Common use of Additional Grant Information Clause in Contracts

Additional Grant Information. Grantee Data Universal Numbering System (DUNS) Number: 807391511 Federal Award Identification Number (▇▇▇▇): NU50CK000501 Catalog of Federal Domestic Assistance (CFDA) Name and Number (list all that apply): Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) – 93.323 Federal Award Date: April 23, 2020 Name of Federal Awarding Agency: Centers for Disease Control and Prevention Awarding Official Contact Information: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇-▇▇▇▇, Grants Management Officer ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ – Mailstop TV2 Atlanta, GA ▇▇▇▇▇-▇▇▇▇ Phone: ▇▇▇-▇▇▇-▇▇▇▇ Signature Signature Printed Name:▇▇▇▇▇▇▇▇ ▇▇▇▇ Title: _Deputy Commissioner Date of Execution: August 16, 2020 Printed Name: ▇▇▇▇ ▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇ Title: _Grants Administrator Date of Execution: August 13, 2020 I. GRANTEE RESPONSIBILITIES Grantee will: A. Establish or enhance ability to aggressively identify cases of COVID-19, conduct contact tracing and follow-up activities, as well as implement recommended containment measures. 1. Enhanced contact tracing including contact elicitation/identification, contact notification, and contact follow-up. Activities could include traditional contact tracing methods as well as healthcare-specific methods. Other proximity/location-based methods using individuals’ cellphone tower data are not allowed to be used for the purposes of contact tracing. Information on contacts must be entered into the Texas Health Trace system in accordance with DSHS’s published guidance. B. Improve morbidity and mortality surveillance, including: 1. Establish or enhance community-based surveillance - Surveillance of populations and individuals includes but not limited to: those without severe illness, those with travel to high-risk locations, or those who are contacts to known cases. 2. Monitor and report daily COVID-19 probable and confirmed COVID cases (including deaths) to DSHS. 3. Track and send Emergency Department and outpatient visits for coronavirus (COVID)-like illness, as well as other illnesses, to Centers for Disease Control and Prevention (CDC). 4. Send copies of all admission, discharge, and transfer (ADT) messages to CDC National Syndromic Surveillance Program (NSSP). 5. Monitor and utilize available data in the CDC’s National Healthcare Safety Network (NHSN) for confirmed 2019 novel coronavirus (COVID-19) infection or for COVID-like illness. a. Long-term care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/ltc/covid19/index.html b. Acute care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/acute-care- hospital/covid19/index.html 6. Work with long-term care facilities to enroll the facility in the NHSN Long- term Care Facility (LTCF) COVID-19 Module. 7. Provide requested information on COVID-19 associated deaths to DSHS within three business days. C. Enhance laboratory testing and reporting capacity: 1. Establish or expand capacity to test all symptomatic individuals, and secondarily expand capacity to achieve community-based surveillance. This capacity would entail increasing testing capabilities above the current number of specimens that can be tested at the jurisdiction’s public health laboratory or by establishing new testing capabilities at the jurisdiction’s laboratory. 2. Screen for past infection (e.g., serology) for health care workers, employees of high-risk facilities, critical infrastructure workforce, and childcare providers. 3. Obtain all jurisdictional laboratory test data electronically, including from new, non-traditional testing settings, and using alternative file formats (e.g., .csv or .xls) to help automate. In addition to other reportable results, this should include all COVID-19 – related testing data, including all tests to detect severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2) and serology testing. 4. Report all COVID-19 – related line level testing data (negatives, positives, indeterminants, serology) daily to DSHS. Data must meet new federal Coronavirus AID, Relief, and Economic Security (CARES) Act laboratory guidance. All public health data must be reported electronically to DSHS in compliance with the Texas Administrative Code and within appropriate reporting timeframes. D. Prevent and control COVID-19 in healthcare settings and protect other vulnerable or high-risk populations: 1. Assess and monitor COVID-19 infections in healthcare workers across the healthcare spectrum. 2. Perform infection control assessments using preparedness tools approved by DSHS to ensure interventions are in place to protect high-risk populations. 3. Monitor and help implement mitigation strategies for COVID-19 in all high- risk healthcare facilities (e.g., hospitals, dialysis clinics, cancer clinics, nursing homes, and other long-term care facilities, etc.). 4. Monitor and help implement mitigation strategies for other high-risk employment settings (e.g., meat processing facilities), and congregate living settings (e.g., prisons, youth homes, shelters). a. This includes coordinating with the Texas Department of Criminal Justice when individuals are released from serving their prison term and will be returning to the jurisdiction. These individuals may have been exposed to COVID-19 while in prison and/or may be COVID-positive and require additional public health follow-up. E. Monitor and mitigate COVID-19 introductions from connected jurisdictions (i.e., neighboring cities, states; including air travel). F. Work with healthcare system to manage and monitor system capacity. 1. Assess and monitor the number and availability of critical care staff, necessary PPE and potentially life-saving medical equipment, as well as access to testing services. 2. Leverage NHSN data to monitor healthcare worker staffing, Patient Impact, Hospital Capacity, and healthcare (PPE, PAPRs, ventilators, etc.) supplies. Grantee will request access to the NHSN database within 30 days of the execution of this Contract or 30 days of hire for the position completing the data entry. Upon access approval, Grantee will review available NHSN data (at least monthly) to assess gaps in the healthcare system. G. Improve understanding of jurisdictional communities with respect to COVID-19 risk. Grantee must build an understanding of population density and high-risk population density (i.e., population of >65 yrs., proportion of population with underlying conditions, households with limited English fluency, healthcare seeking behavior, populations without insurance and those below poverty level). H. Submit a monthly report on the report template to be provided by the DSHS. Monthly reports are due on or before the 15th of each month. Each report must contain a summary of activities that occurred during the preceding month for each activity listed above in Section I, A through G. Submit monthly reports by electronic mail to ▇▇▇▇▇.▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇. The email “Subject Line” and the name of the attached file for all reports should be clearly identified with the Grantee’s Name, Contract Number, IDCU/COVID and the month the report covers. I. May use funds to pay pre-award costs which date back to January 20, 2020, that are directly related to the COVID-19 outbreak response. All pre-award costs must be approved in writing by DSHS. J. Not use funds for research, clinical care, fund raising activities, construction or major renovations, to supplant existing state or federal funds for activities, or funding an award to another party or provider who is ineligible. Other than normal and recognized executive-legislative relationships, no funds may be used for: 1. Publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body; 2. The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative act or Executive order proposed or pending before any legislative body.

Additional Grant Information. Grantee Data Universal Numbering System (DUNS) Number: 807391511 Federal Award Identification Number (▇▇▇▇): NU50CK000501 Catalog of Federal Domestic Assistance (CFDA) Name and Number (list all that apply): Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) – 93.323 Federal Award Date: April 23, 2020 Name of Federal Awarding Agency: Centers for Disease Control and Prevention Awarding Official Contact Information: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇-▇▇▇▇, Grants Management Officer ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ – Mailstop TV2 Atlanta, GA ▇▇▇▇▇-▇▇▇▇ Phone: ▇▇▇-▇▇▇-▇▇▇▇ Signature Signature Printed Name:▇▇▇▇▇▇▇▇ ▇▇▇▇ Title: _Deputy Commissioner Date of Execution: August 16, 2020 g g Printed Name: ▇▇▇▇ ▇▇▇▇▇▇▇▇▇ Title: _Assistant Deputy Commissioner Date of Execution: July _30, 2020 Printed Name: ▇-▇▇▇▇▇▇ ▇▇▇▇▇▇ Title: _Grants Administrator Hidalgo County Judge Date of Execution: August 13July _30, 2020 I. GRANTEE RESPONSIBILITIES Grantee will: A. Establish or enhance ability to aggressively identify cases of COVID-19, conduct contact tracing and follow-follow up activities, as well as implement recommended containment measures. 1. Enhanced contact tracing including contact elicitation/identification, contact notification, and contact follow-up. Activities could include traditional contact tracing methods as well as healthcare-specific methods. Other proximity/location-based methods using individuals’ cellphone tower data are not allowed to be used for the purposes of contact tracing. Information on contacts must be entered into the Texas Health Trace system in accordance with DSHS’s published guidance. B. Improve morbidity and mortality surveillance, including: 1. Establish or enhance community-based surveillance - Surveillance of populations and individuals includes but not limited to: ; those without severe illness, those with travel to high-risk locations, or those who are contacts to known cases. 2. Monitor and report daily COVID-19 probable and confirmed COVID cases (including deaths) to DSHS. 3. Track and send Emergency Department and outpatient visits for coronavirus (COVID)-like illness, as well as other illnesses, to Centers for Disease Control and Prevention (CDC). 4. Send copies of all admission, discharge, and transfer (ADT) messages to CDC National Syndromic Surveillance Program (NSSP). 5. Monitor and utilize available data in the CDC’s National Healthcare Safety Network (NHSN) for confirmed 2019 novel coronavirus (COVID-19) infection or for COVID-like illness. a. Long-term care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/ltc/covid19/index.html b. Acute care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/acute-care- hospital/covid19/index.html 6. Work with long-term care facilities to enroll the facility in the NHSN Long- term Care Facility (LTCF) COVID-19 Module. 7. Provide requested information on COVID-19 associated deaths to DSHS within three business days. C. Enhance laboratory testing and reporting capacity: 1. Establish or expand capacity to test all symptomatic individuals, and secondarily expand capacity to achieve community-based surveillance. This capacity would entail increasing testing capabilities above the current number of specimens that can be tested at the jurisdiction’s public health laboratory or by establishing new testing capabilities at the jurisdiction’s laboratory. 2. Screen for past infection (e.g., serology) for health care workers, employees of high-risk facilities, critical infrastructure workforce, and childcare providers. 3. Obtain all jurisdictional laboratory test data electronically, including from new, non-traditional testing settings, and using alternative file formats (e.g., .csv or .xls) to help automate. In addition to other reportable results, this should include all COVID-19 – related testing data, including all tests to detect severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2) and serology testing. 4. Report all COVID-19 – related line level testing data (negatives, positives, indeterminants, serology) daily to DSHS. Data must meet new federal Coronavirus AID, Relief, and Economic Security (CARES) Act laboratory guidance. All public health data must be reported electronically to DSHS in compliance with the Texas Administrative Code and within appropriate reporting timeframes. D. Prevent and control COVID-19 in healthcare settings and protect other vulnerable or high-risk populations: 1. Assess and monitor COVID-19 infections in healthcare workers across the healthcare spectrum. 2. Perform infection control assessments using preparedness tools approved by DSHS to ensure interventions are in place to protect high-risk populations. 3. Monitor and help implement mitigation strategies for COVID-19 in all high- risk healthcare facilities (e.g., hospitals, dialysis clinics, cancer clinics, nursing homes, and other long-term care facilities, etc.). 4. Monitor and help implement mitigation strategies for other high-risk employment settings (e.g., meat processing facilities), and congregate living settings (e.g., prisons, youth homes, shelters). a. This includes coordinating with the Texas Department of Criminal Justice when individuals are released from serving their prison term and will be returning to the jurisdiction. These individuals may have been exposed to COVID-19 while in prison and/or may be COVID-positive and require additional public health follow-up. E. Monitor and mitigate COVID-19 introductions from connected jurisdictions (i.e., neighboring cities, states; including air travel). F. Work with healthcare system to manage and monitor system capacity. 1. Assess and monitor the number and availability of critical care staff, necessary PPE and potentially life-saving medical equipment, as well as access to testing services. 2. Leverage NHSN data to monitor healthcare worker staffing, Patient Impact, Hospital Capacity, and healthcare (PPE, PAPRs, ventilators, etc.) supplies. Grantee will request access to the NHSN database within 30 days of the execution of this Contract contract or 30 days of hire for the position completing the data entry. Upon access approval, Grantee will review available NHSN data (at least monthly) to assess gaps in the healthcare system. G. Improve understanding of jurisdictional communities with respect to COVID-19 risk. Grantee must build an understanding of population density and high-risk population density (i.e., i.e. population of >65 yrs., proportion of population with underlying conditions, households with limited English fluency, healthcare seeking behavior, populations without insurance and those below poverty level). H. Submit a monthly report on the report template to be provided by the DSHS. Monthly reports are due on or before the 15th of each month. Each report must contain a summary of activities that occurred during the preceding month for each activity listed above in Section I, A through G. Submit monthly reports by electronic mail to ▇▇▇▇▇.▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇. The email “Subject Line” and the name of the attached file for all reports should be clearly identified with the Grantee’s Grantees Name, Contract Number, IDCU/COVID and the month the report covers. I. May use funds to pay pre-award costs which date back to January 20, 2020, that are directly related to the COVID-19 outbreak response. All pre-award costs must be approved in writing by DSHS. J. Not use funds for research, clinical care, fund raising activities, construction or major renovations, to supplant existing state or federal funds for activities, or funding an award to another party or provider who is ineligible. Other than normal and recognized executive-legislative relationships, no funds may be used for: 1. Publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body; 2. The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative act or Executive order proposed or pending before any legislative body.

Additional Grant Information. Grantee Data Universal Numbering System (DUNS) Number: 807391511 Federal Award Identification Number (▇▇▇▇): NU50CK000501 Catalog of Federal Domestic Assistance (CFDA) Name and Number (list all that apply): Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) – 93.323 Federal Award Date: April 23, 2020 Name of Federal Awarding Agency: Centers for Disease Control and Prevention Awarding Official Contact Information: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇-▇▇▇▇, Grants Management Officer ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ – Mailstop TV2 Atlanta, GA ▇▇▇▇▇-▇▇▇▇ Phone: ▇▇▇-▇▇▇-▇▇▇▇ Signature Signature Printed Name:▇▇▇▇▇▇▇▇ ▇▇▇▇ Title: _Deputy Commissioner Date of Execution: August 16, 2020 Printed Name: ▇▇▇▇ ▇▇▇▇▇▇▇▇▇-, DrPH Assistant Deputy Commissioner ▇▇▇▇ ▇▇▇▇▇▇▇▇▇ Title: _Grants Administrator CFO Date of Execution: August 1312, 2020 August 12, 2020 Date of Execution: I. GRANTEE RESPONSIBILITIES Grantee will: A. Establish or enhance ability to aggressively identify cases of COVID-19, conduct contact tracing and follow-follow up activities, as well as implement recommended containment measures. 1. Enhanced contact tracing including contact elicitation/identification, contact notification, and contact follow-up. Activities could include traditional contact tracing methods as well as healthcare-specific methods. Other proximity/location-based methods using individuals’ cellphone tower data are not allowed to be used for the purposes of contact tracing. Information on contacts must be entered into the Texas Health Trace system in accordance with DSHS’s published guidance. B. Improve morbidity and mortality surveillance, including: 1. Establish or enhance community-based surveillance - Surveillance of populations and individuals includes but not limited to: ; those without severe illness, those with travel to high-risk locations, or those who are contacts to known cases. 2. Monitor and report daily COVID-19 probable and confirmed COVID cases (including deaths) to DSHS. 3. Track and send Emergency Department and outpatient visits for coronavirus (COVID)-like illness, as well as other illnesses, to Centers for Disease Control and Prevention (CDC). 4. Send copies of all admission, discharge, and transfer (ADT) messages to CDC National Syndromic Surveillance Program (NSSP). 5. Monitor and utilize available data in the CDC’s National Healthcare Safety Network (NHSN) for confirmed 2019 novel coronavirus (COVID-19) infection or for COVID-like illness. a. Long-term care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/ltc/covid19/index.html b. Acute care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/acute-care- hospital/covid19/index.html 6. Work with long-term care facilities to enroll the facility in the NHSN Long- term Care Facility (LTCF) COVID-19 Module. 7. Provide requested information on COVID-19 associated deaths to DSHS within three business days. C. Enhance laboratory testing and reporting capacity: 1. Establish or expand capacity to test all symptomatic individuals, and secondarily expand capacity to achieve community-based surveillance. This capacity would entail increasing testing capabilities above the current number of specimens that can be tested at the jurisdiction’s public health laboratory or by establishing new testing capabilities at the jurisdiction’s laboratory. 2. Screen for past infection (e.g., serology) for health care workers, employees of high-risk facilities, critical infrastructure workforce, and childcare providers. 3. Obtain all jurisdictional laboratory test data electronically, including from new, non-traditional testing settings, and using alternative file formats (e.g., .csv or .xls) to help automate. In addition to other reportable results, this should include all COVID-19 – related testing data, including all tests to detect severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2) and serology testing. 4. Report all COVID-19 – related line level testing data (negatives, positives, indeterminants, serology) daily to DSHS. Data must meet new federal Coronavirus AID, Relief, and Economic Security (CARES) Act laboratory guidance. All public health data must be reported electronically to DSHS in compliance with the Texas Administrative Code and within appropriate reporting timeframes. D. Prevent and control COVID-19 in healthcare settings and protect other vulnerable or high-risk populations: 1. Assess and monitor COVID-19 infections in healthcare workers across the healthcare spectrum. 2. Perform infection control assessments using preparedness tools approved by DSHS to ensure interventions are in place to protect high-risk populations. 3. Monitor and help implement mitigation strategies for COVID-19 in all high- risk healthcare facilities (e.g., hospitals, dialysis clinics, cancer clinics, nursing homes, and other long-term care facilities, etc.). 4. Monitor and help implement mitigation strategies for other high-risk employment settings (e.g., meat processing facilities), and congregate living settings (e.g., prisons, youth homes, shelters). a. This includes coordinating with the Texas Department of Criminal Justice when individuals are released from serving their prison term and will be returning to the jurisdiction. These individuals may have been exposed to COVID-19 while in prison and/or may be COVID-positive and require additional public health follow-up. E. Monitor and mitigate COVID-19 introductions from connected jurisdictions (i.e., neighboring cities, states; including air travel). F. Work with healthcare system to manage and monitor system capacity. 1. Assess and monitor the number and availability of critical care staff, necessary PPE and potentially life-saving medical equipment, as well as access to testing services. 2. Leverage NHSN data to monitor healthcare worker staffing, Patient Impact, Hospital Capacity, and healthcare (PPE, PAPRs, ventilators, etc.) supplies. Grantee will request access to the NHSN database within 30 days of the execution of this Contract contract or 30 days of hire for the position completing the data entry. Upon access approval, Grantee will review available NHSN data (at least monthly) to assess gaps in the healthcare system. G. Improve understanding of jurisdictional communities with respect to COVID-19 risk. Grantee must build an understanding of population density and high-risk population density (i.e., i.e. population of >65 yrs., proportion of population with underlying conditions, households with limited English fluency, healthcare seeking behavior, populations without insurance and those below poverty level). H. Submit a monthly report on the report template to be provided by the DSHS. Monthly reports are due on or before the 15th of each month. Each report must contain a summary of activities that occurred during the preceding month for each activity listed above in Section I, A through G. Submit monthly reports by electronic mail to ▇▇▇▇▇.▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇. The email “Subject Line” and the name of the attached file for all reports should be clearly identified with the Grantee’s Grantees Name, Contract Number, IDCU/COVID and the month the report covers. I. May use funds to pay pre-award costs which date back to January 20, 2020, that are directly related to the COVID-19 outbreak response. All pre-award costs must be approved in writing by DSHS. J. Not use funds for research, clinical care, fund raising activities, construction or major renovations, to supplant existing state or federal funds for activities, or funding an award to another party or provider who is ineligible. Other than normal and recognized executive-legislative relationships, no funds may be used for: 1. Publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body; 2. The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative act or Executive order proposed or pending before any legislative body.

Additional Grant Information. Grantee Data Universal Numbering System (DUNS) Number: 807391511 Federal Award Identification Number (▇▇▇▇): NU50CK000501 Catalog of Federal Domestic Assistance (CFDA) Name and Number (list all that apply): Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) – 93.323 Federal Award Date: April 23, 2020 Name of Federal Awarding Agency: Centers for Disease Control and Prevention Awarding Official Contact Information: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇-▇▇▇▇, Grants Management Officer ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ – Mailstop TV2 Atlanta, GA ▇▇▇▇▇-▇▇▇▇ Phone: ▇▇▇-▇▇▇-▇▇▇▇ Signature Signature Printed Name:: ▇▇▇▇▇▇▇▇ ▇▇▇▇ Title: _Deputy Commissioner Date of Execution: August 16, 2020 Printed Name: B. ▇▇▇▇ ▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇ Title: _Grants Administrator County Judge Date of Execution: August 1316, 2020 Date of Execution: August 12, 2020 I. GRANTEE RESPONSIBILITIES Grantee will: A. Establish or enhance ability to aggressively identify cases of COVID-19, conduct contact tracing and follow-up activities, as well as implement recommended containment measures. 1. Enhanced contact tracing including contact elicitation/identification, contact notification, and contact follow-up. Activities could include traditional contact tracing methods as well as healthcare-specific methods. Other proximity/location-based methods using individuals’ cellphone tower data are not allowed to be used for the purposes of contact tracing. Information on contacts must be entered into the Texas Health Trace system in accordance with DSHS’s published guidance. B. Improve morbidity and mortality surveillance, including: 1. Establish or enhance community-based surveillance - Surveillance of populations and individuals includes but not limited to: those without severe illness, those with travel to high-risk locations, or those who are contacts to known cases. 2. Monitor and report daily COVID-19 probable and confirmed COVID cases (including deaths) to DSHS. 3. Track and send Emergency Department and outpatient visits for coronavirus (COVID)-like illness, as well as other illnesses, to Centers for Disease Control and Prevention (CDC). 4. Send copies of all admission, discharge, and transfer (ADT) messages to CDC National Syndromic Surveillance Program (NSSP). 5. Monitor and utilize available data in the CDC’s National Healthcare Safety Network (NHSN) for confirmed 2019 novel coronavirus (COVID-19) infection or for COVID-like illness. a. Long-term care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/ltc/covid19/index.html b. Acute care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/acute-care- hospital/covid19/index.html 6. Work with long-term care facilities to enroll the facility in the NHSN Long- term Care Facility (LTCF) COVID-19 Module. 7. Provide requested information on COVID-19 associated deaths to DSHS within three business days. C. Enhance laboratory testing and reporting capacity: 1. Establish or expand capacity to test all symptomatic individuals, and secondarily expand capacity to achieve community-based surveillance. This capacity would entail increasing testing capabilities above the current number of specimens that can be tested at the jurisdiction’s public health laboratory or by establishing new testing capabilities at the jurisdiction’s laboratory. 2. Screen for past infection (e.g., serology) for health care workers, employees of high-risk facilities, critical infrastructure workforce, and childcare providers. 3. Obtain all jurisdictional laboratory test data electronically, including from new, non-traditional testing settings, and using alternative file formats (e.g., .csv or .xls) to help automate. In addition to other reportable results, this should include all COVID-19 – related testing data, including all tests to detect severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2) and serology testing. 4. Report all COVID-19 – related line level testing data (negatives, positives, indeterminants, serology) daily to DSHS. Data must meet new federal Coronavirus AID, Relief, and Economic Security (CARES) Act laboratory guidance. All public health data must be reported electronically to DSHS in compliance with the Texas Administrative Code and within appropriate reporting timeframes. D. Prevent and control COVID-19 in healthcare settings and protect other vulnerable or high-risk populations: 1. Assess and monitor COVID-19 infections in healthcare workers across the healthcare spectrum. 2. Perform infection control assessments using preparedness tools approved by DSHS to ensure interventions are in place to protect high-risk populations. 3. Monitor and help implement mitigation strategies for COVID-19 in all high- risk healthcare facilities (e.g., hospitals, dialysis clinics, cancer clinics, nursing homes, and other long-term care facilities, etc.). 4. Monitor and help implement mitigation strategies for other high-risk employment settings (e.g., meat processing facilities), and congregate living settings (e.g., prisons, youth homes, shelters). a. This includes coordinating with the Texas Department of Criminal Justice when individuals are released from serving their prison term and will be returning to the jurisdiction. These individuals may have been exposed to COVID-19 while in prison and/or may be COVID-positive and require additional public health follow-up. E. Monitor and mitigate COVID-19 introductions from connected jurisdictions (i.e., neighboring cities, states; including air travel). F. Work with healthcare system to manage and monitor system capacity. 1. Assess and monitor the number and availability of critical care staff, necessary PPE and potentially life-saving medical equipment, as well as access to testing services. 2. Leverage NHSN data to monitor healthcare worker staffing, Patient Impact, Hospital Capacity, and healthcare (PPE, PAPRs, ventilators, etc.) supplies. Grantee will request access to the NHSN database within 30 days of the execution of this Contract or 30 days of hire for the position completing the data entry. Upon access approval, Grantee will review available NHSN data (at least monthly) to assess gaps in the healthcare system. G. Improve understanding of jurisdictional communities with respect to COVID-19 risk. Grantee must build an understanding of population density and high-risk population density (i.e., population of >65 yrs., proportion of population with underlying conditions, households with limited English fluency, healthcare seeking behavior, populations without insurance and those below poverty level). H. Submit a monthly report on the report template to be provided by the DSHS. Monthly reports are due on or before the 15th of each month. Each report must contain a summary of activities that occurred during the preceding month for each activity listed above in Section I, A through G. Submit monthly reports by electronic mail to ▇▇▇▇▇.▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇. The email “Subject Line” and the name of the attached file for all reports should be clearly identified with the Grantee’s Name, Contract Number, IDCU/COVID and the month the report covers. I. May use funds to pay pre-award costs which date back to January 20, 2020, that are directly related to the COVID-19 outbreak response. All pre-award costs must be approved in writing by DSHS. J. Not use funds for research, clinical care, fund raising activities, construction or major renovations, to supplant existing state or federal funds for activities, or funding an award to another party or provider who is ineligible. Other than normal and recognized executive-legislative relationships, no funds may be used for: 1. Publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body; 2. The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative act or Executive order proposed or pending before any legislative body.

Additional Grant Information. Grantee Data Universal Numbering System (DUNS) Number: 807391511 Federal Award Identification Number (▇▇▇▇): NU50CK000501 Catalog of Federal Domestic Assistance (CFDA) Name and Number (list all that apply): Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) – 93.323 Federal Award Date: April 23, 2020 Name of Federal Awarding Agency: Centers for Disease Control and Prevention Awarding Official Contact Information: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇-▇▇▇▇, Grants Management Officer ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ – Mailstop TV2 Atlanta, GA ▇▇▇▇▇-▇▇▇▇ Phone: ▇▇▇-▇▇▇-▇▇▇▇ Signature Signature g g Printed Name:: _▇▇▇▇▇▇▇▇ ▇▇▇▇ Title: _Deputy Commissioner Date of Execution: August 16, 2020 Printed Name: ▇▇▇▇ ▇▇▇▇▇▇▇▇▇-_▇▇▇▇▇▇ ▇. Eads Title: _Grants Administrator City Manager Date of Execution: August 137, 2020 Date of Execution: July _30, 2020 I. GRANTEE RESPONSIBILITIES Grantee will: A. Establish or enhance ability to aggressively identify cases of COVID-19, conduct contact tracing and follow-up activities, as well as implement recommended containment measures. 1. Enhanced contact tracing including contact elicitation/identification, contact notification, and contact follow-up. Activities could include traditional contact tracing methods as well as healthcare-specific methods. Other proximity/location-based methods using individuals’ cellphone tower data are not allowed to be used for the purposes of contact tracing. Information on contacts must be entered into the Texas Health Trace system in accordance with DSHS’s published guidance. B. Improve morbidity and mortality surveillance, including: 1. Establish or enhance community-based surveillance - Surveillance of populations and individuals includes but not limited to: those without severe illness, those with travel to high-risk locations, or those who are contacts to known cases. 2. Monitor and report daily COVID-19 probable and confirmed COVID cases (including deaths) to DSHS. 3. Track and send Emergency Department and outpatient visits for coronavirus (COVID)-like illness, as well as other illnesses, to Centers for Disease Control and Prevention (CDC). 4. Send copies of all admission, discharge, and transfer (ADT) messages to CDC National Syndromic Surveillance Program (NSSP). 5. Monitor and utilize available data in the CDC’s National Healthcare Safety Network (NHSN) for confirmed 2019 novel coronavirus (COVID-19) infection or for COVID-like illness. a. Long-term care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/ltc/covid19/index.html b. Acute care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/acute-care- hospital/covid19/index.html 6. Work with long-term care facilities to enroll the facility in the NHSN Long- term Care Facility (LTCF) COVID-19 Module. 7. Provide requested information on COVID-19 associated deaths to DSHS within three business days. C. Enhance laboratory testing and reporting capacity: 1. Establish or expand capacity to test all symptomatic individuals, and secondarily expand capacity to achieve community-based surveillance. This capacity would entail increasing testing capabilities above the current number of specimens that can be tested at the jurisdiction’s public health laboratory or by establishing new testing capabilities at the jurisdiction’s laboratory. 2. Screen for past infection (e.g., serology) for health care workers, employees of high-risk facilities, critical infrastructure workforce, and childcare providers. 3. Obtain all jurisdictional laboratory test data electronically, including from new, non-traditional testing settings, and using alternative file formats (e.g., .csv or .xls) to help automate. In addition to other reportable results, this should include all COVID-19 – related testing data, including all tests to detect severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2) and serology testing. 4. Report all COVID-19 – related line level testing data (negatives, positives, indeterminants, serology) daily to DSHS. Data must meet new federal Coronavirus AID, Relief, and Economic Security (CARES) Act laboratory guidance. All public health data must be reported electronically to DSHS in compliance with the Texas Administrative Code and within appropriate reporting timeframes. D. Prevent and control COVID-19 in healthcare settings and protect other vulnerable or high-risk populations: 1. Assess and monitor COVID-19 infections in healthcare workers across the healthcare spectrum. 2. Perform infection control assessments using preparedness tools approved by DSHS to ensure interventions are in place to protect high-risk populations. 3. Monitor and help implement mitigation strategies for COVID-19 in all high- risk healthcare facilities (e.g., hospitals, dialysis clinics, cancer clinics, nursing homes, and other long-term care facilities, etc.). 4. Monitor and help implement mitigation strategies for other high-risk employment settings (e.g., meat processing facilities), and congregate living settings (e.g., prisons, youth homes, shelters). a. This includes coordinating with the Texas Department of Criminal Justice when individuals are released from serving their prison term and will be returning to the jurisdiction. These individuals may have been exposed to COVID-19 while in prison and/or may be COVID-positive and require additional public health follow-up. E. Monitor and mitigate COVID-19 introductions from connected jurisdictions (i.e., neighboring cities, states; including air travel). F. Work with healthcare system to manage and monitor system capacity. 1. Assess and monitor the number and availability of critical care staff, necessary PPE and potentially life-saving medical equipment, as well as access to testing services. 2. Leverage NHSN data to monitor healthcare worker staffing, Patient Impact, Hospital Capacity, and healthcare (PPE, PAPRs, ventilators, etc.) supplies. Grantee will request access to the NHSN database within 30 days of the execution of this Contract or 30 days of hire for the position completing the data entry. Upon access approval, Grantee will review available NHSN data (at least monthly) to assess gaps in the healthcare system. G. Improve understanding of jurisdictional communities with respect to COVID-19 risk. Grantee must build an understanding of population density and high-risk population density (i.e., population of >65 yrs., proportion of population with underlying conditions, households with limited English fluency, healthcare seeking behavior, populations without insurance and those below poverty level). H. Submit a monthly report on the report template to be provided by the DSHS. Monthly reports are due on or before the 15th of each month. Each report must contain a summary of activities that occurred during the preceding month for each activity listed above in Section I, A through G. Submit monthly reports by electronic mail to ▇▇▇▇▇.▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇. The email “Subject Line” and the name of the attached file for all reports should be clearly identified with the Grantee’s Name, Contract Number, IDCU/COVID and the month the report covers. I. May use funds to pay pre-award costs which date back to January 20, 2020, that are directly related to the COVID-19 outbreak response. All pre-award costs must be approved in writing by DSHS. J. Not use funds for research, clinical care, fund raising activities, construction or major renovations, to supplant existing state or federal funds for activities, or funding an award to another party or provider who is ineligible. Other than normal and recognized executive-legislative relationships, no funds may be used for: 1. Publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body; 2. The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative act or Executive order proposed or pending before any legislative body.

Additional Grant Information. Grantee Data Universal Numbering System (DUNS) Number: 807391511 Federal Award Identification Number (▇▇▇▇): NU50CK000501 Catalog of Federal Domestic Assistance (CFDA) Name and Number (list all that apply): Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) – 93.323 Federal Award Date: April 23, 2020 Name of Federal Awarding Agency: Centers for Disease Control and Prevention Awarding Official Contact Information: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇-▇▇▇▇, Grants Management Officer ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ – Mailstop TV2 Atlanta, GA ▇▇▇▇▇-▇▇▇▇ Phone: ▇▇▇-▇▇▇-▇▇▇▇ Signature Signature Printed Name:: ▇▇▇▇▇▇▇▇ ▇▇▇▇ Title: _Deputy Commissioner Date of Execution: August 16, 2020 Printed Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇ Title: _Grants Administrator San Antonio Metropolitan Health District Director Date of Execution: August 134, 2020 Date of Execution: August 3, 2020 I. GRANTEE RESPONSIBILITIES Grantee will: A. Establish or enhance ability to aggressively identify cases of COVID-19, conduct contact tracing and follow-up activities, as well as implement recommended containment measures. 1. Enhanced contact tracing including contact elicitation/identification, contact notification, and contact follow-up. Activities could include traditional contact tracing methods as well as healthcare-specific methods. Other proximity/location-based methods using individuals’ cellphone tower data are not allowed to be used for the purposes of contact tracing. Information on contacts must be entered into the Texas Health Trace system in accordance with DSHS’s published guidance. B. Improve morbidity and mortality surveillance, including: 1. Establish or enhance community-based surveillance - Surveillance of populations and individuals includes but not limited to: those without severe illness, those with travel to high-risk locations, or those who are contacts to known cases. 2. Monitor and report daily COVID-19 probable and confirmed COVID cases (including deaths) to DSHS. 3. Track and send Emergency Department and outpatient visits for coronavirus (COVID)-like illness, as well as other illnesses, to Centers for Disease Control and Prevention (CDC). 4. Send copies of all admission, discharge, and transfer (ADT) messages to CDC National Syndromic Surveillance Program (NSSP). 5. Monitor and utilize available data in the CDC’s National Healthcare Safety Network (NHSN) for confirmed 2019 novel coronavirus (COVID-19) infection or for COVID-like illness. a. Long-term care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/ltc/covid19/index.html b. Acute care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/acute-care- hospital/covid19/index.html 6. Work with long-term care facilities to enroll the facility in the NHSN Long- term Care Facility (LTCF) COVID-19 Module. 7. Provide requested information on COVID-19 associated deaths to DSHS within three business days. C. Enhance laboratory testing and reporting capacity: 1. Establish or expand capacity to test all symptomatic individuals, and secondarily expand capacity to achieve community-based surveillance. This capacity would entail increasing testing capabilities above the current number of specimens that can be tested at the jurisdiction’s public health laboratory or by establishing new testing capabilities at the jurisdiction’s laboratory. 2. Screen for past infection (e.g., serology) for health care workers, employees of high-risk facilities, critical infrastructure workforce, and childcare providers. 3. Obtain all jurisdictional laboratory test data electronically, including from new, non-traditional testing settings, and using alternative file formats (e.g., .csv or .xls) to help automate. In addition to other reportable results, this should include all COVID-19 – related testing data, including all tests to detect severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2) and serology testing. 4. Report all COVID-19 – related line level testing data (negatives, positives, indeterminants, serology) daily to DSHS. Data must meet new federal Coronavirus AID, Relief, and Economic Security (CARES) Act laboratory guidance. All public health data must be reported electronically to DSHS in compliance with the Texas Administrative Code and within appropriate reporting timeframes. D. Prevent and control COVID-19 in healthcare settings and protect other vulnerable or high-risk populations: 1. Assess and monitor COVID-19 infections in healthcare workers across the healthcare spectrum. 2. Perform infection control assessments using preparedness tools approved by DSHS to ensure interventions are in place to protect high-risk populations. 3. Monitor and help implement mitigation strategies for COVID-19 in all high- risk healthcare facilities (e.g., hospitals, dialysis clinics, cancer clinics, nursing homes, and other long-term care facilities, etc.). 4. Monitor and help implement mitigation strategies for other high-risk employment settings (e.g., meat processing facilities), and congregate living settings (e.g., prisons, youth homes, shelters). a. This includes coordinating with the Texas Department of Criminal Justice when individuals are released from serving their prison term and will be returning to the jurisdiction. These individuals may have been exposed to COVID-19 while in prison and/or may be COVID-positive and require additional public health follow-up. E. Monitor and mitigate COVID-19 introductions from connected jurisdictions (i.e., neighboring cities, states; including air travel). F. Work with healthcare system to manage and monitor system capacity. 1. Assess and monitor the number and availability of critical care staff, necessary PPE and potentially life-saving medical equipment, as well as access to testing services. 2. Leverage NHSN data to monitor healthcare worker staffing, Patient Impact, Hospital Capacity, and healthcare (PPE, PAPRs, ventilators, etc.) supplies. Grantee will request access to the NHSN database within 30 days of the execution of this Contract or 30 days of hire for the position completing the data entry. Upon access approval, Grantee will review available NHSN data (at least monthly) to assess gaps in the healthcare system. G. Improve understanding of jurisdictional communities with respect to COVID-19 risk. Grantee must build an understanding of population density and high-risk population density (i.e., population of >65 yrs., proportion of population with underlying conditions, households with limited English fluency, healthcare seeking behavior, populations without insurance and those below poverty level). H. Submit a monthly report on the report template to be provided by the DSHS. Monthly reports are due on or before the 15th of each month. Each report must contain a summary of activities that occurred during the preceding month for each activity listed above in Section I, A through G. Submit monthly reports by electronic mail to ▇▇▇▇▇.▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇. The email “Subject Line” and the name of the attached file for all reports should be clearly identified with the Grantee’s Name, Contract Number, IDCU/COVID and the month the report covers. I. May use funds to pay pre-award costs which date back to January 20, 2020, that are directly related to the COVID-19 outbreak response. All pre-award costs must be approved in writing by DSHS. J. Not use funds for research, clinical care, fund raising activities, construction or major renovations, to supplant existing state or federal funds for activities, or funding an award to another party or provider who is ineligible. Other than normal and recognized executive-legislative relationships, no funds may be used for: 1. Publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body; 2. The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative act or Executive order proposed or pending before any legislative body.

Additional Grant Information. Grantee Data Universal Numbering System (DUNS) Number: 807391511 Federal Award Identification Number (▇▇▇▇): NU50CK000501 Catalog of Federal Domestic Assistance (CFDA) Name and Number (list all that apply): Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) – 93.323 Federal Award Date: April 23, 2020 Name of Federal Awarding Agency: Centers for Disease Control and Prevention Awarding Official Contact Information: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇-▇▇▇▇, Grants Management Officer ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ – Mailstop TV2 Atlanta, GA ▇▇▇▇▇-▇▇▇▇ Phone: ▇▇▇-▇▇▇-▇▇▇▇ Signature Signature Printed Name:▇▇▇▇▇▇▇▇ ▇▇▇▇ Title: _Deputy Commissioner Date of Execution: August 16, 2020 Printed Name: ▇▇▇▇ ▇▇▇▇▇▇▇▇▇ ▇-▇▇▇▇▇▇▇▇ Title: _Grants Administrator ▇▇▇▇▇▇ Assistant Deputy Commissioner Director Date of Execution: August 1331, 2020 Date of Execution: August 31, 2020 I. GRANTEE RESPONSIBILITIES Grantee will: A. Establish or enhance ability to aggressively identify cases of COVID-19, conduct contact tracing and follow-follow up activities, as well as implement recommended containment measures. 1. Enhanced contact tracing including contact elicitation/identification, contact notification, and contact follow-up. Activities could include traditional contact tracing methods as well as healthcare-specific methods. Other proximity/location-based methods using individuals’ cellphone tower data are not allowed to be used for the purposes of contact tracing. Information on contacts must be entered into the Texas Health Trace system in accordance with DSHS’s published guidance. B. Improve morbidity and mortality surveillance, including: 1. Establish or enhance community-based surveillance - Surveillance of populations and individuals includes but not limited to: ; those without severe illness, those with travel to high-risk locations, or those who are contacts to known cases. 2. Monitor and report daily COVID-19 probable and confirmed COVID cases (including deaths) to DSHS. 3. Track and send Emergency Department and outpatient visits for coronavirus (COVID)-like illness, as well as other illnesses, to Centers for Disease Control and Prevention (CDC). 4. Send copies of all admission, discharge, and transfer (ADT) messages to CDC National Syndromic Surveillance Program (NSSP). 5. Monitor and utilize available data in the CDC’s National Healthcare Safety Network (NHSN) for confirmed 2019 novel coronavirus (COVID-19) infection or for COVID-like illness. a. Long-term care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/ltc/covid19/index.html b. Acute care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/acute-care- hospital/covid19/index.html 6. Work with long-term care facilities to enroll the facility in the NHSN Long- term Care Facility (LTCF) COVID-19 Module. 7. Provide requested information on COVID-19 associated deaths to DSHS within three business days. C. Enhance laboratory testing and reporting capacity: 1. Establish or expand capacity to test all symptomatic individuals, and secondarily expand capacity to achieve community-based surveillance. This capacity would entail increasing testing capabilities above the current number of specimens that can be tested at the jurisdiction’s public health laboratory or by establishing new testing capabilities at the jurisdiction’s laboratory. 2. Screen for past infection (e.g., serology) for health care workers, employees of high-risk facilities, critical infrastructure workforce, and childcare providers. 3. Obtain all jurisdictional laboratory test data electronically, including from new, non-traditional testing settings, and using alternative file formats (e.g., .csv or .xls) to help automate. In addition to other reportable results, this should include all COVID-19 – related testing data, including all tests to detect severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2) and serology testing. 4. Report all COVID-19 – related line level testing data (negatives, positives, indeterminants, serology) daily to DSHS. Data must meet new federal Coronavirus AID, Relief, and Economic Security (CARES) Act laboratory guidance. All public health data must be reported electronically to DSHS in compliance with the Texas Administrative Code and within appropriate reporting timeframes. D. Prevent and control COVID-19 in healthcare settings and protect other vulnerable or high-risk populations: 1. Assess and monitor COVID-19 infections in healthcare workers across the healthcare spectrum. 2. Perform infection control assessments using preparedness tools approved by DSHS to ensure interventions are in place to protect high-risk populations. 3. Monitor and help implement mitigation strategies for COVID-19 in all high- risk healthcare facilities (e.g., hospitals, dialysis clinics, cancer clinics, nursing homes, and other long-term care facilities, etc.). 4. Monitor and help implement mitigation strategies for other high-risk employment settings (e.g., meat processing facilities), and congregate living settings (e.g., prisons, youth homes, shelters). a. This includes coordinating with the Texas Department of Criminal Justice when individuals are released from serving their prison term and will be returning to the jurisdiction. These individuals may have been exposed to COVID-19 while in prison and/or may be COVID-positive and require additional public health follow-up. E. Monitor and mitigate COVID-19 introductions from connected jurisdictions (i.e., neighboring cities, states; including air travel). F. Work with healthcare system to manage and monitor system capacity. 1. Assess and monitor the number and availability of critical care staff, necessary PPE and potentially life-saving medical equipment, as well as access to testing services. 2. Leverage NHSN data to monitor healthcare worker staffing, Patient Impact, Hospital Capacity, and healthcare (PPE, PAPRs, ventilators, etc.) supplies. Grantee will request access to the NHSN database within 30 days of the execution of this Contract contract or 30 days of hire for the position completing the data entry. Upon access approval, Grantee will review available NHSN data (at least monthly) to assess gaps in the healthcare system. G. Improve understanding of jurisdictional communities with respect to COVID-19 risk. Grantee must build an understanding of population density and high-risk population density (i.e., i.e. population of >65 yrs., proportion of population with underlying conditions, households with limited English fluency, healthcare seeking behavior, populations without insurance and those below poverty level). H. Submit a monthly report on the report template to be provided by the DSHS. Monthly reports are due on or before the 15th of each month. Each report must contain a summary of activities that occurred during the preceding month for each activity listed above in Section I, A through G. Submit monthly reports by electronic mail to ▇▇▇▇▇.▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇. The email “Subject Line” and the name of the attached file for all reports should be clearly identified with the Grantee’s Grantees Name, Contract Number, IDCU/COVID and the month the report covers. I. May use funds to pay pre-award costs which date back to January 20, 2020, that are directly related to the COVID-19 outbreak response. All pre-award costs must be approved in writing by DSHS. J. Not use funds for research, clinical care, fund raising activities, construction or major renovations, to supplant existing state or federal funds for activities, or funding an award to another party or provider who is ineligible. Other than normal and recognized executive-legislative relationships, no funds may be used for: 1. Publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body; 2. The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative act or Executive order proposed or pending before any legislative body.

Additional Grant Information. Grantee Data Universal Numbering System (DUNS) Number: 807391511 Federal Award Identification Number (▇▇▇▇): NU50CK000501 Catalog of Federal Domestic Assistance (CFDA) Name and Number (list all that apply): Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) – 93.323 Federal Award Date: April 23, 2020 Name of Federal Awarding Agency: Centers for Disease Control and Prevention Awarding Official Contact Information: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇-▇▇▇▇, Grants Management Officer ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ – Mailstop TV2 Atlanta, GA ▇▇▇▇▇-▇▇▇▇ Phone: ▇▇▇-▇▇▇-▇▇▇▇ Signature Signature Printed Name:▇▇▇▇▇▇▇▇ ▇▇▇▇ Title: _Deputy Commissioner Date of Execution: August 16, 2020 g g Printed Name: ▇▇▇▇ ▇▇▇▇▇▇▇▇▇-▇ Title: _Assistant Deputy Commissioner Printed Name: ▇▇▇▇ ▇▇▇▇ Title: _Grants Administrator Ector County Judge Date of Execution: August 1319, 2020 Date of Execution: August 6, 2020 I. GRANTEE RESPONSIBILITIES Grantee will: A. Establish or enhance ability to aggressively identify cases of COVID-19, conduct contact tracing and follow-follow up activities, as well as implement recommended containment measures. 1. Enhanced contact tracing including contact elicitation/identification, contact notification, and contact follow-up. Activities could include traditional contact tracing methods as well as healthcare-specific methods. Other proximity/location-based methods using individuals’ cellphone tower data are not allowed to be used for the purposes of contact tracing. Information on contacts must be entered into the Texas Health Trace system in accordance with DSHS’s published guidance. B. Improve morbidity and mortality surveillance, including: 1. Establish or enhance community-based surveillance - Surveillance of populations and individuals includes but not limited to: ; those without severe illness, those with travel to high-risk locations, or those who are contacts to known cases. 2. Monitor and report daily COVID-19 probable and confirmed COVID cases (including deaths) to DSHS. 3. Track and send Emergency Department and outpatient visits for coronavirus (COVID)-like illness, as well as other illnesses, to Centers for Disease Control and Prevention (CDC). 4. Send copies of all admission, discharge, and transfer (ADT) messages to CDC National Syndromic Surveillance Program (NSSP). 5. Monitor and utilize available data in the CDC’s National Healthcare Safety Network (NHSN) for confirmed 2019 novel coronavirus (COVID-19) infection or for COVID-like illness. a. Long-term care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/ltc/covid19/index.html b. Acute care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/acute-care- hospital/covid19/index.html 6. Work with long-term care facilities to enroll the facility in the NHSN Long- term Care Facility (LTCF) COVID-19 Module. 7. Provide requested information on COVID-19 associated deaths to DSHS within three business days. C. Enhance laboratory testing and reporting capacity: 1. Establish or expand capacity to test all symptomatic individuals, and secondarily expand capacity to achieve community-based surveillance. This capacity would entail increasing testing capabilities above the current number of specimens that can be tested at the jurisdiction’s public health laboratory or by establishing new testing capabilities at the jurisdiction’s laboratory. 2. Screen for past infection (e.g., serology) for health care workers, employees of high-risk facilities, critical infrastructure workforce, and childcare providers. 3. Obtain all jurisdictional laboratory test data electronically, including from new, non-traditional testing settings, and using alternative file formats (e.g., .csv or .xls) to help automate. In addition to other reportable results, this should include all COVID-19 – related testing data, including all tests to detect severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2) and serology testing. 4. Report all COVID-19 – related line level testing data (negatives, positives, indeterminants, serology) daily to DSHS. Data must meet new federal Coronavirus AID, Relief, and Economic Security (CARES) Act laboratory guidance. All public health data must be reported electronically to DSHS in compliance with the Texas Administrative Code and within appropriate reporting timeframes. D. Prevent and control COVID-19 in healthcare settings and protect other vulnerable or high-risk populations: 1. Assess and monitor COVID-19 infections in healthcare workers across the healthcare spectrum. 2. Perform infection control assessments using preparedness tools approved by DSHS to ensure interventions are in place to protect high-risk populations. 3. Monitor and help implement mitigation strategies for COVID-19 in all high- risk healthcare facilities (e.g., hospitals, dialysis clinics, cancer clinics, nursing homes, and other long-term care facilities, etc.). 4. Monitor and help implement mitigation strategies for other high-risk employment settings (e.g., meat processing facilities), and congregate living settings (e.g., prisons, youth homes, shelters). a. This includes coordinating with the Texas Department of Criminal Justice when individuals are released from serving their prison term and will be returning to the jurisdiction. These individuals may have been exposed to COVID-19 while in prison and/or may be COVID-positive and require additional public health follow-up. E. Monitor and mitigate COVID-19 introductions from connected jurisdictions (i.e., neighboring cities, states; including air travel). F. Work with healthcare system to manage and monitor system capacity. 1. Assess and monitor the number and availability of critical care staff, necessary PPE and potentially life-saving medical equipment, as well as access to testing services. 2. Leverage NHSN data to monitor healthcare worker staffing, Patient Impact, Hospital Capacity, and healthcare (PPE, PAPRs, ventilators, etc.) supplies. Grantee will request access to the NHSN database within 30 days of the execution of this Contract contract or 30 days of hire for the position completing the data entry. Upon access approval, Grantee will review available NHSN data (at least monthly) to assess gaps in the healthcare system. G. Improve understanding of jurisdictional communities with respect to COVID-19 risk. Grantee must build an understanding of population density and high-risk population density (i.e., i.e. population of >65 yrs., proportion of population with underlying conditions, households with limited English fluency, healthcare seeking behavior, populations without insurance and those below poverty level). H. Submit a monthly report on the report template to be provided by the DSHS. Monthly reports are due on or before the 15th of each month. Each report must contain a summary of activities that occurred during the preceding month for each activity listed above in Section I, A through G. Submit monthly reports by electronic mail to ▇▇▇▇▇.▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇. The email “Subject Line” and the name of the attached file for all reports should be clearly identified with the Grantee’s Grantees Name, Contract Number, IDCU/COVID and the month the report covers. I. May use funds to pay pre-award costs which date back to January 20, 2020, that are directly related to the COVID-19 outbreak response. All pre-award costs must be approved in writing by DSHS. J. Not use funds for research, clinical care, fund raising activities, construction or major renovations, to supplant existing state or federal funds for activities, or funding an award to another party or provider who is ineligible. Other than normal and recognized executive-legislative relationships, no funds may be used for: 1. Publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body; 2. The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative act or Executive order proposed or pending before any legislative body.

Additional Grant Information. Grantee Data Universal Numbering System (DUNS) Number: 807391511 Federal Award Identification Number (▇▇▇▇): NU50CK000501 Catalog of Federal Domestic Assistance (CFDA) Name and Number (list all that apply): Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) – 93.323 Federal Award Date: April 23, 2020 Name of Federal Awarding Agency: Centers for Disease Control and Prevention Awarding Official Contact Information: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇-▇▇▇▇, Grants Management Officer ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ – Mailstop TV2 Atlanta, GA ▇▇▇▇▇-▇▇▇▇ Phone: ▇▇▇-▇▇▇-▇▇▇▇ Signature Signature Printed Name:▇▇▇▇▇▇▇▇ ▇▇▇▇ Title: _Deputy Commissioner Date of Execution: August 16, 2020 S g S g Printed Name: ▇▇▇▇ ▇▇▇▇▇▇▇▇▇ Title: _Assistant Deputy Commissioner Date of Execution: July 22, 2020 Printed Name: ▇-▇▇▇▇ ▇▇▇▇▇▇▇ Title: _Grants Administrator CEO Date of Execution: August 13July 22, 2020 I. GRANTEE RESPONSIBILITIES Grantee will: A. Establish or enhance ability to aggressively identify cases of COVID-19, conduct contact tracing and follow-follow up activities, as well as implement recommended containment measures. 1. Enhanced contact tracing including contact elicitation/identification, contact notification, and contact follow-up. Activities could include traditional contact tracing methods as well as healthcare-specific methods. Other proximity/location-based methods using individuals’ cellphone tower data are not allowed to be used for the purposes of contact tracing. Information on contacts must be entered into the Texas Health Trace system in accordance with DSHS’s published guidance. B. Improve morbidity and mortality surveillance, including: 1. Establish or enhance community-based surveillance - Surveillance of populations and individuals includes but not limited to: ; those without severe illness, those with travel to high-risk locations, or those who are contacts to known cases. 2. Monitor and report daily COVID-19 probable and confirmed COVID cases (including deaths) to DSHS. 3. Track and send Emergency Department and outpatient visits for coronavirus (COVID)-like illness, as well as other illnesses, to Centers for Disease Control and Prevention (CDC). 4. Send copies of all admission, discharge, and transfer (ADT) messages to CDC National Syndromic Surveillance Program (NSSP). 5. Monitor and utilize available data in the CDC’s National Healthcare Safety Network (NHSN) for confirmed 2019 novel coronavirus (COVID-19) infection or for COVID-like illness. a. Long-term care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/ltc/covid19/index.html b. Acute care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/acute-care- hospital/covid19/index.html 6. Work with long-term care facilities to enroll the facility in the NHSN Long- term Care Facility (LTCF) COVID-19 Module. 7. Provide requested information on COVID-19 associated deaths to DSHS within three business days. C. Enhance laboratory testing and reporting capacity: 1. Establish or expand capacity to test all symptomatic individuals, and secondarily expand capacity to achieve community-based surveillance. This capacity would entail increasing testing capabilities above the current number of specimens that can be tested at the jurisdiction’s public health laboratory or by establishing new testing capabilities at the jurisdiction’s laboratory. 2. Screen for past infection (e.g., serology) for health care workers, employees of high-risk facilities, critical infrastructure workforce, and childcare providers. 3. Obtain all jurisdictional laboratory test data electronically, including from new, non-traditional testing settings, and using alternative file formats (e.g., .csv or .xls) to help automate. In addition to other reportable results, this should include all COVID-19 – related testing data, including all tests to detect severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2) and serology testing. 4. Report all COVID-19 – related line level testing data (negatives, positives, indeterminants, serology) daily to DSHS. Data must meet new federal Coronavirus AID, Relief, and Economic Security (CARES) Act laboratory guidance. All public health data must be reported electronically to DSHS in compliance with the Texas Administrative Code and within appropriate reporting timeframes. D. Prevent and control COVID-19 in healthcare settings and protect other vulnerable or high-risk populations: 1. Assess and monitor COVID-19 infections in healthcare workers across the healthcare spectrum. 2. Perform infection control assessments using preparedness tools approved by DSHS to ensure interventions are in place to protect high-risk populations. 3. Monitor and help implement mitigation strategies for COVID-19 in all high- risk healthcare facilities (e.g., hospitals, dialysis clinics, cancer clinics, nursing homes, and other long-term care facilities, etc.). 4. Monitor and help implement mitigation strategies for other high-risk employment settings (e.g., meat processing facilities), and congregate living settings (e.g., prisons, youth homes, shelters). a. This includes coordinating with the Texas Department of Criminal Justice when individuals are released from serving their prison term and will be returning to the jurisdiction. These individuals may have been exposed to COVID-19 while in prison and/or may be COVID-positive and require additional public health follow-up. E. Monitor and mitigate COVID-19 introductions from connected jurisdictions (i.e., neighboring cities, states; including air travel). F. Work with healthcare system to manage and monitor system capacity. 1. Assess and monitor the number and availability of critical care staff, necessary PPE and potentially life-saving medical equipment, as well as access to testing services. 2. Leverage NHSN data to monitor healthcare worker staffing, Patient Impact, Hospital Capacity, and healthcare (PPE, PAPRs, ventilators, etc.) supplies. Grantee will request access to the NHSN database within 30 days of the execution of this Contract contract or 30 days of hire for the position completing the data entry. Upon access approval, Grantee will review available NHSN data (at least monthly) to assess gaps in the healthcare system. G. Improve understanding of jurisdictional communities with respect to COVID-19 risk. Grantee must build an understanding of population density and high-risk population density (i.e., i.e. population of >65 yrs., proportion of population with underlying conditions, households with limited English fluency, healthcare seeking behavior, populations without insurance and those below poverty level). H. Submit a monthly report on the report template to be provided by the DSHS. Monthly reports are due on or before the 15th of each month. Each report must contain a summary of activities that occurred during the preceding month for each activity listed above in Section I, A through G. Submit monthly reports by electronic mail to ▇▇▇▇▇.▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇. The email “Subject Line” and the name of the attached file for all reports should be clearly identified with the Grantee’s Grantees Name, Contract Number, IDCU/COVID and the month the report covers. I. May use funds to pay pre-award costs which date back to January 20, 2020, that are directly related to the COVID-19 outbreak response. All pre-award costs must be approved in writing by DSHS. J. Not use funds for research, clinical care, fund raising activities, construction or major renovations, to supplant existing state or federal funds for activities, or funding an award to another party or provider who is ineligible. Other than normal and recognized executive-legislative relationships, no funds may be used for: 1. Publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body; 2. The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative act or Executive order proposed or pending before any legislative body.

Additional Grant Information. Grantee Data Universal Numbering System (DUNS) Number: 807391511 Federal Award Identification Number (▇▇▇▇): NU50CK000501 Catalog of Federal Domestic Assistance (CFDA) Name and Number (list all that apply): Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) – 93.323 Federal Award Date: April 23, 2020 Name of Federal Awarding Agency: Centers for Disease Control and Prevention Awarding Official Contact Information: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇-▇▇▇▇, Grants Management Officer ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ – Mailstop TV2 Atlanta, GA ▇▇▇▇▇-▇▇▇▇ Phone: ▇▇▇-▇▇▇-▇▇▇▇ Signature Signature Printed Name:▇▇▇▇▇▇▇▇ ▇▇▇▇ Title: _Deputy Commissioner Date of Execution: August 16, 2020 Printed Name: ▇▇▇▇ ▇▇▇▇▇▇▇▇▇ Assistant Deputy Commissioner ▇-▇▇▇▇ ▇▇▇▇▇▇▇ Title: _Grants Administrator Executive Director Date of Execution: August 13July _28, 2020 Date of Execution: July_28, 2020 I. GRANTEE RESPONSIBILITIES Grantee will: A. Establish or enhance ability to aggressively identify cases of COVID-19, conduct contact tracing and follow-up activities, as well as implement recommended containment measures. 1. Enhanced contact tracing including contact elicitation/identification, contact notification, and contact follow-up. Activities could include traditional contact tracing methods as well as healthcare-specific methods. Other proximity/location-based methods using individuals’ cellphone tower data are not allowed to be used for the purposes of contact tracing. Information on contacts must be entered into the Texas Health Trace system in accordance with DSHS’s published guidance. B. Improve morbidity and mortality surveillance, including: 1. Establish or enhance community-based surveillance - Surveillance of populations and individuals includes but not limited to: those without severe illness, those with travel to high-risk locations, or those who are contacts to known cases. 2. Monitor and report daily COVID-19 probable and confirmed COVID cases (including deaths) to DSHS. 3. Track and send Emergency Department and outpatient visits for coronavirus (COVID)-like illness, as well as other illnesses, to Centers for Disease Control and Prevention (CDC). 4. Send copies of all admission, discharge, and transfer (ADT) messages to CDC National Syndromic Surveillance Program (NSSP). 5. Monitor and utilize available data in the CDC’s National Healthcare Safety Network (NHSN) for confirmed 2019 novel coronavirus (COVID-19) infection or for COVID-like illness. a. Long-term care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/ltc/covid19/index.html b. Acute care: ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/nhsn/acute-care- hospital/covid19/index.html 6. Work with long-term care facilities to enroll the facility in the NHSN Long- term Care Facility (LTCF) COVID-19 Module. 7. Provide requested information on COVID-19 associated deaths to DSHS within three business days. C. Enhance laboratory testing and reporting capacity: 1. Establish or expand capacity to test all symptomatic individuals, and secondarily expand capacity to achieve community-based surveillance. This capacity would entail increasing testing capabilities above the current number of specimens that can be tested at the jurisdiction’s public health laboratory or by establishing new testing capabilities at the jurisdiction’s laboratory. 2. Screen for past infection (e.g., serology) for health care workers, employees of high-risk facilities, critical infrastructure workforce, and childcare providers. 3. Obtain all jurisdictional laboratory test data electronically, including from new, non-traditional testing settings, and using alternative file formats (e.g., .csv or .xls) to help automate. In addition to other reportable results, this should include all COVID-19 – related testing data, including all tests to detect severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2) and serology testing. 4. Report all COVID-19 – related line level testing data (negatives, positives, indeterminants, serology) daily to DSHS. Data must meet new federal Coronavirus AID, Relief, and Economic Security (CARES) Act laboratory guidance. All public health data must be reported electronically to DSHS in compliance with the Texas Administrative Code and within appropriate reporting timeframes. D. Prevent and control COVID-19 in healthcare settings and protect other vulnerable or high-risk populations: 1. Assess and monitor COVID-19 infections in healthcare workers across the healthcare spectrum. 2. Perform infection control assessments using preparedness tools approved by DSHS to ensure interventions are in place to protect high-risk populations. 3. Monitor and help implement mitigation strategies for COVID-19 in all high- risk healthcare facilities (e.g., hospitals, dialysis clinics, cancer clinics, nursing homes, and other long-term care facilities, etc.). 4. Monitor and help implement mitigation strategies for other high-risk employment settings (e.g., meat processing facilities), and congregate living settings (e.g., prisons, youth homes, shelters). a. This includes coordinating with the Texas Department of Criminal Justice when individuals are released from serving their prison term and will be returning to the jurisdiction. These individuals may have been exposed to COVID-19 while in prison and/or may be COVID-positive and require additional public health follow-up. E. Monitor and mitigate COVID-19 introductions from connected jurisdictions (i.e., neighboring cities, states; including air travel). F. Work with healthcare system to manage and monitor system capacity. 1. Assess and monitor the number and availability of critical care staff, necessary PPE and potentially life-saving medical equipment, as well as access to testing services. 2. Leverage NHSN data to monitor healthcare worker staffing, Patient Impact, Hospital Capacity, and healthcare (PPE, PAPRs, ventilators, etc.) supplies. Grantee will request access to the NHSN database within 30 days of the execution of this Contract or 30 days of hire for the position completing the data entry. Upon access approval, Grantee will review available NHSN data (at least monthly) to assess gaps in the healthcare system. G. Improve understanding of jurisdictional communities with respect to COVID-19 risk. Grantee must build an understanding of population density and high-risk population density (i.e., population of >65 yrs., proportion of population with underlying conditions, households with limited English fluency, healthcare seeking behavior, populations without insurance and those below poverty level). H. Submit a monthly report on the report template to be provided by the DSHS. Monthly reports are due on or before the 15th of each month. Each report must contain a summary of activities that occurred during the preceding month for each activity listed above in Section I, A through G. Submit monthly reports by electronic mail to ▇▇▇▇▇.▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇. The email “Subject Line” and the name of the attached file for all reports should be clearly identified with the Grantee’s Name, Contract Number, IDCU/COVID and the month the report covers. I. May use funds to pay pre-award costs which date back to January 20, 2020, that are directly related to the COVID-19 outbreak response. All pre-award costs must be approved in writing by DSHS. J. Not use funds for research, clinical care, fund raising activities, construction or major renovations, to supplant existing state or federal funds for activities, or funding an award to another party or provider who is ineligible. Other than normal and recognized executive-legislative relationships, no funds may be used for: 1. Publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body; 2. The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative act or Executive order proposed or pending before any legislative body.