HomeMy WebLinkAboutMINUTES - 04161996 - C49 �.
TO: BOARD OF SUPERVISORS .
FROM: William Walker, M.D. , Health Services Director f '
' Contra
- Costa
DATE: April 4, 1996 --;; County
SUBJECT: Approve Standard Agreement (Amendment) #29-208-53 with the State Department of Health
Services for the Immunization Assistance Program
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
I. RECOMMENDED ACTION:
Approve and authorize the Chair, Board of Supervisors, or his designee, to
execute on behalf of the County, Standard Agreement (Amendment) #29-208-53
(State #95-22779, Al) , effective July 1, 1995 with the State Department of
Health Services (Immunization Unit) to increase the contract payment limit by
$193,534 from $254,968 to a new payment limit of $448,502 for FY 1995-96. This
program provides funds for County's Immunization Assistance Program.
II. FINANCIAL IMPACT:
Approval of this Standard Agreement (Amendment) by the State will result in an
increase of $193,534` of State and Federal funding for the Immunization
Assistance Program. No County match is required.
III. REASONS FOR RECOMMENDATIONS/BACKGROUND:
On July 11, 1995, the Board of Supervisors approved Standard Agreement #29-208-
52 with the State Department of Health Services for continuation of the long-
standing Immunization Assistance Program operated by the Public Health Division
of the Health Services Department. The County maintains this program to make
immunizations available to all persons in need of this service in order to
prevent the occurrence and transmission of childhood diseases. This program
also includes an adverse reaction monitoring system and outbreak control team.
This contract must be maintained in order for the County to continue to receive
free vaccine from the State.
Standard Agreement (Amendment) #29-208-53 will provide additional funds to
enhance and expand immunization services for County's Immunization Assistance
Program.
Eight signed copies of this agreement and three certified/sealed copies of this
Board Order should be returned to the Contracts and Grants Unit for submission
to the State Department of Health Services.
CONTINUED ON ATTACHMENT: YES SIGNATURE: J
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON April 16, I qQ6 APPROVED AS RECOMMENDED _X_ OTHER
VOTE OF SUPERVISORS
X UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
OF SUPERVISORS ON THE DATE SHOWN.
Contact: Wendel Brunner, M.D. (313-6712)
CC: Health Services Dept. (Contracts) ATTESTED _Dr-j-1- 16 1996
State DOHS
Phil Batchelor, Clerk of the Board of
Supervisors and Gou0q Administrator
M382/7-88 BY d1.A',4 YJ r4 �� -Y�� n DEPUTY
- i s
-STATE OF CALIfiORNIA 99A d, 49
STANDAE3'D AGREEMENT- APPROVED BY THE CONTRACTNUMBER M.NO.
ATTORNEY GENERAL
STD.2(REV.5-91) 95-22779 A-1
TAXPAYERS FEDERAL EMPLOYER IDENTIFICATION NUMBER
THIS AGREEMENT,malde and entered into this I St day of July 19 95 , 94-.6000509
in the State of California,by and between State of California,through its duly elected or appointed,qualified and acting
TITLE OF OFFICER ACTING FOR STATE AGENCY
Chief, Program Support Branch Department of Health Services ,hereafter called the State,and
CONTRACTOR'S NAME ® o
COUNTY OF CONTRA COSTA ;5 3 hereafter called the Contractor.
WITNESSETH: That the Contractor for and in consideration of the covenants,conditions,agreements,and stipulations of the State hereinafter expressed,
does hereby agree to furnish to the State services and materials as follows: (Set forth service to be rendered by Contractor,amount to be paid Contractor,
time for performance or completion,and attach plans and specifications,if any.)
In that certain agreement between this Department and the County of Contra Costa (Health Services) dated
June 1, 1995:
Paragraph 1 is amended to read:
"1. The Contractor shall complete the objectives as stipulated in the attached Exhibit A Revised entitled"Terms"consisting
of seven pages and made a part of this agreement by this reference".
Paragraph 2 is amended to read:
"2. The attached Exhibit B Revised, entitled "Budget", consisting of one page is made a part of this agreement by this
reference. Exhibit B Revised,Schedule 1,page 2,entitled"Desarollo Familiar",Schedule 2,page 3,entitled"Planned
Parenthood",and Schedule 3,page 4,entitled"Pittsburg Pre-School Coordinating Council,Inc.", are for informational
purposes only.
All references to Exhibit B shall now read Exhibit B Revised".
CONTINUED ON I SHEETS,EACH BEARING NAME OF CONTRACTOR AND CONTRACT NUMBER. FORM APPROVED
The provisions on the reverse side hereof constitute a part of this agreement. yip U ' `,+P'A s 'CSU Se
IN WITNESS WHEREOF,this agreement has been executed by the parties hereto,upon the date first above written.IV Plyqt�
STATE OF CALIFORNIA CONTRACTOR
AGENCY - CONTRACTOR(if other than an individu ,sta)a whether a corporation,partnership,etc.)
Department of Health Services COUNTCACATF(AZOSTA
BY(AUTHORIZED SIGNATURE) BY AUTHOR ED E)
D
PRINTED NAME OF PERSON SIGNINGEDWARD E. STAHLBERG CHIEF PRINTED NAME ND/ITJE OF ON SIGNING
PROGRAM SUPPORT BRANCH Chair, Board of Supervisors or his designee
TITLE ADDRESS
Chief Program Support Branch 651 Line :3treeci 11ar'tinez , California 94553
AMOUNT ENCUMBERED BY THIS PROGRAM/CATEGORY(CODE AND TITLE) FUND TITLE Department of General Services
DOCUMENT Clearing Account General Use Only
$ 193,534.00 (OPTIONAL USE)
PRIOR AMOUNT ENCUMBERED FOR FFP 88.9% Federal Catalog #93.268
THIS CONTRACT
$ 254,968.00 ITEM CHAPTER I STATUTE FISCAL YEAR
4260-001-001 303 1995 1995/96
TOTAL AMOUNT ENCUMBERED TO
DATE OBJECT OF EXPENDITURE(CODE AND TITLE)
$ 448,502.00 95-95330-9159-702-03-95158S-95
1 hereby certify upon my own personal knowledge that budgeted funds T.B.A7DATE B.R.NO.
are available for the period and purpose of the expenditure stated above.
SIGNATURE OF ACCOUNTING OFFICER
D
CONTRACTOR 0 STATE AGENCY DEPT.OF GEN.SER. ❑ CONTROLLER
STATE OF CALIFORNIA
STANDARD AGREEMENT
STC.2(REV.5.91) (REVERSE)
1. The Contractor agrees to indemnify,defend and save harmless the State,its officers,agents and employees
from anv and all claims and losses accruing or resulting to any and all contractors, subcontractors,
materialmen,laborers and any other person,firm or corporation furnishing or supplying work services,
materials or'supplies in connection with the performance of this contract,and from any and all claims and
losses accruing or resulting to any person,firm or corporation who may be injured or damaged by the_
Contractor in the performance of this contract.
2. The Contractor,and the agents and employees of Contractor,in the performance of the agreement,shall
act in an independent capacity and not as officers or employees or agents of State of California.
3.The State may terminate this agreement and be relieved of the payment of any consideration to Contractor
should Contractor fail to perform the covenants herein contained at the time and in the manner herein
provided. In the event of such termination the State may proceed with the work in any manner deemed
proper by the State. The cost to the State shall be deducted from any sum due the Contractor under this
agreement,and the balance,if any,shall be paid the Contractor upon demand.
4. Without the written consent of the State,this agreement is not assignable by Contractor either in whole
or in part.
5. Time is of the essence in this agreement.
6. No alteration or variation of the terms of this contract shall be valid unless made in writing and signed by
the parties hereto,and no oral understanding or agreement not incorporated herein,shall be binding on
any of the parties hereto.
7. The consideration to be paid Contractor, as provided herein, shall be in compensation for all of
Contractor's expenses incurred in the performance hereof, including travel and per diem, unless
otherwise expressly so provided.
91 61014
Contractor: County of Contra Costa Contract No.: 95-22779 A-1
(Health Services) Page 2
Paragraph 11. a. is amended to read:
"a. Under the terms of this contract for the period July 1, 1995 through June 30, 1996,the maximum amount payable shall
not exceed $398,502".
Paragraph 12 is amended to read:
"12. Under the terms of this contract, the combined maximum amount of state and federal funds payable through
June 30, 1996 shall not exceed$448,502".
Paragraph 15 is amended to read:
15. The attached Exhibit E entitled "Subcontracts for Services"consisting of one page is made a part of this agreement
by this reference".
Paragraph 16 is added to read:
"16. The attached Exhibit F entitled"Freeze Exemptions"consisting of one page is made apart of this agreement by this
reference".
Paragraph 17 is added to read:
1.7. The attached 7/95 version of Exhibit A(F) entitled "Additional Provisions" consisting of six pages, back-to-back,
numbered 1-4.2, hereby replace pages 1-4 of the (11/91) version of Exhibit A(F) entitled, "Additional Provisions
referenced in paragraph 5 of the original contract".
Paragraph 18 is added to read:
18. The Contractor(Grantee)shall comply with all requirements established under the Americans with Disabilities Act,in
order to make programs accessible to all participants and to provide equally effective communications".
Paragraph 19 is added to read:
19. The budget detail shown for subcontracts is displayed for information purposes only. Changes to a subcontractor's
identification or budget will not result in a formal contract amendment•. Copies of the budget detail and any changes
are on file with the State and the Contractor".
The effective date of this amendment is July 1, 1995.
All other terms and provisions of said contract shall remain in full force and effect.
EXHIBIT A REVISED
FY 1995-96 Pediatric - IAP
TERM'S
SECTION I. TERMS AND CONDITIONS
The Contractor must agree to the following inclusive objectives and conduct the following activities. Please
note that many of, these Terms and Conditions are also objectives and activities required by the Federal
Government and are conditions for funding of the California Immunization P-rggram'and/or statutory
requirements of State and local health departments. The level of subvention contract funding to be awarded
is not represented as sufficient for support of all the required activities; a significant amount of local support
and funding is expected. Subvention contract funds must not be used to supplant (i.e., replace) local funds
currently being,expended for routine immunization services and activities. Subvention funds can only be
used for the activities outlined in the budget justification.
A. Objectives:
1.) Raise to (or maintain) immunization levels of 98% or greater for each of the legally required
immunizations among all kindergarten entrants and incoming transfer students to schools within the
Contractor's jurisdiction.
2.) By 1996, 90% of two-year-olds should be vaccinated with one dose of measles, mumps, and
rubella (MMR) vaccine, three doses of polio vaccine, at least three dose of diphtheria, tetanus, and
pertussis (DTP) vaccine, and at least three doses of Haemophilus influenzae type b (Hib) vaccine
within the Contractors jurisdiction. In addition, 70% of two-year-olds should have received three
doses of hepatitis b vaccine.
3.) Through prevention, surveillance and outbreak control, reduce, and if possible eliminate, illness,
disability and death due to vaccine preventable diseases such as polio, diphtheria, tetanus,
pertussis, measles, rubella, mumps, hepatitis B, and Haemophilus Influenzae Type b within the
Contractor's jurisdiction.
B. Specific Pediatric Activities:
1.) Immunization Clinic Services
a.) Augment staffing in existing regularly scheduled public immunization clinics and/or expand
clinics in more locations on more days with longer hours which are reasonably accessible to
parents of children who reside within the Contractor's jurisdiction.
b.) Clinic policies must allow for the immunization of all,susceptible infants, children, adolescents
and adults who visit within the scheduled hours of operation regardless of their city, county or
state of residence.
c.) Public immunization clinic policies and practices must be in general accordance with the current
recommendations approved by the U.S. Public Health Service and endorsed by the American
Academy of Pediatrics (AAP) as specified in the 'Standards for Pediatric Immunization
Practices. (Note: ` The Standards represent the consensus of the National Vaccine Advisory
Committee (NVAC) and of a broad group of medical and public health experts about what
constitute the most desirable immunization practices. The Standards are expected to be useful
as a means of assisting providers to identify needed changes, to obtain resources if necessary,
and to actually implement the desirable immunization practices.) Accordingly, appropriate in-
service training shall be instituted to assure compliance with the Standards.
d.) Each patient (or patient's parents) receiving "pediatric" immunizations through the Contractor's
public clinics must be provided a new or updated California Immunization Record (CIR). The
month, day and year of each immunization must be recorded on the CIR.
e.) Assure that the importance of completing the recommended schedule of immunizations is
discussed with all patients (or parents of patients) receiving immunizations at the public clinics.
' EXHIBIT A(PediatriclAP Continued)REVISED
FY 1995-96 Page 2
f.) Assure that the date the next vaccine dose(s) are due is given in writing to the patient or parent.
The appropriate space on the CIR may be used for this purpose.
g.) Within the health jurisdiction, the Contractor shall implement and maintain public immunization
clinic reminder/recall systems among all medical providers,who receive state-supplied vaccines,
to improve age-appropriate immunizations of preschool-age children.'„
h.) In accordance with current Immunization Branch guidelines, which were furnished to the
contractor by the State, the Contractor must participate in the national Vaccine Adverse Events
Reporting System (VAERS)for adverse events following immunization.
2.) Immunization Assessment Levels
a.) In accordance with the guidelines and timetables provided by the Immunization Branch, the
Contractor must coordinate the assessment of the immunization levels of child care centers,
Head Start Centers, and kindergarten entrants.
b.) Through coordination with Immunization Branch Representatives, county health authorities and
local child care center and school authorities, the Contractor must make efforts to ensure that all
(100%) child care centers, Head Start centers and schools fully enforce existing regulations
pertaining to the immunization of children admitted to such institutions.
c.) Annually, within the health jurisdiction, the Contractor shall select at least a 20% representative
random sample of public clinics who receive state-supplied vaccine. Of the public clinics
selected, the Contractor shall conduct immunization record audits of children (24 months - 35
months old) who are served by the clinics. The sampling technique and immunization clinic
record methodology must be compatible with the methodology of the Immunization Branch of
the California Department of Health Services. The record audit specifications (with additional
detailed guidelines), if requested,will be provided to the Contractor by the CDHS Immunization
Branch.
3.) Immunization of Infants and Preschool Children
In addition to the above stated activities, the Contractor agrees to the following activities intended to
assure the age-appropriate immunization of infants and preschoolers who reside within the
Contractor's jurisdiction.
a.) Make efforts to ensure that the immunization status'bf infants and children receiving services
through programs such as CHDP, MCH, AFDC, and WIC are assessed and that a system is
established to ensure age-appropriate immunization.
b.) Promote immunization information and education of parents with newborn children through all
hospitals with maternity services within the Contractor's jurisdiction.
c.) The Contractor (local health department) receiving federal or state funds for immunization
activities shall ensure that all programs within the jurisdiction which deal with childhood
immunizations, including MCH and CHDP Programs, and private and primary care clinics, are
kept informed of planned activities aimed at raising immunization levels of infants and
preschoolers, so that they have the opportunity to provide assistance in the development,
implementation, and maintenance of these activities.
4.) Vaccine Preventable Disease Surveillance and Outbreak Control
a.) Establish and maintain an effective system for identification and reporting of suspect, probable
and confirmed cases of vaccine preventable diseases. Sources of surveillance information
should include practicing physicians, outpatient clinics, hospitals, schools, child care centers
and Head Start centers. Active surveillance is only required during outbreaks of measles.
EXHIBIT A(Pediatric IAP Continued)REVISED
FY 1995-96 Page 3
b.) Investigation and Control of Measles
1.) Investigation of all reported suspect, probable and confirmed cases of measles must be
- initiated within one working day of receipt of a report by the Contractor.
o
2.) Outbreak control procedures in accordance with the guidelines of the Immunization
Branch must be initiated by the Contractor within two working days of determination of a
probable or confirmed measles case.
C. Required Reports
1.) Reports of Local Program Progress and Activities
In accordance with the guidelines and format provided by the Immunization Branch, the Contractor
shall submit, through his/her Immunization Branch District Field Representative, to the Branch
identified in paragraph 6 of Section I in this Exhibit, by the 15th of the month following the end of
each quarter, a written quarterly report of progress and activities. In addition to the written report the
Contractor and Project Liaison, or his designee, may meet and discuss the above matters in person.
2.) Upon completion of the investigation of each probable or confirmed measles case, a completed
investigation form must be submitted to the Immunization Branch.
3.) Contractor agrees that itemized personnel positions listed in the Application for Immunization Project
Subvention Funds shall not be subject to Contractor's personnel policy decisions to refrain from
filling vacant positions. The total amount of the contract will be indicated as either some part,or all,of
the total operations budget. If the total amount of the contract is less than the total operations
budget, the Contractor will be responsible for providing the difference between the total amount of
the contract and the total operations budget. Further, all invoices to the State which request
reimbursements for positions included in the Contractor's Application for Immunization Project
Subvention Funds submitted bey the Contractor on APR 14 JJ9� shall include the name and
position title of the persons that have performed in{hese positions.
4.) The Contractor shall provide for any personnel or operating expenses that are necessary to meet the
provisions included herein but are not provided for in the Budget included as Exhibit "B".
5.) The Contractor shall submit through his/her Immunization Branch District Field Representative, to
the Branch identified in paragraph 6 of Section I in this Exhibit, on or before the 3rd of the month
following the report month, a written Monthly Vaccine Usage Report in'the form prescribed by the
State Department of Health Services, Immunization Branch.
6.) All reports, other than those required to be directed to the District Field Representatives, invoices,
and other written communications are to be addressed and delivered to the State Department of
Health Services, Immunization Branch, 2151 Berkeley Way, Berkeley, California 94704.
7.) The State reserves the right to use and reproduce all reports and data produced and delivered
pursuant to this Contract and reserves the right to authorize others to use or reproduce such
materials, provided that the confidentiality of patient information and records are protected pursuant
to California State laws and regulations.
8.) This Contract may be terminated by either party upon 30 days' written notice to the other party.
Further, this Contract may be terminated or suspended upon written notification by the State at any
time for failure on the part of the Contractor to comply with any of the provisions contained herein.
9.) In consideration of the above services, performed in a manner acceptable to the State, the State
shall reimburse the Contractor quarterly, in arrears, upon submission of a quarterly invoice by
Contractor on Contractor's letterhead, in quadruplicate stating the time period covered, stating the
EXHIBIT A(Pediatric IAP Continued) REVISED
FY 1995-96 Page 4
contract number, for actual expenditures in accordance with the approved budgetary detail, titled,
A p cation for Immunization Project Subvention Funds, submitted by the Contractor on.
��R 141995 ,to the Department of Health Services, Immunization Branch, 2151 Berkeley
Way, Room 712, Berkeley, CA 94704.
The Contractor may request and the State in its sole discretion may approve cumulative line item
shifts of up to a maximum of$10,000 per line item, so long as the annual contract amount does not
increase or decrease. Approved line item shifts meeting the criteria herein, shall not require a formal
contract amendment or control agency approval. Line item shifts may be proposed/requested by
either the State or the Contractor. Any changes to the approved budgetary detail, titled Application
for Immunization Project Subvention Funds, shall require prior approval by the State. The Contractor
shall submit a written explanation of the need for such excess and specifically identify the line item(s)
to be reduced in order to increase the excess iterri and provided further that the State reserves
the right to deny any such claim for any excess reimbursement on any item. It is further understood
that in no event shall the maximum amount payable under this agreement exceed the maximum
amount specified in paragraph 12 of the Standard Agreement.
10.) It is agreed by the Contractor that in the event that a significant portion of the Contract objectives for
the initial four months of the Contract are not met by that time; and in the event that the State
determines from quarterly invoices, performance reports, and other sources of information that the
Contractor will not perform the total quantity of services contracted for; and that therefore, the total
budget allocation will not be depleted; the State and/or Contractor may make an equitable
adjustment in the original Contract budget and Contract objectives in order to decrease the total
quantity of services and commensurate Contract amount. Any adjustment shall be by amendment
only and duly executed by both parties and approved by the Department of General Services (if
applicable).
SECTION 11. TERMS AND CONDITIONS FOR RECEIPT OF VACCINE PURCHASED
WITH STATE OF CALIFORNIA OR FEDERAL FUNDS
The local health department receiving vaccine purchased with State of California/Federal funds, herein called
State purchased vaccines, agrees to the following terms and conditions.
1.) Prior to receipt of an immunization, all patients (or their parents or legal guardians) must be:
a.) provided a copy of the current "Important Information" statement and/or "Vaccine Information
Statement"for each vaccine dose to be administered'(in the case of hepatitis B vaccine given to
newborn infants this can be provided to the mother during prenatal care or within 12 hours after
delivery);
b.) provided a reasonable opportunity to read the "Important Information" statement(s) and/or
"Vaccine Information Statement(s)";
c.) provided an opportunity to ask questions and have questions answered concerning the
benefits and risks of each immunization;
d.) specifically asked if they understand the information provided to them and if they have any
questions;
e.) given a telephone number to call should the patient become ill and have to visit a physician,
clinic or hospital within the 28 days following the immunization;
f.) provided the authorized appropriate translations of the "Important Information" statements
and/or"Vaccine Information Statements" if English is not their first language and their language
is one for which the State has made translations available.
EXHIBIT A(Pediatric IAP Continued) REVISED
FY 1995-96 Page 5
The Immunization Branch will supply to all local.health departments camera-ready copies of the
current "Important Information" statements and a supply of the "Vaccine Information
Statements" in English and Spanish. In addition, should a sufficient need exist, the
Immunization Branch will arrange for authorized translations and provide camera-ready copies of
the "Important Information" statements and a supply of "Vaccine Information Statements" in
other languages. 7
2.) Health care providers are not required to obtain the signature of the patient, parent, or legal
representative, acknowledging receipt of the "Important Information" statement(s) and/or "Vaccine
Information Statement(s)". However, to ensure that a record of provision of the materials exists,
health care providers must make notation in each patient's permanent medical record at the time the
"statements" are provided. For health care providers who obtain vaccine via federal contract, the
CDC Immunization Grant Guidance defines this as (1) date printed on the appropriate "Important
Information" statement(s) and/or "Vaccine Information Statement(s)" and (2) date the "Important
Information" statement(s) and/or "Vaccine Information Statement(s)" was given to the vaccine
recipient, parent, or legal representative.
The record card or log sheet must include as a minimum the following information:
a.) patient name
b.) address
c.) date of birth
d.) age at time of immunization
e.) type of vaccine(s) given
f.) clinic identification
g.) date of immunization
h.) site of immunization
i.) name and title of person administering the vaccine (e.g., S. Smith, R.N.)
j.) vaccine manufacturer
k.) vaccine lot number
I.) signature of patient or parent/guardian authorizing immunization (optional)
m.) date of signature (optional)
n.) date(s) printed on the "Important Information"statement(s) and/or"Vaccine
Information Statements" provided to the.patient or parent/guardian
NO ALTERATION, VARIATIONS OR ADDITIONS TO THE IMPORTANT INFORMATION
STATEMENTS, VACCINE INFORMATION STATEMENTS, OR VACCINE AGREEMENT MAY BE
MADE WITHOUT THE PRIOR WRITTEN APPROVAL OF,THE CHIEF OF THE IMMUNIZATION
BRANCH OF THE CALIFORNIA DEPARTMENT OF HEALTH SERVICES.
3.) The authorized immunization record card or authorized clinic log sheets must be stored by the local
health department in a retrievable file for a minimum of 10 years following the end of the calendar year
in which the statement was provided to the vaccine recipient, parent, or legal representative. In
addition, if a notice of a claim or lawsuit has been made,the record must be retained until after a final
disposition has been made.
4.) In the case of a school-based program, or other programs where the "Important Information"
statement(s) and/or "Vaccine Information Statement(s)" are to be read in advance of the
immunization by the patient or parent/guardian or other authorized person who will not be present at
the site where the immunizations are to be given, procedures shall be established and made known
for answering questions by telephone.
5.) Outside non-profit providers of immunization services must sign the State provided "Outside
Provider Agreement for Receipt of State-Supplied Vaccines" terms prepared by the State
Immunization Branch before they may receive State purchased vaccine. Medical providers of
immunization services who sign the agreement must agree to use the "Important Information"
A
EXHIBIT A(Pediatric IAP Continued) REVISED +t
FY 1995-96 Page 6
statements and/or "Vaccine Information Statements" and must be provided as many copies of the
statements as vaccine doses distributed, or at least one camera-ready copy of each vaccine
-- statement. The "Outside Provider Agreement..." and the use of the "Important Information"
statements and/or"Vaccine Information Statements" are required in clinic settings even if the clinics
are supervised by a physician in attendance. The "Outside Provider Agreement..." shall be signed
annually by non-health department medical providers and retained by the local health department for
a minimum of ten years following the last calendar year in which the State Immunization Branch
purchased vaccine was provided.
6.) No charge may be made to the patient, parent, guardian or third party payer for the cost of State
purchased vaccine provided to local health departments by the Immunization Branch. In addition,
outside, non-profit providers of immunization services receiving State purchased vaccine may not
charge patients or parents for the cost of vaccine. Charges made by local health departments for the
direct costs incurred for administration or injection of the vaccine are discouraged but are not
specifically prohibited. Should the health department or outside medical provider receiving state
vaccine establish an administration fee for an injection of vaccine, information, e.g., sign/poster, must
be prominently displayed which indicates that no one receiving an immunization in a public clinic may
be denied vaccine provided through public funds for failure to pay the administration fee or failure to
make a donation to the provider.
7.) Local health departments and other private and public providers utilizing State purchased vaccine
and/or hepatitis B immune globulin (HBIG) must report quarterly the vaccine and HBIG doses
administered, by vaccine type and age group of patient, and dose in series (for multiple-dose
vaccines) in a format provided by the Immunization Branch. Reports should be submitted to the
Immunization Branch by the third day of the following month.
8.) Each quarter, the local health department must report a current vaccine inventory including all sites
within the county or local jurisdiction. The Immunization Branch will supply the reporting forms. All
local health departments are to notify their Immunization Branch Field Representative of any vaccine
which is unlikely to be used not later than three months prior to its date of expiration.
9.) The local health department agrees to ensure that the storage and handling of State purchased
vaccine within its facilities is in accordance with the manufacturers' specifications. The local health
department also agrees to inform other providers who receive Immunization Branch purchased
vaccine of the manufacturers' specifications for vaccine storage and handling.
EXHIBIT A(Pediatric-IAP-Hepatitis B Continued) Revised
FY 1995-96 Page 7,
SECTION III. TERMS AND CONDITIONS FOR COLLABORATIVE FUNDS
A. Objective
1) By June 30, 1996, within the catchment area the Contractor shall have implemented
and shown documented progress of targeting the "highest risk" children under four years
of age to ensure they receive age-appropriate immunizations on time.
B. Required Reports
1) The quarterly progress report will document the efforts made toward achieving the revised goals,
objectives, and activities stated in the Contractor's Request for Proposal (collaborative application)
originally submitted to the California Department of Health Services Immunization Branch,July 1995.
EXHIBIT B REVISED
BUDGET
Page 1
County of Contra Costa (Health Services)
Contract Number 95-22779 A-1
July 1, 1995 - June 30, 1996
Adjustment
Effective
Prior Approved 7/1/95 New Approved
Amount (-)and/or+ Amount
1. PERSONNEL COSTS $184,703.00 $29,052.00 $213,755.00
II. FRINGE BENEFITS @ 11.09%- 31% $49,374.00 - $3,998.00 $53,372.00
III. OPERATING EXPENSES $5,000.00 $29,221.00 $34,221.00
IV. EQUIPMENT EXPENSES $3,000.00 $1,605.00 $4,605.00
V: TRAVEL AND PER DIEM $4,200.00 $3,195.00 $7,395.00
VI. SUBCONTRACTS $8,691.00 $125,463.00 $134,154.00
VI1. DIRECT OVERHEAD TOTAL = I. - VI. $254,968.00 $192,534.00 $447,502.00
VIII. INDIRECT COSTS @ 0% $0.00 $0.00 $0.00
IX. OTHER COSTS $0.00 $1,000.00 $1,000.00
TOTAL BUDGET $254,968.00 $193,534.00 $448,502.00
'DHS'83 2(2/94) EXHIBIT B REVISED -SCHEDULE 1
BUDGET
PAGE
APPLICATION FOR IMMUNIZATION PROJECT SUBVENTION FUNDS
Applicant: County of Contra Costa
(Health Services)
Budget Period From: 7/1/95-6/30/96
Subcontracts
Name of Applicant(subcontractor): Deparollo, Familiar
Contact Person. Frank
Address: 2W-Mth Street
CRY.$11ale,&zip owe: Richmond, Cai J nia 94aas
Telephone 9: 510-412-5930
Federal Tax 1.0.Nun-ber- . 94-2751073
Dollar Amount
I.Personal Services. %of Time or Salary Range or Requested from
of gms; vw&iab
Outreach Workers (2) 188 Hours I1. $ 2068.00
Persona(Servioes Subtotal $ $ 2068 00
Fringe Benefit Rate 29 % 600.00
Personal$ervices suf2fatal --2668,.00
11.Operating Expenses
Supplies 1032.00
Printing 100.00
Travel 100.00
Equipment Telephone
100.00
operig(Irig EXpenseS 5abiota1 —1332.00
Subcordract Total = Q. Per.Services*ti.Operating Expen-1 r$ 4()OO.OT
Note: A written justification of the above Contractor service(s)and expected completed
work product(s) must be included in Exhibit C Budget Justification of this agreement.
This schedule is being provided for informational purposes. Changes to the schedule do not require
a contract amendment.
Q
DHS 8312(2/94) EXHIBIT B REVISED -SCHEDULE 2
BUDGET
PAGE 3
APPLICATION FOR IMMUNIZATION PROJECT SUBVENTION FUNDS.
Applicant: County of Contra Costa
(Health Services)
Budget Period From: 7/1/95- 6/30/96
Subcontracts
Names of Subwnbwtor. Planned Parenthood
Addrees: 2186 Pacheco St,
City, Staff, &Zip Code. Concord, CA 9452.0
Telephone*. X510) sm 0505 -
Federal Tax ID# 94-1575233
1. r$onalSenrices Rate of Dollars requkod
Lust Positions) Time Period Reimbursement from California
MediCW its-3 15 hrstwk $9 -11/hour $17,580
CliniciM (PNNP) 3 6 hrsfwk X25-31N $21,06p
Out Serialist 4 hrs/wts $15-1 VW $2,625
Pro wam &Dery rDr 5 hrs $15-181hr $3,120
Fmoo is @ 19% $8,427
Persona!Serum Subtofti
r1. Op ►g Mpmsw
Supplies 3.781.00
Health Education Mate s 3,150m
Trani (in—state) 750.00
Equipment
Operating Expense Subtotal T,-6 6 11.o
F- Subcon tsTOW 60,463.00
Note: A written justification of the above Contractor service(s)and expected completed
work product(s) must be included in Exhibit C Budget Justification of this agreement.
This schedule is being provided for informational purposes. Changes to the schedule do not require
a contract amendment.
DHS 8312(2/94) EXHIBIT B REVISED - SCHEDULE 3 C.q7
BUDGET
PAGE 4
APPLICATION FOR IMMUNIZATION PROJECT SUBVENTION FUNDS
Applicant: County of Contra Costa
(Health Services)
Budget Period From: 7/1/95-6/30/96
Subcontracts
Pittsburg Pre-school Coordinating Council, Inc.
Name of Subcontractor:
Address:
City, State, &Zip Code: Pittsburg, CA 94565
Telephone#:
Federal Tax I.D. Number:
I. PERSOMEL SERVICES % of Time Range 0 of Mo. Amount
1 . Fxecut.lve Director 2.5% $6587-6666 6 $ 986
2. Health Ed Coordinator 2.5% 2917-3000 12 876
3 , Out7Ceat`h Coordinator 11) _099 1993-2253 6 1 .352
4. Tmmun. Outreach Super , 54 . 0% 1560-1994 .6 5,980
5. Sr. Oul-reach Worker 40.0% 19117-1993 6 4.576
6. Outreach Workers (3) 100.0% 14-77-1560 6 2151.080
7. Outreach Worker 12.5% 1477--15613 12 2.340
B. clank 20.0% 121.3- 1387 6 1 ,664
Per3onne 1 9ervi c.ez Subtotal 45,856
Staff Benefits @ 24% 11 . 004
Pemonne I Services Total $56,860
11. OPERAT'[NG EXPENSES
1 . Suppl ie's &. materials $ 1 ,800
2. Printing 750
3. Local Travel 4. 506
4. Equspm'1at +4.575
5. TeIecarranunicat ions 1.200
Operating Expepoefr Subtotal $1 2.831
TOTAL SUBG03FTRACT BUDGET $69.691
Note: A written justification of the above Contractor service(s) and expected completed
work product(s) must be included in Exhibit C Budget Justification of this agreement.
This schedule is being provided for informational purposes. Changes to the schedule do not require
a contract amendment.
EXHIBIT E
C �9
SUBCONTRACTS FOR SERVICES
A. Prior written authorization will be required before the Contractor enters into or is_reimbursed for any subcontract for
services costing$5,000 or more. For subcontracts for services exceeding$5,000, Contractors shall obtain at least
three bids or justify a sole source award.
1. The Contractor must provide in its request for authorization, all particulars necessary for evaluating the
necessity or desirability of incurring such cost.
2. The State may identify the information needed to fulfill this requirement.
B. The State reserves the right to approve or disapprove the selection of subcontractors, require the substitution of
subcontractors, and order the termination of subcontracts entered into in support of this agreement.
C. Actual subcontracts (i.e., written agreement between the Contractor and a subcontractor) of $5,000 or more are
subject to the prior review and written approval of the State. The State may, at its discretion, elect to waive this right.
All such waivers shall be confirmed in writing by the State.
D. Contractor shall maintain a copy of each subcontract entered into in support of this agreement and shall, upon
request by the State, make said copies available for approval, inspection,or audit.
E. Sole responsibility rests with the Contractor to ensure that Subcontractors are paid in a timely manner.
F. The Contractor is responsible for all performance requirements under this agreement even though performance
may be carried out through a subcontract.
G. The Contractor is responsible for a subcontractor's actions or failure to take action in fulfilling the requirements of this
agreement.
H. The Contractor may be required to supply budget detail for each subcontractor and/or each major subcontracted
activity under this agreement.
1. Budget detail format and submission requirements will be prescribed by the State.
2. Methods of including budget detail in this agreement, if applicable,will be prescribed by the State.
3. Any subcontractor budget detail displayed in this agreement, oG incorporated by reference, is included for
information purposes only.
a. Changes to a subcontractor's identity or subcontract budget detail may be made with the mutual
consent of the State and the Contractor and said changes shall not require the processing of a
formal amendment to this agreement.
I. The Contractor shall ensure that all subcontracts for services include provision(s) requiring compliance with
applicable terms and conditions specified in this agreement.
J. The Contractor agrees to include the following clause, relevant to record retention, in all subcontracts for services:
"(Subcontractor Name) agrees to maintain and preserve, until three years after termination of (Contract Number] and
final payment from the State, and to permit the State or any duly authorized representative, to have access to,
examine or audit any pertinent books, documents, papers and records related to this subcontract."
K. Unless otherwise stipulated in writing by the State,the Contractor shall be the subcontractor's sole point of contact
for all matters related to performance and payment under this agreement.
L EXHIBIT F
Freeze Exemptions
A. Contractor agrees that any hiring freeze adopted during the term of this
agreement shall not be applied to the positions funded, in whole or in
part, by this agreement.
B. Contractor agrees not to implement any personnel policy which may
adversely affect performance or the positions funded, in whole or in part,
by this agreement.
C. Contractor agrees that any travel freeze or travel limitation policy
adopted during the term of this agreement shall not restrict travel
funded, in whole or in part, by this agreement.
D. Contractor agrees that any purchasing freeze or purchase limitation
policy adopted during the term of this agreement shall not restrict or
limit purchases funded, in whole or in part, by this agreement.
Exhibit A (F)
STATE OF CALIFORNIA
DEPARTMENT OF HEALTH SERVICES
ADDITIONAL PROVISIONS
(FOR FEDERALLY FUNDED SUBVENTION AID/LOCAL ASSISTANCE
AND COST REIMBURSEMENT CONTRACTS/GRANTS)
1. Equal Opportunity Clause
A. The Contractor will not discriminate against any employee or applicant for employment
because of race, color, religion, sex, national origin, physical or mental handicap, or age.
The Contractor will take affirmative action to ensure that qualified applicants are employed,
and that,employees are treated during employment without regard to their race, color,
religion, sex, national origin, physical or mental handicap, or age. Such action shall include,
but not be limited to the following: employment, upgrading, demotion or transfer; recruitment
or recruitment advertising; layoff or termination, rates of pay or other forms of compensation;
and careerdevelopment opportunities and selection for training, including apprenticeship.
The Contractor agrees to post in conspicuous places, available to employees and applicants
for employment, notices to be provided by the Federal Government the State, setting forth
the provisions of the Equal Opportunity clause and the Rehabilitation Act of 1973. Such
notices shall state the Contractor's obligation under the law to take affirmative action to
employ and advance in employment qualified applicants without discrimination based on their
race, color, religion, sex, national origin, physical or mental handicap or age and the rights
of applicants and employees.
B. The Contractor will, in all solicitations or advertisements for employees placed by or on
behalf of the Contractor, state that all qualified applicants will receive consideration for
employment without regard to race, color, religion, sex, national origin, physical or mental
handicap or age.
C. The Contractor will send to each labor union or representative of workers with which he or
she has a collective bargaining agreement or other contract or understanding a notice, to be
provided by the Federal Government or the State, advising the labor union or worker's
representative of the Contractor's commitments under this Equal Opportunity clause and
shall post copies of the notice in conspicuous places available to employees and applicants
for employment.
D. The Contractor will comply with all provisions of the Rehabilitation Act of 1973 and of the
Federal Executive Order No. 11246 as amended, and of the rules, regulations, and relevant
orders of the Secretary of Labor.
E. The Contractor will furnish all information and reports required by Federal Executive Order
No. 11246 as amended and the Rehabilitation Act of 1973, and by the rules, regulations, and
orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books,
records, and accounts by the contracting agency and the Secretary of Labor for purposes of
investigation to ascertain compliance with such rules, regulations and orders.
CMS Instructional Bulletin No.02(Rev.7195) -1-
Exhibit A (F)
F. In the event of the Contractor's noncompliance with the requirements of this Equal
Opportunity clause or with any federal rules, regulations, or orders which are referenced
in this clause, this contract may be canceled, terminated, or suspended in whole or in
part and the Contractor may be declared ineligible for further federal or state contracts
in accordance with procedures authorized in Federal Executive Order No. 11246 as
amended and such other sanctions may be imposed and remedies invoked as provided
in Federal Executive Order No. 111246 as amended, or by rule,,regulation, or order of
the Secretary of Labor, or as otherwise provided by law.
G. The Contractor will include the provisions of paragraphs [a] through [g] in every
subcontract or purchase order unless exempted by rules, regulations, or orders of the
Secretary of Labor issued pursuant to Federal Executive Order No. 11246 as amended,
or Section 503 of the Rehabilitation Act of 1973, so that such provisions will be binding
upon each subcontractor or vendor. The Contractor will take such action with respect
to any subcontract or purchase order as the Director of the Office of Federal Contract
Compliance Programs or the State may direct as a means of enforcing such provisions
including sanctions for noncompliance provided, however, that in the event the
Contractor becomes involved in, or is threatened with, litigation with a subcontractor or
vendor as a result of such direction by the State, the Contractor may request in writing
to the State, who, in turn, may request the United States to enter into such litigation to
protect the interests of the State and of the United States.
2. Travel and Per Diem
Any reimbursement for necessary travel and per diem shall be at rates currently in effect, as
established by the Department of Personnel Administration, for similar State employees.
Exceptions to these rates may be approved by the State upon the verification of a statement
submitted by the Contractor indicating that such rates are not available to the Contractor. No
travel outside the State of California shall be reimbursed without prior written authorization from
the.State.
3. Purchasing/Procurement Rules
A. Units of local government, public entities (including the Universities of California
and California State University and auxiliary organizations/foundations thereof), and
State or federal agencies, whether acting as a contractor and/or subcontractor, may
use their existing procurement systems to secure all articles, supplies, equipment
(e.g., nonexpendable items with a unit cost of$500 or more and a useful life expectancy
of four or more years, including EDP/ADP, telecommunications and motor vehicles), and
services related to such purchases that are required in performance of this agreement,
without regard to dollar limit, subject to the provisions in paragraphs E through I
of this section. The provisions in paragraphs B. C. and D of this section may also apply,
if purchases are subdelegated to subcontractors that are nonprofit organizations,
for-profit entities or private vendors.
B. All other entities (nonprofit organizations and for-profit entities or private vendors),
whether acting as a contractor.or subcontractor, may use their existing procurement
systems to secure articles, supplies, equipment (e.g., nonexpendable items with a
unit cost of$500 or more and a useful life expectancy of four or more years, including
EDP/ADP, telecommunications and motor vehicles), and services related to such
purchases that are required in performan-ce of this agreement. Equipment procurement
shall not exceed an annual maximum limit of$50.000, subject to the provisions in
paragraphs C through I of this section. The provisions in paragraph A of this section
may also apply, if purchases are subdelegated to subcontractors that are units of local
government or pubic entities. State or federal agencies.
CMS Instructional Bulletin No.02(Rev.7(95) -27
Exhibit A (F)
C. All other entities(nonprofit organizations and for-profit entities or private vendors),
whether acting as a contractor or subcontractor, shall use procurement systems
that meet the following standards:
(1) Maintain a code or standard of conduct that shall govern the performance of its
officers, employees, or agents engaged in awarding procurement contracts. No
employee, officer, or agent shall participate in the selection, award, or
administration of a procurement contract in which, to his or her knowledge, he or
she has a financial interest.
(2) Procurements shall be conducted in a manner that provides, to the maximum
extent practical, open and free competition.
(3) Procurements shall be conducted in a manner that provides for all of the
following:
(a) Avoidance of the purchasing of unnecessary or duplicate items.
(b) Solicitations for capital expenditures (equipment) shall be based upon a
clear and accurate description of the technical requirements of the goods
to be procured.
(c) The taking of positive steps to utilize small, minority, women, or veteran
owned businesses.
D. To secure equipment above the annual maximum limit of $50,000, the Contractor
shall make arrangements through the appropriate Department of Health Services (DHS)
program contract manager, to have all remaining equipment purchased through the. DHS
Purchasing Unit by way of the Department of General Services, Office of Procurement.
The cost of equipment purchased by or through State shall be deducted from the funds
available in this agreement. Contractor shall submit to the DHS Purchasing Unit a list
of equipment specifications for those items which the State must procure. The State
may pay the vendor directly for such arranged equipment purchases and title to the
equipment will remain with the State. The equipment will be delivered to jhe Contractor's
address, as stated on the face of the agreement, unless the Contractor notifies the State,
in writing, of an alternate delivery address.
E. Prior written authorization from the appropriate DHS program contract manager will be
required before the Contractor will be reimbursed for any purchase of$5,000 or more for
articles, supplies, equipment, and services related to such purchases. The Contractor
must provide in its request for authorization all particulars necessary, as specified by the
State, for evaluating the necessity or desirability of incurring such costs. The term
"purchase" excludes the purchase of services from a subcontractor and public utility
services at rates established for uniform applicability to the general public.
F. In special circumstances, defined by the State, the State may require prior written
authorization and/or the submission of paid vendor receipts for any purchase, regardless
of dollar amount. The State reserves the right to either deny claims for reimbursement
or to request repayment for any Contractor and/or Subcontractor purchase that the State
determines to be unnecessary in carrying out performance under this agreement.
CMS Instructional Bulletin No.02(Rev.7195) -3-
Exhibit A (F)
G. The Contractor and/or Subcontractor must maintain a copy or narrative description,of the
procurement system, guidelines, rules, or regulations that will be used to make
purchases under this agreement. The State reserves the right to request copies of these -
documents and to inspect the purchasing practices of the Contractor and/or a
Subcontractor at any time.
H. For all purchases, the Contractor and/or Subcontractor must maintain copies of all paid
vendor invoices, documents, bids and other information used in vendor selection, for
inspection or audit by the State. Justifications supporting the absence of bidding (i.e.,
sole source purchases) shall also be maintained on file by the Contractor and/or
Subcontractor for inspection or audit by the State.
I. The State may, with cause (e.g., with reasonable suspicion of unnecessary purchases
or use of inappropriate purchase practices, etc.), withhold, cancel, modify, or retract the
delegated purchase authority granted under paragraphs A and\or B of this section, by
giving the Contractor no less than 30 calendar days written notice.
4. OWNERSHIP/DISPOSITION OF EQUIPMENT PURCHASED/REIMBURSED WITH CONTRACT
FUNDS OR FURNISHED BY THE STATE
A. All equipment of any kind, as defined in section 3 paragraph A, purchased/reimbursed
with contract funds or furnished by the State under the terms of this agreement and not
fully consumed in performance of this agreement shall be considered State equipment
and the property of the State.
B. Title to State.equipment shall not be affected by its incorporation or attachment to any
property not owned by the State.
C. Unless otherwise stipulated, the State shall be under no obligation to pay the cost of
restoration, or rehabilitation of the Contractor's and/or a Subcontractor's facility which
may be affected by the removal of any State equipment.
D. The Contractor and/or Subcontractor shall maintain and administer, according to State
directives and sound business practices, a program for the proper use, maintenance,
repair, protection, insurance and preservation of State equipment.
E. Equipment, as defined in section 3 paragraph`A, purchased/reimbursed with contract
funds or furnished by the State under the terms of this agreement, shall only be used for,
performance of this agreement.
F. Contractor shall submit an annual inventory of equipment, as defined in section 3
paragraph A, purchased/reimbursed with contract funds or furnished by the State under
the terms of this agreement. Include in that inventory, said equipment in the Contractor's
possession and/or in the possession of a subcontractor. The State will prescribe the
inventory format and may supply applicable forms to be used for this purpose.
G. Within 90 calendar days prior to the termination or end of this agreement, the Contractor
shall provide a final inventory of equipment to the State and shall at that time query the
State as to the requirements, including the manner and method, of returning State
equipment to DHS. Final disposition of equipment shall be at State expense and
according to State instructions. Property disposition instructions shall be issued by the
State immediately after receipt of the final equipment inventory.
CMS Instructional Bulletin No.02(Rev.7195) -4.0-
Exhibit A(F)
H. Motor Vehicles
: 1. If motor vehicles are purchased/reimbursed with contract funds or furnished by
the State under the terms of this agreement, within 30 calendar days prior to the
termination or end of this agreement, the Contractor and/or Subcontractor shall
return such vehicles to the State and shall deliver all necessary documents of title
or registration to enable the proper transfer of a marketable title to the State.
2. If motor vehicles are purchased/reimbursed with contract funds or furnished by
the State under the terms of this agreement, the State shall be the legal owner
of said motor vehicles and the Contractor shall be the registered owner. The
Contractor and/or a Subcontractor may only use said vehicles for performance
and under the terms of this agreement.
3. The Contractor and/or Subcontractor agree that all operators of motor'vehicles,
purchased/reimbursed with contract funds or furnished by the State under the
terms of this agreement, shall hold a valid State of California driver's license. In
the event that 10 or more passengers are to be transported in any one vehicle,
the operator shall also hold a State of California Class B driver's license.
4. If any motor vehicle is purchased/reimbursed with contract funds or furnished by
the State under the terms of this agreement, the Contractor and/or
Subcontractor, as applicable, shall provide, maintain and certify that, at a
minimum, the following type and amount of automobile liability insurance is in
effect during the term of this agreement or any period of contract extension
during which any vehicle remains in the Contractor's and/or a Subcontractor's
possession:
a. Automobile Liability Insurance
The Contractor, by signing this agreement, hereby certifies that it
possesses or will obtain automobile liability,insurance in the amount of
$500,000 per occurrence for bodily injury and property damage combined.
Said insurance must be obtained and made effective upon the delivery
date of any motor vehicle, purchased/reimbursed with contract funds or
furnished by the State under the terms of this agreement, to the
Contractor and/or Subcontractor.
b. The Contractor and/or Subcontractor shall, as soon as practical, furnish
a copy of the certificate of insurance to the State.
C. The Contractor and/or Subcontractor agree that bodily injury and property
damage liability insurance, as required herein, shall remain in effect at all
times during the term of this agreement or until such time as the motor
vehicle is returned to the State.
d. The Contractor and/or Subcontractor agree to provide, at least 30 days
prior to the expiration date of said insurance coverage, a copy of a new
certificate of insurance evidencing continued coverage, as indicated
herein, for not less than the remainder of the term of this agreement, the
term of any extension or continuation thereof, or for a period of not less
than one (1) year.
CMS Instructional Bulletin No.02(Rev.V95) -4.1-
Exhibit A (F)
e. The.Contractor and/or Subcontractor must provide evidence, that any
required certificates of insurance contain the following provisions:
1. The insurer will not cancel the insured's coverage without giving .
30 calendar days prior written notice to the State (Department of
Health Services).
2. The State of California, its officers, agents, employees, and
servants are included as additional insureds, but only insofar as
the operations under this agreement and any extension or
continuation of this agreement are concerned.
3. The insurance carrier shall notify the State of California
Department of Health Services, in writing, of the Contractor's
failure to pay premiums; its cancellation of such policies; or any
other substantial change, including, but not limited to, the status,
coverage, or scope of the required insurance. Such notices shall
contain a reference to the contract number for which the
insurance was obtained.
f. The Contractor and/or Subcontractor is hereby advised that copies of
certificates of insurance may be subject to review and approval by the
Department of General Services, Office of Insurance and Risk
Management. The Contractor shall be notified by the State, in writing, if
this provision is applicable to this agreement.
g. In the event the Contractor and/or Subcontractor fails to keep insurance
coverage, as required herein, in effect at all times during vehicle
possession, the State may, in addition to any other remedies it may have,
terminate this agreement upon the occurrence of such event.
5: Standards of Work
The Contractor agrees that the performance of work and services pursuant to the requirements
of this contract shall conform to high professional standards.
CMS Instructional Bulletin No.02(Rev.7195) -4,2-