Common use of Programmatic Reporting Requirements Clause in Contracts

Programmatic Reporting Requirements. Report Name Frequency Period Begin Period End Due Date Annual Progress Report Annually Sept. 1, 2024 August 31, 2025 April 1, 2025 Financial Status Report (FSR) Biannually Sept. 1, 2024 Feb. 28, 2025 March 31, 2025 FSR Biannually March 1, 2025 August 31, 2025 September 30, 2025 Final Quarter-Match Reimbursement / Certification Form - Annually June 1, 2025 August 31, 2025 September 30, 2025 Cohort Review Periods and Submission Schedule Cohort period cases counted in: Are reviewed and reported by: First quarter (Jan 1 Mar 31) current year Mar 31 of the following year Second quarter (Apr 1 Jun 30) current year Jun 30 of the following year Third quarter (Jul 1 Sep 30) current year Sep 30 of the following year Fourth quarter (Oct 1 Dec 31) current year Dec 31 of the following year Submission Instructions: Annual Report: Submit program reports to the TB Reporting Mailbox: XXXxxxxxxxXxxxxxxxx@xxxx.xxxxx.xxx Financial Reports (FSRs, B-13s, and B-13A) Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx X.X. Xxx 149347 Austin, Texas 00000-0000 Fax: (000) 000-0000 Email: xxxxxxxx@xxxx.xxxxx.xxx and XXXxxxxxxxx@xxxx.xxxxx.xxx Attachment B FY25 Budget Budget FY25 Budget Category DSHS Funds Cash Match Category Total Personnel $37,509.00 $1,103.00 $38,612.00 Fringe Benefits $15,257.00 $441.00 $15,698.00 Travel $402.00 $402.00 $804.00 Equipment $0.00 $0.00 $0.00 Supplies $346.00 $8,132.00 $8,478.00 Contractual $0.00 $0.00 $0.00 Other $0.00 $624.00 $624.00 Total Direct Costs $53,514.00 $10,702.00 $64,216.00 Indirect Costs $0.00 $0.00 $0.00 Totals: $53,514.00 $10,702.00 $64,216.00 Health and Human Services (HHS) Uniform Terms and Conditions - Grant Version 3.3 Published and Effective – November 2023 Responsible Office: Chief Counsel ABOUT THIS DOCUMENT In this document, Grantees (also referred to in this document as subrecipients or contractors) will find requirements and conditions applicable to grant funds administered and passed through by both the Texas Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS). These requirements and conditions are incorporated into the Grant Agreement through acceptance by Grantee of any funding award by HHSC or DSHS. The terms and conditions in this document are in addition to all requirements listed in the RFA, if any, under which applications for this grant award are accepted, as well as all applicable federal and state laws and regulations. Applicable federal and state laws and regulations may include, but are not limited to: 2 CFR Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards; requirements of the entity that awarded the funds to HHS; Chapter 783 of the Texas Government Code; Texas Comptroller of Public Accounts’ agency rules (including Uniform Grant and Contract Standards set forth in Title 34, Part 1, Chapter 20, Subchapter E, Division 4 of the Texas Administrative Code); the Texas Grant Management Standards (TxGMS) developed by the Texas Comptroller of Public Accounts; and the Funding Announcement, Solicitation, or other instrument/documentation under which HHS was awarded funds. HHS, in its sole discretion, reserves the right to add requirements, terms, or conditions. TABLE OF CONTENTS

Programmatic Reporting Requirements. Report Name Frequency Period Begin Period End Due Date FY20 Annual Progress Narrative Report Annually Sept. Jan. 1, 2024 August 2020 Dec. 31, 2025 2020 April 1, 2025 2021 FY21 Annual Narrative Report Annually Jan. 1, 2021 Dec. 31, 2021 April 1, 2022 Financial Status Report (FSR) Biannually Sept. & Match Reimbursement/Certification Form (B-13A) Quarterly Jan. 1, 2024 Feb. 28, 2025 March 2021 Mar. 31, 2025 2021 April 30, 2021 FSR Biannually March & Form B-13A Quarterly April 1, 2025 August 2021 June 30, 2021 July 31, 2025 September 2021 FSR & Form B-13A Quarterly July 1, 2021 Sept. 30, 2025 Final Quarter-Match Reimbursement / Certification Form - Annually June 1, 2025 August 2021 Oct. 31, 2025 September 302021 FSR & Form X-00X Xxxxxxxxx Xxx. 0, 2025 Cohort Review Periods and Submission Schedule Cohort period cases counted in: Are reviewed and reported by: First quarter (Jan 1 Mar 0000 Xxx. 31) current year Mar 31 of the following year Second quarter (Apr 1 Jun 30) current year Jun 30 of the following year Third quarter (Jul 1 Sep 30) current year Sep 30 of the following year Fourth quarter (Oct 1 Dec 31) current year Dec 31 of the following year , 2021 Feb. 15, 2022 Annual Report Submission Instructions: Annual Report: Submit program reports to the TB Reporting MailboxMailbox at XXXxxxxxxxXxxxxxxxx@xxxx.xxxxx.xxx. The DSHS TB Program will provide the form and format for the Annual Narrative Report. The Annual Narrative Report will be a separate report for the Grantee and must not be included with reports for the Region. ATTACHMENT B-1 FY2021 BUDGET Grantee: XXXxxxxxxxXxxxxxxxx@xxxx.xxxxx.xxx Financial Reports (FSRs, B-13s, and B-13A) Department of State Collin County Health Care Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx X.X. Xxx 149347 Austin, Texas 00000Program ID: TB/PC-0000 FaxFederal Contract Number: (000) 000-0000 Email: xxxxxxxx@xxxx.xxxxx.xxx and XXXxxxxxxxx@xxxx.xxxxx.xxx Attachment B FY25 HHS000686100011 Budget Budget FY25 Budget Category Categories DSHS Funds Cash Match Category Total Personnel $37,509.00 57,902.00 $1,103.00 16,785.00 $38,612.00 74,687.00 Fringe Benefits $15,257.00 25,228.00 $441.00 6,092.00 $15,698.00 31,320.00 Travel $402.00 5,498.00 $402.00 0.00 $804.00 5,498.00 Equipment $0.00 $0.00 $0.00 Supplies $346.00 $8,132.00 $8,478.00 Contractual 9,767.00 $0.00 $0.00 9,767.00 Contractual $0.00 Other 4,650.00 $0.00 $624.00 4,650.00 Other $624.00 11,341.00 $0.00 $11,341.00 Total Direct Costs $53,514.00 114,386.00 $10,702.00 22,877.00 $64,216.00 137,263.00 Indirect Costs $0.00 .00 $0.00 $0.00 Totals: $53,514.00 114,386.00 $10,702.00 22,877.00 $64,216.00 137,263.00 Page 8 of 8 Certificate Of Completion Envelope Id: DCBAF86FA4E94DE6B743B09610E02ACD Status: Sent Subject: Amending $274,526; HHS000686100011; Collin County Health and Human Care Services (HHS) Uniform Terms and Conditions - Grant Version 3.3 Published and Effective – November 2023 Responsible OfficeA-1; DSHS/LIDS/TB-FED Source Envelope: Chief Counsel ABOUT THIS DOCUMENT In this document, Grantees (also referred to in this document as subrecipients or contractors) will find requirements and conditions applicable to grant funds administered and passed through by both the Document Pages: 12 Signatures: 0 Envelope Originator: Certificate Pages: 2 Initials: 0 Texas Health and Human Services Commission AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (HHSCUTC-06:00) Central Time (US & Canada) 0000 X. 00xx Xx. Xxxxxx, XX 00000 XXX_XxxxXxxx@xxxx.xxxxx.xx.xx IP Address: 167.137.1.15 Record Tracking Status: Original 9/30/2020 2:32:00 PM Holder: Texas Health and the Department of State Health Human Services Commission XXX_XxxxXxxx@xxxx.xxxxx.xx.xx Location: DocuSign Signer Events Signature Timestamp Xxxxx Xxxx xxxxx@xx.xxxxxx.xx.xx Security Level: Email, Account Authentication (DSHS). These requirements None) Electronic Record and conditions are incorporated into the Grant Agreement through acceptance by Grantee of any funding award by HHSC or DSHS. The terms Signature Disclosure: Not Offered via DocuSign Xxxxxx Xxxxxx XxxxxxX.Xxxxxx@xxxx.xxxxx.xxx Security Level: Email, Account Authentication (None) Electronic Record and conditions in this document are in addition to all requirements listed in the RFASignature Disclosure: Not Offered via DocuSign Sent: 9/30/2020 2:40:00 PM In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp CMS inbox xxxxxxxxxxxx@xxxx.xxxxx.xxx Security Level: Email, if anyAccount Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Xxxxxx Xxxxxx Xxxxxx.Xxxxxx@xxxx.xxxxx.xxx CMS Branch Manager Security Level: Email, under which applications for this grant award are acceptedAccount Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Sent: 9/30/2020 2:40:00 PM Sent: 9/30/2020 2:39:59 PM Viewed: 10/1/2020 7:39:18 AM Carbon Copy Events Status Timestamp Xxxxx Xxxxxx xxxxxxxx@xx.xxxxxx.xx.xx Security Level: Email, as well as all applicable federal Account Authentication (None) Electronic Record and state laws and regulations. Applicable federal and state laws and regulations may include, but are not limited toSignature Disclosure: 2 CFR Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards; requirements of the entity that awarded the funds to HHS; Chapter 783 of the Texas Government Code; Texas Comptroller of Public Accounts’ agency rules (including Uniform Grant and Contract Standards set forth in Title 34, Part 1, Chapter 20, Subchapter E, Division 4 of the Texas Administrative Code); the Texas Grant Management Standards (TxGMS) developed by the Texas Comptroller of Public Accounts; and the Funding Announcement, Solicitation, or other instrumentNot Offered via DocuSign Sent: 9/30/2020 2:40:00 PM Viewed: 10/26/2020 8:24:16 AM Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/documentation under which HHS was awarded funds. HHS, in its sole discretion, reserves the right to add requirements, terms, or conditions. TABLE OF CONTENTSEncrypted 9/30/2020 2:40:01 PM

Programmatic Reporting Requirements. Report Name Frequency Period Begin Period End Due Date FY20 Annual Progress Narrative Report Annually Sept. Jan. 1, 2024 August 2020 Dec. 31, 2025 2020 April 1, 2025 2021 FY21 Annual Narrative Report Annually Jan. 1, 2021 Dec. 31, 2021 April 1, 2022 Financial Status Report (FSR) Biannually Sept. & Match Reimbursement/Certification Form (B-13A) Quarterly Jan. 1, 2024 Feb. 28, 2025 March 2021 Mar. 31, 2025 2021 April 30, 2021 FSR Biannually March & Form B-13A Quarterly April 1, 2025 August 2021 June 30, 2021 July 31, 2025 September 2021 FSR & Form B-13A Quarterly July 1, 2021 Sept. 30, 2025 Final Quarter-Match Reimbursement / Certification Form - Annually June 1, 2025 August 2021 Oct. 31, 2025 September 302021 FSR & Form X-00X Xxxxxxxxx Xxx. 0, 2025 Cohort Review Periods and Submission Schedule Cohort period cases counted in: Are reviewed and reported by: First quarter (Jan 1 Mar 0000 Xxx. 31) current year Mar 31 of the following year Second quarter (Apr 1 Jun 30) current year Jun 30 of the following year Third quarter (Jul 1 Sep 30) current year Sep 30 of the following year Fourth quarter (Oct 1 Dec 31) current year Dec 31 of the following year , 2021 Feb. 15, 2022 Annual Report Submission Instructions: Annual Report: Submit program reports to the TB Reporting MailboxMailbox at XXXxxxxxxxXxxxxxxxx@xxxx.xxxxx.xxx. The DSHS TB Program will provide the form and format for the Annual Narrative Report. The Annual Narrative Report will be a separate report for the Grantee and must not be included with reports for the Region. ATTACHMENT B-1 FY2021 BUDGET Grantee: XXXxxxxxxxXxxxxxxxx@xxxx.xxxxx.xxx Financial Reports (FSRs, B-13s, and B-13A) Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx X.X. Xxx 149347 Austin, Texas 00000Fort Bend County Program ID: TB/PC-0000 FaxFederal Contract Number: (000) 000-0000 Email: xxxxxxxx@xxxx.xxxxx.xxx and XXXxxxxxxxx@xxxx.xxxxx.xxx Attachment B FY25 HHS000686100015 Budget Budget FY25 Budget Category Categories DSHS Funds Cash Match Category Total Personnel $37,509.00 53,016.00 $1,103.00 0.00 $38,612.00 53,016.00 Fringe Benefits $15,257.00 26,397.00 $441.00 0.00 $15,698.00 26,397.00 Travel $402.00 2,546.00 $402.00 0.00 $804.00 2,546.00 Equipment $0.00 $0.00 $0.00 Supplies $346.00 2,500.00 $8,132.00 10.00 $8,478.00 2,510.00 Contractual $14,727.00 $19,827.00 $34,554.00 Other $0.00 $0.00 $0.00 Other $0.00 $624.00 $624.00 Total Direct Costs $53,514.00 99,186.00 $10,702.00 19,837.00 $64,216.00 119,023.00 Indirect Costs $0.00 $0.00 $0.00 Totals: $53,514.00 99,186.00 $10,702.00 19,837.00 $64,216.00 Health and Human Services 119,023.00 (HHSRemainder of Page Intentionally Left Blank) Uniform Terms and Conditions - Grant Version 3.3 Published and Effective – November 2023 Responsible OfficeXX Xxxxxx County Judge Certificate Of Completion Envelope Id: Chief Counsel ABOUT THIS DOCUMENT In this document, Grantees (also referred to in this document as subrecipients or contractors) will find requirements and conditions applicable to grant funds administered and passed through by both the E14841AD14794219AC29F0E692B56127 Status: Sent Subject: Amending $238,046.00; HHS000686100015; Fort Bend County A-1; DSHS/LIDS/TB-FED Source Envelope: Document Pages: 18 Signatures: 0 Envelope Originator: Certificate Pages: 2 Initials: 0 Texas Health and Human Services Commission AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (HHSCUTC-06:00) Central Time (US & Canada) 0000 X. 00xx Xx. Xxxxxx, XX 00000 XXX_XxxxXxxx@xxxx.xxxxx.xx.xx IP Address: 167.137.1.18 Record Tracking Status: Original 10/1/2020 7:17:40 AM Holder: Texas Health and the Department of State Health Human Services Commission XXX_XxxxXxxx@xxxx.xxxxx.xx.xx Location: DocuSign Signer Events Signature Timestamp XX Xxxxxx xxxxxx.xxxxx@xxxxxxxxxxxxxxxx.xxx County Judge Fort Bend County Security Level: Email, Account Authentication (DSHS). These requirements None) Electronic Record and conditions are incorporated into the Grant Agreement through acceptance by Grantee of any funding award by HHSC or DSHS. The terms Signature Disclosure: Not Offered via DocuSign Xxxxxx Xxxxxx XxxxxxX.Xxxxxx@xxxx.xxxxx.xxx Security Level: Email, Account Authentication (None) Electronic Record and conditions in this document are in addition to all requirements listed in the RFASignature Disclosure: Not Offered via DocuSign Sent: 10/1/2020 7:23:57 AM Viewed: 10/1/2020 3:49:58 PM In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp CMS inbox xxxxxxxxxxxx@xxxx.xxxxx.xxx Security Level: Email, if anyAccount Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Xxxxxx Xxxxxx Xxxxxx.Xxxxxx@xxxx.xxxxx.xxx CMS Branch Manager Security Level: Email, under which applications for this grant award are acceptedAccount Authentication (None) Electronic Record and Signature Disclosure: Sent: 10/1/2020 7:23:57 AM Sent: 10/1/2020 7:23:57 AM Viewed: 10/13/2020 12:34:33 PM Carbon Copy Events Status Timestamp Not Offered via DocuSign Xxxx Xxxxxx Xxxx.Xxxxxx@xxxxxxxxxxxxxxxx.xxx Security Level: Email, as well as all applicable federal Account Authentication (None) Electronic Record and state laws and regulations. Applicable federal and state laws and regulations may include, but are not limited toSignature Disclosure: 2 CFR Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards; requirements of the entity that awarded the funds to HHS; Chapter 783 of the Texas Government Code; Texas Comptroller of Public Accounts’ agency rules (including Uniform Grant and Contract Standards set forth in Title 34, Part 1, Chapter 20, Subchapter E, Division 4 of the Texas Administrative Code); the Texas Grant Management Standards (TxGMS) developed by the Texas Comptroller of Public Accounts; and the Funding Announcement, Solicitation, or other instrumentNot Offered via DocuSign Sent: 10/1/2020 7:23:58 AM Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/documentation under which HHS was awarded funds. HHS, in its sole discretion, reserves the right to add requirements, terms, or conditions. TABLE OF CONTENTSEncrypted 10/1/2020 7:23:58 AM

Programmatic Reporting Requirements. Report Name Frequency Period Begin Period End Due Date Annual Progress Report Annually Sept. 1, 2024 August 31, 2025 April 1, 2025 Project Service Quarterly 09/01/2015 11/30/2015 12/31/2015 Delivery Plan Project Service Quarterly 12/01/2015 02/29/2016 03/31/2016 Delivery Plan Project Service Quarterly 03/01/2016 05/31/2016 06/30/2016 Delivery Plan Project Service Quarterly 06/01/2016 08/31/2016 09/30/2016 Delivery Plan Financial Status Quarterly 09/01/2015 11/30/2015 12/31/2015 Report (FSR) Biannually Sept. 1, 2024 Feb. 28, 2025 March 31, 2025 FSR Biannually March 1, 2025 August 31, 2025 September 30, 2025 Final Quarter-Match Reimbursement / Certification Form - Annually June 1, 2025 August 31, 2025 September 30, 2025 Cohort Review Periods and Submission Schedule Cohort period cases counted in: Are reviewed and reported by: First quarter Financial Status Quarterly 12/01/2015 02/29/2016 03/31/2016 Report (Jan 1 Mar 31FSR) current year Mar 31 of the following year Second quarter Financial Status Quarterly 03/01/2016 05/31/2016 06/30/2016 Report (Apr 1 Jun 30FSR) current year Jun 30 of the following year Third quarter Financial Status Quarterly 06/01/2016 08/31/2016 09/30/2016 Report (Jul 1 Sep 30FSR) current year Sep 30 of the following year Fourth quarter Project Service Quarterly 09/01/2016 11/30/2016 12/31/2016 Delivery Plan Project Service Quarterly 12/01/2016 02/28/2017 03/31/2017 Delivery Plan Project Service Quarterly 03/01/2017 05/31/2017 06/30/2017 Delivery Plan Project Service Quarterly 06/01/2017 08/31/2017 09/30/2017 Delivery Plan Financial Status Quarterly 09/01/2016 11/30/2016 12/31/2016 Report (Oct 1 Dec 31FSR) current year Dec 31 of the following year Financial Status Quarterly 12/01/2016 02/28/2017 03/31/2017 Report (FSR) Financial Status Quarterly 03/01/2017 05/31/2017 06/30/2017 Report (FSR) Financial Status Quarterly 06/01/2017 08/31/2017 10/15/2017 Report (FSR) Submission Instructions: Annual Report: Submit program reports Contractor shall submit Project Service Delivery Plan (Exhibit A) report on a quarterly basis, as noted on the Exhibit A, to the TB Reporting Mailboxcontract manager by the end of the month following the end of each quarter. Submit to: XXXxxxxxxxXxxxxxxxx@xxxx.xxxxx.xxx Financial Reports (FSRs, B-13s, and B-13A) Department of State Health Services XxxxxXXXxxx@xxxx.xxxxx.xx.xx ; Fax #: 512/000-0000 Contractor shall submit quarterly FSRs to Fiscal-Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx X.X. Xxx 149347 Austin, Texas 00000-0000 Fax: (000) 000-0000 Email: xxxxxxxx@xxxx.xxxxx.xxx and XXXxxxxxxxx@xxxx.xxxxx.xxx Attachment B FY25 Budget Budget FY25 Budget Category DSHS Funds Cash Match Category Total Personnel $37,509.00 $1,103.00 $38,612.00 Fringe Benefits $15,257.00 $441.00 $15,698.00 Travel $402.00 $402.00 $804.00 Equipment $0.00 $0.00 $0.00 Supplies $346.00 $8,132.00 $8,478.00 Contractual $0.00 $0.00 $0.00 Other $0.00 $624.00 $624.00 Total Direct Costs $53,514.00 $10,702.00 $64,216.00 Indirect Costs $0.00 $0.00 $0.00 Totals: $53,514.00 $10,702.00 $64,216.00 Health and Human Services (HHS) Uniform Terms and Conditions - Grant Version 3.3 Published and Effective – November 2023 Responsible Office: Chief Counsel ABOUT THIS DOCUMENT In this document, Grantees (also referred to in this document as subrecipients or contractors) will find requirements and conditions Unit by the last business day of the month following the end of each quarter. Contractor shall submit the final FSR no later than 45 calendar days following the end of the applicable to grant funds administered and passed through by both the Texas Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS)term. These requirements and conditions are incorporated into the Grant Agreement through acceptance by Grantee of any funding award by HHSC or DSHS. The terms and conditions in this document are in addition to all requirements listed in the RFA, if any, under which applications for this grant award are accepted, as well as all applicable federal and state laws and regulations. Applicable federal and state laws and regulations may include, but are not limited Submit to: 2 CFR Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awardsxxxxxxxx@xxxx.xxxxx.xx.xx ; requirements of the entity that awarded the funds to HHS; Chapter 783 of the Texas Government Code; Texas Comptroller of Public Accounts’ agency rules (including Uniform Grant and Contract Standards set forth in Title 34, Part 1, Chapter 20, Subchapter E, Division 4 of the Texas Administrative Code); the Texas Grant Management Standards (TxGMS) developed by the Texas Comptroller of Public Accounts; and the Funding Announcement, Solicitation, or other instrument/documentation under which HHS was awarded funds. HHS, in its sole discretion, reserves the right to add requirements, terms, or conditions. TABLE OF CONTENTSFax #: 512/000-0000.