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HomeMy WebLinkAboutPR 21332: CONTACT AMENDMENT BETWEEN THE CITY OF PORT ARTHUR AND THE DEPARTMENT OF STATE HEALTH SERVICES IMMUNIZATION BRANCH. NO MATCH REQUIRED City of t,� �-2 ort rth u�_ Texas Date: March 19, 2020 To: Ron Burton, City Manager From: Judith A. Smith, RN, BSN, Director of Health Services RE: Contract Amendment between the City of Port Arthur and the Department of State Health Services Immunization Branch. No match required Nature of the Request: This contract amendment will allow the Health Department to continue its immunization program for children, adolescents and adults to eliminate barriers, expand immunization delivery, and establish uniform policies. The contract term will extend through August 31, 2021. The contract budget is amended to add funding for state fiscal year 2021 in the amount of$162,630.00. The total amount of the grant award from September 1, 2020 to August 31,2021 will not exceed$487,890.00. There is no cash match for this grant. Staff Analysis,Considerations: This grant funds salaries and fringe for 3 full-time employees. Recommendations: It is recommended that the City Council approve P.R. No. 21332,amending the contract between the City of Port Arthur and the Department of State Health Services/Immunization Division. This grant will allow the Health Department to continue the immunization program for children,adolescents, and adults. Budget Considerations: This grant will cover personnel salaries and fringe benefits. "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. 21332 03/19/2020-js RESOLUTION NO. A RESOLUTION AUTHORIZING THE FY 2020-2021 CONTRACT AMENDMENT NO. 2 BETWEEN THE CITY OF PORT ARTHUR AND THE DEPARTMENT OF STATE HEALTH SERVICES,IMMUNIZATION BRANCH-LOCAL TO EXTEND THE CONTRACT PERIOD THROUGH AUGUST 31, 2021 AND ADD FUNDING IN THE AMOUNT OF $162,630.00. THE TOTAL AMOUNT OF THIS CONTRACT WILL NOT EXCEED $487,890.00. NO CASH MATCH IS REQUIRED. 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. This contract amendment will allow the City's Health Department to continue the immunization program for children, adolescents, and adults and will help to eliminate barriers, expand immunization delivery, and establish uniform policies; and, WHEREAS, pursuant to Resolution No. 18-245, council approved the FY 2018-2019 contract on June 25, 2018, and on May 21, 2019 council approved Resolution No. 19-199. the FY 2019-2020 contract, now The Department of State Health Services desires to amend the contract to add $162,630.00 to cover the contract period September 1, 2020 through August 31, 2021. The total grant award will not exceed $487.890.00. 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. P.R. No. 21332 03/19/2020-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. 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, Texas, to continue the immunization program 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 March, 2020 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.21332 03/19/2020-js APPROVED AS TO FORM: Val Tizeno, City Attorney APPROVED FOR ADMINISTRATION: ll Jrnk/96 Ron Burton, City ManagerRN, BSN,Judith Smith, Director of Health DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 DEPARTMENT OF STATE HEALTH SERVICES CONTRACT NO. HHS000109900001 AMENDMENT NO. 2 The Department of State Health Services("DSHS"or"System Agency")and City of Port Arthur ("Grantee"), collectively referred to as the "Parties" to DSHS Contract No. HHS000109900001, effective September 1, 2018 (the "Contract"), now want to amend the Contract further. The Contract was established under the Immunization/Locals("IMM/LOCALS")Grant Program. Whereas, DSHS wants to renew the Contract for an additional one-year term; Whereas,DSHS wants to add funds to the Contract,to pay for services provided during the renewal term; Whereas,DSHS wants to revise the Statement of Work; Whereas, DSHS wants to add an updated Federal Funding Accountability and Transparency ("FFATA")certification; and Whereas,DSHS wants to amend the Guidance Document that delineates Grantee's responsibilities under the Contract. The Parties therefore agree as follows: 1. The Contract is hereby renewed. The new term of the Contract begins on September 1,2020 and ends on August 31, 2021 (the"Second Renewal Term"). 2. Article IV ("Budget") is hereby amended to add $162,630.00 to the Contract to pay for services provided in the Second Renewal Term. The total Contract amount is therefore increased from $325,260.00 to $487,890.00. All expenditures must conform with "Attachment B-2—Fiscal Year 2021 Budget." 3. Attachment A-1 to Amendment No.1, Revised Statement of Work, is hereby supplemented by adding,after the fiscal year 2020 reporting schedule,the following new schedule for required quarterly reports due in the Second Renewal Term: Report Type Reporting Period Report Due Date Programmatic 09/01/2020 to 11/30/2020 12/31/2020 Programmatic 12/01/2020 to 02/28/2021 03/31/2021 Programmatic 03/01/2021 to 05/30/2021 06/30/2021 Programmatic 06/01/2021 to 08/31/2021 10/31/2021 4. Attachment B-2—Fiscal Year 2021 Budget is hereby added to the Contract. 5. The Contract is hereby amended by adding Attachment F-2—FFATA Certification. DSHS Contract No.HHS000109900001 Page 1 of 30 Amendment 2 DocuSign Envelope ID:129CB70D-6202-4398-8D74-C04EDA382890 6. Attachment H to Amendment No. 1, Immunization/Locals Program Guidance Document, is hereby revised and restated in its entirety in Attachment H-1. 7. This Amendment shall be effective on September 1, 2020. 8. Except as modified by this Amendment, all terms and conditions of the Contract shall remain in effect. 9. Any further revision to the Contract shall be by written agreement of the Parties. Signature Page to follow Remainder of page intentionally left blank DSHS Contract No.HHS00010990000I Page 2 of 30 Amendment 2 DocuSign Envelope ID:129CB70D-6202-4398-8D74-C04EDA382890 SIGNATURE PAGE FOR AMENDMENT No. 2 DSHS CONTRACT No. HHS000109900001 DEPARTMENT OF STATE OF HEALTH CITY OF PORT ARTHUR SERVICES By: By: Name: Name: Title: Title: Date of Signature: Date of Signature: THE FOLLOWING DOCUMENTS ARE ATTACHED TO THIS AMENDMENT, AND THEIR TERMS ARE HEREBY INCORPORATED INTO THE CONTRACT BY REFERENCE: Attachment B-2 - Fiscal Year 2021 Budget Attachment F-2 - Federal Funding Accountability and Transparency (FFATA) Attachment H-1 - Immunization/Locals Program Guidance Document ATTACHMENTS FOLLOW DSHS Contract No.HHS000109900001 Page 3 of 30 Amendment 2 DocuSign Envelope ID:129CB70D-6202-4398-8D74-C04EDA382890 ATTACHMENT B-2 Fiscal Year 2021 Budget Organization Name: City of Port Arthur Program ID: IMM/LOCALS Contract Number: HHS000109900001 Budget Categories Budget for FY 2021 Personnel $114,217.00 Fringe Benefits $48,413.00 Travel $0.00 Equipment $0.00 Supplies $0.00 Contractual $0.00 Other $0.00 Total Direct Costs $162,630.00 Indirect Costs $0.00 Total $162,630.00 Remainder of page intentionally left blank DSHS Contract No.HHS000109900001 Page 4 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 ATTACHMENT F-2 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,eov 1 1 - ( _ j T-T - State of Texas Comptroller Vendor Identification Number(VIN)14 Digits Printed Name of Authorized Representative Signature of Authorized Representative Title of Authorized Representative Date -1- Department of State Health Services Form 4734—June 2013 DSHS Contract No. HHS000 109900001 Page 5 of 30 Amendment 2 DocuSign Envelope ID:129CB70D-6202-4398-8D74-C04EDA382890 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 ❑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 ❑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?❑Yes ❑No Ifyour 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),780(d))or section 6104 of the Internal Revenue Code of 1986?❑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. Provide compensation information here: -2- Department of Slate Health Services Form 4734—June 2013 DSHS Contract No.HHS000109900001 Page 6 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 ATTACHMENT H-1 IMMUNIZATION/LOCALS PROGRAM GUIDANCE DOCUMENT GRANTEE RESPONSIBILITIES 1. PROGRAM & CONTRACT MANAGEMENT 1.1. PROGRAM MANAGEMENT 1.1.01 Implement and operate an Immunization Program as a Standard Responsible Entity (Universal) 1.1.02 Identify at least one individual to act as the program contact in Required the following areas: Activity Immunization Program Manager, 1. RE Contract Coordinators, 1. RE School Compliance Coordinators, 2. RE Perinatal Hepatitis B Case Manager, 3. RE Disease Surveillance Coordinators, 4. RE Clinical Coordinators, 5. RE Texas Immunization Registry Coordinators, 6. RE TVFC &ASN Coordinators, and 1.1.03 Attend all required trainings for each Area of Work as specified Required in the Immunization Program Contractor's Guide. Ensure that Activity the Immunization Program Manager and TVFC and ASN Coordinator attend the annual Immunization Unit mandatory in- person meeting 1.1.04 Comply with the DSHS Immunization Contractor's Guide for Standard Local Health Departments which includes all immunization (Universal) grant objectives and required activities. The Immunization Contractor's Guide is Attachment A of the ILA and will be attached to the executed contract 1.1.05 Annually complete one LHD Deputization Addendum Form Required (EF11-13999) for all Provider Identification Numbers(PIN) Activity associated with the LHD Grantee to ensure eligibility to provide immunization services to underinsured children 1.1.06 Maintain staffmg levels adequate to meet the required activities Standard of this contract and to assure expenditure of all contract funds (Universal) 1.1.07 Develop and implement an employee immunization policy for Required Grantee's immunization program staff according to CDC Activity recommendations DSHS Contract No.HHS000109900001 Page 7 of 30 Amendment 2 DocuSign Envelope ID: 129C670D-6202-4398-8D74-C04EDA382890 1.1.08 Maintain a record of orientation(new staff) and ongoing Required training for existing contract-funded staff involved in the Activity provision of immunization services 1.1.09 Inform DSHS (in writing)of any changes(both departures and Required arrivals) in LHD Medical Director, Immunization Program Activity Manager and all other positions listed under activity 1.1.02 within 30 days of staffing changes 1.1.10 Submit a written notification for contract-funded staff positions Required that remain vacant more than 90 days Activity 1.1.11 Have a standard method to document all work time spent Standard performing immunization activities for staff who are partially (Universal) funded with immunization contract funds 1.1.12 Use the results of the community assessment conducted in Suggested activity 4.7.01 to review and address an immunization need Activity within the LHD jurisdiction 1.2. PROGRAM COMPLIANCE 1.2.01 Comply with all applicable federal and state regulations and Standard statutes as amended, (Universal) including but not limited to: 1. Human Resources Code §42.043,VTCA; 2. Education Code §§38.001-38.002,VTCA; 3. Health and Safety Code §§12.032, 81.023, and 161.001- 161.009,VTCA; 4. TAC Title 25, Chapter 97; 5. TAC Title 25, Chapter 96; 6. TAC Title 25,Chapter 100; 7. 42 USC §§247b and 300 aa-25; 8. Omnibus Budget Reconciliation Act of 1993, 26 USC §4980B 1.2.02 Ensure compliance with Health and Human Services(HHS) Standard Deputization Guidance. Activities under this requirement (Universal) shall be conducted in accordance with the DSHS Immunization Contractor's Guide for Local Health Departments 1.3. FINANCIAL MANAGEMENT DSHS Contract No.HHS000109900001 Page 8 of 30 Amendment 2 DocuSign Envelope ID. 129CB70D-6202-4398-8D74-C04EDA382890 1.3.01 Agree DSHS reserves the right,where allowed by legal Standard authority,to redirect funds in the event of financial shortfalls (Universal) 1.3.02 Submit monthly invoices with appropriate supplemental Required documentation and request monthly payments using the State Activity of Texas Purchase Voucher(Form B-13)and in accordance with the DSHS Immunization Contractor's Guide for Local Health Departments 1.3.03 Agree DSHS will pay Grantee on a cost reimbursement basis Standard (Universal) 1.3.04 Adhere to travel rates set by the State of Texas TexTravel Standard unless the LHD has their own travel policy. (Universal) 1.3.05 Review monthly contract funding expenditures to ensure that all Standard funds will be properly expended before the end of the contract (Universal) period 1.3.06 Lapse no more than 5 percent of total funded amount of the Required contract Activity 1.3.07 Submit requests to move more than 25%of the total contract Standard amount between direct budget categories in writing to the (When DSHS Contract Management Section(CMS) in Austin and Applicable) obtain approval before monies can be transferred 1.3.08 Expend funds consistently throughout the contract term, Suggested approximately 25%per quarter Activity 1.4. CONTRACT MANAGEMENT 1.4.01 Initiate the purchase of approved equipment purchases in the first Standard quarter of the Contract term. Requests to purchase previously (When approved equipment after the first quarter must be submitted to the Applicable) contract manager. Changes to the approved equipment budget category must be approved by DSHS prior to the purchase of equipment. If a Grantee would like to deviate from the approved equipment budget, a written request to amend the budget is required 1.5. CONTRACT QUALITY ASSURANCE 1.5.01 Participate in remote and on-site technical assistance Required Activity 1.5.02 Participate in on-site contract evaluation visits Required Activity DSHS Contract No.HHS000109900001 Page 9 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 1.6. CONTRACT ACCOUNTABILITY 1.6.01 Submit Corrective Action Plan(CAP)letter to Public Health Region Required Program Manager and DSHS Contract Management Section(CMS) Activity within 30 days after the date of the written notification from DSHS CMS of the on-site evaluation findings(if applicable) 1.6.02 Maintain property records for property and equipment funded or Standard property provided by grant funds (Universal) 1.7. REQUIRED REPORTING 1.7.01 Complete and submit Immunization Inter-Local Agreement(ILA) Required Quarterly Report and supplemental documents according to the Activity formats, mechanisms, and timeframes specified in the DSHS Immunization Contractor's Guide for Local Health Departments 1.7.02 Report program income(PI)generated as a result of the DSHS Required immunization contract activities on the quarterly financial status Activity report(FSR) 1.7.03 Ensure all program income(PI) generated as a result of the DSHS Standard immunization contract activities is expended in accordance with the (Universal) , DSHS Immunization Contractor's Guide for Local Health Departments 1.7.04 Submit quarterly FSRs to Accounts Payable by the last business Required day of the month following the end of each quarter for review and Activity fmancial assessment. Submit the final FSR no later than forty-five (45)calendar days following the end of the applicable term 2. FACILITY IMMUNIZATION ASSESSMENTS 2.1. CHILDCARE& SCHOOL COMPLIANCE 2.1.01 Assess compliance with vaccine requirements at assigned Standard schools and childcare facilities (Universal) DSHS Contract No.HHS000109900001 Page 10 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 2.1.02 Complete 100%of assigned childcare facility Required audits/assessments. By July 15 of contract year, local health Activity department staff will complete 100%of assigned childcare audits and submit into the Children Health Reporting System (CHRS) 2.1.03 Complete 100%of assigned public and private school audits, Required assessments, and/or validation/retrospective surveys in Activity accordance with the DSHS Immunization Contractor's Guide for Local Health Departments by June 15 of contract year, local health department staff will complete 100%of assigned school audits and submit electronically(probably in Survey Gizmo,possibly via email) 2.2. CHILDCARE& SCHOOL COMPLIANCE QA 2.2.01 Provide education to school and childcare facilities with high Required provisional,delinquency, and/or exemption rates at time of Activity audit or when noncompliant records are identified. Report education provided to school or childcare staff in accordance with the DSHS Immunization Contractor's Guide for Local Health Departments 2.2.02 Provide feedback to DSHS ACE Group regarding Required trends/issues for vaccine requirements in accordance with the Activity DSHS Immunization Contractor's Guide for Local Health Departments 2.2.03 Contact schools/districts to remind them to report during the Required Annual School Survey reporting period in accordance with Activity the DSHS Immunization Contractor's Guide for Local Health Departments 2.3. FIRST RESPONDER IMMUNIZATION ASSESSMENTS 2.3.01 Educate and inform first responder facilities on the use of the Suggested Texas Immunization Registry to assess first responder Activity immunization records and forecast any future immunization needs. Use the First Responder Immunization Toolkit(FRIT) to drive these activities DSHS Contract No.HHS000109900001 Page 11 of 30 Amendment 2 DocuSign Envelope ID: 129C570D-6202-4398-8D74-C04EDA382890 3. MANAGING TVFC AND ASN PROVIDERS 3.1. PROVIDER RECRUITMENT 3.1.01 Recruit additional TVFC providers to administer vaccines to Suggested program-eligible populations. The goal is to increase each Activity local health department's provider enrollment by 5% 3.1.02 Ensure New Enrollment Checklist(11-15016)is completed Required for all clinics that join the TVFC/ASN Program Activity 3.1.03 Collaborate with medical societies and/or local health Suggested provider organizations to identify providers to recruit and Activity enroll 3.2. PROVIDER RETENTION 3.2.01 Sustain a network(through re-enrollment)of TVFC providers Required Activity to administer vaccines to program-eligible populations 3.2.02 Promote TVFC and ASN Provider achievements: Suggested Activity - Implement incentives for provider sites that reach vaccination coverage rate goals. - Implement incentives to recognize sites during national nhcPrvanrPc!i P NTTW NUM and NTVW\ 3.3. PROVIDER EDUCATION DSHS Contract No.HHS000109900001 Page 12 of 30 Amendment 2 DocuSign Envelope ID: I29CB70D-6202-4398-8D74-C04EDA382890 3.3.01 Provide a training for TVFC and ASN providers within the Suggested LHD Grantee's jurisdiction on the policies outlined in the Activity TVFC and ASN Provider Manual and recommended procedures for implementing them. These include: - procedures for following storage and handling guidelines - procedures for vaccine management - procedures for using the DSHS vaccine management system(EVI) - procedures for vaccine borrowing - procedures for other compliance guidelines - appropriate reporting of vaccine adverse events - appropriate routine and emergency vaccine storage and handling plans - meeting the federal requirement that the most current Vaccine Information Statements(VIS) (available at (http://www.cdc.gov/vaccines/hcp/vis/index.html)must be distributed to patients prior to patient vaccination 3.3.02 Notify providers of TVFC and ASN updates and changes to Standard program policies and procedures. (Universal) Notify TVFC/ASN providers of the following: - CDC and DSHS Announcements - TVFC/ASN Trainings - Vaccine storage and handling policy updates - Vaccine ordering changes - Vaccine choice 3.3.03 Educate and assist TVFC and ASN providers on a quarterly Standard basis with Provider Choice, as necessary (Universal) 3.3.04 Inform TVFC and ASN providers of the most up-to-date, Standard DSHS-produced immunization information for their offices (Universal) 3.3.05 Identify TVFC and ASN providers experiencing high volumes Required Activity of vaccine loss and develop process improvements/trainings aimed at reducing the amount of vaccine loss(including wasted and expired) in their clinics 3.4. PROVIDER VACCINE MANAGEMENT DSHS Contract No.HHS00010990000I Page 13 of 30 Amendment 2 DocuSign Envelope ID: 129C670D-6202-4398-8D74-C04EDA382890 3.4.01 Utilize the DSHS Inventory Tracking Electronic Asset Required Activity Management System(iTEAMS)reports and other provider submitted reports to perform 100% of quality assurance reviews on the following TVFC and ASN: -monthly biological reports(doses administered and current inventory), -vaccine orders, -temperature logs and - clinic hours of operation from TVFC and ASN providers in LHD Grantee's jurisdiction. Address all issues identified during review. 3.4.02 Transfer vaccines that cannot be stored within provider Standard offices(ex. accidental large orders) and vaccines (Universal) approaching expiration between providers in LHD Grantee's jurisdiction for immediate use 3.4.03 Ensure provider participation in vaccine ordering and Standard inventory management using the Electronic Vaccine (Universal) Inventory(EVI) system -Educate providers regarding vaccine ordering policies -Train providers to use the EVI system for inventory and order entry 3.4.04 Assist TVFC and ASN providers in LHD Grantee's Standard jurisdiction on the maintenance of appropriate vaccine stock (Universal) levels. Activities under this requirement shall be conducted in accordance with the DSHS Immunization Contractor's Guide for Local Health Departments and the current TVFC and ASN Program Operations Manual for Responsible Entities 3.4.05 Train TVFC and ASN providers within LHD Grantee's Standard jurisdiction to ensure that expired and spoiled/wasted (Universal) vaccines are appropriately identified and entered into the Electronic Vaccine Inventory(EVI)system. Train providers to complete returns to CDC's centralized distributor within six months of product expiration 3.4.06 Ensure that 100%of TVFC providers within the LHD Required Activity Grantee's jurisdiction complete the annual influenza pre-book survey 3.5. PROVIDER QUALITY ASSURANCE DSHS Contract No.HHS000109900001 Page 14 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 3.5.01 Utilize the CDC Provider Education Assessment and Reporting Required Activity (PEAR) system and CDC Immunization Quality Improvement for Providers(IQIP)database to document TVFC compliance and IQIP site visits for all subcontracted clinics and non-LHD Grantee's clinics (as applicable) 3.5.02 Utilize the CDC PEAR system and directly enter data into PEAR Required Activity to document TVFC unannounced storage and handling visits to a minimum of 10%of providers within the LHD Grantee's jurisdiction 3.5.03 Utilize the CDC PEAR system and directly enter data into PEAR Required Activity to document TVFC Unannounced Storage and Handling Visits, Compliance Visits and other visits conducted at TVFC provider offices 3.5.04 Complete and document 100%of the follow-up activities for Required Activity TVFC quality assurance visits within required timeframes 3.5.05 Utilize Texas Immunization Registry or DSHS-provided coverage Required Activity rates to assess immunization practices and coverage rates for all subcontracted entities and non-LHD Grantee's clinics(as applicable) 3.5.06 Review 100%of re-enrollment applications from TVFC and ASN Required Activity providers in your jurisdiction by the DSHS specified deadline 3.5.07 Ensure that expired,wasted, and unaccounted-for vaccines Standard (excluding flu)do not exceed 5%in TVFC provider clinics within (Universal) the LHD Grantee's jurisdiction 3.5.08 Review monthly reports to ensure data quality. This includes: Required Activity - Identify sites that have not administered or ordered vaccine in the previous six months. Conduct a discussion and develop a plan of action - Identify sites that are suspended to ensure 90 days is not exceeded - Ensure enrollment and withdrawal forms are submitted correctly and on time to the PHR staff 3.5.09 Review submitted reports to ensure data quality. This includes: Suggested Activity - Quarterly,review 25%of enrolled sites to ensure contacts are listed correctly in EVI. - Quarterly,review 25% of enrolled sites and provide education for the Vaccine borrowing and Vaccine transfer forms DSHS Contract No.HHS000109900001 Page 15 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 3.5.10 Review monthly data logger reports for 25%of providers in LHD Suggested Grantee's jurisdiction to validate the accuracy of provider- Activity submitted monthly temperature reporting forms 3.5.11 Review monthly data logger reports to validate the accuracy of Standard provider-submitted monthly temperature reporting forms for all (Conditional) providers within LHD Grantee's jurisdiction who experience a vaccine loss as a result of temperature excursions 3.5.12 Conduct a monthly review of 10%of randomly selected providers Suggested in LHD Grantee's jurisdiction to identify vaccine loss report forms Activity that were completed in EVI but were not submitted 3.5.13 Conduct a quarterly review of 25% of providers in LHD Grantee's Suggested jurisdiction to identify those that have adjusted more than 10%of Activity their vaccine inventory 3.5.14 Conduct a quarterly review of 25%of providers in LHD Grantee's Suggested jurisdiction to ensure the reported patient population matches the Activity number of doses ordered 3.5.15 Utilize the CDC IQIP database and directly enter data to document Required IQIP follow-ups visits conducted at TVFC provider offices Activity 3.6. PROVIDER ACCOUNTABILITY 3.6.01 Track,report and follow up on vaccine fraud and abuse cases Standard (Universal) 3.6.02 Complete program evaluation activities with TVFC and ASN Required providers to address issues identified as noncompliance issues Activity For all TVFC providers, document corrective action plans in the CDC PEAR system as a contact 3.7. RE STAFF EDUCATION 3.7.01 Train LHD Grantee's staff to follow the policies and procedures Required Activity outlined in the TVFC&ASN Program Operations Manual for Responsible Entities. Provide training on TVFC and ASN requirements and updates(as described in the TVFC&ASN Program Operations Manual for Responsible Entities)annually at a minimum DSHS Contract No.HHS000109900001 Page 16 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 3.7.02 For personnel identified by DSHS, attend and/or complete the Required Activity following trainings: - CDC Immunization Trainings - TVFC/ASN Annual Trainings - Annual Responsible Entity Training - Public Health Region(PHR)Trainings 3.7.03 Ensure that the TVFC &ASN Coordinator conducts quality Suggested Activity assurance on 10%of the temperature recording logs that were reviewed by their staff each quarter 3.8. RE COMPLIANCE 3.8.01 Comply with the current DSHS Immunization Contractor's Standard Guide for Local Health Departments and the TVFC and ASN (Universal) Operations Manual for Responsible Entities 3.8.02 Receive regional approval for any vaccine transfers and Standard document those transfers in EVI within 24 hours of the transfer (Universal) occurring 3.8.03 Address general inquiries by providers about the TVFC/ASN Standard Program, and ensure timely follow-up on requests for (Universal) information 3.8.04 Ensure that providers within LHD Grantee's jurisdiction are Required Activity adhering to the vaccine borrowing procedures outlined in the TVFC and ASN Provider Manual Report the number of borrowing forms submitted by quarter in the Immunization Inter-Local Agreement(ILA)Quarterly Report 3.9. RE EMERGENCY RESPONSE 3.9.01 Communicate the importance of an Emergency Vaccine Storage Standard(Universal) and Handling Plan to all clinics in the LHD Grantee's jurisdiction. Provide technical assistance to support the successful activation of each clinic's Emergency Vaccine Storage and Handling Plan 3.9.02 Transfer, accept, and store TVFC and ASN vaccines from Standard(Universal) clinics in the LHD Grantee's jurisdiction if there is a failure in the clinic's Emergency Vaccine Storage and Handling Plan DSHS Contract No.HHS000109900001 Page 17 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 3.9.03 Be prepared to pack and ship vaccine to other sites, as directed Required Activity by the DSHS Immunization Unit 4. EPIDEMIOLOGY & SURVEILLANCE 4.1. PERINATAL HEPATITIS B CASE IDENTIFICATION 4.1.01 Conduct identification and case management of perinatal Standard(Universal) hepatitis B cases 4.1.02 Determine the number of newborns that do not receive the Required Activity first dose of the hepatitis B vaccine and/or HBIG and work with those facilities to ensure all at-risk infants receive the hepatitis B vaccine series and HBIG within 12 hours of birth 4.1.03 Ensure timely follow-up and reporting of case status of Required Activity possible moms as reported by DSHS within 2 weeks of receipt of report 4.2. PERINATAL HEPATITIS B CASE MANAGEMENT 4.2.01 Contact and provide case management to 100%of hepatitis Required Activity B surface antigen-positive pregnant women identified, along with their infants and contacts 4.3. PERINATAL HEPATITIS B REPORTING 4.3.01 For all cases documented as'lost-to-follow-up'on the Required Activity Perinatal Hepatitis B case management form, report the number and types of attempted activities performed in locating the mother or guardian of the infant to the DSHS Immunization Unit on the Perinatal Hepatitis B case management form 4.4. PERINATAL HEPATITIS B EDUCATION DSHS Contract No.HHS000109900001 Page 18 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 4.4.01 Require Perinatal Hepatitis B Case Manager to attend the Required Activity biannual conference 4.4.02 Conduct educational training for hospitals, prenatal care Required Activity providers,pediatricians,birthing facilities, and other healthcare providers/facilities within the Grantee's jurisdiction, to increase identification, timely reporting, and appropriate case management of pregnant woman with hepatitis and their infants and contacts. 4.4.03 Work with partners, as appropriate, to ensure coordination Standard(Universal) of activities aimed at preventing perinatal hepatitis B transmission 4.5. DISEASE SURVEILLANCE 4.5.01 Complete investigation and document at least 90%of Required Activity confirmed or probable reportable vaccine-preventable disease(VPD) cases within thirty(30)days of initial report to public health 4.5.02 Adhere to the DSHS Emerging and Acute Infectious Standard(Universal) Disease Guidelines and current Epi Case Criteria Guide in conducting all activities 4.5.03 Ensure all new VPD surveillance staff attend'Introduction Required Activity to NBS'training and complete the certification process in order to gain access to the NBS system 4.5.04 Complete all data entry into the Texas National Electronic Standard(Universal) Disease Surveillance System(NEDSS)Base System (NBS)following the NBS Data Entry Guidelines 4.5.05 Routinely review and follow up on all VPD laboratory Standard (Universal) reports received, including electronic lab reports (ELRs) generated through NBS in a timely fashion 4.5.06 Verify and enter complete vaccination history in NBS on Required Activity all VPD investigations with case status of confirmed or probable. Complete vaccination history can be assessed through the Texas Immunization Registry, provider offices, school records, and/or patient records DSHS Contract No.HHS000109900001 Page 19 of 30 Amendment 2 DocuSign Envelope ID: 129C B70D-6202-4398-8D74-C04EDA382890 4.5.07 Initiate vaccine-based disease control activities by Standard (Universal) identifying population in need of a vaccination response and requesting vaccination services for that population by contacting the DSHS Vaccine-Preventable Disease(VPD) Surveillance Team Lead 4.6. DISEASE SURVEILLANCE EDUCATION 4.6.01 Educate physicians, laboratories,hospitals, schools, child- Suggested Activity care staff, and other health providers on VPD reporting requirements 4.7. NEEDS ASSESSMENT 4.7.01 Conduct a community needs assessment to identify gaps Required Activity in coverage rates or"pockets of need"for immunization activities. • Select an area of focus from the list of measurements provided in the Metrix or obtain approval from Immunization Unit epis for an alternate area of focus. • Create an assessment plan,collect data, gather stakeholder feedback, and analyze the information 4.7.02 Design an intervention to address the need identified in Suggested Activity 4.7.01 PROVIDING A VACCINE SAFETY NET 5.1. CLINIC ENROLLMENT 5.1.01 Enroll all eligible LHD clinics into the TVFC and ASN Required Programs as providers Activity 5.1.02 Provide immunization services according to national Standard standards for immunization practices for infants, children, (Universal) adolescents, adults, and healthcare workers. LHD clinics will comply with the National Childhood Vaccine Injury Act of 1986 DSHS Contract No.HHS000109900001 Page 20 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA38289D 5.2. CLINIC STAFF TRAINING 5.2.01 Train all clinic staff on the policies outlined in the TVFC Required and ASN Provider Manual and LHD procedures for Activity implementing them. These include: - procedures for following storage and handling guidelines - procedures for vaccine management - procedures for using the DSHS vaccine management system(EVI)procedures for other compliance guidelines 5.2.02 Develop clinic staff education requirements. Ensure that Required persons who administer vaccines and staff that are involved Activity in the vaccine administration process(including those who screen immunization records and administer vaccines)to follow Advisory Committee on Immunization Practices (ACIP)standards for children and adults and are knowledgeable on immunizations and immunization practices This can be accomplished by having staff complete the most current CDC Pink Book(Epidemiology and the Prevention of Vaccine Preventable Diseases)training and appropriate Vaccine Education Online(VEO)modules 5.2.03 Develop eligibility screening and documentation policy for Required all LHD clinics. Provide training to all staff on appropriate Activity screening and documentation for TVFC eligibility to ensure TVFC vaccine is administered only to TVFC-eligible children. Implement policy and plan for routine adherence to eligibility policies 5.2.04 Develop and implement a policy on the use of the Texas Required Immunization Registry. Train LHD staff on conducting Activity client searches in the Texas Immunization Registry and how to effectively enter client demographic and immunization information 5.3. CLINIC IMMUNIZATION PRACTICES 5.3.01 Comply with current applicable state and federal standards, Standard policies and guidelines for clinics (Universal) 5.3.02 Provide vaccines regardless of residency or ability to pay Standard (Universal) 5.3.03 Adhere to clinical records retention schedule Standard (Universal) DSHS Contract No.HHS000109900001 Page 21 of 30 Amendment 2 DocuSign Envelope ID 129CB70D-6202-4398-8D74-C04EDA382890 5.3.04 Explain the benefits of a"medical home"and assist the Standard parent/guardian in obtaining or identifying the child's (Universal) medical home 5.3.05 Discuss the next ACIP-recommended vaccines and refer the Standard client to a medical home to complete the vaccination series (Universal) 5.3.06 Maintain a list of current providers within the LHD's Standard jurisdiction who accept children on Medicaid or CHIP and (Universal) make this list available to clinic clients and families as needed 5.3.07 Refer uninsured clients to Medicaid or the Children's Health Standard Insurance Program(CHIP) as appropriate (Universal) 5.3.08 Ensure that all ACIP-recommended vaccines are routinely Standard available and offered to TVFC patients (Universal) 5.3.09 Ensure that all vaccines listed on the ASN vaccine formulary Standard are available and offered to eligible adult patients (Universal) 5.3.10 Establish"standing orders"for vaccination in LHD Grantee's Required clinics that are consistent with legal requirements for standing Activity orders(including,but not limited to,those found in the Texas Medical Practice Act) 5.3.11 Search for the client's immunization history at every client Standard encounter. Compare all immunization histories(Texas (Universal) Immunization Registry,TWICES or EMR system,validated patient-held records,clinic medical record) and enter into the Texas Immunization Registry all historical immunizations not in the Registry at every client encounter. Review the client's record for vaccines due and overdue according to the CDC recommended schedules at: https://www.cdc.gov/vaccines/schedules/index.html 5.3.12 Offer updated Immunization History Report to the client or Standard client's parent or guardian at every client encounter (Universal) 5.3.13 Follow and explain recommended guidelines for obtaining Standard and submitting ImmTrac2 consent forms according to the (Universal) instructions found at http://www.dshs.texas.gov/immunise/immtrac/forms.shtm 5.3.14 Report to the Texas Immunization Registry all immunizations Standard administered to consented children(younger than 18 years of (Universal) age)and consented adults in LHD Grantee's clinics,either by entering data directly into the Registry or through electronic data exchange via TWICES or an electronic medical record (EMR)system DSHS Contract No.HHS000109900001 Page 22 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 5.3.15 Verbally and with DSHS-produced literature, inform parents Standard at LHD Grantee's clinics about the Texas Immunization (Universal) Registry, the benefits of inclusion in the Registry, and the importance of maintaining a complete immunization history in the Registry 5.3.16 Update all demographic information, including address, Standard email, and telephone number, at every client encounter in (Universal) EMR and the Texas Immunization Registry 5.3.17 Verbally educate patients and parents/guardians about the Standard benefits and risks of vaccination and distribute DSHS (Universal) educational materials, as applicable,as part of this conversation 5.3.18 Follow only medically supportable contraindications to Standard vaccination (Universal) 5.3.19 Provide immunization services at times other than 8 am to 5 Required pm, Monday through Friday, at least once per month Activity 5.3.20 Institute infection control practices, including effective hand Standard washing and management of hazardous waste (Universal) 5.3.21 Maintain confidentiality of client information Standard (Universal) 5.3.22 Recommend the simultaneous administration of all needed Standard vaccines for the patient (Universal) 5.3.23 Implement clinic policy on screening and documentation of Standard eligibility for TVFC vaccines. The policy must be consistent (Universal) with the TVFC requirements outlined in the current TVFC and ASN Provider Manual 5.3.24 Participate in public health emergencies and exercises that Suggested may require vaccine administration to the public or first Activity responders 5.3.25 Conduct outreach activities to raise the immunization Suggested coverage levels of uninsured adults by visiting sites such as Activity homeless shelters,halfway houses,day labor sites or other locations 5.3.26 Coordinate with community vaccinators to conduct annual Suggested employee-based vaccination clinics for influenza vaccine Activity administration 5.4. CLINIC VACCINE MANAGEMENT DSHS Contract No.HHS000109900001 Page 23 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 5.4.01 Ensure that all expired and spoiled/wasted vaccines are Required Activity appropriately identified and entered into the Electronic Vaccine Inventory(EVI) system for the LHD Grantee's clinics 5.4.02 Submit returns for all vaccines distributed via CDC's Standard centralized distributor back to the centralized distributor for (Universal) returns processing 5.5. CLINIC QUALITY ASSURANCE 5.5.01 Ensure that appropriate routine and emergency vaccine Required Activity storage and handling plans are in place at each of the LHD Grantee clinic locations 5.5.02 Ensure that expired,wasted, and unaccounted-for vaccines Standard (excluding flu)do not exceed 5 percent in LHD Grantee's (Universal) clinics 5.6. CLINIC REPORTING 5.6.01 Conduct timely reporting of monthly clinic activities by Required Activity recording vaccine inventory,doses administered, temperature logs and other reportable activities by the 5th of each month as described in the TVFC/ASN Provider Manual 5.6.02 Report all notifiable conditions as specified in the DSHS Standard(Universal) Immunization Contractor's Guide for Local Health Departments • 5.6.03 Report all vaccine adverse events as specified in the DSHS Standard(Universal) Immunization Contractor's Guide for Local Health Departments 5.6.04 Report the number of unduplicated underinsured clients Required Activity and the number of doses administered to underinsured children monthly as specified in the DSHS Immunization Contractor's Guide for Local Health Departments 5.6.05 Conduct monthly reporting of doses administered to Required Activity women veterans, as required in the ASN Program DSHS Contract No.HHS000109900001 Page 24 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 ¢, INCREASING USE OF THE TEXAS IMMUNIZATION REGISTRY 6.1. TEXAS IMMUNIZATION REGISTRY OUTREACH FOR IMMUNIZATION RECORDS 6.1.01 Conduct Texas Immunization Registry outreach to Suggested organizations regarding missing vaccinations for children and Activity adults for whom consent has been granted but who do not have complete immunization records 6.2. TEXAS IMMUNIZATION REGISTRY OUTREACH FOR PATIENT CONSENTS 6.2.01 Conduct activities aimed at increasing the consent rate for all Suggested age groups, including adults and individuals identified as Activity recently moved in-state 6.2.02 Conduct at least twelve(12)outreach and educational Required Activity activities focused on 18-year-olds in high schools and colleges/universities in LHD Grantee's jurisdiction 6.3. TEXAS IMMUNIZATION REGISTRY OUTREACH TO USERS 6.3.01 Conduct outreach to existing Registry users who have not Required Activity logged into the Registry in the last 90 days 6.3.02 Provide orientation to all new Texas Immunization Registry Suggested organizations within the LHD Grantee's jurisdiction at least Activity once a year and maintain documentation of all technical assistance provided(e.g.,telephone logs). Provide education and training on the effective use of the Texas Immunization Registry according to the Guidelines for Increasing the Use of the Texas Immunization Registry Identify and assist newly registered providers and new users reporting to the Texas Immunization Registry 6.4. TEXAS IMMUNIZATION REGISTRY USER EDUCATION 6.4.01 Provide education,training, and technical assistance to Suggested Activity promote the effective use of the Texas Immunization Registry by organizations DSHS Contract No.HHS000109900001 Page 25 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 6.4.02 Identify and.assist providers to establish electronic Required Activity affirmation of consent 6.5. TEXAS IMMUNIZATION REGISTRY PROMOTION 6.5.01 Promote the use of the Texas Immunization Registry to Required organizations within the LHD Grantee's jurisdiction that are Activity not currently enrolled in the Registry. Identify all providers who administer vaccine in awardee's jurisdiction, including both pediatric and adult immunization providers. Educate them on their statutory requirement to report immunizations and on the enrollment process 6.5.02 Provide education and technical assistance to birth registrars on Suggested the effective use of the Texas Immunization Registry Activity 6.5.03 Collaborate with prenatal healthcare providers,birth registrars, Suggested hospital staff,pediatricians, and other entities to educate Activity parents, expectant parents, and providers about the Texas Immunization Registry and the benefits of participation. This includes the dissemination of DSHS educational materials as appropriate 6.6. TEXAS IMMUNIZATION REGISTRY PROGRAM QUALITY IMPROVEMENT 6.6.01 Review the monthly Provider Activity Report(PAR)to Required Activity identify organizations who are inactive or not routinely submitting immunization data or adding consented clients. Prioritize these organizations for outreach activities 6.6.02 Review the quarterly Consent Accepted Rate Evaluation Required Activity (CARE)report to target organizations with largest client volume and/or lowest consent acceptance rate. Prioritize these organizations for outreach activities 6.6.03 Conduct a minimum of 60 Texas Immunization Registry Required Activity organization quality improvement assessments per FTE each year as described in the Guidelines for Increasing the Use of the Texas Immunization Registry. (For jurisdictions with less than 60 orgs, conduct quality improvement assessment visits to 100%of your orgs) DSHS Contract No.HHS000109900001 Page 26 of 30 Amendment 2 DocuSign Envelope ID. 129C B70D-6202-4398-8D74-C04EDA382890 Z EDUCATION AND PARTNERSHIPS 7.1 PUBLIC EDUCATION 7.1.01 Inform and educate the public about vaccines and vaccine- Required preventable diseases Activity 7.1.02 Inform the general public about the TVFC and ASN Programs Required and the eligibility criteria for qualifying for the programs Activity 7.2 PROVIDER EDUCATION 7.2.01 Educate and update providers on the most current ACIP Suggested recommendations for all age groups Activity 7.2.02 Inform and highly recommend to the medical community and Suggested local providers within the LHD Grantee's jurisdiction the most Activity current Centers for Disease Control and Prevention(CDC) Epidemiology and Prevention of Vaccine-Preventable Disease (EPI-VAC)training(https://www.cdc.gov/vaccines/ed/webinar- e,v/index.html). The most current"Pink Book,"titled Epidemiology and Prevention of Vaccine-Preventable Diseases,can be found on the CDC website at http://www.cdc.gov/vaccines/pubs/pinkbook/index.html 7.2.03 Provide information to community healthcare employers Suggested (hospitals, clinics, doctor offices, long-term care facilities) about Activity the importance of vaccination of healthcare workers 7.2.04 Provide training relating to Standards for Child and Adolescent Suggested Immunization Practices and Standards for Adult Immunization Activity Practices to all immunization providers within LHD Grantee's jurisdiction 7.2.05 Provide training opportunities and/or resources to assist Required immunization providers in communicating with patients and/or Activity parents(e.g.,making a strong recommendation, addressing vaccine hesitancy, etc.) DSHS Contract No.HHS000109900001 Page 27 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 7.3 STAFF EDUCATION 7.3.01 Work to ensure that all Immunization Program Grantee staff are Standard knowledgeable about vaccines and VPDs (Universal) 7.3.02 Develop and implement a written communications and Required Activity customer service plan for Grantee's staff to ensure customers receive consistent, correct immunization information and services in a courteous and friendly manner on a timely basis 7.3.03 Educate healthcare workers on the importance of keeping Required Activity themselves up-to-date with the vaccine schedule 7.4 COALITION BUILDING 7.4.01 Appoint an immunization coalition coordinator Required Activity 7.4.02 Attend and participate in required coalition trainings sponsored Required Activity by DSHS 7.4.03 Develop and maintain a planning group with the goal of Suggested Activity sustaining a coalition 7.4.04 Engage and recruit community groups and immunization Suggested Activity stakeholders into a coalition 7.4.05 Facilitate and host coalition meetings Suggested Activity 7.4.06 Participate in monthly calls to provide updates on coalition Required Activity collaboration activities 7.4.07 Provide signed letters of agreement and other documentation of Suggested Activity commitment to participate in coalition 7.4.08 Document communications,group meetings, and planning of Required Activity activities that promote the best practices identified in contract agreement(documents are to be accessible during site visits) 7.5 COMMUNITY PARTNERSHIP 7.5.01 Plan and implement community education activities and Required Activity partnerships aimed at improving and sustaining immunization coverage levels 7.5.02 Conduct outreach and collaborative activities with American Required Activity Indian tribes, if applicable DSHS Contract No.HHS000109900001 Page 28 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 7.5.03 Participate in at least one collaborative meeting concerning Required Activity tribal health issues,concerns,or needs with American Indian tribal members, if applicable 7.5.04 Coordinate educational and other activities with local Women, Suggested Activity Infants, and Children(WIC)programs to ensure that children participating in WIC are screened and referred to their"medical home"for vaccination using a documented immunization history in accordance with the Standards for Child and Adolescent Imm»ni7ation Practices 7.5.05 Offer educational opportunities to all WIC Programs in the Suggested Activity service area, including information about online and satellite- broadcast continuing education opportunities from the CDC Continuing Education website at https://www.cdc.gov/vaccines/ed/index.html 7.5.06 Engage in education and partnerships aimed at reducing or Required Activity eliminating coverage disparities by race, ethnicity, and socioeconomic status 7.5.07 Maintain a contact list of providers,hospitals, schools, child- Required Activity care facilities, social service agencies, and community groups involved in promoting immunizations and reducing vaccine- preventable diseases 7.5.08 Participate in special initiatives as directed by the DSHS Required Activity Immunization Unit 7.5.09 Implement the DSHS Immunization Ambassador Program Required Activity throughout Grantee's jurisdiction 7.6 STAKEHOLDER ENGAGEMENT 7.6.01 Attend all Texas Immunizers and Stakeholders Working Required Activity Groups(TISWG)and other designated stakeholder meetings (these meetings can be attended remotely) 7.6.02 Host at least 1 immunization stakeholder meeting per Suggested Activity quarter(4 per contract year) 7.7 MEDIA CAMPAIGNS 7.7.01 Distribute ASN information and educational materials at Required Activity venues and clinics that serve eligible adults DSHS Contract No.HHS000109900001 Page 29 of 30 Amendment 2 DocuSign Envelope ID: 129CB70D-6202-4398-8D74-C04EDA382890 7.7.02 Distribute TVFC information and educational materials at Required Activity venues that parents of TVFC-eligible children might frequent 7.7.03 Participate,when directed, in statewide media campaigns by Required Activity distributing DSHS-developed and produced public service announcements and materials to local television and radio stations,newspapers,parent publications,university newspapers,high school newspapers, and neighborhood newspapers 7.7.04 Promote www.Immuni7eTexas.com,the Immunization Unit's Required Activity website; and any other Immunization Unit newsletters to providers in the LHD Grantee's jurisdiction 7.7.05 Use national immunization observances as opportunities to Required Activity conduct specific education and promotional activities to give emphasis to the importance and benefits of vaccines:National Infant Immunization Week(NIIW),National Immunization Awareness Month(NIAM), and National Influenza Immunization Week(NIIW) 7.7.06 Share available federal, state, and/or local adolescent Required Activity vaccination coverage and/or vaccine-uptake-related data with partner organizations, adolescent immunization providers, and other stakeholders DSHS Contract No.HHS000109900001 Page 30 of 30 Amendment 2 Sit4U•R!C Certificate Of Completion Envelope Id: 129CB70D620243988D74C04EDA382890 Status:Sent Subject:Amending$487,890.00;HHS000109900001;City of Port Arthur A-2;DSHS/IMM Source Envelope: Document Pages:36 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: 167.137.1.11 Record Tracking Status:Original Holder:Texas Health and Human Services Location:DocuSign 3/9/2020 3:40:27 PM Commission PCS_DocuSign@hhsc.state.tx.us Signer Events Signature Timestamp Ron Burton Sent:3/9/2020 3:42:52 PM ron.burton@portarthurtx.gov Interim City Manager Security Level:Email,Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Imelda Garcia ImeldaM.Garcia@dshs.texas.gov Security Level:Email,Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Caeli Paradise COPIED Sent:3/9/2020 3:42:50 PM Caeli.paradise@dshs.texas.gov Security Level:Email,Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign CMU Contracts COPIED Sent:3/9/2020 3:42:51 PM cmucontracts@dshs.texas.gov Security Level:Email,Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Carbon Copy Events Status Timestamp Tray Kirkpatrick COPIED Sent:3/9/2020 3:42:51 PM tray.kirkpatrick@dshs.texas.gov Viewed:3/9/2020 3:43:26 PM Contract Manager Security Level:Email,Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Judith Smith COPIED Sent:3/9/2020 3:42:51 PM judith.smith@portarthurbc.gov Viewed:3/9/2020 4:03:02 PM Director of Health Services City of Port Arthur Security Level:Email,Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 3/9/2020 3:42:52 PM Payment Events Status Timestamps