HomeMy WebLinkAboutContract 55037 DocuSign Envelope ID:2D1C2C8E-8250-4A46-80BD-FC56144BC705
CSC No.55037
AGREEMENT BETWEEN THE CITY OF FORT WORTH AND TARRANT COUNTY
HOSPITAL DISTRICT DB/A JPS HEALTH NETWORK FOR MEDICAL
NAVIGATION SERVICES
This AGREEMENT for Medical Navigation Services("Agreement")is made and entered
into by and between the CITY OF FORT WORTH, a Texas home rule municipality ("City"),
and TARRANT COUNTY HOSPITAL DISTRICT DB/A JPS HEALTH NETWORK
("Al4ency"), a unit of local government in Texas, and more specifically a county hospital district
created and operating under Chapter 281 of the Texas Health and Safety Code. City and Agency
are referred to individually as a"Party" and sometimes collectively referred to as the "Parties."
RECITALS:
l. WHEREAS, The City has adopted Directions Home: Making Homelessness Rare, Short-
Term and Nonrecurring in Fort Worth within Ten Years as its homelessness plan (the
"Plan" or"Directions Home"). The Plan sets out key strategies that focus on the goal of
ending homelessness and guides the expenditure of City funds on homeless issues (City
Council Resolution No. 3203-05-2005);
2. WHEREAS, the City issued a Request for Proposals on July 1, 2020 for protective and
permanent supportive housing;
3. WHEREAS,Housing Authority of the City of Fort Worth,Texas, dba Fort Worth Housing
Solutions ("FWHS") was awarded the contract for 119 units of COVID-vulnerable
permanent supportive housing;
4. WHEREAS, FWHS selected Agency to provide medical navigation services to the 119
households at Casa de Esperanza; and
5. WHEREAS,the Parties believe that the services will further the goals of Directions Home
and desire to enter into this Agreement in order to set out the terms, goals, and
responsibilities of each Party.
NOW THEREFORE, the Parties for the mutual consideration included herein agree to enter into
the following Agreement.
AGREEMENT DOCUMENTS:
The Agreement documents shall include the following:
l. This Agreement for Supportive Services;
2. Exhibit"A"—Scope of Services;
3. Exhibit"B"—Budget;
4. Exhibit"C"—Reimbursement Request Form OFFICIAL RECORD
5. Exhibit"D"—Reporting Forms CITY SECRETARY
6. Exhibit"E" --Request for Budget Modification Form
FT.WORTH,TX
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Exhibits "A", "B", "C", "D", and "E" which are attached hereto and incorporated herein, are
made a part of this Agreement for all purposes. In the event of any conflict between the terms and
conditions of Exhibits "A" "B" "C" "D" or "E" and the terms and conditions set forth in the
body of this Agreement, the terms and conditions of this Agreement shall control.
1. SCOPE OF SERVICES.
1.1 Agency shall provide City with case management staffing to support persons
experiencing homelessness who are receiving permanent supportive housing, in order to reduce
the City's population of homeless persons ("Services"), which are more particularly described in
Exhibit"A"— Scope of Service.
1.2 Program Performance.
1.2.1 Agency agrees to maintain full documentation supporting the performance of the
work and fulfillment of the objectives set forth in Exhibit "A."
1.2.2 Agency agrees to provide a monthly report in the form attached as Exhibit "D"
to document the performance of the work described in Exhibit "A".
1.2.3 Agency agrees to provide a quarterly report in the form attached as Exhibit"D"
to document the performance of the work described in Exhibit"A".
1.2.4 Agency agrees that the Reimbursement Request Form and monthly report will be
submitted to City no later than the 15th day after the end of each month. Agency agrees that at the
end of each quarter, Agency shall provide a quarterly report (that lists out each month in that
quarter) with the aggregate information requested therein along with its monthly report and
reimbursement request. Should Agency not be able to meet these requirements in a given month,
the Agency shall provide written notification prior to the deadline that details the expected date of
submission. If no notification is received before the 15th day, the City may document for future
corrective action. If, by the last day of the same month, Agency has not submitted the required
reports, City will send a non-compliance letter notifying Agency's duly authorized representative
of a possible suspension of program funding.
1.2.5 Agency agrees to complete a Corrective Action Plan (CAP) in the event of three
(3) consecutive months or six (6) non-consecutive months with incomplete or incorrect
submissions of a Reimbursement Request Form or report. Agency also agrees to complete a
Corrective Action Plan for recurring late submissions of a Reimbursement Request Form or report.
2. TERM.
This Agreement shall begin on October 1, 2020 ("Effective Date") and shall expire on
September 30, 2021 ("Expiration Date"), unless terminated earlier in accordance with this
Agreement ("Initial Term"). City shall have the option, in its sole discretion, to renew this
Agreement under the same terms and conditions, except for the compensation amount which shall
be provided at the time of the renewal, for 3 additional 1-year terms.
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3. COMPENSATION.
3.1 City shall pay Agency in accordance with the provisions of this Agreement and Exhibit
"B" —Budget. Total payment made by City under this Agreement for the Initial Term shall not
exceed $70,000.00 ("Program Funds"),and shall be paid to Agency on a reimbursement basis.
Agency shall not perform any additional services for City not specified by this Agreement unless
City requests and approves in writing the additional costs for such services. City shall not be liable
for any additional expenses incurred by Agency not specified by this Agreement unless City first
approves such expenses in writing. If City determines in its sole discretion that this Agreement
should be renewed as provided under Section 2 of this Agreement, the City shall provide an
updated Exhibit "B", which shall include the not to exceed amount to be paid to Agency on a
reimbursement basis during the renewal term.
3.2 Payment of the Program Funds from City to Agency shall be made on a cost-
reimbursement basis following receipt by City from Agency of a signed Reimbursement Request
Form("RRF") as described in Exhibit"C" along with copies of all receipts and other supporting
documentation.The RRF and reports shall be submitted to City no later than the 15th day following
the end of the month. Submittal of a monthly RRF and reports is required even if services are not
provided.
3.3 The monthly RRF should be sequentially numbered and include expense
documentation that is detailed, clear and concise. All invoices should be sent electronically to
City's centralized Accounts Payable department invoice email address:
supplierinvoices@fortworthtexas.gov. Programmatic submissions should now be submitted as
part of the invoice, as they are due on the same date.
Agency's emails shall include the following in the subject line: Vendor name, Invoice number,
and PO number(ex: Example, Inc._123456_FW002-00000001234)
Agency's subject line(s) shall read as follows:
TARRANT COUNTY HOSPITAL DISTRICT JPS CASA####_FW002_0000000###
Additionally,the following requirements apply to ensure the system can successfully
process invoices in an expedient manner:
• All invoices must be either a PDF or TIFF format.
• Image quality must be at least 300 DPI (dots per inch).
• Invoices must be sent as an attachment(i.e.no invoice in the body of the email).
• One invoice per attachment (includes PDFs). Each invoice must be a separate
attachment.
• No handwritten invoices or invoices that contain handwritten notes.
• Dot matrix invoice format is not accepted.
• The invoice must contain the following information:
• Supplier Name and Address;
• Remit to Supplier Name and Address, if different;
• Applicable City Department business unit# (i.e. FW002)
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• Complete City of Fort Worth PO number (i.e. the PO number
must contain all preceding zeros);
• Invoice number;
• Invoice date; and
• Invoices to be submitted after delivery of the goods or services.
Reimbursements will not be made until after receipt of an acceptable and approved RRF and
monthly report as required. Reimbursements shall be made within 30 days receipt of said
documents. Incomplete or incorrect submissions will be returned to the Agency for resubmission,
restarting the 30-day reimbursement schedule.
3.4 Agency is authorized to modify up to five (5)percent of any budgeted line-item in the
original approved budget without prior written permission from City. However, Agency must
submit the Request for Budget Modification Form.(Exhibit"E")to City, with the monthly RRF,
during the month the modification took place. The new modified budget cannot exceed the total
amount of Program Funds. Agency shall be solely responsible for any money spent in excess of
the not to exceed amount included in this Agreement for the then-current term.
3.5 Any modifications of more than five (5) percent of any budgeted line-item in the
original approved budget must have prior written permission from City before the modifications
are made. The Budget Modification Form (Exhibit "E") must be submitted, and request must be
approved by City, before any money is moved to the line-item. Once the Budget Modification is
approved, the modified budget will take effect on the first day of the following month. The new
modified budget shall not exceed the total amount of Program Funds. Agency shall be solely
responsible for any money spent in excess of the not to exceed amount included in this Agreement
for the then-current term.
3.6 Any modifications to zero line-items in the original approved budget must have prior
written permission from City before the modifications are made. The Budget Modification Form
(Exhibit "E")must be completed and approved by City before money is transferred into the new
line-item. Once the Budget Modification is approved,the modified budget will take effect on the
first day of the following month. The new modified budget shall not exceed the total amount of
Program Funds. Agency shall be solely responsible for any money spent in excess of the not to
exceed amount included in this Agreement for the then-current term.
3.7 Agency will document cost allocations for all budgeted expenses throughout the
entirety of the Agreement and will be responsible for having a policy and procedure in place for
this documentation. Specifically, Agency will document how all shared costs, personnel time, or
equipment that was fully or partially paid for using City funds, were used in furtherance of the
program activities described in this Agreement. Documentation of these cost allocations, as well
as a copy of the Agency's policy and procedures for the documentation of the cost allocations shall
be made available to the City upon request.
3.8 The City reserves the right to reject any budget modification that the City believes, in
its sole discretion, is not clearly aligned with the program activities and any requests for
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reimbursement expenses that the City believes, in its sole discretion, are not specified in Exhibit
"D" of this Agreement or an approved budget modification form.
3.9 Budget adjustments shall be submitted via either email to
Tara.Perez@fortworthtexas.gov or to the Tara Perez,Directions Home Manager, City Manager's
Office, 200 Texas Street,Fort Worth TX 76102.
4. TERMINATION.
4.1. Written Notice. City or Agency may terminate this Agreement at any time and for
any reason by providing the other Party with 60 days' written notice of termination.
4.2 Non-appropriation of Funds. In the event no funds or insufficient funds are
appropriated by City in any fiscal period for any payments due hereunder, City will notify Agency
of such occurrence and this Agreement shall terminate on the last day of the fiscal period for which
appropriations were received without penalty or expense to City of any kind whatsoever, except
as to the portions of the payments herein agreed upon for which funds have been appropriated.
4.3 Duties and Obligations of the Parties. In the event that this Agreement is terminated
prior to the Expiration Date, City shall pay Agency for services actually rendered up to the
effective date of termination and Agency shall continue to provide City with services requested by
City and in accordance with this Agreement up to the effective date of termination. Upon
termination of this Agreement for any reason, Agency shall provide City with copies of all
completed or partially completed documents prepared under this Agreement. In the event Agency
has received access to City data as a requirement to perform services hereunder, Agency shall
return all City-provided data to City in a machine readable format or other format deemed
acceptable to City.
5. DISCLOSURE OF CONFLICTS AND CONFIDENTIAL INFORMATION.
5.1 Disclosure of Conflicts. Agency hereby represents and warrants to City that
Agency has made full disclosure in writing of any existing or potential conflicts of interest related
to Agency's services under this Agreement. In the event that any conflicts of interest arise after
the Effective Date of this Agreement, Agency hereby agrees to make full disclosure of such
conflict of interest to City immediately in writing.
5.2 Confidential Information. Agency,for itself and its officers,agents and employees,
agrees that it shall treat all information provided to it (i) by City ("City Information") as
confidential and shall not disclose any such information to a third party without City's prior written
approval,and(ii)shall abide by all of the standards of confidentiality of client information("Client
Information")in its performance of its duties and obligations under this Agreement including but
not limited to those standards, rules and regulations regarding confidentiality required by HMIS
and TCHC. "Client Information" is defined for the purposes of this Agreement as personal,
demographic, or treatment data about the individuals being served by the program.
5.3 Public Information Act. Agency acknowledges that the City is a governmental
entity and is subject to the Texas Public Information Act ("Act"). City also acknowledges that
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Agency is a governmental entity and is also subject to the Act. By executing this agreement,
Agency acknowledges that this agreement will be publicly available on the City's website, and
Agency is therefore waiving any claim of confidentiality,whether based in statute or the common
law, to any and all materials contained as part of this agreement including all documents and
information referenced herein or attached hereto.
5.4 Unauthorized Access. Agency shall store and maintain City Information and Client
Information in a secure manner and shall not allow unauthorized users to access,modify, delete or
otherwise corrupt City Information or Client Information in any way. Agency shall notify City
immediately if the security or integrity of any City Information or Client Information has been
compromised or is believed to have been compromised, in which event, Agency shall, in good
faith, use all commercially reasonable efforts to cooperate with City in identifying what
information has been accessed by unauthorized means and shall fully cooperate with City to
protect such City Information or Client Information from further unauthorized disclosure.
6. RIGHT TO AUDIT.
Agency agrees that City shall, until the expiration of 3 years after final payment under this
Agreement, or the final conclusion of any audit commenced during the said 3 years, have access
to and the right to examine at reasonable times any directly pertinent books, documents, papers
and records, including, but not limited to, all electronic records, of Agency involving transactions
relating to this Agreement at no additional cost to City. Agency agrees that City shall have access
during normal working hours to all necessary Agency facilities and shall be provided adequate and
appropriate work space in order to conduct audits in compliance with the provisions of this section.
City shall give Agency reasonable advance notice of intended audits.
This provision shall survive the expiration or termination of this Agreement.
7. INDEPENDENT CONTRACTOR.
It is expressly understood and agreed that Agency shall operate as an independent
contractor as to all rights and privileges and work performed under this Agreement, and not as
agent, representative or employee of City. Subject to and in accordance with the conditions and
provisions of this Agreement, Agency shall have the exclusive right to control the details of its
operations and activities and be solely responsible for the acts and omissions of its officers,agents,
servants, employees, consultants and sub vendors. Agency acknowledges that the doctrine of
respondeat superior shall not apply as between City, its officers, agents, servants and employees,
and Agency, its officers, agents, employees, servants, vendors and sub vendors. Agency further
agrees that nothing herein shall be construed as the creation of a partnership or joint enterprise
between City and Agency. It is further understood that City shall in no way be considered a Co-
employer or a Joint employer of Agency or any officers,agents,servants, employees or sub vendor
of Agency. Neither Agency,nor any officers,agents,servants,employees or sub vendor of Agency
shall be entitled to any employment benefits from City. Agency shall be responsible and liable for
any and all payment and reporting of taxes on behalf of itself, and any of its officers, agents,
servants, employees or sub vendors.
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8. LIABILITY AND INDEMNIFICATION.
8.1 LIABILITY-AGENCY SHALL BE LIABLE AND RESPONSIBLE FOR ANY
AND ALL PROPERTY LOSS, PROPERTY DAMAGE AND/OR PERSONAL INJURY,
INCL UDING DEATH, TO ANY AND ALL PERSONS, OF ANY KIND OR CHARACTER,
WHETHER REAL OR ASSERTED, TO THE EXTENT CAUSED BY THE NEGLIGENT
ACT(S) OR OMISSION(S), MALFEASANCE OR INTENTIONAL MISCONDUCT OF
AGENCY,ITS OFFICERS,AGENTS, SERVANTS OR EMPLOYEES.
8.2 GENERAL INDEMNIFICATION—TO THE EXTENT PERMITTED BY THE
LAWS AND CONSTITUTION OF THE STATE OF TEXAS, THE PARTIES HEREBY
COVENANT AND AGREE TO INDEMNIFY, HOLD HARMLESS AND DEFEND THE
OTHER PARTY, ITS OFFICERS,AGENTS, SERVANTS AND EMPLOYEES, FROMAND
AGAINST ANY AND ALL CLAIMS OR LAWSUITS OF ANY KIND OR CHARACTER,
WHETHER REAL OR ASSERTED, FOR EITHER PROPERTY DAMAGE OR LOSS
(INCLUDING ALLEGED DAMAGE OR LOSS TO AGENCY'S BUSINESS AND ANY
RESULTING LOST PROFITS) AND/OR PERSONAL INJURY, INCLUDING DEATH, TO
ANY AND ALL PERSONS, ARISING OUT OF OR IN CONNECTION WITH THIS
AGREEMENT, TO THE EXTENT CAUSED BY THE NEGLIGENT ACTS OR OMISSIONS
OR MALFEASANCE OF THE INDEMNIFYING PARTY, ITS OFFICERS, AGENTS,
SERVANTS OR EMPLOYEES.
This section shall survive the expiration or termination of this Agreement.
9. ASSIGNMENT AND SUBCONTRACTING.
9.1 Assignment. Agency shall not assign or subcontract any of its duties, obligations
or rights under this Agreement without the prior written consent of City. If City grants consent to
an assignment,the assignee shall execute a written agreement with City and Agency under which,
the assignee agrees to be bound by the duties and obligations of Agency under this Agreement.
Agency and Assignee shall be jointly liable for all obligations of Agency under this Agreement
prior to the effective date of the assignment.
9.2 Subcontract. If City grants consent to a subcontract, subcontractor shall execute a
written agreement with Agency referencing this Agreement under which subcontractor shall agree
to be bound by the duties and obligations of Agency under this Agreement as such duties and
obligations may apply. Agency shall provide City with a fully executed copy of any such
subcontract.
10. INSURANCE.
City recognizes and agrees that Agency is a political subdivision of the Sovereign State of
Texas and is therefore subject to the Tort Claims Act. Agency represents and warrants that it is
self-funded for general liability purposes subject to the limitations of the Texas Tort Claims Act
with liability limits of not less than$100,000 per occurrence and$300,000 in the aggregate.
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11. COMPLIANCE WITH LAWS, ORDINANCES,RULES AND REGULATIONS.
Agency agrees that in the performance of its obligations hereunder,it shall comply with all
applicable federal, state and local laws, ordinances, rules and regulations and that any work it
produces in connection with this Agreement will also comply with all applicable federal, state and
local laws,ordinances,rules and regulations. If City notifies Agency of any violation of such laws,
ordinances,rules or regulations, Agency shall immediately desist from and correct the violation.
12. NON-DISCRIMINATION COVENANT.
Agency, for itself, its personal representatives, assigns, sub vendors and successors in
interest, as part of the consideration herein, agrees that in the performance of Agency's duties and
obligations hereunder, it shall not discriminate in the treatment or employment of any individual
or group of individuals on any basis prohibited by law. IF ANY CLAIM ARISES FROM AN
ALLEGED VIOLATION OF THIS NON-DISCRIMINATION COVENANT BY AGENCY,
ITS PERSONAL REPRESENTATIVES, ASSIGNS, SUB VENDORS OR SUCCESSORS
IN INTEREST, AGENCY AGREES TO ASSUME SUCH LIABILITY AND TO
INDEMNIFY AND DEFEND CITY,AND HOLD CITY HARMLESS FROM SUCH
CLAIM.
This section shall survive the expiration or termination of this Agreement.
13. NOTICES.
Notices required pursuant to the provisions of this Agreement shall be conclusively
determined to have been delivered when (1) hand-delivered to the other Party, its agents,
employees, servants or representatives, (2) delivered by facsimile with electronic confirmation of
the transmission, or(3)received by the other Party by United States Mail,registered,return receipt
requested, addressed as follows:
To City: To Agency:
City of Fort Worth Robert Earley,President and CEO
City Manager's Office Tarrant County Hospital District d/b/a JPS
Attn: Tara Perez,Directions Home Manager Health Network
200 Texas Street 1500 South Main Street
Fort Worth, TX 76102-6314 Fort Worth TX 76104
Phone: (817) 392-2235
With a copy to:
With copy to City Attorney's Office at same
address Daphne Walker, General Counsel
1500 S. Main
Fort Worth, Texas 76101
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14. SOLICITATION OF EMPLOYEES.
Neither City nor Agency shall, during the term of this Agreement and additionally for a
period of 1 year after its termination, solicit for employment or employ, whether as employee or
independent contractor, any person who is or has been employed by the other during the term of
this Agreement, without the prior written consent of the person's employer. Notwithstanding the
foregoing, this provision shall not apply to an employee of either Party who responds to a general
solicitation of advertisement of employment by either Party.
15. GOVERNMENTAL POWERS.
It is understood and agreed that by execution of this Agreement, neither City nor Agency
waives or surrenders any of its governmental powers or immunities.
16. NO WAIVER.
The failure of City or Agency to insist upon the performance of any term or provision of
this Agreement or to exercise any right granted herein shall not constitute a waiver of City's or
Agency's respective right to insist upon appropriate performance or to assert any such right on any
future occasion.
17. GOVERNING LAW/VENUE.
This Agreement shall be construed in accordance with the laws of the State of Texas. If
any action, whether real or asserted, at law or in equity, is brought pursuant to this Agreement,
venue for such action shall lie in state courts located in Tarrant County, Texas or the United States
District Court for the Northern District of Texas, Fort Worth Division.
18. SEVERABILITY.
If any provision of this Agreement is held to be invalid, illegal or unenforceable, the
validity, legality and enforceability of the remaining provisions shall not in any way be affected or
impaired.
19. FORCE MAJEURE.
City and Agency shall exercise their best efforts to meet their respective duties and
obligations as set forth in this Agreement, but shall not be held liable for any delay or omission
in performance due to force majeure or other causes beyond their reasonable control, including,
but not limited to, compliance with any government law, ordinance or regulation, acts of God,
acts of the public enemy, fires, strikes, lockouts, natural disasters, wars, riots, epidemics or
pandemics,material or labor restrictions by any governmental authority,transportation problems,
restraints or prohibitions by any court, board, department, commission, or agency of the United
States or of any States,civil disturbances,other national or regional emergencies,and/or any other
similar cause not enumerated herein but which is beyond the reasonable control of the Party whose
performance is affected (collectively "Force Majeure Event"). The performance of any such
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obligation is suspended during the period of, and only to the extent of, such prevention or
hindrance, provided the affected Party provides notice of the Force Majeure Event, and an
explanation as to how it hinders the party's performance, as soon as reasonably possible, as
determined in the City's discretion, after the occurrence of the Force Majeure Event. The form of
notice required by this section shall be the same as section 13 above.
20. HEADINGS NOT CONTROLLING.
Headings and titles used in this Agreement are for reference purposes only, shall not be
deemed a part of this Agreement, and are not intended to define or limit the scope of any provision
of this Agreement.
21. REVIEW OF COUNSEL.
The Parties acknowledge that each Party and its counsel have reviewed and revised this
Agreement and that the normal rules of construction to the effect that any ambiguities are to be
resolved against the drafting party shall not be employed in the interpretation of this Agreement
or Exhibits "A", "B", "C", "D" and"E".
22. AMENDMENTS/MODIFICATIONS/EXTENSIONS.
No amendment,modification,or extension of this Agreement shall be binding upon a Party
hereto unless set forth in a written instrument, which is executed by an authorized representative
of each Party.
23. ENTIRETY OF AGREEMENT.
This Agreement, including Exhibits "A", "B", "C", "D", and "E" contains the entire
understanding and agreement between City and Agency, their assigns and successors in interest,
as to the matters contained herein. Any prior or contemporaneous oral or written agreement is
hereby declared null and void to the extent in conflict with any provision of this Agreement.
24. COUNTERPARTS.
This Agreement may be executed in one or more counterparts and each counterpart shall,
for all purposes, be deemed an original, but all such counterparts shall together constitute one and
the same instrument.
25. WARRANTY OF SERVICES.
Agency warrants that its services will be of a professional quality and conform to generally
prevailing industry standards. City must give written notice of any breach of this warranty within
30 days from the date that the services are completed. In such event, at Agency's option, Agency
shall either (a) use commercially reasonable efforts to re-perform the services in a manner that
conforms to the warranty, or (b) refund the fees paid by City to Agency for the nonconforming
services.
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26. IMMIGRATION NATIONALITY ACT.
City actively supports the Immigration&Nationality Act(INA)which includes provisions
addressing employment eligibility, employment verification, and nondiscrimination.Agency shall
verify the identity and employment eligibility of all employees who perform work under this
Agreement.Agency shall complete the Employment Eligibility Verification Form (I-9), maintain
photocopies of all supporting employment eligibility and identity documentation for all
employees, and upon request, provide City with copies of all 1-9 forms and supporting eligibility
documentation for each employee who performs work under this Agreement. Agency shall
establish appropriate procedures and controls so that no services will be performed by any
employee who is not legally eligible to perform such services. Agency shall provide City with a
certification letter that it has complied with the verification requirements required by this
Agreement. Agency shall indemnify City from any penalties or liabilities due to violations of this
provision. City shall have the right to immediately terminate this Agreement for violations of this
provision by Agency.
27. CHANGE IN COMPANY NAME OR OWNERSHIP
Agency shall notify City's Assistant City Manager, in writing, of a company name,
ownership, or address change for the purpose of maintaining updated city records. The chief
executive officer of Agency or authorized official must sign the letter. A letter indicating changes
in a company name or ownership must be accompanied with supporting legal documentation such
as an updated W-9, documents filed with the state indicating such change, copy of the board of
director's resolution approving the action,or an executed merger or acquisition agreement. Failure
to provide the specified documentation so may adversely impact future invoice payments.
28. SIGNATURE AUTHORITY.
The person signing this Agreement hereby warrants that he/she has the legal authority to
execute this Agreement on behalf of the respective Party, and that such binding authority has been
granted by proper order,resolution,ordinance or other authorization of the entity. This Agreement
and any amendment hereto, may be executed by any authorized representative of Agency. Each
Party is fully entitled to rely on these warranties and representations in entering into this
Agreement or any amendment hereto.
IN WITNESS WHEREOF, the Parties hereto have executed this Agreement in multiple
originals on the date written below their respective signatures to be effective on the Effective Date.
[Signature Page Follows]
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ACCEPTED AND AGREED:
CITY OF FORT WORTH:
CONTRACT COMPLIANCE MANAGER:
By signing I acknowledge that I am the person
c` responsible for the monitoring and administration of
B`FQrnandoCosta(Dec 14,2020 08:40 CST) this contract,including ensuring all performance and
J Name: Fernando Costa reporting requirements.
Title: Assistant City Manager
Date: Dec 14,2020 jara Perez(Dec 14,202008:30 CST)
y:
Name: Tara Perez
APPROVAL RECOMMENDED: Title: Directions Home Manager
TWIC,± n� APPROVED AS TO FORM AND LEGALITY:
Tara Perez(Dec 14,2020 08:30 CST)
By:
Name: Tara Perez /
Title: Directions Home Manager B �
vaRp
�'0 000--Ada Name: Taylor Paris
ATTEST: gao° Dodd
Ago . Title: Assistant City Attorney
Ovo o=d
�(�� o�Q� ° °°°�� CONTRACT AUTHORIZATION:
j/ 144 nFap54�p M&C: 20-0640 09/15/2020
By: 1295:
Name: Mary J.Kayser
Title: City Secretary
Agency:
Tarrant County Hospital District d/b/a JPS Health
Network
By: R.Gv''1 E.�
Name: Robert Earley
Title: President and CEO
Date: December 10, 2020 1 9:04 PM CST
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
CITY OF FORT WORTH Page 12 of 21
Agreement for Homeless Services—TCHD—MEDICAL NAVIGATION SERVICES
DocuSign Envelope ID:2D1C2C8E-8250-4A46-80BD-FC56144BC705
EXHIBIT "A"
SCOPE OF SERVICES
MEDICAL NAVIGATION SERVICES
TARRANT COUNTY HOSPITAL DISTRICT DB/A JPS HEALTH NETWORK
("TCHD")will do the following:
Employ one(1)community health worker*1 to provide medical navigation services as needed
to approximately 119 permanent supportive housing clients at Casa de Esperanza to do the
following:
A. In General
• Document the nature and extent of all services provided to chronically homeless individuals in
the City of Fort Worth receiving medical navigation services hereunder (client")in a complete
case file, with case notes in the F MIS system within 3 business days of a service being
provided hereunder;
• Eligible clients are those chronically homeless with a COVID vulnerability living at Casa
de Esperanza; /
B. Medical Navigation Services
• Conduct activities including recruiting participants and facilitating self-management,
nutrition, psychosocial support groups and physical activity sessions according to State
approved curriculum;
• Convey the purpose and services of JPS Connection to the user population and the benefits;
• Establish trusting relationships with patients while providing general support and
encouragement;
• Conduct intake interviews with patients, including enrolling and/or referring patients into
programs; assists patients with completing applications and registration forms;
• Follow-up with patients via phone calls and home visits;
• Conduct eligibility determination, enrollment and follow-up with uninsured patients;
1 Agency may employ additional personnel at Casa de Esperanza at its sole cost and expense.
Supportive Services Agreement—Exhibits Page 13 of 21
DocuSign Envelope ID:2D1 C2C8E-8250-4A46-80BD-FC56144BC705
• Provide referrals for services to Presbyterian Night Shelter case managers and My Health,
My Resources mental health services provider at Casa de Esperanza as appropriate;
• Help patients connect with transportation resources and provide appointment reminders;
• Work closely with medical providers to ensure patients have comprehensive and
coordinated care;
• Work cooperatively with other clinical personnel assigned to the same patient;
• Provide consistent communication to evaluate patient, ensuring that provided information
and reports clearly describe progress;
• Ensure that all program applications submitted are complete with supporting
documentation.
Evaluation:
Evaluation meetings will be held with Directions Home staff to continually evaluate program and
Agency shall comply as necessary and in good faith.
Financial reporting:
Reimbursement Request and any necessary supporting documentation and reports will be
submitted by the 15th of every month in format of Exhibit"C".
Programmatic reporting:
Monthly reports will be submitted by the 15th of every month in format of Exhibit"D". Quarterly
reports will be submitted by the 15th of July, October, January and April in the format of Exhibit
CITY OF FORT WORTH Page 14 of 21
Agreement for Homeless Services—TCHD—MEDICAL NAVIGATION SERVICES
DocuSign Envelope ID:2DiC2C8E-8250-4A46-80BD-FC56144BC705
EXHIBIT "B"
BUDGET
_Agency will submit invoice for reimbursement by the 15t" of the month following the month
services were provided.
This report shall itemize each monthly expense requested for reimbursement by the Agency and
shall be included in Budget submitted. In order for this report to be complete the following must
be submitted:
For payroll expenses, timesheets signed and dated by employees and approved by
supervisor for all payroll expenses listed with the code of time being billed to
City/Directions Home. Paystub must include pay period, date paid, amount and
expenses (salary, FICA, benefits etc). If pay stubs are unavailable, payroll registries
with applicable expenses highlighted and labeled will suffice. Agency may not submit
payroll expenses dated 60 calendar days prior to the date of the Reimbursement Request
with the exception of the first Reimbursement Request which may include items from
the Effective Date of the Agreement to the end of the reporting month.
For non-payroll expenses, invoices for each expense listed. Agency may not submit
invoices dated 60 calendar days prior to the date of the Reimbursement Request with
the exception of the first Reimbursement Request which may include items from the
Effective Date of the Agreement to the end of the reporting month.
Proof that each expense was paid by the Agency, which proof can be satisfied by
cancelled checks. . If a cancelled check is not possible, a bank statement with the
expense highlighted and labeled will suffice.
If allocations percentages are used, all documentation must be submitted with the first
month's invoice.
For the audit, bank statements showing payments, Form 941 s and allocation
documentation will be reviewed.
Reimbursement Requests shall be submitted to:
City Manager's Office
Directions Home
Attention Tara Perez
200 Texas Street
Fort Worth TX 76102
CITY OF FORT WORTH Page 15 of 21
Agreement for Homeless Services—TCHD—MEDICAL NAVIGATION SERVICES
DocuSign Envelope ID:2D1C2C8E-8250-4A46-80BD-FC56144BC705
PROGRAM COSTS Total
$70,000.00
A. PERSONNEL (By title) _
Community Health Worker $55,970.00
I- -
PERSONNEL TOTAL: $55,970.00
B. FRINGE BENEFITS f
Social Securi /Medicare FICA
Workers Compensation $281.00
Health Insurance/Retirement $9 547.00
FRINGE BENEFITS TOTAL: - $13,815.00
C. MILEAGE$
Mileage $215.00
MILEAGE TOTAL
_ $215.00
D. CELL PHONES/EQUIPMENT
- - --------------- -- --- -- - - - - - --- --- --- -
CELL PHONES/EQUIPMENT TOTAL:
-----------------
E. CLIENT EXPENSES
CLIENT EXPENSES TOTAL:
F. OTHER APPROVED
--- ---- ----- ---- - ---- ------ ------
OTHER APPROVED TOTAL:
TOTAL PROGRAM COST: $70,000.00
CITY OF FORT WORTH Page 16 of 21
Agreement for Homeless Services—TCHD—MEDICAL NAVIGATION SERVICES
DocuSign Envelope ID:2D1C2C8E-8250-4A46-80BD-FC56144BC705
EXHIBIT "C"
REIMBURSEMENT REQUEST FORM
Expenses Name of employee or Amount Date Check
client Invoiced No.
Expense: Personnel
Salary
Salary
Salary
Salary Total:
FICA(Medicare/Social Security)
FICA(Medicare/Social Security)
FICA(Medicare/Social Security)
Health Insurance
Health Insurance
Health Insurance
Dental Insurance
Dental Insurance
Dental Insurance
Life Insurance
Life Insurance
Life Insurance
Disability Insurance
Disability Insurance
Disability Insurance
Retirement
Retirement
Retirement
Unemployment Insurance
Unemployment Insurance
Unemployment Insurance
Workers Compensation
Workers Compensation
Workers Compensation
Total of all Benefits:
Mileage
Mileage
Mileage
Mileage Total:
Cell phone
Cell phone
CITY OF FORT WORTH Page 17 of 21
Agreement for Homeless Services—TCHD—MEDICAL NAVIGATION SERVICES
DocuSign Envelope ID:2D1C2C8E-8250-4A46-80BD-FC56144BC705
Cell phone
Cell Phone Total:
Type of Client
Ex enseNendor
Client Expense Total:
Operations/Vendor:
Operations Total:
Other
Other Total:
Total Invoiced Amount
Attestation
Contractor:
Program:
Name of Person submitting
report:
Date Range Covered by this
report:
I have reviewed this report and
certify that it is a complete,
accurate, and up-to-date
reflection of the services
rendered under the terms of our
Agreement with the City of Fort
Worth.
Signature:
Total
A B C D E
Total Previous This Remaining
Budget Reimbursements Month's Total Request Balance Available
Budget Category Amount Requested Request to Date(B+D) (A-D)
Personnel
Fringe Benefits
Mileage
Cell
phone/Equipment
Client Costs
Other
Total
CITY OF FORT WORTH Page 18 of 21
Agreement for Homeless Services—TCHD—MEDICAL NAVIGATION SERVICES
DocuSign Envelope ID:2D1C2C8E-8250-4A46-80BD-FC56144BC705
EXHIBIT "D"
REPORTING FORMS
Quarterly Report
Current Reporting
Quarter
Submitting Agency
Contact Name
Phone Number and
Email
Remit Address
Please include outcome narrative that describes how measure was accomplished for each
quarter.
Effectiveness Measures and Quarterly Outcomes
Measure 1 . Recording patient history of emergency department visits and tracking
future visits to establish there is at least a 20% reduction in emergency
department visits after entering Casa de Esperanza housing
Outcome
Measure 2 . Tracking rate of patients attending primary care visits to ensure at least
75% of scheduled visits are attended
Outcome
I have reviewed this report and certify that the measures provided are accurate and
appropriately reflect the Directions Home goals set forth in the contract.
Authorized Signatory Signatory Title
Date
CITY OF FORT WORTH Page 19 of 21
Agreement for Homeless Services—TCHD—MEDICAL NAVIGATION SERVICES
DocuSign Envelope ID:2D1C2C8E-8250-4A46-80BD-FC56144BC705
Monthly Report
If the new Tarrant County Homeless Coalition software system is able to pull data included in
monthly reports included herein and Directions Home staff confirms and agrees in writing, those
reports can be substituted for reports included herein.
Enter all clients in this report and add new clients to subsequent reports.
transportation,Initiated Assisted client Client Client
Client Client Enrolled in JPS with visited
Last First JPS Connection Saw -.
departmentName Name Connection enrollment �� client medicine,other
CITY OF FORT WORTH Page 20 of 21
Agreement for Homeless Services—TCHD—MEDICAL NAVIGATION SERVICES
DocuSign Envelope ID:2D1C2C8E-8250-4A46-80BD-FC56144BC705
EXHIBIT "E"
REQUEST FOR BUDGET MODIFICATION
Date
Submitting Agency
Contact Name
Phone Number and Email
Remit Address
PROGRAM COSTS
Budget Category Approved Budget Change Requested Revised Budget
Personnel
Fringe Benefits
Mileage
Cell Phones/Equipment
Client Costs
Other Approved
Total Costs
• Up to 5% of any budgeted line-item does not need prior approval but form must be sent
to City with monthly RFR
• More than 5%of any budgeted line-item must have prior City approval
• An increase in a zero line-item must have prior City approval
Modification Narrative (describe in detail what change is for)
I have reviewed this request and certify that the listed modifications are correct.
Authorized Signatory Signatory Title
Date
STAFF USE ONLY
r_1 0
Modification Approved Modification NOT Approved
Staff Signature Date
CITY OF FORT WORTH Page 21 of 21
Agreement for Homeless Services—TCHD—MEDICAL NAVIGATION SERVICES
M&C Review Page 1 of 3
Official site of the City of Fort Worth,Texas
CITY COUNCIL AGENDA FORTIVO 4 �"
REFERENCE 02SUPPORTIVE SERVICES
DATE: 9/15/2020 NO.: M&C 20-0640 LOG NAME: FOR COVID-VULNERABLE
PSH CLIENTS
CODE: C TYPE: NOW PUBLIC NO
CONSENT HEARING:
SUBJECT: (ALL)Authorize Execution of Agreements in an Amount Up to $350,000.00
with Presbyterian Night Shelter of Tarrant County, Inc.; My Health, My Resources
(MHMR) of Tarrant County; and Tarrant County Hospital District dba JPS Health Network
to Provide Supportive Services for COVID-Vulnerable Permanent Supportive Housing
Residents and Authorize Three Renewal Options in a Combined Amount Up to
$1,050,000.00
RECOMMENDATION:
It is recommended that the City Council:
1. Authorize the City Manager or his designee to execute agreements with agencies listed below
in a combined amount up to $350,000.00 for a term commencing October 1, 2020 and
terminating September 30, 2021 for the provision of supportive services;
2. Authorize the City Manager or his designee to renew the agreements for Fiscal Years 2022,
2023 and 2024 with the agencies listed below in a combined amount up to $1,050,000.00 for
the provision of supportive services dependent on funds being appropriated for Directions
Home initiatives; and
3. Authorize the City Manager or his designee to amend the agreements if necessary to achieve
program goals provided that the amendment is within the scope of the program and in
compliance with City policies and applicable laws and regulations.
DISCUSSION:
On June 17, 2008, the City adopted Directions Home, the City's plan to make homelessness rare,
short-term and nonrecurring (Resolution No. 3628-06-2008).
One of the goals of Directions Home is the expansion of Permanent Supportive Housing (PSH). PSH
is a type of housing suitable for disabled households experiencing more than one year of
homelessness. PSH clients require ongoing case management and assistance to remain housed.
While there has been significant homeless system funding provided to the City and the Tarrant County
Homeless Coalition through U.S. Housing and Urban Development's (HUD) Emergency Solutions
Grants (ESG) due to COVID-19, this funding does not address the need for PSH.
The U.S. Centers for Disease Control and Prevention (CDC) has noted that congregate living
situations, such as homeless shelters, pose a greater risk of COVID-19 spreading and have issued
recommendations that emergency homeless shelters reduce density/decompress to allow for safe
distancing of homeless clients.
The CDC additionally recommends "protective housing for people who are at highest risk of severe
COVID-19." Per the CDC, two groups defined as particularly vulnerable to severe COVID-19 are
those over 65 years old and those with specific underlying health conditions, especially chronic lung
disease or moderate/severe asthma, serious heart conditions, immunocompromised, severe obesity,
diabetes, chronic kidney disease and liver disease.
In view of the CDC recommendations and the lack of ESG funding for PSH, the City Council voted
(M&C 20-0518) to use $9,300,000.00 of funding provided under the Coronavirus Aid, Relief, and
Economic Security Act (CARES Act), Title V (Coronavirus Relief Funds or Title V funds) to acquire
and convert existing motels, hotels, extended stays, apartment complexes, or similar permanent
http://apps.cfwnet.org/council_packet/Mc review.asp?ID=28209&councildate=9/15/2020 9/23/2020
M&C Review Page 2 of 3
structures to serve as and provide approximately 100 new units of PSH. The new PSH units will
provide protective housing for high risk COVID-19 vulnerable and disabled households experiencing
chronic homelessness.
Currently, 119 units of permanent supportive housing for COVID-vulnerable households are being
developed with Coronavirus Relief Funds.
On July 1, 2020, the City issued Request for Proposals 20-0190 (RFP) seeking proposers to: (1)
quickly acquire and convert existing motels, hotels, extended stays, apartment complexes, or similar
permanent structures to serve as approximately 200 units of PSH split across two or more locations,-
and (2) provide ongoing supportive services for such households for a period of at least twenty (20)
years. The City will provide funding for the initial costs of acquisition via a one-time payment and
subsequent payments for conversion/renovation from Title V funds, and anticipates assisting the
selected proposers to secure ongoing operating subsidies from other sources.
After a competitive scoring process, Housing Authority of the City of Fort Worth, dba Fort Worth
Housing Solutions (FWHS), and The Presbyterian Night Shelter of Tarrant County, Inc. (PNS) were
recommended to be awarded a notice to proceed. These agencies have experience in permanent
supportive housing.
FWHS put an option to purchase on a property which can create 119 units of PSH for COVID-
vulnerable households. FWHS selected PNS, My Health, My Resources of Tarrant County (MHMR),
and Tarrant County Hospital District d/b/a JPS Health Network (JPS) as service providers in order to
meet the unique client needs. Directions Home will provide the funding for the three service
providers in order to create the 119 units of COVID-vulnerable PSH.
PNS will provide three on-site case managers to work with clients to create service plans which can
include goals for increasing income, education, employment, physical and mental health goals and
housing stability plans. MHMR will provide one on-site mental health professional, a licensed
chemical dependence counselor, to work with clients who need mental health services including one
on one counseling and group sessions as well as activities to encourage socialization. JPS will
provide one on-site medical navigator to best assist tenants in connecting to needed medical
services.
This team approach will provide a robust support network for tenants.
City staff recommends awarding agreements to the listed agencies in the listed amounts:
Program Description Agency Funding FY 21
Case Assisting clients in Presbyterian Up to
Management setting and fulfilling Night $201,000.00
for Permanent goals such as health, Shelter of
Supportive education, Tarrant
Housing employment, housing County Inc.
Clients stability for permanent
supportive housing
clients
Mental Health Focus on housing My Health, Up to
Services for stability by addressing My $79,000.00
Permanent addiction, mental Resources
Supportive health, social, coping of Tarrant
Housing skills and other County
Clients adjustment difficulties (MHMR)
for permanent
supportive housing
clients;
Medical Connect clients to Tarrant Up to
Services appropriate medical County $70,000.00
Navigation services Hospital
District d/b/a
http://apps.cfwnet.org/council_packet/Me review.asp?ID=28209&councildate=9/15/2020 9/23/2020
M&C Review Page 3 of 3
JPS Health
Network
This M&C authorizes the City Manager or his designee to approve the renewal amounts up to the
amounts listed above, including any decreases for the specified agencies necessary to bring the total
renewal amounts in line with actual funding. Agencies impacted by a decrease in funding will be
notified as soon as practicable.
Directions Home services and programs are available in ALL COUNCIL DISTRICTS.
FISCAL INFORMATION/CERTIFICATION:
The Director of Finance certifies that upon approval of the above recommendations and adoption of
the Fiscal Year 2021 Budget by the City Council, funds will be available in the Fiscal Year 2021
Operating Budget, as appropriated, in the General Fund. Prior to an expenditure being incurred,
the City Manager's Office has the responsibility to validate the availability of funds.
TO
Fund Department Account Project Program Activity Budget Reference# Amount
ID ID Year Chartfield 2
FROM
Fund Department I Account Project Program Activity Budget Reference# Amount
ID ID Year Chartfield 2
Submitted for City Manager's Office by: Fernando Costa (6122)
Originating Department Head: Tara Perez (2235)
Additional Information Contact: Tara Perez (2235)
ATTACHMENTS
http://apps.cfwnet.org/council_packet/Mc review.asp?ID=28209&councildate=9/15/2020 9/23/2020