HomeMy WebLinkAboutPR 22580: HEALTHY MOTHERS & BABIES COMMUNITY COALITION GRANT FOR $75,000.00 Cm:of
2jZ5 B °
ort 1rt!rr r"
www.PortArthurTgov
INTEROFFICE MEMORANDUM
Date: June 24, 2022
To: The Honorable Mayor and City Council
Through: Ronald Burton, City Manager
From: Christina B. Patteson, MS, RD, LD, WIC Director
Judith A. Smith, RN, BSN, Director of Health Services 518
RE: Authorization to accept the Contract between the Texas Department of State
Health Services and the City of Port Arthur for a Healthy Mothers & Babies
Community Coalition Grant for$75,000.00.
Introduction:
The intent of this Agenda Item is to seek the City Council's approval for the City of Port
Arthur Health Department to receive funding in the amount .of $75,000.00 to ensure the
sustainability of programs created through the Healthy Mothers & Babies coalition in an effort
to continue with initiatives intended to decrease maternal and infant mortality in Jefferson
County.
Background: The Healthy Texas Mothers & Babies initiative was developed to help Texas
communities decrease maternal and infant mortality using evidence-based interventions. It
involves community stakeholders, healthcare providers, and insurance companies. A reduction
in infant mortality will improve the health of Texas babies and mothers and has the potential to
save millions of dollars in healthcare costs. Jefferson County has been recognized as a high
risk area for infant mortality. The goal is to reduce disparities in poor birth outcomes and
maternal and infant mortality among Texans using participatory models of programming.
"Remember, we are here to serve the Citizens of Port Arthur"
P.O.Box 1089 X Port Arthur,Texas 77641-1089 X 409.983.8101 X FAX 409.982.6743
Yi' 1
\''c ttrryi -,
('itv of e
°a kP' ire
oilrtftrrr
www.PortArthurTx.gov
The City of Port Arthur Health Department will utilize the local partnerships that we have
already to maintain initiatives previously set forth to help this community reduce the rate of
maternal and infant deaths.
Budget Impact: Total payments received from this contract will be $75,000 through August
31, 2023. These funds will cover operation of the program: salaries, fringe, travel and supplies.
Recommendation:
It is recommended that City Council approve P.R. No. 22580 between the Texas Department
of State Health Services and the City of Port Arthur for a Texas Health Babies Community
Coalition grant.
"Remember, we are here to serve the Citizens of Port Arthur"
P.O.Box 1089 X Port Arthur,Texas 77641-1089 X 409.983.8101 X FAX 409.982.6743
P. R. No.: 22580
06/24/22-js
RESOLUTION NO.
A RESOLUTION APPROVING THE CONTRACT
BETWEEN TEXAS DEPARTMENT OF STATE HEALTH
SERVICES AND THE CITY OF PORT ARTHUR FOR A
HEALTHY TEXAS MOTHERS & BABIES COMMUNITY
COALITION GRANT FOR A TOTAL NOT TO EXCEED
$75,000 THROUGH AUGUST 31, 2023. NO MATCH
REQUIRED.
WHEREAS, the Healthy Texas Babies Initiative was developed to help Texas
communities decrease infant mortality using evidence-based intervention. This initiative
involves community stakeholders, healthcare providers, and insurance companies; and,
WHEREAS, Jefferson County has been recognized as a high infant mortality
county and these grant funds will help to reduce disparities in poor birth outcomes and
maternal and infant mortality with the potential to save millions of dollars in healthcare
costs.
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.
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 Healthy Mothers and Babies Coalition.
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
P. R. No.. 22580
06/24/22-j s
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 June, 2022 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, Thurman Bartie
ATTEST:
Sherri Bellard, City Secretary
APPROVED AS TO FORM:
•keiL4507?
Attorney
P. R. No. 22580
06/24/22-js
APPROVED FOR ADMINISTRATION:
Ron Burton, City Manager
c �n7dh
ibdith Smith, RN, BSN
Director of Health Services
APPROVED AS TO AVAILABILITY OF FUNDS:
0,70
Kandy Daniel, D ector of Finance
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
SIGNATURE DOCUMENT FOR
DEPARTMENT OF STATE HEALTH SERVICES GRANT AGREEMENT
CONTRACT No.HHS001130300004
UNDER THE
HEALTHY TEXAS MOTHERS AND BABIES(HTMB)GRANT PROGRAM
The parties to this agreement("Grant Agreement"or"Contract") are the DEPARTMENT OF STATE
HEALTH SERVICES("DSHS" or "System Agency"), a pass-through entity, and the CITY OF PORT
ARTHUR ("Grantee"), having its principal office at 449 Austin Avenue, Port Arthur, TX 77640
(each a "Party" and collectively the "Parties").
I. PURPOSE
The purpose of the Grant Agreement is to provide funding to Grantee to implement a Healthy
Texas Mothers and Babies Community Coalition(HTMBCC) in the City of Port Arthur.
II. LEGAL AUTHORITY
This Grant Agreement is entered into pursuant to Texas Health and Safety Code Chapter 12,Texas
Government Code Chapter 531, Texas Government Code Chapter 791, "The Interlocal
Cooperation Act," and Social Security Act, Title V, 45 CFR 96, 42 U.S.C. § 701(a)(1).
III. DURATION
This Grant Agreement is effective on September 1,2022 and terminates on August 31,2023,unless
renewed, extended, or terminated pursuant to the terms and conditions of the Grant Agreement.
System Agency, at its sole discretion,may extend this Grant Agreement for any period(s)of time,
provided the Grant Agreement term, including all extensions or renewals, does not exceed two(2)
years. Notwithstanding the limitation in the preceding sentence, System Agency, at its sole
discretion, also may extend the Grant Agreement beyond two (2) years as necessary to ensure
continuity of service, for purposes of transition, or as otherwise determined by System Agency to
serve the best interest of the State.
IV. STATEMENT OF WORK
The Scope of Grant Project to which Grantee is bound is incorporated into and made a part of this
Grant Agreement for all purposes and included as ATTACHMENT A.
V. BUDGET AND INDIRECT COST RATE
The total amount of this Grant Agreement will not exceed SEVENTY-FIVE THOUSAND DOLLARS
($75,000.00).Grantee is not required to provide matching funds.
DSHS Grant Agreement,Contract#HHS001130300004
Page 1 of 10
HHS Signature Document-Grantee v 3.0
Effective:October 2021
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
The total not-to-exceed amount includes the following:
Total Federal Funds: $25,000.00
Total State Funds: $50,000.00
All expenditures under the Grant Agreement will be in accordance with ATTACHMENT B,
BUDGET.
Indirect Cost Rate: If an indirect cost rate letter is required but has not been issued by System
Agency at the time of Contract Execution, the Parties agree to amend the Grant Agreement to
include the indirect cost rate letter and make any necessary, corresponding amendments to the
budget after the letter is issued.Grantee must have an approved or acknowledged indirect cost rate
in order to recover indirect costs.
If the System Agency approves or acknowledges an updated indirect cost rate, the Grant
Agreement will be amended to incorporate the new rate (and the new indirect cost rate letter, if
applicable) and the budget revised accordingly.
VI. REPORTING REQUIREMENTS
Grantee shall submit the following reports to cdsb@dshs.texas.gov and
InfantHealth@dshs.texas.gov.dshs.texas.gov. Financial Status Reports shall be submitted to
invoices a,dshs.texas.gov, cdsb@dshs.texas.gov, and FSRGrants(a,.dshs.texas.gov.
REPORT FREQUENCY DUE DATE
Finalized Work Plan One-time September 30, 2022
Finalized One-time September 30, 2022
Communication Plan
Annual Program Annually August 31, 2023
Performance Report
HTMBCC Annually August 31, 2023
Sustainability Plan
Report
Financial Status Reports Biannually March 31, 2023
(FSRs)
Final Financial Status 45 days following the October 15, 2023
Report (FSR) end of the final state
DSHS Grant Agreement,Contract#HHS001130300004
Page 2 of 10
IIHS Signature Document-Grantee v 3.0
Effective:October 2021
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
fiscal quarter of the
project period.
VII. CONTRACT REPRESENTATIVES
The following will act as the representative authorized to administer activities under this Grant
Agreement on behalf of their respective Party.
System Agency Grantee
Tray Kirkpatrick Christina Patteson
Department of State Health Services City of Port Arthur
1100 W 49th Street 449 Austin Avenue
Austin, Texas 78756 Port Arthur,TX 77640
Tray.kirkpatrick@dshs.texas.gov Christina.patteson@portarthurtx.gov
VIII. NOTICE REQUIREMENTS
A. All notices given by Grantee shall be in writing, include the Grant Agreement contract
number, comply with all terms and conditions of the Grant Agreement, and be delivered to
the System Agency's Contract Representative identified above.
B. Grantee shall send legal notices to the address below:
System Agency:
Department of State Health Services
Attn: General Counsel
PO Box 149347 MC 1919
Austin,Texas 78714-9347
With a copy to:
Health and Human Services Commission
Attn: Office of Chief Counsel
4601 W. Guadalupe,Mail Code 1100
Austin,Texas 78751
C. Notices given by System Agency to Grantee may be emailed, mailed, or sent by common
carrier. Email notices shall be deemed delivered when sent by System Agency. Notices sent
by mail shall be deemed delivered when deposited by the System Agency in the United States
mail, postage paid, certified, return receipt requested. Notices sent by common carrier shall
be deemed delivered when deposited by the System Agency with a common carrier,
overnight, signature required.
DSHS Grant Agreement,Contract#IIHS001130300004
Page 3 of 10
HHS Signature Document-Grantee v 3.0
Effective:October 2021
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
D. Notices given by Grantee to System Agency shall be deemed delivered when received by
System Agency.
E. Either Party may change its Contract Representative or Legal Notice contact by providing
written notice to the other Party.
IX. FEDERAL AWARD INFORMATION
GRANTEE'S DATA UNIVERSAL NUMBERING SYSTEM(DUNS)NUMBER IS: 137134909
Federal funding under this Grant Agreement is a subaward under the following federal
award.
Federal Award Identification Number (FAIN): B0445246
A. Assistance Listings Title,Number, and Dollar Amount:
• Maternal and Child Health Services Block Grant to the States-93.994—$6,312,639.00
B. Federal Award Date: 10/18/2021
C. Federal Award Period: 10/01/2021-09/30/2023
D. Name of Federal Awarding Agency: U.S. Department of Health and Human Services,
Health Resources and Services Administration
E. Federal Award Project Description: Maternal and Child Health Services
F. Awarding Official Contact Information: Crystal Howard, Grants Management Specialist,
choward@hrsa.gov
G. Total Amount of Federal Funds Awarded to System Agency: $6,312,639.00
H. Amount of Funds Awarded to Grantee: $25,000.00
I. Identification of Whether the Award is for Research and Development: No
X. CONTRACT DOCUMENTS
Unless expressly stated otherwise in this Grant Agreement, in the event of conflict, ambiguity,
or inconsistency between or among any documents, all System Agency documents take
precedence over Grantee's documents.
The following documents are incorporated by reference and made a part of this Grant
Agreement for all purposes.
ATTACHMENT A—SCOPE OF GRANT PROJECT
ATTACHMENT B—BUDGET
ATTACHMENT C—HHS CONTRACT AFFIRMATIONS V 2.1
ATTACHMENT D—HHS UNIFORM TERMS AND CONDITIONS—GRANT VERSION
3.0
ATTACHMENT E—HHS ADDITIONAL PROVISIONS-GRANT FUNDING VERSION 1.0
ATTACHMENT F—FEDERAL ASSURANCES
ATTACHMENT G—CERTIFICATION REGARDING LOBBYING
ATTACHMENT H—FFATA CERTIFICATION FORM
DSHS Grant Agreement,Contract#HHS001130300004
Page 4 of 10
HHS Signature Document-Grantee v 3.0
Effective:October 2021
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
XI. SIGNATURE AUTHORITY
Each Party represents and warrants that the person executing this Grant Agreement on its
behalf has full power and authority to enter into this Grant Agreement. Any services or work
performed by Grantee before this Grant Agreement is effective or after it ceases to be effective
are performed at the sole risk of Grantee.
SIGNATURE PAGE FOLLOWS
DSHS Grant Agreement,Contract#HHS001130300004
Page 5 of 10
HHS Signature Document-Grantee v 3.0
Effective:October 2021
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
I SIGNATURE PAGE FOR DEPARTMENT OF STATE HEALTH SERVICES GRANT
AGREEMENT,CONTRACT No.HHS001130300004
IDEPARTMENT OF STATE HEALTH SERVICESCITY OF PORT ARTHUR
`
Signature Signature
Printed Name: Printed Name:
Title: Title:
Date of Execution: Date of Execution:
0
/11
it
ir
DSHS Grant Agreement,Contract#HHS001130300004
Page 6 of 10
HHS Signature Document-Grantee v 3.0
Effective:October 2021
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
ATTACHMENT A
SCOPE OF GRANT PROJECT
I. GRANTEE RESPONSIBILITIES
Grantee will:
A. Coordinate a Healthy Texas Mothers and Babies Community Coalition
(HTMBCC)initiative and collaborate with community partners and stakeholders to
strengthen local capacity and community partnerships in the City of Port Arthur,
and to improve birth outcomes and reduce disparities in infant mortality rates
toward achievement of Healthy People 2030 goals.
B. Use local and state level data, project indicators, needs assessment information,
strategic planning, and community stakeholder appraisal to develop and refine a
written HTMBCC Work Plan which identifies and justifies:
1. Locally appropriate evidence-based and/or evidence-informed infant
mortality and disparity reduction interventions for implementation;
2. SMART (Specific, Measurable, Attainable/Achievable, Relevant, and
Time-bound) objectives for proposed interventions;
3. Roles and responsibilities for HTMBCC members and partners;
4. Resources needed and resources to be leveraged for plan implementation;
5. Evaluation and sustainability measures and milestones to be employed; and
6. Needs for technical assistance and subject matter expertise support.
C. Develop a Communication Plan incorporating locally specific communication
strategies for the priority health issues and activities identified in the HTMBCC
Work Plan. The Communication Plan should include strategies to address
community-specific disparities in maternal and infant health and safety outcomes
and should align with System Agency's Healthy Texas Mothers and Babies
(HTMB) framework and focus. The Communication Plan must be approved by
System Agency before implementation. The Communication Plan may include:
1. Social media marketing and advertising;
2. Audiovisual and Print materials; and
3. Radio public service announcements.
D. Participate in project planning, sharing, and status meetings (virtual or in person)
with System Agency on approximately a monthly basis and as needed. Attend
Quarterly calls with other HTMBCCs to share programmatic activities.
DSHS Grant Agreement,Contract#HHS001130300004
Page 7 of 10
HHS Signature Document-Grantee v 3.0
Effective:October 2021
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
E. Use local and state level data, project indicators, needs assessment information,
strategic planning, and community stakeholder appraisal to develop and refine an
Annual Report by:
1. Coordinating activities and achievement of milestones with partners,
stakeholders, System Agency, and community members;
2. Establishing and tracking process and outcomes measures;
3. Reporting on activities, progress towards milestones, and challenges as
established by System Agency;
4. Using rapid cycle quality improvement for systems change; and
5. Activating HTMBCC members and stakeholders in implementation efforts
to mobilize community involvement and collective impact.
F. Work with HTMBCC members and System Agency to develop an HTMBCC
Sustainability Plan, based on the CDC Sustainability Planning Guide(cdc.gov) for
Healthy Communities,by:
1. Coordinating periodic HTMBCC meetings to provide a forum to discuss
data,maternal and infant health priorities, and strategies;
2. Coordinating HTMBCC stakeholder participation in webinars, trainings,
collaborative learning forums, and events;
3. Continuing to strengthen and expand community partnerships by recruiting
and engaging members; developing and defining member roles; expanding
and strengthening coordination and collaboration among partners; and
4. Following the 10 steps for developing and implementing a Sustainability
Plan as outlined in the CDC Sustainability Planning Guide for Healthy
Communities.
G. Submit to System agency the following documents or reports in the formats
requested by System Agency:
1. A finalized Work Plan and Communication Plan that outline the Grantee's
planned approach to comply with this Contract, including planned
implementation and communication strategies. System Agency must
provide written approval of the Work Plan and Communication Plan prior
to implementation. Grantee must submit these written plans to
cdsb@dshs.texas.gov and InfantHealth@dshs.texas.gov by September 30,
2022.
2. An Annual Program Performance Report, including a description of the
implementation of strategies during the project period (September 1, 2022
through August 31, 2023), and a HTMBCC Sustainability Plan Report (as
discussed above). Grantee must submit these reports to
cdsb@dshs.texas.gov and InfantHealth@,dshs.texas.gov by August 31,
DSHS Grant Agreement,Contract#H11S001130300004
Page 8 of 10
HHS Signature Document-Grantee v 3.0
Effective:October 2021
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
2023.
3. Biannual Financial Status Reports (FSR) to be submitted to
invoices(&,dshs.texas.gov and to cdsb(cvdshs.texas.gov and to
FSRGrantsAdshs.texas.gov by the below dates each FY:
Period Covered Due Date
September 1 —February 28, 2023 March 31, 2023
March 1- August 31, 2023 October 15, 2023
IL PERFORMANCE MEASURES
The System Agency will monitor the Grantee's performance of the requirements in this
Attachment A and compliance with the Contract's terms and conditions.
III.INVOICE AND PAYMENT
A. Grantee will request payments using the State of Texas Purchase Voucher (Form
B-13) at https://www.dshs.texas.gov/grants/forms.shtm. Voucher and any
supporting documentation will be mailed or submitted by fax or electronic mail to
the address/number below.
Department of State Health Services
Claims Processing Unit,MC 1940
1100 West 49th Street
P.O. Box 149347
Austin, TX 78714-9347
FAX: (512)458-7442
EMAIL: invoicesrdshs.state.tx.us and CMSinvoices(dshs.texas.gov
B. Grantee will be paid on a cost reimbursement basis and in accordance with the
Budget in Attachment B of this Contract.
C. Grantee must electronically submit a final close-out voucher and final financial
status report no later than thirty (30) days following the end of the fiscal year.
Vouchers received more than thirty (30) days following the end of fiscal year are
subject to denial of payment.
DSHS Grant Agreement,Contract#HHS001130300004
Page 9 of 10
HHS Signature Document-Grantee v 3.0
Effective:October 2021
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
ATTACHMENT B
BUDGET
CATEGORY AMOUNT
Personnel $38,040.00
Fringe Benefits $2,815.00
Travel $1,055.00
Equipment $0.00
Supplies $1,665.00
Contractual $0.00
Other $31,425.00
Total Direct Costs $75,000.00
Indirect Costs $0.00
TOTAL $75,000.00
DSHS Grant Agreement,Contract#HHS001130300004
Page 10 of 10
HHS Signature Document-Grantee v 3.0
Effective:October 2021
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
HEALTH AND HUMAN SERVICES
Contract Number HHS001130300004
Attachment c CONTRACT AFFIRMATIONS
For purposes of these Contract Affirmations, HHS includes both the Health and Human Services
Commission(HHSC) and the Department of State Health Services (DSHS). System Agency
refers to HHSC, DSHS, or both, that will be a party to this Contract. These Contract
Affirmations apply to all Contractors and Grantees (referred to as "Contractor") regardless of
their business form(e.g., individual,partnership, corporation).
By entering into this Contract, Contractor affirms,without exception,understands, and agrees to
comply with the following items through the life of the Contract:
1. Contractor represents and warrants that these Contract Affirmations apply to Contractor
and all of Contractor's principals, officers, directors, shareholders,partners, owners,
agents, employees, subcontractors, independent contractors, and any other representatives
who may provide services under, who have a financial interest in, or otherwise are
interested in this Contract and any related Solicitation.
2. Complete and Accurate Information
Contractor represents and warrants that all statements and information provided to HHS
are current, complete, and accurate. This includes all statements and information in this
Contract and any related Solicitation Response.
3. Public Information Act
Contractor understands that HHS will comply with the Texas Public Information Act
(Chapter 552 of the Texas Government Code)as interpreted by judicial rulings and
opinions of the Attorney General of the State of Texas. Information, documentation, and
other material prepared and submitted in connection with this Contract or any related
Solicitation may be subject to public disclosure pursuant to the Texas Public Information
Act. In accordance with Section 2252.907 of the Texas Government Code, Contractor is
required to make any information created or exchanged with the State pursuant to the
Contract, and not otherwise excepted from disclosure under the Texas Public Information
Act, available in a format that is accessible by the public at no additional charge to the
State.
4. Contracting Information Requirements
Contractor represents and warrants that it will comply with the requirements of Section
552.372(a)of the Texas Government Code. Except as provided by Section 552.374(c) of
the Texas Government Code, the requirements of Subchapter J (Additional Provisions
Related to Contracting Information), Chapter 552 of the Government Code, may apply to
the Contract and the Contractor agrees that the Contract can be terminated if the
Contractor knowingly or intentionally fails to comply with a requirement of that
subchapter.
Health and Human Services
Contract Affirmations v.2.1
Effective October 2021
Page 1 of 13
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
5. Assignment
A. Contractor shall not assign its rights under the Contract or delegate the performance
of its duties under the Contract without prior written approval from System Agency.
Any attempted assignment in violation of this provision is void and without effect.
B. Contractor understands and agrees the System Agency may in one or more
transactions assign,pledge, or transfer the Contract. Upon receipt of System
Agency's notice of assignment, pledge, or transfer, Contractor shall cooperate with
System Agency in giving effect to such assignment,pledge, or transfer, at no cost to
System Agency or to the recipient entity.
6. Terms and Conditions
Contractor accepts the Solicitation terms and conditions unless specifically noted by
exceptions advanced in the form and manner directed in the Solicitation, if any, under
which this Contract was awarded. Contractor agrees that all exceptions to the Solicitation,
as well as terms and conditions advanced by Contractor that differ in any manner from
HHS' terms and conditions, if any, are rejected unless expressly accepted by System
Agency in writing.
7. HHS Right to Use
Contractor agrees that HHS has the right to use,produce, and distribute copies of and to
disclose to HHS employees, agents, and contractors and other governmental entities all or
part of this Contract or any related Solicitation Response as HHS deems necessary to
complete the procurement process or comply with state or federal laws.
8. Release from Liability
Contractor generally releases from liability and waives all claims against any party
providing information about the Contractor at the request of System Agency.
9. Dealings with Public Servants
Contractor has not given, has not offered to give, and does not intend to give at any time
hereafter any economic opportunity, future employment, gift, loan, gratuity, special
discount, trip, favor, or service to a public servant in connection with this Contract or any
related Solicitation, or related Solicitation Response.
10. Financial Participation Prohibited
Under Section 2155.004, Texas Government Code (relating to financial participation in
preparing solicitations), Contractor certifies that the individual or business entity named
in this Contract and any related Solicitation Response is not ineligible to receive this
Contract and acknowledges that this Contract may be terminated and payment withheld if
this certification is inaccurate.
11. Prior Disaster Relief Contract Violation
Under Sections 2155.006 and 2261.053 of the Texas Government Code (relating to
convictions and penalties regarding Hurricane Rita, Hurricane Katrina, and other
disasters),the Contractor certifies that the individual or business entity named in this
Contract and any related Solicitation Response is not ineligible to receive this Contract
Health and Human Services
Contract Affirmations v.2.1
Effective October 2021
Page 2 of 13
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
and acknowledges that this Contract may be terminated and payment withheld if this
certification is inaccurate.
12. Child Support Obligation
Under Section 231.006(d) of the Texas Family Code regarding child support, Contractor
certifies that the individual or business entity named in this Contract and any related
Solicitation Response is not ineligible to receive the specified payment and acknowledges
that the Contract may be terminated and payment may be withheld if this certification is
inaccurate.
13. Suspension and Debarment
Contractor certifies that it and its principals are not suspended or debarred from doing
business with the state or federal government as listed on the State of Texas Debarred
Vendor List maintained by the Texas Comptroller of Public Accounts and the System for
Award Management(SAM) maintained by the General Services Administration. This
certification is made pursuant to the regulations implementing Executive Order 12549
and Executive Order 12689, Debarment and Suspension,2 C.F.R. Part 376, and any
relevant regulations promulgated by the Department or Agency funding this project. This
provision shall be included in its entirety in Contractor's subcontracts, if any, if payment
in whole or in part is from federal funds.
14. Excluded Parties
Contractor certifies that it is not listed in the prohibited vendors list authorized by
Executive Order 13224, "Blocking Property and Prohibiting Transactions with Persons
Who Commit, Threaten to Commit, or Support Terrorism,"published by the United
States Depattutent of the Treasury, Office of Foreign Assets Control.'
15. Foreign Terrorist Organizations
Contractor represents and warrants that it is not engaged in business with Iran, Sudan, or
a foreign terrorist organization, as prohibited by Section 2252.152 of the Texas
Government Code.
16. Executive Head of a State Agency
In accordance with Section 669.003 of the Texas Government Code,relating to
contracting with the executive head of a state agency, Contractor certifies that it is not(1)
the executive head of an HHS agency, (2) a person who at any time during the four years
before the date of this Contract was the executive head of an HHS agency, or(3) a person
who employs a current or former executive head of an HHS agency.
17. Human Trafficking Prohibition
Under Section 2155.0061 of the Texas Government Code, Contractor certifies that the
individual or business entity named in this Contract is not ineligible to receive this
Contract and acknowledges that this Contract may be terminated and payment withheld if
this certification is inaccurate.
Health and Human Services
Contract Affirmations v.2.1
Effective October 2021
Page 3 of 13
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
18. Franchise Tax Status
Contractor represents and warrants that it is not currently delinquent in the payment of
any franchise taxes owed the State of Texas under Chapter 171 of the Texas Tax Code.
19. Debts and Delinquencies
Contractor agrees that any payments due under this Contract shall be applied towards any
debt or delinquency that is owed to the State of Texas.
20. Lobbying Prohibition
Contractor represents and warrants that payments to Contractor and Contractor's receipt
of appropriated or other funds under this Contract or any related Solicitation are not
prohibited by Sections 556.005, 556.0055, or 556.008 of the Texas Government Code
(relating to use of appropriated money or state funds to employ or pay lobbyists, lobbying
expenses, or influence legislation).
21. Buy Texas
Contractor agrees to comply with Section 2155.4441 of the Texas Government Code,
requiring the purchase of products and materials produced in the State of Texas in
performing service contracts.
22. Disaster Recovery Plan
Contractor agrees that upon request of System Agency, Contractor shall provide copies of
its most recent business continuity and disaster recovery plans.
23. Computer Equipment Recycling Program
If this Contract is for the purchase or lease of computer equipment, then Contractor
certifies that it is in compliance with Subchapter Y, Chapter 361 of the Texas Health and
Safety Code related to the Computer Equipment Recycling Program and the Texas
Commission on Environmental Quality rules in 30 TAC Chapter 328.
24. Television Equipment Recycling Program
If this Contract is for the purchase or lease of covered television equipment, then
Contractor certifies that it is compliance with Subchapter Z, Chapter 361 of the Texas
Health and Safety Code related to the Television Equipment Recycling Program.
25. Cybersecurity Training
A. Contractor represents and warrants that it will comply with the requirements of
Section 2054.5192 of the Texas Government Code relating to cybersecurity training
and required verification of completion of the training program.
B. Contractor represents and warrants that if Contractor or Subcontractors, officers, or
employees of Contractor have access to any state computer system or database, the
Contractor, Subcontractors, officers, and employees of Contractor shall complete
cybersecurity training pursuant to and in accordance with Government Code, Section
2054.5192.
Health and Human Services
Contract Affirmations v.2.1
Effective October 2021
Page 4 of 13
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
26. Restricted Employment for Certain State Personnel
Contractor acknowledges that,pursuant to Section 572.069 of the Texas Government
Code, a former state officer or employee of a state agency who during the period of state
service or employment participated on behalf of a state agency in a procurement or
contract negotiation involving Contractor may not accept employment from Contractor
before the second anniversary of the date the Contract is signed or the procurement is
terminated or withdrawn.
27. No Conflicts of Interest
A. Contractor represents and warrants that it has no actual or potential conflicts of
interest in providing the requested goods or services to System Agency under this
Contract or any related Solicitation and that Contractor's provision of the requested
goods and/or services under this Contract and any related Solicitation will not
constitute an actual or potential conflict of interest or reasonably create an appearance
of impropriety.
B. Contractor agrees that, if after execution of the Contract, Contractor discovers or is
made aware of a Conflict of Interest, Contractor will immediately and fully disclose
such interest in writing to System Agency. In addition, Contractor will promptly and
fully disclose any relationship that might be perceived or represented as a conflict
after its discovery by Contractor or by System Agency as a potential conflict. System
Agency reserves the right to make a final determination regarding the existence of
Conflicts of Interest, and Contractor agrees to abide by System Agency's decision.
28. Fraud,Waste, and Abuse
Contractor understands that HHS does not tolerate any type of fraud, waste, or abuse.
Violations of law, agency policies,or standards of ethical conduct will be investigated,
and appropriate actions will be taken. Pursuant to Texas Government Code, Section
321.022, if the administrative head of a department or entity that is subject to audit by the
state auditor has reasonable cause to believe that money received from the state by the
department or entity or by a client or contractor of the department or entity may have
been lost,misappropriated, or misused, or that other fraudulent or unlawful conduct has
occurred in relation to the operation of the department or entity, the administrative head
shall report the reason and basis for the belief to the Texas State Auditor's Office (SAO).
All employees or contractors who have reasonable cause to believe that fraud, waste, or
abuse has occurred(including misconduct by any HHS employee, Grantee officer, agent,
employee, or subcontractor that would constitute fraud, waste, or abuse) are required to
immediately report the questioned activity to the Health and Human Services
Commission's Office of Inspector General. Contractor agrees to comply with all
applicable laws, rules,regulations, and System Agency policies regarding fraud, waste,
and abuse including,but not limited to, HHS Circular C-027.
A report to the SAO must be made through one of the following avenues:
• SAO Toll Free Hotline: 1-800-TX-AUDIT
• SAO website: http://sao.fraud.state.tx.us/
All reports made to the OIG must be made through one of the following avenues:
Health and Human Services
Contract Affirmations v.2.1
Effective October 2021
Page 5 of 13
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
• OIG Toll Free Hotline 1-800-436-6184
• OIG Website: ReportTexasFraud.com
• Internal Affairs Email: InternalAffairsReferral@hhsc.state.tx.us
• OIG Hotline Email: OIGFraudHotline@hhsc.state.tx.us.
• OIG Mailing Address: Office of Inspector General
Attn: Fraud Hotline
MC 1300
P.O. Box 85200
Austin, Texas 78708-5200
29. Antitrust
The undersigned affirms under penalty of perjury of the laws of the State of Texas that:
A. in connection with this Contract and any related Solicitation Response,neither I nor
any representative of the Contractor has violated any provision of the Texas Free
Enterprise and Antitrust Act, Tex. Bus. & Comm. Code Chapter 15;
B. in connection with this Contract and any related Solicitation Response,neither I nor
any representative of the Contractor has violated any federal antitrust law; and
C. neither I nor any representative of the Contractor has directly or indirectly
communicated any of the contents of this Contract and any related Solicitation
Response to a competitor of the Contractor or any other company, corporation, firm,
partnership or individual engaged in the same line of business as the Contractor.
30. Legal and Regulatory Actions
Contractor represents and warrants that it is not aware of and has received no notice of
any court or governmental agency proceeding, investigation, or other action pending or
threatened against Contractor or any of the individuals or entities included in numbered
paragraph 1 of these Contract Affirmations within the five (5) calendar years immediately
preceding execution of this Contract or the submission of any related Solicitation
Response that would or could impair Contractor's performance under this Contract, relate
to the contracted or similar goods or services, or otherwise be relevant to System
Agency's consideration of entering into this Contract. If Contractor is unable to make the
preceding representation and warranty,then Contractor instead represents and warrants
that it has provided to System Agency a complete, detailed disclosure of any such court
or governmental agency proceeding, investigation, or other action that would or could
impair Contractor's performance under this Contract, relate to the contracted or similar
goods or services, or otherwise be relevant to System Agency's consideration of entering
into this Contract. In addition, Contractor acknowledges this is a continuing disclosure
requirement. Contractor represents and warrants that Contractor shall notify System
Agency in writing within five(5)business days of any changes to the representations or
warranties in this clause and understands that failure to so timely update System Agency
shall constitute breach of contract and may result in immediate contract termination.
Health and Human Services
Contract Affirmations v.2.1
Effective October 2021
Page 6 of 13
DocuSign Envelope ID:98366D72-71176-4F2C-8771-7DDD39BFB126
31. No Felony Criminal Convictions
Contractor represents that neither Contractor nor any of its employees, agents, or
representatives, including any subcontractors and employees, agents, or representative of
such subcontractors,have been convicted of a felony criminal offense or that if such a
conviction has occurred Contractor has fully advised System Agency in writing of the
facts and circumstances surrounding the convictions.
32. Unfair Business Practices
Contractor represents and warrants that it has not been the subject of allegations of
Deceptive Trade Practices violations under Chapter 17 of the Texas Business and
Commerce Code, or allegations of any unfair business practice in any administrative
hearing or court suit and that Contractor has not been found to be liable for such practices
in such proceedings. Contractor certifies that it has no officers who have served as
officers of other entities who have been the subject of allegations of Deceptive Trade
Practices violations or allegations of any unfair business practices in an administrative
hearing or court suit and that such officers have not been found to be liable for such
practices in such proceedings.
33. Entities that Boycott Israel
Contractor represents and warrants that(1) it does not, and shall not for the duration of
the Contract, boycott Israel or(2)the verification required by Section 2271.002 of the
Texas Government Code does not apply to the Contract. If circumstances relevant to this
provision change during the course of the Contract, Contractor shall promptly notify
System Agency.
34. E-Verify
Contractor certifies that for contracts for services, Contractor shall utilize the U.S.
Department of Homeland Security's E-Verify system during the term of this Contract to
determine the eligibility of:
1. all persons employed by Contractor to perform duties within Texas; and
2. all persons, including subcontractors, assigned by Contractor to perform work
pursuant to this Contract within the United States of America.
35. Former Agency Employees—Certain Contracts
If this Contract is an employment contract, a professional services contract under Chapter
2254 of the Texas Government Code, or a consulting services contract under Chapter
2254 of the Texas Government Code, in accordance with Section 2252.901 of the Texas
Government Code, Contractor represents and warrants that neither Contractor nor any of
Contractor's employees including, but not limited to, those authorized to provide services
under the Contract, were former employees of an HHS Agency during the twelve (12)
month period immediately prior to the date of the execution of the Contract.
Health and Human Services
Contract Affirmations v.2.1
Effective October 2021
Page 7 of 13
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
36. Disclosure of Prior State Employment—Consulting Services
If this Contract is for consulting services,
A. In accordance with Section 2254.033 of the Texas Government Code, a Contractor
providing consulting services who has been employed by, or employs an individual
who has been employed by, System Agency or another State of Texas agency at any
time during the two years preceding the submission of Contractor's offer to provide
services must disclose the following information in its offer to provide services.
Contractor hereby certifies that this information was provided and remains true,
correct, and complete:
1. Name of individual(s) (Contractor or employee(s));
2. Status;
3. The nature of the previous employment with HHSC or the other State of Texas
agency;
4. The date the employment was terminated and the reason for the termination; and
5. The annual rate of compensation for the employment at the time of its
termination.
B. If no information was provided in response to Section A above, Contractor certifies
that neither Contractor nor any individual employed by Contractor was employed by
System Agency or any other State of Texas agency at any time during the two years
preceding the submission of Contractor's offer to provide services.
37. Abortion Funding Limitation
Contractor understands, acknowledges, and agrees that,pursuant to Article IX of the
General Appropriations Act (the Act), to the extent allowed by federal and state law,
money appropriated by the Texas Legislature may not be distributed to any individual or
entity that, during the period for which funds are appropriated under the Act:
1. performs an abortion procedure that is not reimbursable under the state's Medicaid
program;
2. is commonly owned, managed, or controlled by an entity that performs an abortion
procedure that is not reimbursable under the state's Medicaid program; or
3. is a franchise or affiliate of an entity that performs an abortion procedure that is not
reimbursable under the state's Medicaid program.
The provision does not apply to a hospital licensed under Chapter 241, Health and Safety
Code, or an office exempt under Section 245.004(2), Health and Safety Code. Contractor
represents and warrants that it is not ineligible,nor will it be ineligible during the term of
this Contract, to receive appropriated funding pursuant to Article IX.
38. Funding Eligibility
Contractor understands, acknowledges, and agrees that, pursuant to Chapter 2272 (eff.
Sept. 1, 2021, Ch. 2273)of the Texas Government Code, except as exempted under that
Chapter,HHSC cannot contract with an abortion provider or an affiliate of an abortion
provider. Contractor certifies that it is not ineligible to contract with HHSC under the
terms of Chapter 2272 (eff. Sept. 1, 2021, Ch. 2273) of the Texas Government Code.
Health and Human Services
Contract Affirmations v.2.1
Effective October 2021
Page 8 of 13
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
39. Prohibition on Certain Telecommunications and Video Surveillance Services or
Equipment(2 CFR 200.216)
Contractor certifies that the individual or business entity named in this Response or
Contract is not ineligible to receive the specified Contract or funding pursuant to 2 CFR
200.216.
40. COVID-19 Vaccine Passports
Pursuant to Texas Health and Safety Code, Section 161.0085(c), Contractor certifies that
it does not require its customers to provide any documentation certifying the customer's
COVID-19 vaccination or post-transmission recovery on entry to, to gain access to, or to
receive service from the Contractor's business. Contractor acknowledges that such a
vaccine or recovery requirement would make Contractor ineligible for a state-funded
contract.
41. Entities that Boycott Energy Companies
In accordance with Senate Bill 13, Acts 2021, 87th Leg., R.S., pursuant to Section
2274.002 of the Texas Government Code (relating to prohibition on contracts with
companies boycotting certain energy companies), Contractor represents and warrants
that: (1) it does not, and will not for the duration of the Contract,boycott energy
companies or(2)the verification required by Section 2274.002 of the Texas Government
Code does not apply to the Contract. If circumstances relevant to this provision change
during the course of the Contract, Contractor shall promptly notify System Agency.
42. Entities that Discriminate Against Firearm and Ammunition Industries
In accordance with Senate Bill 19, Acts 2021, 87th Leg., R.S., pursuant to Section
2274.002 of the Texas Government Code (relating to prohibition on contracts with
companies that discriminate against firearm and ammunition industries), Contractor
verifies that: (1) it does not, and will not for the duration of the Contract, have a practice,
policy, guidance, or directive that discriminates against a firearm entity or firearm trade
association or(2)the verification required by Section 2274.002 of the Texas Government
Code does not apply to the Contract. If circumstances relevant to this provision change
during the course of the Contract, Contractor shall promptly notify System Agency.
43. Security Controls for State Agency Data
In accordance with Senate Bill 475,Acts 2021, 87th Leg., R.S.,pursuant to Texas
Government Code, Section 2054.138, Contractor understands, acknowledges, and agrees
that if,pursuant to this Contract, Contractor is or will be authorized to access, transmit,
use, or store data for System Agency, Contractor is required to meet the security controls
the System Agency determines are proportionate with System Agency's risk under the
Contract based on the sensitivity of System Agency's data and that Contractor must
periodically provide to System Agency evidence that Contractor meets the security
controls required under the Contract.
Health and Human Services
Contract Affirmations v.2.1
Effective October 2021
Page 9 of 13
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
44. Cloud Computing State Risk and Authorization Management Program
In accordance with Senate Bill 475, Acts 2021, 87th Leg., R.S.,pursuant to Texas
Government Code, Section 2054.0593, Contractor acknowledges and agrees that, if
providing cloud computing services for System Agency, Contractor must comply with
the requirements of the state risk and authorization management program and that System
Agency may not enter or renew a contract with Contractor to purchase cloud computing
services for the agency that are subject to the state risk and authorization management
program unless Contractor demonstrates compliance with program requirements. If
providing cloud computing services for System Agency that are subject to the state risk
and authorization management program, Contractor certifies it will maintain program
compliance and certification throughout the term of the Contract.
45. Office of Inspector General Investigative Findings Expert Review
In accordance with Senate Bill 799,Acts 2021, 87th Leg., R.S., if Texas Government
Code, Section 531.102(m-1)(2) is applicable to this Contract, Contractor affirms that it
possesses the necessary occupational licenses and experience.
46. Contract for Professional Services of Physicians, Optometrists, and Registered
Nurses
In accordance with Senate Bill 799,Acts 2021, 87th Leg., R.S., if Texas Government
Code, Section 2254.008(a)(2) is applicable to this Contract, Contractor affirms that it
possesses the necessary occupational licenses and experience.
47. Foreign-Owned Companies in Connection with Critical Infrastructure
If Texas Government Code, Section 2274.0102(a)(1) (relating to prohibition on contracts
with certain foreign-owned companies in connection with critical infrastructure)is
applicable to this Contract,pursuant to Government Code Section 2274.0102, Contractor
certifies that neither it nor its parent company, nor any affiliate of Contractor or its parent
company, is: (1) majority owned or controlled by citizens or governmental entities of
China, Iran,North Korea, Russia, or any other country designated by the Governor under
Government Code Section 2274.0103, or(2) headquartered in any of those countries.
48. Critical Infrastructure Subcontracts
For purposes of this Paragraph, the designated countries are China, Iran,North Korea,
Russia, and any countries lawfully designated by the Governor as a threat to critical
infrastructure. Pursuant to Section 113.002 of the Business and Commerce Code,
Contractor shall not enter into a subcontract that will provide direct or remote access to or
control of critical infrastructure, as defined by Section 113.001 of the Texas Business and
Commerce Code, in this state, other than access specifically allowed for product warranty
and support purposes to any subcontractor unless (i)neither the subcontractor nor its
parent company,nor any affiliate of the subcontractor or its parent company, is majority
owned or controlled by citizens or governmental entities of a designated country; and(ii)
neither the subcontractor nor its parent company, nor any affiliate of the subcontractor or
its parent company, is headquartered in a designated country. Contractor will notify the
System Agency before entering into any subcontract that will provide direct or remote
Health and Human Services
Contract Affirmations v.2.1
Effective October 2021
Page 10 of 13
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
access to or control of critical infrastructure, as defined by Section 113.001 of the Texas
Business &Commerce Code, in this state.
49. Enforcement of Certain Federal Firearms Laws Prohibited
In accordance with House Bill 957, Acts 2021, 87th Leg., R.S., if Texas Government
Code, Section 2.101 is applicable to Contractor, Contractor certifies that it is not
ineligible to receive state grant funds pursuant to Texas Government Code, Section
2.103.
50. Prohibition on Abortions
Contractor understands, acknowledges, and agrees that,pursuant to Article II of the
General Appropriations Act, (1)no funds shall be used to pay the direct or indirect costs
(including marketing, overhead, rent,phones, and utilities) of abortion procedures
provided by contractors of HHSC; and(2)no funds appropriated for Medicaid Family
Planning, Healthy Texas Women Program, or the Family Planning Program shall be
distributed to individuals or entities that perform elective abortion procedures or that
contract with or provide funds to individuals or entities for the performance of elective
abortion procedures. Contractor represents and warrants that it is not ineligible, nor will it
be ineligible during the term of this Contract,to receive appropriated funding pursuant to
Article II.
51. False Representation
Contractor understands, acknowledges, and agrees that any false representation or any
failure to comply with a representation, warranty, or certification made by Contractor is
subject to all civil and criminal consequences provided at law or in equity including,but
not limited to, immediate termination of this Contract.
52. False Statements
Contractor represents and warrants that all statements and information prepared and
submitted by Contractor in this Contract and any related Solicitation Response are
current, complete, true, and accurate. Contractor acknowledges any false statement or
material misrepresentation made by Contractor during the performance of this Contract
or any related Solicitation is a material breach of contract and may void this Contract.
Further, Contractor understands, acknowledges, and agrees that any false representation
or any failure to comply with a representation, warranty, or certification made by
Contractor is subject to all civil and criminal consequences provided at law or in equity
including,but not limited to, immediate termination of this Contract.
53. Permits and License
Contractor represents and warrants that it will comply with all applicable laws and
maintain all permits and licenses required by applicable city, county, state, and federal
rules,regulations, statutes, codes, and other laws that pertain to this Contract.
54. Drug-Free Workplace
Contractor represents and warrants that it shall comply with the applicable provisions of
the Drug-Free Work Place Act of 1988 (41 U.S.C. §701 et seq.) and maintain a drug-free
work environment.
Health and Human Services
Contract Affirmations v.2.1
Effective October 2021
Page 11 of 13
DocoSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
55. Equal Employment Opportunity
Contractor represents and warrants its compliance with all applicable duly enacted state
and federal laws governing equal employment opportunities.
56. Federal Occupational Safety and Health Law
Contractor represents and warrants that all articles and services shall meet or exceed the
safety standards established and promulgated under the Federal Occupational Safety and
Health Act of 1970, as amended(29 U.S.C. Chapter 15).
57. Signature Authority
Contractor represents and warrants that the individual signing this Contract Affirmations
document is authorized to sign on behalf of Contractor and to bind the Contractor.
Signature Page Follows
Health and Human Services
Contract Affirmations v.2.1
Effective October 2021
Page 12 of 13
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
Authorized representative on behalf of Contractor must complete and sign the following:
Legal Name of Contractor
Assumed Business Name of Contractor,if applicable(d/b/a or `doing business as')
Texas County(s) for Assumed Business Name (d/b/a or `doing business as')
Attach Assumed Name Certificate(s) filed with the Texas Secretary of State and Assumed
Name Certificate(s), if any,for each Texas County Where Assumed Name Certificate(s) has
been filed.
Signature of Authorized Representative Date Signed
Printed Name of Authorized Representative Title of Authorized Representative
First, Middle Name or Initial, and Last Name
Physical Street Address City, State,Zip Code
Mailing Address, if different City, State,Zip Code
Phone Number Fax Number
Email Address DUNS Number
Federal Employer Identification Number Texas Identification Number (TIN)
Texas Franchise Tax Number Texas Secretary of State Filing
Number
SAM.gov Unique Entity Identifier(UEI)
Health and Human Services
Contract Affirmations v.2.1
Effective October 2021
Page 13 of 13
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
Or Nk
40, 4
.744 Ct."' • . a rvic s
Health and Human Services (HHS)
Uniform Terms and Conditions - Grant
Version 3.0
Published and Effective — August 2021
Responsible Office: Chief Counsel
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
ABOUT THIS DOCUMENT
In this document, Grantees(also referred to in this document as subrecipients or contractors)will find
requirements and conditions applicable to grant funds administered and passed-through by both the Texas Health
and Human Services Commission(HHSC)and the Department of State Health Services(DSHS). These
requirements and conditions are incorporated into the Grant Agreement through acceptance by Grantee of any
funding award by HHSC or DSHS.
The terms and conditions in this document are in addition to all requirements listed in the RFA, if any,under
which applications for this grant award are accepted, as well as all applicable federal and state laws and
regulations. Applicable federal and state laws and regulations may include,but are not limited to: 2 CFR Part 200,
Uniform Administrative Requirements,Cost Principles, and Audit Requirements for Federal Awards;
requirements of the entity that awarded the funds to HHS; Chapter 783 of the Texas Government Code; Texas
Comptroller of Public Accounts' agency rules(including Uniform Grant and Contract Standards set forth in Title
34,Part 1, Chapter 20, Subchapter E,Division 4 of the Texas Administrative Code);the Texas Grant
Management Standards(TxGMS)developed by the Texas Comptroller of Public Accounts; and the Funding
Announcement, Solicitation, or other instrument/documentation under which HHS was awarded funds.HHS, in
its sole discretion,reserves the right to add requirements,terms,or conditions.
HHS Uniform Terms and Conditions—Grant v 3.0
Effective August 2021
Page 2 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
TABLE . F CONTENTS
ARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS 6
1.1 DEFINITIONS 6
1.2 INTERPRETIVE PROVISIONS 7
ARTICLE II.PAYMENT PROVISIONS 8
2.1 PROMPT PAYMENT 8
2.2 TAXES 8
2.3 ANCILLARY AND TRAVEL EXPENSES 9
2.4 BILLING 9
2.5 USE OF FUNDS 9
2.6 USE FOR MATCH PROHIBITED 9
2.7 PROGRAM INCOME 9
2.8 NONSUPPLANTING 9
2.9 INDIRECT COST RATES 10
ARTICLE III. STATE AND FEDERAL FUNDING 10
3.1 EXCESS OBLIGATIONS PROHIBITED 10
3.2 No DEBT AGAINST THE STATE 10
3.3 DEBTS AND DELINQUENCIES 10
3.4 REFUNDS AND OVERPAYMENTS 10
ARTICLE IV.ALLOWABLE COSTS AND AUDIT REQUIREMENTS 11
4.1 ALLOWABLE COSTS 1 1
4.2 AUDITS AND FINANCIAL STATEMENTS 1 1
4.3 SUBMISSION OF AUDITS AND FINANCIAL STATEMENTS 12
ARTICLE V.WARRANTY,AFFIRMATIONS,ASSURANCES AND
CERTIFICATIONS 12
5.1 WARRANTY 12
5.2 GENERAL AFFIRMATIONS 13
5.3 FEDERAL ASSURANCES 13
5.4 FEDERAL CERTIFICATIONS 13
5.5 STATE ASSURANCES 13
HHS Uniform Terms and Conditions—Grant v 3.0
Effective August 2021
Page 3 of 29
DocuSign Envelope ID.98366D72-7D76-4F2C-8771-7DDD39BFB126
ARTICLE VI.INTELLECTUAL PROPERTY 13
6.1 OWNERSHIP OF WORK PRODUCT 13
6.2 GRANTEE'S PRE-EXISTING WORKS 14
6.3 THIRD PARTY IP 14
6.4 AGREEMENTS WITH EMPLOYEES AND SUBCONTRACTORS 14
6.5 DELIVERY UPON TERMINATION OR EXPIRATION 14
6.6 SURVIVAL 15
6.7 SYSTEM AGENCY DATA 15
ARTICLE VII. PROPERTY 15
7.1 USE OF STATE PROPERTY 15
7.2 DAMAGE TO STATE PROPERTY 16
7.3 PROPERTY RIGHTS UPON TERMINATION OR EXPIRATION OF CONTRACT 16
7.4 EQUIPMENT AND PROPERTY 16
ARTICLE VIII. RECORD RETENTION,AUDIT,AND CONFIDENTIALITY 17
8.1 RECORD MAINTENANCE AND RETENTION 17
8.2 AGENCY'S RIGHT TO AUDIT 17
8.3 RESPONSE/COMPLIANCE WITH AUDIT OR INSPECTION FINDINGS 18
8.4 STATE AUDITOR'S RIGHT TO AUDIT 18
8.5 CONFIDENTIALITY 18
ARTICLE LX. GRANT REMEDIES, TERMINATION AND PROHIBITED
ACTIVITIES 18
9.1 REMEDIES 18
9.2 TERMINATION FOR CONVENIENCE 19
9.3 TERMINATION FOR CAUSE 19
9.4 GRANTEE RESPONSIBILITY FOR SYSTEM AGENCY'S TERMINATION COSTS 20
9.5 INHERENTLY RELIGIOUS ACTIVITIES 20
9.6 POLITICAL ACTIVITIES 20
ARTICLE X. INDEMNITY 21
10.1 GENERAL INDEMNITY 21
10.2 INTELLECTUAL PROPERTY 21
10.3 ADDITIONAL INDEMNITY PROVISIONS 21
ARTICLE XI. GENERAL PROVISIONS 22
11.1 AMENDMENTS 22
11.2 No QUANTITY GUARANTEES 22
HHS Uniform Terms and Conditions—Grant v 3.0
Effective August 2021
Page 4 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
11.3 CHILD ABUSE REPORTING REQUIREMENTS 22
11.4 CERTIFICATION OF MEETING OR EXCEEDING TOBACCO-FREE WORKPLACE
POLICY MINIMUM STANDARDS 22
11.5 INSURANCE AND BONDS 23
11.6 LIMITATION ON AUTHORITY 23
11.7 CHANGE IN LAWS AND COMPLIANCE WITH LAWS 24
11.8 SUBCONTRACTORS 24
11.9 PERMITTING AND LICENSURE 24
11.10 INDEPENDENT CONTRACTOR 24
11.11 GOVERNING LAW AND VENUE 25
11.12 SEVERABILITY 25
11.13 SURVIVABILITY 25
11.14 FORCE MAJEURE 25
11.15 NO IMPLIED WAIVER OF PROVISIONS 25
11.16 FUNDING DISCLAIMERS AND LABELING 25
11.17 MEDIA RELEASES 26
11.18 PROHIBITION ON NON-COMPETE RESTRICTIONS 26
11.19 SOVEREIGN IMMUNITY 26
11.20 ENTIRE CONTRACT AND MODIFICATION 27
11.21 COUNTERPARTS 27
11.22 PROPER AUTHORITY 27
11.23 E-VERIFY PROGRAM 27
11.24 CIVIL RIGHTS 27
11.25 ENTERPRISE INFORMATION MANAGEMENT STANDARDS 28
11.26 DISCLOSURE OF LITIGATION 28
11.27 NO THIRD PARTY BENEFICIARIES 29
11.28 BINDING EFFECT 29
HHS Uniform Terms and Conditions—Grant v 3.0
Effective August 2021
Page 5 of 29
DocuSign Envelope ID 98366D72-7D76-4F2C-8771-7DDD39BFB126
ARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS
1.1 DEFINITIONS
As used in this Grant Agreement, unless a different definition is specified, or the context
clearly indicates otherwise, the following terms and conditions have the meanings assigned
below:
"Amendment"means a written agreement, signed by the Parties, which documents
changes to the Grant Agreement.
"Contract"or"Grant Agreement"means the agreement entered into by the Parties,
including the Signature Document,these Uniform Terms and Conditions,along with any
attachments and amendments that may be issued by the System Agency.
"Deliverables"means the goods, services, and work product, including all reports and
project documentation, required to be provided by Grantee to the System Agency.
"DSHS"means the Department of State Health Services.
"Effective Date"means the date on which the Grant Agreement takes effect.
"Federal Fiscal Year"means the period beginning October 1 and ending September 30
each year, which is the annual accounting period for the United States government.
"GAAP"means Generally Accepted Accounting Principles.
"GASB"means the Governmental Accounting Standards Board.
"Grantee"means the Party receiving funds under this Grant Agreement. May also be
referred to as "subrecipient"or"contractor" in this document.
"HHSC"means the Texas Health and Human Services Commission.
"Health and Human Services" or"HHS" includes HHSC and DSHS.
"Intellectual Property Rights"means the worldwide proprietary rights or interests,
including patent, copyright, trade secret, and trademark rights, as such right may be
evidenced by or embodied in:
i. any idea, design, concept,personality right, method,process,technique,
apparatus, invention, discovery, or improvement;
ii. any work of authorship, including any compilation, computer code, website or
web page design, literary work,pictorial work, or graphic work;
iii. any trademark, service mark, trade dress,trade name,branding, or other indicia
of source or origin;
iv. domain name registrations; and
v. any other proprietary or similar rights. The Intellectual Property Rights of a Party
include all worldwide proprietary rights or interests that the Party may have
acquired by assignment,by exclusive license, or by license with the right to grant
sublicenses.
"Parties"means the System Agency and Grantee, collectively.
"Party"means either the System Agency or Grantee, individually.
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 6 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
"Project"means specific activities of the Grantee that are supported by funds provided
under this Grant Agreement.
"Signature Document"means the document executed by all Parties for this Grant
Agreement.
"Solicitations""Funding Announcement" or"Request for Applications (RFA)" means
the document(including all exhibits, attachments, and published addenda), issued by the
System Agency under which applications for grant funds were requested, which is
incorporated by reference in the Grant Agreement for all purposes in its entirety.
"Solicitation Response" or"Application" means Grantee's full and complete Solicitation
response (including any attachments and addenda),which is incorporated by reference in
the Grant Agreement for all purposes in its entirety.
"State Fiscal Year"means the period beginning September 1 and ending August 31 each
year,which is the annual accounting period for the State of Texas.
"State of Texas Textravel"means the Texas Comptroller of Public Accounts' state travel
rules, policies, and guidelines.
"Statement of Work"means the description of activities Grantee must perform to complete
the Project, as specified in the Grant Agreement and as may be amended.
"System Agency"means HHSC or DSHS,as applicable.
"Work Product"means any and all works, including work papers,notes, materials,
approaches, designs, specifications, systems, innovations, improvements,inventions,
software,programs, source code, documentation, training materials, audio or audiovisual
recordings, methodologies, concepts, studies,reports,whether finished or unfinished,
and whether or not included in the deliverables, that are developed,produced, generated
or provided by Grantee in connection with Grantee's performance of its duties under the
Grant Agreement or through use of any funding provided under this Grant Agreement.
"Texas Grant Management Standards"or"TxGMS"means uniform grant and contract
administration procedures, developed under the authority of Chapter 783 of the
Texas Government Code, to promote the efficient use of public funds in local
government and in programs requiring cooperation among local, state, and federal
agencies. Under this Grant Agreement, TxGMS applies to Grantee except as otherwise
provided by applicable law or directed by System Agency. Additionally, except as
otherwise provided by applicable law, in the event of a conflict between TxGMS and
applicable federal or state law, federal law prevails over state law and state law prevails
over TxGMS.
1.2 INTERPRETIVE PROVISIONS
A. The meanings of defined terms include the singular and plural forms.
B. The words "hereof,""herein,""hereunder," and similar words refer to this Grant
Agreement as a whole and not to any particular provision, section, attachment, or
schedule of this Grant Agreement unless otherwise specified.
C. The term"including" is not limiting and means "including without limitation" and,
unless otherwise expressly provided in this Grant Agreement, (i)references to contracts
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 7 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
(including this Grant Agreement) and other contractual instruments shall be deemed to
include all subsequent Amendments and other modifications, but only to the extent that
such Amendments and other modifications are not prohibited by the terms of this Grant
Agreement, and(ii) references to any statute or regulation are to be construed as
including all statutory and regulatory provisions consolidating, amending,replacing,
supplementing, or interpreting the statute or regulation.
D. Any references to agreements, contracts, statutes, or administrative rules or regulations
in the Grant Agreement are references to these documents as amended, modified, or
supplemented during the term of the Grant Agreement.
E. The captions and headings of this Grant Agreement are for convenience of reference
only and do not affect the interpretation of this Grant Agreement.
F. All attachments, including those incorporated by reference, and any Amendments are
considered part of the terms of this Grant Agreement.
G. This Grant Agreement may use several different limitations, regulations, or policies to
regulate the same or similar matters. All such limitations, regulations, and policies are
cumulative.
H. Unless otherwise expressly provided, reference to any action of the System Agency or
by the System Agency by way of consent, approval, or waiver will be deemed modified
by the phrase "in its sole discretion."
I. Time is of the essence in this Grant Agreement.
J. Prior to execution of the Grant Agreement, Grantee must notify System Agency's
designated contact in writing of any ambiguity, conflict, discrepancy, omission, or other
error. If Grantee fails to notify the System Agency designated contact of any ambiguity,
conflict, discrepancy, omission or other error in the Grant Agreement prior to Grantee's
execution of the Grant Agreement, Grantee:
i. Shall have waived any claim of error or ambiguity in the Grant Agreement; and
ii. Shall not contest the interpretation by the System Agency of such provision(s).
No grantee will be entitled to additional reimbursement, relief, or time by reason of any
ambiguity, conflict, discrepancy, exclusionary specification, omission, or other error or
its later correction.
ARTICLE II. PAYMENT PROVISIONS
2.1 PROMPT PAYMENT
Payment shall be made in accordance with Chapter 2251 of the Texas Government Code,
commonly known as the Texas Prompt Payment Act. Chapter 2251 of the Texas
Government Code shall govern remittance of payment and remedies for late payment and
non-payment.
2.2 TAXES
Grantee represents and warrants that it shall pay all taxes or similar amounts resulting from
the Grant Agreement, including,but not limited to, any federal, State, or local income, sales
or excise taxes of Grantee or its employees. System Agency shall not be liable for any taxes
resulting from the Grant Agreement.
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 8 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
2.3 ANCILLARY AND TRAVEL EXPENSES
A. Except as otherwise provided in the Grant Agreement,no ancillary expenses incurred by
the Grantee in connection with its provision of the services or deliverables will be
reimbursed by the System Agency. Ancillary expenses include,but are not limited to,
costs associated with transportation, delivery, and insurance for each deliverable.
B. Except as otherwise provided in the Grant Agreement,when the reimbursement of travel
expenses is authorized by the Grant Agreement, all such expenses will be reimbursed in
accordance with the rates set by the Texas Comptroller's Textravel guidelines, which can
currently be accessed at: https://fmx.cpa.texas.gov/fmx/travel/txtravel.l.
2.4 BILLING
Unless otherwise provided in the Grant Agreement, Grantee shall bill the System Agency in
accordance with the Grant Agreement. Unless otherwise specified in the Grant Agreement,
Grantee shall submit requests for reimbursement or payment monthly by the last business
day of the month following the month in which expenses were incurred or services provided.
Grantee shall maintain all documentation that substantiates invoices and make the
documentation available to the System Agency upon request.
2.5 USE OF FUNDS
Grantee shall expend funds under this Grant Agreement only for approved services and for
reasonable and allowable expenses directly related to those services.
2.6 USE FOR MATCH PROHIBITED
Grantee shall not use funds provided under this Grant Agreement for matching purposes in
securing other funding without the written approval of the System Agency.
2.7 PROGRAM INCOME
Program income refers to gross income directly generated by a supporting activity during
the period of performance. Unless otherwise required under the Grant Agreement, Grantee
shall use Program Income, as provided in TxGMS, to further the Project, and Grantee shall
spend the Program Income on the Project. Grantee shall identify and report Program Income
in accordance with the Grant Agreement, applicable law, and any programmatic guidance.
Grantee shall expend Program Income during the Grant Agreement term, when earned, and
may not carry Program Income forward to any succeeding term. Grantee shall refund
Program Income to the System Agency if the Program Income is not expended in the term in
which it is earned. The System Agency may base future funding levels, in part,upon
Grantee's proficiency in identifying, billing, collecting, and reporting Program Income, and
in using Program Income for the purposes and under the conditions specified in this Grant
Agreement.
2.8 NONSUPPLANTING
Grant funds must be used to supplement existing,new or corresponding programming and
related activities. Grant funds may not be used to supplant(replace) existing funds that have
been appropriated, allocated, or disbursed for the same purpose. System Agency may
conduct Grant monitoring or audits may be conducted to review, among other things,
Grantee's compliance with this provision.
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 9 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
2.9 INDIRECT COST RATES
The System Agency may acknowledge an indirect cost rate for Grantees that is utilized for
all applicable Grant Agreements. For subrecipients receiving federal funds, indirect cost
rates will be determined in accordance with applicable law including,but not limited to, 2
CFR 200.414(f). For recipients receiving state funds, indirect costs will be determined in
accordance with applicable law including,but not limited to, TxGMS. Grantees funded with
blended federal and state funding will be subject to both state and federal requirements when
determining indirect costs. In the event of a conflict between TxGMS and applicable federal
law or regulation, the provisions of federal law or regulation will apply._Grantee will provide
any necessary financial documents to determine the indirect cost rate in accordance with the
Uniform Grant Guidance (UGG) and TxGMS.
ARTICLE III. STATE AND FEDERAL FUNDING
3.1 EXCESS OBLIGATIONS PROHIBITED
This Grant Agreement is subject to termination or cancellation,without penalty to System
Agency, either in whole or in part, subject to the availability and actual receipt by System
Agency of state or federal funds. System Agency is a state agency whose authority and
appropriations are subject to actions of the Texas Legislature. If System Agency becomes
subject to a legislative change,revocation of statutory authority, or lack of appropriated
funds that would render either System Agency's or Grantee's delivery or performance under
the Grant Agreement impossible or unnecessary, the Grant Agreement will be terminated or
cancelled and be deemed null and void. In the event of a termination or cancellation under
this Section, System Agency will not be liable to Grantee for any damages that are caused or
associated with such termination or cancellation, and System Agency will not be required to
give prior notice. Additionally, System Agency will not be liable to Grantee for any
remaining unpaid funds under this Grant Agreement at time of termination.
3.2 NO DEBT AGAINST THE STATE
This Grant Agreement will not be construed as creating any debt by or on behalf of the State
of Texas.
3.3 DEBTS AND DELINQUENCIES
Grantee agrees that any payments due under the Grant Agreement shall be directly applied
towards eliminating any debt or delinquency it has to the State of Texas including,but not
limited to, delinquent taxes, delinquent student loan payments, and delinquent child support
during the entirety of the Grant Agreement term.
3.4 REFUNDS AND OVERPAYMENTS
A. At its sole discretion, the System Agency may(i)withhold all or part of any payments to
Grantee to offset overpayments,unallowable or ineligible costs made to the Grantee, or
if any required financial status report(s)is not submitted by the due date(s); or(ii)require
Grantee to promptly refund or credit-within thirty(30) calendar days of written notice—
to System Agency any funds erroneously paid by System Agency which are not expressly
authorized under the Grant Agreement.
B. "Overpayments" as used in this Section include payments (i)made by the System
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 10 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
Agency that exceed the maximum allowable rates;(ii)that are not allowed under applicable
laws,rules, or regulations;or(iii) that are otherwise inconsistent with this Grant
Agreement, including any unapproved expenditures. Grantee understands and agrees that
it shall be liable to the System Agency for any costs disallowed pursuant to financial and
compliance audit(s)of funds received under this Grant Agreement. Grantee further
understands and agrees that reimbursement of such disallowed costs shall be paid by
Grantee from funds which were not provided or otherwise made available to Grantee
under this Grant Agreement.
ARTICLE IV. ALLOWABLE COSTS AND AUDIT REQUIREMENTS
4.1 ALLOWABLE COSTS
A. Allowable Costs are restricted to costs that are authorized under Texas Uniform Grant
Management Standards (TxGMS) and applicable state and federal rules and laws. This
Grant Agreement is subject to all applicable requirements of TxGMS, including the
criteria for Allowable Costs. Additional federal requirements apply if this Grant
Agreement is funded, in whole or in part,with federal funds.
B. System Agency will reimburse Grantee for actual,allowable, and allocable costs incurred
by Grantee in performing the Project,provided the costs are sufficiently documented.
Grantee must have incurred a cost prior to claiming reimbursement and within the
applicable term to be eligible for reimbursement under this Grant Agreement. At its sole
discretion, the System Agency will determine whether costs submitted by Grantee are
allowable and eligible for reimbursement. The System Agency may take repayment
(recoup) from remaining funds available under this Grant Agreement in amounts
necessary to fulfill Grantee's repayment obligations. Grantee and all payments received
by Grantee under this Grant Agreement are subject to applicable cost principles, audit
requirements, and administrative requirements including applicable provisions under 2
CFR 200, 48 CFR Part 31, and TxGMS.
C. OMB Circulars will be applied with the modifications prescribed by TxGMS with effect
given to whichever provision imposes the more stringent requirement in the event of a
conflict.
4.2 AUDITS AND FINANCIAL STATEMENTS
A. Audits
i. Grantee understands and agrees that Grantee is subject to any and all applicable audit
requirements found in state or federal law or regulation or added by this Grant
Agreement
ii. HHS Single Audit Unit will notify Grantee to complete the Single Audit
Determination Form. If Grantee fails to complete the form within thirty(30) calendar
days after receipt of notice, Grantee maybe subject to sanctions and remedies for
non-compliance.
iii. If Grantee, within Grantee's fiscal year, expends at least SEVEN HUNDRED FIFTY
THOUSAND DOLLARS ($750,000) in federal funds awarded, Grantee shall have a
single audit or program-specific audit in accordance with 2 CFR 200. The federal
threshold amount includes federal funds passed through by way of state agency
awards.
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 11 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
iv. If Grantee, within Grantee's fiscal year, expends at least SEVEN HUNDRED FIFTY
THOUSAND DOLLARS ($750,000) in state funds awarded, Grantee shall have a
single audit or program-specific audit in accordance with TxGMS. The audit must be
conducted by an independent certified public accountant and in accordance with 2
CFR 200, Government Auditing Standards, and TxGMS.
v. For-profit Grantees whose expenditures meet or exceed the federal or state
expenditure thresholds stated above shall follow the guidelines in 2 CFR 200 or
TxGMS, as applicable, for their program-specific audits.
vi. Each Grantee required to obtain a single audit must competitively re-procure single
audit services once every six years. Grantee shall procure audit services in
compliance with this section, state procurement procedures, as well as with
applicable provisions of 2 CFR 200 and TxGMS.
B. Financial Statements.
Each Grantee that does not meet the expenditure threshold for a single audit or program-
specific audit,must provide financial statements for the audit period.
4.3 SUBMISSION OF AUDITS AND FINANCIAL STATEMENTS
A. Audits.
Due the earlier of 30 days after receipt of the independent certified public accountant's
report or nine months after the end of the fiscal year, Grantee shall submit one electronic
copy of the single audit or program-specific audit to the System Agency via:
i. HHS portal at https://hhsportal.hhs.state.tx.us/heartwebextr/hhscSau or,
ii. Email to: single audit report@hhsc.state.tx.us.
B. Financial Statements.
Due no later than nine months after the Grantee's fiscal year-end, Grantees not required
to submit an audit, shall submit one electronic copy of their financial statements via:
i. HHS portal at https://hhsportal.hhs.state.tx.us/heartwebextr/hhscSau; or,
ii. Email to: single audit report@hhsc.state.tx.us.
ARTICLE V. WARRANTY, AFFIRMATIONS, ASSURANCES AND
CERTIFICATIONS
5.1 WARRANTY
Grantee warrants that all work under this Grant Agreement shall be completed in a manner
consistent with standards under the terms of this Grant Agreement, in the applicable trade,
profession, or industry; shall conform to or exceed the specifications set forth in the Grant
Agreement;and all deliverables shall be fit for ordinary use,of good quality,and with no
material defects. If System Agency, in its sole discretion, determines Grantee has failed to
complete work timely or to perform satisfactorily under conditions required by this Grant
Agreement,the System Agency may require Grantee, at its sole expense,to:
i. Repair or replace all defective or damaged work;
ii. Refund any payment Grantee received from System Agency for all defective or
damaged work and, in conjunction therewith, require Grantee to accept the return of
such work; and,
iii. Take necessary action to ensure that Grantee's future performance and work conform
to the Grant Agreement requirements.
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 12 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
5.2 GENERAL AFFIRMATIONS
Grantee certifies that,to the extent affirmations are incorporated into the Grant Agreement,
the Grantee has reviewed the affirmations and that Grantee is in compliance with all
requirements.
5.3 FEDERAL ASSURANCES
Grantee further certifies that, to the extent federal assurances are incorporated into the Grant
Agreement,the Grantee has reviewed the federal assurances and that Grantee is in
compliance with all requirements.
5.4 FEDERAL CERTIFICATIONS
Grantee further certifies that,to the extent federal certifications are incorporated into the
Grant Agreement, the Grantee has reviewed the federal certifications and that Grantee is in
compliance with all requirements. In addition,Grantee certifies that it is in compliance with
all applicable federal laws,rules,and regulations,as they may pertain to this Grant Agreement.
5.5 STATE ASSURANCES
Except to the extent of any conflict under applicable law or requirements or guidelines of
any federal awarding agency from which funding for this Grant Agreement originated, the
Grantee must comply with the applicable state assurances included within the TxGMS
which are incorporated here by reference.
ARTICLE VI. INTELLECTUAL PROPERTY
6.1 OWNERSHIP OF WORK PRODUCT
A. All right, title, and interest in the Work Product, including all Intellectual Property
Rights therein,is exclusively owned by System Agency.Grantee and Grantee's
employees will have no rights in or ownership of the Work Product or any other property
of System Agency.
B. Any and all Work Product that is copyrightable under United States copyright law is
deemed to be"work made for hire"owned by System Agency, as provided by Title 17
of the United States Code. To the extent that Work Product does not qualify as a"work
made for hire"under applicable federal law, Grantee hereby irrevocably assigns and
transfers to System Agency, its successors and assigns, the entire right, title, and interest
in and to the Work Product, including any and all Intellectual Property Rights
embodied therein or associated therewith, and in and to all works based upon, derived
from, or incorporating the Work Product, and in and to all income,royalties,damages,
claims and payments now or hereafter due or payable with respect thereto, and in and to
all causes of action, either in law or in equity for past,present or future infringement
based on the copyrights,and in and to all rights corresponding to the foregoing.
C. Grantee agrees to execute all papers and to perform such other acts as System Agency
may deem necessary to secure for System Agency or its designee the rights herein
assigned.
D. In the event that Grantee has any rights in and to the Work Product that cannot be
assigned to System Agency, Grantee hereby grants to System Agency an exclusive,
worldwide,royalty-free, transferable, irrevocable, and perpetual license, with the right to
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 13 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
sublicense, to reproduce, distribute,modify, create derivative works of,publicly perform
and publicly display, make,have made,use, sell and offer for sale the Work Product and
any products developed by practicing such rights.
E. The foregoing does not apply to Incorporated Pre-existing Works or Third Party IP that
are incorporated in the Work Product by Grantee. Grantee shall provide System Agency
access during normal business hours to all Grantee materials,premises, and computer
files containing the Work Product.
6.2 GRANTEE'S PRE-EXISTING WORKS
A. To the extent that Grantee incorporates into the Work Product any works of Grantee that
were created by Grantee or that Grantee acquired rights in prior to the Effective Date of
this Grant Agreement ("Incorporated Pre-existing Works"), Grantee retains ownership
of such Incorporated Pre-existing Works.
B. Grantee hereby grants to System Agency an irrevocable,perpetual,non-exclusive,
royalty-free,transferable,worldwide right and license,with the right to sublicense, to
use,reproduce, modify, copy, create derivative works of, publish,publicly perform and
display, sell, offer to sell,make and have made, the Incorporated Pre-existing Works, in
any medium,with or without the associated Work Product.
C. Grantee represents, warrants, and covenants to System Agency that Grantee has all
necessary right and authority to grant the foregoing license in the Incorporated Pre-
existing Works to System Agency.
6.3 THIRD PARTY IP
A. To the extent that any Third Party IP is included or incorporated in the Work Product by
Grantee,Grantee hereby grants to System Agency,or shall obtain from the applicable
third party for System Agency's benefit, the irrevocable, perpetual,non-exclusive,
worldwide,royalty-free right and license, for System Agency's internal business or
governmental purposes only, to use, reproduce, display,perform, distribute copies of,
and prepare derivative works based upon such Third Party IP and any derivative works
thereof embodied in or delivered to System Agency in conjunction with the Work
Product, and to authorize others to do any or all of the foregoing.
B. Grantee shall obtain System Agency's advance written approval prior to incorporating
any Third Party IP into the Work Product, and Grantee shall notify System Agency on
delivery of the Work Product if such materials include any Third Party IP.
C. Grantee shall provide System Agency all supporting documentation demonstrating
Grantee's compliance with this Section 6.3,including without limitation documentation
indicating a third party's written approval for Grantee to use any Third Party IP that may
be incorporated in the Work Product.
6.4 AGREEMENTS WITH EMPLOYEES AND SUBCONTRACTORS
Grantee shall have written,binding agreements with its employees and subcontractors that
include provisions sufficient to give effect to and enable Grantee's compliance with
Grantee's obligations under this Article VI, Intellectual Property.
6.5 DELIVERY UPON TERMINATION OR EXPIRATION
No later than the first calendar day after the termination or expiration of the Grant Agreement
or upon System Agency's request,Grantee shall deliver to System Agency all completed,or
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 14 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
partially completed, Work Product, including any Incorporated Pre-existing Works, and any
and all versions thereof. Grantee's failure to timely deliver such Work Product is a material
breach of the Grant Agreement.Grantee will not retain any copies of the Work Product or any
documentation or other products or results of Grantee's activities under the Grant Agreement
without the prior written consent of System Agency.
6.6 SURVIVAL
The provisions and obligations of this Article survive any termination or expiration of the
Grant Agreement.
6.7 SYSTEM AGENCY DATA
A. As between the Parties, all data and information acquired, accessed, or made available to
Grantee by,through, or on behalf of System Agency or System Agency contractors,
including all electronic data generated,processed, transmitted, or stored by Grantee in
the course of providing data processing services in connection with Grantee's
performance hereunder(the"System Agency Data"),is owned solely by System Agency.
B. Grantee has no right or license to use, analyze, aggregate, transmit, create derivatives of,
copy, disclose,or process the System Agency Data except as required for Grantee to
fulfill its obligations under the Grant Agreement or as authorized in advance in writing
by System Agency.
C. For the avoidance of doubt, Grantee is expressly prohibited from using, and from
permitting any third party to use, System Agency Data for marketing,research, or other
non-governmental or commercial purposes,without the prior written consent of System
Agency.
D. Grantee shall make System Agency Data available to System Agency, including to
System Agency's designated vendors, as directed in writing by System Agency. The
foregoing shall be at no cost to System Agency.
E. Furthermore, the proprietary nature of Grantee's systems that process, store, collect,
and/or transmit the System Agency Data shall not excuse Grantee's performance of its
obligations hereunder.
ARTICLE VII. PROPERTY
7.1 USE OF STATE PROPERTY
A. Grantee is prohibited from using State Property for any purpose other than performing
Services authorized under the Grant Agreement.
B. State Property includes,but is not limited to, System Agency's office space,
identification badges, System Agency information technology equipment and networks
(e.g., laptops, portable printers, cell phones, iPads or tablets, external hard drives, data
storage devices, any System Agency-issued software, and the System Agency Virtual
Private Network(VPN client)), and any other resources of System Agency.
C. Grantee shall not remove State Property from the continental United States. In addition,
Grantee may not use any computing device to access System Agency's network or e-
mail while outside of the continental United States.
D. Grantee shall not perform any maintenance services on State Property unless the Grant
Agreement expressly authorizes such Services.
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 15 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
E. During the time that State Property is in the possession of Grantee, Grantee shall be
responsible for:
i. all repair and replacement charges incurred by State Agency that are associated with
loss of State Property or damage beyond normal wear and tear,and
ii. all charges attributable to Grantee's use of State Property that exceeds the Grant
Agreement scope. Grantee shall fully reimburse such charges to System Agency
within ten(10) calendar days of Grantee's receipt of System Agency's notice of
amount due. Use of State Property for a purpose not authorized by the Grant
Agreement shall constitute breach of contract and may result in termination of the
Grant Agreement and the pursuit of other remedies available to System Agency
under contract, at law, or in equity.
7.2 DAMAGE TO STATE PROPERTY
A. In the event of loss,destruction,or damage to any System Agency or State of Texas
owned, leased, or occupied property or equipment by Grantee or Grantee's employees,
agents, Subcontractors, or suppliers, Grantee shall be liable to System Agency and the
State of Texas for the full cost of repair, reconstruction, or replacement of the lost,
destroyed, or damaged property.
B. Grantee shall notify System Agency of the loss,destruction, or damage of equipment or
property within one(1)business day. Grantee shall reimburse System Agency and the
State of Texas for such property damage within ten(10)calendar days after Grantee's
receipt of System Agency's notice of amount due.
7.3 PROPERTY RIGHTS UPON TERMINATION OR EXPIRATION OF CONTRACT
In the event the Grant Agreement is terminated for any reason or expires, State Property
remains the property of the System Agency and must be returned to the System Agency by
the earlier of the end date of the Grant Agreement or upon System Agency's request.
7.4 EQUIPMENT AND PROPERTY
A The Grantee must ensure equipment with a per-unit cost of$5,000 or greater purchased
with grant funds under this award is used solely for the purpose of this Grant or is
properly pro-rated for use under this Grant. Grantee must have control systems to
prevent loss, damage, or theft of property funded under this Grant. Grantee shall
maintain equipment management and inventory procedures for equipment,whether
acquired in part or whole with grant funds,until disposition occurs.
B. When equipment acquired by Grantee under this Grant Agreement is no longer needed
for the original project or for other activities currently supported by System Agency, the
Grantee must properly dispose of the equipment pursuant to 2 CFR and/or TxGMS, as
applicable. Upon termination of this Grant Agreement, use and disposal of equipment by
the Grantee shall conform with TxGMS requirements.
C Grantee shall initiate the purchase of all equipment approved in writing by the System
Agency in accordance with the schedule approved by System Agency, 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 Grant Agreement must be submitted to the
assigned System Agency contract manager.
D. Controlled Assets include firearms, regardless of the acquisition cost, and the following
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 16 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
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.
E System Agency funds must not be used to purchase buildings or real property without
prior written approval from System Agency. Any costs related to the initial acquisition
of the buildings or real property are not allowable without written pre-approval.
ARTICLE VIII. RECORD RETENTION, AUDIT, AND
CONFIDENTIALITY
8.1 RECORD MAINTENANCE AND RETENTION
A. Grantee shall keep and maintain under GAAP or GASB, as applicable, full, true, and
complete records necessary to fully disclose to the System Agency, the Texas State
Auditor's Office, the United States Government, and their authorized representatives
sufficient information to determine compliance with the terms and conditions of this Grant
Agreement and all state and federal rules, regulations, and statutes.
B. Grantee shall maintain and retain legible copies of this Grant Agreement and all records
relating to the performance of the Grant Agreement, including supporting fiscal
documents adequate to ensure that claims for grant funds are in accordance with
applicable State of Texas requirements. These records shall be maintained and retained
by the Grantee for a minimum of seven (7) years after the Grant Agreement expiration
date or seven(7)years after all audits, claims, litigation or disputes involving the Grant
Agreement are resolved,whichever is later.
8.2 AGENCY'S RIGHT TO AUDIT
A. Grantee shall make available at reasonable times and upon reasonable notice, and for
reasonable periods, work papers,reports,books, records, supporting documents kept
current by Grantee pertaining to the Grant Agreement for purposes of inspecting,
monitoring, auditing, or evaluating by System Agency and the State of Texas.
B. In addition to any right of access arising by operation of law, Grantee and any of
Grantee's affiliate or subsidiary organizations, or Subcontractors shall permit the System
Agency or any of its duly authorized representatives, as well as duly authorized federal,
state or local authorities,unrestricted access to and the right to examine any site where
business is conducted or services are performed, and all records, which includes but is
not limited to financial, client and patient records,books,papers or documents related to
this Grant Agreement. If the Grant Agreement includes federal funds, federal agencies
that shall have a right of access to records as described in this section include: the federal
agency providing the funds,the Comptroller General of the United States,the General
Accounting Office,the Office of the Inspector General, and any of their authorized
representatives. In addition, agencies of the State of Texas that shall have a right of
access to records as described in this section include: the System Agency,HHS's
contracted examiners, the State Auditor's Office, the Office of the Texas Attorney
General, and any successor agencies. Each of these entities may be a duly authorized
authority.
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 17 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
C. If deemed necessary by the System Agency or any duly authorized authority, for the
purpose of investigation or hearing, Grantee shall produce original documents related to
this Grant Agreement.
D. The System Agency and any duly authorized authority shall have the right to audit
billings both before and after payment, and all documentation that substantiates the
billings.
E. Grantee shall include this provision concerning the right of access to, and examination
of, sites and information related to this Grant Agreement in any Subcontract it awards.
8.3 RESPONSE/COMPLIANCE WITH AUDIT OR INSPECTION FINDINGS
A. Grantee must act to ensure its and its Subcontractors' compliance with all corrections
necessary to address any finding of noncompliance with any law,regulation, audit
requirement, or generally accepted accounting principle, or any other deficiency
identified in any audit,review, or inspection of the Grant Agreement and the services
and Deliverables provided. Any such correction will be at Grantee's or its
Subcontractor's sole expense. Whether Grantee's action corrects the noncompliance shall
be solely the decision of the System Agency.
B. As part of the services, Grantee must provide to HHS upon request a copy of those
portions of Grantee's and its Subcontractors'internal audit reports relating to the services
and Deliverables provided to the State under the Grant Agreement.
8.4 STATE AUDITOR'S RIGHT TO AUDIT
The state auditor may conduct an audit or investigation of any entity receiving funds from the
state directly under the Grant Agreement or indirectly through a subcontract under the Grant
Agreement. The acceptance of funds directly under the Grant Agreement or indirectly
through a subcontract under the Grant Agreement acts as acceptance of the authority of the
state auditor,under the direction of the legislative audit committee,to conduct an audit or
investigation in connection with those funds.Under the direction of the legislative audit
committee,an entity that is the subject of an audit or investigation by the state auditor must
provide the state auditor with access to any information the state auditor considers relevant
to the investigation or audit.
8.5 CONFIDENTIALITY
Grantee shall maintain as confidential and shall not disclose to third parties without System
Agency's prior written consent, any System Agency information including but not limited to
System Agency's business activities,practices, systems, conditions and services. This
section will survive termination or expiration of this Grant Agreement. This requirement
must be included in all subcontracts awarded by Grantee.
ARTICLE IX. GRANT REMEDIES, TERMINATION AND PROHIBITED
ACTIVITIES
9.1 REMEDIES
A To ensure Grantee's full performance of the Grant Agreement and compliance with
applicable law, System Agency reserves the right to hold Grantee accountable for breach
of contract or substandard performance and may take remedial or corrective actions,
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 18 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
including,but not limited to the following:
i. temporarily withholding cash disbursements or reimbursements pending correction of
the deficiency;
ii. disallowing or denying use of funds for the activity or action deemed not to be in
compliance;
iii. disallowing claims for reimbursement that may require a partial or whole return of
previous payments or reimbursements;
iv. suspending all or part of the Grant Agreement;
v. requiring the Grantee to take specific actions in order to remain in compliance with
the Grant Agreement;
vi. recouping payments made by the System Agency to the Grantee found to be in error;
vii. suspending, limiting, or placing conditions on the Grantee's continued performance
of the Project;
viii. prohibiting the Grantee from receiving additional funds for other grant programs
administered by the System Agency until satisfactory compliance resolution is
obtained;
ix. withholding release of new grant agreements; and
x. imposing any other remedies,sanctions or penalties authorized under this Grant
Agreement or permitted by federal or state statute, law, regulation or rule.
B. Unless expressly authorized by System Agency, Grantee may not be entitled to
reimbursement for expenses incurred while the Grant Agreement is suspended.
C. No action taken by System Agency in exercising remedies or imposing sanctions will
constitute or operate as a waiver of any other rights or remedies available to System
Agency under the Grant Agreement or pursuant to law. Additionally, no action taken by
System Agency in exercising remedies or imposing sanctions will constitute or operate
as an acceptance,waiver, or cure of Grantee's breach. Unless expressly authorized by
System Agency, Grantee may not be entitled to reimbursement for expenses incurred
while the Grant Agreement is suspended or after termination.
9.2 TERMINATION FOR CONVENIENCE
The System Agency may terminate the Grant Agreement, in whole or in part, at any time
when, in its sole discretion, the System Agency determines that termination is in the best
interests of the State of Texas. The termination will be effective on the date specified in the
System Agency's notice of termination.
9.3 TERMINATION FOR CAUSE
A. Except as otherwise provided by the U.S. Bankruptcy Code, or any successor law, the
System Agency may terminate the Grant Agreement, in whole or in part,upon either of
the following conditions:
i. Material Breach
The System Agency may terminate the Grant Agreement, in whole or in part, if
the System Agency determines, in its sole discretion, that Grantee has materially
breached the Grant Agreement or has failed to adhere to any laws, ordinances,
rules, regulations or orders of any public authority having jurisdiction,whether or
not such violation prevents or substantially impairs performance of Grantee's duties
under the Grant Agreement. Grantee's misrepresentation in any aspect including,
but not limited to, of Grantee's Solicitation Application, if any, or Grantee's
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 19 of 29
DocuSign Envelope ID:98366072-7076-4F2C-8771-7DDD39BFB126
addition to the SAM exclusion list(identification in SAM as an excluded entity)
may also constitute a material breach of the Grant Agreement.
ii. Failure to Maintain Financial Viability
The System Agency may terminate the Grant Agreement if the System Agency, in
its sole discretion, determines that Grantee no longer maintains the financial
viability required to complete the services and deliverables, or otherwise fully
perform its responsibilities under the Grant Agreement.
B. System Agency will specify the effective date of such termination in the notice to
Grantee. If no effective date is specified,the Grant Agreement will terminate on the
date of the notification.
9.4 GRANTEE RESPONSIBILITY FOR SYSTEM AGENCY'S TERMINATION COSTS
If the System Agency terminates the Grant Agreement for cause, the Grantee shall be
responsible to the System Agency for all costs incurred by the System Agency and the State
of Texas to replace the Grantee. These costs include, but are not limited to,the costs of
procuring a substitute grantee and the cost of any claim or litigation attributable to Grantee's
failure to perform any work in accordance with the terms of the Grant Agreement.
9.5 INHERENTLY RELIGIOUS ACTIVITIES
Grantee may not use grant funding to engage in inherently religious activities, such as
proselytizing, scripture study, or worship. Grantees may engage in inherently religious
activities; however, these activities must be separate in time or location from the grant-
funded program. Moreover, grantees must not compel program beneficiaries to participate in
inherently religious activities. These requirements apply to all grantees, not just faith-based
organizations.
9.6 POLITICAL ACTIVITIES
Grant funds cannot be used for the following activities:
A. Grantees and their relevant sub-grantees or subcontractors are prohibited from using
grant funds directly or indirectly for political purposes, including lobbying, advocating
for legislation, campaigning for, endorsing, contributing to, or otherwise supporting
political candidates or parties, and voter registration campaigns. Grantees may use
private, or non-System Agency money or contributions for political purposes but may
not charge to, or be reimbursed from, System Agency contracts or grants for the costs of
such activities.
B. Grant-funded employees may not use official authority or influence to achieve any
political purpose and grant funds cannot be used for the salary, benefits, or any other
compensation of an elected official.
C. Grant funds may not be used to employ, in any capacity, a person who is required by
Chapter 305 of the Texas Government Code to register as a lobbyist. Additionally, grant
funds cannot be used to pay membership dues to an organization that partially or wholly
pays the salary of a person who is required by Chapter 305 of the Texas Government
Code to register as a lobbyist.
D. As applicable, Grantee will comply with 31 USC § 1352, relating to the limitation on use
of appropriated funds to influence certain Federal contracting and financial transactions.
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 20 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
ARTICLE X. INDEMNITY
10.1 GENERAL INDEMNITY
A. GRANTEE SHALL DEFEND,INDEMNIFY AND HOLD HARMLESS THE
STATE OF TEXAS AND SYSTEM AGENCY,AND/OR THEIR OFFICERS,
AGENTS, EMPLOYEES,REPRESENTATIVES, CONTRACTORS,
ASSIGNEES,AND/OR DESIGNEES FROM ANY AND ALL LIABILITY,
ACTIONS,CLAIMS,DEMANDS, OR SUITS,AND ALL RELATED COSTS,
ATTORNEYS' FEES,AND EXPENSES ARISING OUT OF OR RESULTING
FROM ANY ACTS OR OMISSIONS OF GRANTEE OR ITS AGENTS,
EMPLOYEES, SUBCONTRACTORS, ORDER FULFILLERS,OR SUPPLIERS
OF SUBCONTRACTORS IN THE EXECUTION OR PERFORMANCE OF THE
GRANT AGREEMENT AND ANY PURCHASE ORDERS ISSUED UNDER THE
GRANT AGREEMENT.
B. THIS PARAGRAPH IS NOT INTENDED TO AND WILL NOT BE
CONSTRUED TO REQUIRE GRANTEE TO INDEMNIFY OR HOLD
HARMLESS THE STATE OR THE SYSTEM AGENCY FOR ANY CLAIMS OR
LIABILITIES RESULTING FROM THE NEGLIGENT ACTS OF OMISSIONS
OF THE SYSTEM AGENCY OR ITS EMPLOYEES.
C. For the avoidance of doubt,System Agency shall not indemnify Grantee or any other
entity under the Grant Agreement.
10.2 INTELLECTUAL PROPERTY
GRANTEE SHALL DEFEND, INDEMNIFY,AND HOLD HARMLESS THE
SYSTEM AGENCY AND THE STATE OF TEXAS FROM AND AGAINST ANY
AND ALL CLAIMS,VIOLATIONS,MISAPPROPRIATIONS, OR
INFRINGEMENT OF ANY PATENT, TRADEMARK, COPYRIGHT, TRADE
SECRET, OR OTHER INTELLECTUAL PROPERTY RIGHTS AND/OR OTHER
INTANGIBLE PROPERTY,PUBLICITY OR PRIVACY RIGHTS,AND/OR IN
CONNECTION WITH OR ARISING FROM:
i THE PERFORMANCE OR ACTIONS OF GRANTEE PURSUANT TO THIS
GRANT AGREEMENT;
a ANY DELIVERABLE,WORK PRODUCT, CONFIGURED SERVICE OR
OTHER SERVICE PROVIDED HEREUNDER; AND/OR
M. SYSTEM AGENCY'S AND/OR GRANTEE'S USE OF OR ACQUISITION OF
ANY REQUESTED SERVICES OR OTHER ITEMS PROVIDED TO
SYSTEM AGENCY BY GRANTEE OR OTHERWISE TO WHICH SYSTEM
AGENCY HAS ACCESS AS A RESULT OF GRANTEE'S PERFORMANCE
UNDER THE GRANT AGREEMENT.
10.3 ADDITIONAL INDEMNITY PROVISIONS
A. GRANTEE AND SYSTEM AGENCY AGREE TO FURNISH TIMELY
WRITTEN NOTICE TO EACH OTHER OF ANY INDEMNITY CLAIM.
GRANTEE SHALL BE LIABLE TO PAY ALL COSTS OF DEFENSE,
INCLUDING ATTORNEYS' FEES.
B. THE DEFENSE SHALL BE COORDINATED BY THE GRANTEE WITH THE
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 21 of 29
DocuSign Envelope ID 98366D72-7D76-4F2C-8771-7DDD39BFB126
OFFICE OF THE TEXAS ATTORNEY GENERAL WHEN TEXAS STATE
AGENCIES ARE NAMED DEFENDANTS IN ANY LAWSUIT AND GRANTEE
MAY NOT AGREE TO ANY SETTLEMENT WITHOUT FIRST OBTAINING
THE CONCURRENCE FROM THE OFFICE OF THE TEXAS ATTORNEY
GENERAL.
C. GRANTEE SHALL REIMBURSE SYSTEM AGENCY AND THE STATE OF
TEXAS FOR ANY CLAIMS, DAMAGES, COSTS, EXPENSES OR OTHER
AMOUNTS, INCLUDING,BUT NOT LIMITED TO,ATTORNEYS' FEES AND
COURT COSTS, ARISING FROM ANY SUCH CLAIM.IF THE SYSTEM
AGENCY DETERMINES THAT A CONFLICT EXISTS BETWEEN ITS
INTERESTS AND THOSE OF GRANTEE OR IF SYSTEM AGENCY IS
REQUIRED BY APPLICABLE LAW TO SELECT SEPARATE COUNSEL,
SYSTEM AGENCY WILL BE PERMITTED TO SELECT SEPARATE
COUNSEL AND GRANTEE SHALL PAY ALL REASONABLE COSTS OF
SYSTEM AGENCY'S COUNSEL.
ARTICLE XI. GENERAL PROVISIONS
11.1 AMENDMENTS
Except as otherwise expressly provided,the Grant Agreement may only be amended by a
written Amendment executed by both Parties.
11.2 No QUANTITY GUARANTEES
The System Agency makes no guarantee of volume or usage of work under this Grant
Agreement. All work requested may be on an irregular and as needed basis throughout the
Grant Agreement term.
11.3 CHILD ABUSE REPORTING REQUIREMENTS
A. Grantees shall comply with child abuse and neglect reporting requirements in Texas
Family Code Chapter 261. This section is in addition to and does not supersede any
other legal obligation of the Grantee to report child abuse.
B. Grantee shall develop, implement and enforce a written policy that includes at a
minimum the System Agency's Child Abuse Screening,Documenting,and Reporting
Policy for Grantees/Providers and train all staff on reporting requirements.
C. Grantee shall use the Texas Abuse Hotline Website located at
https://www.txabusehotline.org/Login/Default.aspx as required by the System
Agency. Grantee shall retain reporting documentation on site and make it available for
inspection by the System Agency.
11.4 CERTIFICATION OF MEETING OR EXCEEDING TOBACCO-FREE WORKPLACE POLICY
MINIMUM STANDARDS
A. Grantee certifies that it has adopted and enforces a Tobacco-Free Workplace Policy that
meets or exceeds all of the following minimum standards of:
i. Prohibiting the use of all forms of tobacco products, including but not limited to
cigarettes, cigars,pipes,water pipes (hookah), bidis,kreteks, electronic cigarettes,
smokeless tobacco, snuff and chewing tobacco;
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 22 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
ii. Designating the property to which this Policy applies as a "designated area,"which
must at least comprise all buildings and structures where activities funded under this
Grant Agreement are taking place, as well as Grantee owned, leased, or controlled
sidewalks,parking lots, walkways, and attached parking structures immediately
adjacent to this designated area;
iii. Applying to all employees and visitors in this designated area; and
iv. Providing for or referring its employees to tobacco use cessation services.
B. If Grantee cannot meet these minimum standards, it must obtain a waiver from the
System Agency.
11.5 INSURANCE AND BONDS
Unless otherwise specified in this Contract,Grantee shall acquire and maintain, for the
duration of this Contract, insurance coverage necessary to ensure proper fulfillment of this
Contract and potential liabilities thereunder with financially sound and reputable insurers
licensed by the Texas Department of Insurance, in the type and amount customarily carried
within the industry as determined by the System Agency. Grantee shall provide evidence of
insurance as required under this Contract, including a schedule of coverage or underwriter's
schedules establishing to the satisfaction of the System Agency the nature and extent of
coverage granted by each such policy,upon request by the System Agency. In the event that
any policy is determined by the System Agency to be deficient to comply with the terms of
this Contract, Grantee shall secure such additional policies or coverage as the System
Agency may reasonably request or that are required by law or regulation. If coverage expires
during the term of this Contract,Grantee must produce renewal certificates for each type of
coverage. In addition, if required by System Agency, Grantee must obtain and have on file a
blanket fidelity bond that indemnifies System Agency against the loss or theft of any grant
funds, including applicable matching funds. The fidelity bond must cover the entirety of the
grant term and any subsequent renewals. The failure of Grantee to comply with these
requirements may subject Grantee to remedial or corrective actions detailed in section 10.1,
General Indemnity, above.
These and all other insurance requirements under the Grant apply to both Grantee and its
Subcontractors, if any. Grantee is responsible for ensuring its Subcontractors' compliance
with all requirements.
11.6 LIMITATION ON AUTHORITY
A. Grantee shall not have any authority to act for or on behalf of the System Agency or the
State of Texas except as expressly provided for in the Grant Agreement; no other
authority, power, or use is granted or implied. Grantee may not incur any debt,
obligation, expense, or liability of any kind on behalf of System Agency or the State of
Texas.
B. Grantee may not rely upon implied authority and is not granted authority under the Grant
Agreement to:
i. Make public policy on behalf of the System Agency;
ii. Promulgate, amend,or disregard administrative regulations or program policy
decisions made by State and federal agencies responsible for administration of a
System Agency program;or
iii. Unilaterally communicate or negotiate with any federal or state agency or the Texas
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 23 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
Legislature on behalf of the System Agency regarding System Agency programs or
the Grant Agreement. However,upon System Agency request and with reasonable
notice from System Agency to the Grantee, the Grantee shall assist the System
Agency in communications and negotiations regarding the Work under the Grant
Agreement with state and federal governments.
11.7 CHANGE IN LAWS AND COMPLIANCE WITH LAWS
Grantee shall comply with all laws, regulations,requirements and guidelines applicable to a
Grantee providing services and products required by the Grant Agreement to the State of
Texas, as these laws,regulations,requirements and guidelines currently exist and as amended
throughout the term of the Grant Agreement.Notwithstanding Section 11.1,Amendments,
above, System Agency reserves the right,in its sole discretion,to unilaterally amend the Grant
Agreement to incorporate any modifications necessary for System Agency's compliance, as
an agency of the State of Texas,with all applicable state and federal laws,regulations,
requirements and guidelines.
11.8 SUBCONTRACTORS
Grantee may not subcontract any or all of the Work and/or obligations under the Grant
Agreement without prior written approval of the System Agency. Subcontracts, if any,
entered into by the Grantee shall be in writing and be subject to the requirements of the
Grant Agreement. Should Grantee subcontract any of the services required in the Grant
Agreement, Grantee expressly understands and acknowledges System Agency is in no
manner liable to any subcontractor(s) of Grantee. In no event shall this provision relieve
Grantee of the responsibility for ensuring that the services performed under all subcontracts
are rendered in compliance with the Grant Agreement.
11.9 PERMITTING AND LICENSURE
At Grantee's sole expense, Grantee shall procure and maintain for the duration of this Grant
Agreement any state, county, city, or federal license, authorization, insurance,waiver,
permit, qualification or certification required by statute, ordinance, law, or regulation to be
held by Grantee to provide the goods or services required by this Grant Agreement. Grantee
shall be responsible for payment of all taxes, assessments, fees,premiums,permits, and
licenses required by law. Grantee shall be responsible for payment of any such government
obligations not paid by its Subcontractors during performance of this Grant Agreement.
11.10 INDEPENDENT CONTRACTOR
Grantee and Grantee's employees, representatives, agents, Subcontractors, suppliers, and
third-party service providers shall serve as independent contractors in providing the services
under the Grant Agreement.Neither Grantee nor System Agency is an agent of the other and
neither may make any commitments on the other parry's behalf. The Grantee is not a
"governmental body" solely by virtue of this Grant Agreement or receipt of grant funds
under this Grant Agreement. Grantee shall have no claim against System Agency for
vacation pay, sick leave, retirement benefits, social security, worker's compensation, health
or disability benefits,unemployment insurance benefits, or employee benefits of any kind.
The Grant Agreement shall not create any joint venture,partnership, agency, or employment
relationship between Grantee and System Agency.
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 24 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
1 1.1 1 GOVERNING LAW AND VENUE
The Grant Agreement shall be governed by and construed in accordance with the laws of the
State of Texas,without regard to the conflicts of law provisions. The venue of any suit
arising under the Grant Agreement is fixed in any court of competent jurisdiction of Travis
County, Texas, unless the specific venue is otherwise identified in a statute which directly
names or otherwise identifies its applicability to the System Agency.
11.12 SEVERABILITY
If any provision contained in this Grant Agreement is held to be unenforceable by a court of
law or equity, such construction will not affect the legality, validity, or enforceability of any
other provision or provisions of this Grant Agreement. It is the intent and agreement of the
Parties this Grant Agreement shall be deemed amended by modifying such provision to the
extent necessary to render it valid, legal and enforceable while preserving its intent or, if
such modification is not possible,by substituting another provision that is valid,legal and
enforceable and that achieves the same objective. All other provisions of this Grant
Agreement will continue in full force and effect.
11.13 SURVIVABILITY
Expiration or termination of the Grant Agreement for any reason does not release Grantee
from any liability or obligation set forth in the Grant Agreement that is expressly stated to
survive any such expiration or termination,that by its nature would be intended to be
applicable following any such expiration or termination, or that is necessary to fulfill the
essential purpose of the Grant Agreement, including without limitation the provisions
regarding return of grant funds, audit requirements,records retention, public information,
warranty, indemnification, confidentiality, and rights and remedies upon termination.
11.14 FORCE MAJEURE
Neither Grantee nor System Agency shall be liable to the other for any delay in, or failure of
performance, of any requirement included in the Grant Agreement caused by force majeure.
The existence of such causes of delay or failure shall extend the period of performance until
after the causes of delay or failure have been removed provided the non-performing party
exercises all reasonable due diligence to perform. Force majeure is defined as acts of God,
war, fires, explosions, hurricanes, floods, failure of transportation, or other causes that are
beyond the reasonable control of either party and that by exercise of due foresight such party
could not reasonably have been expected to avoid, and which,by the exercise of all
reasonable due diligence, such party is unable to overcome.
11.15 No IMPLIED WAIVER OF PROVISIONS
The failure of the System Agency to object to or to take affirmative action with respect to
any conduct of the Grantee which is in violation or breach of the terms of the Grant
Agreement shall not be construed as a waiver of the violation or breach, or of any future
violation or breach.
11.16 FUNDING DISCLAIMERS AND LABELING
A. Grantee shall not use System Agency's name or refer to System Agency directly or
indirectly in any media appearance,public service announcement, or disclosure relating
to this Grant Agreement including any promotional material without first obtaining
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 25 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
written consent from System Agency. The foregoing prohibition includes, without
limitation, the placement of banners,pop-up ads, or other advertisements promoting
Grantee's or a third party's products, services,workshops,trainings, or other commercial
offerings on any website portal or internet-based service or software application hosted
or managed by Grantee. This does not limit the Grantee's responsibility to comply with
obligations related to the Texas Public Information Act or Texas Open Meetings Act.
B. In general,no publication(including websites,reports,projects, etc.) may convey
System Agency's recognition or endorsement of the Grantee's project without prior
written approval from System Agency. Publications funded in part or wholly by HHS
grant funding must include a statement that"HHS and neither any of its components
operate, control, are responsible for, or necessarily endorse, this publication(including,
without limitation, its content,technical infrastructure, and policies, and any services or
tools provided)"at HHS's request.
11.17 MEDIA RELEASES
A. Grantee shall not use System Agency's name, logo, or other likeness in any press
release, marketing material or other announcement without System Agency's prior
written approval. System Agency does not endorse any vendor,commodity,or service.
Grantee is not authorized to make or participate in any media releases or public
announcements pertaining to this Grant Agreement or the Services to which they relate
without System Agency's prior written consent, and then only in accordance with
explicit written instruction from System Agency.
B. Grantee may publish, at its sole expense, results of Grantee performance under the Grant
Agreement with the System Agency's prior review and approval, which the System
Agency may exercise at its sole discretion. Any publication(written, visual, or sound)
will acknowledge the support received from the System Agency and any Federal agency,
as appropriate.
11.18 PROHIBITION ON NON-COMPETE RESTRICTIONS
Grantee shall not require any employees or Subcontractors to agree to any conditions, such
as non-compete clauses or other contractual arrangements,that would limit or restrict such
persons or entities from employment or contracting with the State of Texas.
11.19 SOVEREIGN IMMUNITY
Nothing in the Grant Agreement will be construed as a waiver of the System Agency's or
the State's sovereign immunity. This Grant Agreement shall not constitute or be construed as
a waiver of any of the privileges, rights, defenses, remedies, or immunities available to the
System Agency or the State of Texas. The failure to enforce, or any delay in the enforcement,
of any privileges, rights, defenses, remedies, or immunities available to the System Agency
or the State of Texas under the Grant Agreement or under applicable law shall not constitute
a waiver of such privileges, rights, defenses, remedies, or immunities or be considered as a
basis for estoppel. System Agency does not waive any privileges, rights, defenses, or
immunities available to System Agency by entering into the Grant Agreement or by its
conduct prior to or subsequent to entering into the Grant Agreement.
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 26 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
11.20 ENTIRE CONTRACT AND MODIFICATION
The Grant Agreement constitutes the entire agreement of the Parties and is intended as a
complete and exclusive statement of the promises,representations,negotiations,discussions,
and other agreements that may have been made in connection with the subject matter hereof
Any additional or conflicting terms in any future document incorporated into the Grant
Agreement will be harmonized with this Grant Agreement to the extent possible.
11.21 COUNTERPARTS
This Grant Agreement may be executed in any number of counterparts, each of which will
be an original, and all such counterparts will together constitute but one and the same Grant
Agreement.
11.22 PROPER AUTHORITY
Each Party represents and warrants that the person executing this Grant Agreement on its
behalf has full power and authority to enter into this Grant Agreement.
11.23 E-VER1FY PROGRAM
Grantee certifies that it utilizes and will continue to utilize the U.S. Department of
Homeland Security's E-Verify system to determine the eligibility of:
A. all persons employed to perform duties within Texas during the term of the Grant
Agreement; and
B. all persons, (including subcontractors) assigned by the Grantee to perform work pursuant
to the Grant Agreement within the United States of America.
11.24 CIVIL RIGHTS
A. Grantee agrees to comply with state and federal anti-discrimination laws, including:
i. Title VI of the Civil Rights Act of 1964 (42 U.S.C. §2000d et seq.);
ii. Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. §794);
iii. Americans with Disabilities Act of 1990 (42 U.S.C. §12101 et seq.);
iv. Age Discrimination Act of 1975 (42 U.S.C. §§6101-6107);
v. Title IX of the Education Amendments of 1972 (20 U.S.C. §§1681-1688);
vi. Food and Nutrition Act of 2008 (7 U.S.C. §2011 et seq.); and
vii. The System Agency's administrative rules, as set forth in the Texas Administrative
Code, to the extent applicable to this Grant Agreement.
B. Grantee agrees to comply with all amendments to the above-referenced laws, and all
requirements imposed by the regulations issued pursuant to these laws. These laws
provide in part that no persons in the United States may, on the grounds of race, color,
national origin, sex, age, disability, political beliefs, or religion,be excluded from
participation in or denied any aid, care, service or other benefits provided by Federal or
State funding, or otherwise be subjected to discrimination.
C. Grantee agrees to comply with Title VI of the Civil Rights Act of 1964, and its
implementing regulations at 45 C.F.R. Part 80 or 7 C.F.R. Part 15, prohibiting a
contractor from adopting and implementing policies and procedures that exclude or have
the effect of excluding or limiting the participation of clients in its programs, benefits, or
activities on the basis of national origin. State and federal civil rights laws require
contractors to provide alternative methods for ensuring access to services for applicants
and recipients who cannot express themselves fluently in English. Grantee agrees to take
HHS Uniform Terms and Conditions-Grant v.3.0
Effective August 2021
Page 27 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
reasonable steps to provide services and information,both orally and in writing, in
appropriate languages other than English, in order to ensure that persons with limited
English proficiency are effectively informed and can have meaningful access to
programs, benefits, and activities.
D. Grantee agrees to post applicable civil rights posters in areas open to the public
informing clients of their civil rights and including contact information for the HHS
Civil Rights Office. The posters are available on the HHS website at:
https://hhs.texas.gov/about-hhs/your-rights/civil-rights-office/civi l-rights-posters.
E. Grantee agrees to comply with Executive Order 13279, and its implementing regulations
at 45 C.F.R. Part 87 or 7 C.F.R. Part 16. These provide in part that any organization that
participates in programs funded by direct financial assistance from the United States
Department of Agriculture or the United States Department of Health and Human
Services shall not discriminate against a program beneficiary or prospective program
beneficiary on the basis of religion or religious belief.
F. Upon request, Grantee shall provide HHSC's Civil Rights Office with copies of the
Grantee's civil rights policies and procedures.
G. Grantee must notify HHSC's Civil Rights Office of any complaints of discrimination
received relating to its performance under this Grant Agreement. This notice must be
delivered no more than ten(10) calendar days after receipt of a complaint. Notice
provided pursuant to this section must be directed to:
HHSC Civil Rights Office
701 W. 51st Street, Mail CodeW206
Austin, Texas 78751
Phone Toll Free: (888) 388-6332
Phone: (512)438-4313
Fax: (512)438-5885
Email: HHSCivilRightsOffice@hhsc.state.tx.us.
11.25 ENTERPRISE INFORMATION MANAGEMENT STANDARDS
Grantee shall conform to HHS standards for data management as described by the policies
of the HHS Chief Data and Analytics Officer. These include,but are not limited to,
standards for documentation and communication of data models,metadata, and other data
definition methods that are required by HHS for ongoing data governance, strategic portfolio
analysis, interoperability planning, and valuation of HHS System data assets.
11.26 DISCLOSURE OF LITIGATION
A. The Grantee must disclose in writing to the contract manager assigned to this Grant
Agreement any material civil or criminal litigation or indictment either threatened or
pending involving the Grantee. "Threatened litigation" as used herein shall include
governmental investigations and civil investigative demands. "Litigation" as used herein
shall include administrative enforcement actions brought by governmental agencies. The
Grantee must also disclose any material litigation threatened or pending involving
Subcontractors, consultants, and/or lobbyists. For purposes of this section, "material"
refers,but is not limited, to any action or pending action that a reasonable person
knowledgeable in the applicable industry would consider relevant to the Work under the
Grant Agreement or any development such a person would want to be aware of in order
to stay fully apprised of the total mix of information relevant to the Work,together with
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 28 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
any litigation threatened or pending that may result in a substantial change in the
Grantee's financial condition.
B. This is a continuing disclosure requirement; any litigation commencing after Grant
Agreement Award must be disclosed in a written statement to the assigned contract
manager within seven calendar days of its occurrence.
11.27 No THIRD PARTY BENEFICIARIES
The Grant Agreement is made solely and specifically among and for the benefit of the
Parties named herein and their respective successors and assigns, and no other person shall
have any right, interest, or claims hereunder or be entitled to any benefits pursuant to or on
account of the Grant Agreement as a third-party beneficiary or otherwise.
11.28 BINDING EFFECT
The Grant Agreement shall inure to the benefit of,be binding upon, and be enforceable
against each Party and their respective permitted successors, assigns,transferees, and
delegates.
HHS Uniform Terms and Conditions—Grant v.3.0
Effective August 2021
Page 29 of 29
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
*-.4'. i74434 '411014P‘Ar Health and Human Se
Health and Human Services (HHS)
Additional Provisions — Grant Funding
Version 1.0
Effective: February 2021
Health and Human Services
Additional Provisions V.1.0—Grant Funding
Effective: February 2021
Page 1 of 6
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
TABLE OF CONTENTS
1. TURNOVER PLAN 3
2. TURNOVER ASSISTANCE 3
3. DISASTER SERVICES 3
4. NOTICE OF A LICENSE ACTION 4
5. SERVICES AND INFORMATION FOR PERSONS WITH LIMITED ENGLISH
PROFICIENCY 4
6. THIRD PARTY PAYORS 4
7. INTERIM EXTENSION AMENDMENT 5
8. PROJECT COMMENCEMENT 5
9. DUPLICATION OF FUNDING 5
10. NOTICE OF CRIMINAL ACTIVITY AND DISCIPLINARY ACTIONS 5
11. NOTICE OF GRANT AGREEMENT ACTION 6
12. NOTICE OF BANKRUPTCY 6
13. NOTICE OF CHANGE OF CONTACT PERSON OR KEY PERSONNEL 6
Health and Human Services
Additional Provisions V.1.0—Grant Funding
Effective: February 2021
Page 2 of 6
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
ADDITIONAL PROVISIONS
The terms and conditions of these Additional Provisions are incorporated into and made a part of
the Grant Agreement. Terms included in these Additional Provisions and not otherwise defined
have the meanings assigned to them in HHS Uniform Terms and Conditions, Attachment D.
1. TURNOVER PLAN
System Agency, in its sole discretion,may require Grantee to develop and submit a Turnover
Plan at any time during the term of the Grant Agreement. Grantee must submit the Turnover
Plan to System Agency for review and approval. The Turnover Plan must describe Grantee's
policies and procedures that will ensure:
i. The least disruption in the implementation and performance of grant-funded activities
during Turnover; and
ii. Full cooperation with System Agency or its designee in transferring the performance
and obligations of the Grant Agreement.
2. TURNOVER ASSISTANCE
Grantee will provide any assistance and actions reasonably necessary to enable System
Agency or its designee to effectively close out the Grant Agreement and transfer the
performance and obligations of the Grant Agreement to another Grantee or to System
Agency if necessary. Grantee agrees that this obligation survives the termination, regardless
of whether for cause or convenience, or the expiration of the Grant Agreement and remains
in effect until completed to the satisfaction of System Agency.
3. DISASTER SERVICES
In the event of a local, state, or federal emergency, including natural, man-made, criminal,
terrorist, and/or bioterrorism events, declared as a state disaster by the Governor, or a federal
disaster declared by the appropriate federal official, Grantee may be called upon to assist the
System Agency in providing the following services:
i. Community evacuation;
ii. Health and medical assistance;
iii. Assessment of health and medical needs;
iv. Health surveillance;
v. Medical care personnel;
vi. Health and medical equipment and supplies;
vii. Patient evacuation;
viii. In-hospital care and hospital facility status;
ix. Food, drug and medical device safety;
x. Worker health and safety;
xi. Mental health and substance abuse;
xii. Public health information;
xiii. Vector control and veterinary services; and
xiv. Victim identification and mortuary services.
Health and Human Services
Additional Provisions V.1.0—Grant Funding
Effective: February 2021
Page 3 of 6
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
4. NOTICE OF A LICENSE ACTION
Grantee shall notify the assigned System Agency contract manager in writing of any action
impacting Grantee's license to provide services under this Grant Agreement within five
business days of becoming aware of the action and include the following:
i. Reason for such action;
ii. Name and contact information of the local, state or federal department or agency or
entity;
iii. Date of the license action; and
iv. License or case reference number.
5. SERVICES AND INFORMATION FOR PERSONS WITH LIMITED ENGLISH PROFICIENCY
A. Grantee shall take reasonable steps to provide services and information both orally and in
writing, in appropriate languages other than English, to ensure that persons with limited
English proficiency are effectively informed and can have meaningful access to programs,
benefits and activities. Meaningful access may entail providing language assistance
services, including oral interpretation and written translation, if necessary. More
information can be found at https://www.lep.gov/.
B. Grantee shall identify and document on the client records the primary language/dialect of
a client who has limited English proficiency and the need for translation or interpretation
services and shall not require a client to provide or pay for the services of a translator or
interpreter.
C. Grantee shall make every effort to avoid use of any persons under the age of 18 or any
family member or friend of the client as an interpreter for essential communications with
a client with limited English proficiency,unless the client has requested that person and
using the person would not compromise the effectiveness of services or violate the
client's confidentiality and the client is advised that a free interpreter is available.
6. THIRD PARTY PAYORS
A. Except as provided in this Grant Agreement, Grantee shall screen all clients and may not
bill the System Agency for services eligible for reimbursement from third party payors, who
are any person or entity who has the legal responsibility for paying for all or part of the
services provided,including commercial health or liability insurance carriers,Medicaid,or
other federal, state, local and private funding sources.
B. As applicable,the Grantee shall:
i. Enroll as a provider in Children's Health Insurance Program and Medicaid if providing
approved services authorized under this Grant Agreement that may be covered by those
programs and bill those programs for the covered services;
ii. Provide assistance to individuals to enroll in such programs when the screening process
indicates possible eligibility for such programs;
iii. Allow clients that are otherwise eligible for System Agency services,but cannot pay a
deductible required by a third party payor,to receive services and bill the System
Agency for the deductible;
iv. Not bill the System Agency for any services eligible for third party reimbursement until
all appeals to third party payors have been exhausted;
v. Maintain appropriate documentation from the third party payor reflecting attempts to
obtain reimbursement;
Health and Human Services
Additional Provisions V.1.0—Grant Funding
Effective: February 2021
Page 4 of 6
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
vi. Bill all third party payors for services provided under this Grant Agreement before
submitting any request for reimbursement to System Agency; and
vii. Provide third party billing functions at no cost to the client.
7. INTERIM EXTENSION AMENDMENT
A. Prior to or on the expiration date of this Grant Agreement,the Parties agree that this Grant
Agreement can be extended as provided under this section.
B. The System Agency shall provide written notice of interim extension amendment to the
Grantee under one of the following circumstances:
i. Continue provision of services in response to a disaster declared by the governor; or
ii. To ensure that services are provided to clients without interruption.
C. The System Agency will provide written notice of the interim extension amendment that
specifies the reason for it and period of time for the extension.
D. Grantee will provide and invoice for services in the same manner that is stated in the
Grant Agreement.
E. An interim extension under subsection(B)(i) of this section shall extend the term of the
Grant Agreement not longer than 30 days after governor's disaster declaration is declared
unless the Parties agree to a shorter period of time.
F. An interim extension under subsection(B)(i)of this section shall be a one-time extension
for a period of time determined by the System Agency.
8. PROJECT COMMENCEMENT
The Grantee shall begin the grant-funded project within 90 days of the original start date of
the grant term or grant execution date,whichever is later,unless otherwise approved by
System Agency. If project commencement is delayed, the Grantee must submit in writing to
the assigned contract manager, the steps taken to initiate the project,the reasons for the
delay, and the expected start date. System Agency may require Grantee to take immediate
remedial or corrective action in response to any delay.
9. DUPLICATION OF FUNDING
A. If Grantee receives any funding that is duplicative of funding received under this Grant
Agreement that cannot be used for new or expanded eligible grant activities, Grantee will
notify the assigned contract manager as soon as possible. System Agency may issue an
amendment modifying budget and/or project activities to eliminate duplication. Additionally,
Grantee understands that duplicative funding that cannot be re-programmed to support new
or expanded grant-funded activities within the program's scope may be de-obligated from
this Grant Agreement and returned to System Agency.
10.NOTICE OF CRIMINAL ACTIVITY AND DISCIPLINARY ACTIONS
A. Grantee shall immediately report in writing to its assigned System Agency contract
manager when Grantee learns of or has any reason to believe it or any person with
ownership or controlling interest in Grantee, or their agent, employee, subcontractor or
volunteer who is providing services under this Grant Agreement has been placed on
community supervision, received deferred adjudication, or been indicted for or convicted
of a criminal offense relating to involvement in any financial matter, federal or state
program or felony sex crime.
Health and Human Services
Additional Provisions V.1.0-Grant Funding
Effective: February 2021
Page 5 of 6
DocuSign Envelope ID.98366D72-7D76-4F2C-8771-7DDD39BFB126
B. Grantee shall not permit any person who engaged, or was alleged to have engaged, in any
activity subject to reporting under this section to perform direct client services or have
direct contact with clients,unless otherwise directed in writing by the System Agency.
11. NOTICE OF GRANT AGREEMENT ACTION
Grantee shall notify the assigned System Agency contract manager if Grantee has any grant
agreement or contract suspended or terminated for cause by any local, state or federal
department or agency or nonprofit entity within five business days of becoming aware of the
action and include the following:
i. Reason for such action;
ii. Name and contact information of the local, state or federal department or agency or
entity;
iii. Effective start date of the grant agreement;
iv. Date of suspension or termination; and
v. Grant agreement or case reference number.
12. NOTICE OF BANKRUPTCY
Grantee shall notify in writing the assigned System Agency contract manager of its plan to
seek bankruptcy protection within five business days of such action by Grantee.
13. NOTICE OF CHANGE OF CONTACT PERSON OR KEY PERSONNEL
The Grantee shall notify in writing the assigned System Agency contract manager within
ten business days of any change to the Grantee's Contact Person or Key Personnel.
Health and Human Services
Additional Provisions V.1.0—Grant Funding
Effective: February 2021
Page 6 of 6
DocuSign Envelope ID.98366D72-7D76-4F2C-8771-7DDD39BFB 126
OMB Number:4040-0007
Expiration Date: 02/28/2022
ASSURANCES-NON-CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average 15 minutes per response,including time for reviewing
instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other aspect of this collection of information,including suggestions for
reducing this burden,to the Office of Management and Budget, Paperwork Reduction Project(0348-0040),Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND
IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
NOTE: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the
awarding agency. Further,certain Federal awarding agencies may require applicants to certify to additional assurances.
If such is the case,you will be notified.
As the duly authorized representative of the applicant, I certify that the applicant:
1. Has the legal authority to apply for Federal assistance Act of 1973, as amended (29 U.S.C.§794),which
and the institutional, managerial and financial capability prohibits discrimination on the basis of handicaps;(d)
(including funds sufficient to pay the non-Federal share the Age Discrimination Act of 1975,as amended (42 U.
of project cost)to ensure proper planning, management S.C.§§6101-6107),which prohibits discrimination on
and completion of the project described in this the basis of age;(e)the Drug Abuse Office and
application. Treatment Act of 1972(P.L.92-255),as amended,
relating to nondiscrimination on the basis of drug
2. Will give the awarding agency,the Comptroller General abuse; (f)the Comprehensive Alcohol Abuse and
of the United States and,if appropriate,the State, Alcoholism Prevention,Treatment and Rehabilitation
through any authorized representative,access to and Act of 1970(P.L.91-616),as amended, relating to
the right to examine all records, books,papers,or nondiscrimination on the basis of alcohol abuse or
documents related to the award;and will establish a alcoholism; (g)§§523 and 527 of the Public Health
proper accounting system in accordance with generally Service Act of 1912(42 U.S.C.§§290 dd-3 and 290
accepted accounting standards or agency directives. ee-3),as amended, relating to confidentiality of alcohol
and drug abuse patient records; (h)Title VIII of the Civil
3. Will establish safeguards to prohibit employees from Rights Act of 1968(42 U.S.C.§§3601 et seq.),as
using their positions for a purpose that constitutes or amended, relating to nondiscrimination in the sale,
presents the appearance of personal or organizational rental or financing of housing; (i)any other
conflict of interest,or personal gain. nondiscrimination provisions in the specific statute(s)
under which application for Federal assistance is being
4. Will initiate and complete the work within the applicable made;and, (j)the requirements of any other
time frame after receipt of approval of the awarding nondiscrimination statute(s)which may apply to the
agency. application.
5. Will comply with the Intergovernmental Personnel Act of 7. Will comply,or has already complied,with the
Titles II and III of the Uniform
1970(42 U.S.C.§§4728-4763)relating to prescribed requirements
standards for merit systems for programs funded under Relocation Assistance and Real Property Acquisition
one of the 19 statutes or regulations specified in Policies Act of 1970(P.L.91-646)which provide for
Appendixfair and equitable treatment of persons displaced or
A of OPM's Standards for a Merit System of
Personnel Administration(5 C.F.R.900,Subpart F). whose property is acquired as a result of Federal or
federally-assisted programs.These requirements
apply to all interests in real property acquired for
6. Will comply with all Federal statutes relating to project purposes regardless of Federal participation in
nondiscrimination.These include but are not limited to: purchases.
(a)Title VI of the Civil Rights Act of 1964(P.L.88-352)
which prohibits discrimination on the basis of race,color 8. Will comply,as applicable,with provisions of the
or national origin;(b)Title IX of the Education Hatch Act(5 U.S.C.§§1501-1508 and 7324-7328)
Amendments of 1972,as amended(20 U.S.C.§§1681- which limit the political activities of employees whose
1683, and 1685-1686),which prohibits discrimination on principal employment activities are funded in whole
the basis of sex;(c)Section 504 of the Rehabilitation or in part with Federal funds.
Previous Edition Usable Standard Form 424B(Rev.7-97)
Authorized for Local Reproduction Prescribed by OMB Circular A-102
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
9. Will comply, as applicable,with the provisions of the Davis- 13. Will assist the awarding agency in assuring compliance
Bacon Act(40 U.S.C.§§276a to 276a-7),the Copeland Act with Section 106 of the National Historic Preservation
(40 U.S.C.§276c and 18 U.S.C.§874), and the Contract Act of 1966,as amended (16 U.S.C.§470), EO 11593
Work Hours and Safety Standards Act(40 U.S.C.§§327- (identification and protection of historic properties),and
333), regarding labor standards for federally-assisted the Archaeological and Historic Preservation Act of
construction subagreements. 1974(16 U.S.C. §§469a-1 et seq.).
10. Will comply, if applicable,with flood insurance purchase 14. Will comply with P.L.93-348 regarding the protection of
requirements of Section 102(a)of the Flood Disaster human subjects involved in research,development,and
Protection Act of 1973(P.L. 93-234)which requires related activities supported by this award of assistance.
recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of 15. Will comply with the Laboratory Animal Welfare Act of
insurable construction and acquisition is$10,000 or more. 1966(P.L.89-544, as amended,7 U.S.C.§§2131 et
seq.)pertaining to the care, handling,and treatment of
11. Will comply with environmental standards which may be warm blooded animals held for research,teaching,or
prescribed pursuant to the following: (a)institution of other activities supported by this award of assistance.
environmental quality control measures under the National
Environmental Policy Act of 1969(P.L.91-190)and 16. Will comply with the Lead-Based Paint Poisoning
Executive Order(EO) 11514; (b)notification of violating Prevention Act(42 U.S.C.§§4801 et seq.)which
facilities pursuant to EO 11738; (c)protection of wetlands prohibits the use of lead based paint in construction or
pursuant to EO 11990; (d)evaluation of flood hazards in rehabilitation of residence structures.
floodplains in accordance with EO 11988; (e)assurance of 17. Will cause to be performed the required financial and
project consistency with the approved State management compliance audits in accordance with the Single Audit
program developed under the Coastal Zone Management Act Amendments of 1996 and OMB Circular No.A-133,
Act of 1972(16 U.S.C.§§1451 et seq.); (f)conformity of "Audits of States, Local Governments,and Non-Profit
Federal actions to State(Clean Air)Implementation Plans Organizations."
under Section 176(c)of the Clean Air Act of 1955,as
amended (42 U.S.C. §§7401 et seq.); (g)protection of 18. Will comply with all applicable requirements of all other
underground sources of drinking water under the Safe Federal laws,executive orders, regulations,and policies
Drinking Water Act of 1974,as amended(P.L. 93-523); governing this program.
and, (h)protection of endangered species under the
Endangered Species Act of 1973,as amended(P.L.93- 19. Will comply with the requirements of Section 106(g)of
205). the Trafficking Victims Protection Act(TVPA)of 2000,as
amended(22 U.S.C.7104)which prohibits grant award
12. Will comply with the Wild and Scenic Rivers Act of recipients or a sub-recipient from(1)Engaging in severe
1968(16 U.S.C.§§1271 et seq.)related to protecting forms of trafficking in persons during the period of time
components or potential components of the national that the award is in effect(2)Procuring a commercial
wild and scenic rivers system. sex act during the period of time that the award is in
effect or(3)Using forced labor in the performance of the
award or subawards under the award.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
APPLICANT ORGANIZATION DATE SUBMITTED
Standard Form 424E(Rev.7-97)Back
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
CERTIFICATION REGARDING LOBBYING
Certification for Contracts,Grants,Loans,and Cooperative Agreements
The undersigned certifies,to the best of his or her knowledge and belief,that:
(1)No Federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any
person for influencing or attempting to influence an officer or employee of an agency,a Member of
Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with
the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the
entering into of any cooperative agreement,and the extension,continuation,renewal,amendment,or
modification of any Federal contract,grant,loan,or cooperative agreement.
(2)If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency,a Member of Congress,an
officer or employee of Congress,or an employee of a Member of Congress in connection with this Federal
contract,grant,loan,or cooperative agreement,the undersigned shall complete and submit Standard
Form-LLL,"Disclosure of Lobbying Activities,"in accordance with its instructions.
(3)The undersigned shall require that the language of this certification be included in the award documents
for all subawards at all tiers(including subcontracts,subgrants,and contracts under grants,loans,and
cooperative agreements)and that all subrecipients shall certify and disclose accordingly.This certification
is a material representation of fact upon which reliance was placed when this transaction was made or
entered into.Submission of this certification is a prerequisite for making or entering into this transaction
imposed by section 1352,title 31,U.S.Code.Any person who fails to file the required certification shall be
subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure.
Statement for Loan Guarantees and Loan Insurance
The undersigned states,to the best of his or her knowledge and belief,that:
If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer
or employee of any agency,a Member of Congress,an officer or employee of Congress,or an employee of
a Member of Congress in connection with this commitment providing for the United States to insure or
guarantee a loan,the undersigned shall complete and submit Standard Form-LLL,"Disclosure of Lobbying
Activities,"in accordance with its instructions.Submission of this statement is a prerequisite for making or
entering into this transaction imposed by section 1352,title 31,U.S.Code.Any person who fails to file the
required statement shall be subject to a civil penalty of not less than$10,000 and not more than$100,000
for each such failure.
*APPLICANT'S ORGANIZATION
*PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE
Prefix: *First Name: Middle Name:
*Last Name: Suffix:
*Title:
*SIGNATURE: *DATE:
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
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
- 1-
Department of State Health Services Form 4734—June 2013
DocuSign Envelope ID:98366D72-7D76-4F2C-8771-7DDD39BFB126
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? n Yes I I 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? I I 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? 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 State Health Services Form 4734—June 2013
DocuSign
Certificate Of Completion
Envelope Id:98366D727D764F2C87717DDD39BFB126 Status:Sent
Subject:HHS001130300004,City of Port Arthur,DFCHS/HTB FY23 BASE CONTRACT
Source Envelope:
Document Pages:63 Signatures:0 Envelope Originator:
Certificate Pages:5 Initials:0 CMS Internal Routing Mailbox
AutoNav:Enabled 11493 Sunset Hills Road
Envelopeld Stamping:Enabled #100
Time Zone:(UTC-06:00)Central Time(US&Canada) Reston,VA 20190
CMS.InternalRouting@dshs.texas.gov
IP Address:167.137.1.16
Record Tracking
Status:Original Holder:CMS Internal Routing Mailbox Location:DocuSign
5/10/2022 3:13:39 PM CMS.InternalRouting@dshs.texas.gov
Signer Events Signature Timestamp
Ronald Burton Sent:5/10/2022 3:28:03 PM
Ronald.burton@portarthurtx.gov
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Susana Garcia
Susana.Garcia@dshs.texas.gov
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted:5/10/2022 2:40:32 PM
ID:9574c805-b8b1-4262-bf13-f39e30c45fe6
Patty Melchior
Patty.Melchior@dshs.texas.gov
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted:5/5/2022 12:43:08 PM
ID:f01589da-43a7-481e-996a-7c50409e5d48
Manda Hall
manda.hall@dshs.texas.gov
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted:2/26/2021 9:32:20 AM
ID:f3b02d48-3ebd-42cb-a630-09526e3d3701
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
Christina Patteson E Sent:5/10/2022 3:28:02 PM
COPI
Christina.patteson@portarthurtx.gov Viewed:5/10/2022 3:28:56 PM
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
CMS Internal Routing
cms.internalrouting@dshs.texas.gov
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Tray Kirkpatrick
Tray.kirkpatrick@dshs.texas.gov
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 5/10/2022 3:28:03 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
Electronic Record and Signature Disclosure created on:9/14/2020 7:10:18 PM
Parties agreed to:Susana Garcia,Patty Melchior,Manda Hall
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, DSHS Contract Management Section(we,us or Company)may be required
by law to provide to you certain written notices or disclosures. Described below are the terms
and conditions for providing to you such notices and disclosures electronically through the
DocuSign system. Please read the information below carefully and thoroughly, and if you can
access this information electronically to your satisfaction and agree to this Electronic Record and
Signature Disclosure (ERSD),please confirm your agreement by selecting the check-box next to
`I agree to use electronic records and signatures' before clicking `CONTINUE' within the
DocuSign system.
Getting paper copies
At any time,you may request from us a paper copy of any record provided or made available
electronically to you by us. You will have the ability to download and print documents we send
to you through the DocuSign system during and immediately after the signing session and, if you
elect to create a DocuSign account, you may access the documents for a limited period of time
(usually 30 days) after such documents are first sent to you. After such time, if you wish for us to
send you paper copies of any such documents from our office to you, you will be charged a
$0.00 per-page fee. You may request delivery of such paper copies from us by following the
procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time
change your mind and tell us that thereafter you want to receive required notices and disclosures
only in paper format. How you must inform us of your decision to receive future notices and
disclosure in paper format and withdraw your consent to receive notices and disclosures
electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. Further,you will no longer be able to use the DocuSign system to
receive required notices and consents electronically from us or to sign electronically documents
from us.
All notices and disclosures will be sent to you electronically
Unless you tell us otherwise in accordance with the procedures described herein,we will provide
electronically to you through the DocuSign system all required notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or made
available to you during the course of our relationship with you. To reduce the chance of you
inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process, please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
How to contact DSHS Contract Management Section:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: alison.joffrion@hhsc.state.tx.us
To advise DSHS Contract Management Section of your new email address
To let us know of a change in your email address where we should send notices and disclosures
electronically to you, you must send an email message to us at alison.joffrion@hhsc.state.tx.us
and in the body of such request you must state: your previous email address, your new email
address. We do not require any other information from you to change your email address.
If you created a DocuSign account, you may update it with your new email address through your
account preferences.
To request paper copies from DSHS Contract Management Section
To request delivery from us of paper copies of the notices and disclosures previously provided
by us to you electronically, you must send us an email to alison.joffrion@hhsc.state.tx.us and in
the body of such request you must state your email address, full name, mailing address, and
telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with DSHS Contract Management Section
To inform us that you no longer wish to receive future notices and disclosures in electronic
format you may:
i. decline to sign a document from within your signing session, and on the subsequent page,
select the check-box indicating you wish to withdraw your consent, or you may;
ii. send us an email to alison.joffrion@hhsc.state.tx.us and in the body of such request you must
state your email, full name,mailing address, and telephone number. We do not need any other
information from you to withdraw consent.. The consequences of your withdrawing consent for
online documents will be that transactions may take a longer time to process..
Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The
current system requirements are found here: https://support.docusign.com/guides/signer-guide-
signing-system-requirements.
Acknowledging your access and consent to receive and sign documents electronically
To confirm to us that you can access this information electronically, which will be similar to
other electronic notices and disclosures that we will provide to you,please confirm that you have
read this ERSD, and(i) that you are able to print on paper or electronically save this ERSD for
your future reference and access; or(ii)that you are able to email this ERSD to an email address
where you will be able to print on paper or save it for your future reference and access. Further,
if you consent to receiving notices and disclosures exclusively in electronic format as described
herein,then select the check-box next to `I agree to use electronic records and signatures' before
clicking `CONTINUE' within the DocuSign system.
By selecting the check-box next to 'I agree to use electronic records and signatures', you confirm
that:
• You can access and read this Electronic Record and Signature Disclosure; and
• You can print on paper this Electronic Record and Signature Disclosure, or save or send
this Electronic Record and Disclosure to a location where you can print it, for future
reference and access; and
• Until or unless you notify DSHS Contract Management Section as described above, you
consent to receive exclusively through electronic means all notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided
or made available to you by DSHS Contract Management Section during the course of
your relationship with DSHS Contract Management Section.