HHSC MONITORING ACTIVITIES. A. HHSC will monitor the performance of contract awarded under this Grant Agreement. Monitoring activities will be conducted by HHSC for fiscal, programmatic, and administrative components of the Grant Agreement. All services and deliverables under the Grant Agreement must be provided at an acceptable quality level and in a manner consistent with Grant Agreement and program requirements and HHSC Uniform Terms and Conditions. B. Monitoring activities may include, but are not limited to, the following: 1. Any findings regarding performance of internal quality assurance; 2. Any training needs identified and resulting actions; and 3. Any corrective action taken and the resolution of any issues; and 4. Other Project information determined relevant by HHSC. C. Xxxxxxx agrees to cooperate fully and assist with the coordination of the activities that include, but are not limited to, the following: 1. Periodic site visits to monitor for compliance with federal and state requirements of the Grant Agreement; and 2. Adherence to the requirements set forth in this Grant Agreement. D. If individual program compliance or performance is lacking, corrective action recommendations will be made through the Grant Agreement performance improvement plans. HHSC reserves the right to impose remedies as set forth in Section 9.1 (Remedies) of the Uniform Terms and Conditions. E. HHSC reserves the right, where allowed by legal authority, to redirect funds in the event of an financial shortfall by Xxxxxxx. HHSC will monitor Xxxxxxx’s expenditures on a monthly basis. DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E F G Staff Position Justification Monthly Salary No. of Months Annual Salary Percent applied to HHSC contract Amount budgeted to HHSC contract 1 Community Health Educator-Certified Health Education Specialist The Community Health Educator administrates the program, leads evaluation and training efforts and develops health promotion campaigns for NTACHC. 58% of this salary is being covered by other funding. $ 4,216.00 18 $ 75,888.00 42.00% $ 31,872.96 2 Community Health Educator-Registered Nurse The Community Health Educator-RN supervises the Maternal Child Health program, leads evaluation and training efforts and develops health education curriculum for PCHW's. Supervises program staff and conducts classes and education for program participants. $ 6,413.00 18 $ 115,434.00 100.00% $ 115,434.00 3 Perinatal Community Health Worker (PCHW) Open- PCHW will provide community resource referrals, education and support to families in the perinatal period. Salary is based on a competitive salary for community based doulas in Texas. $ 4,166.00 16 $ 66,656.00 100.00% $ 66,656.00 4 Perinatal Community Health Worker (PCHW) Open- PCHW will provide community resource referrals, education and support to families in the perinatal period. Salary is based on a competitive salary for community based doulas in Texas. $ 4,166.00 16 $ 66,656.00 100.00% $ 66,656.00 5 $ - 0 $ - 0.00% $ - 6 Outreach Specialist Attends outreach events to promote health and NTACHC's services. $ 3,571.00 18 $ 64,278.00 25.00% $ 16,069.50 7 Peer educator Open Part-time hourly worker at a rate of $15.00/hr. 20 hours a week. Peer educator will serve as a faciliator during group classes and provide their input for program impovement efforts. $ 1,200.00 6 $ 7,200.00 100.00% $ 7,200.00 8 Peer educator Open Part-time hourly worker at a rate of $15.00/hr. 20 hours a week. Peer educator will serve as a faciliator during group classes and provide their input for program impovement efforts. $ 1,200.00 6 $ 7,200.00 100.00% $ 7,200.00 9 $ - 0 $ - 0.00% $ - 10 $ - 0 $ - 0.00% $ - 11 $ - 0 $ - 0.00% $ - 12 $ - 0 $ - 0.00% $ - 13 $ - 0 $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E F G H I J K Staff Position FICA & Medicare Workers' Compensation State Unemployment Insurance Health Insurance Life Insurance Dental Insurance Retirement Other - See Supplemental Justification Page Subtotals 1 Community Health Educator- Gross $ 5,805.43 $ 119.14 $ 93.34 $ 9,828.00 $ 75.89 $ - $ 1,517.76 $ - $ 17,439.56 42.00% $ 2,438.28 $ 50.04 $ 39.20 $ 4,127.76 $ 31.87 $ - $ 637.46 $ - $ 7,324.61 2 Community Health Educator- Gross $ 8,830.70 $ 181.23 $ 141.98 $ 9,828.00 $ 115.43 $ - $ 2,308.68 $ - $ 21,406.02 100.00% $ 8,830.70 $ 181.23 $ 141.98 $ 9,828.00 $ 115.43 $ - $ 2,308.68 $ - $ 21,406.02 3 Perinatal Community Health Worker Gross $ 5,099.18 $ 117.73 $ 92.24 $ 9,828.00 $ 74.99 $ - $ 1,499.76 $ - $ 16,711.90 100.00% $ 5,099.18 $ 117.73 $ 92.24 $ 9,828.00 $ 74.99 $ - $ 1,499.76 $ - $ 16,711.90 4 Perinatal Community Health Worker Gross $ 5,099.18 $ 117.73 $ 92.24 $ 9,828.00 $ 74.99 $ - $ 1,499.76 $ - $ 16,711.90 100.00% $ 5,099.18 $ 117.73 $ 92.24 $ 9,828.00 $ 74.99 $ - $ 1,499.76 $ - $ 16,711.90 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 6 Outreach Specialist Gross $ 4,917.27 $ 100.92 $ 79.06 $ 9,828.00 $ 64.28 $ - $ 1,285.56 $ - $ 16,275.09 25.00% $ 1,229.32 $ 25.23 $ 19.77 $ 2,457.00 $ 16.07 $ - $ 321.39 $ - $ 4,068.78 7 Peer educator Gross $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 100.00% $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 8 Peer educator Gross $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 100.00% $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 9 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 10 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 11 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Part 2 - Local/Other Travel A B C D E F G H I Local/Other Travel Description Justification No. of Miles Mileage Rate Mileage Cost Other Travel Cost Cost PercentApplied to HHSC Contract Amount Budgeted to HHSC Contract 1 Health Fairs Staff will attend 4 health fairs and other local events a month to provide the public with education and information on the program. Costs will cover health fair registration and mileage. 200 $ 0.670 $ 134.00 $ 600.00 $ 734.00 100.00% $ 734.00 2 0 $ - $ - $ - $ - 0.00% $ - 3 0 $ - $ - $ - $ - 0.00% $ - 4 0 $ - $ - $ - $ - 0.00% $ - 5 0 $ - $ - $ - $ - 0.00% $ - 6 0 $ - $ - $ - $ - 0.00% $ - 7 0 $ - $ - $ - $ - 0.00% $ - 8 0 $ - $ - $ - $ - 0.00% $ - 9 0 $ - $ - $ - $ - 0.00% $ - 10 0 $ - $ - $ - $ - 0.00% $ - 11 0 $ - $ - $ - $ - 0.00% $ - 12 0 $ - $ - $ - $ - 0.00% $ - 13 0 $ - $ - $ - $ - 0.00% $ - 14 0 $ - $ - $ - $ - 0.00% $ - 15 0 $ - $ - $ - $ - 0.00% $ - 16 0 $ - $ - $ - $ - 0.00% $ - 17 0 $ - $ - $ - $ - 0.00% $ - 18 0 $ - $ - $ - $ - 0.00% $ - 19 0 $ - $ - $ - $ - 0.00% $ - 20 0 $ - $ - $ - $ - 0.00% $ - 21 0 $ - $ - $ - $ - 0.00% $ - 22 0 $ - $ - $ - $ - 0.00% $ - 23 0 $ - $ - $ - $ - 0.00% $ - 24 0 $ - $ - $ - $ - 0.00% $ - 25 0 $ - $ - $ - $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E F G H Contractor Name Description Justification No. of Units Rate of Payment Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 ATT Hotspot Hotspot to be used by CHW during outreach activities/ activities away from the NTACHC centers. Hotspot to be paid monthly to AT&T. 18 $ 60.00 $ 1,080.00 100.00% $ 1,080.00 2 Voyce Inc. Translation Services Translation services for patients with needing linguistic acommodations outside of English and Spanish. Rate is $0.65 per minute of a voice call. Patient meetings with PCHW's last up to 90 minutes. Budget accounts for 5 meetings per year per patient, for a total of 30 patients. 13500 $ 0.65 $ 8,775.00 100.00% $ 8,775.00 3 Uber Health Transportation Services Arrange and pay for rides for clients who aren't able to make their appointments due to transportation issues. Average per ride $10 for 20 rides. 20 $ 10.00 $ 200.00 100.00% $ 200.00 4 0 $ - $ - 0.00% $ - 5 0 $ - $ - 0.00% $ - 6 0 $ - $ - 0.00% $ - 7 0 $ - $ - 0.00% $ - 8 0 $ - $ - 0.00% $ - 9 0 $ - $ - 0.00% $ - 10 0 $ - $ - 0.00% $ - 11 0 $ - $ - 0.00% $ - 12 0 $ - $ - 0.00% $ - 13 0 $ - $ - 0.00% $ - 14 0 $ - $ - 0.00% $ - 15 0 $ - $ - 0.00% $ - 16 0 $ - $ - 0.00% $ - 17 0 $ - $ - 0.00% $ - 18 0 $ - $ - 0.00% $ - 19 0 $ - $ - 0.00% $ - 20 0 $ - $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E Description Justification Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 Patient Education Materials Education Classes Patient Material - $1300 printing for 4 events a year. Printed handouts will include educational materials related to the event and agenda. $ 1,300.00 100.00% $ 1,300.00 2 Scientific Pregnancy Pelvis with Mature Fetus Model Anatomy model used for prenatal and childbirth classes and one-on-one education $ 354.24 100.00% $ 354.24 3 NASCO Kit My Plate Classroom My Plate model for healthy eating education $ 719.95 100.00% $ 719.95 4 Printer- Community Health Educator 2 HP- with scanner printer. Printer designated for the program, main uses consist of printing out education handouts and scanning individualized care plans into the patients chart. $ 760.00 100.00% $ 760.00 5 Breastfeeding Model Breastfeeding model for patient education. $ 150.00 100.00% $ 150.00 6 Child Birth Education Posters Educational materials for group classes and one-on-one education $ 150.68 100.00% $ 150.68 7 NTACHC Pregancy Handbook 300 Pregnancy and You printed copies -- 150 in English and 150 in Spanish at $15 per printed copy. $ 4,600.00 100.00% $ 4,600.00 8 Baby Emergency Needs An emergency baby supply warehouse will be stocked with (600) diapers at an average cost of $0.29 each, (25) 6 pack of baby clothes at $14.09 each, 25 cribs at $100 each, (30) cans of formula at $34.99 each. Additional items will be obtained through donations or additional grants. These items will serve to assist families immediate needs, not long term needs. Based on need we can provide these items. $ 3,139.62 100.00% $ 3,139.62 9 $ - 0.00% $ - 10 $ - 0.00% $ - 11 $ - 0.00% $ - 12 $ - 0.00% $ - 13 $ - 0.00% $ - 14 $ - 0.00% $ - 15 $ - 0.00% $ - 16 $ - 0.00% $ - 17 $ - 0.00% $ - 18 $ - 0.00% $ - 19 $ - 0.00% $ - 20 $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E Description Justification Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 Certification- Doula Paradigm Doula Certification to provide CHW's with additional skills to support mother and families in the perinatal period. $ 1,000.00 100.00% $ 1,000.00 2 Certification- Doula Paradigm Doula Certification to provide CHW's with additional skills to support mother and families in the perinatal period. $ 1,000.00 100.00% $ 1,000.00 3 $ - 4 Certified Childbirth Educator Three staff members will become certified in childbirth education through the paradigm doulas course. Each course is $104.12. $ 312.00 100.00% $ 312.00 5 Data Analytics and Visualization in Healthcare Certification The Health Education Specialist will acquire an online data analytics certificate from the Rochester Institute of Technology, to drive program evaluation efforts successfully and through research- based practices. $ 250.00 $ - 11 Registered Nurse Licensing Renewal RN license renewal ($75) $ 75.00 100.00% $ 75.00 12 $ - 0.00% $ - 13 $ - 0.00% $ - 14 $ - 0.00% $ - 15 $ - 0.00% $ - 16 $ - 0.00% $ - 17 $ - 0.00% $ - 18 $ - 0.00% $ - 19 $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Pilot Project Contractor: North Texas Area Community Health Centers, Inc. Cost Category Item # Justification Attachment C_ CONTRACT AFFIRMATIONS For purposes of these Contract Affirmations, HHS includes both the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS). System Agency refers to HHSC, DSHS, or both, that will be a party to this Contract. These Contract Affirmations apply to all Contractors and Grantees (referred to as “Contractor”) regardless of their business form (e.g., individual, partnership, corporation). By entering into this Contract, Contractor affirms, without exception, understands, and agrees to comply with the following items through the life of the Contract: 1. Contractor represents and warrants that these Contract Affirmations apply to Contractor and all of Contractor's principals, officers, directors, shareholders, partners, owners, agents, employees, subcontractors, independent contractors, and any other representatives who may provide services under, who have a financial interest in, or otherwise are interested in this Contract and any related Solicitation.
Appears in 1 contract
Samples: Grant Agreement
HHSC MONITORING ACTIVITIES. A. HHSC will monitor the performance of contract awarded under this Grant Agreement. Monitoring activities will be conducted by HHSC for fiscal, programmatic, and administrative components of the Grant Agreement. All services and deliverables under the Grant Agreement must be provided at an acceptable quality level and in a manner consistent with Grant Agreement and program requirements and HHSC Uniform Terms and Conditions.
B. Monitoring activities may include, but are not limited to, the following:
1. Any findings regarding performance of internal quality assurance;
2. Any training needs identified and resulting actions; and
3. Any corrective action taken and the resolution of any issues; and
4. Other Project information determined relevant by HHSC.
C. Xxxxxxx agrees to cooperate fully and assist with the coordination of the activities that include, but are not limited to, the following:
1. Periodic site visits to monitor for compliance with federal and state requirements of the Grant Agreement; and
2. Adherence to the requirements set forth in this Grant Agreement.
D. If individual program compliance or performance is lacking, corrective action recommendations will be made through the Grant Agreement performance improvement plans. HHSC reserves the right to impose remedies as set forth in Section 9.1 (Remedies) of the Uniform Terms and Conditions.
E. HHSC reserves the right, where allowed by legal authority, to redirect funds in the event of an financial shortfall by Xxxxxxx. HHSC will monitor Xxxxxxx’s expenditures on a monthly basis. DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E F G Staff Position Justification Monthly Salary No. of Months Annual Salary Percent applied to HHSC contract Amount budgeted to HHSC contract 1 Community Health Educator-Certified Health Education Specialist The Community Health Educator administrates the program, leads evaluation and training efforts and develops health promotion campaigns for NTACHC. 58% of this salary is being covered by other funding. Salaries $ 4,216.00 18 1,437,632.00 Fringe Benefits $ 75,888.00 42.00% 439,340.00 Travel $ 31,872.96 2 Community Health Educator-Registered Nurse The Community Health Educator-RN supervises the Maternal Child Health program, leads evaluation and training efforts and develops health education curriculum for PCHW's. Supervises program staff and conducts classes and education for program participants. $ 6,413.00 18 $ 115,434.00 100.00% $ 115,434.00 3 Perinatal Community Health Worker (PCHW) Open- PCHW will provide community resource referrals, education and support to families in the perinatal period. Salary is based on a competitive salary for community based doulas in Texas. $ 4,166.00 16 $ 66,656.00 100.00% $ 66,656.00 4 Perinatal Community Health Worker (PCHW) Open- PCHW will provide community resource referrals, education and support to families in the perinatal period. Salary is based on a competitive salary for community based doulas in Texas. $ 4,166.00 16 $ 66,656.00 100.00% $ 66,656.00 5 38,907.00 Professional/Contract Services $ - 0 Equipment $ 63,435.00 Consumable Supplies $ 3,600.00 Other $ 265,054.00 Direct Cost Total $ 2,247,968.00 Indirect Cost $ 213,998.00 Grantee Family Endeavors, Inc., dba Endeavors City: Houston, TX (Corporate- San Antonio, TX) Budget Period: September 1, 2024 - 0.00% $ - 6 Outreach Specialist Attends outreach events to promote health August 31, 2025 ATTACHMENT 1. SUBCONTRACTOR AGREEMENT FORM HHS CONTRACT NUMBER The DUA between HHS and NTACHC's servicesContractor establishes the permitted and required uses and disclosures of Confidential Information by Contractor. $ 3,571.00 18 $ 64,278.00 25.00% $ 16,069.50 7 Peer educator Open Part-time hourly worker at a rate Contractor has subcontracted with (Subcontractor) for performance of $15.00/hr. 20 hours a week. Peer educator will serve as a faciliator during group classes and provide their input for program impovement efforts. $ 1,200.00 6 $ 7,200.00 100.00% $ 7,200.00 8 Peer educator Open Part-time hourly worker at a rate duties on behalf of $15.00/hr. 20 hours a week. Peer educator will serve as a faciliator during group classes and provide their input for program impovement efforts. $ 1,200.00 6 $ 7,200.00 100.00% $ 7,200.00 9 $ - 0 $ - 0.00% $ - 10 $ - 0 $ - 0.00% $ - 11 $ - 0 $ - 0.00% $ - 12 $ - 0 $ - 0.00% $ - 13 $ - 0 $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E F G H I J K Staff Position FICA & Medicare Workers' Compensation State Unemployment Insurance Health Insurance Life Insurance Dental Insurance Retirement Other - See Supplemental Justification Page Subtotals 1 Community Health Educator- Gross $ 5,805.43 $ 119.14 $ 93.34 $ 9,828.00 $ 75.89 $ - $ 1,517.76 $ - $ 17,439.56 42.00% $ 2,438.28 $ 50.04 $ 39.20 $ 4,127.76 $ 31.87 $ - $ 637.46 $ - $ 7,324.61 2 Community Health Educator- Gross $ 8,830.70 $ 181.23 $ 141.98 $ 9,828.00 $ 115.43 $ - $ 2,308.68 $ - $ 21,406.02 100.00% $ 8,830.70 $ 181.23 $ 141.98 $ 9,828.00 $ 115.43 $ - $ 2,308.68 $ - $ 21,406.02 3 Perinatal Community Health Worker Gross $ 5,099.18 $ 117.73 $ 92.24 $ 9,828.00 $ 74.99 $ - $ 1,499.76 $ - $ 16,711.90 100.00% $ 5,099.18 $ 117.73 $ 92.24 $ 9,828.00 $ 74.99 $ - $ 1,499.76 $ - $ 16,711.90 4 Perinatal Community Health Worker Gross $ 5,099.18 $ 117.73 $ 92.24 $ 9,828.00 $ 74.99 $ - $ 1,499.76 $ - $ 16,711.90 100.00% $ 5,099.18 $ 117.73 $ 92.24 $ 9,828.00 $ 74.99 $ - $ 1,499.76 $ - $ 16,711.90 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 6 Outreach Specialist Gross $ 4,917.27 $ 100.92 $ 79.06 $ 9,828.00 $ 64.28 $ - $ 1,285.56 $ - $ 16,275.09 25.00% $ 1,229.32 $ 25.23 $ 19.77 $ 2,457.00 $ 16.07 $ - $ 321.39 $ - $ 4,068.78 7 Peer educator Gross $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 100.00% $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 8 Peer educator Gross $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 100.00% $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 9 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 10 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 11 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Part 2 - Local/Other Travel A B C D E F G H I Local/Other Travel Description Justification No. of Miles Mileage Rate Mileage Cost Other Travel Cost Cost PercentApplied to HHSC Contract Amount Budgeted to HHSC Contract 1 Health Fairs Staff will attend 4 health fairs and other local events a month to provide the public with education and information on the program. Costs will cover health fair registration and mileage. 200 $ 0.670 $ 134.00 $ 600.00 $ 734.00 100.00% $ 734.00 2 0 $ - $ - $ - $ - 0.00% $ - 3 0 $ - $ - $ - $ - 0.00% $ - 4 0 $ - $ - $ - $ - 0.00% $ - 5 0 $ - $ - $ - $ - 0.00% $ - 6 0 $ - $ - $ - $ - 0.00% $ - 7 0 $ - $ - $ - $ - 0.00% $ - 8 0 $ - $ - $ - $ - 0.00% $ - 9 0 $ - $ - $ - $ - 0.00% $ - 10 0 $ - $ - $ - $ - 0.00% $ - 11 0 $ - $ - $ - $ - 0.00% $ - 12 0 $ - $ - $ - $ - 0.00% $ - 13 0 $ - $ - $ - $ - 0.00% $ - 14 0 $ - $ - $ - $ - 0.00% $ - 15 0 $ - $ - $ - $ - 0.00% $ - 16 0 $ - $ - $ - $ - 0.00% $ - 17 0 $ - $ - $ - $ - 0.00% $ - 18 0 $ - $ - $ - $ - 0.00% $ - 19 0 $ - $ - $ - $ - 0.00% $ - 20 0 $ - $ - $ - $ - 0.00% $ - 21 0 $ - $ - $ - $ - 0.00% $ - 22 0 $ - $ - $ - $ - 0.00% $ - 23 0 $ - $ - $ - $ - 0.00% $ - 24 0 $ - $ - $ - $ - 0.00% $ - 25 0 $ - $ - $ - $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E F G H Contractor Name Description Justification No. of Units Rate of Payment Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 ATT Hotspot Hotspot to be used by CHW during outreach activities/ activities away from the NTACHC centers. Hotspot to be paid monthly to AT&T. 18 $ 60.00 $ 1,080.00 100.00% $ 1,080.00 2 Voyce Inc. Translation Services Translation services for patients with needing linguistic acommodations outside of English and Spanish. Rate is $0.65 per minute of a voice call. Patient meetings with PCHW's last up to 90 minutes. Budget accounts for 5 meetings per year per patient, for a total of 30 patients. 13500 $ 0.65 $ 8,775.00 100.00% $ 8,775.00 3 Uber Health Transportation Services Arrange and pay for rides for clients who aren't able to make their appointments due to transportation issues. Average per ride $10 for 20 rides. 20 $ 10.00 $ 200.00 100.00% $ 200.00 4 0 $ - $ - 0.00% $ - 5 0 $ - $ - 0.00% $ - 6 0 $ - $ - 0.00% $ - 7 0 $ - $ - 0.00% $ - 8 0 $ - $ - 0.00% $ - 9 0 $ - $ - 0.00% $ - 10 0 $ - $ - 0.00% $ - 11 0 $ - $ - 0.00% $ - 12 0 $ - $ - 0.00% $ - 13 0 $ - $ - 0.00% $ - 14 0 $ - $ - 0.00% $ - 15 0 $ - $ - 0.00% $ - 16 0 $ - $ - 0.00% $ - 17 0 $ - $ - 0.00% $ - 18 0 $ - $ - 0.00% $ - 19 0 $ - $ - 0.00% $ - 20 0 $ - $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E Description Justification Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 Patient Education Materials Education Classes Patient Material - $1300 printing for 4 events a year. Printed handouts will include educational materials related CONTRACTOR which are subject to the event and agendaDUA. $ 1,300.00 100.00% $ 1,300.00 2 Scientific Pregnancy Pelvis with Mature Fetus Model Anatomy model used for prenatal and childbirth classes and one-on-one education $ 354.24 100.00% $ 354.24 3 NASCO Kit My Plate Classroom My Plate model for healthy eating education $ 719.95 100.00% $ 719.95 4 Printer- Community Health Educator 2 HP- with scanner printer. Printer designated for the programSubcontractor acknowledges, main uses consist of printing out education handouts and scanning individualized care plans into the patients chart. $ 760.00 100.00% $ 760.00 5 Breastfeeding Model Breastfeeding model for patient education. $ 150.00 100.00% $ 150.00 6 Child Birth Education Posters Educational materials for group classes and one-on-one education $ 150.68 100.00% $ 150.68 7 NTACHC Pregancy Handbook 300 Pregnancy and You printed copies -- 150 in English and 150 in Spanish at $15 per printed copy. $ 4,600.00 100.00% $ 4,600.00 8 Baby Emergency Needs An emergency baby supply warehouse will be stocked with (600) diapers at an average cost of $0.29 each, (25) 6 pack of baby clothes at $14.09 each, 25 cribs at $100 each, (30) cans of formula at $34.99 each. Additional items will be obtained through donations or additional grants. These items will serve to assist families immediate needs, not long term needs. Based on need we can provide these items. $ 3,139.62 100.00% $ 3,139.62 9 $ - 0.00% $ - 10 $ - 0.00% $ - 11 $ - 0.00% $ - 12 $ - 0.00% $ - 13 $ - 0.00% $ - 14 $ - 0.00% $ - 15 $ - 0.00% $ - 16 $ - 0.00% $ - 17 $ - 0.00% $ - 18 $ - 0.00% $ - 19 $ - 0.00% $ - 20 $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E Description Justification Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 Certification- Doula Paradigm Doula Certification to provide CHW's with additional skills to support mother and families in the perinatal period. $ 1,000.00 100.00% $ 1,000.00 2 Certification- Doula Paradigm Doula Certification to provide CHW's with additional skills to support mother and families in the perinatal period. $ 1,000.00 100.00% $ 1,000.00 3 $ - 4 Certified Childbirth Educator Three staff members will become certified in childbirth education through the paradigm doulas course. Each course is $104.12. $ 312.00 100.00% $ 312.00 5 Data Analytics and Visualization in Healthcare Certification The Health Education Specialist will acquire an online data analytics certificate from the Rochester Institute of Technology, to drive program evaluation efforts successfully and through research- based practices. $ 250.00 $ - 11 Registered Nurse Licensing Renewal RN license renewal ($75) $ 75.00 100.00% $ 75.00 12 $ - 0.00% $ - 13 $ - 0.00% $ - 14 $ - 0.00% $ - 15 $ - 0.00% $ - 16 $ - 0.00% $ - 17 $ - 0.00% $ - 18 $ - 0.00% $ - 19 $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Pilot Project Contractor: North Texas Area Community Health Centers, Inc. Cost Category Item # Justification Attachment C_ CONTRACT AFFIRMATIONS For purposes of these Contract Affirmations, HHS includes both the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS). System Agency refers to HHSC, DSHS, or both, that will be a party to this Contract. These Contract Affirmations apply to all Contractors and Grantees (referred to as “Contractor”) regardless of their business form (e.g., individual, partnership, corporation). By entering into this Contract, Contractor affirms, without exception, understands, understands and agrees to comply be bound by the same terms and conditions applicable to Contractor under the DUA, incorporated by reference in this Agreement, with the following items through the life respect to HHS Confidential Information. Contractor and Subcontractor agree that HHS is a third-party beneficiary to applicable provisions of the Contractsubcontract. HHS has the right, but not the obligation, to review or approve the terms and conditions of the subcontract by virtue of this Subcontractor Agreement Form. Contractor and Subcontractor assure HHS that any Breach as defined by the DUA that Subcontractor Discovers shall be reported to HHS by Contractor in the time, manner and content required by the DUA. If Contractor knows or should have known in the exercise of reasonable diligence of a pattern of activity or practice by Subcontractor that constitutes a material breach or violation of the DUA or the Subcontractor's obligations, Contractor shall:
1. Take reasonable steps to cure the violation or end the violation, as applicable;
2. If the steps are unsuccessful, terminate the contract or arrangement with Subcontractor, if feasible;
3. Notify HHS immediately upon Discovery of the pattern of activity or practice of Subcontractor that constitutes a material breach or violation of the DUA and keep HHS reasonably and regularly informed about steps Contractor represents and warrants that these Contract Affirmations apply is taking to Contractor and all of Contractorcure or end the violation or terminate Subcontractor's principalscontract or arrangement. Date , officers, directors, shareholders, partners, owners, agents, employees, subcontractors, independent contractors, and any other representatives who may provide services under, who have a financial interest in, or otherwise are interested in this Contract and any related Solicitation.202 . Date:
Appears in 1 contract
Samples: Grant Agreement
HHSC MONITORING ACTIVITIES. A. HHSC will monitor the performance of contract awarded under this Grant Agreement. Monitoring activities will be conducted by HHSC for fiscal, programmatic, and administrative components of the Grant Agreement. All services and deliverables under the Grant Agreement must be provided at an acceptable quality level and in a manner consistent with Grant Agreement and program requirements and HHSC Uniform Terms and Conditions.
B. Monitoring activities may include, but are not limited to, the following:
1. Any findings regarding performance of internal quality assurance;
2. Any training needs identified and resulting actions; and
3. Any corrective action taken and the resolution of any issues; and
4. Other Project information determined relevant by HHSC.
C. Xxxxxxx agrees to cooperate fully and assist with the coordination of the activities that include, but are not limited to, the following:
1. Periodic site visits to monitor for compliance with federal and state requirements of the Grant Agreement; and
2. Adherence to the requirements set forth in this Grant Agreement.
D. If individual program compliance or performance is lacking, corrective action recommendations will be made through the Grant Agreement performance improvement plans. HHSC reserves the right to impose remedies as set forth in Section 9.1 (Remedies) of the Uniform Terms and Conditions.
E. HHSC reserves the right, where allowed by legal authority, to redirect funds in the event of an financial shortfall by Xxxxxxx. HHSC will monitor Xxxxxxx’s expenditures on a monthly basis. DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health CentersXxxxxxx Children and Family Services, Inc. A B C D E F G Staff Position Justification Monthly Salary No. of Months Annual Salary Percent applied to HHSC contract Amount budgeted to HHSC contract 1 Community Health Educator-Certified Health Education Specialist The Community Health Educator administrates LifeDesign Maternity Counselor - 1 LifeDesign Maternity Counselors work directly with the program, leads evaluation and training efforts and develops health promotion campaigns for NTACHCRFA Target Population to provide counseling support. 58An estimated 80% of this salary time is being covered by other fundingspent with clients, with 20% of staff time spent on administrative duties. $ 4,216.00 18 6,175.17 16 $ 75,888.00 42.0098,802.72 75.00% $ 31,872.96 74,102.04 2 Community Health Educator-Registered Nurse The Community Health Educator-RN supervises LifeDesign Maternity Counselor - 2 LifeDesign Maternity Counselors work directly with the Maternal Child Health programRFA Target Population to provide counseling support. An estimated 80% of time is spent with clients, leads evaluation and training efforts and develops health education curriculum for PCHW's. Supervises program with 20% of staff and conducts classes and education for program participantstime spent on administrative duties. $ 6,413.00 18 6,071.88 16 $ 115,434.00 100.0097,150.08 75.00% $ 115,434.00 72,862.56 3 Perinatal Community Health Worker (PCHW) Open- PCHW will provide community resource referrals, education Director of Counseling Director of Counseling oversees LifeDesign Maternity Counseling program and support to spends approximately 20% of time working directly with clients in the RFA Target Population providing counseling support. $ 8,143.77 16 $ 130,300.32 10.00% $ 13,030.03 4 FHC Family Coach - Dallas Family Hope Center Family Coaches spend approximately 20% of their time working individually with families in the perinatal period. Salary is based on a competitive salary for community based doulas in TexasRFA Target Population, providing individualized family coaching, life skills progression score assessment, and support resources. $ 4,166.00 4,632.15 16 $ 66,656.00 100.0074,114.40 15.00% $ 66,656.00 4 Perinatal Community Health Worker (PCHW) Open- PCHW will provide community resource referrals, education and support to 11,117.16 5 FHC Family Coach - Dallas Family Hope Center Family Coaches spend approximately 20% of their time working individually with families in the perinatal period. Salary is based on a competitive salary for community based doulas in TexasRFA Target Population, providing individualized family coaching, life skills progression score assessment, and support resources. $ 4,166.00 3,799.22 16 $ 66,656.00 100.0060,787.52 15.00% $ 66,656.00 5 9,118.13 6 FHC Family Coach - Dallas (VACANT) Family Hope Center Family Coaches spend approximately 20% of their time working individually with families in the RFA Target Population, providing individualized family coaching, life skills progression score assessment, and support resources. $ - 0 3,575.23 16 $ - 0.0057,203.68 15.00% $ 8,580.55 7 FHC Family Coach - 6 Outreach Specialist Attends outreach events to promote health Dallas Family Hope Center Family Coaches spend approximately 20% of their time working individually with families in the RFA Target Population, providing individualized family coaching, life skills progression score assessment, and NTACHC's servicessupport resources. $ 3,571.00 18 3,842.25 16 $ 64,278.00 25.0061,476.00 15.00% $ 16,069.50 7 Peer educator Open Part-9,221.40 8 FHC Family Coach - Dallas Family Hope Center Family Coaches spend approximately 20% of their time hourly worker at a rate of $15.00/hr. 20 hours a week. Peer educator will serve as a faciliator during group classes working individually with families in the RFA Target Population, providing individualized family coaching, life skills progression score assessment, and provide their input for program impovement effortssupport resources. $ 1,200.00 6 3,662.53 16 $ 7,200.00 100.0058,600.48 15.00% $ 7,200.00 8 Peer educator Open Part-8,790.07 9 FHC Family Coach - Xxxxx Xxx Grande Valley Family Hope Center Family Coaches spend approximately 20% of their time hourly worker at a rate of $15.00/hr. 20 hours a week. Peer educator will serve as a faciliator during group classes working individually with families in the RFA Target Population, providing individualized family coaching, life skills progression score assessment, and provide their input for program impovement effortssupport resources. $ 1,200.00 6 3,089.04 16 $ 7,200.00 100.0049,424.64 15.00% $ 7,200.00 9 7,413.70 10 FHC Family Coach - Houston Family Hope Center Family Coaches spend approximately 20% of their time working individually with families in the RFA Target Population, providing individualized family coaching, life skills progression score assessment, and support resources. $ - 0 3,883.17 16 $ - 0.0062,130.72 15.00% $ 9,319.61 11 FHC Family Coach - 10 Houston (VACANT) Family Hope Center Family Coaches spend approximately 20% of their time working individually with families in the RFA Target Population, providing individualized family coaching, life skills progression score assessment, and support resources. $ - 0 3,661.04 16 $ - 0.0058,576.64 15.00% $ 8,786.50 12 FHC Family Coach - 11 Houston (VACANT) Family Hope Center Family Coaches spend approximately 20% of their time working individually with families in the RFA Target Population, providing individualized family coaching, life skills progression score assessment, and support resources. $ - 0 3,661.04 16 $ - 0.0058,576.64 15.00% $ 8,786.50 13 FHC Family Coach - 12 Houston Family Hope Center Family Coaches spend approximately 20% of their time working individually with families in the RFA Target Population, providing individualized family coaching, life skills progression score assessment, and support resources. $ - 0 3,763.99 16 $ - 0.0060,223.84 15.00% $ 9,033.58 14 FHC Family Coach - 13 Longview Family Hope Center Family Coaches spend approximately 20% of their time working individually with families in the RFA Target Population, providing individualized family coaching, life skills progression score assessment, and support resources. $ - 0 3,741.56 16 $ - 0.0059,864.96 15.00% $ 8,979.74 15 FHC Family Coach - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Longview Family Hope Center Family Coaches spend approximately 20% of their time working individually with families in the RFA Target Population, providing individualized family coaching, life skills progression score assessment, and support resources. $ 3,410.26 16 $ 54,564.16 15.00% $ 8,184.62 Contractor: North Texas Area Community Health CentersXxxxxxx Children and Family Services, Inc. A B C D E F G H I J K Staff Position FICA & Medicare Workers' Compensation State Unemployment Insurance Health Insurance Life Insurance Dental Insurance Retirement Other - See Supplemental Justification Page Subtotals 1 Community Health Educator- LifeDesign Maternity Counselor - 1 Gross $ 5,805.43 7,558.41 $ 119.14 $ 93.34 $ 9,828.00 $ 75.89 99 $ - $ 1,517.76 15,437.76 $ 187.52 $ 779.84 $ 4,940.14 $ - 75.00% $ 5,668.81 $ 74.25 $ - $ 17,439.56 42.00% 11,578.32 $ 2,438.28 140.64 $ 50.04 584.88 $ 39.20 3,705.11 $ 4,127.76 - 2 LifeDesign Maternity Counselor - 2 Gross $ 31.87 7,431.98 $ 97 $ - $ 637.46 187.52 $ 3,705.72 $ - 75.00% $ 5,573.99 $ 72.75 $ - $ 7,324.61 2 Community Health Educator- Gross - $ 8,830.70 $ 181.23 $ 141.98 $ 9,828.00 $ 115.43 140.64 $ - $ 2,308.68 2,779.29 $ - 3 Director of Counseling Gross $ 9,967.97 $ 130 $ - $ 21,406.02 100.00% 14,221.76 $ 8,830.70 187.52 $ 181.23 $ 141.98 $ 9,828.00 $ 115.43 779.84 $ - $ 2,308.68 - 10.00% $ 996.80 $ 13.00 $ - $ 21,406.02 3 Perinatal Community Health Worker Gross 1,422.18 $ 5,099.18 18.75 $ 117.73 $ 92.24 $ 9,828.00 $ 74.99 77.98 $ - $ 1,499.76 - 4 FHC Family Coach - Xxxxxx Xxxxx $ 5,669.75 $ 74 $ - $ 16,711.90 100.0014,221.76 $ 187.52 $ 779.84 $ 5,929.15 $ - 15.00% $ 5,099.18 850.46 $ 117.73 $ 92.24 $ 9,828.00 $ 74.99 11.10 $ - $ 1,499.76 2,133.26 $ 28.13 $ 116.98 $ 889.37 $ - 5 FHC Family Coach - Xxxxxx Xxxxx $ 4,650.25 $ 61 $ - $ 16,711.90 4 Perinatal Community Health Worker Gross 14,861.76 $ 5,099.18 187.52 $ 117.73 779.84 $ 92.24 3,039.38 $ 9,828.00 - 15.00% $ 74.99 697.54 $ 9.15 $ - $ 1,499.76 2,229.26 $ 28.13 $ 116.98 $ 455.91 $ - 6 FHC Family Coach - Dallas (VACANT) Gross $ 4,376.08 $ 57 $ - $ 16,711.90 100.0014,861.76 $ 187.52 $ 779.84 $ 2,860.18 $ - 15.00% $ 5,099.18 656.41 $ 117.73 $ 92.24 $ 9,828.00 $ 74.99 8.55 $ - $ 1,499.76 2,229.26 $ 28.13 $ 116.98 $ 429.03 $ - 7 FHC Family Coach - Xxxxxx Xxxxx $ 4,702.91 $ 61 $ - $ 16,711.90 14,221.76 $ 187.52 $ 779.84 $ - $ - 15.00% $ 705.44 $ 9.15 $ - $ 2,133.26 $ 28.13 $ 116.98 $ - $ - 8 FHC Family Coach - Xxxxxx Xxxxx $ 4,482.94 $ 59 $ - $ 14,221.76 $ 187.52 $ 779.84 $ - $ - 15.00% $ 672.44 $ 8.85 $ - $ 2,133.26 $ 28.13 $ 116.98 $ - $ - 9 FHC Family Coach - Xxxxx Xxx Grande Valley Gross $ 3,780.98 $ 49 $ - $ 14,861.76 $ 187.52 $ - $ - 15.00% $ 567.15 $ 7.35 $ - $ 2,229.26 $ 28.13 $ - $ - $ - 10 FHC Family Coach - Houston Gross $ 4,753.00 $ 62 $ - $ 14,221.76 $ 187.52 $ 779.84 $ - $ - 15.00% $ 712.95 $ 9.30 $ - $ 2,133.26 $ 28.13 $ 116.98 $ - $ - 11 FHC Family Coach - Houston (VACANT) Gross $ 4,481.11 $ 59 $ - $ 14,861.76 $ 187.52 $ 779.84 $ 2,928.83 $ - 15.00% $ 672.17 $ 8.85 $ - $ 2,229.26 $ 28.13 $ 116.98 $ 439.32 $ - 12 FHC Family Coach - Gross $ 4,481.11 $ 59 $ - $ 14,861.76 $ 187.52 $ 779.84 $ 2,928.83 $ - Houston (VACANT) 15.00% $ 672.17 $ 8.85 $ - $ 2,229.26 $ 28.13 $ 116.98 $ 439.32 $ - 13 FHC Family Coach - Houston Gross $ 4,607.12 $ 60 $ - $ 15,437.76 $ 187.52 $ 779.84 $ - $ - 15.00% $ 691.07 $ 9.00 $ - $ 2,315.66 $ 28.13 $ 116.98 $ - $ - 14 FHC Family Coach - Longview Gross $ 4,579.67 $ 60 $ - $ 14,221.76 $ 187.52 $ 779.84 $ 4,789.20 $ - 15.00% $ 686.95 $ 9.00 $ - $ 2,133.26 $ 28.13 $ 116.98 $ 718.38 $ - 15 FHC Family Coach - Longview Gross $ 4,174.16 $ 55 $ - $ 14,221.76 $ 187.52 $ - $ - $ - 15.00% $ 626.12 $ 8.25 $ - $ 2,133.26 $ 28.13 $ - $ - $ - 16 FHC Family Coach - Lubbock Gross $ 3,943.39 $ 52 $ - $ 187.52 $ - $ - $ - 15.00% $ 591.51 $ 7.80 $ - $ - $ 28.13 $ - $ - $ - 17 FHC Family Coach - Midland Gross $ 4,590.00 $ 60 $ - $ 14,221.76 $ 187.52 $ 779.84 $ - $ - 15.00% $ 688.50 $ 9.00 $ - $ 2,133.26 $ 28.13 $ 116.98 $ - $ - 18 FHC Family Coach - Penitas Rio Grande Valley Gross $ 3,928.70 $ 51 $ - $ 15,437.76 $ 187.52 $ 779.84 $ - $ - 15.00% $ 589.31 $ 7.65 $ - $ 2,315.66 $ 28.13 $ 116.98 $ - $ - 19 FHC Family Coach - Penitas Rio Grande Valley Gross $ 3,951.59 $ 52 $ - $ 15,437.76 $ 187.52 $ 779.84 $ - $ - 15.00% $ 592.74 $ 7.80 $ - $ 2,315.66 $ 28.13 $ 116.98 $ - $ - 20 FHC Family Coach - Penitas Rio Grande Valley Gross $ 3,905.56 $ 51 $ - $ - $ 187.52 $ 779.84 $ - $ - 15.00% $ 585.83 $ 7.65 $ - $ - $ 28.13 $ 116.98 $ - $ - 21 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - 22 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - 23 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - 24 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - 25 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 6 Outreach Specialist Gross 3,494.71 $ 4,917.27 21,072.24 $ 100.92 3,160.84 $ 79.06 24,617.99 $ 9,828.00 3,692.70 $ 64.28 18,638.44 $ 2,795.76 $ 4,182.91 $ 627.44 $ 19,839.12 $ 2,975.87 $ 20,384.82 $ 3,057.73 $ 20,408.71 $ 3,061.31 $ 4,923.92 $ 738.59 $ - $ 1,285.56 $ - $ 16,275.09 25.00% $ 1,229.32 $ 25.23 $ 19.77 $ 2,457.00 $ 16.07 $ - $ 321.39 $ - $ 4,068.78 7 Peer educator Gross $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 100.00% $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 8 Peer educator Gross $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 100.00% $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 9 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 10 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 11 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - DocuSign Envelope ID: A359C78F-2ED6482DE0E0-45D77910-90154C42-A2B093FB9A4E FY24 Part 2 - Local/Other Travel A B C D E F G H I Local/Other Travel Description Justification No. of Miles Mileage Rate Mileage Cost Other Travel Cost Cost PercentApplied to HHSC Contract Amount Budgeted to HHSC Contract 1 Health Fairs Staff will attend 4 health fairs and other local events a month to provide the public with education and information on the program. Costs will cover health fair registration and mileage. 200 $ 0.670 $ 134.00 $ 600.00 $ 734.00 100.00% $ 734.00 2 0 $ - $ - $ - $ - 0.00% $ - 3 0 $ - $ - $ - $ - 0.00% $ - 4 0 $ - $ - $ - $ - 0.00% $ - 5 0 $ - $ - $ - $ - 0.00% $ - 6 0 $ - $ - $ - $ - 0.00% $ - 7 0 $ - $ - $ - $ - 0.00% $ - 8 0 $ - $ - $ - $ - 0.00% $ - 9 0 $ - $ - $ - $ - 0.00% $ - 10 0 $ - $ - $ - $ - 0.00% $ - 11 0 $ - $ - $ - $ - 0.00% $ - 12 0 $ - $ - $ - $ - 0.00% $ - 13 0 $ - $ - $ - $ - 0.00% $ - 14 0 $ - $ - $ - $ - 0.00% $ - 15 0 $ - $ - $ - $ - 0.00% $ - 16 0 $ - $ - $ - $ - 0.00% $ - 17 0 $ - $ - $ - $ - 0.00% $ - 18 0 $ - $ - $ - $ - 0.00% $ - 19 0 $ - $ - $ - $ - 0.00% $ - 20 0 $ - $ - $ - $ - 0.00% $ - 21 0 $ - $ - $ - $ - 0.00% $ - 22 0 $ - $ - $ - $ - 0.00% $ - 23 0 $ - $ - $ - $ - 0.00% $ - 24 0 $ - $ - $ - $ - 0.00% $ - 25 0 $ - $ - $ - $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6B747-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E F G H Contractor Name Description Justification No. of Units Rate of Payment Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 ATT Hotspot Hotspot to be used by CHW during outreach activities/ activities away from the NTACHC centers. Hotspot to be paid monthly to AT&T. 18 $ 60.00 $ 1,080.00 100.00% $ 1,080.00 2 Voyce Inc. Translation Services Translation services for patients with needing linguistic acommodations outside of English and Spanish. Rate is $0.65 per minute of a voice call. Patient meetings with PCHW's last up to 90 minutes. Budget accounts for 5 meetings per year per patient, for a total of 30 patients. 13500 $ 0.65 $ 8,775.00 100.00% $ 8,775.00 3 Uber Health Transportation Services Arrange and pay for rides for clients who aren't able to make their appointments due to transportation issues. Average per ride $10 for 20 rides. 20 $ 10.00 $ 200.00 100.00% $ 200.00 4 0 $ - $ - 0.00% $ - 5 0 $ - $ - 0.00% $ - 6 0 $ - $ - 0.00% $ - 7 0 $ - $ - 0.00% $ - 8 0 $ - $ - 0.00% $ - 9 0 $ - $ - 0.00% $ - 10 0 $ - $ - 0.00% $ - 11 0 $ - $ - 0.00% $ - 12 0 $ - $ - 0.00% $ - 13 0 $ - $ - 0.00% $ - 14 0 $ - $ - 0.00% $ - 15 0 $ - $ - 0.00% $ - 16 0 $ - $ - 0.00% $ - 17 0 $ - $ - 0.00% $ - 18 0 $ - $ - 0.00% $ - 19 0 $ - $ - 0.00% $ - 20 0 $ - $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E Description Justification Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 Patient Education Materials Education Classes Patient Material - $1300 printing for 4 events a year. Printed handouts will include educational materials related to the event and agenda. $ 1,300.00 100.00% $ 1,300.00 2 Scientific Pregnancy Pelvis with Mature Fetus Model Anatomy model used for prenatal and childbirth classes and one-on-one education $ 354.24 100.00% $ 354.24 3 NASCO Kit My Plate Classroom My Plate model for healthy eating education $ 719.95 100.00% $ 719.95 4 Printer- Community Health Educator 2 HP- with scanner printer. Printer designated for the program, main uses consist of printing out education handouts and scanning individualized care plans into the patients chart. $ 760.00 100.00% $ 760.00 5 Breastfeeding Model Breastfeeding model for patient education. $ 150.00 100.00% $ 150.00 6 Child Birth Education Posters Educational materials for group classes and one-on-one education $ 150.68 100.00% $ 150.68 7 NTACHC Pregancy Handbook 300 Pregnancy and You printed copies -- 150 in English and 150 in Spanish at $15 per printed copy. $ 4,600.00 100.00% $ 4,600.00 8 Baby Emergency Needs An emergency baby supply warehouse will be stocked with (600) diapers at an average cost of $0.29 each, (25) 6 pack of baby clothes at $14.09 each, 25 cribs at $100 each, (30) cans of formula at $34.99 each. Additional items will be obtained through donations or additional grants. These items will serve to assist families immediate needs, not long term needs. Based on need we can provide these items. $ 3,139.62 100.00% $ 3,139.62 9 $ - 0.00% $ - 10 $ - 0.00% $ - 11 $ - 0.00% $ - 12 $ - 0.00% $ - 13 $ - 0.00% $ - 14 $ - 0.00% $ - 15 $ - 0.00% $ - 16 $ - 0.00% $ - 17 $ - 0.00% $ - 18 $ - 0.00% $ - 19 $ - 0.00% $ - 20 $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E Description Justification Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 Certification- Doula Paradigm Doula Certification to provide CHW's with additional skills to support mother and families in the perinatal period. $ 1,000.00 100.00% $ 1,000.00 2 Certification- Doula Paradigm Doula Certification to provide CHW's with additional skills to support mother and families in the perinatal period. $ 1,000.00 100.00% $ 1,000.00 3 $ - 4 Certified Childbirth Educator Three staff members will become certified in childbirth education through the paradigm doulas course. Each course is $104.12. $ 312.00 100.00% $ 312.00 5 Data Analytics and Visualization in Healthcare Certification The Health Education Specialist will acquire an online data analytics certificate from the Rochester Institute of Technology, to drive program evaluation efforts successfully and through research- based practices. $ 250.00 $ - 11 Registered Nurse Licensing Renewal RN license renewal ($75) $ 75.00 100.00% $ 75.00 12 $ - 0.00% $ - 13 $ - 0.00% $ - 14 $ - 0.00% $ - 15 $ - 0.00% $ - 16 $ - 0.00% $ - 17 $ - 0.00% $ - 18 $ - 0.00% $ - 19 $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E 3F2233E741E8 FY24 Pilot Project Contractor: North Texas Area Community Health CentersXxxxxxx Children and Family Services, Inc. Cost Category Item # Justification Attachment C_ CONTRACT AFFIRMATIONS For purposes of these Contract Affirmations, HHS includes both the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS). System Agency refers to HHSC, DSHS, or both, that will be a party to this Contract. These Contract Affirmations apply to all Contractors and Grantees (referred to as “Contractor”) regardless of their business form (e.g., individual, partnership, corporation). By entering into this Contract, Contractor affirms, without exception, understands, and agrees to comply with the following items through the life of the Contract:
1. Contractor represents and warrants that these Contract Affirmations apply to Contractor and all of Contractor's principals, officers, directors, shareholders, partners, owners, agents, employees, subcontractors, independent contractors, and any other representatives who may provide services under, who have a financial interest in, or otherwise are interested in this Contract and any related Solicitation.Justification
Appears in 1 contract
Samples: Grant Agreement
HHSC MONITORING ACTIVITIES. A. HHSC will monitor the performance of contract awarded under this Grant Agreement. Monitoring activities will be conducted by HHSC for fiscal, programmatic, and administrative components of the Grant Agreement. All services and deliverables under the Grant Agreement must be provided at an acceptable quality level and in a manner consistent with Grant Agreement and program requirements and HHSC Uniform Terms and Conditions.
B. Monitoring activities may include, but are not limited to, the following:
1. Any findings regarding performance of internal quality assurance;
2. Any training needs identified and resulting actions; and
3. Any corrective action taken and the resolution of any issues; and
4. Other Project information determined relevant by HHSC.
C. Xxxxxxx agrees to cooperate fully and assist with the coordination of the activities that include, but are not limited to, the following:
1. Periodic site visits to monitor for compliance with federal and state requirements of the Grant Agreement; and
2. Adherence to the requirements set forth in this Grant Agreement.
D. If individual program compliance or performance is lacking, corrective action recommendations will be made through the Grant Agreement performance improvement plans. HHSC reserves the right to impose remedies as set forth in Section 9.1 (Remedies) of the Uniform Terms and Conditions.
E. HHSC reserves the right, where allowed by legal authority, to redirect funds in the event of an financial shortfall by Xxxxxxx. HHSC will monitor Xxxxxxx’s expenditures on a monthly basis. DocuSign Envelope ID: A359C78F-2ED6A8C93FDD-168A-4E51-45D7A466-9015-A2B093FB9A4E 38910FFA4E92 FY24 Contractor: North Texas Area Community Health Centers, Inc. Metrocare Services A B C D E F G Staff Position Justification Monthly Salary No. of Months Annual Salary Percent applied to HHSC contract Amount budgeted to HHSC contract 1 Community Health EducatorChief of IDD Provider & Specialized Services Responsible for collecting all necessary data, completing all necessary reporting, monitoring metrics, and leading the continuous quality improvement and change management of the project. HHSC = 25%. Metrocare = 75% $ 14,166.00 18 $ 254,988.00 25.00% $ 63,747.00 2 Nurse Manager Responsible for the day-Certified Health Education Specialist The Community Health Educator administrates to-day operations of the project, hiring and training the staff, providing reflective supervision to all the home visitors, ensuring fidelity to the curriculum and program, leads evaluation and completing home visits as necessary to support the team. Provides Promoting First Relationships Module 2 training efforts to all new staff and develops health promotion campaigns for NTACHCcompletes fidelity monitoring throughout the year. 58% of this salary is being covered by other fundingHHCS = 0%. Metrocare = 100%. $ 4,216.00 7,687.51 18 $ 75,888.00 42.00% $ 31,872.96 2 Community Health Educator-Registered Nurse The Community Health Educator-RN supervises the Maternal Child Health program, leads evaluation and training efforts and develops health education curriculum for PCHW's. Supervises program staff and conducts classes and education for program participants. $ 6,413.00 18 $ 115,434.00 100.00% $ 115,434.00 3 Perinatal Community Health Worker (PCHW) Open- PCHW will provide community resource referrals, education and support to families in the perinatal period. Salary is based on a competitive salary for community based doulas in Texas. $ 4,166.00 16 $ 66,656.00 100.00% $ 66,656.00 4 Perinatal Community Health Worker (PCHW) Open- PCHW will provide community resource referrals, education and support to families in the perinatal period. Salary is based on a competitive salary for community based doulas in Texas. $ 4,166.00 16 $ 66,656.00 100.00% $ 66,656.00 5 $ - 0 $ - 138,375.18 0.00% $ - 6 Outreach Specialist Attends outreach events 3 Lead Home Visitor Provides home visiting directly with families to promote health fidelity to the Promoting First Relationships Model and NTACHC's servicesprovides quality assurance through documentation review and field support. $ 3,571.00 18 $ 64,278.00 25.00HHSC = 100% $ 16,069.50 7 Peer educator Open Part-time hourly worker at a rate of $15.00/hr. 20 hours a week. Peer educator will serve as a faciliator during group classes and provide their input for program impovement efforts. 4,246.66 17 $ 1,200.00 6 $ 7,200.00 72,193.22 100.00% $ 7,200.00 8 Peer educator Open Part-time hourly worker at a rate of $15.00/hr. 20 hours a week. Peer educator will serve as a faciliator during group classes and provide their input for program impovement efforts. 72,193.22 4 $ 1,200.00 6 $ 7,200.00 - 100.00% $ 7,200.00 9 $ - 0 $ - 0.005 Home Visitor Provides home visits and education to the families. The Home Visitors will complete all the necessary assessments and screeners, link with resources and lead the families through the Promoting First Relationships curriculum. HHSC = 100% $ - 10 3,900.00 17 $ - 0 $ - 0.0066,300.00 100.00% $ - 11 $ - 0 $ - 0.0066,300.00 6 Home Visitor Provides home visits and education to the families. The Home Visitors will complete all the necessary assessments and screeners, link with resources and lead the families through the Promoting First Relationships curriculum. HHSC = 100% $ - 12 3,900.00 17 $ - 0 $ - 0.0066,300.00 100.00% $ - 13 $ - 0 $ - 0.00% $ - 66,300.00 DocuSign Envelope ID: A359C78F-2ED6A8C93FDD-168A-4E51-45D7A466-9015-A2B093FB9A4E 38910FFA4E92 FY24 Contractor: North Texas Area Community Health Centers, Inc. Metrocare Services A B C D E F G H I J K Staff Position FICA & Medicare Workers' Compensation State Unemployment Insurance Health Insurance Life Insurance Dental Insurance Retirement Other - See Supplemental Justification Page Subtotals 1 Community Health Educator- Chief of IDD Provider & Specialized Gross $ 5,805.43 19,506.58 $ 119.14 1,504.43 $ 93.34 841.05 $ 9,828.00 35,698.32 $ 75.89 166.95 $ - ######### $ 742.00 $ 68,658.85 25.00% $ 4,876.65 $ 376.11 $ 210.26 $ 8,924.58 $ 41.74 $ - $ 1,517.76 2,549.88 $ 185.50 $ 17,164.72 2 Nurse Manager Gross $ 10,585.70 $ 816.41 $ 841.05 $ 19,372.53 $ 166.95 $ - $ 17,439.56 42.00% 5,535.01 $ 2,438.28 742.00 $ 50.04 $ 39.20 $ 4,127.76 $ 31.87 $ - $ 637.46 $ - $ 7,324.61 2 Community Health Educator- Gross $ 8,830.70 $ 181.23 $ 141.98 $ 9,828.00 $ 115.43 $ - $ 2,308.68 $ - $ 21,406.02 100.00% $ 8,830.70 $ 181.23 $ 141.98 $ 9,828.00 $ 115.43 $ - $ 2,308.68 $ - $ 21,406.02 3 Perinatal Community Health Worker Gross $ 5,099.18 $ 117.73 $ 92.24 $ 9,828.00 $ 74.99 $ - $ 1,499.76 $ - $ 16,711.90 100.00% $ 5,099.18 $ 117.73 $ 92.24 $ 9,828.00 $ 74.99 $ - $ 1,499.76 $ - $ 16,711.90 4 Perinatal Community Health Worker Gross $ 5,099.18 $ 117.73 $ 92.24 $ 9,828.00 $ 74.99 $ - $ 1,499.76 $ - $ 16,711.90 100.00% $ 5,099.18 $ 117.73 $ 92.24 $ 9,828.00 $ 74.99 $ - $ 1,499.76 $ - $ 16,711.90 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 38,059.65 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 6 Outreach Specialist 3 Lead Home Visitor Gross $ 4,917.27 5,522.78 $ 100.92 425.94 $ 79.06 841.05 $ 9,828.00 10,107.05 $ 64.28 157.68 $ - $ 1,285.56 2,887.73 $ 701.25 $ 20,643.48 100.00% $ 5,522.78 $ 425.94 $ 841.05 $ 10,107.05 $ 157.68 $ - $ 16,275.09 25.00% 2,887.73 $ 1,229.32 701.25 $ 25.23 $ 19.77 $ 2,457.00 $ 16.07 $ - $ 321.39 $ - $ 4,068.78 7 Peer educator Gross $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 100.00% $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 8 Peer educator Gross $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 100.00% $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 9 20,643.48 4 0 Gross $ - $ - $ 841.05 $ - $ 157.68 $ - $ - $ - 701.25 $ 1,699.98 100.00% $ - $ - $ 841.05 $ - $ 157.68 $ - $ - $ 701.25 $ 1,699.98 5 Home Visitor Gross $ 5,071.95 $ 391.17 $ 841.05 $ 9,282.00 $ 157.68 $ - $ 2,652.00 $ 701.25 $ 19,097.10 100.00% $ 5,071.95 $ 391.17 $ 841.05 $ 9,282.00 $ 157.68 $ - $ 2,652.00 $ 701.25 $ 19,097.10 6 Home Visitor Gross $ 5,071.95 $ 391.17 $ 841.05 $ 9,282.00 $ 157.68 $ - $ 2,652.00 $ 701.25 $ 19,097.10 100.00% $ 5,071.95 $ 391.17 $ 841.05 $ 9,282.00 $ 157.68 $ - $ 2,652.00 $ 701.25 $ 19,097.10 7 Home Visitor Gross $ 5,071.95 $ 391.17 $ 841.05 $ 9,282.00 $ 157.68 $ - $ 2,652.00 $ 701.25 $ 19,097.10 100.00% $ 5,071.95 $ 391.17 $ 841.05 $ 9,282.00 $ 157.68 $ - $ 2,652.00 $ 701.25 $ 19,097.10 8 Office Coordinator Gross $ 4,508.39 $ 347.71 $ 841.05 $ 8,250.65 $ 157.68 $ - $ 2,357.33 $ 701.25 $ 17,164.06 100.00% $ 4,508.39 $ 347.71 $ 841.05 $ 8,250.65 $ 157.68 $ - $ 2,357.33 $ 701.25 $ 17,164.06 9 Gross $ - $ - $ 841.05 $ - $ 157.68 $ - $ - $ 123.75 $ 1,122.48 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 10 0 Marketing Associate Gross $ 1,392.03 $ 107.36 $ 841.05 $ 2,547.51 $ 157.68 $ - $ - 727.86 $ 123.75 $ 5,897.24 10.00% $ 139.20 $ 10.74 $ 84.11 $ 254.75 $ 15.77 $ - $ - 72.79 $ - 12.38 $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 589.74 11 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - DocuSign Envelope ID: A359C78F-2ED6A8C93FDD-168A-4E51-45D7A466-9015-A2B093FB9A4E 38910FFA4E92 FY24 Part 2 - Local/Other Travel A B C D E F G H I Local/Other Travel Description Justification No. of Miles Mileage Rate Mileage Cost Other Travel Cost Cost PercentApplied Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 Health Fairs Staff will attend 4 health fairs and other local events a month Local Mileage Mileage reimbursement for 5 Flourishing Family staff to provide the public home visits with education families. Travel costs budgeted in compliance with state rules and information based on the programcurrent GSA per diem rates; mileage @ $0.655/mile. Costs will cover health fair registration and mileageAll costs are estimates based on current knowledge. 200 8333 $ 0.670 0.665 $ 134.00 5,541.45 $ 600.00 - $ 734.00 5,541.45 100.00% $ 734.00 5,541.45 2 0 $ - $ - $ - $ - 0.00% $ - 3 0 $ - $ - $ - $ - 0.00% $ - 4 0 $ - $ - $ - $ - 0.00% $ - 5 0 $ - $ - $ - $ - 0.00% $ - 6 0 $ - $ - $ - $ - 0.00% $ - 7 0 $ - $ - $ - $ - 0.00% $ - 8 0 $ - $ - $ - $ - 0.00% $ - 9 0 $ - $ - $ - $ - 0.00% $ - 10 0 $ - $ - $ - $ - 0.00% $ - 11 0 $ - $ - $ - $ - 0.00% $ - 12 0 $ - $ - $ - $ - 0.00% $ - 13 0 $ - $ - $ - $ - 0.00% $ - 14 0 $ - $ - $ - $ - 0.00% $ - 15 0 $ - $ - $ - $ - 0.00% $ - 16 0 $ - $ - $ - $ - 0.00% $ - 17 0 $ - $ - $ - $ - 0.00% $ - 18 0 $ - $ - $ - $ - 0.00% $ - 19 0 $ - $ - $ - $ - 0.00% $ - 20 0 $ - $ - $ - $ - 0.00% $ - 21 0 $ - $ - $ - $ - 0.00% $ - 22 0 $ - $ - $ - $ - 0.00% $ - 23 0 $ - $ - $ - $ - 0.00% $ - 24 0 $ - $ - $ - $ - 0.00% $ - 25 0 $ - $ - $ - $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6A8C93FDD-168A-4E51-45D7A466-9015-A2B093FB9A4E 38910FFA4E92 FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E F G H Contractor Name Description Justification No. of Units Rate of Payment Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 ATT Hotspot Hotspot to be used by CHW during outreach activities/ activities away from the NTACHC centers. Hotspot to be paid monthly to AT&T. 18 $ 60.00 $ 1,080.00 100.00% $ 1,080.00 2 Voyce Inc. Translation Metrocare Services Translation services for patients with needing linguistic acommodations outside of English and Spanish. Rate is $0.65 per minute of a voice call. Patient meetings with PCHW's last up to 90 minutes. Budget accounts for 5 meetings per year per patient, for a total of 30 patients. 13500 $ 0.65 $ 8,775.00 100.00% $ 8,775.00 3 Uber Health Transportation Services Arrange and pay for rides for clients who aren't able to make their appointments due to transportation issues. Average per ride $10 for 20 rides. 20 $ 10.00 $ 200.00 100.00% $ 200.00 4 0 $ - $ - 0.00% $ - 5 0 $ - $ - 0.00% $ - 6 0 $ - $ - 0.00% $ - 7 0 $ - $ - 0.00% $ - 8 0 $ - $ - 0.00% $ - 9 0 $ - $ - 0.00% $ - 10 0 $ - $ - 0.00% $ - 11 0 $ - $ - 0.00% $ - 12 0 $ - $ - 0.00% $ - 13 0 $ - $ - 0.00% $ - 14 0 $ - $ - 0.00% $ - 15 0 $ - $ - 0.00% $ - 16 0 $ - $ - 0.00% $ - 17 0 $ - $ - 0.00% $ - 18 0 $ - $ - 0.00% $ - 19 0 $ - $ - 0.00% $ - 20 0 $ - $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E Description Justification Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 Patient Education Materials Education Classes Patient Material - Office supplies Office for one office that support the Flourishing Family Project = $1300 printing for 4 events a year100 per month *17 months = $1700. Printed handouts will include educational materials related to the event and agenda. HHSC = 100% $ 1,300.00 1,700.00 100.00% $ 1,300.00 1,700.00 2 Scientific Pregnancy Pelvis with Mature Fetus Model Anatomy model used for prenatal Program Curriculum & Assessments Assessments and childbirth classes and one-on-one education family training materials to support the families in the FFP = $50 per month *17 months = $850. HHSC = 100% $ 354.24 850.00 100.00% $ 354.24 850.00 3 NASCO Kit My Plate Classroom My Plate model for healthy eating education Outreach materials Fliers and marketing materials to distribute to community partners, health fairs and community outreach = $1655.49 $.71 per double-sided color flier * 2332 fliers = $1655.49. HHSC = 100% $ 719.95 1,655.49 100.00% $ 719.95 1,655.49 4 Printer- Community Health Educator 2 HP- Laptops Laptop for new positions within the project = $1850 for one laptop with scanner printerdocking station and mouse. Printer designated for the program, main uses consist of printing out education handouts and scanning individualized care plans into the patients chart5 new staff * 1850 per laptop = $9250. HHSC = 100% $ 760.00 11,100.00 100.00% $ 760.00 11,100.00 5 Breastfeeding Model Breastfeeding model Basic Needs for patient education. families Carseats: $130 each * 65 families = $8450 , Pack & Plays with bassinets = $85 each * 65 families = $5525 , diapers: $28.49 each * 65 cases= $1851, wipes = $12 each * 14 cases= $168 $ 150.00 15,994.00 100.00% $ 150.00 15,994.00 6 Child Birth Education Posters Educational materials for group classes and one-on-one education $ 150.68 100.00- 0.00% $ 150.68 - 7 NTACHC Pregancy Handbook 300 Pregnancy and You printed copies -- 150 in English and 150 in Spanish at $15 per printed copy. $ 4,600.00 100.00- 0.00% $ 4,600.00 - 8 Baby Emergency Needs An emergency baby supply warehouse will be stocked with (600) diapers at an average cost of $0.29 each, (25) 6 pack of baby clothes at $14.09 each, 25 cribs at $100 each, (30) cans of formula at $34.99 each. Additional items will be obtained through donations or additional grants. These items will serve to assist families immediate needs, not long term needs. Based on need we can provide these items. $ 3,139.62 100.00- 0.00% $ 3,139.62 - 9 $ - 0.00% $ - 10 $ - 0.00% $ - 11 $ - 0.00% $ - 12 $ - 0.00% $ - 13 $ - 0.00% $ - 14 $ - 0.00% $ - 15 $ - 0.00% $ - 16 $ - 0.00% $ - 17 $ - 0.00% $ - 18 $ - 0.00% $ - 19 $ - 0.00% $ - 20 $ - 0.00% $ - 21 $ - 0.00% $ - 22 $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6A8C93FDD-168A-4E51-45D7A466-9015-A2B093FB9A4E 38910FFA4E92 FY24 Contractor: North Texas Area Community Health Centers, Inc. Metrocare Services A B C D E Description Justification Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 Certification- Doula Paradigm Doula Certification Software licensing fees MyAvatar Electronic Health Record subscription for service documentation = $123.92 per FTE per month. Zoom license to provide CHW's with additional skills to support mother telehealth services as requested by families and families in the perinatal periodattend/host meetings= $20.83 per FTE per month. $144.75*6.5 FTEs*17 months = $15994.87. HHSC = 100% $ 1,000.00 15,994.87 100.00% $ 1,000.00 15,994.87 2 Certification- Doula Paradigm Doula Certification Professional Development Staff are provided $1500 a year in professional development to provide CHW's with additional skills to support mother and families in the perinatal periodmaintain licenses, attend trainings, or take classes which = $125 per month. $125*6.5 FTEs*17 months = $13,812.50. HHSC = 100% $ 1,000.00 13,812.50 100.00% $ 1,000.00 13,812.50 3 Company issued cell phones Cell phone (phone and service) to support 4 FTE direct service home visiting staff - $50/month per phone x 17 months x 4 FTEs = $3400. HHSC = 100% $ - 4 Certified Childbirth Educator Three staff members will become certified in childbirth education through the paradigm doulas course. Each course is $104.12. $ 312.00 4,420.00 100.00% $ 312.00 4,420.00 4 $ - 0.00% $ - 5 Data Analytics and Visualization in Healthcare Certification The Health Education Specialist will acquire an online data analytics certificate from the Rochester Institute of Technology, to drive program evaluation efforts successfully and through research- based practices. $ 250.00 - 0.00% $ - 6 $ - 0.00% $ - 7 $ - 0.00% $ - 8 $ - 0.00% $ - 9 $ - 0.00% $ - 10 $ - 0.00% $ - 11 Registered Nurse Licensing Renewal RN license renewal ($75) $ 75.00 100.00- 0.00% $ 75.00 - 12 $ - 0.00% $ - 13 $ - 0.00% $ - 14 $ - 0.00% $ - 15 $ - 0.00% $ - 16 $ - 0.00% $ - 17 $ - 0.00% $ - 18 $ - 0.00% $ - 19 $ - 0.00% $ - 20 $ - 0.00% $ - 21 $ - 0.00% $ - 22 $ - 0.00% $ - 23 $ - 0.00% $ - 24 $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6A8C93FDD-168A-4E51-45D7A466-9015-A2B093FB9A4E 38910FFA4E92 FY24 Pilot Project Contractor: North Texas Area Community Health Centers, Inc. Metrocare Services Cost Category Item # Justification 1 Fringe Benefits J Short Term Disability = $41.25 per month per FTE = $742.50 for 18 months or $701.25 for 17 months or $41.25 for 3 months Attachment C_ CONTRACT AFFIRMATIONS For purposes of these Contract Affirmations, HHS includes both the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS). System Agency refers to HHSC, DSHS, or both, that will be a party to this Contract. These Contract Affirmations apply to all Contractors and Grantees (referred to as “Contractor”) regardless of their business form (e.g., individual, partnership, corporation). By entering into this Contract, Contractor affirms, without exception, understands, and agrees to comply with the following items through the life of the Contract:
1. Contractor represents and warrants that these Contract Affirmations apply to Contractor and all of Contractor's principals, officers, directors, shareholders, partners, owners, agents, employees, subcontractors, independent contractors, and any other representatives who may provide services under, who have a financial interest in, or otherwise are interested in this Contract and any related Solicitation.
Appears in 1 contract
Samples: Grant Agreement
HHSC MONITORING ACTIVITIES. A. HHSC will monitor the performance of contract awarded under this Grant Agreement. Monitoring activities will be conducted by HHSC for fiscal, programmatic, and administrative components of the Grant Agreement. All services and deliverables under the Grant Agreement must be provided at an acceptable quality level and in a manner consistent with Grant Agreement and program requirements and HHSC Uniform Terms and Conditions.
B. Monitoring activities may include, but are not limited to, the following:
1. Any findings regarding performance of internal quality assurance;
2. Any training needs identified and resulting actions; and
3. Any corrective action taken and the resolution of any issues; and
4. Other Project information determined relevant by HHSC.
C. Xxxxxxx agrees to cooperate fully and assist with the coordination of the activities that include, but are not limited to, the following:
1. Periodic site visits to monitor for compliance with federal and state requirements of the Grant Agreement; and
2. Adherence to the requirements set forth in this Grant Agreement.
D. If individual program compliance or performance is lacking, corrective action recommendations will be made through the Grant Agreement performance improvement plans. HHSC reserves the right to impose remedies as set forth in Section 9.1 (Remedies) of the Uniform Terms and Conditions.
E. HHSC reserves the right, where allowed by legal authority, to redirect funds in the event of an financial shortfall by Xxxxxxx. HHSC will monitor Xxxxxxx’s expenditures on a monthly basis. DocuSign Envelope ID: A359C78F-2ED66C45DD26-45D7DE5F-43D6-901581B8-A2B093FB9A4E E3D18F3AB105 FY24 Contractor: North Texas Area Community Health Centers, Inc. Catholic Charities of the Archdiocese of Galveston-Houston A B C D E F G Staff Position Justification Monthly Salary No. of Months Annual Salary Percent applied to HHSC contract Amount budgeted to HHSC contract 1 Community Health Educator-Certified Health Education Specialist The Community Health Educator administrates the programProgram Director Program Coordinator - Will manage service delivery and support case managers, leads evaluation develop partnerships, and training efforts and develops health promotion campaigns for NTACHCoversee other program resources. 58% of this $6,666.67 monthly salary is being covered by other funding. x 18 months x 0.75FTE = $90,005 $ 4,216.00 6,666.67 18 $ 75,888.00 42.00120,000.06 75.00% $ 31,872.96 90,000.05 2 Community Health Educator-Registered Nurse The Community Health Educator-RN supervises the Maternal Child Health programLead Case Manager Lead Case Manager - Will oversee case management program elementas, leads evaluation and training efforts provide intensive case management and develops health education curriculum for PCHW'scare coordination to an average caseload of 20 clients in Harris County. Supervises program staff and conducts classes and education for program participants. $4,166.67 monthly salary x 18 months = $75.000.06 $ 6,413.00 5,000.00 18 $ 115,434.00 90,000.00 100.00% $ 115,434.00 90,000.00 3 Perinatal Community Health Worker (PCHW) Open- PCHW will Case Manager Case Manager - Will provide community resource referrals, education intensive case management and support care coordination to families an average caseload of 20 clients in the perinatal periodHarris County. Salary is based on a competitive $4,166.67 monthly salary for community based doulas in Texas. x 18 months = $75.000.06 $ 4,166.00 16 4,166.67 18 $ 66,656.00 75,000.06 100.00% $ 66,656.00 75,000.06 4 Perinatal Community Health Worker (PCHW) Open- PCHW will provide community resource referralsOutreach Specialist - Harris County Outreach Specialist - Will execute outreach plans and strategies to recruit eligible clients, education advertise services, and support to families identify partner organizations in the perinatal periodHarris County. Salary is based on a competitive $4,166.67 monthly salary for community based doulas in Texas. x 18 months = $75.000.06 $ 4,166.00 16 3,611.12 18 $ 66,656.00 65,000.16 100.00% $ 66,656.00 65,000.16 5 $ - 0 $ - 0.00% $ - 6 Outreach Specialist Attends outreach events to promote health and NTACHC's services. $ 3,571.00 18 - $ 64,278.00 25.00% - 7 $ 16,069.50 7 Peer educator Open Part-time hourly worker at a rate of $15.00/hr. 20 hours a week. Peer educator will serve as a faciliator during group classes and provide their input for program impovement efforts. - $ 1,200.00 6 - 8 $ 7,200.00 100.00% - $ 7,200.00 8 Peer educator Open Part-time hourly worker at a rate of $15.00/hr. 20 hours a week. Peer educator will serve as a faciliator during group classes and provide their input for program impovement efforts. $ 1,200.00 6 $ 7,200.00 100.00% $ 7,200.00 - 9 $ - 0 $ - 0.00% $ - 10 $ - 0 $ - 0.00% $ - 11 $ - 0 $ - 0.00% $ - 12 $ - 0 $ - 0.00% $ - 13 $ - 0 $ - 0.00% 14 $ - $ - 15 $ - $ - 16 $ - $ - 17 $ - $ - 18 $ - $ - 19 $ - $ - 20 $ - $ - DocuSign Envelope ID: A359C78F-2ED66C45DD26-45D7DE5F-43D6-901581B8-A2B093FB9A4E E3D18F3AB105 FY24 Contractor: North Texas Area Community Health Centers, Inc. Catholic Charities of the Archdiocese of Galveston-Houston A B C D E F G H I J K Staff Position FICA & Medicare Workers' Compensation State Unemployment Insurance Health Insurance Life Insurance Dental Insurance Retirement Other - See Supplemental Justification Page Subtotals 1 Community Health Educator- Program Director Gross $ 5,805.43 9,180.00 $ 119.14 1,200.00 $ 93.34 1,200.00 $ 9,828.00 $ 75.89 16,020.01 $ - $ 1,517.76 - $ 6,000.00 $ - $ 17,439.56 42.0033,600.01 75.00% $ 2,438.28 6,885.00 $ 50.04 900.00 $ 39.20 900.00 $ 4,127.76 $ 31.87 12,015.01 $ - $ 637.46 - $ 4,500.00 $ - $ 7,324.61 25,200.01 2 Community Health Educator- Lead Case Manager Gross $ 8,830.70 6,885.00 $ 181.23 900.00 $ 141.98 900.00 $ 9,828.00 $ 115.43 12,015.00 $ - $ 2,308.68 - $ 4,500.00 $ - $ 21,406.02 25,200.00 100.00% $ 8,830.70 6,885.00 $ 181.23 900.00 $ 141.98 900.00 $ 9,828.00 $ 115.43 12,015.00 $ - $ 2,308.68 - $ 4,500.00 $ - $ 21,406.02 25,200.00 3 Perinatal Community Health Worker Case Manager Gross $ 5,099.18 5,737.50 $ 117.73 750.00 $ 92.24 750.00 $ 9,828.00 $ 74.99 10,012.51 $ - $ 1,499.76 - $ 3,750.00 $ - $ 16,711.90 21,000.01 100.00% $ 5,099.18 5,737.50 $ 117.73 750.00 $ 92.24 750.00 $ 9,828.00 $ 74.99 10,012.51 $ - $ 1,499.76 - $ 3,750.00 $ - $ 16,711.90 21,000.01 4 Perinatal Community Health Worker Case Manager - Harris County Gross $ 5,099.18 4,972.51 $ 117.73 650.00 $ 92.24 650.00 $ 9,828.00 $ 74.99 8,677.52 $ - $ 1,499.76 - $ 3,250.01 $ - $ 16,711.90 18,200.04 100.00% $ 5,099.18 4,972.51 $ 117.73 650.00 $ 92.24 650.00 $ 9,828.00 $ 74.99 8,677.52 $ - $ 1,499.76 - $ 3,250.01 $ - $ 16,711.90 18,200.04 5 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 6 Outreach Specialist 0 Gross $ 4,917.27 $ 100.92 $ 79.06 $ 9,828.00 $ 64.28 $ - $ 1,285.56 $ - $ 16,275.09 25.00% $ 1,229.32 $ 25.23 $ 19.77 $ 2,457.00 $ 16.07 $ - $ 321.39 $ - $ 4,068.78 7 Peer educator Gross $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 100.00- $ - $ - $ - 0.00% $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 8 Peer educator - $ - $ - $ - 7 0 Gross $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 100.00- $ - $ - $ - 0.00% $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 - $ - $ - $ - 8 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 9 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 10 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 11 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - DocuSign Envelope ID: A359C78F-2ED66C45DD26-45D7DE5F-43D6-901581B8-A2B093FB9A4E E3D18F3AB105 FY24 Part 2 - Local/Other Travel A B C D E F G H I Local/Other Travel Description Justification No. of Miles Mileage Rate Mileage Cost Other Travel Cost Cost PercentApplied Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 Health Fairs Staff Mileage Mileage will attend 4 health fairs be used to conduct home visits, classes, counseling sessions, and other local events a services in locations convenient to clients including home visits. $0.67 x 300 miles per month to provide the public with education and information on the program. Costs will cover health fair registration and mileage. 200 x 18 months = $3,618.00 5400 $ 0.670 $ 134.00 3,618.00 $ 600.00 - $ 734.00 3,618.00 100.00% $ 734.00 3,618.00 2 0 $ - $ - $ - $ - 0.00% $ - 3 0 $ - $ - $ - $ - 0.00% $ - 4 0 $ - $ - $ - $ - 0.00% $ - 5 0 $ - $ - $ - $ - 0.00% $ - 6 0 $ - $ - $ - $ - 0.00% $ - 7 0 $ - $ - $ - $ - 0.00% $ - 8 0 $ - $ - $ - $ - 0.00% $ - 9 0 $ - $ - $ - $ - 0.00% $ - 10 0 $ - $ - $ - $ - 0.00% $ - 11 0 $ - $ - $ - $ - 0.00% $ - 12 0 $ - $ - $ - $ - 0.00% $ - 13 0 $ - $ - $ - $ - 0.00% $ - 14 0 $ - $ - $ - $ - 0.00% $ - 15 0 $ - $ - $ - $ - 0.00% $ - 16 0 $ - $ - $ - $ - 0.00% $ - 17 0 $ - $ - $ - $ - 0.00% $ - 18 0 $ - $ - $ - $ - 0.00% $ - 19 0 $ - $ - $ - $ - 0.00% $ - 20 0 $ - $ - $ - $ - 0.00% $ - 21 0 $ - $ - $ - $ - 0.00% $ - 22 0 $ - $ - $ - $ - 0.00% $ - 23 0 $ - $ - $ - $ - 0.00% $ - 24 0 $ - $ - $ - $ - 0.00% $ - 25 0 $ - $ - $ - $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED66C45DD26-45D7DE5F-43D6-901581B8-A2B093FB9A4E E3D18F3AB105 FY24 Contractor: North Texas Area Community Health Centers, Inc. Catholic Charities of the Archdiocese of Galveston-Houston A B C D E F G H Contractor Name Description Justification No. of Units Rate of Payment Method Used (Lease or Purchase) Unit Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 ATT Hotspot Hotspot to Laptops 4 laptop computers and peripherals will be used by CHW during outreach activities/ activities away from Blessed Beginnings staff to deliver services to clients in the NTACHC centersfield and office, assist with data collection, and facilitate communications. Hotspot to be paid monthly to AT&T. 18 $1,500 per computer x 4 staff = $6,000.00 Purchase $ 60.00 $ 1,080.00 6,000.00 100.00% $ 6,000.00 2 Printer/Copiers Printer/Copier lease for Blessed Beginnings staff to use in collecting documentation, data entry, and service delivery. $240 per month x 18 months x 0.50 = $1,080.00 2 Voyce Inc. Translation Services Translation services Lease $ 2,160.00 50.00% $ 1,080.00 3 Office Furniture Desks, chairs, file cabinets, table for patients with needing linguistic acommodations outside of English Blessed Beginnings staff to meet clients and Spanishconduct operations. Rate is $0.65 1,500 per minute of a voice call. Patient meetings with PCHW's last up to 90 minutes. Budget accounts for 5 meetings per year per patient, for a total of 30 patients. 13500 staff x 4 staff = $6,000.00 Purchase $ 0.65 $ 8,775.00 6,000.00 100.00% $ 8,775.00 3 Uber Health Transportation Services Arrange and pay for rides for clients who aren't able to make their appointments due to transportation issues. Average per ride $10 for 20 rides. 20 $ 10.00 $ 200.00 100.00% $ 200.00 6,000.00 4 0 $ - $ - 0.00% $ - 5 0 $ - $ - 0.00% $ - 6 0 $ - $ - 0.00% $ - 7 0 $ - $ - 0.00% $ - 8 0 $ - $ - 0.00% $ - 9 0 $ - $ - 0.00% $ - 10 0 $ - $ - 0.00% $ - 11 0 $ - $ - 0.00% $ - 12 0 $ - $ - 0.00% $ - 13 0 $ - $ - 0.00% $ - 14 0 $ - $ - 0.00% $ - 15 0 $ - $ - 0.00% $ - 16 0 $ - $ - 0.00% $ - 17 0 $ - $ - 0.00% $ - 18 0 $ - $ - 0.00% $ - 19 0 $ - $ - 0.00% $ - 20 0 $ - $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E Description Justification Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 Patient Education Materials Education Classes Patient Material - $1300 printing for 4 events a year. Printed handouts will include educational materials related to the event and agenda. $ 1,300.00 100.00% $ 1,300.00 2 Scientific Pregnancy Pelvis with Mature Fetus Model Anatomy model used for prenatal and childbirth classes and one-on-one education $ 354.24 100.00% $ 354.24 3 NASCO Kit My Plate Classroom My Plate model for healthy eating education $ 719.95 100.00% $ 719.95 4 Printer- Community Health Educator 2 HP- with scanner printer. Printer designated for the program, main uses consist of printing out education handouts and scanning individualized care plans into the patients chart. $ 760.00 100.00% $ 760.00 5 Breastfeeding Model Breastfeeding model for patient education. $ 150.00 100.00% $ 150.00 6 Child Birth Education Posters Educational materials for group classes and one-on-one education $ 150.68 100.00% $ 150.68 7 NTACHC Pregancy Handbook 300 Pregnancy and You printed copies -- 150 in English and 150 in Spanish at $15 per printed copy. $ 4,600.00 100.00% $ 4,600.00 8 Baby Emergency Needs An emergency baby supply warehouse will be stocked with (600) diapers at an average cost of $0.29 each, (25) 6 pack of baby clothes at $14.09 each, 25 cribs at $100 each, (30) cans of formula at $34.99 each. Additional items will be obtained through donations or additional grants. These items will serve to assist families immediate needs, not long term needs. Based on need we can provide these items. $ 3,139.62 100.00% $ 3,139.62 9 $ - 0.00% $ - 10 $ - 0.00% $ - 11 $ - 0.00% $ - 12 $ - 0.00% $ - 13 $ - 0.00% $ - 14 $ - 0.00% $ - 15 $ - 0.00% $ - 16 $ - 0.00% $ - 17 $ - 0.00% $ - 18 $ - 0.00% $ - 19 $ - 0.00% $ - 20 $ - 0.00% $ - 21 $ - 0.00% $ - 22 $ - 0.00% $ - 23 $ - 0.00% $ - 24 $ - 0.00% $ - 25 $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED66C45DD26-45D7DE5F-43D6-901581B8-A2B093FB9A4E E3D18F3AB105 FY24 Contractor: North Texas Area Community Health Centers, Inc. Catholic Charities of the Archdiocese of Galveston-Houston A B C D E Description Justification Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 Certification- Doula Paradigm Doula Certification Postage Postage to provide CHW's with additional skills to support mother facilitate client communications, service delivery, and families in the perinatal periodoutreach strategies. $150 per month x 18 months = $2,700.00 $ 1,000.00 2,700.00 100.00% $ 1,000.00 2,700.00 2 Certification- Doula Paradigm Doula Certification Program Specific Insurance Program specific insurance to align risk mitigation strategies with service delivery. Blessed Beginnings will provide CHW's with additional skills to support mother in home visits and families in the perinatal periodclient-focused scheduling requiring program-specific insurance coverage. $500 per month x 18 months = $9,000.00 $ 1,000.00 9,000.00 100.00% $ 1,000.00 9,000.00 3 Client Assistance Client assistance is used to engage clients and facilitate service planning and achievement. Client assistance includes housing assistance, pregnancy and infant supplies, class incentives, and other direct assistance. $342.42 per client x 240 clients = $82,181.59 $ - 4 Certified Childbirth Educator Three staff members will become certified in childbirth education through the paradigm doulas course. Each course is $104.12. $ 312.00 82,181.59 100.00% $ 312.00 82,181.59 4 Training Training to onboard staff and facilitate best practices in service delivery including trauma-informed care and other research-based methods. $500 per employee x 4 employees = $2,000.00 $ 2,000.00 100.00% $ 2,000.00 5 Data Analytics Office Space Rent Office space rent for programs in Harris, Fort Bend, and Visualization in Healthcare Certification The Health Education Specialist will acquire an online data analytics certificate from the Rochester Institute of Technology, Galveston counties to drive facilitate case management and other services. $25 per sq. ft. per year x 600 sq. ft. x 1.5 years = $22,500.00 $ 22,500.00 100.00% $ 22,500.00 6 Telephone Phones for Blessed Beginnings staff to facilitate communication between clients and staff for service delivery and program evaluation efforts successfully and through research- based practicesadministration. $20 per staff x 4 staff x 18 months = $1,440.00 $ 250.00 1,440.00 100.00% $ 1,440.00 7 $ - 0.00% $ - 8 $ - 0.00% $ - 9 $ - 0.00% $ - 10 $ - 0.00% $ - 11 Registered Nurse Licensing Renewal RN license renewal ($75) $ 75.00 100.00- 0.00% $ 75.00 - 12 $ - 0.00% $ - 13 $ - 0.00% $ - 14 $ - 0.00% $ - 15 $ - 0.00% $ - 16 $ - 0.00% $ - 17 $ - 0.00% $ - 18 $ - 0.00% $ - 19 $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED66C45DD26-45D7DE5F-43D6-901581B8-A2B093FB9A4E E3D18F3AB105 FY24 Pilot Project Contractor: North Texas Area Community Health Centers, Inc. Catholic Charities of the Archdiocese of Galveston-Houston Cost Category Item # Justification Attachment C_ CONTRACT AFFIRMATIONS For purposes of these Contract Affirmations, HHS includes both the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS). System Agency refers to HHSC, DSHS, or both, that will be a party to this Contract. These Contract Affirmations apply to all Contractors and Grantees (referred to as “Contractor”) regardless of their business form (e.g., individual, partnership, corporation). By entering into this Contract, Contractor affirms, without exception, understands, and agrees to comply with the following items through the life of the Contract:
1. Contractor represents and warrants that these Contract Affirmations apply to Contractor and all of Contractor's principals, officers, directors, shareholders, partners, owners, agents, employees, subcontractors, independent contractors, and any other representatives who may provide services under, who have a financial interest in, or otherwise are interested in this Contract and any related Solicitation.
Appears in 1 contract
Samples: Grant Agreement
HHSC MONITORING ACTIVITIES. A. HHSC will monitor the performance of contract awarded under this Grant Agreement. Monitoring activities will be conducted by HHSC for fiscal, programmatic, and administrative components of the Grant Agreement. All services and deliverables under the Grant Agreement must be provided at an acceptable quality level and in a manner consistent with Grant Agreement and program requirements and HHSC Uniform Terms and Conditions.
B. Monitoring activities may include, but are not limited to, the following:
1. Any findings regarding performance of internal quality assurance;
2. Any training needs identified and resulting actions; and
3. Any corrective action taken and the resolution of any issues; and
4. Other Project information determined relevant by HHSC.
C. Xxxxxxx agrees to cooperate fully and assist with the coordination of the activities that include, but are not limited to, the following:
1. Periodic site visits to monitor for compliance with federal and state requirements of the Grant Agreement; and
2. Adherence to the requirements set forth in this Grant Agreement.
D. If individual program compliance or performance is lacking, corrective action recommendations will be made through the Grant Agreement performance improvement plans. HHSC reserves the right to impose remedies as set forth in Section 9.1 (Remedies) of the Uniform Terms and Conditions.
E. HHSC reserves the right, where allowed by legal authority, to redirect funds in the event of an financial shortfall by Xxxxxxx. HHSC will monitor Xxxxxxx’s expenditures on a monthly basis. DocuSign Envelope ID: A359C78F-2ED63B2977A2-45D7263A-4A2D-9320-9015-A2B093FB9A4E 72452204CA28 FY24 Contractor: North Texas Area Community Health CentersMotivation Education & Training, Inc. A B C D E F G Staff Position Justification Monthly Salary No. of Months Annual Salary Percent applied to HHSC contract Amount budgeted to HHSC contract 1 Community Health Educator-Certified Health Education Specialist The Community Health Educator administrates the programDirector of Special Programs Administrative oversight for Montgomery, leads evaluation Liberty, Xxxxxx, and training efforts Polk County. Rate of pay $97,890.00 annually and develops health promotion campaigns then allocated THV 34% / HOPES 16% / HOPES CBCAP 2% / HOPES HMG 3% / FHD FIRE 18% / FHD EFFECT 3% / SCSEP TX 6% / SCSEP MN 6% / SMVF 5% / TTF 7% = 100%. Actual hours worked for NTACHCTTFP approx. 58% of this salary is being covered by other funding195 hours annually. $ 4,216.00 18 8,194.41 17 $ 75,888.00 42.00139,304.97 7.00% $ 31,872.96 9,751.35 2 Community Health Educator-Registered Nurse The Community Health Educator-RN supervises the Maternal Child Health programOperations Manager Administrative oversight for Montgomery, leads evaluation Liberty, Xxxxxx, and training efforts Polk County. Rate of pay $60,255.00 annually and develops health education curriculum then allocated THV 39% / HOPES 18% / HOPES CBCAP 2% / HOPES HMG 4% / FHD FIRE 20% / FHD EFFECT 4% / SMVF 5% / TTF 8% = 100%. Actual hours worked for PCHW'sTTFP approx. Supervises program staff and conducts classes and education for program participants222 hours annually. $ 6,413.00 18 5,043.97 17 $ 115,434.00 85,747.49 8.00% $ 6,859.80 3 TTFP Project Manager Programmatic leadership for Xxxxxxxxxx, Liberty, Xxxxxx, and Polk County. Rate of pay $25.00 hourly, annual salary $48,750.00, budget reflects 17 month project period. $ 4,080.88 17 $ 69,374.96 100.00% $ 115,434.00 3 Perinatal 69,374.96 4 TTFP Family Advocate Provide direct service through TTFP sessions and Community Health Worker (PCHW) Open- PCHW will provide community resource referralsAdvocacy / Rate of Pay $19.00 hourly, education and support to families in the perinatal annual salary $37,050.00, budget reflects 17 month project period. Salary is based on a competitive salary for community based doulas in Texas. $ 4,166.00 16 3,101.47 17 $ 66,656.00 52,724.99 100.00% $ 66,656.00 4 Perinatal 52,724.99 5 TTFP Family Advocate Provide direct service through TTFP sessions and Community Health Worker (PCHW) Open- PCHW will provide community resource referralsAdvocacy / Rate of Pay $19.00 hourly, education and support to families in the perinatal annual salary $37,050.00, budget reflects 17 month project period. Salary is based on a competitive salary for community based doulas in Texas. $ 4,166.00 16 3,101.47 17 $ 66,656.00 52,724.99 100.00% $ 66,656.00 5 52,724.99 6 TTFP Family Advocate Provide direct service through TTFP sessions and Community Advocacy / Rate of Pay $19.00 hourly, annual salary $37,050.00, budget reflects 17 month project period. $ 3,101.47 17 $ 52,724.99 100.00% $ 52,724.99 7 $ - 0 $ - 0.00100.00% $ - 6 Outreach Specialist Attends outreach events to promote health and NTACHC's services. 8 $ 3,571.00 18 $ 64,278.00 25.00% $ 16,069.50 7 Peer educator Open Part-time hourly worker at a rate of $15.00/hr. 20 hours a week. Peer educator will serve as a faciliator during group classes and provide their input for program impovement efforts. $ 1,200.00 6 $ 7,200.00 - 100.00% $ 7,200.00 8 Peer educator Open Part-time hourly worker at a rate of $15.00/hr. 20 hours a week. Peer educator will serve as a faciliator during group classes and provide their input for program impovement efforts. $ 1,200.00 6 $ 7,200.00 100.00% $ 7,200.00 - 9 $ - 0 $ - 0.00% $ - 10 $ - 0 $ - 0.00% $ - 11 $ - 0 $ - 0.00% $ - 12 $ - 0 $ - 0.00% $ - 13 $ - 0 $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED63B2977A2-45D7263A-4A2D-9320-9015-A2B093FB9A4E 72452204CA28 FY24 Contractor: North Texas Area Community Health CentersMotivation Education & Training, Inc. A B C D E F G H I J K Staff Position FICA & Medicare Workers' Compensation State Unemployment Insurance Health Insurance Life Insurance Dental Insurance Retirement Other - See Supplemental Justification Page Subtotals 1 Community Health Educator- Director of Special Programs Gross $ 5,805.43 10,656.83 $ 119.14 2,577.14 $ 93.34 1,121.43 $ 9,828.00 12,432.00 $ 75.89 32.00 $ - 368.14 ######### $ 1,517.76 1,516.57 $ - $ 17,439.56 42.0047,714.40 7.00% $ 2,438.28 745.98 $ 50.04 180.40 $ 39.20 78.50 $ 4,127.76 870.24 $ 31.87 2.24 $ - 25.77 $ 637.46 1,330.72 $ - 106.16 $ 7,324.61 3,340.01 2 Community Health Educator- Operations Manager Gross $ 8,830.70 6,559.68 $ 181.23 1,586.38 $ 141.98 1,121.38 $ 9,828.00 12,432.00 $ 115.43 32.00 $ - 368.13 $ 2,308.68 4,633.13 $ - 981.13 $ 21,406.02 27,713.83 8.00% $ 524.77 $ 126.91 $ 89.71 $ 994.56 $ 2.56 $ 29.45 $ 370.65 $ 78.49 $ 2,217.10 3 TTFP Project Manager Gross $ 5,307.18 $ 1,283.44 $ 1,121.40 $ 12,432.00 $ 31.96 $ 368.15 $ 2,690.27 $ 817.33 $ 24,051.73 100.00% $ 8,830.70 5,307.18 $ 181.23 1,283.44 $ 141.98 1,121.40 $ 9,828.00 12,432.00 $ 115.43 31.96 $ - 368.15 $ 2,308.68 2,690.27 $ - 817.33 $ 21,406.02 3 Perinatal Community Health Worker 24,051.73 4 TTFP Family Advocate Gross $ 5,099.18 4,033.46 $ 117.73 975.41 $ 92.24 1,121.40 $ 9,828.00 12,432.00 $ 74.99 31.96 $ - 368.15 $ 1,499.76 1,850.00 $ - 650.83 $ 16,711.90 21,463.21 100.00% $ 5,099.18 4,033.46 $ 117.73 975.41 $ 92.24 1,121.40 $ 9,828.00 12,432.00 $ 74.99 31.96 $ - 368.15 $ 1,499.76 1,850.00 $ - 650.83 $ 16,711.90 4 Perinatal Community Health Worker 21,463.21 5 TTFP Family Advocate Gross $ 5,099.18 4,033.46 $ 117.73 975.41 $ 92.24 1,121.40 $ 9,828.00 12,432.00 $ 74.99 31.96 $ - 368.15 $ 1,499.76 1,850.00 $ - 650.83 $ 16,711.90 21,463.21 100.00% $ 5,099.18 4,033.46 $ 117.73 975.41 $ 92.24 1,121.40 $ 9,828.00 12,432.00 $ 74.99 31.96 $ - 368.15 $ 1,499.76 1,850.00 $ - 650.83 $ 16,711.90 21,463.21 6 TTFP Family Advocate Gross $ 4,033.46 $ 975.41 $ 1,121.40 $ 12,432.00 $ 31.96 $ 368.15 $ 1,850.00 $ 650.83 $ 21,463.21 100.00% $ 4,033.46 $ 975.41 $ 1,121.40 $ 12,432.00 $ 31.96 $ 368.15 $ 1,850.00 $ 650.83 $ 21,463.21 7 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00100.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 6 Outreach Specialist 8 0 Gross $ 4,917.27 $ 100.92 $ 79.06 $ 9,828.00 $ 64.28 $ - $ 1,285.56 $ - $ 16,275.09 25.00100.00% $ 1,229.32 $ 25.23 $ 19.77 $ 2,457.00 $ 16.07 $ - $ 321.39 $ - $ 4,068.78 7 Peer educator Gross $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 100.00% $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 8 Peer educator Gross $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 100.00% $ 550.80 $ 11.30 $ 8.86 $ - $ - $ - $ - $ - $ 570.96 9 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 10 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - 11 0 Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - 0.00% $ - $ - $ - $ - $ - $ - $ - $ - $ - Gross $ - $ - $ - $ - $ - $ - $ - $ - $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Part 2 - Local/Other Travel A B C D E F G H I Local/Other Travel Description Justification No. of Miles Mileage Rate Mileage Cost Other Travel Cost Cost PercentApplied to HHSC Contract Amount Budgeted to HHSC Contract 1 Health Fairs Staff will attend 4 health fairs and other local events a month to provide the public with education and information on the program. Costs will cover health fair registration and mileage. 200 $ 0.670 $ 134.00 $ 600.00 $ 734.00 100.00% $ 734.00 2 0 $ - $ - $ - $ - 0.00% $ - 3 0 $ - $ - $ - $ - 0.00% $ - 4 0 $ - $ - $ - $ - 0.00% $ - 5 0 $ - $ - $ - $ - 0.00% $ - 6 0 $ - $ - $ - $ - 0.00% $ - 7 0 $ - $ - $ - $ - 0.00% $ - 8 0 $ - $ - $ - $ - 0.00% $ - 9 0 $ - $ - $ - $ - 0.00% $ - 10 0 $ - $ - $ - $ - 0.00% $ - 11 0 $ - $ - $ - $ - 0.00% $ - 12 0 $ - $ - $ - $ - 0.00% $ - 13 0 $ - $ - $ - $ - 0.00% $ - 14 0 $ - $ - $ - $ - 0.00% $ - 15 0 $ - $ - $ - $ - 0.00% $ - 16 0 $ - $ - $ - $ - 0.00% $ - 17 0 $ - $ - $ - $ - 0.00% $ - 18 0 $ - $ - $ - $ - 0.00% $ - 19 0 $ - $ - $ - $ - 0.00% $ - 20 0 $ - $ - $ - $ - 0.00% $ - 21 0 $ - $ - $ - $ - 0.00% $ - 22 0 $ - $ - $ - $ - 0.00% $ - 23 0 $ - $ - $ - $ - 0.00% $ - 24 0 $ - $ - $ - $ - 0.00% $ - 25 0 $ - $ - $ - $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health CentersMotivation Education & Training, Inc. A B C D E F G H Contractor Name Description Justification No. of Units Rate of Payment Cost Percent Applied to HHSC Contract Amount Budgeted Description Justification Contract to HHSC Contract 1 ATT Hotspot Hotspot Consumable Supplies for Training Sessions MET will run 5 cohorts of 22 individuals (curriculum fidelity) per advocate each quarter. Each cohort will receive parenting classes through the Triple P parenting program, health marriage classes through the Within my Reach curriculum and Financial Literacy Training through local community partners such as Bank of America. There are fifteen sessions in each cohort. Through the duration of the project period there is a total of 225 Sessions. (5/ Cohorts X 15/ Sessons X 3/ Advocates ). These sessions are estimated at a cost of $50.00 each to be used by CHW during outreach activities/ activities away from the NTACHC centersimplement evidenced based curriculum. Hotspot $50 X 225/ Sessions = $11,250.00. This costs includes items such as tablets for note taking, chart paper, markers, and other miscellaneous items to be paid monthly to AT&T. 18 support sessions and curriculum. $ 60.00 $ 1,080.00 11,250.00 100.00% $ 1,080.00 11,250.00 2 Voyce Inc. Translation Services Translation services Infant Care and Pregnancy Supplies Basic Needs Essential Support, based on the RFA suggestions for patients Infant Care and Pregnancy Supplies will cover the costs of items such as cribs, car seats, maternity clothes, formula, diapers, wipes, and other approved items. This cost category is related to any additional expenses needed to provide support for the eligible population of families with needing linguistic acommodations outside infant children. MET estimates that one hundred sixty-four (164), 50% of English the budget, will qualify for receiving provision of supplies for infant care and Spanishpregnancy. Rate is These supplies are estimated at a cost per participant of $0.65 per minute of a voice call350.00 each. Patient meetings with PCHW's last up to 90 minutesTotal Annual estimate $350.00 / E X 164 participants = $57,400.00. Budget accounts for 5 meetings per year per patient, for a total of 30 patients. 13500 $ 0.65 $ 8,775.00 57,400.00 100.00% $ 8,775.00 57,400.00 3 Uber Health Transportation Services Arrange and pay Office Supplies Estimated at $100.00 Per Staff Member (5 staff) Per Month (17 Months) for rides for clients who aren't able to make their appointments due to transportation issuesthe purchase of paper, pens, toner, etc. Average per ride $10 for 20 rides100.00/E X 5/Staff X 17/ Months = $8,500.00. 20 $ 10.00 $ 200.00 8,500.00 100.00% $ 200.00 8,500.00 4 0 Technology (controlled assets) Five (5) new TTFP staff will need initial technology set up to have the correct tools to enter data and perform program monitoring and operational activities for Thriving Texas Families Program. Initial set up of hardware includes laptop, printer, cables, and mouse. In addition, software, virus protection and security will be needed. This will include the purchase and subscriptions to Adobe, Microsoft 365, Zoom Video Communication, Virus Protection - Comodo, and Cisco Meraki. The total cost is estimated at $1,500.00 for new set up. $1,500.00/ E X 5/ Staff = $7,500.00. Subscription service renewals are due after annual anniversary date. Renewal subscriptions are estimated at $225.00 each for the six TTFP staff. $225.00/ Each X 5/ Staff = $1,125.00. In addition, the purchase of a copier to facilitate the TTFP program and supplies for the 17 month duration of project is estmated at $1,695.15. Total cost of technology for the project period $7,500.00 + $1,125.00 + $1,695.15 = $10,320.15. $ - $ - 0.0010,320.15 100.00% $ 10,320.15 5 Outreach Materials Outreach Materials - 5 0 Recruitment Supplies and resources such as brochures and pamphlets, which will support Infant Care and Pregnancy. These outreach materials will be made available for families in Montgomery, Liberty, Hardin, and Xxxx Counties. Estimated cost for each county includes Handouts ($500.00), Pamphlets ($400.00), Postcards ($500.00), Presentation Folders ($500.00) and other outreach materials to support dissemination of information to the community. Total per county $500.00 + $400.00 + $500.00 + $500.00 = $1,900.00. Total cost of three Offices 3 / Offices X $1,900.00 = $5,700.00. Outreach materials are provided to approximately 1,000 families throughout the four counties for the duration of project period. $ - $ - 0.005,700.00 100.00% $ - 6 0 $ - $ - 0.00% $ - 7 0 $ - $ - 0.00% $ - 8 0 $ - $ - 0.00% $ - 9 0 $ - $ - 0.00% $ - 10 0 $ - $ - 0.00% $ - 11 0 $ - $ - 0.00% $ - 12 0 $ - $ - 0.00% $ - 13 0 $ - $ - 0.00% $ - 14 0 $ - $ - 0.00% $ - 15 0 $ - $ - 0.00% $ - 16 0 $ - $ - 0.00% $ - 17 0 $ - $ - 0.00% $ - 18 0 $ - $ - 0.00% $ - 19 0 $ - $ - 0.00% $ - 20 0 $ - $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E FY24 5,700.00 Contractor: North Texas Area Community Health CentersMotivation Education & Training, Inc. A B C D E Description Justification Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 Patient Education Materials Education Classes Patient Material Space Cost for TTFP Program Space Cost for TTFP ProgramSpace Cost consists of Rent, Utilities, and Other Space Costs. The Thriving Texas Families Program will be officed in a facility shared with two of MET’s current grant programs, Fatherhood Fire and Fatherhood Effect. Space Cost is allocated b/w - EFFECT 11% / FIRE 58% / TTFP 31%. The building has a monthly rental rate of $1300 printing 4,500, which equals $76,500 for 4 events a yearthe duration of project period. Printed handouts will include educational materials related Allocated Rent Cost for TTPF is $76,500 X 31% TTFP Allocation % = $23,715.00. The average cost of Other Space Cost such as utilities, janitorial and other miscellaneous costs are estimated to the event and agendabe at approximately $5,000 per duration of project period. The TTFP Allocated portion is $5,000 X 31% = $1,550.00. Total Annual Space Cost for TTFP is $23,715.00 + $1,550.00 = $25,265.00. $ 1,300.00 81,500.00 31.00% $ 25,265.00 2 Insurance-General Liability Annual Insurance Premium, One Time Fee, to be paid in October - General Contents Liability Insurance $700.00 Annually. Project period ends in August; unless otherwise extended. $ 700.00 100.00% $ 1,300.00 2 Scientific Pregnancy Pelvis with Mature Fetus Model Anatomy model used for prenatal 700.00 3 Human Resources Screening Estimated annual DMV $6.00 per 5 Staff, renewal due on annual anniversary, two sets of reports will be required during TTFP project Period. $6.00/ Each X 5/ Staff X 2/ Sets = $60.00 / Fingerprint Estimated 5 @54.00 = $270.00 = Total DMV and childbirth classes and one-on-one education Fingerprint during scope of project $60.00 + $270.00 = $330.00. $ 354.24 330.00 100.00% $ 354.24 3 NASCO Kit My Plate Classroom My Plate model for healthy eating education 330.00 4 Cell Phone Verizon - 5 Cell Phones Average $72.00 A Month Per Unit X 17 Months. 5/ Staff X $72.00 / E X 17 Months of Project Period = $6,120.00. $ 719.95 6,120.00 100.00% $ 719.95 4 Printer- Community Health Educator 2 HP- with scanner printer6,120.00 5 $ - 6 Storage Costs Public Storage is a monthly bill and will be used for the exclusive use of the TTFP program and is not allocated. Printer designated Storage is used for large items such as cribs, car seats, outreach materials, folding tables, chairs, ladders, step stools, fans, etc. Storage is also used to keep additional supplies that are used in group connections, outreach events, and cohorts. The lease agreement is estimated at $175.00 per month. The annual rate is $175.00 x 17/Months = $2,975.00. $ 2,975.00 100.00% $ 2,975.00 7 TTFP Parent Leadership Council Meetings To elevate Infant and Pregnancy services offered to each county; MET will form a Thriving Texas Family Parent Leadership Council which will meet every other month to share in policy making and planning for the program, main uses . The council will consist of printing out education handouts eight members with two representatives from each of the four counties – Montgomery, Liberty, Polk and scanning individualized care plans into the patients chartHardin. Estimated cost for supplies are $50.00 per meeting. 9/ Meetings during project period X $50.00/ Each = $450.00. $ 760.00 450.00 100.00% $ 760.00 5 Breastfeeding Model Breastfeeding model for patient education450.00 8 Training Programs / Certifications Educational Programs / Vocational Certificates - Various certification-based programs (Private or Corporate Security, Forklift, Safety/ Hazcom Training, Authorized & Competent Climber & Capstain Hoist, Graphic Design, Pesticide Application, etc.). Estimated at $500 per training, 164 participants (50% of the 328 enrolled) will engage in certificate training. (Avg. $500 X 164/P = $82,000). $ 150.00 82,000.00 100.00% $ 150.00 6 Child Birth Education Posters Educational materials 82,000.00 9 Professional Development Facilitator training for group classes and one“Triple P-on-one education Positive Parenting Program” curriculum @ $2,850.00 each for five TTFP newly hired staff. Total 5/E X $2,850.00 = $14,250.00 $ 150.68 14,250.00 100.00% $ 150.68 7 NTACHC Pregancy Handbook 300 Pregnancy and You printed copies -- 150 in English and 150 in Spanish at 14,250.00 10 Professional Development Advocate Curriculum training for “Within My Reach” curriculum @ $15 per printed copy700.00 each for five TTFP newly hired staff. Total 5/E X $700.00 = $3,500.00. $ 4,600.00 3,500.00 100.00% $ 4,600.00 8 Baby Emergency Needs An emergency baby supply warehouse will be stocked with (600) diapers at an average cost of $0.29 each, (25) 6 pack of baby clothes at $14.09 each, 25 cribs at $100 each, (30) cans of formula at $34.99 each. Additional items will be obtained through donations or additional grants. These items will serve to assist families immediate needs, not long term needs. Based on need we can provide these items. $ 3,139.62 100.00% $ 3,139.62 9 $ - 0.00% $ - 10 $ - 0.00% $ - 3,500.00 11 $ - 0.00% $ - 12 $ - 0.00% $ - 13 $ - 0.00% $ - 14 $ - 0.00% $ - 15 $ - 0.00% $ - 16 $ - 0.00% $ - 17 $ - 0.00% $ - 18 $ - 0.00% $ - 19 $ - 0.00% $ - 20 $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED63B2977A2-45D7263A-4A2D-9320-9015-A2B093FB9A4E FY24 Contractor: North Texas Area Community Health Centers, Inc. A B C D E Description Justification Cost Percent Applied to HHSC Contract Amount Budgeted to HHSC Contract 1 Certification- Doula Paradigm Doula Certification to provide CHW's with additional skills to support mother and families in the perinatal period. $ 1,000.00 100.00% $ 1,000.00 2 Certification- Doula Paradigm Doula Certification to provide CHW's with additional skills to support mother and families in the perinatal period. $ 1,000.00 100.00% $ 1,000.00 3 $ - 4 Certified Childbirth Educator Three staff members will become certified in childbirth education through the paradigm doulas course. Each course is $104.12. $ 312.00 100.00% $ 312.00 5 Data Analytics and Visualization in Healthcare Certification The Health Education Specialist will acquire an online data analytics certificate from the Rochester Institute of Technology, to drive program evaluation efforts successfully and through research- based practices. $ 250.00 $ - 11 Registered Nurse Licensing Renewal RN license renewal ($75) $ 75.00 100.00% $ 75.00 12 $ - 0.00% $ - 13 $ - 0.00% $ - 14 $ - 0.00% $ - 15 $ - 0.00% $ - 16 $ - 0.00% $ - 17 $ - 0.00% $ - 18 $ - 0.00% $ - 19 $ - 0.00% $ - DocuSign Envelope ID: A359C78F-2ED6-45D7-9015-A2B093FB9A4E 72452204CA28 FY24 Pilot Project Contractor: North Texas Area Community Health CentersMotivation Education & Training, Inc. Cost Category Item # Justification Attachment C_ CONTRACT AFFIRMATIONS For purposes 1 Fringe Benefit- Vision United Health Care - Employer vision contributions are paid at a rate of these Contract Affirmations$3.24 per employee bi-weekly. Employer based Vision Insurance is payable when employee reaches 60 days of employment. 2 Fringe Benefit- Disability Blue Cross Blue Shield $.307/$10 payroll, HHS includes both the Health and Human Services Commission (HHSC) and the Department with maximum base compensation of State Health Services (DSHS)$2,142.86/wk. System Agency refers Employer based Short Term Disability is payable when employee reaches first year anniversary. Blue Cross Blue Shield $.608/$100 of payroll, limited to HHSC, DSHS, or both, that will be a party to this Contractbase compensation of $10,494.75/month. These Contract Affirmations apply to all Contractors and Grantees (referred to as “Contractor”) regardless of their business form (e.g., individual, partnership, corporation). By entering into this Contract, Contractor affirms, without exception, understands, and agrees to comply with the following items through the life of the Contract:
1. Contractor represents and warrants that these Contract Affirmations apply to Contractor and all of Contractor's principals, officers, directors, shareholders, partners, owners, agents, employees, subcontractors, independent contractors, and any other representatives who may provide services under, who have a financial interest in, or otherwise are interested in this Contract and any related Solicitation.Employer based Long Term Disability is payable when employee reaches first year anniversary
Appears in 1 contract
Samples: Grant Agreement
