HomeMy WebLinkAboutPR 19581: APPROVING THE AMENDMENT OF THE FY 2016 CONTRACT •
City of
ort rthur
Texas
DATE: October 25, 2016
To: Brian McDougal, City Manager
From: Judith A. Smith, RN, BSN 4
RE: Approval To Amend The Contract Between the Department of State Health Services
Primary Health Care Program and the City of Port Arthur
Nature of the Request: This is a request to amend the contract ID # 2016-048585 with Texas
Department of State Health Services to increase the total amount of the contract to $140,000, of
which $70,000 is allocated toward the contract period of September 1, 2016 through August 31,
2017. This Primary Health Care contract provides preventive health services including
immunizations, diagnosis and treatment of acute illnesses, family planning, health education, and
diagnostic tests including lab and x-ray for eligible participants at or below 150% of the current
federal poverty guidelines.
Analysis, Considerations: The contract period starts 09/01/2016 and ends 08/31/2017 and
provides for salaries and fringe benefits for one full-time eligibility/billing clerk.
Recommendations: It is recommended that the City Council approve P.R. No. 19581 for the FY
2017 contract between the Department of State Health Services Primary Health Care Program
and the City of Port Arthur program to provide primary and preventive health care services.
Budget Considerations: The total budget is $70,000 to cover the cost of salaries, fringe benefits,
supplies, contractual and travel.
"REMEMBER WE ARE HERE TO SERVE THE CITIZENS OF PORT ARTHUR"
P.O.BOX 1089•PORT ARTHUR,TX 77641-1089.409/983-8101•FAX 409/982-6743
P. R. NO. 19581
10/25/2016-js
RESOLUTION NO.
A RESOLUTION APPROVING THE AMENDMENT OF THE FY
2016 CONTRACT BETWEEN THE CITY OF PORT ARTHUR
AND THE DEPARTMENT OF STATE HEALTH SERVICES
PRIMARY HEALTH CARE PROGRAM, INCREASING THE
AMOUNT TO $140,000, OF WHICH $70,000 IS ALLOCATED
TOWARD THE CONTRACT PERIOD SEPTEMBER 1, 2016
THROUGH AUGUST 31,2017.
WHEREAS, the FY 2016 Primary Health Care contract was approved by council
on September 15, 2015, Resolution No. 15-334 for funding for FY 2016; and,
WHEREAS, this program provide preventive health services including
immunizations, diagnosis and treatment of acute illnesses, family planning, health
education, and diagnostic tests including lab and x-rays for eligible participants at or
below 150%of the current federal poverty guidelines: and,
WHEREAS, this is an amendment to the FY 2016 contract increasing the total
contract to $140,000, of which $70,000 is allocated toward the contract period of
September 1, 2016 through August 31, 2017.
NOW THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF
THE CITY OF PORT ARTHUR:
Section 1. That,the facts and opinions in the preamble are true and correct.
Section 2. That, the City Council of the City of Port Arthur hereby approves
the contract amendment between the City of Port Arthur and the Department of State
Health Services.
P. R. NO. 19581
Paget—js
Section 3. That, the City Council deems it is in the best interest of the City to
approve and authorize the City Manager to execute the contract amendment between the
Department of State Health Services and the City of Port Arthur for Primary Health Care
Services, as delineated in Exhibit"A."
Section 4. That, a copy of the caption of this Resolution be spread upon the
Minutes of the City Council.
READ,ADOPTED,AND APPROVED,this day of October, 2016
A.D., at a Regular Meeting of the City Council of the City of Port Arthur, Texas by the
following Vote:
AYES: Mayor: ,
Councilmembers: ,
NOES: .
Mayor
ATTEST:
Sherri Bellard, City Secretary
P. R. NO. 19581
Page 3—js
APPROVED AS, 0 FORM:
I /gar
Val" izeno, Cit"Attorney
millia
APPROVED FOR ADMINISTRATION:
dailkeffiCailo 06-rit)
Brian McDougal Mdith Smith, RN, BSN
City Manager Director of Health Services
EXHIBIT "A"
DEPARTMENT OF STATE HEALTH SERVICES
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Amendment #01
The Department of State Health Services (DSHS) and CITY OF PORT ARTHUR (Contractor)
agree to amend Contract ID# 2016-048585 (Contract), which was effective on September 1,
2015. This Contract has not been amended prior to this Amendment. This Amendment will be
denominated as Contract No. 2016-048585-002.
I. The Parties agree to amend Section 2. Total Amount of the Contract and Payment Method, to
increase the total amount of the Contract to ONE HUNDRED FORTY THOUSAND DOLLARS
($140,000), of which SEVENTY THOUSAND DOLLARS ($70,000) is allocated toward the
contract period of September 1, 2016 through August 31, 2017.
II. The Parties agree to amend Section 4. Term of the Contract, and the term of the Program
Attachment, to extend the Contract term to August 31, 2017.
III. The Parties agree to amend the third paragraph in Section I. Statement of Work of the
Program Attachment, to add the following documents to the list of documents that are
incorporated by reference and made a part of the Contract:
• Primary Health Care Program Certification Form;
• DSHS FY17 Primary Health Care Renewal Application, and any revisions; and
• Contractor's response to DSHS FY17 Primary Health Care Renewal Application, and
any revisions.
IV.The Parties agree to delete the following struck-through language from Section I. Statement
of Work:
Service Area:
Location: Multiple clinic locations identified on DSHS website at:
https://www.ixclinics.com.
V. The Parties agree to amend Section II. Performance Measures of the Program Attachment, to
add the following:
Between September 1, 2016 and August 31, 2017, Contractor shall provide services to a
minimum of 389 unduplicated clients who live or receive services in the following counties:
Jefferson County.
VI.The Parties agree to amend Section IV. Renewals of the Program Attachment, to reflect that
there are three (3) renewals remaining under the Contract.
v.06.22.2016 Page 1 of 7
VII. The Parties agree to delete SECTION VII. BUDGET, in its entirety and replace it with
the following:
SECTION VII. BUDGET: Cost Reimbursement(Categorical)
Funding is further detailed in the attached Categorical Budget.
Funding is allocated through this Program Attachment for reimbursement of allowable PHC
costs on a cost reimbursement basis.
Contractor shall include funds in the Travel budget category for a minimum of two (2) staff
members to attend up to two (2) trainings for two (2) days; to be held in Austin, Dallas/Fort
Worth, Houston or San Antonio in the fall, spring or summer of Fiscal Year 2017.
Contractor shall not move funds from the Contractual budget category into any other budget
category without prior approval from DSHS.
Contractor's DSHS PHC share of fringe benefits shall not exceed 30%of the approved
DSHS PHC share of direct Personnel costs.
Contractor's DSHS PHC share of indirect costs shall not exceed 15%of the approved DSFIS
PKC share of direct Personnel costs.
Funds made available in each Contract year shall be used only for services performed during
the same Contract year. Funds that are not expended for services during the Contract year
cannot be used for services in any other Contract year, or any other Program Attachment
term.
DSHS shall distribute funds to maximize the delivery of authorized services to eligible
clients. DSHS will monitor Contractor's billing activity. Contractor may be subject to
contract amount decreases if Contractor's billing activity is less than projected.
SOURCE OF FUNDS: State of Texas
DUNS Number: 137134909
VIII. The Parties agree to delete in its entirety the attached Categorical Budget in Section VII.
Budget of the Program attachment and replace it with the following:
FY 16 (September 1, 2015 FY17 (September 1, 2016
through August 31, 2016) through August 31, 2017)
PERSONNEL $33,804.00 $33,588.00
FRINGE BENEFITS $10,141.00 $10,076.00
TRAVEL $1,843.00 $1,312.00
v.06.22.2016 Page 2 of 7
SUPPLIES $3,212.00 $6,024.00
EQUIPMENT $0.00 $0.00
CONTRACTUAL $21,000.00 $18,000.00
OTHER $0.00 $1,000.00
TOTAL DIRECT CHARGES $70,000.00 $70,000.00
INDIRECT CHARGES $0.00 $0.00
TOTAL $70,000.00 $70,000.00
DSHS SHARE $70,000.00 $70,000.00
CONTRACTOR SHARE $0.00 $0.00
OTHER MATCH $0.00 $0.00
IX.The Parties agree to delete Section VIII. Special Provisions of the Program Attachment, in its
entirety and replace it with the following:
Section VIII. Special Provisions:
For purposes of this Program Attachment,the following provisions shall apply:
A. General Provisions, Article II, Compliance and Reporting, Section 2.03 Reporting, is
revised to include the following:
Contractor shall provide information and supporting documentation as requested by
DSHS to conduct desk reviews to verify accurate reporting/billing for the PHC Program.
Failure to submit requested information in a timely manner may result in sanctions as
authorized by the Contract. If Contractor's desk review results in a finding of
misappropriation of DSHS PHC co-payment (co-pay) policy, Contractor shall reimburse
client(s).
Contractor shall submit monthly, quarterly, and annual programmatic reports and/or
financial vouchers/reports as required in the PHC Policy Manual. Other data and/or
reports deemed necessary by DSHS may be required, upon reasonable notice to
Contractor.
Contractor shall provide the following routine reports during each Contract year to DSHS
in compliance with the dates and conditions specified below:
Report Title Submission Frequency Due Date
v.06.22.2016 Page 3 of 7
PHC 225 Report Monthly By the last working day of the
month following service;
submit simultaneously with
the corresponding monthly B-
13 Purchase Voucher.
Staff Training Plan Annually — within 45 days October 15
of the beginning of the
contract year
Contractor's Co-pay Policy One time (beginning of September 30
and Fee Schedule contract year)
State of Texas Purchase Monthly By the last working day of the
Voucher(Form B-13)and month following service;
corresponding supporting submit simultaneously with
document, Supporting the corresponding final,
Schedule for DSHS PHC complete PHC 225 monthly
Categorical Reimbursement report.
Voucher(Form B-13P)
B-13P Supporting Monthly By the last working day of the
Documentation month following service;
submit simultaneously with
the corresponding monthly B-
13 Purchase Voucher and the
PHC 225 monthly report.
Financial Status Report Quarterly
(FSR) 1St Quarter: Sept—Nov December 31
2nd Quarter: Dec—Feb March 31
3rd Quarter: Mar—May June 30
4th Quarter: June—Aug October 15
PHC 350 Annual Report Annually-within sixty (60) October 30
days after the end of the
contract year
Contractor shall send a Monthly Report (Form PHC 225)to cdsb@dshs.state.tx.us by the
last working day of the month following the month of service. Contractor shall provide
requested data according to specified criteria (e.g., age, gender, number of unduplicated
clients, etc.) as detailed in PHC 225 report. Vouchers will not be paid until the
corresponding monthly PHC 225 report is received and approved.
Contractor shall provide an annual program report (Form PHC 350) to DSHS no later
than sixty(60) days after the end of the Contract year. Contractor shall provide requested
data according to specified criteria (e.g., age, gender, race, ethnicity, number of
unduplicated clients, etc.) as detailed in PHC 350 report.
Contractor shall maintain data and management information systems that are compatible
with accurate reporting of contract performance.
v.06.22.2016 Page 4 of 7
B. General Provisions, Article II, Compliance and
Reporting, Section 2.04 Client Financial Eligibility Section, is revised to include the
following:
All individuals considered for the PHC program shall be screened and determined
eligible using a DSHS-approved screening process in accordance with the PHC Policy
Manual. Contractor may not alter DSHS eligibility form(s) or use another eligibility form
unless it is submitted to and approved by DSHS PHC Program.
C. General Provisions, Article III, Services, Section 3.05 Fees for Personal Health
Services Section, is revised to include the following:
Contractor shall make reasonable efforts to investigate and apply for all other sources of
third party funding available to, or identified by, the patient before submitting DSHS
Program claims for allowable costs.
Contractor is responsible for implementation of policies and procedures for charging,
billing, and collecting fees for individual client services provided. These policies and
procedures shall be reviewed by Contractor's policy board or advisory committee.
Contractor may assess a co-payment (co-pay) from clients who receive services under
this Program Attachment, in accordance with the DSHS PHC policy manual. A client
shall not be denied a service due to inability to pay.
If Contractor charges client co-pay, Contractor shall adhere to the PHC fee schedule in the
PHC Policy Manual. Contractor shall submit the entity's FY17 PHC client co-pay policy
and fee schedule to the PHC mailbox (primaryhealthcare(a,dshs.state.tx.us) for review and
approval by September 30, 2016.The Contractor shall waive the fee if a client self-declares
an inability to pay.No client shall be denied services based on an inability to pay.
Client co-pays shall be reported as program income on the monthly State Purchase Voucher
Supporting Document (Form B-13P) and the quarterly Financial Status Report (FSR or
Form 269a). See Appendices in the DSHS PHC Policy and Procedure Manual for the
DSHS client co-pay fee schedule.
D. General Provisions, Article IV, Funding, Section 4.05 Program Income Section, is
revised to include the following:
Client co-pays collected as a result of the Program Attachment(s) during the term of the
Program Attachment(s) are considered program income. Contractor shall identify and
report program income monthly and annually as specified in the DSHS Contractor's
Financial Procedures Manual (CFPM) and in the DSHS PHC Policy Manual.
This section shall not be construed to apply to funds raised by Contractor from fundraising
activities or donations. Fundraising includes membership drives or special events used to
raise program funds. Donations include monies donated to the program by individuals and
v.06.22 2016 Page 5 of 7
private groups, such as churches or other organizations.
Program income generated under this Contract shall be used to further the program
objectives of the State/Federal statute under which the Statement of Work for the Program
Attachment was made. The receipt and expenditure of all program income shall also be
reported monthly on the Supporting Schedule for DSHS Categorical PHC Reimbursement
Vouchers (Form B-13P).
E. General Provisions, Article V, Payment Methods and Restrictions, Section 5.04
Working Capital Advance, is revised to include the following:
The Primary Health Care Program Attachment does not allow a working capital advance.
F. General Provisions, Article VI, Terms and Conditions of Payment, Section 6.03
Withholding Payments, is revised to include the following:
The final voucher of the fiscal year will not be processed for payment until the final FSR
is received, reviewed, and approved by DSHS.
G. General Provisions, Article VI, Terms and Conditions of Payment, Section 6.05
Acceptance as Payment in Full, is deleted in its entirety and replaced with:
Contractor shall accept reimbursement or payment from DSHS and any applicable fees
from clients for clinical services as payment in full for services or goods provided to
clients. Contractor shall not seek additional reimbursement or payment for services or
goods from clients other than applicable fees for clinical health services.
H. General Provisions, Article XI, Access Inspection and Audit of Records, Section
11.01 Access and Inspection, is revised to include the following:
Contractor shall allow DSHS to conduct on-site quality assurance reviews as deemed
necessary by DSHS. Unsatisfactory review findings may result in implementation of
General Provisions, Article XVI, Breach of Contract and Remedies for Non-Compliance.
I. General Provisions, Article XIV, General Business Operations of Contractor,
Section 14.18 Notice of Organizational Change Section, is revised to include the
following:
Contractor shall immediately notify the Performance Management Unit, Contract
Development and Support Branch, of any clinic site information changes, e.g., changes in
contact person, hours of operation, address,National Provider Identification (NPI) number,
Texas Provider Identification (TPI) number, and the closure, relocation, and/or opening of
clinic site(s).
J.General Provisions, Article XIV, General Business Operations of Contractor, Section
14.20 Equipment, is revised to include the following:
v.06.22.2016 Page 6 of 7