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									          HARRIS COUNTY
    REQUEST FOR PROPOSAL                                                       JOB NO. 98/0429
                  Cover Sheet
                                                                               Date Due: November 24, 1998
                                                                               DUE NO LATER THAN 1:00 P.M.

                                                                               Proposals received later than the date
                                                                               and time above will not be considered.


 PROPOSAL TO: Provide Ryan White Title I Services for Harris County

                                                 OFFERORS NOTE!!
Carefully read all instructions, requirements and specifications. Fill out all forms properly and completely. Submit your proposal with all
appropriate supplements and/or samples.

Please return proposal in the envelope provided or in a comparable size envelope. Be sure that return envelope shows the Job Number,
Description and is marked "SEALED PROPOSAL."

                                          RETURN PROPOSAL TO:
                                  HARRIS COUNTY PURCHASING AGENT
                                    1001 PRESTON AVENUE, SUITE 670
                                          HOUSTON, TEXAS 77002

For additional information, contact           Mary Lou Sotolongo at (713) 755-6832.

You must sign below in INK; failure to sign WILL disqualify the offer. All prices must be typewritten or written in
ink.
                    Service Category Code__________________

                              Total Amount of Proposal: $_______________________

Company Name:______________________________________________________

Company Address: ____________________________________________________

                  _________________________________________________________

Telephone No. __________________________FAX No. _______________________

Print Name: _________________________________________________________________

Signature: ___________________________________________________________________
[Your signature attests to your offer to provide the goods and/or services in this proposal according to the published provisions of this
Job. After Commissioners Court award of bid, a Purchase Order will be issued. Contract is not valid until Purchase Order is
issued.]

ACCEPTED BY:_____________________________________________Date:______________________
               Robert Eckels, County Judge
                                                                  TABLE OF CONTENTS

Items checked below represent components which comprise this bid/proposal package. If the item IS NOT checked, it is NOT APPLICABLE to this
bid/proposal. Offerors are asked to review the package to be sure that all applicable parts are included. If any portion of the package is missing, notify the
Purchasing Department immediately.

It is the Offeror's responsibility to be thoroughly familiar with all Requirements and Specifications. Be sure you understand the following before you return
your bid packet.

   X      1.        Cover Sheet
                    Your company name, address, the total amount of the bid/proposal, and your signature (IN INK) should appear on this page.

   X   2. Table of Contents
                    This page is the Table of Contents.

   X 3. General Requirements
                 You should be familiar with all of the General Requirements.

   X   4. Special Requirements/Instructions
                   This section provides information you must know in order to properly make an offer.

   X   5. Specifications
                    This section contains the detailed description of the product/service sought by the County.

       6. Pricing/Delivery Information
                   This form is used to solicit exact pricing of goods/services and delivery costs.

   X   7. Attachments
                     X       a.          Residency Certification
                                         Be sure to complete this form and return with packet.

                    ______     b.        Bid Guaranty & Performance Bond Information & Requirements
                                         This form applies only to certain bids/proposals. Please read carefully and fill out completely.

                    ______     c.        Bid Check Form
                                         This form applies only to certain forms. Please read carefully and fill out completely.

                    ______     d.        Vehicle Delivery Instructions
                                         Included only when purchasing vehicles

                               e.        Minimum Insurance Requirements
                                         Included when applicable (does not supersede "Hold Harmless" section of General Requirements).

                             f. Workers' Compensation Insurance Coverage Rule 110.110
                                        This requirement is applicable for a building or construction contract.

                    ______     g.        Financial Statement
                                         When this information is required, you must use this form.

                    ______     h.        Reference Sheet

                       X       i.        Other
                                         From time to time other attachments may be included.
                                               GENERAL REQUIREMENTS
                                                   FOR PROPOSALS

READ THIS ENTIRE DOCUMENT CAREFULLY. FOLLOW ALL INSTRUCTIONS. YOU ARE RESPONSIBLE FOR
FULFILLING ALL REQUIREMENTS AND SPECIFICATIONS. BE SURE YOU UNDERSTAND THEM.

General Requirements apply to all advertised requests for proposals, however, these may be superseded, whole or in part, by the SPECIAL
REQUIREMENTS/INSTRUCTIONS OTHER DATA CONTAINED HEREIN. Review the Table of Contents. Be sure your proposal
package is complete.

GOVERNING LAW
Offeror is advised that these requirements shall be fully governed by the laws of the State of Texas and that Harris County may request and
rely on advice, decisions and opinions of the Attorney General of Texas and the County Attorney concerning any portion of these
requirements.

PROPOSAL COMPLETION
Fill out and return to Purchasing, ONE (1) complete proposal form, using the envelope provided. An authorized company representative
should sign the Cover Sheet. Completion of these forms is intended to verify that the offeror has submitted the proposal, is familiar with its
contents and has submitted the material in accordance with all requirements.

PROPOSAL RETURNS
Offerors must return all completed proposals to the Harris County Purchasing Department reception desk at 1001 Preston Avenue, Suite 670,
Houston, Texas before 1:00 P.M. on the date specified. Late proposals will not be accepted.

GOVERNING FORMS
In the event of any conflict between the terms and provisions of these requirements and the specifications, the specifications shall govern. In
the event of any conflict of interpretation of any part of this overall document, Harris County's interpretation shall govern.

ADDENDA
When specifications are revised, the Harris County Purchasing Department will issue an addendum addressing the nature of the change.
Offerors must sign it and include it in the returned proposal package.

HOLD HARMLESS AGREEMENT
Contractor, the successful offeror, shall indemnify and hold Harris County harmless from all claims for personal injury, death and/or property
damage resulting directly or indirectly from contractor's performance. Contractor shall procure and maintain, with respect to the subject matter
of this proposal, appropriate insurance coverage including, as a minimum, public liability and property damage with adequate limits to cover
contractor's liability as may arise directly or indirectly from work performed under terms of this proposal. Certification of such coverage must
be provided to the County upon request.

WAIVER OF SUBROGATION
Offeror and offeror's insurance carrier waive any and all rights whatsoever with regard to subrogation against Harris County as an indirect
party to any suit arising out of personal or property damages resulting from offeror's performance under this agreement.

SEVERABILITY
If any section, subsection, paragraph, sentence, clause, phrase or word of these requirements or the specifications shall be held invalid, such
holding shall not affect the remaining portions of these requirements and the specifications and it is hereby declared that such remaining
portions would have been included in these requirements and the specifications as though the invalid portion had been omitted.

BONDS
If this proposal requires submission of proposal guarantee and performance bond, there will be a separate page explaining those requirements.
Offers      submitted      without     the    required      proposal    bond      or    Cashier's      Check      are     not     acceptable.
TAXES
Harris County is exempt from all federal excise, state and local taxes unless otherwise stated in this document. Harris County claims
exemption from all sales and/or use taxes under Texas Tax Code §151.309, as amended. Texas Limited Sales Tax Exemption Certificates will
be furnished upon written request to the Harris County Purchasing Agent.

FISCAL FUNDING
A multi-year lease or lease/purchase arrangement (if requested by the specifications), or any contract continuing as a result of an extension
option, must include fiscal funding out. If, for any reason, funds are not appropriated to continue the lease or contract, said lease or contract
shall become null and void on the last day of the current appropriation of funds. After expiration of the lease, leased equipment shall be
removed by the contractor from the using department without penalty of any kind or form to Harris County. All charges and physical activity
related to delivery, installation, removal and redelivery shall be the responsibility of the offeror.

PRICING
Prices for all goods and/or services shall be negotiated to a firm amount for the duration of this contract or as agreed to in terms of time frame.
All prices must be written in ink or typewritten. Where unit pricing and extended pricing differ, unit pricing prevails.

SILENCE OF SPECIFICATIONS
The apparent silence of specifications as to any detail, or the apparent omission from it of a detailed description concerning any point, shall be
regarded as meaning that only the best commercial practice is to prevail and that only material and workmanship of the finest quality are to be
used. All interpretations of specifications shall be made on the basis of this statement. The items furnished under this contract shall be new,
unused of the latest product in production to commercial trade and shall be of the highest quality as to materials used and workmanship.
Manufacturer furnishing these items shall be experienced in design and construction of such items and shall be an established supplier of the
item proposed.

SUPPLEMENTAL MATERIALS
Offerors are responsible for including all pertinent product data in the returned proposal package. Literature, brochures, data sheets,
specification information, completed forms requested as part of the proposal package and any other facts which may affect the evaluation and
subsequent contract award should be included. Materials such as legal documents and contractual agreements, which the offeror wishes to
include as a condition of the proposal, must also be in the returned proposal package. Failure to include all necessary and proper supplemental
materials may be cause to reject the entire proposal.

MATERIAL SAFETY DATA SHEETS
Under the "Hazardous Communication Act", commonly known as the "Texas Right To Know Act", a offeror must provide to the County with
each delivery, material safety data sheets which are applicable to hazardous substances defined in the Act. Failure of the offeror to furnish this
documentation will be cause to reject any bid applying thereto.

EVALUATION
Evaluation shall be used as a determinant as to which proposed items or services are the most efficient and/or most economical for the County.
It shall be based on all factors which have a bearing on price and performance of the items in the user environment. All proposals are subject
to negotiations by the Purchasing Department and other appropriate departments, with recommendation to Commissioners Court. Compliance
with all requirements, delivery and needs of the using department are considerations in evaluating proposals. Pricing is NOT the only
criteria for making a recommendation. A preliminary evaluation by Harris County will be held and appropriate proposals will be subjected
to the negotiating process. Upon completion of the negotiations, Harris County will make an award. All proposals that have been submitted
shall be available and open for public inspection after the contract is awarded except for trade secrets or confidential information contained in
the proposals and identified as such.

INSPECTIONS
Harris County reserves the right to inspect any item(s) or service location for compliance with specifications and requirements and needs of the
using department. If an offeror cannot furnish a sample of a proposed item, where applicable, for review, or fails to satisfactorily show an
ability to perform, the County can reject the offer as inadequate.

TESTING
Harris County reserves the right to test equipment, supplies, material and goods proposed for quality, compliance with specifications and
ability to meet the needs of the user. Demonstration units must be available for review. Should the goods or services fail to meet requirements
and/or be unavailable for evaluation, the offer is subject to rejection.

DISQUALIFICATION OF OFFEROR
Upon signing this proposal document, an offeror offering to sell supplies, materials, services, or equipment to Harris County certifies that the
offeror has not violated the antitrust laws of this state codified in Section 15.01, et seq., Business & Commerce Code, or the federal antitrust
laws, and has not communicated directly or indirectly the offer made to any competitor or any other person engaged in such line of business.
Any or all proposals may be rejected if the County believes that collusion exists among the offerors. Proposals in which the prices are
obviously unbalanced may be rejected. If multiple proposals are submitted by an offeror and after the proposals are opened, one of the
proposals is withdrawn, the result will be that all of the proposals submitted by that offeror will be withdrawn, however, nothing herein
prohibits a vendor from submitting multiple offers for different products or services.

AWARD
Harris County reserves the right to award this contract on the basis of LOWEST AND BEST OFFER in accordance with the laws of the State
of Texas, to waive any formality or irregularity, to make awards to more than one offeror, to reject any or all proposals. In the event the lowest
dollar offeror meeting specifications is not awarded a contract, the offeror may appear before the Commissioners Court and present evidence
concerning his responsibility.

ASSIGNMENT
The successful offeror may not assign, sell or otherwise transfer this contract without written permission of Harris County Commissioners
Court.

TERM CONTRACTS
If the contract is intended to cover a specific time period, the term will be given in the specifications under SCOPE.

MAINTENANCE
Maintenance required for equipment proposed should be available in Harris County by a manufacturer authorized maintenance facility. Costs
for this service shall be shown on the Pricing/Delivery Information. If Harris County opts to include maintenance, it shall be so stated in the
purchase order and said cost will be included. Service will commence only upon expiration of applicable warranties and should be priced
accordingly.

CONTRACT OBLIGATION
Harris County Commissioners Court must award the contract and the County Judge or other person authorized by the Harris County
Commissioners Court must sign the contract before it becomes binding on Harris County or the offeror. Department heads are NOT
authorized to sign agreements for Harris County. Binding agreements shall remain in effect until all products and/or services covered by this
purchase have been satisfactorily delivered and accepted.

TITLE TRANSFER
Title and Risk of Loss of goods shall not pass to Harris County until Harris County actually receives and takes possession of the goods at the
point or points of delivery. Receiving times may vary with the using department. Generally, deliveries may be made between 8:30 a.m. and
4:00 p.m., Monday through Friday. Offerors are advised to consult the using department for instructions. The place of delivery shall be shown
under the "Special Requirements/Instructions" section of this proposal and/or on the Purchase Order as a "Deliver To:" address.

WARRANTIES
Offerors shall furnish all data pertinent to warranties or guarantees which may apply to items in the proposal. Offerors may not limit or
exclude any implied warranties. Offeror warrants that product sold to the County shall conform to the standards established by the U.S.
Department of Labor under the Occupational Safety and Health Act of 1970. In the event product does not conform to OSHA Standards,
where applicable, Harris County may return the product for correction or replacement at the offeror's expense. If offeror fails to make the
appropriate correction within a reasonable time, Harris County may correct at the offeror's expense.

PURCHASE ORDER AND DELIVERY
The successful offeror shall not deliver products or provide services without a Harris County Purchase Order, signed by an authorized agent of
the Harris County Purchasing Department. The fastest, most reasonable delivery time shall be indicated by the offeror in the proper place on
the proposal document. Any special information concerning delivery should also be included, on a separate sheet, if necessary. All items shall
be shipped F.O.B. INSIDE DELIVERY unless otherwise stated in the specifications. This shall be understood to include bringing
merchandise to the appropriate room or place designated by the using department. Every tender or delivery of goods must fully comply with
all provisions of these requirements and the specifications including time, delivery and quality. Nonconformance shall constitute a breach
which must be rectified prior to expiration of the time for performance. Failure to rectify within the performance period will be considered
cause to reject future deliveries and cancellation of the contract by Harris County without prejudice to other remedies provided by law. Where
delivery times are critical, Harris County reserves the right to award accordingly.

CONTRACT RENEWALS
Renewals may be made ONLY by written agreement between Harris County and the offeror. Any price escalations are limited to those stated
by the offeror in the original proposal.



INVOICES AND PAYMENTS
Offerors shall submit invoices in duplicate on each purchase order or purchase release after each delivery, indicating the purchase order
number. Invoices must be itemized. Any invoice which cannot be verified by the contract price and/or is otherwise incorrect, will be returned
to the offeror for correction. Under term contracts, when multiple deliveries and/or services are required, the offeror may invoice following
each delivery and the County will pay on invoice. Contracts providing for a monthly charge will be billed and paid on a monthly basis only.

TERMINATION
Harris County reserves the right to terminate the contract for default if Seller breaches any of the terms therein, including warranties of offeror
or if the offeror becomes insolvent or commits acts of bankruptcy. Such right of termination is in addition to and not in lieu of any other
remedies which Harris County may have in law or equity. Default may be construed as, but not limited to, failure to deliver the proper goods
and/or services within the proper amount of time, and/or to properly perform any and all services required to Harris County's satisfaction
and/or to meet all other obligations and requirements. Contracts may be terminated without cause upon thirty (30) days written notice to either
party unless otherwise specified.

RECYCLED MATERIALS
Harris County encourages the use of products made of recycled materials and shall give preference in purchasing to products made of recycled
materials if the products meet applicable specifications as to quantity and quality. Harris County will be the sole judge in determining product
preference application.

SCANNED OR RE-TYPED RESPONSE
If in its response, offeror either electronically scans, re-types, or in some way reproduces the County's published proposal package, then in the
event of any conflict between the terms and provisions of the County's published proposal package, or any portion thereof, and the terms and
provisions of the response made by offeror, the County's proposal package as published shall control. Furthermore, if an alteration of any kind
to the County's published proposal package is only discovered after the contract is executed and is or is not being performed, the contract is
subject to immediate cancellation.

FLOPPY DISK
If offeror obtained the specifications on a floppy disk in order to prepare a response, the proposal must be submitted in hard copy according
to the instructions contained in this Request-for-Proposals package. If, in its response, offeror makes any changes whatsoever to the County's
published specifications, the County's specifications as published shall control. Furthermore, if an alteration of any kind to the County's
published specifications is only discovered after the contract is executed and is or is not being performed, the contract is subject to immediate
cancellation.
                                RESIDENCE CERTIFICATION

Pursuant to Texas Government Code §2252.001 et seq., as amended, Harris County requests Residence Certification.
§2252.001 et seq. of the Government Code provides some restrictions on the awarding of governmental contracts;
pertinent provisions of §2252.001 are stated below:

       (3)    "Nonresident bidder" refers to a person who is not a resident.

       (4)      "Resident bidder" refers to a person whose principal place of business is in this state, including
       a contractor whose ultimate parent company or majority owner has its principal place of business in
       this state.


 I certify that ______________________________________ is a Resident Bidder of Texas as
                            [Company Name]
      defined in Government Code §2252.001.



      I certify that ______________________________________ is a Nonresident Bidder as defined in
                        [Company Name]
       Government Code §2252.001 and our principal place of business is
       __________________________________.
                [City and State]
                                            ATTENTION VENDORS



This document is an alternative competitive proposal as specified in LGC 262.030.

All documents will be held by the County and are NOT subject to public review until the negotiating process is
completed and an award made. A preliminary evaluation by Harris County will be held. Appropriate proposals will
be subjected to review and may go through negotiating process.

After award by Commissioners Court, proposals will be made public.
                                 SPECIAL REQUIREMENTS/INSTRUCTIONS

Term Contracts To Provide Ryan White Title I Services for Harris County

Where these specific requirements differ from the preceding General Requirements, these specific requirements will
control. If you need additional information, contact Mary Lou Sotolongo at (713) 755-6832. For technical assistance
contact Charles Henley at (713) 439-6034.

The following statement is made in accordance with the FY 1995 Appropriations Act (P.L.103-333). All funds being
offered in this Request for Proposal (RFP) are 100% Ryan White C.A.R.E. Act funds with no contribution of any non-
Federal funds required of the vendor, although subsequent to any award made to the vendor resulting from this RFP
the vendor will be required to document, in a manner acceptable to the County, the total cost of the project, the
amount and percentage financed by federal money and the amount and percentage financed by non governmental
sources.

PRE-PROPOSAL CONFERENCE
A Pre-Proposal Conference will be held November 4, 1998 from 1:00 to 4:00 pm in the Harris County Health
Department Building, 5th floor Jensen-Jefferson Auditorium located at 2223 W. Loop South, Houston, TX 77027.
Attendance is not mandatory, however it is highly recommended that vendors attend in order to discuss and clarify the
Request for Proposal (RFP) requirements and answer vendor questions regarding the proposal review and award
process. Persons with disabilities requiring special accommodations please contact Vicki Cerna at (713) 439-6042 for
arrangements.

Special Requirements

I.     SUBMISSION INSTRUCTIONS
Separate proposal responses must be returned for each service category. The service category code number
should be filled in on the request for proposal cover sheet.

Proposals must be formatted as follows:
    Applications must be in English;
    Submit all copies of proposal unbound, (with each individual proposal held together by a metal clip or
       sufficiently strong rubber band);
    Use standard size black type that is not smaller than 10 characters per inch nor larger than 12 characters per
       inch (colored print is not allowable);
    Use 8.5 inch x 11 inch paper that can be photocopied;
    Top, bottom, left and right margins may not be less than 1 inch each;
    Text may be either 1.5 or double-spaced;
    Do not submit double-sided copies;
    Do not use photo-reduction;
    Do not include photos, pamphlets, brochures, or over-sized documents;

A complete description of all the services the vendor will provide together with all the forms completed and in the
proper order, adequate documentation that the vendor meets the agency qualifications and requirements, cost for unit
of service, etc. will comprise the vendor’s proposal. All signature pages in the document must also be signed. It is the
vendor’s responsibility to adequately identify and define their qualifications and capabilities with regard to meeting
the requirements in this RFP including those which are specific to the Service Category under which the response is
submitted. Your proposal must offer substantial assurance that all goals and requirements will be
                         SPECIAL REQUIREMENTS/INSTRUCTIONS - (Continued)

reached and maintained by your organization. All vendors must respond to items listed below and are encouraged to
supply all other relevant information as Appendices. Narrative answers/statements must be self explanatory and
understandable to members of the independent review panel who will read, evaluate and score your proposal. Assume
that these individuals are unfamiliar with your agency and its programs, and that they have little information about
your target population.

The complement of forms included with this RFP must be completed and submitted, in the proper order. All vendors
should address each of the forms by filling out each one with the appropriate, detailed information required by the
form. Omission of any or all forms may be cause to reject your proposal in its entirety. If, for some reason, the
form does not apply to your response, you must note that decision on your copy of the form and include it in your
submitted proposal.

The vendor is responsible for making additional copies required in order to fulfill the RFP requirements and/or to
respond to additional categories. Original and copies must be secured individually with a single binder clip or rubber
band for each. SUBMIT SIGNED ORIGINAL AND TEN (10) COPIES. All signatures for all forms throughout
this package must be original on the copy marked, "ORIGINAL". Copies of the original may contain copies of
signatures. If you need to use an envelope other than the one supplied or a small box to submit your sealed proposal,
please include the job number, due date and your company name on the outside of the envelope or box.

Completed proposals must be clocked in at the Harris County Purchasing Department; 1001 Preston Ave., Suite 670;
Houston, Texas 77002 on the date and time specified on the cover sheet. On that date, proposals will be opened.
Under the Request For Proposal process, sealed offers will be received and opened in the Purchasing Department and
considered confidential until an award is made. Neither information nor copies of proposals will be available to
anyone other than Harris County and the External Review Committee until a formal award is made by Commissioners
Court. All proposals shall be available for public inspection under the Open Records Act after all contracts are
awarded. Please call the Purchasing Department to make an Open Records Act request.

II.    EVALUATION CRITERIA AND AWARD PROCESS
       The following guidelines will be used in the Evaluation/Award process.

A.     Submit your best proposal initially. A technical review will be conducted by Harris County to ensure all
       proposals contain the required documentation and are in conformance with the requirements set forth herein.
       In the event 1) the number of proposals submitted is equal to or less than the minimum number of providers to
       be funded as specified in any single service category, and/or 2) the total amount of funding requested by
       vendors is equal to or less than the total amount of funding available in any single service category the County
       reserves the option to waive the External Review step (see B. below), and recommend an award of a contract
       to that vendor provided their proposal is determined by the County to meet all other requirements and
       minimum specifications for that service category.

B.     An independent External Review Committee will score acceptable proposals which conform with all required
       documentation and requirements and using a point system based on the following evaluation criteria: 100
       Total Points (see point distribution below). Submission of a proposal implies vendor’s acceptance of the
       evaluation criteria and vendor recognition that subjective judgments must be made by reviewers.




                         SPECIAL REQUIREMENTS/INSTRUCTIONS - (Continued)
C.     Award of contracts shall be made to responsible vendor, whose proposal is determined to be the highest
       scored proposal meeting all other requirements and best meeting the county’s needs for that service category.
       In the event qualified for-profit and non-profit entities submit proposals in the same service category only the
       non-profit vendor(s) will be eligible for award. All awards will be made in accordance with Department of
       Health & Human Services, Health Resources and Services Administration (HRSA) guidelines and the Ryan
       White Comprehensive AIDS Resources Emergency (CARE) Act of 1990, as amended. Prospective
       vendors are encouraged to read the attached letter from HRSA dated March 6, 1997, regarding Requests for
       Proposals (See Attachment A in this RFP packet). All corporate vendors must provide a copy of their
       Articles of Incorporation. Additionally, all non-profit vendors must provide written proof of their non-
       profit status.

       Any vendors who propose subcontracting any portion of the services to be provided must include a copy of
       their proposed subcontractor’s Articles of Incorporation, if any, and, where applicable, proof of the
       subcontractor’s non-profit status. If the documentation is not included in the proposal, County will assume
       the proposed subcontractor is a for-profit entity and award contracts accordingly.

       The vendor’s legal name must appear on all required licenses or certifications (i.e., the name of proposer as
       stated on the proposal must be the same as the name stated on any required licenses and/or certifications).
       Any vendor who proposes subcontracting any portion of the HIV-related services to be provided must
       include a copy of the executed contract between the vendor and their (proposed) subcontractor in the
       Appendices. In the case where the vendor is subcontracting any portion of services where a license and/or
       certification is required, the legal name of the subcontractor and the name on the subcontractor’s
       license/certification must be identical. In service categories where Medicaid/Medicare certification is
       required, the County will only contract with entities who meet this criteria. Vendors may not use
       subcontractors to meet this criteria. The only exception to this requirement will be vendors who are eligible
       for, and have been granted, a waiver from the Ryan White Planning Council.

D.     No award or acquisition can be made until Commissioners Court approves such action. No County funds will
       be expended for contracts resulting from this RFP. All contracts resulting from this RFP will be funded
       contingent upon funds allocated and received by the County from HRSA under a federal grant awarded to the
       County.

The Evaluation Criteria follows:
All proposals MUST be submitted in the order listed below.

       A.     Request For Proposal Cover Sheet (Enclosed in RFP)

       B.     Residence Certification (Enclosed in RFP)

       C.     Signed Assurances Form I (Enclosed in RFP Forms Section)

       D.     Signed Certification Concerning Lobbying (Enclosed in RFP Forms Section)

       E.     Signed Compliance with Americans With Disabilities Act of 1990 (Enclosed in RFP
              Forms Section)
       SPECIAL REQUIREMENTS/INSTRUCTIONS - (Continued)

F.   Assurance - Non-Construction Programs (s-424B) (Enclosed in RFP Forms Section)

G.   Respondent Certification (Enclosed in RFP Forms Section)

H.   Licenses, Permits, & Certifications (Provided by Vendor/Proposer) (see item C.
     under Section II, Evaluation Criteria and Award Process)

I.   Renewal Option

J.   Cover Page (Enclosed in RFP Forms Section)

K.   Table of Contents for Proposal (Provided by Vendor) Number all pages and list
     according to this Table of Contents. Page one (1) of the proposal should be the Cover
     Page (item J. Above), with all pages numbered sequentially forward.

L.   ABSTRACT - 5 points
     Using a maximum of one (1) typed, single spaced sheet, summarize the proposed project's scope of
     work (objectives, target audience, geographic area served) including the following.
     ABSTRACT - centered at top of page
     Legal Name of Organization
     Mailing Address
     Street Address (if different from mailing address)
     Telephone number and contact person
     Service Category
     Code Number
     Title of Service
     Summation of proposed project's scope of work (objectives, target audience, geographic area served)

M.   BUDGET - 25 points

     Complete and include the following three (3) tables. If the proposal is for a service category that
     requires a cost reimbursement budget include Table I.B marked "n/a" (not applicable). If the proposal
     is for a service category that requires a fee-for-service budget complete and include all three (3) budget
     forms. If no subcontractors will be used to provide HIV-related services under this proposal include
     budget form I.C marked "n/a" (not applicable).

     Tables
     I.A. Budget Narrative – One (1) per proposal, regardless of the number of fee-for-service
                              budgets unless a subcontractor will be utilized to provide direct
                              client services at which time, a Budget Narrative for each
                              subcontractor must also be submitted.
     I.B. Fee-for-Service Budget Form (if necessary) one form for each fee charged.
     I.C. Subcontractor Budget Form
                   SPECIAL REQUIREMENTS/INSTRUCTIONS - (Continued)

     The following documentation must be included in the appendices:
      A job description of each type of personnel position listed in the budget narrative, with a one (1)
        page limit per job description;
      Proof of Non-profit status and Articles of Incorporation;
      Copy of all signed and dated contracts with subcontractors to be used by applicant agency in the
        provision of Ryan White Title I funded HIV-related client services (if applicable);
      Proof of Non-profit status and Articles of Incorporation of any subcontractors to be used in the
        provision of client services (if applicable);

N.       ORGANIZATION - 30 points
         In a maximum of 15 pages (not including tables) address the following points:

        The history of applicant agency in providing services to Persons Living With HIV (PLWH) in the
         Houston EMA. Discuss the impact of new therapies (i.e., multiple drug regimens, etc.) on PLWH
         served by applicant agency and how applicant agency has adapted to the changes in demographics
         and treatment modalities in HIV. Discuss the role of PLWH in agency's program development,
         ongoing quality assurance activities and other aspects of organizational development. Include
         Tables II.A. and II.B. in this section. (10 points);
        The capacity of applicant agency to provide services to PLWH who are members of historically
         underserved/unserved populations and/or who are characterized by the following co-morbidities
         specifically cited in the C.A.R.E. Act: tuberculosis, homelessness, sexually transmitted diseases,
         substance abuse, severe mental illness. Specifically discuss issues relating to client access of
         agency's services (geographic location of services, hours of operation, availability of bilingual staff,
         ability to serve deaf and hard of hearing individuals, etc.). (10 points);
        The capacity of applicant agency to serve populations with severe needs (as cited in the HRSA
         FY1999 Title I Grant Application Guidance). These populations are: white/anglo men who have
         sex with men, men of color who have sex with men, women of child bearing age (13 years and
         older), injecting drug users, and adolescents (13 - 19 years old). Specifically discuss how applicant
         agency proposes to implement processes that address the unique needs of PLWH who are members
         of the above described severe need groups. Clearly describe the methods to be utilized by applicant
         agency to address service needs of the above populations, including staffing patterns, geographic
         access, program design and related issues. Differentiate clearly between processes currently
         provided versus those that will be implemented if applicant agency receives funding as a result of
         this RFP. Include Table II.C. in this section. (10 points)

     Tables:
     II.A. Organization Information Table
     II.B. Current HIV/AIDS Related Funding
     II.C. Documented Services to PLWH by Gender, Age, Co-morbidity and Severe Need Category
           (1/1/97 - 12/31/97)

     The following documentation must be included in the appendices:
      List of Board Members (including the name, address, phone and fax number of each Board member)
        (to be removed prior to external review);
      Copy of applicant's most recent fiscal year audit and/or certified financial statement (to be removed
        prior to external review);
                   SPECIAL REQUIREMENTS/INSTRUCTIONS - (Continued)

        Letters from all administrative agencies listed in Table II.B. for applicant agency's current City,
         County, State or Federal HIV/AIDS related HIV prevention and/or treatment grants or contracts
         which state applicant agency's compliance and performance with each current contract (excluding
         Ryan White Title I contracts with Harris County Public Health and Environmental Services). These
         letters must be dated no earlier than the release date of the RFP under which this proposal is
         submitted (to be removed prior to external review);

O.       PROGRAM - 40 points
         In a maximum of 15 pages (not including required tables) describe the specific program (service)
         applicant agency is proposing to provide.
        Goals and Objectives - Describe the goal(s) of the service you propose to provide. Discuss how
         applicant agency will operationalize (objectives, activities) these goals so that PLWH will receive
         quality services in a timely manner. Include Table III.A. in this section. (20 points)
        Proposed Clients to Be Served by Program During Contract Term - Discuss the proposed clients to
         be served in terms of access to services, frequency of services, benefit of services, and quality of
         services. Describe in detail the relationship of the proposed services in the overall continuum of
         care for PLWH. Clearly delineate where applicant agency expects clients (incoming referrals) to
         come from. Be specific in noting these referral sources, including information on current referral
         sources and numbers of clients expected from each specific source. Clearly delineate what services
         clients who are served by applicant agency with services proposed will be referred to, the process of
         making those referrals and what methods will be used to assure that clients receive the services they
         have been referred to. Clearly describe all collaborative agreements that these proposed services are
         contingent upon. Include Tables III.B. and III.C. in this section. (10 points)
        Evaluation Process - Describe the specific evaluative processes applicant agency will utilize to
         assure quantity and quality of services provided. Discuss in detail the specific processes to be used
         by applicant agency to assure that the services provided will meet contractual requirements in terms
         of numbers of clients served, units of services provided and allocated funds expended on allowable
         costs in accordance with all contract provisions. Discuss what activities will be undertaken to assure
         that services provided to PLWH will be of the highest possible quality, consistent with all locally
         defined standards of care, Public Health Service guidelines and rules and regulations from all
         applicable licensing entities and/or regulatory agencies. Discuss how input from consumers and
         other PLWH will be integrated into program evaluation in order to monitor and improve quality of
         care. Delineate the frequency (how often each specific activity is conducted) of all listed monitoring
         and evaluative activities, including but not limited to, the job title of the staff persons responsible,
         the size of the sample (if sampling is used), and methodology (e.g., chart reviews, client satisfaction
         instruments, etc.). Include in the appendices a sample (in English and Spanish) of all client surveys
         to be used in evaluating the proposed services. Do not include surveys used for services not being
         proposed. Do not include results of any surveys which have been administered to clients in the past.
         Proposer may develop tables to illustrate the evaluative processes they propose to utilize. However,
         any Proposer developed tables are included in the page limit for this section. (10 points)

         Tables
         III.A. Goals and Objectives
         III.B. Proposed Clients to be Served by Program During Contract Term
         III.C. Collaborative Agreements With Other Service Providers
                  SPECIAL REQUIREMENTS/INSTRUCTIONS - (Continued)
          The following documentation must be included in the appendices:
           Copies of signed and dated collaborative agreement(s) with other service providers;
           Copies (in a minimum of English and Spanish) of all client surveys/evaluations to be used in
             program and/or agency evaluation;

     P.   APPLICATION CHECKLIST
          Applications must be submitted in the order of the Application Checklist, including appendices. Do
          not submit any material that is not stipulated on the Application Checklist.

     Q.   OTHER REQUIREMENTS:

          Services MUST be available to ALL eligible clients in the Houston EMA. All clients will be
          served without regard to age, sex, race, color, religion, national origin or sexual orientation and
          in accordance with the American Disabilities Act (ADA). No eligible client will be refused
          services.

          For the 1999 grant year, the Re-authorized CARE Act mandates a 10% aggregate cap on
          administrative costs. The result of this mandate is that the total administrative costs from all service
          contracts, planning council and program support activities cannot exceed 10% of the total funds
          available for those purposes. The County will review each awardee’s budget to determine allowable
          administrative costs. While the aggregate cap does not limit any single contract to 10% administrative
          costs, the County will, to the extent possible, require each contract to meet this requirement. Such
          negotiations as are necessary to insure compliance with this CARE Act requirement will be conducted
          prior to the County issuing a contract for services with any provider. The County will monitor
          administrative costs of each individual contract on a monthly basis.

          No single funding source is likely to adequately support activities for an entire client population and in
          such cases multiple funding of the same activity is acceptable; however, Title I grant funds must not
          be used for duplicate funding of the same activity.

          No indirect costs can be charged to Title I funding requests.

     R.   APPENDIX - All required information that has been specified. Only include in your proposal
          submission information specifically requested in the RFP (including any addendums which may
          be issued). Do not include any additional (not required) information.

III. ADDITIONAL INFORMATION

     A.   SUGGESTIONS FOR COMPLETING PROPOSALS
          In addition to the proposal writer, one or more individuals should review your proposal for content and
          form. Have them read through this RFP, and then let them pretend that they are on the independent
          review panel: have them read through your application, paying special attention to the narrative
          information that you have provided, and using the evaluation criteria as a basis for their review and
          comment. Check that the information provided on all of the forms and documents is consistent and
          complete and all budget forms are consistent with other information (for example, the math is correct).
                    SPECIAL REQUIREMENTS/INSTRUCTIONS - (Continued)

        Also, one or more individuals should review your application for completeness and format correctness,
        taking the time to verify that your narrative responses conform to the physical space limitations given
        for each section; that all required information has been assembled; that all pages, including
        attachment(s), have been numbered sequentially; that binder clips or rubber bands have been used; that
        the correct number (one original and ten copies) of the finished proposal has been prepared for
        delivery.

B. GRIEVANCES

Grievance Procedures are as required by the Ryan White CARE Act for contracts funded with Ryan White
Title I grant money.

Eligibility:   Only individuals within the following groups are authorized to bring grievances.
        1.     HIV service providers eligible to receive Ryan White Title I funding;
        2.     persons with HIV disease;
        3.     consumer groups or coalitions or caucuses of persons with HIV disease; or
        4.     members of the Houston Area HIV Health Services Planning Council (“Planning Council”).

Grievable Actions: Only the following actions are the proper subject of a grievance under these procedures:
       1. deviations from the procedures established by the Harris County Purchasing Agent in the
           competitive proposal package;
       2. contracts and awards which are inconsistent with the priorities and resource allocations made by
           the Planning Council; and
       3. deviations from any established, written process for any subsequent changes to priorities or
           allocations.

*note: only a member of the Planning Council is authorized to bring a grievance under
grievable actions item 2.

The procedure with timelines and appropriate forms for grievances defined in Grievable Actions above may be
obtained from the Harris County Purchasing Department by calling 713-755-5036.

The awarding of contracts is the responsibility of Harris County Commissioners Court and their award
decision is final. Award will be based on the evaluation criteria and process described in the RFP document.

Contact Mary Lou Sotolongo at (713) 755-6832 in order to seek an informal resolution to your concerns. Prior
to scheduling appearances before Commissioners Court, grievance procedures must have been followed with
notification given to the Purchasing Department.

The priority setting of service categories is the responsibility of the Ryan White Planning Council. All
grievances pertaining to the priority setting process should be directed in writing to the Ryan White Planning
Council. For information call the Ryan White Planning Council Manager at (713) 572-3724.
                        SPECIAL REQUIREMENTS/INSTRUCTIONS - (Continued)

IV.   DEFINITION OF SPECIAL LANGUAGE AND GUIDELINES

A.    Culturally Sensitive and Language Competent is the ability to communicate effectively and interact with
      individuals whose cultural, ethnic and socio-economic status is different from your own as demonstrated by
      shared values, beliefs, understanding of community norms, traditions, language and customs. Culturally
      competent services include, but are not limited to services that are provided in a language and format the client
      understands; interpreter services; communications devices for the deaf/hard of hearing; and staff with
      documented prior experience, training, and/or education regarding populations to be served.

B.    CDC/OSHA refers to Centers for Disease Control and the Occupational Safety and Health Administration.
      The contracting organization must adhere to all CDC and/or OSHA recommended guidelines for blood borne
      pathogens and infectious diseases and must document that in the application.

C.    Quality Assurance Program is intended to ensure that providers have a means in place to control for
      appropriateness of services including accordance with all applicable laws and regulations and required
      documentation. Provider must have prior HIV/AIDS experience and/or on-going education programs which
      must be documented in the application and updated quarterly.

D.    Houston EMA is a six county area including Chambers, Fort Bend, Harris, Liberty, Montgomery and Waller
      in which services under this agreement must be provided.

E.    Health Resources and Services Administration (HRSA) is the Federal administrator for Ryan White Title I
      funds.

F.    Uniform Reporting System (URS) is a HRSA designed reporting system. Recipients of funds must provide
      Aggregate Level Reporting.

G.    Aggregate Level Reporting includes unduplicated numbers of clients served per provider, basic
      demographics (gender, ethnicity, age) regarding clients served, estimated percent of clients by transmission
      category (medical providers only), minority composition of entity's board and/or staff, amounts and types of
      services provided, estimated percent of clients who are HIV positive and AIDS, amount of HIV/AIDS funding
      by source and information on numbers, types and salaries of HIV/AIDS staff. This information must be
      summarized annually in the Annual Administrative Report.

H.    Annual Administrative Report is a data summary by each funded provider according to Aggregate Level
      Reporting prescribed by HRSA. Everyone receiving 1999 funds must submit this report to Harris County by
      1-20-00 summarizing activities from the beginning of their contract through 12-31-99. The County will
      provide the required format for submission of annual reports.

I.    Monthly Activity Report (MAR) is a monthly summary of clients served per service contract, including
      demographics and service related information. The minimum data set for the Monthly Activity Report
      includes Age, Gender, Ethnicity, Stage of Illness, Severe Need Category, Co-morbidity, number of service
      units or interventions received, number of clients who are deaf/hard of hearing and sight impaired. The MAR
      must describe the number of unduplicated clients served per month and for the total term of the contract
      according to the above described minimum data set. The County will provide the required format for the
      submission of the MAR.
                       SPECIAL REQUIREMENTS/INSTRUCTIONS - (Continued)

J.   Collaboration is defined as: Two or more separate entities who have a formal written agreement to work
     together in a cooperative effort toward specified and agreed upon objectives.
     Referrals to other agencies do not constitute collaboration.

V.   OVERVIEW

A.   The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1990 provides federal support
     for comprehensive health and social services for people living with HIV/AIDS in the Houston Eligible
     Metropolitan Area (Houston EMA). Houston EMA includes Chambers, Fort Bend, Harris, Liberty,
     Montgomery, and Waller counties. Title I provides emergency relief grants to meet needs of individuals
     infected and affected. CARE Act funding is intended to supplement, not supplant, existing and planned
     funding for HIV/AIDS services at local and state levels.

     Eligible recipients of these funds are providers of relevant services such as public or nonprofit private entities,
     or private for-profit entities if such entities are the only available provider of quality HIV care in the area,
     including hospitals (which may include Department of Veterans Affairs facilities), community-based
     organizations, hospices, ambulatory care facilities, community health centers, migrant health centers, homeless
     health centers, substance abuse treatment programs, and mental health programs.

     The Ryan White Planning Council is responsible for establishing priorities, conducting needs assessments, and
     long range planning for Title I funds. Its members are appointed by the Harris County Judge and are
     representatives of various segments of the community including service providers, caregivers, medical
     authorities, and persons infected and affected by HIV/AIDS.

     The Harris County Commissioners Court has appointed the Director of Harris County Public Health and
     Environmental Services (PHES) as the Administrative Agent to the program. The HIV Services division of
     PHES assists the Planning Council in its duties and provides grant administration and monitoring for the
     Houston EMA. The Harris County Commissioners Court, as the governing body of the grant recipient, has
     ultimate authority over awards of Ryan White Title I Grant funds.

B.   AVAILABLE MONIES
     Estimated dollar amounts are listed for each Service Category. Awardees will be notified at time of award of
     the specific contract period and amount. All contracts will be for a maximum 12 month term. All awards are
     contingent on the amount of Harris County’s Federal Fiscal Year 1999 Ryan White CARE Act Title I
     award from HRSA. The Planning Council has approved the FY1999 Ryan White Title I service priorities
     and funding allocations. These service funding allocations include contingencies in the event that the total
     FY1999 Title I award received by the County is less than the amount of funding anticipated. The County will
     adjust all awards made based on the contingency plan approved by the Planning Council.

C.   FUNDING REQUESTS
     Agencies must submit complete proposals for each Service Category in which they seek funding. DO NOT
     COMBINE FUNDING REQUESTS FOR MORE THAN ONE SERVICE CATEGORY INTO THE SAME
     PROPOSAL. Organizations must write separate proposals for each Service Category.

D.   COMMENCEMENT OF SERVICES/FORFEITURE OF FUNDS
     Each agency must demonstrate its ability to implement proposed services quickly, including hiring/training
     appropriate personnel. If an agency fails to begin expending funds within 30 days from receipt of funds, the
     agency may have to forfeit said funds.

                       SPECIAL REQUIREMENTS/INSTRUCTIONS - (Continued)
E.   CHARGES FOR SERVICES
     If an agency charges for its services, it must do so on a sliding fee schedule which is available to the public.
     Individual, annual aggregate charges to clients receiving services must conform to the following limits:

     INDIVIDUAL/FAMILY                             TOTAL ALLOWABLE
     ANNUAL GROSS INCOME                           ANNUAL CHARGES
     Equal to or below official                    No charges permitted
     poverty line (OPL)
     101 to 200% of OPL                            5% or less of Gross Income Level (GIL)
     201 to 300% of OPL                            7% or less of GIL
     300+% of OPL                                  10% or less of GIL

     "Aggregate Charges" applies to annual charges imposed for all services regardless of terminology (i.e.
     enrollment fees, premiums, deductibles, cost-sharing, co-payments, coinsurance, etc.) and applies to all service
     providers from whom individuals receive services. The Planning Council may waive this requirement for a
     provider when said provider does not impose a charge or accept reimbursement from a third party payor,
     including reimbursement under any insurance policy or any Federal or State health benefits program.

     A simple application showing annual gross salary of an individual or family shall be used to establish the
     appropriate level of fees.

F.   APPLICABLE LAWS
     Proposers MUST comply with all applicable federal, state, and local laws, regulations, Public Health Services
     Guidelines, Houston Ryan White Title I standards of care for HIV Primary Care, Professional Counseling,
     Care Management Services & General Transportation Services and HIV Services Site Visit Guidelines. HIV
     Services will conduct site visits to insure compliance of all the above. Proposers may contact the Project
     Monitoring section of HIV Services for a copy of the Site Visit Guidelines and any additional information.

G.   OTHER CONDITIONS/RESTRAINTS
     The following conditions/restraints are imposed on all recipients of Ryan White Title I funds. Vendors are not
     required to submit information concerning these issues within their proposals; however, agencies must
     comply with them if they receive Ryan White Title I funds.
     1.     AUDIT
            Not for profit and governmental agencies receiving Federal funding assistance in the aggregate amount
            of $300,000.00 or more within their fiscal year must have an audit conducted in accordance with
            Office of Management and Budget (OMB) Circular A-133. The audit must be submitted to the Harris
            County Auditor’s Office no later than 13 months of an agency’s fiscal year end (within 9 months for
            fiscal years beginning after June 30, 1998). Proprietary agencies receiving awards of $25,000.00 or
            more must submit an audit of their general financial statements within 12 months of their fiscal year
            end. Not for profit and governmental agencies meeting the $300,000.00 aggregate threshold may
            charge OMB A-133 single audit costs proportionally to their Ryan White grants. However, agencies
            who do not meet the $300,000.00 aggregate threshold may not use Federal funds to pay for OMB A-
            133 single audit costs. Those agencies not meeting the $300,000.00 aggregate threshold may use
            Federal funds to pay for limited scope audits, site visits, document reviews and other monitoring
            activities.
               SPECIAL REQUIREMENTS/INSTRUCTIONS - (Continued)

2.   BONDING
     All employees of agencies receiving Title I funds must be covered by the terms of a fidelity bond, if
     they handle those funds, providing for indemnification of losses by:

     a.     any fraudulent or dishonest act or acts committed by any of the above mentioned employees
            either individually or in concert with others, and/or

     b.     the failure of the agency or any of its employees to perform faithfully his/her duties or to
            account properly for all monies and properties received by virtue of his/her position of
            employment.

            Fidelity bond will be in an amount not less than ten thousand dollars ($10,000).
            Documentation of bonding must be provided within sixty (60) days of receipt of grant award.

3.   REPORTING AND MONITORING
     All agencies receiving Title I funds must comply with all aspects of "Aggregate Level Reporting" as
     implemented by HRSA (See "Definitions of Special Language and Guidelines").

     All agencies receiving Title I funds must submit monthly activity reports. The County will provide
     contractors with the required format for these reports.

     All agencies receiving Title I funding must report annually on progress in implementing funded
     programs and services and on issues or problems which impede implementation and must provide
     input strategies for resolving those matters. Agencies must also provide a year-end financial statement
     identifying total amounts of grant funds received and amounts expended for each category of services
     provided. Agencies receiving funding must provide monthly expenditure reports for the purposes of
     reimbursement.

4.   DOCUMENTATION OF SERVICES AND COSTS
     All agencies receiving Title I funding are expected to cooperate in the development of a standard data
     set to provide information on costs of services and client demographics. As a condition of receiving
     grant funds, each organization must provide all information required under Aggregate Level Reporting
     as instituted by HRSA.

5.   MEDICAID
     If a particular service is available under State Medicaid Plan, the political subdivision involved either
     must provide service directly or enter into an agreement with a public or private entity to provide the
     service. The entity providing service must enter into a participation agreement under the State
     Medicaid Plan and must be qualified to receive payment under the State Medicaid Plan. The Planning
     Council may waive the requirement regarding participation agreements with the State Medicaid Plan if
     the entity providing the service does not impose charges or accept payment for services (with the
     exclusion of voluntary donations for provision of services) from any third party payor, including any
     insurance policy or any Federal or State health benefits program. Funds must not be used to provide
     items or services for which payment has already been made or reasonably can be expected to be made,
     by third party payors, including Medicaid, Medicare and/or other state or local entitlement programs,
     prepaid health plans or private insurance. Proposers are reminded that this is subject to audit and must
     be carefully documented in the year-end program report.
                SPECIAL REQUIREMENTS/INSTRUCTIONS - (Continued)

6.    PURCHASE OF LAND - NEW CONSTRUCTION
      No use of Title I funds may be made for improving or purchasing land or constructing or permanently
      repairing any building. Minor remodeling is acceptable.

7.    All agencies receiving Title I funding must have available during regular business hours at least one
      staff member who is fluent in both English and Spanish. Agencies targeting Hispanic/Latino clients
      must have sufficient bilingual (English/Spanish) staff to serve their client population.

8.    The Ryan White Planning Council has determined that all Ryan White Title I funded agencies must
      utilize a Centralized Patient Care Data Management System (CPCDMS). This will require that
      agencies utilize the CPCDMS to document the eligibility status of clients and enter service utilization
      data (including client demographic, client stage of illness and co-morbidity data). If a funded agency
      chooses to send the required service utilization data in batch mode, this must be done every twenty-
      four (24) hours during non-working hours. All funded agencies will be required to have an ISDN
      communications line for all participating service sites if the site is located in the Southwestern Bell
      service area. This ISDN line must be utilized for the CPCDMS. Additional information regarding the
      implementation of the CPCDMS will be provided to agencies that receive awards under this RFP.

9.    All agencies receiving Title I funding must participate fully in any HIV/AIDS community needs
      assessment and/or service effectiveness activities undertaken by the Houston Ryan White Planning
      Council.

10.   The Ryan White C.A.R.E. Act (Section 2603(b)(E) requires that resources be allocated at no less than
      the percentage constituted by the ratio of the population of infants, children and women with AIDS to
      the general population with AIDS. For the Houston EMA, in FY 1999, a minimum of 16.4% of
      serv35ces provided with funds awarded under this RFP must be provided to infants, children and
      women. Vendors receiving FY 1999 Ryan White Title I awards will be required to meet or exceed this
      minimum requirement. HIV Services will monitor compliance with this requirement through Monthly
      Activity Reports (MAR) and Contractor Expense Reports (CER) submitted by funded providers.

11.   RENEWAL OPTION:
      The County has the option of renewing contracts in specific service categories on an annual basis. The
      renewal criteria follows:

      1. Only those contracts with fee-for-service (unit cost) budgets are eligible. The vendor must agree to
         the same terms, specifications, unit cost(s) and conditions of the previous contract term (i.e., the
         unit cost and service definition must remain the same, the total value of the contract may increase
         or decrease as necessary depending on service category allocations);

      2. All renewals are contingent upon Planning Council service category allocations, receipt of such
         funding from HRSA and Commissioners Court approval;

      3. All providers in the service category must agree to the renewal option.
          SPECIAL REQUIREMENTS/INSTRUCTIONS - (Continued)

RENEWAL OPTION
Harris County wishes to consider two (2) annual renewal options, renewable one year at a time, based
on the same terms, conditions and pricing as the original year. If the vendor does not wish to renew,
mark “N.A.” in the space for the year indicated.

Harris County retains the option to rebid at any time if in its best interest and is not automatically
bound to renewal or rebid.

Vendor agrees to continue this contract for the time frames stated below under the same terms and
conditions and pricing as the original contract. If vendor does not wish to renew, write “N.A.” in the
space provided.

Renewal Year 1 (2000-2001):           ____________

Renewal Year 2 (2001-2002):           ____________
                         SPECIAL REQUIREMENTS/INSTRUCTIONS - (Continued)

VI.    SPECIFICATIONS

SERVICE CATEGORIES:
The detailed description and specifications for each Service Category directly follow this listing.

Ambulatory/Outpatient Medical Care

       1.      Outpatient/Ambulatory Primary Health Care Code MC-01
       2.      Pediatric Outpatient/Ambulatory Primary Health Care Code MC-02

Other Outpatient/Community-Based Healthcare Services (Dental, Substance Abuse, Psychiatry, Mental Health
Professional Counseling, Home Health Care, Health Insurance, Hospice, Rehabilitation Care)

       1.      Substance Abuse Treatment/Levels I and IV (intensive) Code HS-01
       2.      Substance Abuse Treatment/Levels III and IV Code HS-02
       3.      Outpatient Psychiatric Care Code HS-03
       4.      Professional Counseling/Emotional Support Code HS-04
       5.      Health Insurance Code HS-05
       6.      Hospice Services Code HS-06
       7.      Skilled Rehabilitation Code HS-7

Home/Community-Based Support Services (Case Management, Transportation, Food Pantry/Home Delivered
Meals, Direct Emergency Assistance, Health Education/Risk Reduction, Adult Day Care, Child Day Care, Support
Groups [Non-Mental Health], Legal, Buddy Companion)

       1.      Community-Based Case Management Team Code SS-01 (a total of 3 teams have been allocated in
               this category)
       2.      Community-Based Medical Case Management Team Code SS-02 (1 team has been allocated in this
               category)
       3.      Community-Based Rural Case Management Team Code SS-03 (1 team has been allocated in this
               category)
       4.      Community-Based Hispanic/Monolingual Case Management Team Code SS-04 (1 team has been
               allocated in this category)
       5.      Community-Based Children & Adolescents Case Management Team Code SS-05 (1 team has been
               allocated in this category)
       6.      Community-Based African American Women and Children Medical Case Management Team Code
               SS-06 (1 team has been allocated in this category)
       7.      Transportation Vouchering Program Code SS-07
       8.      Food Pantry Code SS-08
       9.      Meals Served at Public Primary Health Clinic Code SS-9
       10.     Nutritional Supplements Code SS-10
       11.     Emergency Housing/Utility Assistance Code SS-11
              SPECIAL REQUIREMENTS/INSTRUCTIONS - (Continued)

12.   Household Items Code SS-12
13.   Health Education/Risk Reduction Code SS-13
14.   Child Day Care Code SS-14
15.   Support Groups, Other Code SS-15
16.   Volunteerism – Respite Care Team Code SS-16
17.   Volunteerism – Community Volunteer Programs Code SS-17
18.   Volunteerism – Other Code SS-18
                                      APPLICATION CHECKLIST


__________ REQUEST FOR PROPOSAL COVER SHEET
__________ SIGNED ADDENDUM (if applicable)
__________ RESIDENCE CERTIFICATION
__________ SIGNED ASSURANCES FORM I
__________ SIGNED CERTIFICATION CONCERNING LOBBYING
__________ SIGNED COMPLIANCE WITH AMERICANS WITH DISABILITIES ACT OF 1990
__________ ASSURANCE – NON-CONSTRUCTION PROGRAMS
__________ RESPONDENT CERTIFICATION
__________ LICENSES, PERMITS & CERTIFICATION
__________ RENEWAL OPTION
__________ COVER PAGE
__________ TABLE OF CONTENTS FOR PROPOSAL
__________ ABSTRACT
__________ BUDGET
       _________Table I.A. Budget Narrative
       _________Table I.B. Fee-for-Service Budget Form
       _________Table I.C. Subcontractor Budget Form
__________ ORGANIZATION
       _________History of applicant agency
       _________Table II.A. Organization Information Table
       _________Table II.B. Current HIV/AIDS Related Funding
       _________Capacity to serve underserved/unserved populations
       _________Capacity to serve populations with special (severe) needs
       _________Table II.C. Documented Services to PLWH
__________ PROGRAM
       _________Goals & Objectives
       _________Table III.A. Goals & Objectives
       _________Proposed Clients to be served
       _________Table III.B. Proposed Clients to be Served
       _________Table III.C. Collaborative Agreements
       _________Evaluation Process
__________ APPENDIX
       _________Job description of each type of personnel position
       _________Proof of Non-profit status and Articles of Incorporation
       _________Copy of all signed and dated contracts with subcontractors
       _________Proof of Non-profit status and Articles of Incorporation of any subcontractors
       _________Copies of signed and dated collaborative agreement(s)
       _________Copies of all client surveys/evaluations (English & Spanish)
       _________Other relevant information supplied by proposer – limit 5 pages total
       _________List of Board Members
       _________Copy of applicant’s most recent fiscal year audit and/or certified financial statement
       _________Letters from all administrative agencies listed in Table II.B.
                                    FOLLOWING ARE DESCRIPTIONS OF

                      AMBULATORY/OUTPATIENT MEDICAL CARE CATEGORIES

All Home Health Care Agencies must be licensed by the Texas Department of Health as a Home and Community
Support Services Agency. Proposers must include all applicable licenses or certifications in the appropriate section of
their response. (Refer to II. Evaluation Criteria and Award Process, Item C., for more information regarding this
requirement).

All contracting organizations submitting proposals on services listed in these categories must adhere to all
CDC/OSHA/PHS recommended guidelines for blood borne pathogens and infectious diseases, and document that in
the proposal.

An existing Quality Assurance Program must be in operation to assure: 1) appropriateness of service; 2) accordance
with all applicable laws, regulations, and PHS Guidelines; and 3) be documented quarterly. Provider must have prior
HIV/AIDS experience and/or on-going education programs, all documented in the proposal and updated quarterly.
Provider must be culturally sensitive and language competent.
SERVICE CATEGORY:            AMBULATORY/OUTPATIENT MEDICAL CARE

TITLE OF SERVICE:            Outpatient/Ambulatory Primary Health Care

CODE:                        MC-01

AMOUNT AVAILABLE: $1,508,313.00 of which $200,000 must be specifically designated for services
                  provided to clients located in the rural counties (Chambers, Fort Bend, Liberty,
                  Montgomery and Waller) - To be divided among at least two (2) providers.

                             The maximum available to any single vendor is $754,156.50, of which $100,000
                             must be specifically designated for services provided to clients located in the rural
                             counties (Liberty, Chambers, Fort Bend, Montgomery and Waller). For each
                             award made under this category, 16.4% of funding must be utilized to provide
                             services for women and children. In the event only one (1) provider submits a
                             qualified proposal the County has the option of negotiating with that vendor to
                             utilize the remaining funds in the category in order to prevent a gap in services in
                             the community.

BUDGET:                      Fee for Service - Maximum average fee per unit of service is $94.00. Vendor
                             may have more than one proposed fee (i.e., a specific fee for an initial visit, a
                             specific fee for follow-up visits, etc.), however the average unit cost may not
                             exceed $94.00/unit. For example, if a vendor requests the maximum amount of
                             funding available ($754,156.50), the vendor must provide at least 8,061 units of
                             service.

DEFINITION/SERVICE: A unit of service is defined as a primary care office/clinic visit. Subspecialty
                    physician, primary care nursing or ancillary health care provider services must
                    be available on site or by specific established referral protocols upon primary
                    care physician order.

SERVICES TO BE PROVIDED:
Primary health care services include on site physician, physician extender, nursing, phlebotomy, radiographic,
laboratory, pharmacy, intravenous therapy, home health care referral, licensed dietician, patient medication
education and patient care coordination. The agency/clinic must provide continuity of care with inpatient services
and subspecialty services (either on-site or through specific referral to appropriate agencies).

The program must be able to provide:
        Services must be provided to all eligible HIV-positive clients in the Houston Eligible Metropolitan Area
          (EMA). Services to clients who reside in the rural counties must be provided at facilities located in
          those counties (Chambers, Fort Bend, Liberty, Montgomery and Waller).
        Continuity of care for all stages of adult HIV infection;
        Laboratory and pharmacy services including intravenous medications (either on-site or through
          established referral systems);
        On-site pelvic and prostate exams as needed with appropriate treatment and referral.
        Access to the Texas ADAP program (either on-site or through established referral systems);
        Access to compassionate use HIV medication programs (either directly or through established referral
          systems);
        Must provide literature and access to HIV related research protocols (either directly or through
          established referral systems);
          Must, at a minimum, comply with the attached Adult Standards for HIV Primary Medical Care
           Components of Medical Practice. Providers must demonstrate on an ongoing basis the ability to
           provide state-of-the-art HIV-related primary care medicine in accordance with the most recent Public
           Health Service and National Institute of Health (NIH) HIV treatment guidelines. The recent rapid
           advances in HIV treatment protocols require that all funded providers be able to provide services which
           to the greatest extent possible maximize a patient’s opportunity for long term survival and maintenance
           of the highest quality of life possible.

Patient Medication Education Services must adhere to the following requirements:
        1. Educators must be a State Licensed Registered Nurse or Masters Level Mental Health Professional.
        2. Clients must be able to contact Patient Medication Educators by phone with questions regarding
           medication compliance.
        3. Clients who will be prescribed ongoing medical regimens (i.e. protease inhibitors) must be assessed in
           regard to adherence. Clients with adherence issues related to lack of understanding, must receive
           additional education regarding their medical regimen. Clients with adherence issues that are behavioral or
           involve mental health issues must be referred to appropriate counseling.

Vendor must provide a written plan ensuring that services are provided in rural counties (Chambers, Fort Bend,
Liberty, Montgomery and Waller).

Providers receiving awards in this category will be required to submit a written plan by July 1, 1999, outlining
recommendations for integrating women’s and pediatric services at a single location(s). Do not include this plan in
proposal.

QUALIFICATIONS:
Services must be provided by State licensed physicians, registered nurses, nurse practitioners, vocational nurses,
pharmacists, physician assistants, x-ray technologists, dieticians, social workers and ancillary health care providers
in accordance with appropriate State licensing and/or certification requirements and with knowledge and
experience of HIV disease. The providers and system must be Medicaid/Medicare certified. A copy of the
appropriate licensure for the type of provider/facility must be included in the proposal. The acceptable
documentation for Medicaid enrollment is a copy of the agency’s Medicaid enrollment/participation letter from
National Heritage Insurance Corporation (refer to example in the Appendix). The acceptable documentation for
Medicare participation is a copy of the agency’s Medicare enrollment/participation letter from the Health Care
Financing Administration (refer to example in the Appendix). No exceptions to this required documentation will
be accepted.

STANDARDS OF CARE
See attached Adult Standards for HIV Primary Medical Care Components of Medical Practice
SERVICE CATEGORY:            AMBULATORY/OUTPATIENT MEDICAL CARE

TITLE OF SERVICE:            Pediatric Outpatient/Ambulatory Primary Health Care

CODE:                        MC-02

AMOUNT AVAILABLE: $100,000.00

BUDGET:                      Fee for Service - Maximum average fee per unit of service is $94.00. Vendor
                             may have more than one proposed fee (i.e., a specific fee for an initial visit, a
                             specific fee for follow-up visits, etc.), however the average unit cost may not
                             exceed $94.00/unit. For example, if a vendor requests the maximum amount of
                             funding available ($100,000.00), the vendor must provide at least 1,063 units of
                             service.

DEFINITION/SERVICE: A unit of service is defined as a pediatric primary care office/clinic visit.
                    Subspecialty physician, primary care nursing or ancillary health care provider
                    services must be available on site or by specific established referral protocols
                    upon primary care physician order.

SERVICES TO BE PROVIDED:
Primary health care services include on site physician, physician extender, nursing, phlebotomy, radiographic,
laboratory, pharmacy, intravenous therapy, home health care referral, licensed dietician, patient medication
education and patient care coordination. The agency/clinic must provide continuity of care with inpatient services
and subspecialty services (either on-site or through specific referral to appropriate agencies).

The program must be able to provide:
        Services must be provided to all eligible HIV-positive pediatric clients (ages 0-18) in the Houston
          Eligible Metropolitan Area (EMA).
        Continuity of care for all stages of HIV infection;
        Laboratory and pharmacy services including intravenous medications (either on-site or through
          established referral systems);
        Access to the Texas ADAP program (either on-site or through established referral systems);
        Access to compassionate use HIV medication programs (either directly or through established referral
          systems);
        Must provide literature and access to HIV related research protocols (either directly or through
          established referral systems);
        Providers must demonstrate on an ongoing basis the ability to provide state-of-the-art HIV-related
          primary care medicine in accordance with the most recent National Institute of Health (NIH) HIV
          treatment guidelines. The recent rapid advances in HIV treatment protocols require that all funded
          providers be able to provide services which to the greatest extent possible maximize a patient’s
          opportunity for long term survival and maintenance of the highest quality of life possible.

The Patient Medication Education Services must adhere to the following requirements:
       1. Educators must be a State Registered Nurse or Masters Level Mental Health Profession.
       2. Clients must be able to contact Patient Medication Educators by phone with questions regarding
           medication compliance.
       3. Clients who will be prescribed ongoing medical regimens (i.e. protease inhibitors) must be assessed in
           regard to adherence. Clients with adherence issues related to lack of understanding, must receive
           additional education regarding their medical regimen. Clients with adherence issues that are behavioral or
           involve mental health issues must be referred to appropriate counseling.

QUALIFICATIONS:
Services must be provided by State licensed physicians, registered nurses, nurse practitioners, vocational nurses,
pharmacists, physician assistants, x-ray technologists, dieticians social workers and ancillary health care providers
in accordance with appropriate State licensing and/or certification requirements and with knowledge and
experience of HIV disease. The providers and system must be Medicaid/Medicare certified. A copy of the
appropriate licensure for the type of provider/facility must be included in the proposal. The acceptable
documentation for Medicaid enrollment is a copy of the agency’s Medicaid enrollment/participation letter from
National Heritage Insurance Corporation (refer to example in the Appendix). The acceptable documentation for
Medicare participation is a copy of the agency’s Medicare enrollment/participation letter from the Health Care
Financing Administration (refer to example in the Appendix). No exceptions to this required documentation will
be accepted.
                                    FOLLOWING ARE DESCRIPTIONS OF

         OTHER OUTPATIENT/COMMUNITY-BASED HEALTHCARE SERVICE CATEGORIES

All Home Health Care Agencies must be licensed by the Texas Department of Health as a Home and Community
Support Services Agency. Proposers must include all applicable licenses or certifications in the appropriate section of
their response. (Refer to II. Evaluation Criteria and Award Process, Item C., for more information regarding this
requirement).

All contracting organizations submitting proposals on services listed in these categories must adhere to all
CDC/OSHA/PHS recommended guidelines for blood borne pathogens and infectious diseases, and document that in
the proposal.

An existing Quality Assurance Program must be in operation to assure: 1) appropriateness of service; 2) accordance
with all applicable laws, regulations and PHS Guidelines; and 3) be documented quarterly. Provider must have prior
HIV/AIDS experience and/or on-going education programs, all documented in the proposal and updated quarterly.
Provider must be culturally sensitive and language competent.
SERVICE CATEGORY:             OTHER OUTPATIENT/COMMUNITY-BASED
                              HEALTHCARE SERVICES

TITLE OF SERVICE:             Substance Abuse Treatment/Levels I and IV

CODE:                         HS-01

AMOUNT AVAILABLE:             $141,952.00

BUDGET:                       Fee for Service - Costs not to exceed $90 per hour of substance abuse treatment
                              with a maximum of 150 hours per client per year.

DEFINITION/SERVICE:           A unit of service is defined as one (1) hour of substance abuse treatment.

TARGET POPULATION:
HIV/AIDS infected and affected individuals residing within the Houston Eligible Metropolitan Area (EMA).

CLIENT ELIGIBILITY:
      Client must be HIV positive.
      Client must have an income at or less than 500% of the Federal Poverty Level.
      Client must not be eligible for services from and/or can not be served by other programs/providers (i.e.
        MHMRA of Harris County, Tricounty MHMRA, Riceland MHMRA) unless the client is in crisis and
        cannot be provided immediate services from the other programs/providers. In this case, clients may be
        provided services, as long as the client applies for the other programs/providers, until the other
        programs/providers can take over services. Agencies receiving awards under this contract understand that
        they must obtain written documentation from those programs/providers on a monthly basis stating that
        they lack the capacity to serve the client in a timely fashion. This must be documented on a per client
        basis. Once the program/provider has capacity to serve the client, services rendered may no longer be
        billed to Ryan White Title I. All services (including crisis services) provided to clients prior to obtaining
        aforementioned documentation are conducted at the agency’s own risk and discretion. The
        appropriateness of reimbursement for all services (including crisis services) rendered to clients prior to
        obtaining aforementioned documentation is subject to audit.

SERVICES PROVIDED:
Substance Abuse Treatment 1 and 4
Services must be provided for all eligible HIV/AIDS patients with substance abuse disorders. Outpatient Substance
Abuse Treatment must be provided in accordance with the Texas Commission on Alcohol and Drug Abuse Chemical
Dependency (TCADA) Treatment Facility Licensure Standards. Specifically, regarding service provision, services
must comply with §148.202. Services Required In All Programs, §148.211 Level I Treatment and §148.214. Level IV
Treatment.

§148.202. Services Required In All Programs states:
(a) All services shall be delivered according to a written plan which includes a service schedule listing services
    provided and timeframes in which they are provided.
(b) The program shall be culturally appropriate for the population served.
(c) Members of the client’s treatment team shall demonstrate effective communication and coordination of efforts and
    activities.
(d) Every residential client shall have a medical history and physical examination that is signed by a physician,
    physician assistant, or advanced nurse practitioner.
(e) Chemical dependency education shall follow a course outline that identifies lecture topics and major points to be
    discussed.
(f) The program shall provide education about the health risks of tobacco products and nicotine addiction.
(g) The program shall provide HIV education based on the Model Workplace Guidelines developed by the Texas
    Department of Health.
(h) The provider shall:
    (1) provide access to pre-test and post-test counseling and anonymous or confidential HIV testing; and
    (2) ensure that testing for the etiologic agent for AIDS is not carried out unless it is accompanied by written
        consent and counseling that conforms to the model protocol developed by the Texas Department of Health;
        and
    (3) refer HIV positive clients to a provider of HIV early intervention services (when available).
(i) The program shall make testing for tuberculosis and sexually transmitted diseases available to all clients unless the
    program has access to test results obtained during the past year.
    (1) Services may be made available directly or through referral.
    (2) If a client tests positive, the program shall refer the client to an appropriate health care provider and take
        appropriate steps to protect clients and staff.
(j) The program shall refer clients to health, mental health, and ancillary services necessary to meet treatment goals
    and conduct follow-up. Residential programs shall ensure clients have access to appropriate health care and
    mental health services.
(k) Programs that admit females of child-bearing age shall ensure that at least one staff person has training and/or
    experience in providing specialized care for substance-abusing pregnant females. In addition, the program shall:
    (1) adopt procedures for the care of pregnant clients that is approved by a licensed health care professional;
    (2) implement the procedures whenever a pregnant female is admitted; and
    (3) refer pregnant clients who are not receiving prenatal care to an appropriate health care provider and monitor
        follow-through.
(l) Clients in residential programs shall have an opportunity for eight continuous hours of sleep each night.

§148.211. Level I Treatment states:
(a) Every client shall have a medical history and physical.
    (1) Residential clients shall have the medical history and physical within 24 hours of admission. If the facility
         cannot meet this deadline because of exceptional circumstances, the circumstances shall be documented in the
         client record. Until a client’s medical history and physical is complete, staff shall observe the client closely
         and monitor vital signs.
    (2) Outpatient clients shall have the medical history and physical before admission.
(b) The program shall provide continuous supervision for clients.
    (1) In residential programs, direct care staff shall be awake and on site 24 hours a day.
         (A) During day and evening hours, at least two awake staff shall be on duty for the first 12 clients, with one
             more person on duty for each additional one to 16 clients.
         (B) At night, at least one awake staff member shall be on duty for the first 12 clients, with one more person on
             duty for each additional one to 16 clients.
    (2) In outpatient programs, direct care staff shall be awake and on site whenever a client is on site. Clients shall
         have access to on-call staff 23 hours a day.
(c) If the program accepts clients with acute withdrawal symptoms or a history of acute withdrawal symptoms, the
    program shall have:
    (1) a licensed vocational nurse or registered nurse on duty during all hours of operation; and
    (2) a physician on-call 24 hours a day.
(d) Level of observation shall be based on medical recommendations and program design.
(e) A physician shall approve all medical policies, procedures, guidelines, tools, and forms, which shall include:
    (1) screening instruments (including a medical risk assessment) and procedures;
    (2) treatment protocol or standing orders for each chemical the program is prepared to detoxify; and
      (3) emergency procedures.
(f)   The clinical supervisor shall be a physician, physician assistant, advanced practice nurse, or registered nurse.
(g)   The program shall:
      (1) ensure continuous access to emergency medical care;
      (2) provide clients access to mental health evaluation and linkage with mental health services when indicated; and
      (3) use written procedures to encourage clients to seek appropriate treatment after detoxification.
(h)   Direct care staff shall complete training as described in §148.114 of this title (relating to Special Training
      Requirements).
(i)   Staff shall help each client develop an individualized post-detoxification plan that includes appropriate referrals.

§148.214. Level IV Treatment states:
(a) All clients admitted to intermediate programs shall be:
    (1) medically stable; and
    (2) able to function with minimal structure and support.
(b) A Level IV program shall not admit a client transferred directly from Level I without written justification in the
    client record.
(c) The program shall have enough staff to provide clients with adequate support and guidance.
(d) Counselor caseloads shall not exceed 20 clients per counselor in residential programs. Outpatient programs shall
    set limits on counselor caseload size that ensure effective, individualized treatment and rehabilitation. Criteria
    used to set the caseload size shall be documented.
(e) The program shall be adequately staffed during hours of operation to ensure effective service delivery.
(f) In residential programs, the awake direct care staff-to-client ratio shall be at least 1:16 during the hours clients are
    awake. At least one staff person shall be on site and accessible to clients during sleeping hours.
(g) For clients transferred from Level I or admitted directly to this level of treatment, counselors shall complete a
    comprehensive client assessment within:
    (1) five individual service days of admission in residential programs; and
    (2) 45 calendar days of admission in outpatient programs.
(h) All clients shall have an individualized treatment plan within:
    (1) seven individual service days of admission in residential programs; and
    (2) 45 calendar days of admission in outpatient programs.
(i) The facility shall deliver an average of two hours of structured activities per week for each client, including at least
    one hour of chemical dependency counseling and one hour of additional counseling, life skills training, or
    chemical dependency education. These activities shall be designed to help clients establish a healthy, independent
    lifestyle.

The vendor must ensure that Substance Abuse Level I Treatment will be available to all eligible patients diagnosed
with HIV/AIDS residing with the Houston EMA.

The vendor must also provide a written plan for ensuring that group therapy will be available in Spanish for
monolingual (Spanish) clients.

The following information regarding Substance Abuse Treatment is an excerpt from the HRSA U.S.
Department of Health & Human Services Ryan White C.A.R.E. Act Title I Manual, section IV: Policies and
Program Guidance 97-02.15 Substance Abuse Treatment for Eligible Individuals.

Outpatient Substance Abuse Treatment Services: Funds awarded under Title I or II of the Ryan White CARE act
may be used for outpatient drug or alcohol substance abuse treatment, including expanded HIV-specific capacity of
programs if timely access to treatment and counseling is not available. Such services should be limited to:
        the pre-treatment program of recovery readiness;
        harm reduction;
        mental health counseling to reduce depression, anxiety, and other disorders associated with substance
         abuse;
        outpatient drug-free treatment and counseling;
        methadone treatment;
        neuro-psychiatric pharmaceuticals; and
        relapse prevention

In accordance with Sec. 2678 and Sec. 422 of the CARE Act, as amended, funds may not be used for syringe
exchange programs.

Residential Substance Abuse Treatment Services: CARE Act funds may be used for residential substance abuse
treatment programs, including expanded HIV-specific capacity of programs if timely access to treatment is not
available. The following limitations apply to use of CARE Act funds for residential services:
         Because of the CARE Act limitations on inpatient hospital care [see Sec. 2604.(b)(1)(B) and Sec.
           2613.(a)(2)(A)(B)], CARE Act funds may not be used for inpatient detoxification in a hospital setting.
           However, if detoxification is offered in a separate licensed residential setting (including a separately-
           licensed detoxification facility within the walls of a hospital), CARE Act funds may be used for this
           activity.
         If the residential treatment service is in a facility that primarily provides inpatient medical or psychiatric
           care, the component providing the drug and/or alcohol treatment must be separately licensed for that
           purpose.

AGENCY QUALIFICATIONS: The facility must have the capacity to serve all clients in the Houston EMA. The
facility must include a written statement that reflects that Substance Abuse Treatment Level I will be made available
to clients in the entire Houston EMA. The facility must be licensed by the Texas Commission on Alcohol and Drug
Abuse with Level I and Level IV treatment designations. The acceptable documentation for Medicaid enrollment is a
copy of the agency’s Medicaid enrollment/participation letter from National Heritage Insurance Corporation (refer to
example in the Appendix). The acceptable documentation for Medicare participation is a copy of the agency’s
Medicare enrollment/participation letter from the Health Care Financing Administration (refer to example in the
Appendix). In the situation where the vendor is not a clinic based provider the Medicaid/Medicare certification of the
individuals providing direct client care must be included in the vendor’s submission. No exceptions to this required
documentation will be accepted.
SERVICE CATEGORY:             OTHER OUTPATIENT/COMMUNITY-BASED
                              HEALTHCARE SERVICES

TITLE OF SERVICE:             Substance Abuse Treatment/Levels III and IV

CODE:                         HS-02

AMOUNT AVAILABLE:             $147,273.00 - To be divided among at least two (2) providers. The maximum
                              amount available to any single vendor is $73,636.50.

BUDGET:                       Fee for Service - Each vendor must provide at least 1,227 units of service without
                              exceeding the maximum amount of funding available per vendor.

DEFINITION/SERVICE:           A unit of service is defined as one (1) client visit for substance abuse treatment.

TARGET POPULATION:
HIV/AIDS infected and affected individuals residing within the Houston Eligible Metropolitan Area (EMA).

CLIENT ELIGIBILITY:
      Client must be HIV positive.
      Client must have an income at or less than 500% of the Federal Poverty Level.
      Client must not be eligible for services from and/or can not be served by other programs/providers (i.e.
        MHMRA of Harris County, Tricounty MHMRA, Riceland MHMRA) unless the client is in crisis and
        cannot be provided immediate services from the other programs/providers. In this case, clients may be
        provided services, as long as the client applies for the other programs/providers, until the other
        programs/providers can take over services. Agencies receiving awards under this contract understand that
        they must obtain written documentation from those programs/providers on a monthly basis stating that
        they lack the capacity to serve the client in a timely fashion. This must be documented on a per client
        basis. Once the program/provider has capacity to serve the client, services rendered may no longer be
        billed to Ryan White Title I. All services (including crisis services) provided to clients prior to obtaining
        aforementioned documentation are conducted at the agency’s own risk and discretion. The
        appropriateness of reimbursement for all services (including crisis services) rendered to clients prior to
        obtaining aforementioned documentation is subject to audit.

SERVICES PROVIDED:
Substance Abuse Treatment 3 and 4
Services for all eligible HIV/AIDS patients with substance abuse disorders. Services provided must be integrated with
HIV-related issues which trigger relapse. All services must be provided in accordance with the Texas Commission on
Alcohol and Drug Abuse Chemical Dependency (TCADA) Treatment Facility Licensure Standards. Specifically,
regarding service provision, services must comply with §148.202. Services Required In All Programs, §148.213 Level
III Treatment and §148.214. Level IV Treatment.

§148.202. Services Required In All Programs states:
(a) All services shall be delivered according to a written plan which includes a service schedule listing services
    provided and timeframes in which they are provided.
(b) The program shall be culturally appropriate for the population served.
(c) Members of the client’s treatment team shall demonstrate effective communication and coordination of efforts and
    activities.
(d) Every residential client shall have a medical history and physical examination that is signed by a physician,
    physician assistant, or advanced nurse practitioner.
(e) Chemical dependency education shall follow a course outline that identifies lecture topics and major points to be
    discussed.
(f) The program shall provide education about the health risks of tobacco products and nicotine addiction.
(g) The program shall provide HIV education based on the Model Workplace Guidelines developed by the Texas
    Department of Health.
(h) The provider shall:
    (1) provide access to pre-test and post-test counseling and anonymous or confidential HIV testing; and
    (2) ensure that testing for the etiologic agent for AIDS is not carried out unless it is accompanied by written
        consent and counseling that conforms to the model protocol developed by the Texas Department of Health;
        and
    (3) refer HIV positive clients to a provider of HIV early intervention services (when available).
(i) The program shall make testing for tuberculosis and sexually transmitted diseases available to all clients unless the
    program has access to test results obtained during the past year.
    (1) Services may be made available directly or through referral.
    (2) If a client tests positive, the program shall refer the client to an appropriate health care provider and take
        appropriate steps to protect clients and staff.
(j) The program shall refer clients to health, mental health, and ancillary services necessary to meet treatment goals
    and conduct follow-up. Residential programs shall ensure clients have access to appropriate health care and
    mental health services.
(k) Programs that admit females of child-bearing age shall ensure that at least one staff person has training and/or
    experience in providing specialized care for substance-abusing pregnant females. In addition, the program shall:
    (1) adopt procedures for the care of pregnant clients that is approved by a licensed health care professional;
    (2) implement the procedures whenever a pregnant female is admitted; and
    (3) refer pregnant clients who are not receiving prenatal care to an appropriate health care provider and monitor
        follow-through.
(l) Clients in residential programs shall have an opportunity for eight continuous hours of sleep each night.

§148.213. Level III Treatment states:
(a) All clients admitted to Level III shall be:
    (1) medically stable; and
    (2) able to function with limited supervision and support
(b) The program shall have enough staff to meet treatment needs within the context of the program description.
(c) Counselor caseloads shall not exceed 16 clients per counselor.
(d) Direct care staff shall be awake and on site during all hours of program operation. The direct care staff-to-client
    ratio shall be at least 1:16 during:
    (1) the hours clients are awake in residential programs; and
    (2) all hours of operation in outpatient programs.
(e) For clients transferred from Level 1 or admitted directly to this level of treatment, counselors shall complete a
    comprehensive client assessment within five individual service days of admission.
(f) All clients shall have an individualized treatment plan within seven individual service days of admission.
(g) The facility shall deliver an average of ten hours of structured activities per week for each client, including at least
    two hours of chemical dependency counseling (with at least one hour of individual counseling every two weeks)
    and eight hours of additional counseling, chemical dependency education, or life skills training.

§148.214. Level IV Treatment states:
(a) All clients admitted to intermediate programs shall be:
    (1) medically stable; and
    (2) able to function with minimal structure and support.
(b) A Level IV program shall not admit a client transferred directly from Level I without written justification in the
    client record.
(c) The program shall have enough staff to provide clients with adequate support and guidance.
(d) Counselor caseloads shall not exceed 20 clients per counselor in residential programs. Outpatient programs shall
    set limits on counselor caseload size that ensure effective, individualized treatment and rehabilitation. Criteria
    used to set the caseload size shall be documented.
(e) The program shall be adequately staffed during hours of operation to ensure effective service delivery.
(f) In residential programs, the awake direct care staff-to-client ratio shall be at least 1:16 during the hours clients are
    awake. At least one staff person shall be on site and accessible to clients during sleeping hours.
(g) For clients transferred from Level I or admitted directly to this level of treatment, counselors shall complete a
    comprehensive client assessment within:
    (1) five individual service days of admission in residential programs; and
    (2) 45 calendar days of admission in outpatient programs.
(h) All clients shall have an individualized treatment plan within:
    (1) seven individual service days of admission in residential programs; and
    (2) 45 calendar days of admission in outpatient programs.
(i) The facility shall deliver an average of two hours of structured activities per week for each client, including at least
    one hour of chemical dependency counseling and one hour of additional counseling, life skills training, or
    chemical dependency education. These activities shall be designed to help clients establish a healthy, independent
    lifestyle.

The vendor must provide a written plan addressing coordination with local TCADA HIV Early Intervention funded
programs.

The following information regarding Substance Abuse Treatment is an excerpt from the HRSA U.S.
Department of Health & Human Services Ryan White C.A.R.E. Act Title I Manual, section IV: Policies and
Program Guidance 97-02.15 Substance Abuse Treatment for Eligible Individuals.

Outpatient Substance Abuse Treatment Services: Funds awarded under Title I or II of the Ryan White CARE act
may be used for outpatient drug or alcohol substance abuse treatment, including expanded HIV-specific capacity of
programs if timely access to treatment and counseling is not available. Such services should be limited to:
        the pre-treatment program of recovery readiness;
        harm reduction;
        mental health counseling to reduce depression, anxiety, and other disorders associated with substance
           abuse;
        outpatient drug-free treatment and counseling;
        methadone treatment;
        neuro-psychiatric pharmaceuticals; and
        relapse prevention

In accordance with Sec. 2678 and Sec. 422 of the CARE Act, as amended, funds may not be used for syringe
exchange programs.

Residential Substance Abuse Treatment Services: CARE Act funds may be used for residential substance abuse
treatment programs, including expanded HIV-specific capacity of programs if timely access to treatment is not
available. The following limitations apply to use of CARE Act funds for residential services:
         Because of the CARE Act limitations on inpatient hospital care [see Sec. 2604.(b)(1)(B) and Sec.
           2613.(a)(2)(A)(B)], CARE Act funds may not be used for inpatient detoxification in a hospital setting.
           However, if detoxification is offered in a separate licensed residential setting (including a separately-
           licensed detoxification facility within the walls of a hospital), CARE Act funds may be used for this
           activity.
        If the residential treatment service is in a facility that primarily provides inpatient medical or psychiatric
         care, the component providing the drug and/or alcohol treatment must be separately licensed for that
         purpose.

AGENCY QUALIFICATIONS: The facility must be licensed by the Texas Commission on Alcohol and Drug
Abuse with Level III and Level IV treatment designations. The acceptable documentation for Medicaid enrollment is a
copy of the agency’s Medicaid enrollment/participation letter from National Heritage Insurance Corporation (refer to
example in the Appendix). The acceptable documentation for Medicare participation is a copy of the agency’s
Medicare enrollment/participation letter from the Health Care Financing Administration (refer to example in the
Appendix). In the situation where the vendor is not a clinic based provider the Medicaid/Medicare certification of the
individuals providing direct client care must be included in the vendor’s submission. No exceptions to this required
documentation will be accepted.
SERVICE CATEGORY:             OTHER OUTPATIENT/COMMUNITY-BASED
                              HEALTHCARE SERVICES

TITLE OF SERVICE:             Outpatient Psychiatric Care

CODE:                         HS-03

AMOUNT AVAILABLE:             $194,543.00

BUDGET:                       Fee for Service - The average cost per unit of service may not exceed $120.00 per
                              unit.

DEFINITION/SERVICE:           A unit of service is defined as one client visit for Outpatient Psychiatric Care.

TARGET POPULATION:
HIV/AIDS infected and affected individuals residing within the Houston Eligible Metropolitan Area (EMA).

CLIENT ELIGIBILITY:
      Client must be HIV positive.
      HIV positive client must have a DSM-IV Axis I diagnosis eligible for reimbursement under the State
        Medicaid Plan.
      Client must have an income at or less than 500% of the Federal Poverty Level.
      Client must not be eligible for services from and/or can not be served by other programs/providers (i.e.
        MHMRA of Harris County, Tricounty MHMRA, Riceland MHMRA) unless the client is in crisis and
        cannot be provided immediate services from the other programs/providers. In this case, clients may be
        provided services, as long as the client applies for the other programs/providers, until the other
        programs/providers can take over services. Agencies receiving awards under this contract understand that
        they must obtain written documentation from those programs/providers on a monthly basis stating that
        they lack the capacity to serve the client in a timely fashion. This must be documented on a per client
        basis. Once the program/provider has capacity to serve the client, services rendered may no longer be
        billed to Ryan White Title I. All services (including crisis services) provided to clients prior to obtaining
        aforementioned documentation are conducted at the agency’s own risk and discretion. The
        appropriateness of reimbursement for all services (including crisis services) rendered to clients prior to
        obtaining aforementioned documentation is subject to audit.
      Medicaid/Medicare, 3rd Party Payer and Private Pay status of clients receiving services under this grant
        must be verified by the provider prior to requesting reimbursement under this grant.

SERVICES PROVIDED:
Comprehensive Outpatient Psychiatric Services:
Services for all eligible HIV/AIDS patients with psychiatric disorders. Program must be supervised by a Psychiatrist
and include diagnostic assessments, emergency evaluations and psychopharmacotherapy. The program must be able
to provide:

1.     Diagnostic Assessments: comprehensive evaluation for identification of psychiatric disorders, mental status
       evaluation, differential diagnosis which may involve use of other clinical and laboratory tests, case
       formulation, and treatment plans or disposition.

2.     Emergency Psychiatric Services: rapid evaluation, differential diagnosis, acute treatment, crisis intervention,
       and referral. These services must be available twenty four hours a day.
3.     Brief Psychotherapy: individual, supportive, group, couple, family, hypnosis, biofeedback, and other
       psychophysiological treatments and behavior modification.

4.     Psychopharmacotherapy: evaluation and medication treatment of psychiatric disorders, including, but not
       limited to, anxiety disorders, major depression, pain syndromes, habit control problems, psychosis and organic
       mental disorders. Access to an on site pharmacy must be available.

5.     Rehabilitation Services: some, but not necessarily all, of the following: physical, psychosocial, behavioral,
       and cognitive training.

AGENCY QUALIFICATIONS: Director of the Program must be a Board Certified Psychiatrist. Licensed and/or
Certified Allied Health professionals (Licensed Psychologists, Physicians, Licensed Master Social Workers, Licensed
Professional Counselors, Licensed Marriage and Family Therapists, Certified Alcohol and Drug Abuse Counselors,
etc.) must be used in all treatment modalities. Documentation of the Director’s credentials, licensures and
certifications must be included in the proposal. Documentation of the Allied Health professionals licensures and
certifications must be included in the proposal. The acceptable documentation for Medicaid enrollment is a copy of
the agency’s Medicaid enrollment/participation letter from National Heritage Insurance Corporation (refer to example
in the Appendix). The acceptable documentation for Medicare participation is a copy of the agency’s Medicare
enrollment/participation letter from the Health Care Financing Administration (refer to example in the Appendix). In
the situation where the vendor is not a clinic based provider the Medicaid/Medicare certification of the individuals
providing direct client care must be included in the vendor’s submission. No exceptions to this required
documentation will be accepted.
SERVICE CATEGORY:                      OTHER OUTPATIENT/COMMUNITY-BASED
                                       HEALTHCARE SERVICES

TITLE OF SERVICE:                      Professional Counseling/Emotional Support Groups

CODE:                                  HS-04

AMOUNT AVAILABLE:                      $337,578.00 – The maximum amount any single proposal may request is
                                       $67,515.60.

BUDGET:                                Fee for Service — Costs not to exceed $60 per office session and $90 for
                                       in-home/hospital session for individual therapy. For group counseling
                                       sessions, costs not to exceed $16 per hour or $24 per 90 minutes per eligible
                                       client and a maximum of $144 per session.

DEFINITION/SERVICE:                    A unit of service is described as an individual counseling session lasting a
                                       minimum of 45 minutes or one group session lasting a minimum of 90
                                       minutes. Support Groups are defined as professionally-led (licensed
                                       therapists or counselor) groups that comprise HIV positive individuals,
                                       family members, or significant others for the purpose of providing
                                       emotional support directly related to the stress of caring for an HIV
                                       positive person.

TYPE OF CONTRACT:                      Contracts in this service category will be term contracts. Providers will
                                       receive contracts with a set fee schedule (i.e., $60.00/individual session,
                                       $90.00 per non-office based individual session, $16.00/per hour/per client
                                       with a maximum charge of $24.00 for a single support group session per
                                       client or a maximum cost per single group session of $144.00) for a
                                       specified term (up to 12 months). A maximum of four (4) providers will be
                                       awarded a contract in this category, with the funding divided among the
                                       four (4) providers. The original allocation of funds to each provider will
                                       be 20% of the total funds available for the category. These remaining
                                       funds will be distributed to the four providers on an as needed basis based
                                       on client utilization. Total funds expended will not exceed maximum
                                       amount available in the service category.

TARGET POPULATION:
HIV/AIDS infected and affected individuals residing within the Houston Eligible Metropolitan Area (EMA).

CLIENT ELIGIBILITY:
For individual therapy sessions (office and non-office based):
         Client must be HIV positive or the affected significant other of an HIV positive person.
         HIV positive client must have a DSM-IV Axis I diagnosis eligible for reimbursement under the State
           Medicaid Plan.
         Affected family member and/or significant other is eligible for services only related to the stress of caring
           for an HIV positive family member and/or significant other.
         Client must have an income at or less than 500% of the Federal Poverty Level.
         Client must not be eligible for services from and/or can not be served by other programs/providers (i.e.
           MHMRA of Harris County, Tricounty MHMRA, Riceland MHMRA) unless the client is in crisis and
           cannot be provided immediate services from the other programs/providers. In this case, clients may be
           provided services, as long as the client applies for the other programs/providers, until the other
           programs/providers can take over services. Agencies receiving awards under this contract understand that
           they must obtain written documentation from those programs/providers on a monthly basis stating that
           they lack the capacity to serve the client in a timely fashion. This must be documented on a per client
           basis. Once the program/provider has capacity to serve the client, services rendered may no longer be
           billed to Ryan White Title I. All services (including crisis services) provided to clients prior to obtaining
           aforementioned documentation are conducted at the agency’s own risk and discretion. The
           appropriateness of reimbursement for all services (including crisis services) rendered to clients prior to
           obtaining aforementioned documentation is subject to audit.
          Medicaid/Medicare, 3rd Party Payer and Private Pay status of clients receiving services under this grant
           must be verified by the provider prior to requesting reimbursement under this grant.

For support group sessions:
        Client must be either an HIV positive person or a family member and/or significant other of an HIV
           positive person.
        Affected family member and/or significant other is eligible for services only related to the stress of caring
           for an HIV positive significant other.

SERVICES TO BE PROVIDED:
Proposals are requested for delivery of professionally led support groups or individual or family counseling sessions
for infected and affected populations. Services may include short-term (10 sessions) bereavement counseling for
affected individuals.

The group counseling sessions should be provided according to the following formula: no less than 48 sessions for a
12-month period at no more than $16 per hour per eligible client and a maximum of $144 per session. Group sessions
should be 1-1/2 to 2 hours in length, held weekly and should include a minimum of 3 people and a maximum of 15
people. Applicant agencies should provide a plan for establishing criteria for prioritizing participation in group
sessions and for termination from group participation.

Individual and family counseling must be provided according to the following formula: no more than 24 sessions per
client or family per year. Extensions will be addressed on an individual basis when meeting the criteria of counseling
directly related to HIV illness. Approval from Harris County must be obtained prior to any client receiving more than
24 sessions. Under no circumstances will the County reimburse more than two (2) units of individual therapy per
client in any single 24 hour period.

Agencies are encouraged to have available to clients all modes of counseling services, i.e., crisis, individual, family
and group.

Counseling services funded under this grant cannot be used to supplant insurance or Medicare/Medicaid
reimbursements for such services. Clients eligible for such reimbursement may not be billed to this grant. Medicare
and private insurance co-payments are eligible for reimbursement under this grant (in this situation the County will
reimburse the client’s co-payment only, not the cost of the session which must be billed to Medicare and/or the 3rd
party payer). Under no circumstances may the provider bill the County for the difference between the reimbursement
from Medicaid, Medicare or 3rd party insurance and the fee schedule under this grant.

Agency must provide professional support group sessions led by a licensed counselor. A minimum of two groups
must be established during the funding year.
PERSONNEL QUALIFICATIONS:
It is required that counselors have the following qualifications:
          Licensed Mental Health Practitioner by the State of Texas (LMSW, LPC or LMFT).
          At least two years experience working with HIV disease and two years work experience with chronic care
             of a catastrophic illness.
          Counselors providing family sessions must have at least two years experience in family therapy.
          Counselors must be covered by professional liability insurance with limits of at least $300,000 per
             occurrence.

It is required that Agencies:
          Provide assurance that the professional counselor will be supervised by a licensed therapist qualified by
             the State of Texas to provide clinical supervision. This supervision should be documented through
             supervision notes.
          Keep individual/family client case records which include documentation of eligibility, assessment,
             progress notes, treatment plans and discharge summary.
          Keep attendance records for group sessions.
          Must provide 24-hour access to a licensed counselor for current clients with emotional emergencies.
          Must document the financial resources, private insurance and/or Medicaid/Medicare status of all clients
             served under this category, and seek payment from all applicable 3rd party payers. Clients eligible for
             Medicaid/Medicare or 3rd party payer reimbursement may not be billed to grant funds.
          Documentation of at least one therapist certified by Medicaid/Medicare on the staff of the agency must be
             provided in the proposal. All funded agencies must maintain the capability to serve and seek
             reimbursement from Medicaid/Medicare throughout the term of their contract with the County. Potential
             clients who are Medicaid/Medicare eligible may not be denied services by a funded agency based on their
             reimbursement status (Medicaid/Medicare eligible clients may not be referred elsewhere in order that non-
             Medicaid/Medicare eligible clients may be added to this grant). Failure to serve Medicaid/Medicare
             eligible clients based on their reimbursement status will be grounds for the immediate termination of the
             provider’s contract with the County.
          Must comply with the Houston Ryan White Title I Professional Counseling Standards of Care.
          Submit to the County, for prior approval, all clients to be billed to the grant. This is necessary in order
             for the County to administer the allocation of funds among the providers of Professional Counseling
             Services under the term contract format. The information to be submitted will include:
          An eleven character case number (in the format designated by the County);
          The number and type of sessions (i.e., # of individual and/or group sessions) to be allocated for this client;
          A certification by the provider that the services are not eligible for reimbursement from any other source,
             or that the client is not eligible for services from any other program. The provider must also certify that the
             client will not exceed the limit on total sessions available to a client under this grant.
          The names, addresses and other identifying information of clients will not be submitted to the County as
             part of this prior approval process.
SERVICE CATEGORY:             OTHER OUTPATIENT/COMMUNITY-BASED
                              HEALTHCARE SERVICES

TITLE OF SERVICE:             Health Insurance

CODE:                         HS-05

AMOUNT AVAILABLE:             $63,814.00

BUDGET:                       Line Item

DEFINITION/SERVICE:           One (1) month of insurance coverage.

SERVICES PROVIDED:
Financial assistance for all eligible HIV-positive individuals residing within the Houston Eligible Metropolitan Area
(EMA) to pay for the State of Texas high-risk pool insurance. Assistance must be in the form of vouchers or checks
made payable to insurance companies. No payments may be made directly to individual clients, family members or
care givers.
SERVICE CATEGORY:            OTHER OUTPATIENT/COMMUNITY-BASED
                             HEALTHCARE SERVICES

TITLE OF SERVICE:            Hospice Services

CODE:                        HS-06

AMOUNT AVAILABLE:            $123,530.00

BUDGET:                      Fee for Service

DEFINITION/SERVICE:

The following definition of Hospice services is an excerpt from the Texas Health & Safety Code, Chapter 142.
Home and Community Support Services, Subchapter A. Home and Community Support Services license,
Section 142.001. Definitions.

       "Hospice services" means services, including services provided by unlicensed personnel under
       the delegation of a registered nurse or physical therapist, provided to a client or a client's
       family as part of a coordinated program consistent with the standards and rules adopted
       under this chapter. These services include palliative care for terminally ill clients and support
       services for clients and their families that:

           (A) are available 24 hours a day, seven days a week, during the last stages of illness,
               during death, and during bereavement;
           (B) are provided by a medically directed interdisciplinary team; and
           (C) may be provided in a home, nursing home, residential unit, or inpatient unit
               according to need. These services do not include inpatient care normally provided in a
               licensed hospital to a terminally ill person who has not elected to be a hospice client.

Only those hospice services provided to HIV-positive individuals may be reimbursed under contracts awarded
for this category. Under no circumstances will services that are provided to family members of HIV-positive
clients be reimbursed.

A unit of service is defined as one (1) twenty-four (24) hour day of hospice services that includes a full range of
physical and psychological support to HIV patients in the final stages of AIDS. Services may be provided in
any of the four (4) hospice care settings:

      Routine Home Care (Hospice services provided in the client’s home.);
      Continuous Home Care (Intensive hospice services provided to a client in his or her home, on a
       continuous basis during periods of crisis as necessary to maintain a client at home.);
      Inpatient Respite Care (Hospice services provided under a short-term inpatient care setting to clients
       only when necessary to relieve the family members, or other persons caring for the hospice recipient at
       home. These services may be provided only on an occasional basis and may not be reimbursed for more
       than five consecutive days at a time. Services must be provided in a facility licensed to provide hospice
       services);
      General Inpatient Care (Hospice services, specifically general inpatient care for pain control or acute or
       chronic symptom management which cannot be managed in other settings. These services are provided to
       clients in a facility licensed to provide hospice services.).
SERVICES TO BE PROVIDED:
Services must include but are not limited to medical and nursing care, palliative care, psychosocial support, spiritual
guidance and bereavement services for the patient and surviving family members. Physical therapy services can be
made available on a subcontract basis. Services must be provided to all eligible HIV-positive clients residing in the
Houston Eligible Metropolitan Area (EMA).

AGENCY QUALIFICATIONS:
Providing agency must be licensed by the Texas Department of Health as a hospital, special hospital, special care
facility, Home and Community Support Services Agency with Hospice Designation, with staff qualified in treating
individuals requiring hospice services and a copy of these included in the proposal. The acceptable documentation for
licensure is a copy of the agency’s current license from the Texas Department of Health. The acceptable
documentation for Medicaid enrollment is a copy of the agency’s Medicaid enrollment/participation letter from
National Heritage Insurance Corporation (refer to example in the Appendix). The acceptable documentation for
Medicare participation is a copy of the agency’s Medicare enrollment/participation letter from the Health Care
Financing Administration (refer to example in the Appendix). No exceptions to this required documentation will
be accepted.

QUALITY ASSURANCE:
The facility shall adhere to all CDC/OSHA recommended guidelines for blood-borne pathogens and infectious
diseases. The facility must demonstrate safety guidelines for occupational HIV, HBV, and MTB exposure for staff
and volunteers.
SERVICE CATEGORY:              OTHER OUTPATIENT/COMMUNITY-BASED
                               HEALTHCARE SERVICES

TITLE OF SERVICE:              Skilled Rehabilitation

CODE:                          HS-07

AMOUNT AVAILABLE:              $21,599.00

BUDGET:                        Fee for Service: Vendor must provide at least 392 units of service without
                               exceeding the maximum amount of funding available.

DEFINITION/SERVICE:            A unit of service is a Physician-ordered physical therapy and/or skilled
                               rehabilitation service provided to HIV patients in community-based
                               organizations, health care facilities, and/or patient’s home.

SERVICES TO BE PROVIDED:
Services include but are not limited to diagnostic evaluations, pain management and training/rehabilitation in the
following areas: activities of daily living, neuromuscular rehabilitation, gait, mobility, speech, language and cognitive
abilities.

QUALIFICATIONS:
Skilled rehabilitation shall be provided by licensed Physical Therapists (PT), licensed PT Assistants, licensed Massage
Therapist, PT Aides, Registered Occupational Therapists, Certified Occupational Therapy Assistants or Licensed
Speech Pathologist. Providers must have documented expertise in providing HIV-specific physical therapies.

Providing agency must be licensed by the Texas Department of Health as a Home and Community Support Services
Agency and a copy of these included in the proposal. The acceptable documentation for licensure is a copy of the
agency’s current Home and Community Support Services Agency license from the Texas Department of Health. The
acceptable documentation for Medicaid enrollment is a copy of the agency’s Medicaid enrollment/participation letter
from National Heritage Insurance Corporation (refer to example in the Appendix). The acceptable documentation for
Medicare participation is a copy of the agency’s Medicare enrollment/participation letter from the Health Care
Financing Administration (refer to example in the Appendix). No exceptions to this required documentation will
be accepted.
    FOLLOWING ARE DESCRIPTIONS OF

HOME/COMMUNITY-BASED SUPPORT SERVICES
                  CASE MANAGEMENT SYSTEM CONTRACT CAPS

The contract caps are inclusive of all costs of each Team. Each vendor may only submit one
application per group. A single agency may only be awarded one untargeted case
management team (Group A) and one targeted case management team (Group B). Caps are
as follows:


                  GROUP A – UNTARGETED CASE MANAGEMENT TEAMS
                  No more than one application in either CM-01 or CM-02 per vendor.

   Community-Based Case Management Team (CM-01)                                    $209,094.00
    (Three teams of four [4] FTEs to be awarded)

   Community-Based Medical Case Management Team (CM-02)                            $289,094.00
    (One team of five [5] FTEs to be awarded)

                    GROUP B – TARGETED CASE MANAGEMENT TEAMS
                     No more than one application in these categories per vendor.
                               (CM-03, CM-04, CM-05 and CM-06)

   Community-Based Rural Case Management Team (CM-03)                              $215,666.00
    (One team of four [4] FTEs to be awarded)

   Community-Based Hispanic/Monolingual                                            $209,094.00
    Case Management Team (CM-04)
    (One team of four [4] FTEs to be awarded)

   Community-Based Children & Adolescents                                          $209,094.00
    Case Management Team (CM-05)
    (One team of four [4] FTEs to be awarded)

   Community-Based African American Women and
    Children Medical                                                                $289,094.00
    Case Management Team (CM-06)
    (One team of five [5] FTEs to be awarded)
Definitions:

The Houston Regional HIV Care Management System is a comprehensive system of care
which provides a wide spectrum of services to HIV-positive individuals who require assistance
accessing various medical and psychosocial services. The Care Management System is
designed and structured so as to ensure the availability of services to HIV-positive individuals
at all levels of need.

The components of the Care Management System are client identification, client assessment
and service linkage.

Case management teams serve HIV-positive individuals at all levels of need. This includes
persons who need only limited or occasional assistance (service linkage) as well as those who
need more intensive involvement in order to access the full range of services they require and
to develop the skills and/or knowledge necessary to function without ongoing intervention.

Service linkage and case management are an integral component of the Care Management
System.
SERVICE CATEGORY:                        HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:                        Community-Based, Case Management Team

CODE:                                    SS-01

FUNCTIONAL TITLE:                        4 FTEs — Each team will be comprised of 1 Supervisor 2 Case
                                         Managers (CM) and 1 Service Linkage Worker (SLW). Each
                                         agency will be contractually obligated to serve 200 unduplicated
                                         clients per team during the contract year with a minimum of 40
                                         new clients (no carryover, never been in system). Each team must
                                         provide at least 3,328 direct service hours per contract term, as
                                         documented by encounter entries into the HIV/CMS URS
                                         database or Centralized Patient Care Data Management System
                                         (CPCDMS).        This minimum requirement is based on the
                                         expectation that at least 50% of CMs’ and SLWs’, and 10% of
                                         the supervisor’s available time will be spent in documented direct
                                         service activities.

MAXIMUM AMOUNT FUNDED:                   $209,094.00/team

DEFINITION OF SERVICE:                   Case management services includes networking outreach activities,
                                         service linkage and case management services. Case management is
                                         a working agreement between a client and a case manager for a
                                         defined period of time based on the client’s assessed needs. The
                                         purpose of case management is to assist clients with the
                                         procurement of needed services so that the problems associated
                                         with living with the disease are mitigated. Case management is
                                         primarily home and community-based. Service linkage is a working
                                         agreement between a client and a service linkage worker for a
                                         variable period of time, based on client needs, during which
                                         information, referrals and service linkage are provided on an as-
                                         needed basis. The purpose of service linkage is to assist clients who
                                         do not require the intensity of a case management relationship, as
                                         determined by service need level. Service linkage is primarily
                                         office-based. SLW will be expected to conduct outreach activities
                                         that include but are not limited to identifying and screening HIV-
                                         positive clients not currently accessing care, assessing their needs,
                                         providing them with information, referral and linkage into care
                                         management services.
KEY ACTIVITIES:
      Networking with HIV testing sites, medical facilities and service providers for referrals.
      Identifying and screening clients
      Assessing each client’s medical and psychosocial history and current service needs
      Developing and regularly updating a service plan based upon the client’s needs and choices
      Implementing the plan in a timely manner
      Providing information, referrals and assistance with linkage to medical and psychosocial services as
       needed
      Monitoring the efficacy and quality of services through periodic reevaluation
          Advocating on behalf of clients to decrease service gaps and remove barriers to services helping clients
           develop and utilize independent living skills and strategies

POPULATION TO BE SERVED:
Services will be available to eligible HIV-positive clients residing in the Houston EMA including Harris, Fort
Bend, Montgomery, Chambers, Waller, and Liberty counties with priority given to clients most in need. No
eligible client will be refused services. All clients will be served without regard to age, gender, race, color,
religion, national origin, sexual orientation, or handicap.

Services will target low income individuals with HIV/AIDS who demonstrate multiple medical and psychosocial
needs including, but not limited to:
        primary care
        specialized care
        alternative treatment
        medications
        placement in a medical facility
        emotional support
        mental health counseling
        substance abuse treatment
        basic needs for food, clothing, and shelter
        transportation
        legal services; and
        vocational services

Services will also target clients who cannot function in the community due to barriers which include, but are not
limited to:
         extreme lack of knowledge regarding available services
         inability to maintain financial independence
         inability to complete necessary forms
         inability to arrange and complete entitlement and medical appointments
         homelessness
         deteriorating medical condition
         psychiatric illness
         illiteracy
         language/cultural barriers; or
         the absence of speech, sight, hearing, or mobility

Non-HIV infected family members of persons will be served to the extent that their needs are related to or result
from the HIV-positive status of the infected individual.

Case Managers are to serve eligible clients, especially those underserved or unserved population groups which
include:
        African American
        Hispanic/Latino
        Women and Children
        Veteran
        Deaf/Hard of Hearing
        Substance Abusers
        Gay/Lesbian/Transsexual
          Homeless

SERVICES TO BE DELIVERED:
Case Management/Service Linkage services will be integrated into the Houston Regional HIV Care Management
System (HIV/CMS) and comply with HIV/CMS Case Management/Service Linkage Standards for Care and
policies and procedures as they are completed and/or revised including linkage to the Houston Case Management
Uniform Reporting System (URS) database or Centralized Patient Care Data Management System (CPCDMS).

Case Managers/Service Linkage Workers must spend at least 50% (1,040 hours per FTE) of their time providing
direct case management services. One of the team members must function as the designated full time supervisor
who will be required to have at least 10% direct service time with the clients of the team. Direct case management
services include any activities with a client (face-to-face or by telephone), communication with other service
providers or significant others to access client services, monitoring client care, and accompanying clients to
services. Case Managers are required to have at least one (1) face-to-face encounter per month with all of the
team’s active clients in the clients’ natural environment. Service linkage workers will maintain contact by phone
or face-to-face with clients as needed. Indirect activities include travel to and from a client's residence or agency,
staff meetings, supervision, community education, documentation, and computer input. Direct case management
activities must be documented in the Uniform Reporting System (URS) or Centralized Patient Care Data
Management System(CPCDMS) according to the Case Management/Service Linkage Standards of Care.

AGENCY QUALIFICATIONS:
Proposers must demonstrate their history of working with underserved/unserved HIV/AIDS populations.
Proposers must demonstrate their history of or describe plans for coordinating services and cooperating with other
agencies providing HIV/AIDS services. Proposers must also demonstrate their proven history of providing case
management services or their plan for supporting a case management unit within their agency.

Proposers must also demonstrate the ability to serve these populations in their natural environment and in a
culturally competent manner. Culturally competent services include but are not limited to services that are
provided in a language and format the client understands, interpreter services, communications devices for the
deaf/hard of hearing, and staff with documented prior experience, training and/or education regarding the
underserved/unserved populations.

First-time proposers must demonstrate the agency's capacity to interface with the Uniform Reporting System
(URS) or Centralized Patient Care Data Management System (CPCDMS) maintained by the Harris County Health
Department and/or include funds in their budget to purchase necessary equipment.

PERSONNEL QUALIFICATIONS
See Attached Case Management/Service Linkage Standards of Care and Position Descriptions.
At least one (1) of the Case Manager FTE positions on the Case Management/Service Linkage Team must be
fluent in both English and Spanish (both oral and written) Case Management/Service Linkage staff must
have at least one year of paid HIV/AIDS experience. Failure to maintain this requirement may be cause for
contract termination.

Exceptions to Personnel Qualifications:
None

Supervision:
See Attached Case Management /Service Linkage Standards of Care
SERVICE CATEGORY:        HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:        Community-Based, Medical Case Management Team

CODE:                    SS-02

FUNCTIONAL TITLE:        5 FTEs — This team will be comprised of 1 Supervisor, 2 Case
                         Managers (CM), 1 Service Linkage Worker (SLW) and 1 State
                         licensed Registered Nurse or Licensed Masters of Social Worker
                         (LMSW) Medical Social Worker. Each agency will be
                         contractually obligated to serve 200 unduplicated clients per team
                         during the contract year with a minimum of 40 new clients (no
                         carryover, never been in system). Each team must provide at
                         least 3,328 direct service hours per contract term, as documented
                         by encounter entries into the HIV/CMS URS database or
                         Centralized Patient Care Data Management System (CPCDMS).
                         This minimum requirement is based on the expectation that at
                         least 50% of CMs’ and SLWs’, and 10% of the supervisor’s
                         available time will be spent in documented direct client service
                         activities.

MAXIMUM AMOUNT FUNDED:   $289,094.00 for 1 team

DEFINITION OF SERVICE    The focus of the Medical Case Management Team concept will be
                         to provide short-term intensive intervention by a team of case
                         managers which will address service linkage, medical needs and
                         psychosocial needs depending on client need followed by long-
                         term availability of information, referrals and intermittent
                         interventions, if required. Clients with intensive medical needs
                         will be served.

                         The Medical Case Management Team will provide case
                         management services through a team approach that integrates
                         service linkage, case management, medical assessment and
                         consultation and supervision.

                         Service linkage is a working agreement between a client and a
                         service linkage worker for a variable period of time, based on client
                         needs, during which information, referrals and service linkage are
                         provided on an as-needed basis. The purpose of service linkage is to
                         assist clients who do not require the intensity of a case management
                         relationship, as determined by service need level. Service linkage is
                         primarily office-based. SLW will be expected to conduct outreach
                         activities that include but are not limited to identifying and
                         screening HIV-positive clients not currently accessing care,
                         assessing their needs, providing them with information, referral
                         and linkage into care management services.
KEY TEAM FUNCTIONS:
Medical Assessment and Consultation
       Client assessments;
       Develop a service plan for each client and ensure its implementation;
       Home visits;
       Interaction and advocacy with medical providers on behalf of clients;
       Monitor medical services accessed by clients and follow-up as needed;
       Transition clients out of medical case management upon completion of medical service plan and
          medical stabilization;
       Medical assessment and consultation
       Documentation of services provided in client record and URS database or Centralized Patient Care Data
          Management System (CPCDMS).
Case Management
       Networking with HIV testing sites, medical facilities and service providers for referrals;
       Client assessments;
       Develop a service plan for each client and work with clients to implement the plan
       Home visits;
       Advocacy for client services as needed;
       Assist clients with development of independent life skills and strategies;
       Monitor initiation and continuation of services and follow-up as needed;
       Transition clients out of case management upon completion of the service plan;
       Documentation of services provided in client record and URS database or Centralized Patient Care Data
          Management System (CPCDMS).

Service Linkage
        Provide information, referrals and service linkage for clients;
        Assist clients with completion of applications and other paperwork;
        Documentation of services provided in client record and URS database or Centralized Patient Care Data
           Management System (CPCDMS);
        Monitor and follow-up with the team’s clients;

Supervision (must include these functions)
        Triage all new clients for appropriate level of care and assign cases;
        Provision of supervision to all team staff;
        Routine evaluation of cases for appropriateness of service level, with adjustments made if necessary;
        Limited caseload;
        Documentation of services provided in client record and URS database or Centralized Patient Care Data
          Management System (CPCDMS).

POPULATION TO BE SERVED:
Services will be available to eligible HIV-positive clients residing in the Houston EMA including Harris, Fort
Bend, Montgomery, Chambers, Waller, and Liberty counties with priority given to clients most in need. No eligible
client will be refused services. All clients will be served without regard to age, gender, race, color, religion,
national origin, sexual orientation, or handicap.

Services will target low income individuals with HIV/AIDS who demonstrate multiple medical and psychosocial
needs including, but not limited to:
        primary care
        specialized care
          alternative treatment
          medications
          placement in a medical facility
          emotional support
          mental health counseling
          substance abuse treatment
          basic needs for food, clothing, and shelter
          transportation
          legal services; and
          vocational services

Services will also target clients who cannot function in the community due to barriers which include, but are not
limited to:
         extreme lack of knowledge regarding available services
         inability to maintain financial independence
         inability to complete necessary forms
         inability to arrange and complete entitlement and medical appointments
         homelessness
         deteriorating medical condition
         psychiatric illness
         illiteracy
         language/cultural barriers; or
         the absence of speech, sight, hearing, or mobility

Non-HIV infected family members of persons will be served to the extent that their needs are related to or result
from the HIV-positive status of the infected individual.

Case Managers are to serve eligible clients, especially those underserved or unserved population groups which
include:
        African American
        Hispanic/Latino
        Women and Children
        Veteran
        Deaf/Hard of Hearing
        Substance Abusers
        Gay/Lesbian/Transsexual
        Homeless

SERVICES TO BE DELIVERED:
Case Management/Service Linkage services will be integrated into the Houston Regional HIV Care Management
System (HIV/CMS) and comply with HIV/CMS Case Management/Service Linkage Standards for Care and
policies and procedures as they are completed and/or revised including linkage to the Houston Case Management
Uniform Reporting System (URS) database or Centralized Patient Care Data Management System (CPCDMS).

Case Managers/Service Linkage Workers must spend at least 50% (1,040 hours per FTE) of their time providing
direct case management services. One of the team members must function as the designated full time supervisor
who will be required to have at least 10% direct service time with the clients of the team. Direct case management
services include any activities with a client (face-to-face or by telephone), communication with other service
providers or significant others to access client services, monitoring client care, and accompanying clients to
services. Case Managers are required to have at least one (1) face-to-face encounter per month with all of the
team’s active clients in the clients’ natural environment. Service linkage workers will maintain contact by phone
or face-to-face with clients as needed. Indirect activities include travel to and from a client's residence or agency,
staff meetings, supervision, community education, documentation, and computer input. Direct case management
activities must be documented in the Uniform Reporting System (URS) or Centralized Patient Care Data
Management System (CPCDMS) according to the Case Management/Service Linkage Standards of Care.

AGENCY QUALIFICATIONS:
Proposers must demonstrate their history of working with underserved/unserved HIV/AIDS populations.
Proposers must demonstrate their history of or describe plans for coordinating services and cooperating with other
agencies providing HIV/AIDS services. Proposers must also demonstrate their proven history of providing case
management services or their plan for supporting a case management unit within their agency.

Proposers must also demonstrate the ability to serve these populations in their natural environment and in a
culturally competent manner. Culturally competent services include but are not limited to services that are
provided in a language and format the client understands, interpreter services, communications devices for the
deaf/hard of hearing, and staff with documented prior experience, training and/or education regarding the
underserved/unserved populations.

Proposers must provide a summary of the previous year’s client service evaluation surveys, if applicable.

First-time proposers must demonstrate the agency's capacity to interface with the Uniform Reporting System
(URS) or Centralized Patient Care Data Management System (CPCDMS) maintained by the Harris County Health
Department and/or include funds in their budget to purchase necessary equipment.

PERSONNEL QUALIFICATIONS
See Attached Case Management/Service Linkage Standards of Care and Position Descriptions.

At least one (1) of the Case Manager FTE positions on the Case Management/Service Linkage Team must be
fluent in both English and Spanish (both oral and written) Case Management/Service Linkage staff must
have at least one year of paid HIV/AIDS experience. Failure to maintain this requirement may be cause for
contract termination.

Medical Assessment and Consultation:
Minimum Requirements:
LMSW Medical Social Worker or BSN/RN with two (2) years paid health care experience, with at least one of
those years of experience in the field of HIV/AIDS.

Exceptions to Personnel Qualifications:
None

Supervision:
See Attached Case Management /Service Linkage Standards of Care
SERVICE CATEGORY:                        HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:                        Community-Based, Rural Case Management Team

CODE:                                    SS-03

FUNCTIONAL TITLE:                        4 FTEs — This team will be comprised of 1 Supervisor 2 Case
                                         Managers (CM) and 1 Service Linkage Worker (SLW). Each
                                         agency will be contractually obligated to serve 200 unduplicated
                                         clients per team during the contract year with a minimum of 40
                                         new clients (no carryover, never been in system). Each team must
                                         provide at least 3,328 direct service hours per contract term, as
                                         documented by encounter entries into the HIV/CMS URS
                                         database or Centralized Patient Care Data Management System
                                         (CPCDMS).        This minimum requirement is based on the
                                         expectation that at least 50% of CMs’ and SLWs’, and 10% of
                                         the supervisor’s available time will be spent in documented direct
                                         service activities.

MAXIMUM AMOUNT FUNDED:                   $215,666.00 for 1 team

DEFINITION OF SERVICE:                   Case management services includes networking outreach activities,
                                         service linkage and case management services. Case management is
                                         a working agreement between a client and a case manager for a
                                         defined period of time based on the client’s assessed needs. The
                                         purpose of case management is to assist clients with the
                                         procurement of needed services so that the problems associated
                                         with living with the disease are mitigated. Case management is
                                         primarily home and community-based. Service linkage is a working
                                         agreement between a client and a service linkage worker for a
                                         variable period of time, based on client needs, during which
                                         information, referrals and service linkage are provided on an as-
                                         needed basis. The purpose of service linkage is to assist clients who
                                         do not require the intensity of a case management relationship, as
                                         determined by service need level. Service linkage is primarily
                                         office-based. SLW will be expected to conduct outreach activities
                                         that include but are not limited to identifying and screening HIV-
                                         positive clients not currently accessing care, assessing their needs,
                                         providing them with information, referral and linkage into care
                                         management services.
KEY ACTIVITIES:
      Networking with HIV testing sites, medical facilities and service providers for referrals.
      Identifying and screening clients
      Assessing each client’s medical and psychosocial history and current service needs
      Developing and regularly updating a service plan based upon the client’s needs and choices
      Implementing the plan in a timely manner
      Providing information, referrals and assistance with linkage to medical and psychosocial services as
       needed
      Monitoring the efficacy and quality of services through periodic reevaluation
          Advocating on behalf of clients to decrease service gaps and remove barriers to services helping clients
           develop and utilize independent living skills and strategies

POPULATION TO BE SERVED:
Services will be targeted (and limited) to clients residing in the Houston EMA in Counties other than Harris.
No eligible client will be refused services. All clients will be served without regard to age, gender, race, color,
religion, national origin, sexual orientation or handicap.

Services will target low income individuals with HIV/AIDS who demonstrate multiple medical and psychosocial
needs including, but not limited to:
        primary care
        specialized care
        alternative treatment
        medications
        placement in a medical facility
        emotional support
        mental health counseling
        substance abuse treatment
        basic needs for food, clothing, and shelter
        transportation
        legal services; and
        vocational services

Services will also target clients who cannot function in the community due to barriers which include, but are not
limited to:
         extreme lack of knowledge regarding available services
         inability to maintain financial independence
         inability to complete necessary forms
         inability to arrange and complete entitlement and medical appointments
         homelessness
         deteriorating medical condition
         psychiatric illness
         illiteracy
         language/cultural barriers; or
         the absence of speech, sight, hearing, or mobility

Non-HIV infected family members of persons will be served to the extent that their needs are related to or result
from the HIV-positive status of the infected individual.

Case Managers are to serve eligible clients, especially those underserved or unserved population groups which
include:
        African American
        Hispanic/Latino
        Women and Children
        Veteran
        Deaf/Hard of Hearing
        Substance Abusers
        Gay/Lesbian/Transsexual
        Homeless
SERVICES TO BE DELIVERED:
Case Management/Service Linkage services will be integrated into the Houston Regional HIV Care Management
System (HIV/CMS) and comply with HIV/CMS Case Management/Service Linkage Standards for Care and
policies and procedures as they are completed and/or revised including linkage to the Houston Case Management
Uniform Reporting System (URS) database or Centralized Patient Care Data Management System (CPCDMS).

Case Managers/Service Linkage Workers must spend at least 50% (1,040 hours per FTE) of their time providing
direct case management services. One of the team members must function as the designated full time supervisor
who will be required to have at least 10% direct service time with the clients of the team. Direct case management
services include any activities with a client (face-to-face or by telephone), communication with other service
providers or significant others to access client services, monitoring client care, and accompanying clients to
services. Case Managers are required to have at least one (1) face-to-face encounter per month with all of the
team’s active clients in the clients’ natural environment. Service linkage workers will maintain contact by phone
or face-to-face with clients as needed. Indirect activities include travel to and from a client's residence or agency,
staff meetings, supervision, community education, documentation, and computer input. Direct case management
activities must be documented in the Uniform Reporting System (URS) or Centralized Patient Care Data
Management System(CPCDMS) according to the Case Management/Service Linkage Standards of Care.

AGENCY QUALIFICATIONS:
Proposers must demonstrate their history of working with underserved/unserved HIV/AIDS populations.
Proposers must demonstrate their history of or describe plans for coordinating services and cooperating with other
agencies providing HIV/AIDS services. Proposers must also demonstrate their proven history of providing case
management services or their plan for supporting a case management unit within their agency. Proposer must have
service locations in at least two (2) rural counties within the Houston Eligible Metropolitan Area (EMA).

Proposers must also demonstrate the ability to serve these populations in their natural environment and in a
culturally competent manner. Culturally competent services include but are not limited to services that are
provided in a language and format the client understands, interpreter services, communications devices for the
deaf/hard of hearing, and staff with documented prior experience, training and/or education regarding the
underserved/unserved populations.

First-time proposers must demonstrate the agency's capacity to interface with the Uniform Reporting System
(URS) or Centralized Patient Care Data Management System (CPCDMS) maintained by the Harris County Health
Department and/or include funds in their budget to purchase necessary equipment.

PERSONNEL QUALIFICATIONS
See Attached Case Management/Service Linkage Standards of Care and Position Descriptions.
At least one (1) of the Case Manager FTE positions on the Case Management/Service Linkage Team must be
fluent in both English and Spanish (both oral and written) Case Management/Service Linkage staff must
have at least one year of paid HIV/AIDS experience. Failure to maintain this requirement may be cause for
contract termination.
Exceptions to Personnel Qualifications:
None

Supervision:
See Attached Case Management /Service Linkage Standards of Care
SERVICE CATEGORY:                        HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:                        Community-Based, Hispanic/Monolingual
                                         Case Management Team

CODE:                                    SS-04

FUNCTIONAL TITLE:                        4 FTEs — This team will be comprised of 1 Supervisor 2 Case
                                         Managers (CM) and 1 Service Linkage Worker (SLW). Each
                                         agency will be contractually obligated to serve 200 unduplicated
                                         clients per team during the contract year with a minimum of 40
                                         new clients (no carryover, never been in system). Each team must
                                         provide at least 3,328 direct service hours per contract term, as
                                         documented by encounter entries into the HIV/CMS URS
                                         database or Centralized Patient Care Data Management System
                                         (CPCDMS).        This minimum requirement is based on the
                                         expectation that at least 50% of CMs’ and SLWs’, and 10% of
                                         the supervisor’s available time will be spent in documented direct
                                         service activities.

MAXIMUM AMOUNT FUNDED:                   $209,094.00 for 1 team

DEFINITION OF SERVICE:                   Case management services includes networking outreach activities,
                                         service linkage and case management services. Case management is
                                         a working agreement between a client and a case manager for a
                                         defined period of time based on the client’s assessed needs. The
                                         purpose of case management is to assist clients with the
                                         procurement of needed services so that the problems associated
                                         with living with the disease are mitigated. Case management is
                                         primarily home and community-based. Service linkage is a working
                                         agreement between a client and a service linkage worker for a
                                         variable period of time, based on client needs, during which
                                         information, referrals and service linkage are provided on an as-
                                         needed basis. The purpose of service linkage is to assist clients who
                                         do not require the intensity of a case management relationship, as
                                         determined by service need level. Service linkage is primarily
                                         office-based. SLW will be expected to conduct outreach activities
                                         that include but are not limited to identifying and screening HIV-
                                         positive clients not currently accessing care, assessing their needs,
                                         providing them with information, referral and linkage into care
                                         management services.

KEY ACTIVITIES:
      Networking with HIV testing sites, medical facilities and service providers for referrals.
      Identifying and screening clients
      Assessing each client’s medical and psychosocial history and current service needs
      Developing and regularly updating a service plan based upon the client’s needs and choices
      Implementing the plan in a timely manner
      Providing information, referrals and assistance with linkage to medical and psychosocial services as
       needed
          Monitoring the efficacy and quality of services through periodic reevaluation
          Advocating on behalf of clients to decrease service gaps and remove barriers to services helping clients
           develop and utilize independent living skills and strategies

POPULATION TO BE SERVED:
Services will be available to eligible HIV-positive clients residing in the Houston EMA including Harris, Fort
Bend, Montgomery, Chambers, Waller, and Liberty counties with priority given to clients most in need. Services
will be targeted to Hispanic/Monolingual HIV-positive individuals. No eligible client will be refused services. All
clients will be served without regard to age, gender, race, color, religion, national origin, sexual orientation, or
handicap.

Services will target low income individuals with HIV/AIDS who demonstrate multiple medical and psychosocial
needs including, but not limited to:
        primary care
        specialized care
        alternative treatment
        medications
        placement in a medical facility
        emotional support
        mental health counseling
        substance abuse treatment
        basic needs for food, clothing, and shelter
        transportation
        legal services; and
        vocational services

Services will also target clients who cannot function in the community due to barriers which include, but are not
limited to:
         extreme lack of knowledge regarding available services
         inability to maintain financial independence
         inability to complete necessary forms
         inability to arrange and complete entitlement and medical appointments
         homelessness
         deteriorating medical condition
         psychiatric illness
         illiteracy
         language/cultural barriers; or
         the absence of speech, sight, hearing, or mobility

Non-HIV infected family members of persons will be served to the extent that their needs are related to or result
from the HIV-positive status of the infected individual.

Case Managers are to serve eligible clients, especially those underserved or unserved population groups which
include:
        African American
        Hispanic/Latino
        Women and Children
        Veteran
        Deaf/Hard of Hearing
          Substance Abusers
          Gay/Lesbian/Transsexual
          Homeless

SERVICES TO BE DELIVERED:
Case Management/Service Linkage services will be integrated into the Houston Regional HIV Care Management
System (HIV/CMS) and comply with HIV/CMS Case Management/Service Linkage Standards for Care and
policies and procedures as they are completed and/or revised including linkage to the Houston Case Management
Uniform Reporting System (URS) database or Centralized Patient Care Data Management System (CPCDMS).

Case Managers/Service Linkage Workers must spend at least 50% (1,040 hours per FTE) of their time providing
direct case management services. One of the team members must function as the designated full time supervisor
who will be required to have at least 10% direct service time with the clients of the team. Direct case management
services include any activities with a client (face-to-face or by telephone), communication with other service
providers or significant others to access client services, monitoring client care, and accompanying clients to
services. Case Managers are required to have at least one (1) face-to-face encounter per month with all of the
team’s active clients in the clients’ natural environment. Service linkage workers will maintain contact by phone
or face-to-face with clients as needed. Indirect activities include travel to and from a client's residence or agency,
staff meetings, supervision, community education, documentation, and computer input. Direct case management
activities must be documented in the Uniform Reporting System (URS) or Centralized Patient Care Data
Management System(CPCDMS) according to the Case Management/Service Linkage Standards of Care.

AGENCY QUALIFICATIONS:
Proposers must demonstrate their history of working with underserved/unserved HIV/AIDS populations.
Proposers must demonstrate their history of or describe plans for coordinating services and cooperating with other
agencies providing HIV/AIDS services. Proposers must also demonstrate their proven history of providing case
management services or their plan for supporting a case management unit within their agency.

Proposers must also demonstrate the ability to serve these populations in their natural environment and in a
culturally competent manner. Culturally competent services include but are not limited to services that are
provided in a language and format the client understands, interpreter services, communications devices for the
deaf/hard of hearing, and staff with documented prior experience, training and/or education regarding the
underserved/unserved populations.

First-time proposers must demonstrate the agency's capacity to interface with the Uniform Reporting System
(URS) or Centralized Patient Care Data Management System (CPCDMS) maintained by the Harris County Health
Department and/or include funds in their budget to purchase necessary equipment.

PERSONNEL QUALIFICATIONS
See Attached Case Management/Service Linkage Standards of Care and Position Descriptions.
All four (4) of the Case Manager FTE positions of this Case Management/Service Linkage Team must be
fluent in both English and Spanish (both oral and written) Case Management/Service Linkage staff must
have at least one year of paid HIV/AIDS experience. Failure to maintain this requirement may be cause for
contract termination.

Exceptions to Personnel Qualifications:
None

Supervision:
See Attached Case Management /Service Linkage Standards of Care
SERVICE CATEGORY:                      HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:                          Community-Based, Children/Adolescents
                                           Case Management Team

CODE:                                      SS-05

FUNCTIONAL TITLE:                          4 FTEs — This team will be comprised of 1 Supervisor 2 Case
                                           Managers (CM) and 1 Service Linkage Worker (SLW). Each
                                           agency will be contractually obligated to serve 200 unduplicated
                                           clients per team during the contract year with a minimum of 40
                                           new clients (no carryover, never been in system). Each team must
                                           provide at least 3,328 direct service hours per contract term, as
                                           documented by encounter entries into the HIV/CMS URS
                                           database or Centralized Patient Care Data Management System
                                           (CPCDMS).        This minimum requirement is based on the
                                           expectation that at least 50% of CMs’ and SLWs’, and 10% of
                                           the supervisor’s available time will be spent in documented direct
                                           service activities.

MAXIMUM AMOUNT FUNDED:                     $209,094.00 for 1 team

DEFINITION OF SERVICE:                     Case management services includes networking outreach activities,
                                           service linkage and case management services. Case management is
                                           a working agreement between a client and a case manager for a
                                           defined period of time based on the client’s assessed needs. The
                                           purpose of case management is to assist clients with the
                                           procurement of needed services so that the problems associated
                                           with living with the disease are mitigated. Case management is
                                           primarily home and community-based. Service linkage is a working
                                           agreement between a client and a service linkage worker for a
                                           variable period of time, based on client needs, during which
                                           information, referrals and service linkage are provided on an as-
                                           needed basis. The purpose of service linkage is to assist clients who
                                           do not require the intensity of a case management relationship, as
                                           determined by service need level. Service linkage is primarily
                                           office-based. SLW will be expected to conduct outreach activities
                                           that include but are not limited to identifying and screening HIV-
                                           positive clients not currently accessing care, assessing their needs,
                                           providing them with information, referral and linkage into care
                                           management services. Services by this team are limited to HIV-
                                           positive clients, 0-24 years of age without prior approval from HIV
                                           Services.

KEY ACTIVITIES:
      Networking with HIV testing sites, medical facilities and service providers for referrals.
      Identifying and screening clients
      Assessing each client’s medical and psychosocial history and current service needs
      Developing and regularly updating a service plan based upon the client’s needs and choices
          Implementing the plan in a timely manner
          Providing information, referrals and assistance with linkage to medical and psychosocial services as
           needed
          Monitoring the efficacy and quality of services through periodic reevaluation
          Advocating on behalf of clients to decrease service gaps and remove barriers to services helping clients
           develop and utilize independent living skills and strategies

POPULATION TO BE SERVED:
Services will be available to eligible HIV-positive clients residing in the Houston EMA including Harris, Fort
Bend, Montgomery, Chambers, Waller, and Liberty counties with priority given to clients most in need. Services
will be targeted to HIV-positive children and adolescents. No eligible client will be refused services. All clients
will be served without regard to age (ages 0-23), gender, race, color, religion, national origin, sexual orientation, or
handicap.

Services will target low income individuals with HIV/AIDS who demonstrate multiple medical and psychosocial
needs including, but not limited to:
        primary care
        specialized care
        alternative treatment
        medications
        placement in a medical facility
        emotional support
        mental health counseling
        substance abuse treatment
        basic needs for food, clothing, and shelter
        transportation
        legal services; and
        vocational services

Services will also target clients who cannot function in the community due to barriers which include, but are not
limited to:
         extreme lack of knowledge regarding available services
         inability to maintain financial independence
         inability to complete necessary forms
         inability to arrange and complete entitlement and medical appointments
         homelessness
         deteriorating medical condition
         psychiatric illness
         illiteracy
         language/cultural barriers; or
         the absence of speech, sight, hearing, or mobility

Non-HIV infected family members of persons will be served to the extent that their needs are related to or result
from the HIV-positive status of the infected individual.

Case Managers are to serve eligible clients, especially those underserved or unserved population groups which
include:
        African American
        Hispanic/Latino
          Women and Children
          Veteran
          Deaf/Hard of Hearing
          Substance Abusers
          Gay/Lesbian/Transsexual
          Homeless

SERVICES TO BE DELIVERED:
Case Management/Service Linkage services will be integrated into the Houston Regional HIV Care Management
System (HIV/CMS) and comply with HIV/CMS Case Management/Service Linkage Standards for Care and
policies and procedures as they are completed and/or revised including linkage to the Houston Case Management
Uniform Reporting System (URS) database or Centralized Patient Care Data Management System (CPCDMS).

Case Managers/Service Linkage Workers must spend at least 50% (1,040 hours per FTE) of their time providing
direct case management services. One of the team members must function as the designated full time supervisor
who will be required to have at least 10% direct service time with the clients of the team. Direct case management
services include any activities with a client (face-to-face or by telephone), communication with other service
providers or significant others to access client services, monitoring client care, and accompanying clients to
services. Case Managers are required to have at least one (1) face-to-face encounter per month with all of the
team’s active clients in the clients’ natural environment. Service linkage workers will maintain contact by phone
or face-to-face with clients as needed. Indirect activities include travel to and from a client's residence or agency,
staff meetings, supervision, community education, documentation, and computer input. Direct case management
activities must be documented in the Uniform Reporting System (URS) or Centralized Patient Care Data
Management System(CPCDMS) according to the Case Management/Service Linkage Standards of Care.

AGENCY QUALIFICATIONS:
Proposers must demonstrate their history of working with underserved/unserved HIV/AIDS populations.
Proposers must demonstrate their history of or describe plans for coordinating services and cooperating with other
agencies providing HIV/AIDS services. Proposers must also demonstrate their proven history of providing case
management services or their plan for supporting a case management unit within their agency.

Proposers must also demonstrate the ability to serve these populations in their natural environment and in a
culturally competent manner. Culturally competent services include but are not limited to services that are
provided in a language and format the client understands, interpreter services, communications devices for the
deaf/hard of hearing, and staff with documented prior experience, training and/or education regarding the
underserved/unserved populations.

First-time proposers must demonstrate the agency's capacity to interface with the Uniform Reporting System
(URS) or Centralized Patient Care Data Management System (CPCDMS) maintained by the Harris County Health
Department and/or include funds in their budget to purchase necessary equipment.
PERSONNEL QUALIFICATIONS
See Attached Case Management/Service Linkage Standards of Care and Position Descriptions.

At least one (1) of the Case Manager FTE positions on the Case Management/Service Linkage Team must be
fluent in both English and Spanish (both oral and written) Case Management/Service Linkage staff must
have at least one year of paid HIV/AIDS experience. Failure to maintain this requirement may be cause for
contract termination.

Exceptions to Personnel Qualifications:
None

Supervision:
See Attached Case Management /Service Linkage Standards of Care
SERVICE CATEGORY:        HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:        Community-Based, African American Women/Children
                         Medical Case Management Team

CODE:                    SS-06

FUNCTIONAL TITLE:        5 FTEs — This team will be comprised of 1 Supervisor, 2 Case
                         Managers (CM), 1 Service Linkage Worker (SLW) and 1 State
                         licensed Registered Nurse or Licensed Masters of Social Worker
                         (LMSW) Medical Social Worker. Each agency will be
                         contractually obligated to serve 200 unduplicated clients per team
                         during the contract year with a minimum of 40 new clients (no
                         carryover, never been in system). Each team must provide at
                         least 3,328 direct service hours per contract term, as documented
                         by encounter entries into the HIV/CMS URS database or
                         Centralized Patient Care Data Management System (CPCDMS).
                         This minimum requirement is based on the expectation that at
                         least 50% of CMs’ and SLWs’, and 10% of the supervisor’s
                         available time will be spent in documented direct client service
                         activities.

MAXIMUM AMOUNT FUNDED:   $289,094.00 for 1 team

DEFINITION OF SERVICE    The focus of the Medical Case Management Team concept will be
                         to provide short-term intensive intervention by a team of case
                         managers which will address service linkage, medical needs and
                         psychosocial needs depending on client need followed by long-
                         term availability of information, referrals and intermittent
                         interventions, if required. Clients with intensive medical needs
                         will be served.

                         The Medical Case Management Team will provide case
                         management services through a team approach that integrates
                         service linkage, case management, medical assessment and
                         consultation and supervision.

                         Service linkage is a working agreement between a client and a
                         service linkage worker for a variable period of time, based on client
                         needs, during which information, referrals and service linkage are
                         provided on an as-needed basis. The purpose of service linkage is to
                         assist clients who do not require the intensity of a case management
                         relationship, as determined by service need level. Service linkage is
                         primarily office-based. SLW will be expected to conduct outreach
                         activities that include but are not limited to identifying and
                         screening HIV-positive clients not currently accessing care,
                         assessing their needs, providing them with information, referral
                         and linkage into care management services.
KEY TEAM FUNCTIONS:
Medical Assessment and Consultation
       Client assessments;
       Develop a service plan for each client and ensure its implementation;
       Home visits;
       Interaction and advocacy with medical providers on behalf of clients;
       Monitor medical services accessed by clients and follow-up as needed;
       Transition clients out of medical case management upon completion of medical service plan and
          medical stabilization;
       Medical assessment and consultation
       Documentation of services provided in client record and URS database or Centralized Patient Care Data
          Management System (CPCDMS).

Case Management
       Networking with HIV testing sites, medical facilities and service providers for referrals;
       Client assessments;
       Develop a service plan for each client and work with clients to implement the plan
       Home visits;
       Advocacy for client services as needed;
       Assist clients with development of independent life skills and strategies;
       Monitor initiation and continuation of services and follow-up as needed;
       Transition clients out of case management upon completion of the service plan;
       Documentation of services provided in client record and URS database or Centralized Patient Care Data
         Management System (CPCDMS).

Service Linkage
        Provide information, referrals and service linkage for clients;
        Assist clients with completion of applications and other paperwork;
        Documentation of services provided in client record and URS database or Centralized Patient Care Data
           Management System (CPCDMS);
        Monitor and follow-up with the team’s clients;

Supervision (must include these functions)
        Triage all new clients for appropriate level of care and assign cases;
        Provision of supervision to all team staff;
        Routine evaluation of cases for appropriateness of service level, with adjustments made if necessary;
        Limited caseload;
        Documentation of services provided in client record and URS database or Patient Care Data
          Management System (CPCDMS).

POPULATION TO BE SERVED:
Services will be available to eligible HIV-positive clients residing in the Houston EMA including Harris, Fort
Bend, Montgomery, Chambers, Waller, and Liberty counties with priority given to clients most in need. Services
will be targeted to African American females and children. No eligible client will be refused services. All clients
will be served without regard to age, gender, race, color, religion, national origin, sexual orientation, or handicap.

Services will target low income individuals with HIV/AIDS who demonstrate multiple medical and psychosocial
needs including, but not limited to:
        primary care
          specialized care
          alternative treatment
          medications
          placement in a medical facility
          emotional support
          mental health counseling
          substance abuse treatment
          basic needs for food, clothing, and shelter
          transportation
          legal services; and
          vocational services

Services will also target clients who cannot function in the community due to barriers which include, but are not
limited to:
         extreme lack of knowledge regarding available services
         inability to maintain financial independence
         inability to complete necessary forms
         inability to arrange and complete entitlement and medical appointments
         homelessness
         deteriorating medical condition
         psychiatric illness
         illiteracy
         language/cultural barriers; or
         the absence of speech, sight, hearing, or mobility

Non-HIV infected family members of persons will be served to the extent that their needs are related to or result
from the HIV-positive status of the infected individual.

Case Managers are to serve eligible clients, especially those underserved or unserved population groups which
include:
        African American
        Hispanic/Latino
        Women and Children
        Veteran
        Deaf/Hard of Hearing
        Substance Abusers
        Gay/Lesbian/Transsexual
        Homeless

SERVICES TO BE DELIVERED:
Case Management/Service Linkage services will be integrated into the Houston Regional HIV Care Management
System (HIV/CMS) and comply with HIV/CMS Case Management/Service Linkage Standards for Care and
policies and procedures as they are completed and/or revised including linkage to the Houston Case Management
Uniform Reporting System (URS) database or Centralized Patient Care Data Management System (CPCDMS).

Case Managers/Service Linkage Workers must spend at least 50% (1,040 hours per FTE) of their time providing
direct case management services. One of the team members must function as the designated full time supervisor
who will be required to have at least 10% direct service time with the clients of the team. Direct case management
services include any activities with a client (face-to-face or by telephone), communication with other service
providers or significant others to access client services, monitoring client care, and accompanying clients to
services. Case Managers are required to have at least one (1) face-to-face encounter per month with all of the
team’s active clients in the clients’ natural environment. Service linkage workers will maintain contact by phone
or face-to-face with clients as needed. Indirect activities include travel to and from a client's residence or agency,
staff meetings, supervision, community education, documentation, and computer input. Direct case management
activities must be documented in the Uniform Reporting System (URS) or Centralized Patient Care Data
Management System (CPCDMS) according to the Case Management/Service Linkage Standards of Care.

AGENCY QUALIFICATIONS:
Proposers must demonstrate their history of working with underserved/unserved HIV/AIDS populations.
Proposers must demonstrate their history of or describe plans for coordinating services and cooperating with other
agencies providing HIV/AIDS services. Proposers must also demonstrate their proven history of providing case
management services or their plan for supporting a case management unit within their agency.

Proposers must also demonstrate the ability to serve these populations in their natural environment and in a
culturally competent manner. Culturally competent services include but are not limited to services that are
provided in a language and format the client understands, interpreter services, communications devices for the
deaf/hard of hearing, and staff with documented prior experience, training and/or education regarding the
underserved/unserved populations.

First-time proposers must demonstrate the agency's capacity to interface with the Uniform Reporting System
(URS) or Centralized Patient Care Data Management System (CPCDMS) maintained by the Harris County Health
Department and/or include funds in their budget to purchase necessary equipment.

PERSONNEL QUALIFICATIONS
See Attached Case Management/Service Linkage Standards of Care and Position Descriptions.

At least one (1) of the Case Manager FTE positions on the Case Management/Service Linkage Team must be
fluent in both English and Spanish (both oral and written) Case Management/Service Linkage staff must
have at least one year of paid HIV/AIDS experience. Failure to maintain this requirement may be cause for
contract termination.

Medical Assessment and Consultation:
Minimum Requirements:
LMSW Medical Social Worker or BSN/RN with two (2) years paid health care experience, with at least one of
those years of experience in the field of HIV/AIDS.

Exceptions to Personnel Qualifications:
None

Supervision:
See Attached Case Management /Service Linkage Standards of Care
SERVICE CATEGORY                      HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:                     Transportation Vouchering Program

CODE:                                 SS-07

AMOUNT:                               $117,300.00 - Only one (1) vendor will be awarded a contract in this
                                      category.

BUDGET:                               Line Item Budget - At least $75,000 of the total funds must be applied
                                      directly to the actual cost to purchase vouchers. Proposals must clearly
                                      identify the administrative costs associated with this service. Salary and
                                      fringe for 1 FTE, who works directly with providing clients
                                      transportation vouchers, may be applied to the budget.

DEFINITION OF SERVICE:                Transportation Voucher service is defined as providing vouchers for the
                                      essential transportation of eligible clients. Vouchers consist of the
                                      following:
                                           METRO bus tokens and passes
                                           Gas Vouchers

                                      Taxi vouchers cannot be purchased with this contract.

                                      Transportation Voucher service hours are from 8am to 5pm on
                                      weekdays (non-holidays).    Exceptions noted under AGENCY
                                      REQUIREMENTS.

CLIENT ELIGIBILITY:
In order to be eligible for Transportation Voucher, individuals must meet the following criteria:
 HIV/AIDS diagnosed person and eligible affected individuals
 Reside in Houston EMA (Harris, Chambers, Fort Bend, Liberty, Montgomery and Waller Counties)
 Income no greater than 150% of the Federal Poverty Level
 Agrees to and signs consent for transportation, rights and responsibilities

Documentation of the above eligibility criteria must be obtained by the provider prior to a client receiving services
and must be documented in accordance with the Transportation Standards of Care.

SERVICES TO BE PROVIDED:
The intent of this funding is to provide transportation services to access medical and/or support services for eligible
individuals. Clients receiving METRO bus passes are ineligible for tokens. Gasoline Voucher services will be
authorized for use only after reasonable alternative transportation sources have been exhausted.

AGENCY REQUIREMENTS:
1. Provider must abide by the Transportation Standards of Care (attached).
2. Provider must enter all transportation services on the Transportation System (URS) Centralized Patient Care
   Data Management System (CPCDMS) in accordance with Transportation Standards of Care.
3. Provider must have a separate phone line from their main number so that clients can access transportation
   services directly without cost to clients.
4. Provider must have a fax machine with a dedicated line.
5. Provider must provide quarterly reports on high usage and trends of services to the County.
6. Once a month, provider must offer four (4) hours of intake services on a regularly scheduled Saturday.
7. Provider must provide 16 hours per month of off-site intakes in clinics, rural counties (Fort Bend, Chambers,
   Liberty, Montgomery and Waller), etc.
8. Provider must ensure that gasoline vouchers are available and redeemable in all Title I counties (Fort Bend,
   Chambers, Liberty, Montgomery and Waller).

HARRIS COUNTY HEALTH DEPARTMENT/HIV SERVICES WILL PROVIDE:
1. Tracking and coordination system software.
2. System and software training for the provider.
3. System support for the database.
SERVICE CATEGORY:                    HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:                    Food Pantry

CODE:                                SS-08

BUDGET:                              Line Item Budget

AMOUNT AVAILABLE:                    $322,117.00 - The maximum available to a single vendor is $80,529.25.
                                     Proposals submitted for an amount exceeding $80,529.25 may be rejected
                                     by the County as non-responsive to the RFP.

DEFINITION OF SERVICE:               A facility that provides food and related grocery items to include personal
                                     hygiene, paper products, cleaning supplies and diapers. This service does
                                     not provide food to affected persons and individuals who are caregivers
                                     for HIV/AIDS infected persons. Up to 90% of funds can be used for the
                                     wholesale purchase of food and specialty items. In addition an agency has
                                     an option of purchasing food vouchers in an amount up to 10% of its
                                     award. Agencies planning to use this option must provide the County a
                                     copy of written guidelines for the issuance, recording and safeguarding of
                                     food vouchers and receive approval of these guidelines prior to issuing
                                     food vouchers.

TARGET POPULATION:
HIV-positive persons living within the Houston Eligible Metropolitan Area (EMA).

SERVICES TO BE PROVIDED:
Operation of a food pantry for HIV-positive residents residing in the Houston EMA.

Food vouchers must be issued and recorded in the name of the client only. Tobacco, liquor and pet food or pet
products may not be purchased with funds awarded under this RFP (including food vouchers).

AGENCY QUALIFICATIONS:
Agency must have the following permits: Food Dealer’s Permit, Occupancy Permit, and Fire Marshall’s Permit. A
copy of the agency’s permits must be included in the proposal
SERVICE CATEGORY:             HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:             Meals Served at the Public Primary Health Care Clinic

CODE:                         SS-9

AMOUNT AVAILABLE: $96,976.00

BUDGET:                       Fee for Service – Cost not to exceed $2.25 per meal.

DEFINITION/SERVICE: A unit of service is defined as one (1) light meal, which includes some
                    combination of fresh fruit, sandwiches, prepackaged snacks and beverage
                    appropriate for HIV/AIDS infected persons.

TARGET POPULATION: Persons utilizing the Thomas Street Clinic for primary medical care.

SERVICES TO BE PROVIDED:
The provision of light meals at Thomas Street for patients and their families.

The Harris County Hospital District will provide and maintain a walk-in refrigerator for storage of light meals.
The District will also provide staff to distribute the food daily (Monday-Friday). The applicant agency will be
responsible for the delivery of food by 10:00 AM each morning, and for the pick up of unused food by 2:00 PM
each afternoon. Unused food will be delivered to an appropriate HIV/AIDS service provider for distribution to
clients.

AGENCY QUALIFICATIONS:
Agency must have the following permits (if applicable to the location of the food preparation site): Food Dealer’s
Permit, Occupancy Permit and Fire Marshall’s Permit. A copy of the agency’s applicable permits must be included
in the proposal.
SERVICE CATEGORY:              HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:              Nutritional Supplements

CODE:                          SS-10

AMOUNT AVAILABLE:              $37,000.00

BUDGET:                        Line Item Budget

DEFINITION/SERVICE:            Provision of nutritional supplements (up to a 90-day supply at any given time, per
                               client) to HIV/AIDS infected individuals.

                               The following nutritional supplements may be provided:
                                       L-Glutamine;
                                       Supplemental Protein Powder;
                                       Acidophilus;
                                       Multi-Vitamins;
                                       Milk Thistle;
                                       Alpha-Lipoic Acid

SERVICES PROVIDED:
Services are to be provided for all eligible HIV/AIDS infected individuals residing within the Houston Eligible
Metropolitan Area (EMA). This service includes providing eligible HIV/AIDS infected individuals with therapeutic
nutritional supplements that are beneficial to the wellness and increased health conditions of clients. Nutritional
supplements may only be provided to clients who have an income at or less than 300% of the Federal Poverty Level
and present with a written referral from a State licensed physician or dietician which specifies frequency, duration and
amount. An eligible client may only receive an annual total of $1,000.00 in nutritional supplements. Written requests
for exceeding the annual total must be submitted to Harris County for prior approval. Providers receiving awards in
this category must communicate existence of services to health care providers funded by Titles I and II.
SERVICE CATEGORY:                    HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:                    Emergency Housing/Utility Assistance

CODE:                                SS-11

AMOUNT AVAILABLE:                    $175,394.00

BUDGET:                              Line Item Budget: A single provider is to be awarded this contract.

DEFINITION/SERVICE:                  The term ―emergency‖ is defined as a need for funds within 24 hours to 72
                                     hours. Agency is required to acknowledge receipt of the assistance request
                                     within 24 hours. Emergency essential living needs include housing,
                                     utilities, rent, electricity, telephone, TTY, water and gas for HIV/AIDS
                                     infected individuals. There will be a limit of $500 per client/family in a
                                     contract year.

CLIENT ELIGIBILITY:
Agency must make funds available to all HIV-positive individuals residing in the Houston EMA.

SERVICES TO BE PROVIDED:
Emergency Housing/Utilities Assistance consists of the following needs:
       Rent (late rental payments are excluded)
       Utilities (gas, water and electricity)
       Telephone bills/TTY, including long distance charges up to $25.00

Clients will be limited to utilizing this assistance once per contract year for each individual service need unless
extreme hardship is documented by the contracting agency.

The agency must adhere to the following guidelines in providing these services:
        Assistance must be in the form of vouchers made payable to vendors, merchants, landlords, etc. No
          payments may be made directly to individual clients, family members or care givers.
        Agency must operate during regular business hours, Monday through Friday from 8:00 a.m. to 5:00 p.m.
        Agency must provide services to homebound clients.
        Agency may not require a client to have a case manager as a prerequisite for assistance.

AGENCY QUALIFICATIONS:
Contracting agency must work closely with other service providers to minimize duplication of services and ensure that
assistance is given only when no reasonable alternatives are available. Additionally, agency must document ability to
refer clients for food, transportation, clothing and other needs from other service providers when clients need is
justified.

The contracting agency will ensure that emergency housing/utility funds are available throughout the contract year by
expending approximately one twelfth (1/12) of the funds per month unless prior written approval for expenditures is
obtained from Harris County/HIV Services.
SERVICE CATEGORY:                    HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:                    Household Items

CODE:                                SS-12

AMOUNT AVAILABLE:                    $28,316.00

BUDGET:                              Line Item Budget

DEFINITION OF SERVICE:               To provide HIV/AIDS infected persons with household items to support
                                     their independent living. No more than 20% of these funds can be used
                                     for the purchase of household items.

TARGET POPULATION:
HIV/AIDS infected individuals residing within the Houston Eligible Metropolitan Area (EMA).

SERVICES TO BE PROVIDED:
Pickup, delivery, and storage of donated household items including but not limited to furniture, small appliances,
kitchen utensils, bathroom accessories, and linens; purchase of basic household items that are not donated
including but not limited to mattresses, etc. Contractor will make appropriate provisions (on site or voucher) for
clothing to eligible indigent clients.
SERVICE CATEGORY:             HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:             Health Education/Risk Reduction

CODE:                         SS-13

AMOUNT AVAILABLE:             $168,025.00 - To be divided among at least two (2) providers. The maximum
                              amount available to any single vendor is $84,012.50.

BUDGET:                       Fee for Service - Costs not to exceed $420.00 per course in health education and
                              risk reduction.

DEFINITION/SERVICE:           A unit of service is defined as one (1) course lasting a minimum of two (2) hours in
                              health education and risk reduction and provided to a minimum of five (5) HIV-
                              positive infected individuals.

SERVICES PROVIDED:
Health Education/Risk Reduction
Services for all eligible HIV/AIDS infected individuals residing within the Houston Eligible Metropolitan Area
(EMA). This service is defined as the provision of information about medical and psychosocial support services and
counseling. The services also includes the preparation and distribution of materials in the context of medical and
psychosocial support services to educate clients with HIV about methods to reduce the spread of HIV. Services
include, but are not limited to, health education on understanding and communicating about HIV infection; its effects
on the body, emotions and interpersonal relations; risk reduction on the transmission of HIV and information on
complimentary/alternative therapies.

AGENCY QUALIFICATIONS: The Program must utilize a Registered Nurse licensed by the State of Texas, who
has a minimum of a Bachelors of Nursing educational level, and who has at least two years, paid experience in all
areas of HIV/AIDS care, to provide the educational services.
SERVICE CATEGORY:                    HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:                    Child Day Care

CODE:                                SS-14

AMOUNT AVAILABLE:                    $134,157.00 – Of the $134,157, the provider(s) must designate $13,416.00
                                     or 10% of their total award for the In-Home Reimbursement Program.

BUDGET:                              Fee for Service:
                                      Child Day Care - No more than $35.00 per unit of service.
                                      In-Home Reimbursement Program - No more than $25.00 per unit of
                                        service (this rate is for 1 or 2 children, additional eligible children
                                        may be reimbursed at no more than $6.25 per unit of service, with a
                                        maximum per unit reimbursement of $50.00).

DEFINITION OF SERVICE:               Child Day Care at a licensed facility - A unit of service is one (1) day of
                                     childcare (up to 12 hours) for one (1) client.

                                     In-Home Reimbursement Program - A unit of service is one-half day of
                                     care (up to 4 hours). One full day of care (more than 4 hours) would be
                                     2 units of service. One family may use half or full day increments as
                                     needed. One family is limited to a total of forty-eight (48) units per
                                     calendar year. If an eligible family needs more than 48 units during the
                                     contract year the providing agency may request an exception to this
                                     limitation from the County prior to authorizing such services.

                                     Childcare is defined as the care, supervision and guidance of a child or
                                     children unaccompanied by a parent, guardian or custodian on an as
                                     needed basis. Eligible recipients of the service are HIV-positive children
                                     ages 0-12, siblings of HIV-positive children ages 0-12, and all children of
                                     an HIV-positive parent, up to twelve (12) years of age.
                                     Nursing staff will be required to provide medical support to HIV-
                                     positive children in consultation with physicians and an interdisciplinary
                                     team.


CLIENT ELIGIBILITY:
All HIV/AIDS infected and affected individuals residing within the Houston EMA in need of episodic child day
care services.

SERVICES PROVIDED:
Services include intermittent or continuing childcare through licensed child day care centers and an in-home
reimbursement program for HIV-positive children. Services also include intermittent childcare for eligible affected
children to enable an infected adult or child to secure needed medical or support services.

Day care services provided to HIV-positive and affected children in licensed day care centers should be designed to
meet the specific needs of and provide a supportive environment for children infected and affected with HIV.
Services shall include but not be limited to day/evening (6:30 AM - 6:30 PM) childcare, supervision (HIV-positive
and affected children) and monitoring of child’s general physical condition (only for HIV-positive children), which
includes medication administration by a Registered Nurse. The Registered Nurse will be required to provide
medical support to HIV-positive children and day care staff in consultation with the child’s primary care physician
and an interdisciplinary team at the day care center. Day care staff, in consultation with the Registered Nurse and
the HIV-positive child’s parent/guardian, must develop and implement a medical and nursing care plan for each
child that includes objectives, outcomes and goals necessary for the physical and emotional growth and
development of the child. The day care must be able to accommodate other service providers/ professionals
(physical, occupational, speech therapists, etc.) who provide treatment to HIV-positive children during day care
hours.

A secondary method of childcare delivery will be the In-Home Reimbursement Program. The In-Home
Reimbursement Program must be implemented in a manner that there is no out of pocket expense to the client.
Funds allocated to this delivery system will reimburse for childcare provided by a neighbor, family member or
other person. The purpose of this program is not to replace or overlap the childcare provided through the
independent Child Day Care Centers. The purpose of the In-Home Reimbursement System is to augment the
primary delivery system.

This In-Home Reimbursement system is available for the following situations:
        In-Home care may be used if the parent/caretaker feels this is a more appropriate alternative than care
          provided in a Licensed Child Center. This option must comply with the 48 days/year limitation on in-
          home reimbursement.
        In-Home care may be used for an HIV-positive child who is too ill for day care. Written verification of
          the child’s illness by a medical professional must be maintained in the client file if this need exists for
          more than 15 consecutive days (such documentation is not necessary for illness related need of less than
          15 consecutive days).
        In-Home care may be used for primary caregivers in rural areas while they attend non-emergency
          medical appointments.
        In-home care may be used in the situation where the primary caregiver of an HIV-positive child is too ill
          to care for the child. Written verification of the caregiver’s illness by a medical professional must be
          maintained in the client file if this need exists. Provider must have policies and procedures which to the
          maximum extent possible prevent inappropriate use of this alternative.

Funds awarded for childcare may only be used in the following instances:
       Independent Child Day Care Centers
        Support to a licensed facility for daily or drop-in child care of HIV-positive children;
        Support to a licensed facility for drop-in childcare to HIV-positive or affected children which enables an
          HIV-positive adult to secure needed medical or support services.

       In-Home Reimbursement Program
        To support informal child care provided by a neighbor, family member or other person through the
          Reimbursement Program which enables an infected adult to secure needed medical or support services
          or to care for an HIV-positive child too ill for day care (with the understanding that existing Federal
          restrictions prohibit giving cash to individuals to pay for these services).
        Documentation of primary caregiver approval for in-home care must be on file with subcontractor
          (signed letter from primary caregiver).

Subcontractor must maintain documentation in client file each time an affected child is cared for under this
contract to account for HIV-positive adults access to needed medical support services. Documentation of primary
caregiver approval for in-home care must be on file with subcontractor. (signed letter from primary caregiver).
The Subcontractor is expected to demonstrate adequate geographic coverage of the service area. Childcare needs
of HIV infected and affected persons is often associated with scheduled medical appointments. Affected and
infected parents will be able to make an appointment for child care. Emphasis will be placed on capacity located in
the near vicinity of the medical facilities including but not limited to the Thomas Street Clinic, LBJ Hospital and
Ben Taub Hospital.

The funds available through Title I of the Ryan White Care Act of 1990 may be expended only after all other
funding streams available and applicable to the individual client have been exhausted. The Subcontractor must
demonstrate through its administrative procedures and controls that it will enforce compliance with this directive.

SUBCONTRACTOR QUALIFICATIONS:
The agency must be licensed by the Texas Department of Regulatory and Protective Services as a Day Care Center.
The agency must have an Occupancy Permit, Food Dealer’s Permit, and a Fire Marshall’s Permit for the facility. A
copy of the agency’s licenses and permits must be included in the appropriate section of the proposal.

Vendor must provide a written plan for providing the appropriate staff training for personnel for dealing with HIV
disease.

Specific to the In-Home Reimbursement Program, the following requirements also apply:
        Develop a waiver to be signed by the client which relieves the Subcontractor of liability for all aspects
            of In-Home child care. This waiver should also clearly state that Subcontractor is not responsible for
            the training of in-home care givers.
        Develop a consent form giving the Subcontractor authority from the Primary Caregiver to reimburse a
            child care attendant directly. Consent form must be on file with the Subcontractor. Under this contract,
            payment will be made to the Subcontractor and the contractor must reimburse the attendant.
        Subcontractor must report in writing to the County on a quarterly basis on the progress and
            shortcomings of this program.

CHILD DAY CARE CENTERS QUALIFICATIONS:
The Child Day Care Center must be fully licensed by the Texas Department of Regulatory and Protective Services
as a child day care facility and have an Occupancy Permit and a Fire Marshall’s Permit for each location at which it
operates. The Child Day Care Center must also demonstrate that its staff and management have been trained, or
are in the process of obtaining training, in providing day care for HIV infected children and cultural sensitivity.

Subcontractor must provide a written plan for providing the appropriate staff training for personnel for dealing with
HIV disease.
SERVICE CATEGORY:             HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:             Support Groups, Other

CODE:                         SS-15

AMOUNT AVAILABLE: $29,453.00 - The maximum funding available to any single vendor is
             $14,726.00.

BUDGET:                       Fee for Service - Vendor must provide at least 73 units of service without
                              exceeding the maximum amount of funding available per vendor of $14,726.00.

DEFINITION/SERVICE: A unit of service is defined as one (1) support group session lasting a minimum of
                    two (2) hours. Support groups (non-mental health) for Persons Living with HIV
                    (PLWH) who are in need of support with issues secondary to recent developments in
                    HIV-related treatment. Groups must have at least 5 and no more than 15
                    participants, not including agency staff and/or facilitators. Groups must meet at least
                    weekly throughout the term of the contract year. Groups must focus on changes
                    PLWH face since the introduction of protease inhibitor (PI) class medications and
                    multiple drug therapies. The changes in attitudes and behaviors of PLWH who may
                    have been preparing for terminal stage AIDS and are now healthier include:
                     loss of disability income eligibility;
                     returning to the workforce and the implications that may have in benefit
                        eligibility, family and personal relationships (increased stress, questions about
                        one’s absence from the workforce for an extended period of time, etc.,);
                     coping with changes in personal health brought on by PI medications

TARGET POPULATION: Persons Living with HIV residing in the Houston EMA.

AGENCY QUALIFICATIONS:
Agency must have a Registered Nurse (RN) with at least 2 years HIV-related experience on staff or available as a
contractor to provide coordination and consultation to the group participants and facilitator in regards to
medication and health issues. Groups may be facilitated by a lay person who has personal knowledge of
HIV/AIDS related issues (PLWH preferred). Agency must have at least 2 years experience in the provision of
HIV/AIDS related services in the greater Houston metropolitan area. Agency must document the HIV status of all
group participants (only those persons HIV-positive are eligible for services in this category) and maintain a copy
of this documentation in agency files. Once a participant’s eligibility is verified a group attendance sign-in sheet
will suffice as documentation of service delivery. The sign-in sheet will list the date of the group, location,
facilitator and attendees. Agency must provide support groups in community based locations which are convenient
to the attendees’ residence (community centers, churches, etc.).
SERVICE CATEGORY:                    HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:                    Volunteerism - Respite Care Team

CODE:                                SS-16

AMOUNT AVAILABLE:                    $163,953.00 - To support at least 150 volunteers providing a minimum of
                                     10,000 hours of volunteer services during the contract year to at least 100
                                     unduplicated eligible clients.

BUDGET:                              Line Item

DEFINITION/SERVICE:                  Respite Care Teams - The use of volunteers to provide social, emotional
                                     and physical care to HIV/AIDS infected individuals which includes
                                     training these volunteers to provide in-home bedside care/support services
                                     and providing supervision and support for respite care teams dealing with
                                     the stress of caring for these clients.

                                     The intent of all the volunteer programs is to provide direct ―hands on‖
                                     volunteer services and not volunteers for agency administrative assistance.

TARGET POPULATION:
HIV/AIDS infected individuals residing within the Houston Eligible Metropolitan Area (EMA).

SERVICES TO BE PROVIDED:
The proposer must demonstrate a capacity to recruit, train, coordinate and support a pool of volunteers to service a
broad geographical area.

An agency may not provide outreach or case management services under this category (See Case Management
Section).
SERVICE CATEGORY:                    HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:                    Volunteerism - Community Volunteer Programs

CODE:                                SS-17

AMOUNT AVAILABLE:                    $28,083.00 - To support at least 25 volunteers providing a minimum of
                                     1,750 hours of volunteer services during the contract year to at least 25
                                     unduplicated eligible clients.


BUDGET:                              Line Item

DEFINITION/SERVICE:                  Community Volunteer Programs - The use of volunteers to support a
                                     variety of volunteer programs to provide support services for HIV/AIDS
                                     infected individuals which may include, but are not limited to, buddy
                                     programs, spiritual and emotional support and companionship.

                                     The intent of volunteer programs is to provide direct ―hands on‖
                                     volunteer services and not volunteers for agency administrative assistance.

TARGET POPULATION:
HIV/AIDS infected individuals residing within the Houston Eligible Metropolitan Area (EMA).

SERVICES TO BE PROVIDED:
The proposer must demonstrate a capacity to recruit, train, coordinate and support a pool of volunteers to service a
broad geographical area.

An agency may not provide outreach or case management services under this category (See Case Management
Section).
SERVICE CATEGORY:                    HOME/COMMUNITY-BASED SUPPORT SERVICES

TITLE OF SERVICE:                    Volunteerism – Other

CODE:                                SS-18

AMOUNT AVAILABLE:                    $30,847.00 - To support at least 35 volunteers providing a minimum of
                                     2,000 hours of volunteer services during the contract year to at least 30
                                     unduplicated eligible clients.

BUDGET:                              Line Item

DEFINITION/SERVICE:                  Programs that provide innovative volunteer programs to benefit
                                     HIV/AIDS infected individuals

                                     The intent of all the volunteer programs is to provide direct ―hands on‖
                                     volunteer services and not volunteers for agency administrative assistance.

TARGET POPULATION:
HIV/AIDS infected individuals residing within the Houston Eligible Metropolitan Area (EMA).

SERVICES TO BE PROVIDED:
The proposer must demonstrate a capacity to recruit, train, coordinate and support a pool of volunteers to service a
broad geographical area. This services funded in this service category may not be used to provide respite care or
“buddy” programs.

An agency may not provide outreach or case management services under this category (See Case Management
Section).
                                         FORMS & TABLES SECTION


The forms contained in this section must be inserted in the appropriate section of your proposal response.

There are three options from which you may choose to present your Table information. They are:

   You may type on these forms.

   You may create your own forms in the same format as those contained in this packet.

   You may pick up a diskette in Word for Windows 6.0 at the office of HIV Services, 2223 W. Loop S., Suite 417.
                                                              Assurances Form I



By signing and submitting this proposal, the applicant organization certifies compliance with the following assurances in the event that Ryan
White funds are awarded:

·        Assurance that applicant agency will provide services without regard to ability to pay or the current or past health condition of an
         individual and in settings accessible to low-income persons; and funds awarded not be used to make payments for any item or service
         to the extent that payment has been made, or can reasonably be expected to be made, by another third party benefits program or by an
         entity that provides services on a prepaid basis.

·        Assurance that applicant agency will provide outreach to low-income persons to inform them of the availability of services.

·        Assurance that applicant agency will not discriminate against persons eligible for services on the grounds of race, creed, color,
         handicap, national origin, sex, political affiliation or beliefs, or sexual orientation.

·        Assurance that applicant agency will provide information to clients, either verbally or in print, on use of condoms and risk
         avoidance/reduction behaviors for sharing of intravenous needles, or make referrals to other agencies that will do so.

·        Assurance that drug-free workplace guidelines are or will be in place in agency at time of funding award in accordance with Federal
         Regulation 45 CFR part 76.

·        Assurance that applicant agency will maintain the confidentiality of client records.

·        Assurance that applicant agency will comply with Federal Regulation 45 CFR part 76 regarding debarment and suspension.

·        Assurance that agency understands specified restrictions on the use of grant award funds.




                                                                         ______________________________________
         Date                                                                               Applicant Organization



                            ___________________________________________________
                                     Signature and Title of Authorized Official
                                          Certification Concerning Lobbying

                               DEPARTMENT OF HEALTH AND HUMAN SERVICES
                                      U.S. PUBLIC HEALTH SERVICE


The Undersigned certifies, to the best of his or her knowledge and belief, that:

         (1)       No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person or
                   influencing organization attempting to influence an officer or employee of any agency, a member of Congress, or an
                   employee of a member of Congress in connection with the awarding of any Federal contract, the making of any Federal
                   grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation,
                   renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

         (2)       If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting
                   to influence an officer or employee of any agency, a member of Congress, or an employee of a member of Congress in
                   connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
                   Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.

         (3)       The undersigned shall require that the language of this certification be included in the award documents for all subawards at
                   all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all
                   subrecipients shall certify and disclose accordingly.

This certification is a material representation of the fact upon which reliance was placed with this transaction was made or enter into.
Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code.
Any persons who fail to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000
for each such failure.



                                                                           _____________________________________
Date                                                                                                       Entity



                                                                ______________________________________________
Address of Organization                                              Name and Title of Official Signing for Organization



                                                                      _________________________________________
Telephone of Organization                                                                      Signature of Official
                              Compliance with American With Disabilities Act of 1990




_______________________________________
Name of Applicant Agency


guarantees and assures, with respect to the operation of the program and activities outlined in this proposal and all agreements or arrangements
to carry out such program or activities for which financial assistance may be awarded in any subsequent subcontract, that will comply fully
with the Americans with Disabilities Act of 1990 (ADA) and any and all Regulations promulgated thereunder. The applicant agency
understands that failure to comply with this requirement shall be sufficient cause to terminate any contract existing between the applicant
agency and the Harris County HIV Services Division.




_______________________________________________________
Signature of Person Authorized to Represent Applicant Agency




___________________________________________________
Printed Name and Title




____________________________________________________
Date Signed
                             ASSURANCE — NON-CONSTRUCTION PROGRAMS


Note:            Certain of these assurance may not be applicable to your project or program. If you have questions,
                 please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to
                 certify to additional assurances. If such is the case, you will be notified.


        As the duly authorized representative of the applicant I certify that the applicant:

         1.        Has the legal authority to apply for Federal                        prohibits discrimination on the basis of age;
                   assistance, and the institutional, managerial                       (e) the Drug Abuse Office and Treatment Act
                   and financial capability (including funds                           of 1972 (P.L. 92-255, as amended, relating to
                   sufficient to pay the non-Federal share of                          nondiscrimination on the basis of drug abuse;
                   project costs) to ensure proper planning,                           (f) the Comprehensive Alcohol Abuse and
                   management and completion of the project                            Alcoholism Prevention, Treatment and
                   described in this application.                                      Rehabilitation Act of 1970 (P.L. 91-616, as
                                                                                       amended, relating to nondiscrimination on the
         2.        Will give the awarding agency, the                                  basis of alcohol abuse or alcoholism; (g) 523
                   Comptroller General of the United States, and                       and 527 of the Public Health Service Act of
                   if appropriate, the State, through any                              1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as
                   authorized representative, access to and the                        amended, relating to confidentiality of alcohol
                   right to examine all records, books, papers, or                     and drug abuse patient records; (h) Title VII
                   documents related to the award; and will                            of the Civil Rights Act of 1968 (42 U.S.C.
                   establish a proper accounting system in                             3501 et seq.) as amended, relating to
                   accordance     with      generally    accepted                      nondiscrimination in the sale, rental or
                   accounting standards or agency directives.                          financing of housing; (i) any other
                                                                                       nondiscrimination provisions in the specific
         3.        Will establish safeguards to prohibit                               statute(s) under which application for Federal
                   employees from using their positions for a                          assistance is being made; and (j) the
                   purpose that constitutes or presents the                            requirements of any other nondiscrimination
                   appearance of personal or organizational                            statute(s) which may apply to the application.
                   conflict of interest, or personal gain.
                                                                             7.        Will comply, or has already complied, with
         4.        Will initiate and complete the work within the                      the requirements of Titles II and III of the
                   application time frame after receipt of                             Uniform Relocation Assistance and Real
                   approval of the awarding agency.                                    Property Acquisition Policies Act of 1970
                                                                                       (P.L. 91-646) which provide for fair and
         5.        Will comply with the Intergovernmental                              equitable treatment of persons displaced or
                   Personnel Act of 1970 (42 U.S.C. 4728-4763)                         whose property is acquired as a result of
                   relating to prescribed standard for merit                           Federal or federally assisted programs. These
                   systems for programs funding under one of                           requirements apply to all interests in real
                   the nineteen statutes of regulations specified                      property acquired for project purposes
                   in Appendix A of OPM's Standards of a Merit                         regardless of Federal participation in
                   System of Personnel Administration (5 C.F.R.                        purchases.
                   900, Subpart F).
                                                                             8.        Will comply with the provisions of the Hatch
         6         Will comply with all Federal statutes relating                      Act (5 U.S.C. 1501-1508 and 7324-7328)
                   to nondiscrimination. These include but are                         which limit the political activities of
                   not limited to: (a) Title VI of the Civil Rights                    employees whose principal employment
                   Act of 1964 (P.L. 88-352) which prohibits                           activities are funded in whole or in part with
                   discrimination on the basis of race, color, or                      Federal funds.
                   national origin; (b) Title IX of the Educational
                   Amendments of 1972, as amended (20 U.S.C.                 9.        Will comply, as application, with the
                   1681-1683, and 1685-1686), which prohibits                          provisions of the Davis-Bacon Act (40 U.S.C.
                   discrimination on the basis of sex; (c) Section                     276a to 276a-7), the Copeland Act (40 U.S.C.
                   504 of the Rehabilitation Act of 1973, as                           276c and 18 U.S.C 874, and the Contract
                   amended (29 U.S.C. 794), which prohibits                            Work House and Safety Standards Act (40
                   discrimination on the basis of handicaps; (d)                       U.S.C. 327-333), regarding labor standards
                   the Age Discrimination Act of 1975, as                              for     federally    assisted   construction
                   amended (42 U.S.C. 6101-6107), which                                subagreements.
                                                               amended, (P.L. 93-523); and (h) protection of
10.   Will comply, if applicable, with flood                   endangered species under the Endangered
      insurance purchase requirements of Section               Species Act of 1973, as amended, (P.L. 93-
      102(a) of the Flood Disaster Protection Act of           205).
      1973 (P.L. 93-2343) which requires recipients
      in a special flood hazard area to participate in   12.   Will comply with the Wild and Scenic Rivers
      the program and to purchase flood insurance              Act of 1968 (16 U.S.C. 1271 et seq.) related
      if the total cost of insurable construction and          to protecting components or potential
      acquisition is $10,000 or more.                          components of the national wild and scenic
                                                               rivers system.
11.   Will comply with environmental standards
      which may be prescribed pursuant to the            13.   Will assist the awarding agency in assuring
      following (a) institution of environmental               compliance with Section 106 of the National
      quality control measures under the National              Historic Preservation Act of 1966, as
      Environmental Policy Act of 1969 (P.L. 91-               amended (16 U.S.C. 470), EO 11593
      190) and Executive Order (EO 11514; (b)                  (identification and protection of historic
      notification of violating facilities pursuant to         properties), and the Archaeological and
      EO 11738; (c) protection of wetlands                     Historical Preservation Act of 1974 (16
      pursuant to EO 11990; (d) evaluation of flood            U.S.C. 469a-1 et seq.).
      hazards in flood plains in accordance with EO
      11988; (e) assurance of project consistency        14.   Will comply with P.L. 93-348 regarding the
      with the approved State management program               protection of human subjects involved in
      developed under the Coastal Zone                         research, development, and related activities
      Management Act of 1972 (16 U.S.C. 1451 et                supported by this award assistance.
      seq.); (f) conformity of Federal actions to
      State (Clear Air) Implementation Plans under       15.   Will comply with the Laboratory Animal
      Section 176(c) of the Clear Air Act of 1955,             Welfare Act of 1966 (P.L. 89-544, as
      as amended (42 U.S.C. 7401 et seq.); (g)                 amended, 7 U.S.C. 2131 et seq.) pertaining to
      protection of underground sources of drinking            the care, handling, and treatment of warm-
      water under the Safe Drinking Water Act of               blooded animals held for research, teaching,
      1974, as                                                 or other activities supported by this award of
                                                               assistance.

                                                         16.   Will comply with the Lead-Based Paint
                                                               Poisoning Prevention Act (42 U.S.C. 4801 et
                                                               seq.) which prohibits the use of lead-based
                                                               pain in the construction or rehabilitation of
                                                               residence structures.

                                                         17.   Will cause to be performed the required
                                                               financial and compliance audits in accordance
                                                               with the Single Audit Act of 1984.

                                                         18.   Will comply with all applicable requirements
                                                               of all other Federal laws, executive orders,
                                                               regulations and policies governing this
                                                               program.
Signature of Authorized Certifying Official   Title


Applicant Organization                        Date Submitted
RESPONDENT CERTIFICATION



________________________________________
Name of Applicant Agency




I,                                       , certify that I am the



__________________________________________
Title Printed


of the corporation, committee, commission, association, partnership, or public agency named as the Applicant
Agency herein, that this proposal was duly submitted and signed for on behalf of said corporation, committee,
commission, association, or public agency by authority of its governing body and is within the scope of its legal
powers.

__________________________________________
Signature of Person Making Certification


_________________________________
Date Signed
                                      COVER PAGE

                                1999 Ryan White Title I Funds


Applicant organization: _________________________________________________________________


Service Category of proposal as designated in RFP: __________________________________________


Code Number: ________________________________________________________________________


Total amount requested: ________________________________________________________________


Contact Person for proposal clarifications: _________________________________________________


Title: _______________________________________________________________________________


Contact person telephone number: ________________________________________________________

Fax number: _________________________________________________________________________

Identify your agency as one of the following: For - Profit ______________, Non-Profit ______________ or Public
(governmental) _______________.

Has your agency complied with all HRSA requirements and regulations for all previously funded programs.
yes_________ no___________ If no, explain.
                                        BUDGET NARRATIVE
                                            (Table I.A.)

You must complete this form whether you are submitting a line item budget or a fee for service budget.
Complete only (1) per proposal, regardless of number of fee-for-service budgets unless a subcontractor will
be utilized to provide direct client services at which time, a Budget Narrative for each subcontractor must
also be submitted.

Name of Agency:             ____________________________________

       Name of Sub-Contracting Agency: ________________________
       (If applicable)

Service Category:

Title of Service:

1.     PERSONNEL                                                                     $

                                                 $
       (             /mo. x 12 months x %)




                                                 $
       (             /mo. x 12 months x %)




                                                 $
       (             /mo. x 12 months x %)




                                                 $
       (             /mo. x 12 months x %)
1.     PERSONNEL (continued)
                                              $
       (              /mo. x 12 months x %)




                                              $
       (              /mo. x 12 months x %)




                                              $
       (              /mo. x 12 months x %)




                                              $
       (              /mo. x 12 months x %)




                                              $
       (              /mo. x 12 months x %)




                                              $
       (              /mo. x 12 months x %)




                                              $
       (              /mo. x 12 months x %)




Note: Use additional pages as needed.
2.   FRINGE                                               $
     (Total Personnel costs x TOTAL %)
             FICA                               %
             State Unemployment                 %
             Workers Comp.                      %
             Health Insurance                   %
             Life Insurance                     %
                                                %
                                                %
                                                %
            TOTAL                               %

            Note: All fringe benefits must be included.

3.   TRAVEL                                               $
     Local Travel                               $
                    miles x $    /mile

     Out of Town Travel                         $
     (within the Houston EMA only)
                                          :
     Transportation $
     Lodging               $
     Per Diem/Meals        $
     TOTAL          $

                                          :
     Transportation $
     Lodging               $
     Per Diem/Meals        $
     TOTAL          $

4.   EQUIPMENT                                            $
     Description:                               $
                                                $
                                                $

5.   SUPPLIES                                             $
     General Consumable Office Supplies         $
     Other:                                     $
                                                $
                                                $
                                                $
6.   CONTRACTUAL                             $

                                         $
     ($     /hr. x         hours)

                                         $
     ($     /hr. x         hours)

7.   OTHER                                   $
                                         $
                                         $
                                         $
                                         $
                                         $
                                         $
                                         $
                                         $
                                         $
                                         $
                                         $
                                         $
                                         $
                                         $
                                         $
                                         $
     TOTAL                               $

     Note: Include all other expenses.

TOTAL DIRECT COSTS                           $

TOTAL INDIRECT COSTS (NOT ALLOWED)           $   ---

TOTAL COSTS                                  $
                                   FEE FOR SERVICE BUDGET FORM
                                             (Table I.B.)


You must complete this form if you are submitting a fee for service budget. One form must be completed for
each fee charged.


Service Category:

Title of Service:


1.     Fee Charged per Unit of Service:                                      $


2.     Number of Units of Service to be Provided:


3.     Total Cost of these Services (#1 x #2):                               $

4.     Breakdown of Fee per Unit of Service:


                                                    $
                                                    $
                                                    $
                                                    $
                                                    $
                                                    $
                                                    $
                                                    $
                                                    $
        TOTAL                                       $


5.      Definition of Unit of Service:

        1 unit of service =
                                                         SUBCONTRACTOR LIST BUDGET FORM
                                                                    (Table I.C.)




              You must complete this form if you are using any subcontractors to provide direct services under this proposal


Service Category:

Title of Service:


Name of Subcontractor(s):      1. _____________________________________

                            2. _____________________________________

                            3. _____________________________________

Amount of Funds from this contract assigned to each subcontractor:

1. $_________________ 2. $_________________ 3. $__________________

Ownership status of each subcontractor:

1. non-profit (or public) ___ yes    ___ no

2. non-profit (or public) ___ yes    ___ no

3. non-profit (or public) ___ yes    ___ no

Any Bidders who propose subcontracting any portion of the direct services to be provided must include a copy of their proposed subcontractor’s Articles of Incorporation,
if any, and, where applicable, proof of the subcontractor’s non-profit status. For each subcontractor, a Budget Narrative (Budget Form I.A.) must be included. If the
documentation is not included in the proposal, County will assume the proposed subcontractor is a for-profit entity.
The bidder’s legal name must appear on all required licenses or certifications (i.e., the name of bidder as stated on the proposal must be the same as the name stated on any required
licenses and/or certifications). Any bidder who proposes subcontracting any portion of the services to be provided must include a copy of the executed contract between the bidder
and their (proposed) subcontractor in the Appendices. In the case where the bidder is subcontracting any portion of services where a license and/or certification is required, the legal
name of the subcontractor and the name on the subcontractor’s license/certification must be identical.

                                                                       use additional sheets if necessary
TABLE II.A. - ORGANIZATION INFORMATION TABLE

Complete Table II.A. for each of applicant agency's locations (include all sites which will be used in the provision of services described in this
proposal). Include non-agency sites if those sites will be used to provide services described in this proposal. Answer each required data element
in the column to the right of the shaded area. Every data element must be answered. If the applicant agency does not have a TTY phone line, or
Bilingual staff, etc., the appropriate answer is "none available". Do not leave any cells blank. Use additional copies as necessary.

 Legal Name of Entity                                                      Days/hours of operation.

 Street Address of Entity's                                                Is location within walking distance of
 Administrative Office.                                                    Metro bus stop? (yes or no) If yes,
                                                                           what is walking distance (in miles).
                                                                           (not applicable for locations outside of
                                                                           Harris County)
 Mailing Address (if different).                                           Is facility wheelchair accessible? (yes
                                                                           or no).


 Phone number of this location                                             Bilingual (English/Spanish) speaking
 Fax number of this location                                               staff on duty during all business
 TTY number of this location.                                              hours? (yes or no) (if yes, how many
                                                                           staff).

 PRIMARY CLIENT SERVICES                                                   Days/hours of operation.
 LOCATION
 Street address of Entity's primary                                        Is location within walking distance of
 client services location (primary                                         Metro bus stop? (yes or no) If yes,
 location is defined as that location                                      what is walking distance (in miles).
 which serves the greatest number of                                       (not applicable for locations outside of
 PLWH).                                                                    Harris County)
 Number of years at this location.                                         Is facility wheelchair accessible? (yes
                                                                           or no).
 Phone number of this location                                             Bilingual (English/Spanish) speaking
 Fax number of this location                                               staff on duty during all business
 TTY number of this location.                                              hours? (yes or no) (if yes, how many
                                                                           staff).
 PRIMARY CLIENT SERVICES                                                   Days/hours of operation.
 LOCATION
Street address of Entity's primary     Is location within walking distance of
client services location (primary      Metro bus stop? (yes or no) If yes,
location is defined as that location   what is walking distance (in miles).
which serves the greatest number of    (not applicable for locations outside of
PLWH).                                 Harris County)
Number of years at this location.      Is facility wheelchair accessible? (yes
                                       or no).
Phone number of this location          Bilingual (English/Spanish) speaking
Fax number of this location            staff on duty during all business
TTY number of this location.           hours? (yes or no) (if yes, how many
                                       staff).




PRIMARY CLIENT SERVICES                Days/hours of operation.
LOCATION
Street address of Entity's primary     Is location within walking distance of
client services location (primary      Metro bus stop? (yes or no) If yes,
location is defined as that location   what is walking distance (in miles).
which serves the greatest number of    (not applicable for locations outside of
PLWH).                                 Harris County)
Number of years at this location.      Is facility wheelchair accessible? (yes
                                       or no).
Phone number of this location          Bilingual (English/Spanish) speaking
Fax number of this location            staff on duty during all business
TTY number of this location.           hours? (yes or no) (if yes, how many
                                       staff).
TABLE II.B. - CURRENT HIV/AIDS CONTRACTS

Complete the Current HIV/AIDS Contracts Table below. Use additional copies as necessary. Include all HIV/AIDS related
prevention and services contracts (including RW Title I contracts with Harris County) for which the applicant has signed and fully
executed contracts or formal written notifications of award. A letter noting the applicant's performance and compliance with contract
conditions from each administrative agency (other than HIV Services) listed on Table II.B. must be included in the appendices (these
letters will be removed from the proposal by the County prior to external review). Any situation wherein applicant is reported by these
administrative agencies to have problematic performance issues must be resolved to the County's satisfaction prior to an award being
made subsequent to this RFP.

      Funding Source          Administrative Agency        Contract Term        Amount of Funding          Services to be Provided
(e.g., RW Title I, RW II,           for these funds
RW III, RW IV, TDH           (e.g., HIV Services, The
State Services, HOPWA,       Resource Group, City of
etc.)                        Houston, etc.)
TABLE III.A. - GOALS and OBJECTIVES

Complete Table III.A. Clearly state measurable goals, objectives, activities, title of staff person(s) responsible for implementation and
specific measurement criteria for the services applicant agency is proposing to provide with the funds requested. (Use additional copies of
this table if additional space is needed to list objectives, activities, etc.).

 Service Category:                                                           New Service or Continuation Funding? (check one)

 Category           Amount ($$) Requested:                                   New Service ________                 Continuation* ________
 Code:
                                                                             *Continuation = currently funded for this service by RW Title I

 GOAL ___:                           OBJECTIVES:                             ACTIVITIES:                                      RESPONSIBLE
                                                                                                                              PERSON(S):




                                                                                                                              MEASUREMENT
                                                                                                                              CRITERIA:




 GOAL ___:                           OBJECTIVES:                             ACTIVITIES:                                      RESPONSIBLE
                                                                                                                              PERSON(S):




                                                                                                                              MEASUREMENT
                                                                                                                              CRITERIA:
TABLE III.B. - PROPOSED CLIENTS TO BE SERVED DURING CONTRACT TERM

Complete Table III.B. Delineate the specific number of clients you propose to serve under this service category with the amount of
funding you are requesting. Indicate the number (not percentages) of clients you propose to serve under each demographic category.
Note that agencies who are awarded funds will be held accountable for the numbers they project on this table.


                                   MALES                                                   FEMALES
             White/     African    Hispanic/   Asian,     Native     White/     African    Hispanic/   Asian,     Native
             Anglo      American   Latino      Pacific-   American   Anglo      American   Latino      Pacific-   American   Totals
                                               Islander                                                Islander
 Age
 0-12

 Age
 13-19

 Age
 20-44

 Age 45+


 Totals



Total number of unduplicated clients proposed to be served if agency is awarded all funds requested in this proposal: ___________
TABLE III.C. - COLLABORATIVE AGREEMENTS WITH OTHER SERVICE PROVIDERS

Complete Table III.C. Specifically identify all collaborative agreements with other entities which are a component of the service
delivery proposed by applicant agency. Proposer must include signed and dated copies of all referenced collaborative agreements in
the appendices. These collaborative agreements must be in place at the time of proposal submission as documented by appropriate
signature. In order to be valid in respect to this RFP the collaborative agreement must be current, as documented by a signed
agreement dated no earlier than September 1, 1998. Any collaborative agreement not dated September 1, 1998, or later, will be
considered unacceptable for purposes of this RFP process. Use additional copies of this table as necessary.

Collaboration is defined as: Two or more separate entities who have a formal written agreement to work together in a
cooperative effort toward specified and agreed upon objectives.

Name and Street Address of     What specific services will this   What specific services will be    What will be the net benefit to
Collaborative Agency:          collaborative agency provide in    provided by applicant agency in   PLWH from this collaborative
                               support of applicant agency's      this collaborative effort?        effort? Be specific - how does
                               proposed services?                                                   this collaboration make a
                                                                                                    positive difference - what is the
                                       (answer below)                     (answer below)            gain? (answer below)



Phone and Fax Number of
Collaborative Agency:


Contact Person at
Collaborative Agency:

Date Collaboration
Formalized in Writing:
HARRIS COUNTY HIV - SAMPLE CONTRACT
  SAMPLE BUDGET TABLES
(For Line Item Budget Categories)
     SAMPLE BUDGET TABLES
(For Fee-For-Service Budget Categories)
               Attachment A

Health Resources and Services Administration

            March 6, 1997 letter
FY 1998 Ryan White Title I Transportation
          Standards of Care

								
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