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Home My WebLink AboutC2012-389 - 11/20/2012 - ApprovedTexas Department otAglriq and Disability-Services' State of Texas § County of Travis § x Community Services Contract Amendment Forth 3264• HDM T }t Section 1. Contractor Information Legal Name of Entity (Contractor) City of Corpus Christi Doing Business As (dibla) Name, if applicable Son for Community Services Adtl ress of Contractor {street, city, stake, ZIP) P.4, Box 9277, Corpus Christi, Tx 78.469 Contract No. 1 Amendment No. 11 -5 Waiver Contract Area Nueces Contract Type CLAD HDM FZegion No. 11 Comp -- - -•- e HCS Section 2. Change Information This Amendment to the contract number referenced above (the "Contract ") is entered between the Department of Aging and Disability Services (Department) and the legal entity (Contractor) named above (Department and Contractor, collectively, the "parties,' each, a "party "). The Department represents the Health and Human Services (HHSC), the Texas Medicaid agency, for any Medicaid services provided under this Contract, The Department, as the representative for HHSC, administers community services programs under Title XIX, including Section 1915(c); Title XX of the Social Security Act. and Title 2, Texas Human Resources Code. The parties agree to amend the Contract as follows: Check all applicable changes: ❑ The following ❑ counties ❑ MRAs are added to the contract referenced above. ❑ The following ❑ counties ❑ MRAs are deleted from the contract referenced above. ❑ The list of covered counties in Section 3 of this amendment is adopted by the Department and the Contractor and represents the frill listing of counties served as a result of thls amendment. ❑ The attached Form 3681 -A, Service Area Designation, replaces and supersedes, in its entirety, the Contractors previously submitted Form 3691 -A. Other: Contractor will provide 50,235 units of Title XX Community Care for the Aged and Disabled /Home Delivered Meals for October 1, 2011 through September 30, 2012 (budget period), The unit rate for each meal is $4.95, and the approved budget for the budget period is$248,663.25. The approved budget is reflected in the attached Form 2029, Information Sheet, Purchase of Service Contract, which is incorporated into this amendment. The geographical area covered by this contract is Corpus Christi, Texas. ® The Home Delivered Meals provider will serve meals in alternate format (frozen, chilled or shelf - stable) and /or deliver on fewer than five days per week. The alternate delivery terms for the period Ootober 1, 2.011 through September 30, 2012 are described on the attached Home Delivered Meals FFY.2012 Waiver Description (Form 2027). The parties agree that the following provision is hereby added to Section 111 of the Contract (relating to Contractor Agreements) as though it were set out word - for - word -in the Contract: Contractor agrees to screen its employees and contractors to determine whether they have been excluded from participation in Medicare and stale health care programs. Contractor agrees to search monthly the HHS- Office of the inspector General (OIG) and HHSC -OIG List of Excluded Individuals /Entities (LEIE) websites to capture exclusions and reinstatements that have occurred since the last search and to immediately report to the HHSC -OIG any exclusion information the contractor discovers. Exclusionary searches for prospective employees or contractors shall be performed prior to employment or contracting. Contractor also acknowledges and agrees that no Medicaid payments can be made for any items or . services directed or prescribed by an excluded physician or other authorized person when the individual or entity furnishing the items or services either knew or should have known of the exclusion, This prohibition 2012 -389 Medicaid payment ilseif is made to another provider, practitioner or supplier that is 11/20/12 Ord. 029686 Dept of Aging & Disability INDEXED ® Thin following provision is added to the contract. , The Contractor agrees: That in accordance with 42 CFR §455.23, the Department shall suspend all Medicaid payments to the Contractor upon notification by HHSC -OIG that a credible allegation of fraud under the Medicaid program is pending against the Contractor, unless the Department has good cause not to suspend the payments or to suspend the payments only in part. This Amendment is effective on October 1, 2411. The above - marked changes are adopted by the Department and the Contractor as an amendment to the above - referenced contract effective the date signed by the Department representative, unless otherwise indicated above, All other terms and conditions of the Contract and prior Amendments, if any, shall remain in effect acrd continue to govern except to the extent modified in this Amendment. Department of Aging and Disability Services el— Sig ature- Department pros five p t q ign Lure - Contractor Repr entative bate Paul T- Ebrom Name of Department RepresenfaGve (Print or type) Michael Morris Name of Contractor Representative (print or type) Communal Services Re ionat D €rector Director, Parks and R ecreation Title of Department Representative (Print or type) Title of Contractor Representative {print or type) Legal Approval AR~0 CHAPA , C31Y BECRETARv IhUM4 elf t�fllUllf�t:il � l �12 ac Texas Department of Aging and Disability Services Contract/Vendor Number i &7400 SECTION I— CONTRACTOR DATA Legal Name City of Corpus Christi Commonly Used Name (if different) S enior Community Services Address (Street, City, State, Zip) P.O. Sox 9277, Corpus Christi, TX 7 8469 Person Authorized to Sign Contract Title Michael Morris Director, Parks and Recreation Charter Number Employer ID Number Contract Person Title N t7460 005741 Elsa Munoz Sop SECTION 11 — SUMMARY OF PAYMENT (Enter estimated Information in this section.) Effective Payment Dates Budget Name Budget Unit Rate Number 101011 - 09130112 Title SECTION III —SERVICE Program Activity Name Long Term Care - Community Care for the Aged and gisabled Service Activity Name Dome Delivered Me SECTION IV --- WENT DATA Information Worksheet Form 2029 _ _ ._._ _........__. ._ C)ctober -2002. A6rcfiase of Service Contract Region Number County Number 11 178 Contract Effective pate 10/01/11 Contract Termination Date Open Ended Area C od d Telephone Nurrrber (361) - 880 -3150 Estimated Contract Total $0.00 Percent of Contract 0 $248,669.25 1 $2 48,663.25 100% Code 7 Code 25 Ownership ® Public ❑ Non - profit ❑ Profit Area Code and Telephone Number tendent (361) - 880 -3150 Estimated Number Estimated Estimated Estimated Eli iblo Units Local Funds DADS Funds Budget Amount 50,235 $0.00 $248,663.25 $2480125 Estimated Contract Total $0.00 Percent of Contract 0 $248,669.25 1 $2 48,663.25 100% Code 7 Code 25