HRSA site visit documents- December 3-5, 2012
Item
#
1
Final RFP’s
Item Description
This information is posted on the DSHS HIV web site:
https://www.dshs.state.tx.us/hivstd/funding/default.shtm
Evidence
RW Administrative and Services RFP
Word
PDF
Excel
Title
Renewal Memo
(PDF : 186 kb)
Renewal Guidance
(Word : 217 kb)
Budget Summary
(Excel : 368 kb)
Table 1
(Excel : 41 kb)
2012-2013 Ryan White Services and Administrative Application Package
1
2
Contracts between DSHS and Administrative Agency.
Attached are contracts with two Administrative Agencies:
Tarrant County and Brazos Valley Council of Governments.
Attached is a sample contract between an Administrative Agency and a
service provider.
3
Contract between Administrative Agency and
providers.
4
Planning – Part B.
Planning responsibilities are outlined in contract between DSHS and
the Administrative Agencies on pages 3 and 4, Planning Services
section (see contract for item #2) as well as Apendix A located on the
DSHS HIV funding information page bullet #4, see link below.
https://www.dshs.state.tx.us/hivstd/funding/default.shtm
5
Site visit assessment tools.
Attached you will find two sets of site visit tools. One set represents
the site visit tools used by DSHS HIV program to assess the
Administrative Agencies and the other set is for Administrative
Agencies assessing service providers.
1) DSHS fiscal tool- On-site procedures report
2) DSHS program tool- Desk-Top review of administrative
Sample site visit reports.
7
Sample intake forms.
8
9
10
11
Memorandums of understanding for point of entry.
Organizational chart (including vacant positions)
Examples of invoices.
Grantee fiscal system set up.
2
6
policies and procedures
3) DSHS program tool- On-site clinical review
4) DSHS program tool- On-site program review tool
5) AA to provider program review tools
Sample site visit reports for fiscal, program, and clinical.
Sample intake forms for primary care and case management to be
provided later.
Direct provider MOU’s. Will be provided at a later date.
To be provided.
Get samples of current invoices from CMU.
DSHS Contract Oversight and Support home web link to the
Contractors Financial Procedures Manual:
http://www.dshs.state.tx.us/contracts/cfpm.shtm
DSHS Client Services Contracting Unit web link to the General
Provisions: http://www.dshs.state.tx.us/grants/default.shtm