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HomeMy WebLinkAboutPR 19121: CONTRACT WITH DEPARTMENT OF STATE HEALTH SERIVES, TUBERCULOISIS PREVENTION AND CONTROL City of• urt rthur�/" 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 Page 1 of 21 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 Page 2 of 21 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 Page 3 of 21 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 Page 4 of 21 •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. Page 5 of 21 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. Page 6 of 21 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 Page 7 of 21 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 Page 8 of 21 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 Page 9 of 21 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 Adobe Document Cloud Electronic Signature Service and Digital E-signature Solution—... 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All rights reserved. • https://stericycle.echosign.com/public/esign?tsid=CBFCIBAA2AAABLbIgZhBM9SuEZ9... 8/18/2015 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