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HomeMy WebLinkAboutPR 15484: TEXAS NURSE-FAMILY PARTNERSHIP AGREEMENTMemorandum City of Part Arthur, Texas Health Department TO: Stephen Fitzgibbons, City Manager FROM: Yoshi D. Alexander, MBA-HCM, Health Director DATE: September 1, 2009 SUBJECT: Proposed Resolution No. 15484 Approval of Amendment Two to the Texas Nurse-Family Partnership Agreement for the FY 2010 grant program RECOMMENDATION It is recommended that the City Council approve P.R. No. 15484, authorizing approval of Amendment Two to the Texas Nurse-Family Partnership Program Agreement between the Health and Human Services Commission and the City of Port Arthur for aNurse-Family Partnership grant in the amount of $522,337. BACKGROUND This will be the second yeaz since the establishment and operation of local Nurse-Family Partnership (NFP) program to provide educational, health, guidance, and other resources for low- income, Medicaid eligible, first-time pregnant women during pregnancy, and during the first two years of their infant's life through visits by highly trained registered nurses. This grant has provided for five (5) full-time registered nurses, one full-time clerical support person, and a maximum caseload of 100 families. Currently, the program is servicing over 60 families. BUDGETARY AND FISCAL EFFECT This grant covers personnel and fringe benefits, supplies, training, education, and travel. HHSC will award grant funds for approximately 90% of the total annual base budget of $522,337. The City has budgeted for and will contribute the remaining 10% from local match funds. For Year 1, this amount was $53,548 and $52,334 for Year 2. STAFFING EFFECT The grant will fund six (6) full-time employees (5 nurses and 1 data entry support person) contingent upon available grant funding. SUMMARY It is recommended that the City Council approve P.R. No. 15484, authorizing approval of Amendment Two to the Texas Nurse-Family Partnership Program Agreement between the Health and Human Services Commission and the City of Port Arthur for aNurse-Family Partnership grant in the amount of $522,337. P. R. NO. 15484 9/1/09-yda RESOLUTION NO. A RESOLUTION APPROVING AMENDMENT TWO TO THE TEXAS NURSE-FAMILY PARTNERSHIP PROGRAM AGREEMENT BETWEEN THE HEALTH AND HUMAN SERVICES COMMISSION AND THE CITY OF PORT ARTHUR WHEREAS, the State of Texas, by and through the Texas Health and Human Services Commission (HHSC) is seeking grant proposals from eligible entities to support the establishment and operation of local Nurse-Family Partnership (NFP) programs to provide educational, health, guidance, and other resources for low-income, first-time pregnant women during pregnancy, and during the first two years of their infant's life through visits by highly trained registered nurses; and, WHEREAS, this grant provides for five (5) full-time registered nurses, one (1) full-time clerical support person, and will allow for a caseload of 100 families; and, WHEREAS, HHSC will award grant funds for approximately 90% of the grantee's total annual base budget and grantees are expected to contribute the remaining 10% from local match funds. NOW THEREFORE BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PORT ARTHUR: Section 1. That, the facts and opinions in the preamble are true and correct; Section 2. That, the City Council of the City of Port Arthur hereby authorizes Amendment Two to the Texas Nurse-Family Partnership Agreement to allow for grant P. R NO. 15484 Page 2 - 9/1/09 awazd for FY 2010 in the amount of $522,337 as delineated in Exhibit "A," with the understanding that the grant requires a 10% local match or $52,234. Section 3. 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 September 2009 A.D., at a Regular Meeting of the City Council of the City of Port Arthur, Texas by the following Vote: AYES: Mayor: Council members: NOES: Mayor ATTEST: Terri Hanks, City Secretary P. R. NO. 15484 Page 3 - 9/1/09 APPROVED AS TO FORM: Mark Sokolow, City Attorney APPROVED FOR ADMINISTRATION: Stephen Fitzgibbons, City Manager 1r ~ ~ ~ ~. ~.~,lc~,,4Lz,~. oshi D. Alexander, MBA-HCM Director of Health Services APPROVED FOR AVAILABILITY OF FUNDS: /tX~t~~~~ ~~~ Deborah Echols, CPA, Director of Finance EXHIBIT "A" HHSC 529-OS-0110-OOOOSB COUNCY OF TRAVIS STATE OF TEXAS Amendment Two To the Teaas Nurse-Family Partnership Program Agreement between the Health & Human Services Commission and City of Port Arthur ARTICLE 1. AUTHORITY AND OBIECTIVES .............................................................................. ........................................t Section 1.01 AUTHORITY ................................................................................................... ........................................2 Section 1.02 OB]ECTIVES ................................................................................................... ........................................2 Sec[lon 1.03 MODIFICATIONS ............................................................................................ ........................................3 SeC[IOn 1.04 EFFECTIVE DATE ........................................................................................... ........................................3 ARTICLE 2. AMENDMENT TO THE OBLIGATIONS OF THE PARTIES ........................................... ........................................3 Section 2.01 MODIFICATIONS ............................................................................................ ........................................3 ARTICLE 3. REPRESENTATIONS A:ID AGREEMENT OF THE PARTIES .............................. ...............................5 HHSC 529-08-0110-00002B HHSC 529-08-0110-000O8B COL'MTY OF TRAVIS STATE OF TEXAS Amendment Two To the Agreement Between the Health & Human Services Commission And City of Port Arthur For The Texas Nurse-Family Partnership Program This Amendment Two ("the Amendment") to HHSC Contract No. 529-08-0110-00008 (the "Agreement") is entered into between the Health and Human Services Commission ("HHSC") an administrative agency within the executive department of the State of Texas with offices at 4900 North Lamar, Austin, Texas and City of Port Arthur. (CONTRACTOR) with offices at 449 Austin Avenue Port Arthur, Texas, for the purpose of amending certain key teens of the Original Agreement. The Parties entered into an agreement (the "Agreement") for Services and Deliverables pursuant to RFP No. 529-08-0110 with an original teen of performance of September 1, 2008 through August 31, 2009. On April 17, 2009, the Parties modified the Agreement to incorporate changes to the Services and Deliverables to be provided by CONTRACTOR. These modifications were incorporated into Amendment One to the Agreement. The Parties hereby agree to amend the Agreement, as amended, HHSC contract number 529-08-01 ] 0- 00008, subject to the following terms and conditions. The Parties agree that the modified terms and conditions will apply to the Services and Deliverables to be provided by CONTRACTOR unless further modified or amended by the Parties. Article 1. Authority and Objectives. Section I.01 Authority. The Parties in accordance with Section 6.03(b) (3) of the Agreement execute this Amendment Two. This modification is also executed in accordance with Article VI of the NFP Agreement document, and Article 7 of HHSC's General Contract Terms and Conditions, attached as Exhibit C to the NFP Agreement document. Section I.02 Objectives. HHSC awarded a grant to City of Port Arthur to establish and operate a Texas Nurse-Family Partnership Program utilizing the program model developed by and in accordance with Nurse Family Partnership National Service Office. The purpose of this Agreement is to modify certain terms of the original Agreement to effectuate the maximum provision of program services and extend the contract period of the contract. Section 1.03 Modifications to Agreement. The Contract is modified for the following purpose: HHSC 529-08-0110-00008B • To extend the term of this contract. • To revise the Project Managers and other Key Staff section of the contract. • To revise the General Payment Terms section of the contract. • To revise the service deliverables of [his contract Section 1.04 Effective Date. The modifications to the Agreement agreed to in this Amendment Two shall be effective upon execution by both Parties, and will terminate on the Expiration Date of the Agreement, unless extended or terminated sooner by HHSC in accordance with the Agreement. Article 2. Amendment to the Obligations of the Parties Section 2.01 Modifications. (1) Amendment of Contract Section 2.07 (al. Term of the Agreement The term of this agreement will begin on the Effective Date, as defined by HHSC's Uniform Terms and conditions, version, and will expire on August 31, 2010 (the "Expiration Date") unless terminated sooner or extended pursuant to the terms and conditions of this Agreement. (2) Amendment of Contract Section 2.08 Proiect Managers and other Kev Staff Section 2.08 is deleted in its entirety and replaced with the following language: The following Project Managers will serve as the primary contacts for all administrative issues: Isabel Eguez, LMSW Project Manager Health and Human Services Commission (HHSC) 11209 Metric Boulevard, Building H, MC 370 Austin, Texas 78758 Tel. # (512) 491-1161 Fax # (512) 491-1953 E-mail: isabel.eguez@hhsc.state.tx.us Yoshi D. Alexander, MBA Director of Health Services City of Port Arthur Health Department. 449 Austin Avenue Port Arthur, TX 77640 Tel. # 409-983-8832 Fax # 409-984-9093 E-mail: yoshi@portarthur.net HHSC 529-08-0110-00008B The following Contract Manager will serve as primary contact for all invoices, purchase vouchers and reporting deliverables: Vicki Echols Contract Manager Health and Human Services Commission (HHSC) 11209 Metric Boulevard, Building H, MC 340, Austin, Texas 78758 Tel. # (512) 491-5556 Fax # (512) 491-1960 E-mail: vicki echolsna hhscstate.tx.us The following State Nurse Consultant will serve as primary contact for all clinical requirements: Rebecca Pack, RN, MN, PHD State Nurse Consultant Health and Human Services (HHSC) 11209 Metric Boulevard, Building H, MC 370 Austin, Texas 78758 Tel. # (512) 491-1123 Fax # (512) 491-1953 E-mail: rebecca pack(a~hhscstate.tx.us (3) Amendment of Contract Section 4.02 General Pavment Terms Section 4.02 is deleted in it entirety and replaced with the following new language: (a) HHSC shall pay contractor an amount up to but not to exceed $470,104.00 for the term beginning September 1, 2009 and ending August 31, 2010, whereas those payments will be made on a monthly cost reimbursement basis, in response to an invoice and purchase voucher being received and monthly deliverables being approved. (b) Contractor will submit to the HHSC Contract Manager an Invoice and Purchase Voucher for the amount of expenses incurred by the Contractor on a monthly basis no later than the 15`s day of the month following that in which expenditure occun•ed, if the 15'h falls on a weekend or holiday the documents will be due the next business day. (c) CONTRACTOR will receive payment under the terms of this amended Agreement only upon expending all funds from the previous fiscal yeaz's payment. CONTRACTOR must continue to invoice HHSC for each month to show amounts expended for each month in this amended Agreement until all previously received funds from HHSC are expended.. Contractor's end of fiscal year 2009 (EOY) expenditure report along with an HHSC review of such report will determine the amount of additional funding that the program will receive from HHSC. (d) CONTRACTOR will maintain a separate bank account into which all NFP programs funds received from HHSC and any local match funds are maintained in order to determine and accrue interest for the purpose of program income. (3) Amendment to Exhibit F Reporting Requirements [-IHSC 529-OS-0110-00008B Exhibit F is deleted in its entirety and replaced with the revised Exhibit F which is attached. Exhibit G is incorporated into this contract by reference. Article 3. Representations and Agreement of the Parties. The Parties hereto contract and agree that the terms of the Original Contract shall remain in effect and continue to govern except to the extent modified by this Amendment. ey signing this Amendment, the Parties hereto expressly understand and agree that the Amendment is hereby made a part of the original Contract as though it were set out word for word therein. The Parties have executed this Amendment in their capacities as stated below with authority to bind their organizations on the dates set forth by their signatures. IN THE WITNESS HEREOF, HHSC and CONTRACTOR, have each caused this Amendment Two to the Agreement to be signed and delivered by its duly authorized representative. HEALTH & HUMAN SERVICES COMMISSION CITY OF PORT ARTHUR Albert Hawkins Executive Commissioner Stephen Fitzgibbons City Manager Date Date HHSC 529-08-0110-00008B Exhibit E Additional Contract Requirements Invoices and purchase vouchers are due no later than the 1 ~t° day of the month following the month in which expenditures were incurred.. If any reporting items are not received by their due dates, identified payment dates are null and void and payments will not be made until all reporting items due prior to the payment date have been received. Any promotional or marketing materials, client notifications, business presentations or client materials created and used by the Grantee, outside NFPNSO created materials, must be approved before use. To obtain approval of items noted above, copies must be made available to the assigned HHSC Project Manager to provide I S business days for approval. Upon official notification of grant award, Grantee will be required to immediately enter into implementation planning with NFPNSO and the HHSC State Nurse Consultant, making key Grantee staff available and flexible for consultation with the afore mentioned parties. Grantee is prohibited from performing research on the NFP Staff and client population without prior written authorization from both NFPNSO and HHSC. All CIS data submission is required to be directly inputted, without prior approval or modification. Grantees must adhere to HHSC's client eligibility requirements which are amended to include `Texas Residents at or below 185 FPL' as opposed to the initial requirement in Section 2.5 of the RFP for the Texas Nurse Family Partnership, which forms part of the contract through Exhibit A (RFP No. 529-08-0110 Date of Release: February 21, 2008) which states that "HHSC requires enrolled clients to be Medicaid-eligible pregnant women only. The Medicaid income limit for pregnant women is 185 percent or below of the Federal Poverty Level. Clients must also be U.S. citizens or fit the Medicaid-eligibility criteria for legal permanent residents." and may not disenroll clients without the express written approval of the HHSC State Nurse Consultant. All HHSC NFP Program nursing staff must follow all nursing licensure requirements for the State of Texas and all other laws applicable to the practice setting. Grant funds may only be used for the budget approved by HHSC NFP staff: Any shifts among budget line items that account for more than 10 percent of that line item must be authorized by the HHSC Contract Manager prior to the line item shift. Exhibit F Reporting Requirements All reporting templates provided to the CONTRACTOR by HHSC will be utilized as requested in order to improve the uniformity and clarity of CONTRACTOR'S data submission. Additional data elements may be requested by HHSC and it is required that CONTRACTOR make all reasonable efforts to assure that these data elements aze collected and reported to HHSC upon their request. Templates and data element requests will not constitute the entirety of deliverables and requirements required for submission by this contract. Therefore, CONTRACTOR remains responsible for ensuring that alt deliverables and requirements are met and reported as required by this contract. All Reporting Requirements listed below are due to HHSC by the 15`° day of each month beginning November 15, 2009 and ending September I5, 2010. If the 15a' falls on a weekend or holiday all Reporting Requirement will be due on the next business day. Submit a narrative that includes: o Implementation Progress include progress/status of staff recruitment and retention, training, caseloads, use of CIS, issues/concems, future plans and/or any other relevant information to describe your implementation progress. o Description of Referral Network: include the names of the organizations in your referral network, expected versus actual flow of referrals, community partner meetings and presentations, future plans, and/or any other relevant information to describe your referral network. o Comments: provide any comments, accomplishments, lessons Teamed, upcoming events, or anything you would like to share that is not captured in other sections of the report. • Submit Staff Requirements Data Report including data collected the previous month. This report shall remain cumulative. • Submit Individual Client Data Report including data collected the previous month. This report shall remain cumulative. • Submit required data into the NFPNSO Clinical Information System (CIS). • Submit an annual audit, performed by a CPA according to federal OMB standazds, of HHSC NFP grant expenditures by Sept 30`", 2010. • Submit a Quarterly Expenditure Report covering, September 1 -November 30, December 1 -February 28, Mazch 1 -May 31 and June 1 -August 31. These reports will be due to HHSC 30 days after the end of the reporting period Exhibit G Performance Measures Performance Measures quantitatively illustrate compliance with services required as part of the Texas Nurse-Family Partnership progam. These performance measures assess operational components and were selected as critical elements in progess towards positive progam outcomes. Measurement areas include: client enrollment, staffing, and number of completed visits. HHSC will hack performance measures through TNFP Deliverables and through data collected in CIS. Data will be collected monthly and/or quarterly as indicated below, and observed/expected numbers calculated. PERFORMANCE MEASURES of expected case emollment o Data Source: CIS; Staff Requirements Data Report o Goal: 90% or higher per month o Rationale and notes: Implementation of the Nurse Family Partnership model of caze has evidence based positive outcomes. In order for wlnerable families to benefit, they must be informed and enrolled in the progam. Case enrollment expected is based on client accrual of 4 clients per nurse per month. Nurses will start to accrue clients after they have completed Unit 2. Each Nurse Home Visitor is limited to an active caseload of 25 clients. enrolled by 16 weeks o Data Source: CIS; Individual Client Data Report o Goal: 40% or higher per month o Rationale and notes: The program is most effective when nurses are able to establish a relationship eazly in the pregnancy. While the first year of implementation saw the goal of enrolling participants by the 28's week, per the NFP Model, implementing agencies should strive to enroll more participants at or before 16 weeks gestation. of expected staffing attained o Da[a Source: CIS; S[affRequvements Data Report o Goal: 90% or higher per month o Rationale and notes: Staffing is a critical component to the success of the program. Without adequate staff, contract goals for enrollment cannot be attained and more importantly, the wlnerable population we strive to impact will be left unserved. Mean % of completed/expected visits during pregnancy for clients who have completed the pregnancy phase. o Data Source: CIS o Goal: 70% or higher per quarter o Rationale and notes: The required number of visits per client need to be completed (performed) in order for the program to have positive maximum effect on behavior and pregnancy outcome. The goal for completed visits during pregnancy approximates the goal at the national level. • Mean % of completed/expected visits during infancy for clients who have completed the infancy phase. Data Source: CIS Goal: 40% or higher per quarter Rationale and notes: The required number of visits per client need to be completed (performed) in order for the program to have positive maximum effect on attaining the goals described by the NFP model for infants. The goal for completed visits during infancy approximates the goal at the national level. HHSC program staff including the Project Manager and State Nurse Consultant will provide support and consultation to CONTRACTOR as they strive to achieve the above stated goals. At the discretion of the Project Manager and State Nurse Consultant, performance improvement plans may be requested from CONTRACTOR when CONTRACTOR is not meeting one or more performance. measure goals. CONTRACTORS that do not implement a performance improvement plan with the aim of improving performance measure goals, may have all or part of their monthly payment withheld in accordance with Section 5.01 of HHSC's and CONTRACTOR's agreement for the Texas Nurse-Family Partnership Program. HHSC 529-08-0110-OOODSB COUNTY OF TRA\'IS STATE OF TES.aS Amendment Two To the Texas Nurse-Family Partnership Program Agreement between the Health & Human Services Commission and City of Port Arthur ARTICLE I. AUTHORITY AND OBJECTIVES ............................................................................. 2 Section 1.01 AUTHORITY ..... . ......................................... . ........................................................................................... Section 1.02OB1EGTIVE$ ........ .........................................2 .......................................................................................... SCCtIOfI 1.03 MODIFICATIONS ... .........................................2 ........................................................................................ SeCtlon 1.04 EFFECTIVE DATE ... . .........................................3 . ...................................................................................... ARTICLE 2. AMENDMENT TO THE OBLIGATIONS OF THE PARTIES .............. ........................................3 ............................. Section 2.01 MODIFICATIONS ...... ........................................3 ...................................................................................... ARTICLE 3. REPRESENTATIONS AND AGREEMENT OF THE PARTIES ........................................3 .............................. ...............................5 HHSC 529-08-0110-00002B HHSC 529-08-0110.00008B COONTI` OF TRAVIS STATE OF TE\.AS Amendment Two To the Agreement Between the Health & Human Services Commission And City of Port Arthur For The Texas Nurse-Family Partnership Program This Amendment Two ("the Amendment") to HHSC Contract No. 529-08-0110-00008 (the "Agreement") is entered into between the Health and Human Services Commission ("HHSC") an administrative agency within the executive department of the State of Texas with offices at 4900 North Lamar, Austin, Texas and City of Port Arthur. (CONTRACTOR) with offices at 449 Austin Avenue Port Arthur, Texas, for the purpose of amending certain key terms of the Original Agreement. The Parties entered into an agreement (the "Agreement") for Services and Deliverables pursuant to RFP No. 529-08-O1 10 with an original term of performance of September 1, 2008 through August 31, 2009. On April 17, 2009, [he Parties modified the Agreement [o incorporate changes to the Services and Deliverables to be provided by CONTRACTOR. These modifications were incorporated into Amendment One to the Agreement. The Parties hereby agree to amend the Agreement, as amended, HHSC contract number 529-08-0110- 00008, subject to the following terms and conditions. The Parties agree that the modified terms and conditions will apply to the Services and Deliverables to be provided by CONTRACTOR unless further modified or amended by the Parties. Article 1. Authority and Objectives. Section L01 Authority. The Parties in accordance with Section 6.03(6) (3) of the Agreement execute this Amendment Two. This modification is also executed in accordance with Article VI of the NFP Agreement document, and Article 7 of HHSC's General Contract Terms and Conditions, attached as Exhibit C to the NFP Agreement document. Section 1.01 Objectives. HHSC awarded a grant to City of Port Arthur to establish and operate a Texas Nurse-Family Partnership Program utilizing the program model developed by and in accordance with Nurse Family Partnership National Service Office. The purpose of this Agreement is to modify certain terms of the original Agreement to effectuate the maximum provision of program services and extend the contract period of the contract. Section 1.03 Modifications to Agreement. The Contract is modified for the following purpose: HHSC 529-OS-DI 10-000088 • To extend the term of this contract. • To revise the Project Managers and other Key Staff section of the contract. • To revise the General Payment Terms section of the contract. • To revise the service deliverables of [his contract Section 1.04 Effective Date. The modifications to the Agreement agreed to in this Amendment Two shall be effective upon execution by both Parties, and will terminate on the Expiration Date of the Agreement, unless extended or terminated sooner by HHSC in accordance with the Agreement. Article 2. Amendment to the Obligations of the Parties Section 2.01 Modifications. (I) Amendment of Contract Section 2 07 (a) Term of the Agreement The term of this agreement will begin on the Effective Date, as defined by HHSC's Uniform Terms and conditions, version, and will expire on August 31, 2010 (the "Expiration Date") unless terminated sooner or extended pursuant to the terms and conditions of [his Agreement. (2) Amendment of Contract Section ~ 08 Proiect Managers and other Kev Staff Section 2.08 is deleted in its entirety and replaced with the following language: The following Project Managers will serve as [he primary contacts for all administrative issues: Isabel Eg0ez, LMSW Project Manager Health and Human Services Commission (HHSC) 11209 Metric Boulevard, Building H, MC 370 Austin, Texas 78758 Tel. # (512) 491-I 16] Fax # (512) 491-1953 E-mail: isabel.eguez~a hhsastate.tx.us Yoshi D. Alexander, MBA Director of Health Services City of Port Arthur Health Department. 449 Austin Avenue Port Arthur, TX 77640 Tel. # 409-983-8832 Fax # 409-984-9093 E-mail: Yoshi@portarthur.net HHSC 529-08-0110-000086 The following Contract Manager will serve as primary contact for all invoices, purchase vouchers and reporting deliverables: Vicki Echols Contract Manager Health and Human Services Commission (HHSC) ] 1209 Metric Boulevard, Building H, MC 340, Austin, Texas 78758 Tel. # (512) 491-5556 Fax # (512) 491-1960 E-mail: vicki.echolsruhhscstate.tx.us The following State Nurse Consultant will serve as primary contact for all clinical requirements: Rebecca Pack. RN, MN, PHD State Nurse Consultant Health and Human Services (HHSC) 11209 Metric Boulevard, Building H, MC 370 Austin, Texas 78758 Tel. # (512) 491-1 123 Fax # (512) 491-1953 E-mail: rebecca.oack~hhscstate.t~ us (3) Amendment of Contract Section 4.02 General Payment Terms Section 4.02 is deleted in it entirety and replaced with the following new language: (a) HHSC shall pay contractor an amount up to but not to exceed $470,104.00 for the [enn beginning September 1, 2009 and ending August 31, 2010, whereas those payments will be made on a monthly cost reimbursement basis, in response to an invoice and purchase voucher being received and monthly deliverables being approved. (b) Contractor will submit to the HHSC Contract Manager an Invoice and Purchase Voucher for the amount of expenses incurred by the Contractor on a monthly basis no later than the 15'" day of the month following that in which expenditure occurred, if the I5'" falls on a weekend or holiday the documents will be due the next business day. (c) CONTRACTOR will receive payment under the terms of this amended Agreement only upon expending all funds from the previous fiscal year's payment. CONTRACTOR must continue to invoice HHSC for each month to show amounts expended for each month in this amended Agreement until all previously received funds from HHSC are expended.. Contractor's end of fiscal year 2009 (EOY) expenditure report along with an HHSC review of such report will determine the amount of additional funding that the program will receive from HHSC. (d) CONTRACTOR will maintain a separate bank account into which all NFP programs funds received from HHSC and any local match funds are maintained in order to determine and accrue interest for the purpose of program income. (3) Amendment to Exhibit F Reoortinu Requirements HHSC 529-08-0110-000088 Exhibit F is deleted in its entirety and replaced with the revised Exhibit F which is attached. Exhibit G is incorporated into this contract by reference. Article 3. Representations and Agreement of the Parties. The Parties hereto contract and agree that the terms of the Original Contract shall remain in effect and continue to govern except to the extent modified by this Amendment. By signing this Amendment, the Parties hereto expressly understand and agree that the Amendment is hereby made a part of the original Contract as though it were set out word for word therein. The Parties have executed this Amendment in their capacities as stated below with authority to bind their organizations on the dates set forth by their signatures. IN THE WITNESS HEREOF, HHSC and CONTRACTOR, have each caused this Amendment Two to the Agreement to be signed and delivered by its duly authorized representative. HEALTH & HUMAN SERVICES COMMISSION CITY OF PORT ARTHUR Albert Hawkins Executive Commissioner Stephen Fitzgibbons City Manager Date Date HHSC 529-08-O1 IO-000088 Exhibit E Additional Contract Requirements Invoices and purchase vouchers are due no later than the I5'~' day of the month following the month in which expenditures were incurred.. If any reporting items are not received by their due dates, identified payment dates are null and void and payments will not be made until all reporting items due prior to the payment date have been received. Any promotional or marketing materials, client notifications, business presentations or client materials created and used by the Grantee, outside NFPNSO created materials, must be approved before use. To obtain approval of items noted above, copies must be made available to the assigned HHSC Project Manager to provide I S business days for approval. Upon official notification of grant award, Grantee will be required to immediately enter into implementation planning with NFPNSO and the HHSC State Nurse Consultant, making key Grantee staff available and flexible for consultation with the afore mentioned parties. Grantee is prohibited from performing research on the NFP Staff and client population without prior written authorization from both NFPNSO and HHSC. All CIS data submission is required to be directly inputted, without prior approval or modification. Grantees must adhere to HHSC's client eligibility requirements which are amended to include `Texas Residents at or below 185 FPL' as opposed to the initial requirement in Section 2.5 of the RFP for the Texas Nurse Family Partnership, which forms part of the contract through Exhibit A (RFP No. 529-08-O1 10 Date of Release: February 21, 2008) which states that "HHSC requires enrolled clients to be Medicaid-eligible pregnant women only. The Medicaid income limit for pregnant women is 185 percent or below of the Federal Poverty Level. Clients must also be U.S. citizens or fi[ the Medicaid-eligibility criteria for legal permanent residents." and may not disenroll clients without the express written approval of the HHSC State Nurse Consultant. All HHSC NFP Program nursing staff must follow all nursing licensure requirements for the State of Texas and all other laws applicable to the practice setting. Grant funds may only be used for the budget approved by HHSC NFP staff. Any shifts among budget line items that account far more than 10 percent of that line item must be authorized by the HHSC Contract Manager prior to the line item shift. Exhibit F Reporting Requirements All reporting templates provided to the CONTRACTOR by HHSC will be utilized as requested in order to improve the uniformity and clarity of CONTRACTOR'S data submission. Additional data elements maybe requested by HHSC and it is required that CONTRACTOR make all reasonable efforts to assure that these data elements are collected and reported to HHSC upon their request. Templates and data element requests will not constitute the entirety of deliverables and requirements required far submission by this contract. Therefore, CONTRACTOR remains responsible for ensuring that all deliverables and requirements are met and reported as required by this contract. All Reporting Requirements listed below are due to HHSC by the 15'h day of each month beginning November I5, 2009 and ending September I5, 2010. If the I5'h falls on a weekend or holiday all Reporting Requirement will be due on the next business day. • Submit a narrative that includes: o Implementation Progress include progress/status of staff recmitment and retention, paining, caseloads, use of CIS, issues/concerns, future plans and/or any other relevant information to describe your implementation progress. o Description of Referral Network include the names of the organizations in your referral network, expected versus actual flow of referrals, community partner meetings and presentations, future plans, and/or any other relevant information to describe your referral network. o Comments: provide any comments, accomplishments, lessons teamed, upcoming events, or anything you would like to share that is not captured in other sections of the report. • Submit Staff Requirements Data Report including data collected the previous month. This report shall remain cumulative. • Submit Individual Client Data Report including data collected the previous month. This report shall remain cumulative. • Submit required data into the NFPNSO Clinical Information System (CIS). • Submit an annual audit, performed by a CPA according to federal OMB standards, of HHSC NFP grant expenditures by Sept 30th, 20]0. • Submit a Quarterly Expenditure Report covering, September 1 -November 30, December I -February 28, March I -May 3I and June I -August 31. These reports will be due to HHSC 30 days after the end of the reporting period Exhibit G Performance Measures Performance Measures quantitatively illustrate compliance with services required as part of the Texas Nurse-Family Partnership Program. These performance measures assess operational components and were selected as critical elements in progress towards positive program outcomes. Measurement areas include: client enrollment, staffing, and number of completed visits. HHSC will track performance measures through TNFP Deliverables and through data collected in CIS. Data will be collected monthly and/or quarterly as indicated below, and observed/expected numbers calculated. PERFORMANCE MEASURES of expected case enrollment o Data Source: CIS; Staff Requirements Data Report o Goal: 90% or higher per month o Rationale and notes: Implementation of the Nurse Family Partnership model of care has evidence based positive outcomes. [n order for vulnerable families to benefit, they must be informed and enrolled in the program. Case enrollment expected is based on client accrual of 4 clients per nurse per month. Nurses will start to accrue clients after they have completed Unit 2. Each Nurse Home Visitor is limited to an active caseload of 25 clients. enrolled by 16 weeks o Data Source: CIS; Individual Client Data Report o Goal: 40% or higher per month o Rationale and notes: The program is most effective when nurses aze able to establish a relationship early in the pregnancy. While the first year of implementation saw the goal of enrolling participants by the 28th week, per the NFP Model, implementing agencies should strive [o enroll more participants at or before 16 weeks gestation. of expected staffing attained o Data Source: CIS; Staff Requirements Data Report o Goal: 90% or higher per month o Rationale and notes: Staffing is a critical component to the success of the program. Without adequate staff, contract goals for enrollment cannot be attained and more importantly, the vulnerable population we strive to impact will be left unnerved. • Mean % of completed/expected visits during pregnancy for clients who have completed the pregnancy phase. o Data Source: CIS o Goal: 70% or higher per quarter o Rationale and notes: The required number of visits per client need to be completed (performed) in order for the program to have positive maximum effect on behavior and pregnancy outcome. The goal for completed visits during pregnancy approximates the goal at the national level. • Mean % of completed/expected visits during infancy for clients who have completed the infancy phase. o Data Source: CIS o Goal: 40% or higher per quarter o Rationale and notes: The required number of visits per client need to be completed (performed) in order far the program to have positive maximum effect on attaining the goals described by the NFP model for infants. The goal far completed visits during infancy approximates the goal at the national level. HHSC program staff including the Project Manager and State Nurse Consultant will provide support and consultation to CONTRACTOR as they strive to achieve the above stated goals. At the discretion of the Project Manager and State Nurse Consultant, performance improvement plans may be requested from CONTRACTOR when CONTRACTOR is not meeting one or more performance measure goals. CONTRACTORS that do not implement a performance improvement plan with the aim of improving performance measure goals, may have all or part of their monthly payment withheld in accordance with Section 5.01 of HHSC°s and CONTRACTOR'S agreement for the Texas Nurse-Family Partnership Program. HHSC 529-08-0110-00008B COUNT\' OF TRA\'IS STATE OF TEXAS Amendment Two To the Texas Nurse-Family Partnership Program Agreement between the Health & Human Services Commission and City of Port Arthur ARTICLE 1. AUTHORITY AND OBJECTIVES .............................................................. Section 1.01 AUTHORITY ................................................................................... Sec[lon 1.0208JECTIVES .................................................................................... Section 1.03 MODIFICATIONS ............................................................................. Section 1.04 EFFECTIVE DATE ............................................................................ ARTICLE 2. AMENDMENT TO THE OBLIGATIONS OF THE PARTIES ............................ Section 2.01 MODIFICATIONS ............................................................................. ARTICLE 3. REPRESENTATIONS AND AGREEMENT OF THE PARTIES ................... ........................................ 2 ......................................2 ......................................3 ..................................... 3 HHSC 529-08-0110-000028 HHSC 529-08-0110-OOOOSB COUNTI' of TaAVIs STATE OE TESAS Amendment Two To the Agreement Between the Health & Human Services Commission And City of Part Arthur For The Texas Nurse-Family Partnership Program This Amendment Two ("the Amendment") to HHSC Contract No. 529-08-0110-00008 (the "Agreement") is entered into between the Health and Human Services Commission ("HHSC") an administrative agency within the executive department of the State of Texas with offices at 4900 North Lamar, Austin, Texas and City of Port Arthur. (CONTRACTOR) with offices at 449 Austin Avenue Part Arthur, Texas, for the purpose of amending certain key terms of the Original Agreement. The Parties entered into an agreement (the "Agreement") for Services and Deliverables pursuant to RFF No. 529-OS-OI 10 with an original term of performance of September 1, 2008 through August 31, 2009. On April 17, 2009, the Parties modified the Agreement to incorporate changes to the Services and Deliverables to be provided by CONTRACTOR. These modifications were incorporated into Amendment One to the Agreement. The Parties hereby agree to amend the Agreement, as amended, HHSC contract number 529-08-0110- 00008, subject to the following terms and conditions. The Parties agree that the modified terms and conditions will apply to the Services and Deliverables to be provided by CONTRACTOR unless further modified or amended by the Parties. Article 1. Authority and Objectives. Section 1.01 Authority. The Parties in accordance with Section 6.03(b) (3) of the Agreement execute this Amendment Two. This modification is also executed in accordance with Article VI of the NFP Agreement document, and Article 7 of HHSC's General Contract Tenns and Conditions, attached as Exhibit C to the NFP Agreement document. Section 1.02 Objectives. HHSC awarded a grant to City of Port Arthur to establish and operate a Texas Nurse-Family Partnership Program utilizing the program model developed by and in accordance with Nurse Family Partnership National Service Office. The purpose of this Agreement is to modify certain terms ofthe original Agreement to effectuate the maximum provision of program services and extend the contract period of the contract. Section 1.03 Modificotions to Agreement. The Contract is modified for the following purpose: HHSC 529-08-0110-000086 • To extend the term of this contract. • To revise the Project Managers and other Key Staff section of [he contract. • To revise the General Payment Tenns section of the contract. • To revise the service deliverables of this contract Section 1.04 Effective Date. The modifications to the Agreement agreed to in this Amendment Two shall be effective upon execution by both Parties, and will terminate on the Expiration Date of the Agreement, unless extended or terminated sooner by HHSC in accordance with the Agreement. Article 2. Amendment to the Obligations of the Parties Section 1.O1 Modifrcations. (I) Amendment of Contract Section 2.07 (a), Term of the Agreement The term of this agreement will begin on the Effective Date, as defined by HHSC's Uniform Terms and conditions, version, and will expire on August 31, 2010 (the "Expiration Date") unless terminated sooner or extended pursuant to the terms and conditions of this Agreement. (2) Amendment of Contract Section 2.08. Proiect Managers and other Kev Staff Section 2.08 is deleted in its entirety and replaced with the following language: The following Project Managers will serve as the primary contacts for all administrative issues: Isabel Eg0ez, LMSW Project Manager Health and Human Services Commission (HHSC) 11209 Metric Boulevard, Building H, MC 370 Austin, Texas 78758 Tel. # (512) 491-1 161 Fax # (512) 49]-1953 E-mail: isabel.eguez~hhsc.state.tx.us Yoshi D. Alexander, MBA Director of Health Services City of Port Arthur Health Department. 449 Austin Avenue Port Arthur, TX 77640 Tel. # 409-983-8832 Fax # 409-984-9093 E-mail: yoshi@portarthur.net HHSC 529.08-0110-OOOOSB The following Contract Manager will serve as primary contact for all invoices, purchase vouchers and reporting deliverables: Vicki Echols Contract Manager Health and Human Services Commission (HHSC) 11209 Metric Boulevard, Building H, MC 340, Austin, Texas 78758 Tel. # (512) 491-5556 Fax # (512) 491-1960 E-mail: vieki.eeholsnhhsc.state.te.us The following State Nurse Consultant will serve as primary contact for all clinical requirements: Rebecca Pack, RN, MN, PHD State Nurse Consultant Health and Human Services (HHSC) 11209 Metric Boulevard, Building H, MC 370 Austin, Texas 78758 Tel. # (512) 491-1123 Fax # (512) 491-1953 E-mail: rebecca.oack(rt7hhscstate.tx.us (3) Amendment of Contract Section 4.02 General Payment Terms Section 4.02 is deleted in it entirety and replaced with the following new language: (a) HHSC shall pay contractor an amount up to but not to exceed $470,104.00 for the term beginning September 1, 2009 and ending August 31, 2010, whereas those payments will be made on a monthly cost reimbursement basis, in response to an invoice and purchase voucher being received and monthly deliverables being approved. (b) Contractor will submit to the HHSC Contract Manager an Invoice and Purchase Voucher for the amount of expenses incurred by the Contractor on a monthly basis no later than the 15`h day of the month following that in which expenditure occurred, if the 15th falls on a weekend or holiday the documents will be due the next business day. (c) CONTRACTOR will receive payment under the terms of this amended Agreement only upon expending all funds from the previous fiscal year's payment. CONTRACTOR must continue to invoice HHSC for each month to show amounts expended for each month in this amended Agreement until all previously received funds from HHSC are expended.. Contractor's end of fiscal year 2009 (EOY) expenditure report along with an HHSC review of such report will determine the amount of additional funding that the program will receive from HHSC. (d) CONTRACTOR will maintain a separate bank account into which all NFP programs funds received from HHSC and any local match funds are maintained in order to determine and accrue interest for the purpose of program income. (3) Amendment to Exhibit F Reportine Requirements HHSC 529-08-0110-000088 Exhibit F is deleted in its entirety and replaced with the revised Exhibit F which is attached. Exhibit G is incorporated into this contract by reference. Article 3. Representations and Agreement of the Parties. The Parties hereto contract and agree that the terms of the Original Contract shall remain in effect and continue to govern except to the extent modified by this Amendment. By signing this Amendment, the Parties hereto expressly understand and agree that the Amendment is hereby made a part of [he original Contract as though it were set out word for word therein. The Parties have executed this Amendment in their capacities as stated below with authority to bind their organizations on the dates set forth by their signatures. IN THE WITNESS HEREOF, HHSC and CONTRACTOR, have each caused this Amendment Two to the Agreement to be signed and delivered by its duly authorized representative. HEALTH & HUMAN SERVICES COMMISSION CITY OE PORT ARTHUR Albert Hawkins Executive Commissioner Stephen Fitzgibbons City Manager Date Date HHSC S?9-OS-0110-0000SB Exhibit E Additional Contract Requirements Invoices and purchase vouchers are due no later than the 15'x' day of the month following the month in which expenditures were incurred.. If any reporting items are not received by their due dates, identified payment dates are null and void and payments will not be made until all reporting items due prior to the payment date have been received. Any promotional or marketing materials, client notifications, business presentations or client materials created and used by the Grantee, outside NFPNSO created materials, must be approved before use. To obtain approval of items noted above, copies must be made available to the assigned HHSC Project Manager to provide 15 business days for approval. Upon official notification of grant award, Grantee will be required to immediately enter into implementation planning with NFPNSO and the HHSC State Nurse Consultant, making key Grantee staff available and flexible for consultation with the afore mentioned parties. Grantee is prohibited from performing research on the NFP Staff and client population without prior written authorization from both NFPNSO and HHSC. All CIS data submission is required to be directly inputted, without prior approval or modification. Grantees must adhere to HHSC's client eligibility requirements which are amended to include 'Texas Residents at or below 185 FPL' as opposed to the initial requirement in Section 2.5 of the RFP for the Texas Nurse Family Partnership, which forms part of the contract through Exhibit A (RFP No. 529-08-O1 10 Date of Release: February 21, 2008) which states that "HHSC requires enrolled clients to be Medicaid-eligible pregnant women only. The Medicaid income limit for pregnant women is 185 percent or below of the Federal Poverty Level. Clients must also be U.S. citizens or fit the Medicaid-eligibility criteria for legal permanent residents." and may not disenroll clients without the express written approval of the HHSC State Nurse Consultant. All HHSC NFP Program nursing staff must follow all nursing licensure requirements for the State of Texas and all other laws applicable to the practice setting. Grant funds may only be used for the budget approved by HHSC NFP staff. Any shifts among budget line items that account for more than 10 percent of that line item must be authorized by the HHSC Contract Manager prior to the line item shift. Exhibit F Reporting Requirements All reporting templates provided to the CONTRACTOR by HHSC will be utilized as requested in order to improve the uniformity and clarity of CONTRACTOR'S data submission. Additional data elements may be requested by HHSC and it is required that CONTRACTOR make all reasonable efforts to assure that these data elements are collected and reported to HHSC upon their request. Templates and data element requests will not constitute the entirety of deliverables and requirements required for submission by this contract. Therefore, CONTRACTOR remains responsible for ensuring that all deliverables and requirements are met and reported as required by this contract. All Reporting Requirements listed below are due to HHSC by the ISth day of each month beginning November 15, 2009 and ending September 15, 2010. If the ISth falls on a weekend or holiday all Reporting Requirement will be due on the next business day. • Submit a narrative that includes: o Implementation Prooress: include progress/status of staff recruitment and retention, training, caseloads, use of CIS, issues/concerns, future plans and/or any other relevant information to describe your implementation progress. o Description of Referral Network: include the names of the organizations in your referral network, expected versus actual flow of referrals, community partner meetings and presentations, future plans, and/or any other relevant information to describe your referral network. o Comments: provide any comments, accomplishments, lessons teamed, upcoming events, or anything you would like to share that is not captured in other sections of the report. • Submit Staff Requirements Data Report including data collected [he previous month. This report shall remain cumulative. • Submit Individual Client Data Report including data collected the previous month. This report shall remain cumulative. • Submit required data into the NFPNSO Clinical Information System (CIS). • Submit an annual audit, performed by a CPA according to federal OMB standards, of HHSC NFP grant expenditures by Sept 30'", 2010. • Submit a Quarterly Expenditure Report covering, September 1 -November 30, December 1 - Febmary 28, March I -May 31 and June I -August 31. These reports will be due [o HHSC 30 days after the end of the reporting period Exhibit G Performance Measures Perfonnance Measures quantitatively illustrate compliance with services required as part of the Texas Nurse-Family Partnership Program. These performance measures assess operational components and were selected as critical elements in progress towards positive program outcomes. Measurement areas include: client enrollment, staffing, and number of completed visits. HHSC will track performance measures through TNFP Deliverables and through data collected in CIS. Data wilt be collected monthly and/or quarterly as indicated below, and observed/expected numbers calculated. PERFORMANCE MEASURES of expected case enrollment o Data Source: CIS; Staff Requirements Data Report o Goal: 90% or higher per month o Rationale and notes: implementation of the Nurse Family Partnership model of care has evidence based positive outcomes. In order for vulnerable families to benefit, they must be informed and enrolled in the program. Case enrollment expected is based on client accrual of 4 clients per nurse per month. Nurses will start to accrue clients after they have completed Unit 2. Each Nurse Home Visitor is limited to an active caseload of 25 clients. enrolled by 16 weeks o Data Source: CIS; Individual Client Data Report o Goal: 40% or higher per month o Rationale and notes: The program is most effective when nurses are able to establish a relationship early in the pregnancy. While the first year of implementation saw the goal of enrolling participants by the 28`" week, per the NFP Model, implementing agencies should strive [o enroll more participants at or before 16 weeks gestation. of expected staffing attained o Data Source: CIS; Staff Requirements Data Report o Goal: 90% or higher per month o Rationale and notes: Staffing is a critical component to the success of the program. Without adequate staff, contract goals for enrollment cannot be attained and more importantly, the vulnerable population we strive to impact will be left unserved. Mean % of completed/expected visits during pregnancy for clients who have completed the pregnancy phase. o Data Source: CIS o Goal: 70% or higher per quarter o Rationale and notes: The required number of visits per client need to be completed (performed) in order for the program to have positive maximum effect on behavior and pregnancy outcome. The goal for completed visits during pregnancy approximates the goal at the national level. • Mean % of completed/expected visits during infancy far clients who have completed the infancy phase. Data Source: CIS Goal: 40% or higher per quarter Rationale and notes: The required number of visits per client need to be completed (performed) in order for the program to have positive maximum effect on attaining the goals described by the NFP model for infants. The goal for completed visits during infancy approximates the goal at the national level. HHSC program staff including the Project Manager and State Nurse Consultant will provide support and consultation to CONTRACTOR as they strive to achieve the above stated goals. A[ the discretion of the Project Manager and State Nurse Consultant, performance improvement plans may be requested from CONTRACTOR when CONTRACTOR is not meeting one or more performance measure goals. CONTRACTORS that do not implement a performance improvement plan with the aim of improving performance measure eoals, may have all or part of their monthly payment withheld in accordance with Section 5.01 of HHSC's and CONTRACTOR'S agreement for the Texas Nurse-Family Partnership Program.