HomeMy WebLinkAboutPR 20818: CONTRACT AMENDMENT FOR PUBLIC HEALTH EMERGENCY PREPAREDNESS PROGRAM INTEROFFICE MEMORANDUM
Date: April 26, 2019
To: The Honorable Mayor and City Council
Through: Rebecca Underhill, Interim City Manager
From: Judith A. Smith, RN, BSN, Director of Health Services
RE: Authorization to approve the Contract Amendment for Public Health
Emergency Preparedness Program to extend the contract and add funds of
$100,296 for the contract period July 1, 2019 through June 30, 2020. Requires
a 10% City Match of$10,296.
Introduction:
The intent of this Agenda Item is to seek the City Council's approval for the City Manager to
amend the contract for Public Health Emergency Preparedness Program adding funds for the
contract period July 1, 2019 through June 30, 2020.
Background: This contract amendment for FY 2020 between the City of Port Arthur and the
Department of State Health services Public Health Emergency Preparedness Program will
continue to allow the City of Port Arthur Health Department to perform and support activities
and develop interventions to prevent human illness related to chemical, biological, radiological
agents, naturally occurring health threats and other public health emergencies. The amending
contract will add $100,296 to cover FY 2020 contract period from July 1, 2019 through June
30, 2020 and will require a city match of$10,029.
Budget Impact: This grant requires a 10% city match of $10,296 for FY 2020. This is
contingent on the 10%match being budgeted in the city's general fund for FY 2020.
Staff Analysis, Considerations: This funding supports the salary and fringe for one (1) full
time Epidemiologist.
Recommendation: It is recommended that the City Council approve P.R. No.20818,
approving the contract amendment between the City of Port Arthur and the Department of
State Health Services to add funds for contract period July 1, 2019 through June 30, 2020.
P. R. No. 20818
04/26/2019-js
RESOLUTION NO.
A RESOLUTION APPROVING THE FY 2020 CONTRACT
AMENDMENT BETWEEN THE CITY OF PORT ARTHUR
AND THE DEPARTMENT OF STATE HEALTH SERVICES
FOR THE PUBLIC HEALTH EMERGENCY
PREPAREDNESS PROGRAM BY ADDING $100,296.00 IN
FEDERAL FUNDING WITH A 10% CITY MATCH OF
$10,029.00 FOR THE CONTRACT PERIOD BEGINNING
JULY 1, 2019 THROUGH JUNE 30, 2020
WHEREAS, the contract between the City of Port Arthur and the Department of
State Health Services provides financial assistance to the Port Arthur City Health
Department to supplement the delivery of public health services including responding to
bioterrorism, outbreaks of infectious disease, and other public health threats and
emergencies in accordance with an established set of public health preparedness
capabilities; and,
WHEREAS, pursuant to Resolution No. 17-067, Council approved the FY 2017-
2018 contract, and pursuant to Resolution No. 18-137, Council approved FY 2018-2019
contract, and now the Department of State Health Services desires to amend the contract
to add $100,296.00 to cover contract period July 1, 2019 through June 30, 2020 with a
10% city match of$10,029.00.
WHEREAS, this resolution will be contingent on the 10% city match of
$10,029.00 being budgeted in the City's general fund for FY 2019-2020 budget.
NOW THEREFORE BE IT RESOLVED BY THE CITY COUNCIL OF
THE CITY OF PORT ARTHUR:
Section 1. That,the facts and opinions are true and correct.
P. R. No. 20818
04/26/2019-js
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 for the Public Health Preparedness Program.
Section 3. That, the City Council deems it is in the best interest of the City to
approve and authorize the City Manager and the Director of the City's Health
Department to execute the contract amendment between the Department of State Health
Services and the City of Port Arthur, TX in substantially the same form as attached hereto
as 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 May, 2019 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, Derrick Freeman
ATTEST:
Sherri Bellard, City Secretary
P. R. No. 20818
04/26/2019-js
APPROVED AS TO FORM:
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al 'f/no, Ci Attorney
APPROVED FOR ADMINISTRATION:
Rebecca Underhill, Interim City Manager
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J>jiUth A. Smith, RN, BSN
Director of Health Services
APPROVED AS TO AVAILABILI OF FUNDS:
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Kandy Daniel, Idgerim Finance Director
EXHIBIT "A"
DocuSign Envelope ID.98249D5F-7A7A-46D5-8D42-3A7A6CD7626A
DEPARTMENT OF STATE HEALTH SERVICES
CONTRACT No. 537-18-0120-00001
AMENDMENT No. 02
RENEWAL
The DEPARTMENT OF STATE HEALTH SERVICES("System Agency")and CITY OF PORT ARTHUR
("Grantee"),which are collectively referred to herein as the"Parties,"to that certain grant Contract
effective July 1, 2017, and denominated DSHS Contract No. 537-18-0120-00001, now desire to
amend the Contract.
WHEREAS, System Agency has elected to extend the term of the Contract;
WHEREAS, the Parties desire to revise the Budget to add funds for the Contract period beginning
July 1, 2019,through June 30,2020 ("Fiscal Year 2020"or"FY2020"); and
WHEREAS, the Parties desire to add the FY2020 Statement of Work.
NOW,THEREFORE, the Parties hereby amend and modify the Contract as follows:
1. SECTION III of the Signature Document,DURATION,is hereby amended to reflect a revised
termination date of June 30, 2020.
2. SECTION IV of the Signature Document, BUDGET, is hereby amended to add ONE
HUNDRED THOUSAND TWO HUNDRED NINETY-SIX DOLLARS ($100,296.00) in federal
funding with the Grantee providing a total of TEN THOUSAND TWENTY-NINE DOLLARS
($10,029.00)in match funds for the Fiscal Year of 2020. The total Contract amount is not
to exceed THREE HUNDRED THOUSAND EIGHT HUNDRED EIGHTY-EIGHT DOLLARS
($300,888.00) in federal funding and THIRTY THOUSAND EIGHTY-NINE DOLLARS
($30,089.00)in match funds for a combined total of THREE HUNDRED THIRTY THOUSAND
NINE HUNDRED SEVENTY-SEVEN DOLLARS ($330,977.00). All expenditures under the
Contract will be in accordance with the revised budget set forth herein. Funds provided in
support of one Contract activity may only be used for that activity and may not be
comingled with other funds provided under this Contract.
3. SECTION VIII of the Signature Document, NOTICE TO PROCEED, is hereby deleted in its
entirety and replaced with the following:
VIII.NOTICE TO PROCEED
Funding for this Contract is dependent on the award of the applicable federal grant.No FY
2020 work may begin, and no charges may be incurred until the System Agency issues a
written notice to proceed to Grantee. This Notice to Proceed may include an amended or
ratified budget which will be incorporated into this Contract by a subsequent amendment,
as necessary. Notwithstanding the preceding, at the discretion of the System Agency,
System Agency Contract No.537-18-0120-00001 Page 1 of 4
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Grantee may be eligible to receive reimbursement for eligible expenses incurred during the
period of performance as defined by 2 CFR§200.309.
4. ATTACHMENT B,BUDGET, is hereby amended by deleting the budget table in its entirety
and replacing it with the following:
FY18 Budget FY19 Budget FY20 Budget
Budget Summary Summary Summary Total Budget
Categories (7/1/17— (7/1/18— (7/1/19— Summary
6/30/18) 6/30/19) 6/30/20)
Personnel $66,984.00 $69,384.00 $70,800.00 $207,168.00
Fringe $32,085.00 $30,912.00 $29,496.00 $92,493.00
Benefits
Travel $6,205.00 $6,667.00 $7,089.00 $19,961.00
Equipment $0.00 $0.00 $0.00 $0.00
Supplies $2,112.00 $446.00 $0.00 $2,558.00
Contractual $0.00 $0.00 $0.00 $0.00
Other $2,940.00 $2,917.00 $2,940.00 $8,797.00
Sum of Direct $110,326.00 $110,326.00 $110,325.00 $330,977.00
Costs
Indirect Costs $0.00 $0.00 $0.00 $0.00
Sum of Direct
Costs and $110,326.00 $110,326.00 $110,325.00 $330,977.00
Indirect Costs
Required
Match(Cash $10,030.00 $10,030.00 $10,029.00 $30,089.00
or In-Kind)
TOTAL $110,326.00 $110,326.00 $110,325.00 $330,977.00
It is agreed that Grantee shall provide matching funds in the amount of$30,089.00 for the
Contract term.
5. The Parties agree to add ATTACHMENT A.3, FY2020 STATEMENT OF WORK, which is
attached hereto and incorporated into the Contract as if fully set forth therein.
6. This Amendment No. 02 shall be effective on July 1,2019.
7. Except as amended and modified by this Amendment No. 02, all terms and conditions of
the Contract, as amended, shall remain in full force and effect.
System Agency Contract No.537-18-0120-00001 Page 2 of 4
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8. Any further revisions to the Contract shall be by written agreement of the Parties.
SIGNATURE PAGE FOLLOWS
System Agency Contract No.537-18-0120-00001 Page 3 of 4
DocuSign Envelope ID:98249D5F-7A7A-46D5-8D42-3A7A6CD7626A
SIGNATURE PAGE FOR AMENDMENT NO.02
SYSTEM AGENCY CONTRACT NO.537-18-0120-00001
TEXAS DEPARTMENT OF STATE HEALTH CITY OF PORT ARTHUR
SERVICES
By:
Name:
Title:
Date of Execution: Date of Execution:
ARTICLE 1: THE FOLLOWING ATTACHMENTS ARE ATTACHED AND INCORPORATED AS PART
OF THE CONTRACT:
ATTACHMENT A.3- FY2020 STATEMENT OF WORK
ATTACHMENT C- FFATA
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ATTACHMENT A.3
STATEMENT OF WORK
July 1,2019 through June 30,2020
GRANTEE RESPONSIBILITIES
Grantee will:
A. Perform activities in support of the PHEP Cooperative Agreement from the Centers for
Disease Control and Prevention (CDC) to align Public Health Emergency Preparedness
(PHEP) and Hospital Preparedness Programs (HPP) and advance public health and
healthcare preparedness.
B. Perform the activities required under this Contract in the following county: Jefferson
County.
C. Provide System Agency with situational awareness data generated through interoperable
networks of electronic data systems.
D. Address the following public health preparedness capabilities:
1. Capability 1 — Community preparedness is the ability of communities to prepare
for, withstand, and recover from public health incidents in both the short and long
term.
2. Capability 2—Community recovery is the ability of communities to identify critical
assets, facilities, and other services within public health, emergency management,
health care, human services, mental/behavioral health, and environmental health
sectors that can guide and prioritize recovery operations.
3. Capability 3 —Emergency operations coordination is the ability to coordinate with
emergency management and to direct and support an incident or event with public
health or health care implications by establishing a standardized, scalable system
of oversight, organization, and supervision that is consistent with jurisdictional
standards and practices and the National Incident Management System(NIMS).
4. Capability 4—Emergency public information and warning is the ability to develop,
coordinate, and disseminate information, alerts, warnings, and notifications to the
public and incident management personnel.
5. Capability 5 — Fatality management is the ability to coordinate with partner
organizations and agencies to provide fatality management services to ensure the
proper recovery and preservation of remains; identification of the deceased;
determination of cause and manner of death; release of remains to an authorized
individual; and provision of mental/behavioral health assistance for the grieving.
The role also may include supporting activities for the identification, collection,
documentation, retrieval, and transportation of human remains, personal effects, and
evidence to the examination location or incident morgue.
6. Capability 6—Information sharing is the ability to conduct multijurisdictional and
multidisciplinary exchange of health-related information and situational awareness
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ATTACHMENT A.3
STATEMENT OF WORK
July 1,2019 through June 30,2020
data among federal, state, local,tribal, and territorial levels of government and the
private sector. This capability includes the routine sharing of information as well
as issuing of public health alerts to all levels of government and the private sector
in preparation for and in response to events or incidents of public health
significance.
7. Capability 7—Mass care is the ability of public health agencies to coordinate with
and support partner agencies to address, within a congregate location (excluding
shelter-in-place locations),the public health,health care,mental/behavioral health,
and human services needs of those impacted by an incident.This capability includes
coordinating ongoing surveillance and public health assessments to ensure that
health needs continue to be met as the incident evolves.
8. Capability 8—Medical countermeasure dispensing,and administration is the ability
to provide medical countermeasures to targeted population(s)to prevent, mitigate,
or treat the adverse health effects of a public health incident, according to public
health guidelines.This capability focuses on dispensing and administering medical
countermeasures, such as vaccines, antiviral drugs, antibiotics, and antitoxins.
9. Capability 9 — Medical materiel management and distribution is the ability to
acquire, manage, transport, and track medical materiel during a public health
incident or event and the ability to recover and account for unused medical materiel,
such as pharmaceuticals, vaccines, gloves, masks, ventilators, or medical
equipment after an incident.
10. Capability 10—Medical surge is the ability to provide adequate medical evaluation
and care during events that exceed the limits of the normal medical infrastructure
of an affected community. It encompasses the ability of the health care system to
endure a hazard impact, maintain or rapidly recover operations that were
compromised,and support the delivery of medical care and associated public health
services, including disease surveillance, epidemiological inquiry, laboratory
diagnostic services, and environmental health assessments.
11. Capability 11 — Nonpharmaceutical interventions are actions that people and
communities can take to help slow the spread of illness or reduce the adverse impact
of public health emergencies. This capability focuses on communities, community
partners, and stakeholders recommending and implementing nonpharmaceutical
interventions in response to the needs of an incident, event, or threat.
Nonpharmaceutical interventions may include isolation; quarantine;restrictions on
movement and travel advisories or warnings; social distancing; external
decontamination; hygiene; and precautionary protective behaviors.
12. Capability 12 — Public health laboratory testing is the ability to implement and
perform methods to detect, characterize, and confirm public health threats. It also
includes the ability to report timely data, provide investigative support, and use
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ATTACHMENT A.3
STATEMENT OF WORK
July 1,2019 through June 30,2020
partnerships to address actual or potential exposure to threat agents in multiple
matrices, including clinical specimens and food, water, and other environmental
samples. This capability supports passive and active surveillance when preparing
for,responding to, and recovering from biological, chemical, and radiological(if a
Radiological Laboratory Response Network is established) public health threats
and emergencies.
13. Capability 13 —Public health surveillance and epidemiological investigation is the
ability to create, maintain, support, and strengthen routine surveillance and
detection systems and epidemiological investigation processes. It also includes the
ability to expand these systems and processes in response to incidents of public
health significance.
14. Capability 14 —Responder safety and health is the ability to protect public health
and other emergency responders during pre-deployment, deployment, and post-
deployment.
15. Capability 15—Volunteer management is the ability to coordinate with emergency
management and partner agencies to identify, recruit, register, verify, train, and
engage volunteers to support the jurisdictional public health agency's preparedness,
response, and recovery activities during pre-deployment, deployment, and post-
deployment.
E. Match funds awarded under this Contract with costs or third-party contributions that are
not paid by the federal government under another award, except where authorized by
federal statute to be used for cost sharing or matching. The non-federal contributions
(match)may be provided directly or through donations from public or private entities and
may be in cash or in-kind donations, fairly evaluated, including plant, equipment, or
services. The costs that the Grantee incurs in fulfilling the matching or cost-sharing
requirement are subject to the same requirements, including the cost principles, that are
applicable to the use of federal funds,including prior approval requirements and other rules
for allowable costs as described in 45 CFR 74.23 and 45 CFR 92.24, as amended.
Grantee will provide matching in the amount of at least ten percent(10%)of the allocation
amount. Cash match is defined as an expenditure of cash by the Grantee on allowable costs
of this Contract that are borne by the Grantee. In-kind match is defined as the dollar value
of non-cash contributions by a third party given in goods,commodities,or services that are
used in activities that benefit this Contract's project and that are contributed by non-federal
third parties without charge to the Grantee. The criteria for match must:
1. Be an allowable cost under the applicable federal cost principle;
2. Be necessary and reasonable for the efficient accomplishment of project or program
objectives;
3. Be verifiable within the Grantee's(or subgrantee's) records;
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ATTACHMENT A.3
STATEMENT OF WORK
July 1,2019 through June 30,2020
4. Be documented, including methods and sources, in the approved budget (applies
only to cost reimbursement contracts);
5. Not be included as contributions toward any other federally-assisted project or
program(match can count only once);
6. Not be paid by the federal government under another award, except where
authorized by federal statute to be used for cost sharing or match;
7. Conform to other provisions of governing circulars/statutes/regulations as
applicable for the Contract;
8. Be adequately documented;
9. Follow procedures for generally accepted accounting practices as well as meet audit
requirements; and
10. Value the in-kind contributions reported and be supported by documentation
reflecting the use of goods and/or services during the Contract term.
F. In the event of a public health emergency involving a portion of the state, mobilize and
dispatch staff or equipment purchased with funds from previous PHEP cooperative
agreements and not currently performing critical duties in the jurisdiction served, to the
affected area of the state upon receipt of a written request from System Agency.
G. Inform System Agency in writing if Grantee will not continue performance under this
Contract within 30 days of receipt of an amended standard(s) or guideline(s). System
Agency may terminate this Contract immediately or within a reasonable period of time as
determined by System Agency.
H. Develop, implement and maintain a timekeeping system for accurately documenting staff
time and salary expenditures for all staff funded through this Contract, including partial
full-time employees and temporary staff.
I. Complete and submit programmatic reports as directed by System Agency in a format
specified by System Agency. Due dates will be listed in the most current System Agency
reporting schedule,to be released within thirty(30)days of the Contract start date. Grantee
will provide System Agency other reports,including financial reports,that System Agency
determines necessary to accomplish the objectives of this Contract and to monitor
compliance.
J. Submit Performance Measures to System Agency within an established timeframe
designated by System Agency as required by the CDC.
K. Submit the work plan that encompasses the Contract term, due to System Agency within
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ATTACHMENT A.3
STATEMENT OF WORK
July 1,2019 through June 30,2020
an established timeline designated by System Agency.
L. Conduct, or participate in, an annual Training and Exercise Planning Workshop (TEPW)
with all applicable agencies in accordance with Homeland Security Exercise and
Evaluation Program (HSEEP) guidelines to develop a strategy and structure for a multi-
year Training and Exercise Plan(TEP). Prepare,maintain,and upon request,submit a copy
of the TEPW agenda and participant roster as documentation of TEPW attendance.
M. Submit a current Multi-Year Training & Exercise Plan that covers FY20 through FY24
(July 1, 2019, through June 30, 2023) to System Agency within an established timeframe
designated by System Agency,using the template provided by System Agency.
N. Conduct, or participate in, at least one annual Preparedness Exercise consistent with their
TEP. Submit a Notification of Exercise (NOE) form to System Agency Preparedness
Exercise inbox at preparednessexerciseAdshs.texas.gov no later than sixty(60)days prior
to the start of the exercise.
O. Submit at least one (1)After Action Review/Improvement Plan (AAR/IP). All AAR/IPs
must be submitted to System Agency Preparedness Exercise inbox,
preparednessexerciseAdshs.texas.gov within sixty(60) days, or ninety(90) days for Real
World Incident (RWI), of the completion of the exercise/response to System Agency
Exercise Team and no later than June 30,2020. AAR/IPs must be completed in accordance
with Notification and Reporting of Exercise Grant.
P. Complete and submit all supporting documents for the Operational Readiness Review
(ORR) twenty(20)business days prior to review date. The review takes place every other
year; however, documentation will still be required annually.
1. ORR forms include:
a. Jurisdictional Data Sheet
b. Dispensing Planning Form
c. Distribution Planning Form
d. Training and Exercising Form
e. Dispensing Full-Scale Exercise(FSE) Form
f. Distribution FSE Form
2. Provide updated Transportation Spreadsheet for submission to Health Emergency
Preparedness and Response Section (HEPRS) External SharePoint by April 1,
2020.
3. Perform and submit metrics (data collection sheets) on each of the three (3) SNS
operation drills (at pre-identified Point of Dispensing [POD] locations and using
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ATTACHMENT A.3
STATEMENT OF WORK
July 1,2019 through June 30,2020
existing call down rosters)to HEPRS External SharePoint and submit After Action
Reviews/Improvements sixty(60) days after drill completion or by April 1, 2020,
to the preparednessexercise@dshs.texas.gov inbox. Acceptable drills include:
a. Staff Call Down;
b. Facility Set-Up; and
c. POD Activation.
Q. Submit the Texas Public Health Risk Assessment Tool due to System Agency within an
established timeframe designated by System Agency.
R. Submit the Mid-Year Report due to System Agency within an established timeframe
designated by System Agency.
S. Complete an End-Of-Year Performance Report in a format specified by System Agency
no later than August 15, 2020.
T. Designate a member of the PHEP program to attend, in person, two (2) PHEP quarterly
meetings during the Contract term. If the designee is unable to attend any of the meetings
in person, the Grantee must notify System Agency in writing as to the reason for
noncompliance.
U. Designate a member of the PHEP program to attend, in person, four regional healthcare
coalition meetings during the term of the Contract from July 1, 2019, to June 30, 2020.
Submit sign-in sheets from meetings as evidence of attendance.
V. Submit a current Texas Preparedness and Evaluation Process (TxPEP) report to System
Agency within an established timeframe designated by System Agency,using the template
provided by System Agency.
W. Submit a report on the Grantee's vulnerable population outreach activities to System
Agency within an established timeframe designated by System Agency, using a template
provided by System Agency.
X. Immediately notify System Agency in writing if Grantee is legally prohibited from
providing any report under this Contract.
Y. Use the Texas Disaster Volunteer Registry (TDVR), which is Texas' version of the
Emergency System for the Advanced Registration of Volunteer Health Professionals
(ESAR-VHP), as their main volunteer management tool, if utilizing Medical Reserve
Corps or other volunteer groups. If Grantee uses volunteers as provided in the Section,the
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ATTACHMENT A.3
STATEMENT OF WORK
July 1,2019 through June 30,2020
Grantee must either:
1. Request access to the TDVR from the State ESAR-VHP System Administrator,
participate in required administrator trainings, and provide access to volunteers for
registration or
2. Petition System Agency in writing for an exemption from using the TDVR.
Successful petitioners must be currently using a fully operational, ESAR-VHP-
compliant,web-based volunteer management system. If petitioning System Agency
to use a fully operational,ESAR-VHP-compliant,web-based volunteer management
system, then the substitute system must meet, but is not limited to, the following
federal requirements:
a. Must offer Internet-based registration;
b. Volunteer information is collected and maintained in a manner consistent
with all federal, state and local laws governing security and confidentiality;
c. Must be able to register and collect the credentials and qualifications of
health professionals that are then verified with the issuing entity or
appropriate authority;
d. Must be able to verify the credentials of the 20 mandated professions;
e. Must be able to assign to one of four emergency credential levels;
f. Must be able to identify volunteers willing to participate in a federally
coordinated emergency response;
g. Must be able to re-verify professional credentials every 6 months;
h. Must have the ability to include the differing scope of work information for
each of the 20 mandated professions;
i. Must be able to record all volunteer health professional affiliations; and
j. Must be able to verify that all volunteers across all credential levels not be
included on the U.S. Department of Health and Human Services, Office of
the Inspector General's List of Excluded Individuals/Entities(LEIE).
k. Additionally, the fully operational, ESAR-VHP-compliant, web-based
volunteer management system must be able to register, collect, and verify
the credentials and qualifications of the health professionals entered into the
system.
Z. Not use funds for research, clinical care, fund-raising activities or lobbying, construction
or major renovations, reimbursement of pre-award costs, to supplant existing state or
federal funds for activities, payment or reimbursement of backfilling costs for staff,
purchase of vehicles of any kind, uniforms or furniture, or funding an award to another
party or provider who is ineligible.
AA. Cooperate with System Agency to coordinate all planning, training and exercises
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ATTACHMENT A.3
STATEMENT OF WORK
July 1,2019 through June 30,2020
performed under this Contract with local emergency management and the Texas Division
of Emergency Management(TDEM) District Coordinators assigned to the Grantee's sub-
state region, to ensure consistency and coordination of requirements at the local level and
eliminate duplication of effort between the various domestic preparedness funding sources
in the state.
BB. Coordinate all risk communication activities with the System Agency Communications
Unit by using System Agency's core messages posted on the System Agency website and
submitting copies of draft risk communication materials to System Agency for
coordination prior to dissemination.
CC. Initiate the purchase of all equipment approved in writing by the System Agency in the
first quarter of the FY20 Contract term (July 1, 2019 — June 30, 2020), as applicable.
Failure to timely initiate the purchase of equipment may result in the loss of availability
of funds for the purchase of equipment. Requests to purchase previously approved
equipment after the first quarter in the Contract must be submitted to the assigned System
Agency contract manager.
DD. Controlled Assets include firearms, regardless of the acquisition cost, and the following
assets with an acquisition cost of$500 or more,but less than $5,000: 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. Controlled Assets are considered
Supplies.
EE. Grantee shall maintain an inventory of equipment, supplies defined as Controlled Assets,
and real property and submit an annual cumulative report of the equipment and other
property on HHS System Agency Grantee's Property Inventory Report to the assigned
System Agency contract manager by email not later than October 15 of each year.
FF. System Agency funds must not be used to purchase buildings or real property without prior
written approval from the System Agency. Any costs related to the initial acquisition of
the buildings or real property are not allowable without written pre-approval.
GG. At the expiration or termination of this Contract for any reason, title to any remaining
equipment and supplies purchased with funds under this Contract reverts to System
Agency. Title may be transferred to any other party designated by System Agency. The
System Agency may, at its option and to the extent allowed by law, transfer the
reversionary interest to such property to Grantee.
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ATTACHMENT A.3
STATEMENT OF WORK
July 1,2019 through June 30,2020
HH. Comply with all applicable federal and state laws,rules, and regulations including,but not
limited to,the following:
1. Public Law 107-188, Public Health Security and Bioterrorism Preparedness and
Response Act of 2002;
2. Public Law 113-05,Pandemic and All-Hazards Preparedness Reauthorization Act;
and
3. Texas Health and Safety Code Chapter 81.
II. Comply with all applicable regulations, standards and guidelines in effect on the beginning
date of the term of this Contract.
JJ. Submit other reports as required by System Agency. The initial reporting schedule for the
requirements is subject to change as System Agency and CDC may modify requirements
and due dates.
KK. Work with the Regional Health Care Coalition to develop comprehensive preparedness
strategies. Plans will be submitted to System Agency by the Health Care Coalition.
II. PERFORMANCE MEASURES
System Agency will monitor the Grantee's performance of the requirements and
compliance with the Contract's terms and conditions.Grantee must demonstrate adherence
to PHEP reporting deadlines and the capability to receive, stage, store, distribute, and
dispense materiel during a public health emergency. Failure to meet these requirements
may result in withholding a portion of the current PHEP base awards.
III. INVOICE AND PAYMENT
A. Grantee will request payment using the State of Texas Purchase Voucher(Form B-13) on
a monthly basis and acceptable supporting documentation for reimbursement of the
required services/deliverables. Additionally, the Grantee will submit the Financial Status
Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting
documentation,Financial Status Reports, and Match Certification Forms should be mailed
or emailed to the addresses below.
Department of State Health Services
System Agency Contract No.537-18-0120-00001
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DocuSign Envelope ID:98249D5F-7A7A-46D5-8D42-3A7A6CD7626A
ATTACHMENT A.3
STATEMENT OF WORK
July 1,2019 through June 30,2020
Claims Processing Unit, MC 1940
1100 West 49th Street
P.O. Box 149347
Austin,TX 78714-9347
FAX: (512)458-7442
EMAIL: invoices@dshs.texas.gov& CMSlnvoicesgdshs.texas.gov
B-13, B-13A, and supporting documentation should be sent to: invoices@dshs.texas.gov,
&CMSInvoices@dshs.texas.gov
FSRs should be sent to: invoices@dshs.texas.gov, FSRGrants@a,dshs.texas.gov &
CMSInvoices@dshs.texas.gov
B. Grantee will be paid on a monthly basis and in accordance with Attachment B,Budget.
C. System Agency reserves the right, where allowed by legal authority, to redirect funds in
the event of fmancial shortfalls. System Agency will monitor Grantee's expenditures on a
quarterly basis. If expenditures are below that projected in Grantee's total Contract
amount,Grantee's budget may be subject to a decrease for the remainder of the term of the
Contract. Vacant positions existing after ninety days may result in a decrease in funds.
D. Grantee may request a one-time working capital advance not to exceed 12% of the total
amount of the Contract funded by System Agency. All advances must be expended by the
end of the Contract term. Advances not expended by the end of the Contract term must be
refunded to System Agency.
E. Grantee will repay all or part of advance funds at any time during the Contract's term.
However, if the advance has not been repaid prior to the last three months of the Contract
term,the Grantee must deduct at least one-third of the remaining advance from each of the
last three months' reimbursement requests. If the advance is not repaid prior to the last
three months of the Contract term, System Agency will reduce the reimbursement request
by one-third of the remaining balance of the advance.
System Agency Contract No. 537-18-0120-00001
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DocuSign Envelope ID:98249D5F-7A7A-46D5-8D42-3A7A6CD7626A
Attachment C
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:
Primary Address of Contractor: FFATA Contact#2 Name, Email and Phone Number:
ZIP Code:9-digits Required www.usps.com DUNS Number:9-digits Required www.sam.gov
State of Texas Comptroller Vendor Identification Number (VIN) 14 Digits
Printed Name of Authorized Representative Signature of Authorized Representative
Title of Authorized Representative Date
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Department of State Health Services Form 4734—June 2013
DocuSign Envelope ID.98249D5F-7A7A-46D5-8D42-3A7A6CD7626A
Attachment C
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 n 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? n Yes 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? n Yes I 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 n 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 Blum:500000;Mary Redd:50000;Eric Gant:400000;Todd Platt:300000;
Sally Tom:300000
Provide compensation information here:
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Department of State Health Services Form 4734—June 2013