease as resources allow.
Identify and examine all household, social, occupational and other close contacts to the
suspected infectious TB suspects
within seven (7) days of notification utilizing the concentric circle and send the preliminary TB 340
to DSHS-TB in Austin.. All close household contacts to a smear positive TB suspect/case will
have a chest x-ray regardless of their TB skin test result.
The final TB 3401341 (contact report} is to be forwarded to Austin TB Elimination within 90 days.
All children with a negative chest x-ray that live in the house with a smear positive TB
suspectlcase will be placed on directly observed preventive therapy on INH. Those with a
positive ppd are continued for nine (9} months on INH and those that have a negative ppd at
three months may discontinue INH if the ppd is negative and -the TB case is no longer smear
positive or no longer in the home. All household contacts five (5} years and under are placed on
DOPY. Older household contacts are placed on DOPY as resources allow.
All patients on DOTIDOPT are assessed for drug toxicity prior to each dose of medication and
must came into the clinic once a month for a workup that includes a drug toxicity check, age
appropriate fob and a visual acuity.
All positive reactors referred to CCTBC by private physicians are questioned as to who infected
them. They are provided a chest x-ray or given a referral for a chest x-ray privately. The x-rays
are read by Dr. William W. Burgin, Jr. and !NH is ordered if the chest x-ray is normal. Positive
reactors picking up medication monthly must have a drug toxicity check and age appropriate lab
with their monthly work-up. Treatment for latent TB infection. is provided without cost to the
patient.
12. Describe your process for the review of ongoing contact investigations and your strategy
to assess reasons for identification of fewer than three contacts for each case; for delays
in interviewing cases or evaluating contacts, and law completion of preventive therapy for
infected contacts.
Early morning staff meetings to identify problematic areas with DOTIDOPT, suspectslcases
and/or contacts. When problems are identified, additional assessment is done and solutions are
presented. If necessary, additional consultation with the client and staff fs scheduled. The client
has the option to attend or not attend, a date is set to readdress the problem and update staff on
progress.
13. Describe your infection control procedures.
Alf CCNCTBEP staff receive continuing education yearly and annual fit testing far personal
respirators. They are taught when to wear them, when to change to a new N-95 and how to store
them. CCNCTBEP maintains a more than adequate supply of N-95 masks.
CCNCTBEP has three portable hepa filter units that are used as needed in the patient exam
rooms, the x-ray room or any other area of the clinic when needed. A mask is placed on anyone
that comes into the clinic that is coughing and the individual is immediately taken to an exam
room with a hepa filter and UV light. Sputum is collected in a negative pressure chamber.
CCNCTBEP has seven (7) UV lights installed in the three clinic rooms, the x-ray room, lobby and
hallway over the exit door.
CCNCTBEP collects sputum in a negative pressure booth with bath a UV light and a hepa filter.
Staff is TB skin tested every'6 months. To day, the 5 employees have not converted their skin
test. All have been employed in the TB clinic 10 years or more.
14. Describe plans to conduct targeted TB screening programs #or high-risk popula#ians.
Include steps to ensure effective interventions are implemented so that foreign-barn and
U.S.-born minorities at highest risk for developing TB are identified, evaluated, and treated
for TB or LTBI.
Targeted testinglscreening is to be performed monthly for high-risk populations. When an
individual is identified as having a positive TB skin test, a chest x-ray is scheduled and evaluation
ofi the x-ray is done by Dr. William W. Burgin, ,ir. Results are given to the client by scheduled
appoin#ment of the physician's recommendations. Monthly monitoring is performed an each
client from the day of admission to service through discharge and post discharge.
15. Describe your strategy to provide professional educa#ion and training programs far new
and current TB staff.
Staff education is obtained through webinars, Heartland National TB Center and annual training
updates through the DSHS
offices in Austin, Texas. Patricia A. Otto, RN, BSN, successfully completed an intensive year
long series of trainings in Advanced TB Nurse Case Management for TB Nurse Consultant.
Professional education consists of the education and training of new employees and the
continuing education of TB staff. Training will be provided to all new employees within 60 days.
Each new employee must receive 40 hours of TB education within the first 60 days of
employment and 16 hours of training each year thereafter. This includes all staff involved in TB
activities including physicians, nurses, investigators, outreach workers, clerical and other support
staff. The TB education will be utilized when possible to provide workshops with continuing hours
of education being documented. CDC's "Self Study Modules on Tuberculosis" will be used in the
initial training and the test will be given at the completion of the modules. Initial and follow-up
training will,inciude the suggested reading materials identified in the TDH contract. A written plan
will be developed for each new employee and addressed with the new staff member by the TB
Program Manager on the first day the employee spent in the TB clinic after city orientation. A
time frame will be established for completing the initial education phase and a time frame will be
established for acquiring the 16 hours of TB education needed yearly. The assessment of need
will be done by the employee and the program manager, and the plan will be written yearly before
the annual evaluation and reviewed quarterly with the employee by the Program Manager. A
copy will be placed in their personal record and they will retain a copy for themselves.
Staff will be instructed where the staff education notebook is kept and that they are responsible
for recording each education event and notifying the program"manager if a workshop is cancelled
and rescheduling is needed. A copy of DSHS performance standards far professional education
will be given to each new employee at time of hire and to all other staff. A copy of DSHS
performance standards will be placed in the TB education notebook for reference.
i6. Describe your strategy to document the evaluation of immigrants and refugees with the
following notifications: Class A (Applicants who have tuberculosis disease diagnosed
[sputum smear positive or culture positive] and require treatment overseas but who have
been granted a waiver to travel prior to the completion of therapy.); Class Bi -Pulmonary
(No treatment: -Applicants who have medical history, physical exam, or CXR findings
suggestive of pulmonary tuberculosis but have negative AFB sputum smears and cultures
and are not diagnosed with tuberculosis or can wait to have tuberculosis treatment started
after immigration. Completed treatment: -Applicants who were diagnosed with pulmonary
tuberculosis and successfully completed directly observed therapy prior to immigration.);
Class Bi -Extra-pulmonary (evidence of extra-pulmonary tuberculosis); Class B2 (LTBI
(. : i~ ~~ .y 4 t
Evaluation -Applicants who have a tuberculin skin test z 1D mm but who otherwise have
a negative evaluation for tuberculosis.); Class B3 (Contact Evaluation -applicants who
are a contact of a known tuberculosis case.)
Class A applicants are first located and a home assessment is done. If small children are in the
home, other living arrangements must be made. If needed, the client is transported to the T6
clinic, sputum is collected, a record is opened, arrangements are made for a chest x-ray,
explanations are given in the patient's language ar in English and medications will be started per
physician orders as what to expect, a personal and medical history is taken. The state TB
elimination program is notified, client information and current status is given with the name of the
airlines, the flight number, number of stops made by the plane where individuals either got on or
off the plane, and if the client changed planes. If unable to locate the client at the given address,
if individuals are there, information will be requested as to where the individual Etas gone and a
referral will be made to the local health department in that area to locate this individual far a
comprehensive evaluation far tuberculosis.
Class Bi pulmonary applicants must be located and provided a complete evaluation and
education as above to determine if they have developed active disease. The same information
as above needs to be collected to ensure if this person has or has not developed active disease
so that ail the people they traveled with can be notified and evaluated in a timely manner.
Class B1 completed treatment applicants must be located, provided a chest x-ray, three
consecutive sputum collected and travel information obtained if necessary, to inform the
authorities and the airlines to locate contacts to the individual traveling on the planes. If the
evaluation is negative no additional testing is necessary at this time. Educate the client about TB
and have them follow-up as needed. Educate an the signs and symptoms of TB.
Class B~ extra pulmonary and Class B2 LTBI applicants must tae located and provided a
complete work-up. Collect the information necessary, i.e., the airlines, in the event the client is
active. Identify and obtain addresses of individuals the client was around prior to immigrating that
might have had TB or could have been exposed. Educate the client to recognize signs and
symptoms of tuberculosis, treat with DOT if physician elects to treat.
Class B3 contact applicants are given a TB skin test, if necessary, to complete the immigration
process. If the TB skin test is positive a chest x-ray must be done to rule out tuberculosis. if the
x-ray is negative, the applicant is given education in TB
disease vs. infection, i.e. the advantages and possible side effects of the medication, length of
treatment and that there is no guarantee that by taking the medication one will not get TB, as the
TB skin test will always show positive even if the medication is taken.
~,.
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS GRANTS LOANS AND COOPERATIVE
The undersigned certifies, to the best of his or her knowledge and belief that:
(1} No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to
any person for influencing or attempting to influence an officer or an employee of any agency, a
member of Congress, an officer or employee of Congress, or an employee of a member of Congress in
connection with the awarding of any federal contract, the making of any federal grant, the malting of
any federal loan, the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement.
(2) if any funds other than federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a member of Congress,
an officer or employee of Congress, or an employee of a member of Congress in wnnection with this
federal contract, grant. loan, or cooperative agreement, the undersigned shall complete and submit
Standard Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants,
loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Subrnission of this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less that $10,000 and not more than $100,000 for each
such failure.
,~ ,~
Si t e
1 ~ ~co bow.
Print tP ame of Authorized Individual
- 593
Application or Contract Number
~~ ~ ~
Date
CORPUS CHRISTI-NUECES COUNTY
PU]3LiC HEALTH DISTRICT (CITY}
Organization Name
CSCU # EF29-12374 -Revised 08.10.D7