HomeMy WebLinkAboutC2019-350 - 8/20/2019 - Approved DocuSign Envelope ID:D2202D38-01303-4748-B170-94425C4347C7
HEALTH AND HUMAN SERVICES COMMISSION
CONTRACT No.2017-049800-001
AMENDMENT No.3
The HEALTH AND HUMAN SERVICES COMMISSION ("HHSC" or "System Agency") and
CORPUS CHRISTI-NUECES COUNTY PUBLIC HEALTH DISTRICT (CITY) ("Grantee" or
"Subrecipient"), who are collectively referred to herein as the "Parties"to that certain Women,
Infant and Children's Nutrition Local Agency grant contract effective October 1, 2016 and
denominated HHSC Contract No. 2017-049800-001 ("Contract"), as amended, now desire to
further amend the Contract.
RECITALS
WHEREAS, System Agency has elected to extend the Contract through Fiscal Year ("FY") 2020
(October 1, 2019 through September 30, 2020) in accordance with Section III of the Contract.
WHEREAS, the Parties desire to revise the Budget to add funds for FY 2019 (October 1, 2018
through September 30, 2019) and FY 2020;
WHEREAS;the Parties desire to revise the Statement of Work; and
WHEREAS, these revisions will result in an addition of EIGHT HUNDRED SEVENTY-NINE
THOUSAND SEVEN HUNDRED SIXTY-SIX DOLLARS ($879,766.00)in federal grant funds.
Now,THEREFORE,the Parties hereby amend and modify the Contract as follows:
1. The Parties agree that all references in the Contract to "Grantee" are hereby changed to
"Subrecipient".
2. SECTION III of the Contract Signature Document, DURATION, is hereby amended to
reflect a new termination date of September 30, 2020.
3. SECTION IV of the Contract, BUDGET, is deleted and replaced in its entirety with the
following:
IV. BUDGET
The total amount of this Contract will not exceed THREE MILLION SIX HUNDRED
TWENTY THOUSAND FIVE HUNDRED FORTY-FOUR DOLLARS ($3,620,544.00), of
which$1,012,631.00 is allocated to FY 2017 (October 1, 2016 through September 30,
2017), $870,213.00 is allocated to FY 2018 (October 1, 2017 through September 30,
2018), $868,850.00 is allocated to FY 2019 (October 1, 2018 through September 30,
2019), and $868,850.00 is allocated to FY 2020 (October 1, 2019 through September
30, 2020). All expenditures under the Contract will be in accordance with
Attachment A, Statement of Work.
4. SECTION I(D) of ATTACHMENT A, STATEMENT OF WORK, is deleted and replaced in its
entirety with the following:
JLl3.1,..I_AUTHORI[c►
System Agency Contract No.2017-049800-001 If WM.0 goci
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DocuSign Envelope ID:D2202D38-0B03-4748-8170-94425C4347C7
D. Determine eligibility of applicants through assessment of their categorical
eligibility, household or adjunctive income, identification, residency, nutritional
status, and provide nutrition education and counseling to eligible participants.
5. SECTION I(H) of ATTACHMENT A, STATEMENT OF WORK, is deleted and replaced in its
entirety with the following:
H. Conduct outreach to potential participants and implement strategies to retain
existing participants in accordance with Subrecipient's outreach plan.
6. SECTION I(L) of ATTACHMENT A, STATEMENT OF WORK, is deleted and replaced in its
entirety with the following:
L. Issue pre-numbered WIC Electronic Benefit Transfer (EBT) cards furnished by
System Agency to qualified participants who shall use such EBT cards to obtain
specified food items from participating vendors; maintain complete
accountability and security of all WIC EBT cards received from System
Agency. Subrecipient shall be held financially responsible for all unaccounted
WIC EBT cards and/or for the redeemed value of those issued to ineligible
participants.
7. SECTION I(M) of ATTACHMENT A, STATEMENT OF WORK, is deleted and replaced in its
entirety with the following:
M. Subrecipient will configure all desktop, laptops, and tablets purchased with
WIC funds for access to the Texas Integrated Network ("TXIN") Management
Information System ("MIS") at all Subrecipient WIC clinics and administrative
offices. Subrecipient will notify System Agency not less than forty-five (45)
days prior to a relocation or a deployment of a new site to arrange for internet
connectivity at the site. Subrecipient is responsible for all desktop, laptop, and
tablet maintenance and hardware support.
8. SECTION I(N) of ATTACHMENT A, STATEMENT OF WORK, is deleted and replaced in its
entirety with the following:
N. Subrecipient is required to immediately address, or facilitate internal access to
all its clinics, including remote access to clinic workstations, to the System
Agency or its agency to facilitate the resolution of any issues restricting valid
food benefit issuance to eligible WIC participants, including allowing the
System Agency to make configuration changes to WIC computers.
Subrecipient is required to notify the System Agency of any issues resulting in
the interruption of services for a period of four(4) hours or more.
9. SECTION I(P) of ATTACHMENT A, STATEMENT OF WORK, is deleted and replaced in its
entirety with the following:
P. Offer services during extended hours of operation outside the traditional times
of 8:00 a.m. to 5:00 p.m., Monday through Friday.
10. SECTION I(X) of ATTACHMENT A, STATEMENT OF WORK, is amended by deleting it in its
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entirety and replacing it with the following:
X. If selected by the System Agency, Implement or expand the Improving
Participant Experience (IPE) initiative. The IPE initiative will enable
Subrecipient to enhance their clinic to promote a welcoming, child-friendly
environment and any improvements to counseling spaces should promote knee-
to-knee conversations, thus improving the participant's clinic experience.
1. Subrecipient shall submit proposed initiatives and required reports in a
frequency and format designated by System Agency for review and
approval.
2. Subrecipient shall appoint a project coordinator to oversee the
implementation and evaluation of each initiative.
3. Subrecipient shall participate in activities as requested by System Agency,
including but not limited to, writing news articles, submitting mid-year and
end of year reports and participating in sharing sessions.
11. SECTION I(Z) of ATTACHMENT A, STATEMENT OF WORK, is deleted and replaced in its
entirety with the following:
Z. Subrecipient shall resolve all possible dual participation records anytime the
"duplicate detection" grid appears in the MIS. System Agency reserves the
right to withhold payment if Subrecipient fails to accurately resolve all possible
dual participation records within thirty (30) days of the appearance of the
duplicate detection grid.
12. SECTION I(BB) of ATTACHMENT A, STATEMENT OF WORK, is amended by deleting it in
its entirety and replacing it with the following:
BB. The Summer Electronic Benefit Transfer for Children (SEBTC) project
provides nourishing foods to eligible school-age children in selected schools
during the summer months.
1. If selected by System Agency, Subrecipient will use SEBTC funds to
provide the following:
a. Implement SEBTC project according to System Agency-approved plan.
b. Designate a SEBTC lead responsible for overseeing training,
implementation, and evaluation of project activities.
c. Provide customer support services for SEBTC card recipients during the
benefit period.
d. Submit requested updates and/or reports in a frequency and format
designated by System Agency for review and approval.
13. SECTION I of ATTACHMENT A, STATEMENT OF WORK, is amended by adding the
following:
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CC. Implement the Obesity Prevention project.
1. Subrecipient shall submit proposed initiatives for review and approval.
2. If selected by System Agency, Subrecipient shall:
a. Appoint a project coordinator to oversee the implementation and
evaluation of each initiative.
b. Participate in activities as requested by System Agency, including but
not limited to, writing news articles, and participating in sharing
sessions.
c. Follow the System Agency guidance related to allowable WIC costs for
approved Obesity Prevention projects.
d. Submit all requested reports in a frequency and format designated by
System Agency for review and approval.
14. SECTION II(A) Of ATTACHMENT A, STATEMENT OF WORK, is deleted and replaced in its
entirety with the following:
A. Subrecipient shall ensure:
1. An average of 95% of families each quarter who participate in WIC
Program by receiving food benefits shall also receive nutrition education
classes or individual counseling;
2. Each quarter an average of 20%or greater of all pregnant women who enter
the WIC Program are certified as eligible during the period of the first or
second trimester of their pregnancy;
3. Each quarter an average of 80% of clients who are enrolled in the WIC
Program, excluding dual participants and transfer locked and/or migrant
clients, participate as food benefit recipients each month (breast-feeding
infants are also included in the client count); and
4. 100% of participants who indicate during the enrollment process for the
WIC Program that they have no source of health care are referred to at least
one (1) source of health care at certification of eligibility.
Subrecipient shall submit reports, if requested, in a frequency and format
designated by System Agency for review and approval.
15. SECTION III(D)(6) of ATTACHMENT A, STATEMENT OF WORK, is deleted and replaced in
its entirety with the following:
6. Surplus encumbered by September 30 shall be billed and vouchers received by
System Agency no later than 60 calendar days following the Contract term.
16. The Parties agree to revise the supplemental condition for Section 2.02, Final Billing
Submission in ATTACHMENT D, SUPPLEMENTAL AND SPECIAL CONDITIONS by deleting it
in its entirety and replacing it with the following:
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Unless otherwise provided by the System Agency, Subrecipient shall submit a
reimbursement or payment request as a final close-out invoice not later than sixty
(60) calendar days following the end of the term of the Contract. Reimbursement or
payment requests received in the System Agency's offices more than sixty (60)
calendar days following the termination of the Contract may not be paid.
17. The Parties agree to revise the supplemental condition for Section 2.03, Financial Status
Reports (FSRs) in ATTACHMENT D, SUPPLEMENTAL AND SPECIAL CONDITIONS by
deleting it in its entirety and replacing it with the following:
Except as otherwise provided in these Uniform Terms and Conditions or in the terms
of any Attachment(s) that is incorporated into the Contract, Subrecipient shall submit
quarterly FSRs to System Agency by the last business day of the month following the
end of each quarter of the Program Attachment term for System Agency review and
financial assessment. Subrecipient shall submit the final FSR no later than sixty (60)
calendar days following the end of the applicable Fiscal Year.
18. Article IX Miscellaneous Provisions of the Health and Human Services Commission
Uniform Terms and Conditions — Grant, Version 2.13, previously referenced Section
9.22 Equipment and Supplies, is deleted and replaced with the following:
a. Grant Purchased Equipment.
Equipment means tangible personal property having a useful lifetime of more than
one year and a per-unit acquisition cost that exceeds the lesser of the capitalization
level established by the of $5,000 or more. Subrecipient shall inventory all
equipment, and report the inventory on the DSHS GC-11 Contractor's Property
Inventory Report form.
1. Tangible personal property includes controlled assets, including firearms,
regardless of the acquisition cost, and the following assets with an acquisition
cost of$500 or more, but less than $5,000, which includes desktop and laptop
computers (including notebooks, tablets and similar devices), non-portable
printers and copiers, emergency management equipment, communication
devices and systems, medical and laboratory equipment, and media equipment
are also considered Supplies.
2. Prior approval by System Agency of the purchase of Controlled Assets is not
required unless stipulated by WIC program policy, but such purchases must be
reported on the DSHS GC-11 Contractor's Property Inventory Report form as
detailed in this section.
b. Supplies.
1. 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.
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c. Property Inventory and Protection of Assets.
1. Subrecipient shall inventory of equipment supplies defined as controlled assets,
and property described in this Section annually and maintain a cumulative
report of the equipment and other property on DSHS GC-11 Contractor's
Property Inventory Report form.
2. Subrecipient is responsible for maintenance and accuracy of this inventory and
it shall be available for review upon System Agency request. The DSHS GC-
11 Contractor's Property Inventory Report form is located at:
http://www.dshs.state.tx.us/contracts/forms.shtm.
3. Subrecipient shall maintain, repair, and protect assets under this Contract to
assure their full availability and usefulness.
4. If Subrecipient is indemnified, reimbursed, or otherwise compensated for any
loss of, destruction of, or damage to the assets provided or obtained under this
Contract, Subrecipient shall use the proceeds to repair or replace those assets.
d. Assets as Collateral Prohibited.
Subrecipients on a cost reimbursement payment method shall not encumber
equipment purchased with System Agency funds without prior written approval
from the System Agency.
e. Disposition of Property.
1. Subrecipient shall follow the procedures in the American Hospital
Association's (AHA) "Estimated Useful Lives of Depreciable Hospital Assets"
in disposing, at any time during or after the Contract term, of equipment
purchased with System Agency 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.
2. 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.
3. 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 $5,000, Subrecipient shall request disposition approval
and instructions in writing from the contract manager assigned to this
Contract.
4. After an item reaches the end of its useful life, Subrecipient shall ensure that
disposition of any equipment is in accordance with Generally Accepted
Accounting Principles, and any applicable federal guidance.
f. Closeout of Equipment.
At the end of the term of a Contract that has no additional renewals or that will not
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be renewed (Closeout), or when a Contract is otherwise terminated, Subrecipient
shall submit to the contract manager assigned to this Contract, an inventory of
equipment purchased with grant funds and request disposition instructions for such
equipment.
All equipment purchased with grant funds must be secured by Subrecipient at the
time of Closeout, or termination of this Contract, and must be disposed of
according to System Agency's disposition instructions, which may include return
of the equipment to System Agency or transfer of possession to another System
Agency contractor, at Subrecipient's expense.
19. This Amendment No. 3 shall be effective as of July 1, 2019 or upon the date this
Amendment is signed by both Parties,whichever occurs later.
20. Except as amended and modified by this Amendment No. 3 all terms and conditions of
the Contract, as amended, shall remain in full force and effect.
21. Any further revisions to the Contract shall be by written agreement of the Parties.
SIGNATURE PAGE FOLLOWS
System Agency Contract No.2017-049800-001
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SIGNATURE PAGE FOR AMENDMENT No.3
HHSC CONTRACT No.2017-049800-001
HEALTH AND HUMAN SERVICES CORPUS CHRISTI-NUECES COUNTY
COMMISSION PUBLIC HEALTH DISTRICT(CITY)
—DocuSigned by: ,—DocuSigned by:
&At, jelklASOl& By: AAAC.44py�ez
'-217A61A927E0461... '-4FC9D92742CE414...
Ruth T. Johnson Name: Annette Rodriguez
Chief Operating Officer Title: Health Director
Date of Execution: August 22, 2019 Date of Execution. August 22, 2019
ATTEST eein-e--teifk-
REB CCA HUERTA
(-IT,5Ff:RFTAnV
THE FOLLOWING ATTACHMENTS ARE ATTACHED AND INCORPORATED AS PART OF THE
CONTRACT:
ATTACHMENT A-1 FFATA
71
Approved as to form:
42'
Assistant City Attorney
For City Attorney
System Agency Contract No.2017-049800-001
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DocuSign Envelope ID: D2202D38-0603-4748-8170-94425C4347C7
Fiscal Federal Funding Accountability and Transparency Act
(FFATA) CERTIFICATION
The certifications enumerated below represent material facts upon which DSHS relies when reporting
information to the federal government required under federal law. If the Department later determines
that the Contractor knowingly rendered an erroneous certification, DSHS may pursue all available
remedies in accordance with Texas and U.S. law. Signor further agrees that it will provide immediate
written notice to DSHS if at any time Signor learns that any of the certifications provided for below were
erroneous when submitted or have since become erroneous by reason of changed circumstances. If the
Signor cannot certify all of the statements contained in this section, Signor must provide written
notice to DSHS detailing which of the below statements it cannot certify and why.
Legal Name of Contractor: FFATA Contact#1 Name, Email and Phone Number:
Corpus Christi- Nueces County Public Health Constance Sanchez, Constancep@cctexas.com,
District 361-826-3227
Primary Address of Contractor: FFATA Contact#2 Name, Email and Phone Number:
1702 Horne Rd Blandina Costley, Blandinac@cctexas.com,
361-826-7252
ZIP Code:9-digits Required www.usps.com DUNS Number:9-digits Required www.sam.gov
78416-1902 - 069457786
State of Texas Comptroller Vendor Identification Number (VIN) 14 Digits
7460005741C27
Printed Name of Authorized Representative Signature of Authorized Representative
DocuSigned by:
Annette Rodriguez '' ff
A Ane.44. Patri JQL
4EC0042742CE4,4.
Title of Authorized Representative Date
Health Director August 22, 2019
- 1-
Department of State Health Services Form 4734-June 2013
DocuSign Envelope ID: D2202D38-0803-4748-8170-94425C4347C7
Fiscal Federal Funding Accountability and Transparency Act
(FFATA) CERTIFICATION
As the duly authorized representative (Signor) of the Contractor, I hereby certify that
the statements made by me in this certification form are true, complete and correct to
the best of my knowledge.
Did your organization have a gross income, from all sources, of less than $300,000 in
your previous tax year? Yes X No
If your answer is "Yes", skip questions "A", "B", and "C" and finish the certification.
If your answer is "No", answer questions "A" and "B".
A. Certification Regarding% of Annual Gross from Federal Awards.
Did your organization receive 80% or more of its annual gross revenue from federal
awards during the preceding fiscal year? Yes X No
B. Certification Regarding Amount of Annual Gross from Federal Awards.
Did your organization receive $25 million or more in annual gross revenues from federal
awards in the preceding fiscal year? I I Yes Ix I No
If your answer is "Yes" to both question "A" and "B", you must answer question "C".
If your answer is "No" to either question "A" or "B", skip question "C" and finish the
certification.
C. Certification Regarding Public Access to Compensation Information.
Does the public have access to information about the compensation of the senior
executives in your business or organization (including parent organization, all branches,
and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d)
of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the
Internal Revenue Code of 1986? I I Yes No
If your answer is"Yes"to this question, where can this information be accessed?
If your answer is "No" to this question, you must provide the names and total
compensation of the top five highly compensated officers below.
For example:
John BIum:500000;Mary Redd:50000;Eric Gant:400000;Todd Platt:300000;
Sally Tom:300000
Provide compensation information here:
- 2-
Department of State Health Services Form 4734—June 2013
Docu$ .i
: SECURED
Certificate Of Completion
Envelope Id: D2202D380B034748B17094425C4347C7 Status:Sent
Subject:Amending$3,620,544;2017-049800-001;Corpus Christi-Neuces County PHD A-3; MSS/HDIS/HDS/WIC
Source Envelope:
Document Pages: 19 Signatures:0 Envelope Originator:
Certificate Pages:2 Initials:0 Texas Health and Human Services Commission
AutoNav:Enabled 1100 W.49th St.
Envelopeld Stamping:Enabled Austin,TX 78756
Time Zone: (UTC-06:00)Central Time(US&Canada) PCS_DocuSign@hhsc.state.tx.us
IP Address: 167.137.1.13
Record Tracking
Status:Original Holder:Texas Health and Human Services Location:DocuSign
6/11/2019 8:08:03 AM Commission
PCS_DocuSign@hhsc.state.tx.us
Signer Events Signature Timestamp
Greta Rymal Completed Sent:6/11/2019 8:11:34 AM
Greta.Rymal@hhsc.state.tx.us Viewed:6/11/2019 3:08:43 PM
Texas Health and Human Services Commission Signed:6/11/2019 3:09:40 PM
Security Level:Email,Account Authentication Using IP Address: 167.137.1.15
(None)
Electronic Record and Signature Disclosure:
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Annette Rodriguez Sent:6/11/2019 3:09:43 PM
annetter@cctexas.com Viewed:6/12/2019 3:49:04 PM
Health Director
Corpus Christi-Nueces County Public Health District
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Andy Marker
Edward.Marker@hhsc.state.tx.us
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Karen Ray
Karen.Ray@hhsc.state.tx.us
Security Level: Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Cecile Young
cecile.young@hhsc.state.tx.us
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
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Sherry Mojica COPIED Sent:6/11/2019 8:11:34 AM
sherry.mojica@hhsc.state.tx.us
Contract Coordinator
Texas Health and Human Services Commission
Security Level: Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Donna Ockletree COPIED Sent:6/11/2019 8:11:34 AM
donna.ockletree06@hhsc.state.tx.us
Security Level: Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Cynthia Wright COPIED Sent:6/11/2019 8:11:34 AM
cynthia.wright@hhsc.state.tx.us
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
William Uhlarick COPIED Sent:6/11/2019 3:09:43 PM
williamu2@cctexas.com
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Pam Wells
pam.wells@hhsc.state.tx.us
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
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