HomeMy WebLinkAboutPR 19121: CONTRACT WITH DEPARTMENT OF STATE HEALTH SERIVES, TUBERCULOISIS PREVENTION AND CONTROL City of•
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Texas
DATE: August 25, 2015
To: Brian McDougal, City Manager
From: Judith A. Smith, RN, BSN 0
RE: CONTRACT BETWEEN THE CITY OF PORT ARTHUR AND THE
DEPARTMENT OF STATE HEALTH SERVICES FOR TB CONTROL AND
PREVENTION.
Nature of the Request: This is a contract between the City of Port Arthur and the Department
of State Health Services to provide basic services and associated activities for tuberculosis (TB)
prevention and control, and expanded outreach services to individuals of identified special
populations who have TB or who are at high risk of developing TB.
Staff Analysis, Considerations: There are currently two employees working in the Tuberculosis
(TB) clinic. These grant funds will cover a percentage of salaries, travel and supplies for the TB
clinic.
Recommendations: It is recommended that the City Council approve P.R. No. 19121,
authorizing the City Manager and the City Health Director to enter into a contract with Texas
Department of State Health Services for TB funds totaling $25,278 to begin September 1, 2015
and end August 31, 2016.
Budget Considerations:None
"REMEMBER WE ARE HERE TO SERVE THE CITIZENS OF PORT ARTHUR"
P.O.BOX 1089•PORT ARTHUR,TX 77641-1089.409/983-8101•FAX 409/982-6743
P.R.NO. 19121
08/25/2015-j s
RESOLUTION NO.
A RESOLUTION AUTHORIZING A CONTRACT BETWEEN THE CITY
OF PORT ARTHUR AND THE DEPARTMENT OF STATE HEALTH
SERVICES FOR FUNDS IN THE AMOUNT OF $25,278.00 FOR
TUBERCULOSIS PREVENTION AND CONTROL
WHEREAS, this contract between the City of Port Arthur and the Department of State
Health Services will provide financial assistance to the Port Arthur City Health Department,
basic services and associated activities for tuberculosis (TB) prevention and control, and
expanded outreach services to individuals of identified special populations who have TB or who
are at high risk of developing TB; and,
WHEREAS, the contract is for $25,278 and will cover a portion of salaries, travel, and
supplies for the TB clinic in the health department; and,
WHEREAS, the contract will begin 09/01/2015 and end 08/31/2016, and will require a
20% in kind match of$5,056.
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 accepts and
approves the contract between the City of Port Arthur and the Department of State Health
Services for tuberculosis prevention and control services in the amount of$25,278.
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
P.R. NO. 19121
Page 2
contract between the Department of State Health Services and the City of Port Arthur as
delineated in Exhibit "A".
Section 4. That, a copy of the caption of this Resolution be spread upon the Minutes of
the City Council.
READ,ADOPTED, AND APPROVED,this day of September, 2015 A.D.,
at a Regular Meeting of the City Council of the City of Port Arthur, Texas by the following
Vote: AYES: Mayor:
Councilmembers:
NOES:
Mayor
ATTEST:
Sherri Bellard, City Secretary
APPROVE AS TO FORM:
V a
Val Tizeno, i tto
APPROVED FOR ADMINISTRATION:
g.Udidib /6, !mni 65'/J
Brian McDougal, CityManager Judith A. Smith, RN, BSN
g g
Director of Health Services
EXHIBIT "A"
DEPARTMENT OF STATE HEALTH SERVICES
CONTRACT 2016-003790-00
This Contract is entered into by and between the Department of State Health Services (DSHS or
the Department), an agency of the State of Texas, and Port Arthur Health Department (Contractor),
a Governmental, (collectively, the Parties) entity.
1. Purpose of the Contract: DSHS agrees to purchase, and Contractor agrees to provide,
services or goods to the eligible populations.
2. Total Amount: The total amount of this Contract is $25,278.00.
3. Funding Obligation: This Contract is contingent upon the continued availability of funding. If
funds become unavailable through lack of appropriations, budget cuts, transfer of funds between
programs or health and human services agencies, amendment to the Appropriations Act, health
and human services agency consolidation, or any other disruptions of current appropriated funding
for this Contract, DSHS may restrict, reduce, or terminate funding under this Contract.
4. Term of the Contract: This Contract begins on 09/01/2015 and ends on 08/31/2016. DSHS
has the option, in its sole discretion, to renew the Contract. DSHS is not responsible for payment
under this Contract before both parties have signed the Contract or before the start date of the
Contract, whichever is later.
5. Authority: As applicable, DSHS enters into this Contract under the authority of Texas Health
and Safety Code Chapters 12 or 1001 or Texas Government Code Chapters 531, 771, 791 or
2155.
6. Program Name: TB/PC-STATE Tuberculosis Prevention and Control-State
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7. Statement of Work:
SECTION I: FY16 FRAMEWORK FOR DELIVERY OF TUBERCULOSIS SERVICES:
The Statement of Work establishes parameters in which local health departments (LHDs) receiving state
funds will deliver services to maintain an effective infrastructure that promotes consistent public health
practices for the health and well-being of Texans.
Local health departments shall comply with the most current version of the Tuberculosis Work Plan located
at http://www.texastb.org/policies and all applicable state laws, regulations, standards and guidelines.
Local health departments shall perform the following in accordance with the Tuberculosis Work Plan:
-Implement a comprehensive TB prevention and control program;
•Develop and maintain TB policies and procedures;
•Provide services to evaluate, treat, and monitor clients with suspected or confirmed TB disease;
•Initiate contact investigations;
•Provide services to evaluate, treat, and monitor contacts to suspected or confirmed cases of pulmonary,
pleural, or laryngeal TB disease;
•Provide treatment services for at-risk persons diagnosed with TB infection;
•Develop and maintain surveillance mechanism for early identification and reporting of TB;
•Perform Targeted testing;
•Submit designated reports by established deadlines and schedules using DSHS-approved mechanisms;
•Apply appropriate administrative, environmental, and respiratory controls to prevent exposure to and
transmission of Mycobacterium tuberculosis;
•Provide professional education, training and orientation for new TB program staff and continuing
education for current TB program staff;
•Monitor budget expenditures and maintain accurate and concise records;
•Comply wth confidentiality and security standards;
•Monitor and participate in correctional TB control activities;
•Perform self-auditing activities to assess clinical care services and reporting practices; and
•Perform ongoing continuing quality improvement activities to meet Texas performance measures.
A. PROVISION OF SERVICES:
Throughout the Contractor's defined service area, Contractor shall develop and provide services and
associated activities to prevent and control tuberculosis in their jurisdiction.
Contractor shall perform activities required under this Program Attachment in the Service Area designated
in the most recent version of Section 8. "Service Area" of this contract.
Contractor shall provide these services in compliance with the following:
•All TB and Refugee Health Service Branch (TB Branch)standards and policies on TexasTB.org;
• DSHS Tuberculosis Work Plan, http://www.dshs.state.tx.us/idcu/disease/tb/policies/;
• DSHS Standards of Performance for the Prevention and Control of Tuberculosis, 2008,
http://www.dshs.state.tx.us/idcu/disease/tb/policies/;
•American Thoracic Society (ATS) and Centers for Disease Control and Prevention (CDC)joint
statements on diagnosis, treatment and control of TB, 2003,
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5211al.htm;
• Diagnostic Standards and Classification of Tuberculosis in Adults and Children, American Journal of
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Respiratory and Critical Care Medicine, Vol. 161, pp. 1376-1395, 2000,
http://atsjo u rna l s.org/doi/a bs.10.1164/aj rccm.161.4.16141#.vrm 6 roko4dy;
• Targeted Tuberculin Testing and Treatment of Latent TB Infection (LTBI), Morbidity and Mortality Weekly
Report, Vol. 49, No. RR-6, 2000, http://www.cdc.gov/mmwr/PDF/rr/rr4906.pdf;
• Updated: Adverse Event Data and Revised ATS/CDC Recommendations against the Use of Rifampin
and Pyrazinamide for Treatment of Latent Tuberculosis Infection — United States, 2003, MMWR 52 (No.
31), http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5231a4.htm;
• Controlling Tuberculosis in the United States, MMWR, Vol. 54, No. RR-12, 2005,
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5412al.htm;
• Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV-Exposed and
HIV-Infected Children, http://www.cdc.gov/mmwr/pdf/rr/rr58e0826.pdf; and
• Tuberculosis Surveillance Data Training Report of Verified Case of Tuberculosis (RVCT) Instruction
Manual, http://www.cdc.gov/tb/programs/rvct/InstructionManual.pdf.
Contractor shall comply with all applicable federal and state regulations and statutes, including but not
limited to, the following:
•Tuberculosis Code, Texas Statutes, Health and Safety Code, Chapter 13, Subchapter B;
• Communicable Disease Prevention and Control Act, Texas Statutes, Health and Safety Code, Chapter
81;
• Screening and Treatment for Tuberculosis in Jails and Other Correctional Facilities, Texas Statutes,
Health and Safety Code, Chapter 89;
• Control of Communicable Diseases, Texas Administrative Code TAC, Title 25, Part 1, Chapter 97,
Subchapter A;
• Tuberculosis Screening for Jails and Other Correctional Facilities, Texas Administrative Code (TAC),
Title 25, Part 1, Chapter 97, Subchapter H; and
• Retention of Medical Records, General Provisions Article VIII "Records Retention" and by Texas
Administrative Code Title 22, Part 9, Chapter 165, §165.1.
Contractor shall perform all activities under this Program Attachment in accordance with the Tuberculosis
Work Plan, and detailed budget as approved by DSHS. Contractor must receive written approval from
DSHS before varying from applicable procedures in the Tuberculosis Work Plan. If approval is provided,
the Contractor shall update their policies and procedures within five (5)working days so that staff working
on activities under this contract knows of the change(s).
Contractor shall provide TB services to individuals with suspected or confirmed TB disease including
persons identified as a contact to a known case or suspect, refugees and class B immigrants regardless of
their ability to pay for services.
DSHS reserves the right, where allowed by legal authority, to redirect funds in the event of financial
shortfalls. DSHS will monitor
Contractor's expenditures on a quarterly basis. If expenditures are below what is projected in Contractor's
total Renewal Program Attachment amount, Contractor's budget may be subject to a decrease for the
remainder of the Contract term. Vacant positions existing after ninety (90) days may result in a decrease in
funds.
CONFIDENTIALITY
Contractor will designate and identify a HIPAA Privacy Officer, who is authorized to act on behalf of
Contractor and is responsible for the development and implementation of the privacy and security
requirements of federal and state privacy laws.
Contractor shall designate, from its staff, a Local Responsible Party (LRP) who has the overall
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responsibility for ensuring the security of the TB/HIV/STD confidential information maintained by Contractor
as part of activities under this Program Attachment. The LRP must:
•Ensure that appropriate policies/procedures are in place for handling confidential information, for the
release of confidential TB/HIV/STD data, and for the rapid response to suspected breaches of protocol
and/or confidentiality. These policies and procedures must comply with DSHS policies and procedure
(Contractor may choose to adopt those DSHS policies and procedures as its own).
•Ensure that security policies are reviewed periodically for efficacy, and that the Contractor monitors
evolving technology (e.g. new methods hackers are using to illegally access confidential data; new
technologies for keeping confidential data protected from hacking) on an on-going basis to ensure that the
program's data remain as secure as possible.
•Approve any Contractor staff requiring access to TB/HIV/STD confidential information. LRP will grant
authorization to Contractor staff who have a work-related need (i.e. work under this Program Attachment)to
view TB/HIV/STD confidential information.
•Maintain a list of authorized Contractor staff persons who have been granted permission to view and work
with TB/HIV/STD confidential information. The LRP will review the authorized user list ten (10) days from the
effective date of this Program Attachment to ensure it is current. All Contractor staff with access to
confidential information will have a signed copy of a confidentiality agreement on file and it be updated
once during the term of this Program Attachment.
•Ensure that all Contractor staff with access to confidential information will be trained on TB/HIV/STD
security policies and procedures before access to confidential information is granted and that this training
will be renewed once during the term of this Program Attachment.
•Ensure that all Contractor staff with access to confidential information will be trained on federal and state
privacy laws and policies before access to confidential information is granted and that this training will be
renewed once during the term of this Program Attachment.
•Thoroughly and quickly investigate all suspected breaches of confidentiality in consultation with the DSHS
LRP, all in compliance with the DSHS Program Policy TB/HIV/STD and Viral Hepatitis Breach of
Confidentiality Response Policy" http://www.dshs.state.tx.us/hivstd/policy/security.shtm.
•Ensure that all required quarterly reports will be submitted on time.
Contractor shall include the following in their security procedures:
•Computers and networks meet DSHS security standards, as certified by DSHS IT staff
•Provide a list to DSHS of personnel with access to secured areas and of all identified personnel who have
received security training
•Provide a list to DSHS of personnel with access to all network drives where confidential information is
stored and all identified personnel received security training
•Requests for TB/HIV/STD systems user account terminations are sent to DSHS within 1 business day of
the identification of need for account termination
•Transfer secure data electronically using the Public Health Information Network
•A visitors log for individuals entering the secured areas and reviewed quarterly by the LRP
•TB/HIV/STD system user passwords changes verified by the LRP at least every 90 days
•Confidential data were:
•Maintained in a secured area
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•Locked when not in use
•Confidential documents are not left in plain sight
•Shredded before disposal
•Portable devices that are used to store confidential data are approved by the LRP and encrypted
B. USE OF FUNDS:
Contractor shall demonstrate fiduciary responsibility in administering program funds. Contractor will be
subject to adjustments in award amounts based on changes to the number of clients served, utilization of
funds, or other factors.
Contractor shall provide a match of no less than 20% of the total budget reflected in the Program
Attachment. Contractor shall provide match at the required percentage or DSHS may withhold payments,
use administrative offsets, or request a refund from
Contractor until such time as the required match ratio is met. No federal or other grant funds can be used
as part of meeting the match requirement.
Contractor shall not use DSHS funds or matching funds (including in-kind contributions)for:
1. Entertainment; or
2. Sectarian worship, instruction, or proselytization.
However, food and incentives are allowed using DSHS funds, but are not allowed for matching funds
(including in-kind contributions).
Contractor shall:
1. Lapse no more than 5% of the total funded amount of the contract;
2. Maintain and adjust spending plan throughout the contract term to avoid lapsing funds; and
3. Maintain staffing levels to meet required activities of the contract and to ensure all funds in personnel
category are expended.
Contractor's budget shall include costs to cover:
1. Required TB trainings;
2. Continuing education training; and
3. Patient transportation, i.e. ambulance services as needed.
DSHS reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfall.
DSHS Program will monitor Contractor's expenditures on a quarterly basis. If expenditures are below that
projected in Contractor's total contract amount as approved for this Program Attachment, Contractor's
budget may be subject to a decrease for the remainder of the Program Attachment term. Vacant positions
existing after ninety (90) days may result in a decrease in funds.
Contractor agrees to read DSHS Contractor Financial Procedures Manual (CFPM) and work with DSHS
staff regarding the management of funds received under this Contract.
http://www.dshs.state.tx.us/contracts/cfpm.shtm.
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C.MEDICATIONS AND SUPPLY INVENTORY MANAGEMENT:
Contractor shall order TB medications through DSHS-enabled pharmacy ordering system. Contractor shall
ensure that TB medications and supplies purchased with DSHS TB Branch funds are used in a prudent
manner that contributes to disease control in their service area and shall not be distributed to entities for
which the Contractor does not provide treatment oversight.
Contractor shall monitor and manage its usage of TB medications and testing supplies furnished by DSHS
in accordance with first-expiring-first-out (FEFO) principles of inventory control and set maximum stock
levels at a two (2) month average usage.
Contractor shall count DSHS-purchased medications and supplies, on a monthly basis, and reconcile their
inventory according to the product and lot number listed in the DSHS Inventory Tracking Electronic and
Asset Management System (ITEAMS).
Contractor will coordinate with ITEAMS inventory staff to ensure their TB orders comply with best practices.
Contractor shall perform these tasks no later than the seventh working day of the month, using the
DSHS-designated electronic management system and procedures established by the TB Branch.
Products that have not been used in six (6) months, or will not be used in six (6) months shall be returned to
DSHS Pharmacy or transferred to another TB program where the demand may be greater and recorded in
(TEAMS. All DSHS-purchased medications shall be stored properly and securely, in accordance with
manufacturer's instructions (refer to TB Work Plan, Section V).
Contractor shall obtain a TB expert physician consultation and approval from the TB Branch prior to
ordering the following second-line medications:
•Injectable Agents: capreomycin, kanamycin, amikacin, streptomycin;
•Fluoroquinolones: levofloxacin (Levoquin), ciprofloxacin, moxifloxacin, ofloxacin;
•Bacteriostatic Agents: ethionamide, para-aminosalicylic acid, cycloserine; and
•Other Agents: clofazamine, linezolid, bedaquiline, clarithromycin, amoxicillin.
Contractor may distribute Purified Protein Derivative (PPD) and syringes for TB skin testing to correctional
facilities that meet Texas Health and Safety Code, Chapter 89 requirements. Contractor shall monitor
distribution of these items in accordance with screening activities submitted on the correctional monthly
report.
D. USE OF INTERFERON GAMMA RELEASE ASSAY TESTS:
Contractor shall:
1.Perform tuberculosis screenings using DSHS-supplied interferon gamma release assays (IGRA)
specifically T-SPOT®.TB or QuantiFERON®—TB Gold in-tube tests for the following populations in
accordance with DSHS-approved age requirements:
a.TB suspects;
b.TB cases;
c.Contacts to TB suspects and cases—Consultation with the TB Branch is required for contact
investigations in which 50 or more persons are targeted for screening;
d.Targeted testing except screening in correctional facilities— Monthly screening reports shall be submitted
in accordance with reporting schedule; and
e.Routine screening of employees providing TB services.
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2.IGRA testing products/supplies supported by DSHS funds shall not be provided to any organization or
establishment without documented approval from the TB Branch.
E. CONDUCT SURVEILLANCE:
Contractor shall:
1.Contact providers that deliver TB care to at-risk populations within Contractor's service area to obtain
data of unreported cases (refer to TB Work Plan, Section VIII, B);
2.Submit Surveillance Quality Assurance Template via the Public Health Information Network (PHIN)to the
Surveillance Branch (refer to TB Work Plan, Section VIII, A);
3.Identify high risk groups and congregate settings for which testing for TB infection (TBI) and disease are
justified. The goal for target testing is to identify, evaluate, and treat persons who are at high risk for TB
infection or at high risk for developing TB disease, once infected with M. tuberculosis (refer to TB Work
Plan, Section VIII, B).
F. REPORTING:
Contractor shall:
1.Provide a complete and accurate Annual Progress Report covering the period from January to
December 2015, in the format provided by DSHS, demonstrating compliance with requirements of the
Program Attachments during that time period. The report shall include, but not limited to, a detailed analysis
of performance related to the performance measures (see Section II FY16 Performance Measures).
The Contractor's Annual Progress Report shall not be combined with another Contractor's or health service
region's Annual Progress Report. The report is due March 15, 2016, and shall be sent to the TB Reporting
Mailbox -TBContractReporting@dshs.state.tx.us (refer to TB Work Plan, Section IX, 0). Any
individual-level patient data must be sent via the PHIN. Contractors can mail the Annual Progress Report to
their DSHS Health Service Region (HSR)thereby authorizing them to submit the report on their behalf. If
the Contractor sends the report to a DSHS HSR, the deadline for submission to the TB Branch remains
unchanged;
2.Ensure designated reports for Cases, Suspects and Contact Investigations are submitted by established
deadlines and schedules using DSHS-approved mechanisms (refer to TB Work Plan, Section IX);
3.Submit monthly correctional TB screening reports from those jails and community corrections under
Texas Health and Safety Code Chapter 89 Requirements (refer to TB Work Plan, Section IX, N);
4.Submit completed Cohort Review documents for the appropriate cohort year and quarter to the TB
Branch via the PHIN (refer to TB Work Plan, Section IX, P);
5.Submit completed Incident Report(s)and weekly written updates for media sensitive situations and or
large contact investigations (= 50 contacts, or in a school = 25 contacts) are sent to the TB Branch via the
PHIN (refer to TB Work Plan, Section IX, Q);
6.Conduct DGMQ airline contact investigations and report to the TB Branch (refer to TB Work Plan,
Section IX, R); and
7.Submit a Report of Adverse Drug Reaction to the TB Branch Nurse Case Manager Consultant (or
designee), if a TB Suspect or Case dies or is hospitalized due to an adverse drug reaction (refer to TB
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Work Plan, Section IX, S).
G. MAINTAIN A COMPETENT WORKFORCE:
Contractor shall provide professional education, training and orientation for new TB program staff and
continuing education for current TB program staff to include: physicians, nurses, contact investigators,
outreach workers, case registry staff, receptionists, epidemiologists, and other support staff(refer to TB
Work Plan, Section XI).
Within 90 days of employment, all newly hired employees shall complete 40 hours of required TB training
specific to their duties and responsibilities. Refer to the TB Work Plan for required trainings for newly hired
employees. Each year, employees providing TB services shall receive 16 hours of continuing education or
training relevant to their position.
Documentation of all training (including the name of staff person,job title, hours received, course name, and
date of course) shall be retained for each employee who delivers TB services and made available upon
request by the TB Branch and listed in detail in the Accomplishments section of the Annual Progress
Report(refer to TB Work Plan, Section XI, C).
Contractor shall provide to the TB Branch, "Notice of Change in TB Personnel" form no later than the 5th
day of each month (see Attachment A).
Contractor's case registry staff shall attend annual medical records conference and workshop to obtain the
latest records management procedures.
By October 14th of each year, Contractor shall submit documents demonstrating acknowledgment of
jurisdictional TB policies and procedures by TB personnel. Orders and procedures are to be reviewed and
signed at least annually by all employees delivering TB clinical (registered nurses, licensed vocational
nurses, and non-licensed staff) or data services (epidemiologists, case registrars, etc.). Each Contractor
shall send the following documents to the TB Branch via the PHIN; Nurse Admin folder:
1.Copy of fully signed TB Policies and Procedures signature page, and
2.Copy of table of contents listing all enacted TB policies and procedures with the period of time the
policies and procedures are valid.
H. INITIATE AND MAINTAIN AUDITING AND QUALITY ASSURANCE PRACTICES:
Contractor must ensure that appropriate clinical and reporting standards are adequately maintained for
audit activities (refer to TB Work Plan, Section XVI).
Contractors are subject to audits, desktop reviews and site visits at the discretion of DSHS.
SECTION II: FY16 PERFORMANCE MEASURES:
The following performance measures will be used to assess, in part, Contractor's effectiveness in providing
the services described in this Contract, without waiving the enforceability of any of the other terms of the
Contract or any other method of determining compliance (refer to TB Work Plan, Section XVI):
1.Newly-reported TB cases shall have an HIV test performed (unless they are known HIV-positive, or if the
patient refuses)and shall have positive or negative HIV test results reported to DSHS according to the
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reporting schedule provided in Section 1, B herein.
For FY16 reporting, data will be drawn from calendar year 2015 (1/1/2015 -12/31/2015). A compliance
percentage of not less than 82.9% is required.
If fewer than 82.9% of newly reported TB cases have a result of an HIV test reported, then DSHS may (at
its sole discretion) require additional measures be taken by Contractor to improve that percentage, on a
timeline set by DSHS;
2.Cases, and suspected cases, of TB under treatment by Contractor shall be placed on timely and
appropriate Directly Observed Therapy (DOT).
For FY16 reporting, data will cover all cases from calendar year 2015 (1/1/2015 -12/31/2015). A
compliance percentage of not less than 91.6% is required.
If data indicates a compliance percentage for this Performance Measure of less than 91.6%, then DSHS
may (at its sole discretion) require additional measures be taken by Contractor to improve that percentage,
on a timeline set by DSHS;
3.Newly-reported suspected cases of TB disease shall be started in timely manner on the recommended
initial 4-drug regimen.
For FY16 reporting, data will be drawn from calendar year 2015 (1/1/2015 -12/31/2015). A compliance
percentage of not less than 93.4% is required.
If fewer than 93.4% of newly-reported TB cases are started on an initial 4-drug regimen in accordance with
this requirement, then DSHS may (at its sole discretion) require additional measures be taken by
Contractor to improve that percentage, on a timeline set by DSHS;
4.Newly-reported TB patients that are older than 12-years-old and that have a pleural or respiratory site of
disease shall have sputum acid-fast bacilli (AFB)-culture results reported to DSHS according to the
timelines for reporting initial and updated results given herein.
For FY16 reporting, data will be drawn from calendar year 2015 (1/1/2015 -12/31/2015). A compliance
percentage of not less than 91.5% is required.
If data indicates a compliance percentage for this Performance Measure of less than 91.5%, then DSHS
may (at its sole discretion) require additional measures be taken by Contractor to improve that percentage,
on a timeline set by DSHS;
5.Newly-reported cases of TB with AFB positive sputum culture results will have documented conversion to
sputum culture-negative within 60 days of initiation of treatment.
For FY16 reporting, data will be drawn from calendar year 2014 (1/1/2014-12/31/2014). A compliance
percentage of not less than 47% is required.
If data indicates a compliance percentage for this Performance Measure of less than 47%, then DSHS may
(at its sole discretion) require additional measures be taken by contractor to improve the percentage, on a
timeline set by DSHS;
6. Newly diagnosed TB cases that are eligible*to complete treatment within 12 months shall complete
therapy within 365 days or less.
*Exclude TB cases 1) diagnosed at death, 2)who die during therapy, 3)who are resistant to Rifampin, 4)
who have meningeal disease, and/or 5)who are younger than 15 years with either miliary disease or a
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positive blood culture for TB.
For FY16 reporting, data will cover all cases from calendar year 2014 (1/1/2014 -12/31/2014). A
compliance percentage of not less than 87% is required.
If data indicates a compliance percentage for this Performance Measure of less than 87%, then DSHS may
(at its sole discretion) require additional measures be taken by Contractor to improve that percentage, on a
timeline set by DSHS;
7. Increase the proportion of culture-confirmed TB cases with a genotyping result reported.
For FY16 reporting, data will be drawn from calendar year 2015 (1/1/2015 -12/31/2015). A compliance
percentage of not less than 94.2% is required.
If data indicates a compliance percentage for this Performance Measure of less than 94.2%, then DSHS
may (at its sole discretion) require additional measures be taken by Contractor to improve that percentage,
on a timeline set by DSHS;
8. TB cases with initial cultures positive for Mycobacterium tuberculosis complex shall be tested for drug
susceptibility and have those results documented in their medical record.
For FY16 reporting, data will be drawn from calendar year 2014 (1/1/2014 -12/31/2014). A compliance
percentage of not less than 97.8% is required.
If data indicates a compliance percentage for this Performance Measure of less than 97.8%, then DSHS
may (at its sole discretion) require additional measures be taken by Contractor to improve that percentage,
on a timeline set by DSHS;
9. Newly-reported TB patients with a positive AFB sputum-smear result shall have at least three contacts
identified as part of the contact investigation that must be pursued for each case.
For FY16 reporting, data will be drawn from calendar year 2015 (1/1/2015 -12/31/2015). A compliance
percentage of not less than 92% is required.
If data indicates a compliance percentage for this Performance Measure of less than 92%, then DSHS may
(at its sole discretion) require additional measures be taken by Contractor to improve that percentage, on a
timeline set by DSHS;
10. Newly-identified contacts, identified through the contact investigation, that are associated with a sputum
AFB smear-positive TB case shall be evaluated for TBI and disease.
For FY16 reporting, data will be drawn from calendar year 2014 (1/1/2014 -12/31/2014). A compliance
percentage of not less than 82.5% is required.
If data indicates a compliance percentage for this Performance Measure of less than 82.5%, then DSHS
may (at its sole discretion) require additional measures be taken by Contractor to improve that percentage,
on a timeline set by DSHS;
11. Contacts, identified through the contact investigation, that are associated with a sputum AFB
smear-positive case and that are newly diagnosed with TBI shall be started on timely and appropriate
treatment.
For FY16 reporting, data will be drawn from calendar year 2014 (1/1/2014 -12/31/2014). A compliance
percentage of not less than 70% is required.
If data indicates a compliance percentage for this Performance Measure of less than 70%, then DSHS may
(at its sole discretion) require additional measures be taken by Contractor to improve that percentage, on a
Page 10 of 21
timeline set by DSHS;
12. Contacts, identified through the contact investigation, that are associated with a sputum AFB
smear-positive case that are newly diagnosed with TBI and that were started on treatment shall complete
treatment for TBI as described in Targeted Tuberculin Testing and Treatment of Latent TB Infection (LTBI),
Morbidity and Mortality Weekly Report, Vol. 49, No. RR-6, 2000; according to timelines given, therein.
For FY16 reporting, data will be drawn from calendar year 2014 (1/1/2014 -12/31/2014). A compliance
percentage of not less than 50% is required.
If data indicates a compliance percentage for this Performance Measure of less than 50%, then DSHS may
(at its sole discretion) require additional measures be taken by Contractor to improve that percentage, on a
timeline set by DSHS;
13. For Class B immigrants and refugees with abnormal chest x-rays read overseas as consistent with TB,
increase the proportion who initiate a medical evaluation within 30 days of arrival. Arrival is defined as the
first notice or report; whether that is by fax, phone call, visit to the health department or EDN notification.
For FY16 reporting, data will be drawn from calendar year 2015 (1/1/2015 -12/31/2015). A compliance
percentage of not less than 62% is required.
If data indicates a compliance percentage for this Performance Measure of less than 62%, then DSHS may
(at its sole discretion) require additional measures be taken by Contractor to improve that percentage, on a
timeline set by DSHS;
14. For Class B immigrants and refugees with abnormal chest x-rays read overseas as consistent with TB,
increase the proportion who initiate and complete a medical evaluation within 90 days of arrival.
For FY16 reporting data will be drawn from calendar year 2015 (1/1/2015-12/31/2015). A compliance
percentage of not less than 45% is required.
If data indicates a compliance percentage for this Performance Measure of less than 45%, then DSHS may
(at its sole discretion) require additional measures be taken by Contractor to improve that percentage, on a
timeline set by DSHS;
15. For Class B immigrants and refugees with abnormal chest x-rays read overseas as consistent with TB
and who are diagnosed with TBI during evaluation in the US, increase the proportion who start treatment.
For FY16 reporting, data will be drawn from calendar year 2015 (1/1/2015 -12/31/2015). A compliance
percentage of not less than 64% is required.
If data indicates a compliance percentage for this Performance Measure of less than 64%, then DSHS may
(at its sole discretion) require additional measures be taken by Contractor to improve that percentage, on a
timeline set by DSHS; and
16. For Class B immigrants and refugees with abnormal chest x-rays read overseas as consistent with
TB and who are diagnosed with TBI during evaluation in the US and started on treatment, increase the
proportion who complete TBI treatment.
For FY16 reporting, data will be drawn from calendar year 2014 (1/1/2014 -12/31/2014). A compliance
percentage of not less than 70% is required.
If data indicates a compliance percentage for this Performance Measure of less than 70%, then DSHS may
(at its sole discretion) require additional measures be taken by Contractor to improve that percentage, on a
timeline set by DSHS.
Page 11 of 21
Contractor shall maintain documentation used to calculate performance measures as required by General
Provisions Article VIII "Records Retention" and by Texas Administrative Code Title 22, Part 9 Chapter 165,
§165.1 regarding retention of medical records.
All reporting to DSHS shall be completed as described in Section I, "D. Reporting" and submitted by the
deadlines given.
If Contractor fails to meet any of the performance measures, Contractor shall furnish in the Annual Progress
Report, due March 15, 2016, a written narrative explaining the barriers and the plan to address those
barriers. This requirement does not excuse any violation of this Contract, nor does it limit DSHS as to any
options available under the contract regarding breach.
SECTION III: BILLING INSTRUCTIONS:
Contractor shall request payment using the State of Texas Purchase Voucher (Form B-13) and acceptable
supporting documentation for reimbursement of the required services/deliverables.
Vouchers and supporting documentation can be mailed, faxed or sent via e-mail:
Claims Processing Unit, MC 1940
Department of State Health Services
1100 West 49th Street
PO Box 149347
Austin, Texas 78714-9347
The fax number for submitting State of Texas Purchase Voucher (Form B-13)to the Claims Processing
Unit is (512) 776-7442. The email address is invoices@dshs.state.tx.us and to
CMU.invoices@dshs.state.ts.us.
Page 12 of 21
8. Service Area
Jefferson County
Page 13 of 21
This section intentionally left blank.
Page 14 of 21
10. Procurement method:
Competitive RFP
GST-2016-Solicitation-00022 DCPS FY16 TB PC STATE NEW CONTRACT
11. Renewals:
Number of Renewals Remaining: 0 Date Renewals Expire: 08/31/2016
12. Payment Method:
Cost Reimbursement
13. Source of Funds:
STATE
14. DUNS Number:
137134909
Page 15 of 21
15. Programmatic Reporting Requirements:
Report Name Frequency Period Begin Period End Due Date
Annual Report Annually January 1, 2015 December 31, 2015 March 15, 2016
Financial Status Quarterly September 1, 2015 November 30, 2015 December 31, 201;
Reports (FSRs) &
Match
Reimbursements
Financial Status Quarterly December 1, 2015 February 29, 2016 March 31, 2016
Reports (FSRs) &
Match
Reimbursements
Financial Status Quarterly March 1, 2016 May 31, 2016 June 30, 2016
Reports (FSRs) &
Match
Reimbursements
Financial Status Quarterly June 1, 2016 August 31, 2016 October 17, 2016
Reports (FSRs) &
Match
Reimbursements
Submission Instructions:
Annual Report: Submit program reports to the TB Reporting Mailbox-
TBContractReporting@dshs.state.tx.us .
Financial Status Reports:
Claims Processing Unit, MC1940
Department of State Health Services
1100 West 49th Street
PO Box 149347
Austin, TX 78714-9347
The fax number is (512)776-7442. The email address is invoices@dshs.state.tx.us .
Page 16 of 21
16. Special Provisions
SECTION IV: FY16 SPECIAL PROVISIONS:
General Provisions, ARTICLE VII CONFIDENTIALITY, Section 7.03 Exchange of client-identifying
information, is revised to include the following:
Neither Contractor, nor any subcontractor, shall transfer a client or patient record through any means,
including electronically, to another entity or person, or subcontractor without written consent from the client or
patient, or someone authorized to act on his or her behalf; however, DSHS may require Contractor, or any
subcontractor, to timely transfer a client or patient record to DSHS if the transfer is necessary to protect
either the confidentiality of the record or the health and welfare of the client or patient, or is otherwise
provided by law.
DSHS shall have timely access to a client or patient record in the possession of Contractor, or any
subcontractor, under authority of the Texas Health and Safety Code, Chapters 81 and 85, and the Medical
Practice Act, Texas Occupations Code, Chapter 159. In such cases, DSHS shall keep confidential any
information obtained from the client or patient record, as required by the Texas Health and Safety Code,
Chapter 81, and Texas Occupations Code, Chapter 159.
General Provisions, Article XXIII, Program Funds and Payment, Section 23.04 Nonsupplanting, is revised to
include the following:
Funding from this Contract shall not be used to supplant (i.e., used in place of funds dedicated, appropriated
or expended for activities funded through this Contract) state or local funds, but Contractor shall use such
funds to increase state or local funds currently available for a particular activity. Contractor shall maintain
local funding at a sufficient rate to support the local program. If the total cost of the project is greater than
DSHS' share set out in SECTION VII. BUDGET, Contractor shall supply funds for the remaining costs in
order to accomplish the objectives set forth in this Contract.
All revenues directly generated by this Contract or earned as a result of this Contract during the term of this
Contract are considered program income; including income generated through Medicaid billings for TB
related clinic services. Contractor may use the program income to further the scope of work detailed in this
Contract, and must keep documentation to demonstrate such to DSHS's satisfaction. This program income
may not be used to take the place of existing local, state, or federal program funds.
General Provision, ARTICLE XIV, General Terms, Section 14.12, Amendment is revised to include the
following:
Contractor must submit all amendment and revision requests in writing to the Division Contract Management
Unit at least ninety (90) days prior to the end of the term of this Program Attachment.
Page 17 of 21
17. Documents Forming Contract. The Contract consists of the following:
a. Contract (this document) 2016-003790-00
b. General Provisions Subrecipient General Provisions
c. Attachments Budget
d. Declarations Fiscal Federal Funding Accountability and Transparency Act
(FFATA) Certification
e. Exhibits Attachment A: Personnel Form
Any changes made to the Contract, whether by edit or attachment, do not form part of the Contract
unless expressly agreed to in writing by DSHS and Contractor and incorporated herein.
18. Conflicting Terms. In the event of conflicting terms among the documents forming this Contract, the
order of control is first the Contract, then the General Provisions, then the Solicitation Document, if any, and
then Contractor's response to the Solicitation Document, if any.
19. Payee. The Parties agree that the following payee is entitled to receive payment for services rendered
by Contractor or goods received under this Contract:
Name: Port Arthur City Health Dept
Vendor Identification Number: 17460018850
20. Entire Agreement. The Parties acknowledge that this Contract is the entire agreement of the Parties
and that there are no agreements or understandings, written or oral, between them with respect to the
subject matter of this Contract, other than as set forth in this Contract.
I certify that I am authorized to sign this document and I have read and agree to all parts of the contract,
Department of State Health Services Port Arthur Health Department
By: By:
Signature of Authorized Official Signature of Authorized Official
Date Date
Name and Title Name and Title
1100 West 49th Street
Address Address
Austin, TX 78756-4204
City, State, Zip City, State, Zip
Telephone Number Telephone Number
E-mail Address E-mail Address
Page 18 of 21
Budget Summary
Organization Name: Port Arthur Health Department Program ID: TB/PC-STATE
Contract Number: 2016-003790-00
Budget Categories
Budget Categories DSHS Funds Cash Match In Kind Match Category Total
Requested Contributions
Personnel $19,587.00 $0.00 $0.00 $19,587.00
Fringe Benefits $0.00 $0.00 $0.00 $0.00
Travel $1,866.00 $0.00 $0.00 $1,866.00
Equipment $0.00 $0.00 $0.00 $0.00
Supplies $3,825.00 $0.00 $5,056.00 $8,881.00
Contractual $0.00 $0.00 $0.00 $0.00
Other $0.00 $0.00 $0.00 $0.00
Total Direct Costs $25,278.00 $0.00 $5,056.00 $30,334.00
Indirect Costs $0.00 $0.00 $0.00 $0.00
Totals $25,278.00 $0.00 $5,056.00 $30,334.00
Page 19 of 21
Attachment A: Personnel Form
Organization Name: Port Arthur Health Department
Contract Number: 2016-003790-00 Program ID: TB/PC-STATE
Contract Term: 09/01/2015 - 08/31/2016 Program Name: Tuberculosis Prevention and Control
Tuberculosis and Refugee Health Services Branch
NOTICE OF CHANGE in TB PERSONNEL
(To be completed only when there is a change in personnel)
Submit no later than the 5th day of each month
Submit to Staff Services Officer: Lara.Miller@dshs.state.tx.us
Month /Year
Local Health Department/Health Service Region
Contact Person
Phone Number
Check all that apply:
NEW HIRE NAME CHANGE NEW FTE
TRANSFER PROMOTION RESIGNATION
RECLASSIFICATION RETIREMENT TERMINATION
OTHER (SPECIFY)
PERSONNEL INFORMATION
Name as Listed on Payroll
Supervisor
Work Location
Phone & Phone Extension
Position Title
Effective Date
New Base Salary
Last Physical Day on Duty
Summary of Duties
Page 20 of 21
Percent Paid by State Funds
Percent Paid by Federal Funds
Percent Paid by Neither State nor Federal Funds
Page 21 of 21
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DCPS FY16 TB PC STATE NEW CONTRACT
Organization: Port Arthur Health Department DCPS-2016-TB/PC-ST-00004
Budget Summary
Organization Name: Port Arthur Health Department Program ID: TB/PC-STATE
Contract Number: 2016-003790-00 Procurement ID: GST-2016-Solicitation-0
0022
Proposal ID: DCPS-2016-TB/PC-ST-00004 Procurement Name: DCPS FY16 TB PC
STATE NEW
CONTRACT
Budget Categories
DSHS Funds
Budget Categories Requested Cash Match In Kind Match Category Total
Personnel $19,587 $0 $0 $19,587
Fringe Benefits $0 $0 $0 $0
Travel $1,866 $0 $0 $1,866
Equipment $0 $0 $0 $0
Supplies $3,825 $0 $5,056 $8,881
Contractual $0 $0 $0 $0
Other $0 $0 $0 $0
Total Direct Costs $25,278 $0 $5,056 $30,334
Indirect Costs $0 $0 $0 $0
Totals: $25,278 $0 $5,056 $30,334
Subcontracting
Subcontracting Percentage: 0.00%
Match Contributions
Applicable Match Amount: $5,056
Required Match Percentage: 20.00%
Required Match Amount: $1,011 Calculated Match Amount: $5,056
Source of Cash Match Funds
None
Source of In Kind Match Funds
Supplies
Program Income
Projected Earnings: $0
Source of Earnings
08/18/2015 Page 1 of 2
DCPS FY16 TB PC STATE NEW CONTRACT
Organization: Port Arthur Health Department DCPS-2016-TB/PC-ST-00004
Budget Summary
Non DSHS Fundinq
Direct Federal Funds: $0
Other State Agency Funds: $0
Local Funding Sources: $0
Other Funds: $0
Total Projected Non DSHS Funding: $0
08/18/2015 Page 2 of 2
DCPS FY16 TB PC STATE NEW CONTRACT
Organization: Port Arthur Health Department DCPS-2016-TB/PC-ST-00004
Proposal Overview
Procurement ID: GST-2016-Solicitation-00022
Procurement Name: DCPS FY16 TB PC STATE
NEW CONTRACT
Business Entity
Organization Name: Port Arthur Health Department
Department:
Address: 449 Austin Avenue
Port Arthur,TX 77640
Payee
Vendor ID/Mail Code: 17460018850 011
Mail Code: 011
Payee Name: Port Arthur City Health Dept
Address: 449 Austin Ave
City: Port Arthur State: TX Zip Code: 77640-0000
DUNS Number: 137134909
Type of Entity: Governmental
Entity Sub-Type:
Contract Information
Contract Period Start Date: 9/1/2015
Contract Period End Date: 8/31/2016
Counties to be served:
Jefferson County
Amount Requested: $25,278.00
08/18/2015 Page 1 of 1
DCPS FY16 TB PC STATE NEW CONTRACT
Organization: Port Arthur Health Department DCPS-2016-TB/PC-ST-00004
Fiscal Federal Funding Accountability and Transparency Act(FFATA) Certification
Organization Name Port Arthur Health Department
Address 449 Austin Avenue
City Port Arthur State Texas Zip Code (9 digit) 77640
Payee Name Port Arthur City Health Dept
Address 449 Austin Ave
City Port Arthur State TX Zip Code (9 digit) 77640-0000
Vendor identification No. 17460018850 MailCode 011
Payee DUNS No. * 137134909
1. Did your organization have a gross income, from all sources, of more than $300,000 in your previous tax
year? *
Yes No
2. 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
3. Certification Regarding Amount of Annual Gross from Federal Awards.
Did your organization receive $25 million or more in annual gross revenues from federal awards in the
preceding fiscal year?
Yes .0 No
4. 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 Yes, where can this information be found?
If No, you must provide the names and total compensation of the top five highly compensated officers.
Example: John BIum:500000;Mary Redd:50000;Eric Gant:400000;Todd Platt:300000;Sally Tom:300000
Identify contact persons for FFATA Correspondence. *
08/18/2015 Page 1 of 2
DCPS FY16 TB PC STATE NEW CONTRACT
Organization: Port Arthur Health Department DCPS-2016-TB/PC-ST-00004
Fiscal Federal Funding Accountability and Transparency Act(FFATA) Certification
FFATA Contact Person #1
Name* Jerry Dale
Email* jerry.dale@portarthurtx.gov
Telephone* (409) 983-8174
FFATA Contact Person #2
Name* Judith Smith
Email* judith.smith@portarthurtx.gov
Telephone* (409) 983-8832
As the authorized representative of the Organization, I hereby certify that the statements made by me in
this certification form are true, complete and correct to the best of my knowledge.
E-Signature Date
Mrs. Judith Smith 8/18/2015
08/18/2015 Page 2 of 2
DCPS FY16 TB PC STATE NEW CONTRACT
DCPS-2016-TB/PC-ST-00004
Supplies Category Detail
Organization Name: Port Arthur Health Department Program ID: TB/PC-STATE
Contract Number: 2016-003790-00 Procurement ID: GST-2016-Solicitation-00022
Proposal ID: DCPS-2016-TB/PC-ST-00004 Procurement Name: DCPS FY16 TB PC STATE NEW
CONTRACT
Description of Item ( Purpose&Justification Funding Source Total Cost
General office supplies Pens,paper,labels,clipboards,toner,TB pamphlets, Cash $3,000
binders,dividers,folders,index cards,etc..
Medical supplies N-95 mask and surgical masks,blood pressure cuffs, Cash $825
gloves,stethoscopes,thermometers,etc..
Other supplies necessary for the TB TB videos,business cards,appointment cards,chart In Kind Match $5,056
clinic. copies,rolling office supply cart for outside clinics,
rolling case for TB supplies when doing outside contact
investigation.
Cash Total: $3,825
In Kind Match Total: $5,056
Total Amount Requested for Supplies: $8,881
08/18/2015 Page 1 of 1
DCPS FY16 TB PC STATE NEW CONTRACT
DCPS-2016-TB/PC-ST-00004
Travel Category Detail
Organization Name: Port Arthur Health Department Program ID: TB/PC-STATE
Contract Number: 2016-003790-00 Procurement ID: GST-2016-Solicitation-00022
Proposal ID: DCPS-2016-TB/PC-ST-00004 Procurement Name: DCPS FY16 TB PC STATE NEW
CONTRACT
Indicate Policy Used:* v Organization's Travel Policy Attach travel policy if using organization's travel policy
State of Texas Travel Policy Ihttps://egrants.dshs.texas.gov/_Upload/39981-TravelPolicy_CityofP
ortArthur.pdf
Conference/Workshop Travel Costs
Description or Conference/ Justification* Destination/Details Cost
Workshop
TB conferences in Austin(Brenda Milo, To receive updates on City and State:*Austin,Texas Funding Source:*Cash
LVN,and Elizabeth Cardenas,TB Tuberculosis information. #of Employees:*2 Mileage:*$0
Admin Clerk)will attend. #of Days:*2 Airfare:*$0
Meals:*$303
Lodging:*$600
Other Costs:*$100
Total:$1,003
City and State:* Funding Source:*
#of Employees:* Mileage:*
#of Days:* Airfare:*
Meals:*
Lodging:*
Other Costs:*
Total:$0
City and State:* Funding Source:*
#of Employees:* Mileage:*
#of Days:* Airfare:*
08/18/2015 Page 1 of 3
DCPS FY16 TB PC STATE NEW CONTRACT
DCPS-2016-TB/PC-ST-00004
Travel Category Detail
Meals:*
Lodging:*
Other Costs:*
Total:$0
City and State:* Funding Source:*
#of Employees:* Mileage:*
#of Days:* Airfare:*
Meals:*
Lodging:*
Other Costs:*
Total:
Total Cash for Conference/Workshop: $1,003
Total In Kind Match for Conference/Workshop:
Total for Conference/Workshop Travel: $1,003
9ther/Loral Travel Costs
Justification* Mileage Number of Mileage Other Funding Source* Total Cost
Reimbursement Miles* Cost Costs*
Rate*
Local travel for Directly Observed Therapy $0.575 1501 $863 $0 Cash $863
(Performed by Brenda Milo, LVN or Elizabeth
Cardenas).
$0 $0
$0 $0
$0 $0
Total Cash for Other/Local Travel: $863
08/18/2015 Page 2 of 3
DCPS FY16 TB PC STATE NEW CONTRACT
DCPS-2016-TB/PC-ST-00004
Travel Category Detail
Total In Kind Match for Other/Local Travel:
Total for Other/Local Travel: $863
Conference/Workshop Travel Costs: $1,003
Other/Local Travel Costs: $863
Total Travel Costs: $1,866
08/18/2015 Page 3 of 3