HomeMy WebLinkAboutUNIVERSITY OF CALIFONIA IRVINEINSURANCE ON FILE
N VVO PH MAY PROCEED A-2021-131-02
uaE: AGREEMENT FOR USE OF
THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES OFFICE OF
0'-6Ak6(0r, RU1140,11) yZXkJ MINORITY HEALTH GRANT FUNDS
This Agreement is hereby made and entered into this 9-M day ofSept. 2021, by and between
the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution
and laws of the State of California ("CITY"), and The Regents of the University of California, on behalf of its
hvine campus, a corporation of the State of California with an office located at 160 Aldrich Hall , Irvine, CA
92697-7700 ("SUBRECH31ENT").
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A. The CITY, as an entitlement recipient and grantee of the United States Department of Health and Human
Services ("HHS") Office of Minority Health ("OMH") Grant Fund Program, Funding Opportunity Number
MP-CPI-21-006 and Federal Award Identification Number (FAIN) CPIMP211286, desires to enter into this
Agreement with the SUBRECIPIENT for the expenditure of OMH FUNDS in accordance with the authority
of 42 U.S.C. § 300u-6 (Section 1707 of the Public Health Service Act), 45 CFR Part 75 and the Coronaviras
Response and Relief Supplemental Appropriations Act, 2021 (P.L. 116-260) ("OMH REGS").
B. The SUBRECIPIENT is a public nonprofit corporation that has been selected by the CITY to receive
OMH FUNDS and administer such financial assistance; and to provide the services described in Exhibit A, in
accordance with the Schedule of Performance included therein, hereinafter referred to as "said program".
SUBRECIPIENT represents that it is qualified and willing to operate said program and certifies that the
activities carved out with funds provided under this Agreement will meet one or more of the HEAL-OC
program's National Objectives.
C. CITY and SUBRECIPIENT, along with other participating entities, executed a Memorandum of
Understanding dated August 31, 2021, outlining the requirements of the HEAL-OC grant program and
committing each entity to work cooperatively to adhere to the HEAL-OC grant program requirements.
D. SUBRECIPIENT agrees that it will adhere to the performance measurements and outcomes as
indicated on Exhibit A (Schedule of Performance). Failure to follow the measurements and meet the stated
outcomes may constitute breach of contract that could result in termination of this Agreement or serve as
reason for the City to recapture the grant funds awarded to SUBRECIPIENT pursuant to this Agreement.
WHEREFORE, it is agreed by and between the parties that the foregoing Recitals are a substantive
part of this Agreement and the following terms and conditions are approved and together with all exhibits and
attachments hereto, shall constitute the entire Agreement between the CITY and SUBRECIPIENT:
L SUBRECIPIENT'S OBLIGATIONS
A. Nonprofit Status - Representations and Warranties
(a) Authority. SUBRECIPIENT is a duly organized and existing nonprofit corporation in good
standing and authorized to do business under the laws of the State of California. SUBRECIPIENT has full
right, power and lawful authority to accept the funding hereunder and to undertake all obligations as
provided herein and the execution, performance and delivery of this Agreement by SUBRECIPIENT has
been fully authorized by all requisite actions on the part of SUBRECIPIENT.
(b) Experience. SUBRECIPIENT is a qualified provider of the services to be provided hereunder.
(c) Familiarity With Services Required, By executing this Agreement, SUBRECIPIENT
warrants that (i) it has thoroughly investigated and considered the services to be performed and provided
hereunder, (ii) it has carefully considered how the services should be pet -formed, and (iii) it fully
understands the facilities, difficulties and restrictions attending performance of the services under this
Agreement.
(d) No Conflict. To the best of SUBRECIPIENT'S knowledge, SUBRECIPIENT'S execution,
delivery and performance of its obligations under this Agreement will not constitute a default or a breach
under any contract, agreement or order to which SUBRECIPIENT is a party or by which it is bound,
(e) No Bankruptcy, SUBRECIPIENT is not the subject of any current or threatened bankruptcy
proceeding.
(I) No Pending Legal Proceedings. SUBRECIPIENT is not the subject of a current or threatened
litigation that would or may materially affect SUBRECIPIENT'S performance under this Agreement.
(g) Application Veracity. All provisions of and information provided in SUBRECIPIENT'S
application for funding submitted to CITY, including any exhibits, are true and correct in all material
respects.
(h) No Pending Investigation, SUBRECIPIENT has no knowledge that it is the subject of any
current or threatened criminal or civil action investigation by any public agency, including without
limitation a police agency or prosecuting authority, that would relate to or affect performance of the
Agreement or provision of services hereunder,
B. AnIpun t.___of _ Granti7erru and Quarterly „ Disbursement, The amount granted to
SUBRECIPIENT is $689,804 ("OMHFUNDS"), for the two-year term from July 1, 2021 through June 30,
2023 for the program named; Health Equity and Literacy in OC (HEAL-OC). Such funds shall be
expended by SUBRECIPIENT on or before June 30, 2023. The Term of this Agreement may be extended
by a writing executed by the City Manager, or his or her designee, and the City Attorney. The OMH FUNDS
shall be disbursed by CITY to SUBRECIPIENT on a quarterly basis subject to and upon receipt and
approval of a complete quarterly activity report from SUBRECIPIENT, with the final payment subject to
the satisfaction of the condition precedent of submittal of complete reporting information due on or before
July 15 of the applicable funding year, as hereinafter more fully set forth. SUBRECIPIENT shall be
obligated to perform such duties as would norinally extend beyond the terin, including, but not limited to,
obligations with respect to indemnification, audits, reporting, data retention/reporting, and accounting.
.Failure to provide any of the required documentation and reporting will cause CITY to withhold all or a
portion of a request for reimbursement, or return the entire reimbursement package to SUBRECIPIENT,
until such documentation and reporting has been received and approved by CITY.
The CITY reserves the right to reduce the amount of OMH FUNDS to SUBRECIPIENT, or to
completely terminate thisAgreement, in theCITY's sole discretion, if there is a reduction In OMH FUNDS
provided to the CITY for program year 2021-2022 or 2022-2023,
The CITY reserves the right to reduce the grant application if the CITY's fiscal monitoring indicates
that SUBRECIPIENT's rate of expenditure will result in unspent funds at the end of the program years.
Amendments in the grant allocation will be made after consultation with SUBRECIPIENT,
C. Use of Funds. SUBRECIPIENT agrees to use all federal funds provided by CITY to
SUBRECIPIENT pursuant to this Agreement to operate said program, as set forth in "Exhibit A," attached
hereto and by this reference incorporated herein. SUBRECIPIENT'S failure to porfort-A as required may, in
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addition to other remedies set forth in this Agreement, result in readjustment of the amount of funds CITY is
otherwise obligated to pay to SUBRECIPIENT hereunder.
D. Allowable Costs. SUBRECIPIENT agrees to complete said program on or before June 30,
2023, and to use said funds to pay for necessary and reasonable costs allowable under the federal law and
regulations to operate said program. Said amounts shall include, but not be limited to, wages, administrative
costs, and employee benefits comparable to other similarly situated employees, and indirect costs, Other
allowable program costs are detailed in the budget, as set forth in 'Exhibit B,` attached hereto and by this
reference incorporated herein. SUBRECIPIENT shall use all income received from said funds only for the
same purposes for which said funds pray be expended pursuant to the terms and conditions of this Agreement.
SUBRECIPIENT has the ability to adjust line item amounts in the budget with the written approval of the
CITY's City Manager or designee, so long as the total budget amount does not increase.
Pursuant to 45 CFR Part 75 the Indirect Cost Rate for the SUBRLCIPIENT's award shall be an
approved federally recognized indirect cost rate negotiated between the SUBRBClPIENT and the'Federal
government, or, if no such rate exists, the do minimis indirect cost rate as defined in 2 CFR §200.414(b)
Indireot (F&A) costs.
For this agreement, the de: minimis indirect cost rate of 10% will apply.
E. Licensing, SUBRECIPIENT agrees to obtain and maintain all required licenses, registrations,
accreditation and inspections from all agencies governing its operations. SUBRECIPIENT shall ensure that its
staff shall also obtain and maintain all required licenses, registrations, accreditation and inspections from all
agencies governing SUBRECIPIENT's operations hereunder, Such licensing requirements include obtaining
a City business license, as applicable.
F. .Zoning. SUBRECIPIENT agrees that any facility/property used in furtherance of said
program shall be specifically zoned and permitted for such use(s) and activity(ies). Should SUBRECIPIENT
fail to have the required land entitlement and/or permits, thus violating any local, state or federal rules and
-regulations relating thereto, SUBRECIPIENT shall immediately make good -faith efforts to gain compliance
with local, state or federal rules and regulations following written notification of said violation(s) from the
CITY or other authorized citing agency. SIJBRECIIJEW shall notify CITY immediately of any pending
violations. Failure to notify CITY of pending violations, or to remedy such known violation(s) shall result in
termhation of grant funding hereunder. SUBRECIPIENT must make all corrections required to bring the
faoility/property into compliance with the law within sixty (60) days of notification of the violation(s), failure
to gain compliance within such time shall result in termination of grant funding hereunder.
Cr. .Separation of Accounts. All funds received by SUBRECIPIENT from CITY pursuant to this
Agreement shall be maintained in an account in a federally insured banking or savings and loan institution with
record keeping of such accounts maintained pursuant to applicable 45 CFR Part 75 requirements.
SUBRECIPIENT is not required to maintaia separate depository accounts for HEAL-OC FUNDS; provided
however, the SUBRECIPIENT must be able to account for receipt, obligation and expenditure of H> AL-OC
FUNDS pursuant to applicable 45 CFR Part 75 requirements.
H. Audit Report Requirements. SUBRECIPIENT agrees that if SUBRECIPIENT expends
Seven Hundred Fifty Thousuad Dollars ($750,000) or more in federal funds, SUBRECIPIBNT shall have an
annual audit conducted by a certified public accountant in accordance with the standards as set forth and
published by the United States Office of Management and Budget. SUBRECIPIENT shall provide CITY with
a copy of said audit by April I of the year following the program year in which this Agreement is executed.
I. Repord I cg in Re ordn . SUBRBCIPIE:NT shall keep and maintain complete and adequate
records and reports on program participants to determine their initial and continuing eligibility for the program
services being provided to assist CITY in meeting and maintaining its record keeping responsibilities under the
OMH RUGS, including the following:
(1) Records
a. Documentation of the number of persons and/or families participating in or benefiting by
the SUBRECIPIENT program,
b. Household information shall include number of persons, identification of head of
household, racelethnicity, and income verification of all household members ages 18 and over.
c. Documentation of all OMH FUNDS received from CITY.
d, Documentation of expenses as identified in the Budget Proposal, including evidence of
incurring the expense, invoices for goods or services, copies of any and all contracts or documentation
pertaining to costs for subcontractors, plus all other invoices and proof of payment for which OMH
FUNDS were expended, and any payments therefor.
e. Any such other related records as CITY shall reasonably require or as required to be
maintained pursuant to the OMH REGS.
(2) Re orts
a. Payment Request. Concurrently with the submittal of oach quarterly report, on or before
the 15th day of October, January, April and July, SUBRECIPIENT shall submit both: an original
invoice/request for reimbursement and true copies of invoices, receipts, canceled checks, bank
statements, credit card statements, procurement documentation for goods or services, timesheets,
payroll records, benefit statements, agreements, contracts or documentation pertaining to costs for
subcontractors, and/or other documentation supporting and evidencing how the OMH FUNDS have
been expended during the applicable quarter.
b. Quarterly Progress Report, SUBRECIPUNT agrees to keep records of all ethnic and
racial statistics of persons and families benefited by SUBREC1PIEiNT in the performance of its
obligations under this Agreement, including, but not limited to, new program information and year-
to-date program statistics on expenditures, caseload and activities, Failuro to provide any of the
required documentation and reporting will cause CITY to withhold all or a portion of a request for
reimbursement, or return the entire reimbursement package to SUBRECIPIBNT, until such
documentation and reporting has been received and approved by CITY.
J. Access to Records. CI"1"Y and the United States Govortunent and their representatives or
auditors shall have access for purposes of monitoring, auditing, and examining SUBRECIPIBNT's activities
and performance, to books, documents and papers, acid the right to examine records of SUBRECIPIENT's
subcontractors, bookkeepers and accountants, employees and participant's in regard to said program, CITY
and the United States Government Arid their representatives or auditors shall also schedule on -site
monitoring at their discretion. Monitoring activities may also include, but are not limited to, questioning
employees and participants in said program and entering any premises or any site in which any of the
services or activities funded hereunder is conducted or in which any of the records of SUBRBCIPIENT are
kept. Nothing herein shall be construed to require access to any privileged or confidential information as
set forth in federal or state law.
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K, Location of Recards/Rettuired Length of Record Keeping, All accounting records, reports,
and evidence pertaining to all costs, expenses and the OMH FUNDS of SUBRECIPIENT and all documents
related to this Agreement shall be maintained and Icept available at SUBRECIPTENT'S office or place of
business for the duration of the Agreement and thereafter for three (3) years from the date of final payment
under this Agreement. Records which relate to (a) complaints, claims, administrative proceedings or
litigation arising out of the performance of this Agreement, or (b) costs and expenses of this Agreement to
which CITY or any other governmental agency take exception, shall be retained beyond the five (5) years
until complete resolution or disposition of such appeals, litigation claims, or exceptions. In the event
SUBRLCIPIBNT does not make the above -referenced documents available within the city of Santa Ana,
California, SUBRECIPIENT agrees to pay all necessary and reasonable expenses incurred by CITY in
conducting any audit at the location where said records and books of account are maintained.
L. Compliance with Law/Program Income. SUBRECIPIENT acknowledges that the funds being
provided by CITY for said program are received by CITY pursuant to the ACT as amended and that
expenditures of these funds shall be in accordance with the ACT and all pertinent regulations issued by agencies
of the federal government, including, but not limited to, all regulations found at Title 45 of the Code of Federal
Regulations, Program income received by SUBRECIPIENT shall be returned to CITY unless otherwise
provided for in this Agreement. SUBRECIPIENT agrees to comply fully with all federal, state and local laws
and court orders applicable to its operation whether or not referred to in this Agreement.
M. Debarment. To protect the public interest and ensure the integrity of Federal programs,
CITY may only conduct business with responsible persons and may not make any award or permit any
award to any party which is debarred or suspended or is otherwise excluded from or -ineligible for
participation in Federal assistance programs under Executive Order 12549, "Debarment and Suspension".
See also 24 CFR 570.609, SUBRECIPIENT must review and sign Exhibit C "Debarment", which is
attached hereto and incorporated hereui by this reference. SU13RECIPIBNT shall be in good standing,
without suspeasiout by the California Secretary of State, Franchise Tax Board and Internal Revenue Service.
Any change in the corporate status or suspension of SUBRECIPIENT shall be reported immediately to CITY.
N. Confidentiality, 'Without prejudice to any other provisions of this Agreement,
SUBRECIPIENT shall, where applicable, maintain the confidential :nature of information provided to it
concerning participants in accordance with the requirements of federal and state law. However,
SURRECIPI.CNI` shall submit to CITY and or OMH or its representatives, all records requested, including
audit, examinations, monitoring and verifications of reports submitted by SUBRECIPIENT, costs incurred and
services rendered hereunder.
O. Independent Contractor. SUBRECIPiENT agrees that the performance of obligations
hereunder is rendered in its capacity as an independent contractor and that it is in no way an agency of CITY.
P. Violation ofTenns and Conditions, SUBRLCIPIENT agrees that if SUBRECIPIENT violates
any of the terms and conditions of this Agreement or any prior Agreement whereby OMII FUNDS were
received by SUBRECIPIBNT, or if SUBRECIPIENT reports inaccurately, or if on audit there is a disallowance
of certain expen&ures, SUBRECIPIENT agrees to remedy the acts or omissions causing the disallowance and
repay CITY all amounts spent in violation thereof. If SUBRECII' ENT engaged in fraudulent activity to obtain
and/or justify expenditure of the OMH FUNDS .granted hereunder, SUBRECIPMNT shall be required to
reimburse the CITY of all such funds that were obtained and/or spent under fraudulent circumstances.
Q. Fouipm.ent. SUBRECIPTENT agrees to maintain a record for each item of non -expandable
personal property acquired under the terms of this Agreement. Said record shall be made available to CITY
upon request. The terns "non -expendable personal property" shall include leased and purchased equipment.
R. Prohibited Use. SUBRECIPIENT hereby certifies and agrees that it will not use funds
provided through this Agreement to pay for entertainment, meals or gifts, or other prohibited uses,
S. Lobbying, SUBRECIPIENT certifies that it will comply with federal law (31 U.S.C. 1352)
and regulations found at 45 CFR Part 75, which provide that no appropriated funds may be expended by the
recipient of a federal contract, grant, loan or cooperative agreement to pay any person for influencing or
attempting to influencer an officer or employee of any agency, Member of Congress„ or an officer or employee
of a Member of Congress in connection with awarding of any federal contract, the making of any federal grant
or loan, entering into any cooperative agreement and the extension, renewal, amendment or modification of
any federal contract, grant, loan or cooperative agreement. SUBRECIPIENT shall sign a certification to that
effect in a form as set forth in "Exhibit D," attached hereto and by this reference incorporated herein.
SUBRECIPIENT shall submit said signed certif cation to CITY prior to performing any ofits obligations under
this Agreement and prior to any obligation arising on the part of CITY to pay any sums to SUBRECIPMNT
under the terms and conditions of this Agreement.
If any (ands 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 Mernber of Congress, an
officer or employee 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 a "Disclosure Form .
to Report Lobbying," In accordance with its instructions (Exhibit D).
SUBRECIPIENT shall require that the language of this certification be included in the award
documents for all sub -awards at all tiers (including subcontractors, sub -grants, and contracts under grants,
loans, and cooperative agreements), and agrees to take all actions necessary to ensure that all subrecipients shall
similarly cortify and disclose accordingly.
T. Financial Interest SUBRECIPIENT agrees that except for the use of OMII FUNDS to pay
salaries and other related administrative or personnel costs, no persons who exercise or have exercised any
function with respect to OMI4 activities assisted under the terms of this Agreement, or who are in a position
to participate in a decision -making process or gain inside information with regard to such activities, inay
obtain a financial interest or benefit from a OMI3-assisted activity of SUBRECIPIENT, either for
themselves or those with whom they have family or business ties, during their tenure ar for one year
thereafter. This prohibition applies to any person who is an employee, agent, consultant, officer, or elected
or appointed official of CITY, or of any designated public agency, or the SUBRECIPIENT.
U. Labour Standards. The SUBRECIPIENT agrees to comply with the requirements of the
Secretary of La or in accordance with the Davis -Bacon Act as amended, the provisions of Contract Work
Hours and Safety Standards Act (40 U.S.C. 327 et seq) and all other applicable Federal, state and local
laws and regulations pertaining to labor standards insofar as those acts apply to the performance of this
Agreement. The SUBRECIPIENT agrees to comply with the Copeland Anti -Kick Back Act (18 U.S.C, 874
et seq.) and its implementing regulations of the U.S, Department of Labor at 29 CFR Part 5. The
SUBRECIPIENT shall maintain documentation that demonstrates compliance with hour and wage
requirements of this part. Such documentation shall be made available to the CITY for review upon request.
V. Druiz Free Workplace. SUBRBCIPIENT agrees to provide a drug -free work place and to execute
a certification as set forth in "Exhibit E" attached hereto and incorporated herein by this reference.
II. CITY'S OBLIGATIONS
A. Payment of Funds. On July 20, 2021, tho CITY was allocated $4,000,000 from the United States
Department of Health and Human Services ("HHS") Office of Minority Health Grant ('OMH") program.
Subject to the terins of this Agreement, CITY agrees to pay to SUBRECIPIENT when, if and to the extent
federal funds are :received a sum not to exceed SIX HUNDRED AND EIGHTY NINE THOUSAND EIGHT
HUNDRED AND FOUR DOLLARS ($689,804) for SUBRECIPIENT'S performance in accordance with the
Budget attached hereto as "Exhibit B" during the two-year period of this Agreement. Payments shall be made
to SUBRBCIPIENT through the submission ofinvoices/reimbursement requests,
CITY shall pay such invoices/rei:tubursemeat requests within thirty (30) days after receipt thereof
provided CITY is satisfied that such expenses have been incurred and documented within the scope and
provisions of this Agreement and that SUBRECIPIENT is in compliance with the terms and conditions of
this Agreement. Failure to provide any of the required documentation and reporting , dill, cause CITY to
withhold all or a portion of a request for reimbursement, or return the entire reimbursement package to
SUBRECIPMNT, until such documentation and reporting has been received and approved by CITY.
Documentation may include, but is not limited to, true copies of invoices, receipts, canceled checks, bank
statements, credit card statements, procurement documentation for goods or services, timesheets, payroll
records, benefit statements, agreements, contracts or documentation pertaining to costs for subcontractors,
and/or other documentation supporting and evidencing how the CMH FUNDS have been expended during
the applicable quarter,
B. Audit of Account. CITY shall include an audit of the account maintained by SUBRECIPIENT
in CITY's annual audit of all HEAL-OC FUNDS in accordance with Title 45 of the Code of Federal
Regulations and other applicable federal laws and regulations.
C. Common Rule: Pursuant to AS CFR Part 75, the CITY manages the day today operations of each
grant and subgrant supported activities. CITY staff has detailed knowledge of the grant program requirements
and monitors grant and subgrant supported activities to assure compliance with Federal requirements. Such
monitoring covers each program, function and activity and performance goals are reviewed periodically.
D. _Environmental Review: In accordance with 45 CFR Part 75, the CITY is responsible for
undertaking environmental review and maintaining environmental review records for each applicable
project,
E. Performance Monitoring: CITY shall monitor the performance of SUBRECIPIEMI' against
goals and performance standards required herein. The SUBRECIPIENT shall be responsible to accomplish
the levels of performance as set forth in Exhibit A and report such measures quarterly to the CITY. If the
SUBRECIPIENT estimates such goals will not be inct, the SUBRECIPIENT is to contact the CITY, at
which time the CITY will determine if any adjustments to the grant award is appropriate. Substandard
performance as determined by the CITY will constitute non-compliance with this Agreement. Should the
CITY determine that the SUBRECIPIENT has not performed its obligations as stated in this contract in a
satisfactory manner, or if the CITY determines that insufficient supporting information has been submitted,
the CITY shall notify the SUBRECIPIENT in writing of its determination specifying in full detail the
objections which it has to the SUBRECIPIENT's perfornianw. If action to correct such substandard
performance is not taken by the SUBRECIPIENT after being notified by the CITY, within a reasonable
period of time as stipulated in the written notification, contract suspension or termination procedures will
be initiated.
III. 1V ONDIS CRiM [NATION
A. SUBRECIPIENT agrees to comply with Executive Order 11246 which requires that during the
performance of this Agreement, SUBR TMPIENT agrees not to discriminate against any employee or applicant
for employment because of race, religion, sex, color or national origin. Such action shall include, but not be
limited to the following: employment, upgrading, demotion, or transfer, rates of pay or other forms of
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compensation, and selection for training, including apprenticeship. SUBRECIPIENT agrees to post in
conspicuous places, available to employees and applicants for employment, notices to be provided by the
SUBRECIPIENT setting forth the provisions of this nondiscrimination clause.
13, SUBRECIPIENT agrees to comply with Title VI of the Civil Rights Act of 1964 which indicates
that no person shall, on the ground of race, color or national origin, be excluded from participation in, be denied
the benefits of, or be subject to discrimination under any program of activity receiving federal financial
assistance,
C. No persot shall, on the grounds of race, sex, creed, color, religion, marital status, national origin,
age, sexual orientation, or physical or wontal handicap be excluded from participation in, he refused the benefits
of, or otherwise be subject to discrimination in any activities, programs or employment supported by this
Agreement. SUBRECIPIENT is prohibited from discrimination on the basis of age or with respect to an
otherwise qualified handicapped person as provided for under Section 109 of the Housing and Community
Development Act of 1974, as amended.
D. SUBRECIPIBNT agrees to comply with the Age Discrimination Act of 1975 which requires that
during the performance of this Agreement, SUBRECIPIENT agrees not to discrimutate against arty employee
or applicant for employment because of age. Such action shall include, but not be limited to the following:
employment upgrading, demotion, or transfer, rates of pay or other forms of compensation, and selection for
training, including apprenticeship. SUBRECIPIENT agrees to post in conspicuous places, available to
employees and applicants for employment, notices to be provided by the "RECIPIENT setting forth the
provisions of this age discrimination clause.
E. SUBRECIPIENT agrees to comply with ,Section 504 of the Rehabilitation Act of 1973 which
requires that no otherwise qualified individual with a disability in the United States, shall, solely by reason of
his or her disability, be excluded from the participation in, be denied the benefits of, or be subjected to
discrimination under any program or activity receiving federal financial assistance or under any program or
activity conducted by any executive agency or by the United States Postal Service.
TV. CONFLICT OF INTEREST
Pursuant to the conflict of interest requirements set forth in 45 CPR Part 75, SUBRECIPIENT
certifies that no member, officer, employee, agent or assignee of CITY having direct or indirect control of any
OMH monies granted to the CITY, inclusive of the subject OMH FUNDS, shall serve as an officer of.
SUBRECIPIENT. Further, any conflict or potential conflict of interest of any officer of SUBRECIPMMI` shall
be fully disclosed in writing prior to the execution of this Agreement and said writing shall be attached and
deemed fully incorporated as a part hereof. Notice shall be sent by SUBRECIPIENT to CITY regarding any
changes or modifications to its board of directors and list of officers.
V. SPECIAL CERTIFICATION FOR RELIGIOUS ENTITIES
If SUBRECIPIENT is a religious entity, SUBRECIPIENT hereby agrees that in connection with the
provision of the services SUBRECIPIENT shall provide with OMH FUNDS, in accordance with 45 CFR fail:
75:
A. SUBRECIPIENT shall not discriminate against any employee or applicant for employment on the
basis of religion and shall not limit employment or give preference iri employment to persons on the basis of
religion.
B. SUBRECIPIENT shall not discriminate against any person applying for the services
SUBRECIPIENT agrees to provide under the teens of this Agreement on the basis of religion and shall not
limit such services or give preference to applicants for such services on the basis of religion.
C. SUBRECIPIENT shall NOT provide religious instruction or counseling, conduct any religious
worship or services, or engage in any religious proselytizing„ or exert any religious influence in the provision
of the services in said program. The parties agree that this covenant is intended to and shall be construed for
the limited purpose of assuring compliance with respect to the use of CITY funds by SUBRECIPIENT with
applicable constitutional litnitations respecting the establishment of religion as set forth in the establislunont
clause corder the First ,Amendment of the United States Constitution and Article I, Section 4 of the California
Constitution, and is not in any manner intended to restrict other activities of SUBRECIPIENT.
D. The portion of a facility used to provide public services assisted in whole or in part under this
Agreement shall contain no sectarian or religious symbols.
B, Where the services to be provided under said program are tendered on property owned by the
primarily religious entity SUBRECIPMNT, OMH FUNDS may also be used for minor repairs to such property
which are directly related to the cost of rendering the services under said program, where the cost constitutes
in dollar terms only an incidental portion of the OMH expenditure for rendering the services under said
program.
VI, PRO1111BITION Or NEPOTISM
SUBRECIPIENT agrees not to hire or permit the hiring of any person to fill a position funded through
this Agreement if a member of that person's inunediate family is employed in an administrative capacity by
SUBRECIPIENT. For the purposes of this section, the term "immediate fancily" means spouse, child, mother,
father, brother, sister, brother-in-law, sister-in-law, father-in-law, mother-in-law, son-in-law, daughter -ire -law,
aunt, uncle, niece, nephew, stepparent and stepchild. The tertn "administrative capacity" means having
selection, hiring, supervisor or management responsibilities.
VII. NOTICES
Notices to the parties shall, unless otherwise requested in writing, be sent by U.S. Mail, postage
prepaid, and addressed as follows:
TO CITY: City of Santa Area
City Manager's Office (M-31)
20 Civic Center Plaza
P.O. Box 1988
Santa Ana, California 92702-1988
TO SUBRECIPIENT: The Regents of the University of California
Office of Research
160 Aldrich Hall
Irvine, CA 92697-7600
Attention: Wanda Seang, Ancillary Agreements Officer
VIII. ASSIGNABTLITY
None of the duties of, or work to be performed by, SUBRECIPIENT under this Agreement shall be
subcontracted or assigned to any agency, consultant, or person without the prior written consent of both Parties,
SUBRECIPIENT trust submit all subcontracts and other agreements that relate to this Agreement to CITY.
No subcontract or assignment shall terminate or alter the legal obligations of SUBRECIPIENT pursuant to this
Agreement,
IX. HOLD HARMLESS
To the extend allowed by United States federal, state, and local law, SUBRECIPMW shall indemnify,
defend and save harmless CITY, its officers, employees, agents, representatives and volunteers from and
against any and all claims, damages to or for loss of use of property and for injuries to or death of any person
or persons, including property and employees or agents of CITY arising out of its performance of this
Agreement but only in proportion to and to the extent such liability, loss for use of property, expense, injuries
are caused by ox result from the negligent or intentional acts or omission of the Subrecipient, its officers, agents,
employees, representatives and volunteers. Claims, demands, suits, actions or proceedings of any kind or
nature, includes, but not by way of limitation, workers compensation claims and including attorney fees and
reasonable expenses for litigation or settlement, resulting from or arising out of the negligent or wrongful acts,
errors or omissions of SUBRECIPIENT, its officers, directors, employees, agents, subcontractors and suppliers
arising out of SUBRECIPMNT"s performance of this Agreement.
To the extend allowed by United States federal, state, and local law, City shall indemnify, defend and
save harmless Subrecipient, its officers, employees, agents, representatives and volunteers from and against
any and all claims, damages to or for loss ofuse of property and for injuries to or death of any person or persons,
including property and employees or agents of Subrecipient arising out of its performance of this Agreement
but only in proportion to and to the extent such Iiability, loss for use of property, expense, injuries are caused
by or result from the negligent or intentional acts or omission of the Subrecipient, its officers, agents,
employees, representatives and volunteerrs. Claims, demands, suits, actions or proceedings of any kind or
nature, includes, but not by way of limitation, workers compensation claima and including attorney fees and
reasonable expenses for litigation or settlement, resulting from or arising out of the negligent or wrongful acts,
errors or omissions of CITY, its officers, directors, employees, agents, subcontractors and suppliors arising out
of CITY's performance of this Agreement.
►M§1LNAVM"V
SUBRECIPIENT shall procure and maintain for the duration of the contract insurance against
claims for injuries to persons or damages to property which may arise from or in connection with the
performance of the work hereunder by the SUBRECIPIENT, its agents, representatives, employees or
subcontractors.
a. MINIMUM SCOPE AND LIMIT OF INSURANCE Coverage shall be at least as broad as:
1. Commercial General Liability (CGL): Insurance Services Office Form CG 00 01
covering CCL on an "occurrence" basis, including products and completed operations,
property damage, bodily injury and personal & advertising injury with limits no less
than $1,000,000 per occurrence. If a general aggregate limit applies, either the general
aggregate limit shall apply separately to this project/location (ISO CG 25 03 or 25 04)
or the general aggregate limit shall be twice the required occurrence lunit.
2. Automobile Liability: Insurance Services Office Form Number C,A. 00 01 covering
Code 1 (any auto), or if SUBRECIPIENThas no owned autos, Code 8 (hired) and 9
(non -owned), with limit no less than $1,000,000 per accident for bodily injury and
property damage. (Not required if SUBRECIPIENT does not use an automobile to
perform services,)
10
3. Workers' Compensation: insurance as required by the State of California, with
Statutory Limits, and Employer's Liability Insurance with limit of no less than
$1,000,000 per accident £orbodily injury or disease. (Not required if SUBRL-CII'IENT
provides written verification it has no employees.)
4. Professional Liability (Errors and Omissions): insurance appropriate to the
SUBRECIPIENT's profession, with limit no less than $1,000,000 per occurrence or
claim, $2,000,000 aggregate,
5. If the SUBRECIPIENT maintains broader coverage and/or higher limits than the
minimunis shown above, the City requires and shall be entitled to the broader coverage
and/or the higher limits maintained by the SUBRECIPIENT. Any available insurance
proceeds in excess of the specified minimum limits of insurance and coverage shall be
available to the City.
b. Other Insurance provisions — The insurance policies are to contain, or be endorsed to contain,
the following provisions:
1, Additional -Insured Status; The City, its officers, officials, employees, and volunteers
are to be covered as additional insureds on the CGI, policy with respect to liability
arising out of work or operations performed by or on behalf of the SUBRECIPIENT
including materials, parts, or equipment furnished in connection with such work or
operations. General liability coverage can be provided in the forin of an endorsement
to the SUBRECIPIENT's insurance (at least as broad as ISO Form CG 20 10 1185 or
both CG 2010, CG 20 26, CG 20 33, or CG 20 38; and CG 20 37 forms if later revisions
used).
2. Prinwry Coverage: For any claims related to this contract, the SUBRECIPIENT's
insurance coverage shall be primary coverage at least as broad as ISO CG 20 01 04 13
as respects the City, its officers, officials, employees, and volunteers. Any insurance
or self-insurance maintained by the City, its officers, officials, employees, or
volunteers shall be excess of the SUBR) CIPIENT's insurance and shall not contribute
with it.
3. RBSEIIVED
4. Waiver of Subrogation: SUBRECIPIENT hereby ,grants to City a waiver of any right
to subrogation which any insurer of said SUBRECIPIENT may acquire against the
City by virtue of the payment of any loss under such insurance. SUBRECIPIENT
agrees to obtain any endorsement that may be necessary to affect this waiver of
subrogation, but this provision applies regardless of whether or not the City has
received a waiver of subrogation endorsement from the insurer,
5. Self -Insured Retentions: Self -insured retentions must be declared to and approved by
the City. The City may require the SUBRECIPIENT to purchase coverage with a lower
retention or provide proof of ability to pay losses and related investigations, claim
administration, and defense expenses within the retention. The policy language shall
provide, or be endorsed to provide, that the sell: -insured retention may be satisfied by
either the named insured or City.
6, Acceptability of1murers: Insurance is to be placed with insurers authorized to conduct
business in the state with a current A.M. Best's rating of no less than ANJI, unless
otherwise acceptable to the City.
7. Chinas Made Policies: If any of the required policies provide coverage on a claims -
made basis:
11
1. The Retroactive Date must be shown and must be before the date of the
contract or the beginning of contract work,
2. Insurance must be maintained and evidence of insurance must be provided for
at least five (5) years after completion of the contract of work,
3, If coverage is canceled or non -renewed, and not replaced with another claims -
made policy form with a Retroactive Date prior to the contract effective date,
the SUBRECIPIENT must purchase "extended reporting" coverage for a
minimum of five (5) years after completion of contract work.
8. Verification of Coverage; ,SUBRECIPIENT shall furnish the City with original
Certificates of Insurance including all required amendatory endorsements (or
copies of the applicable policy language affecting coverage required by this
clause) and a copy ofthe Declarations and Endorsement Page of the CGL policy
listing all policy endorsements to City before work begins. However, failure to
obtain the required documents prior to the work beginning shall not waive the
SUBRBCIPMNT's obligation to provide them, City reserves the right to require
complete, certified copies of all required insurance policies, including endorsements
required by these specifications, at any time,
9. Subcontractors; SUBRECIPIENT shall require and verify that all subcontractors
maintain .insurance meeting all the requirements stated herein.
10. Special Risks or Circumstances; City reserves the right to modify these requirements,
including limits, based on the nature of the risk, prior experience, insurer, ooverage, or
other special cireumstauces.
A. Tbis Agreement may be terminated on thirty (30) days' written notice by either party. In the event
of rich termination, SUBRECIPIENT shall only be entitled to reimbursement for approved expenses incurred
to the effective date of termination.
B. This Agreement may be suspended or terminated by CITY upon ten (10) days' written notice for
violation by SUBRECIPIENT of Federal Laws governing the use of Office of Minority Health Grant Funds.
In the event of such suspension or termination, SUBRECIPIENT shall only be entitled to reimbursernent for
approved expenses inourrod up to the effective date of suspension or termination.
C. Pursuant to 2 CFR 200.340, in the event SUBRECIPIENT defaults by failing to fulfill all or any of
its obligations hereunder, CITY may declare a default and termination of this Agtecinent by written notice to
SUBRECIPIENT, which default and termination shall be. effective on a date stated in the notice which is to be
not less than ten (10) days after certified mailing or personal service of such notice, unless such default is cured
before the effective date of termination stated in such notice, If terminated for cause, CITY shall be relieved
of further liability or responsibility under this Agreement, or as a result of the termination thereof, including
the payment of nxoney, except for payment for approved expenses incurred for services satisfactorily and timely
performed prior to the mailing or service of the notico of termination, and except for reimbursement of any
payments made for services not subsequently performed in a timely and satisfactory manner, and (2) costs
incurred by CITY in obtaining substitute performance.
D. The grant of funds under this Agreement may be terminated for convenience by either the CITY
or SUBRECIPIENT, in whole or in part, by setting forth the reasons for such termination, the effective date,
and, in the case of portion termination, their portion to be terminated, However, if in the case of a partial
12
termination, the CITY determines that the remaining portion of the award will not accomplish the purpose for
with the award was made, the CITY may terminate the award in its entirety.
E. The grant of fiends under this Agreement may be terminated due to the nog -performance of
SUBRECIPIENT and/or failure of SUBRECIPENT to perform the work described in Exhibits A and B or
failure to meet the performance standards and program goals set forth die rein,
F. The grant of -funds under this Agreement may be terminated due to the failure of the CITY to receive
sufficient or andoipated funding from HITS for the OMI-I program for any year terra subject to this Agreement.
MI. LEWIITATION OF FUNDS
TheUnited States of America, through HHS, may in the future pl ace programmatic or fiscal limitations
on the use of OWI FUNDS which limitations are not presently anticipated. Accordingly, CITY reserves the
right to revise this Agreement in order to take account of actions affecting OMH program. £tending. In the event
of funding reduction, CITY may, in its sole and absolute discretion, reduce the budget of this Agreement as a
whole or as to costs category, may limit the rate of SUBREC➢.'IENT's authority to commit and spend funds,
at may rostdot SUBRBCIPITNT's use of both its uncoirnnitted and its unspent funds, Where HHS has directed
or requested CITY to implement a reduction in funding, in whole or as to a cost category, with respect to
funding for this Agreement, CITY's City Manager or delegate is authorized to act for CITY in implementing
and effecting such a reduction and in revising, modifying, or amending the Agreement for such purposes. If
such a reduction in heading occurs, SUBRECIPIENT shall be permitted to desoope accordingly. Where CITY
has reasonable grounds to question SUBRECIPIENT's fiscal accountability, financial soundness, or
compliance with this Agreement, CITY may suspend the operation of this Agreement for up to sixty (60) days
upon five (5) days written notice to SUBRECIPIENT of its intention, to so act, pending an audit or other
resolution of such questions. In no event, however, shall any revisions made by CITY affect expenditures and
legally binding commitments made by SUBRECIPIENT before it received notice of such revision, provided
that such amounts have been committed in good faith and are otherwise allowable and (hat such commitments
are consistent with I H8 cash withdrawal guidel ne-s,
MR. EXCLUSIVITY AND AMENDMENT OF AGILE EMENT
This Agreement supet-sedes any and all other agreetnetrts, either oral or in writing, between the parties
hereto with respect to the use of CITY''s OMH FUNDS by SU$IECIPMNT and contains all the covenants
and agreemments between the parties with respect to such employment in any manner whatsoever. Each party
to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or
otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied
herein, and. that no other agreement or amendment hereto shall be effective unless oxcouted in writing and
signed by both CITY and SUBRECIPIENT.
M V. LAWS GOVERNING THIS AGREEMENT
This Agreement shall be governed by and construed in accordance with the laws of the State of
California, and all applicable federal laws and regulations.
XV. CLOSE-OUT
The SUBRECIPIENT agrees to comply with the closeout procedures detailed in 2 CPR §200,343,
including the following:
1. SUBRECIPIENT must subnut, no later than ninety (90) calendar days after, the end date
13
of the period of performance, all financial, performance, and other reports as required by the terms
and conditions of the Federal award;
2. Unless the CITY authorizes an extension, SUBRECIPIENT must liquidate all
obligations incurred sunder the Federal award not later than ninety (90) calendar days after the end
date of the period of performance as specified in the terms and conditions of the Federal award;
3. SUBRECIPIENT must promptly refund any balances of unobli"gated cash that the CITY
paid in advance or paid and that is not authorized to be retained by SUBRECIPIENT for use in
other projects (See OMB Circular A-129 and 2 CFR. §200.345);
4. SUBRECIPIENT must account for any heal and personal property acquired with Federal
funds or received from the Federal government in accordance with 2 CFR. § §200.310-200.316 and
200.329; and,
5. The CITY should complete all closeout actions for the Federal award no later than one
year after receipt and acceptance of all required final reports,
XVL YALII?ITY AND SEVERABILITY
The invalidity in whole or in part of any provision of this Agreement shall not void or affect
the validity of any other provision of this Agreement. Whenever possible, each provision of this
AGREEMENT shall be interpreted in such manner as to be effective and valid under applicable
law, but if any provision of this AGREEMENT is held to be prohibited by or invalid under
applicable law, such provision shall be ineffective only to the extont of such prohibition or
invalidity, without invalidating the remainder of such provisions of this AGREEMENT.
XVII. WAIVER
No delay or omission by either party hereto to exercise any right or power accruing upon
any noncompliance or default by the other party with respect to any of the terms of this Agrecitont
shall impair any such right or power or be construed to be a waiver thereof: A waiver by either of
the parties hereto of any of the covenants, conditions, or agreements to be performed by the other
shall not be construed to be a waiver of any succeeding breach thereof or of any other covenant,
condition or agreement herein contained.
XVIII. MISCELLANEOUS PROVISIONS
a. Each undersigned represents and warrants that its signaWre herein below has the power,
authority and right to bind their respective parties to each of the terms of this Agreement, and shall
indemnify CITY frilly, including reasonable costs and attorney's fees, for any injuries or damages to
CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn,
b. All Exhibits and Attachments referenced herein and attached hereto shall be incorporated
as if fully set forth in the body of this Agreement.
14
{Signatures on following page}
15
WW A
IN WITNESS WHEREOF, the pat -ties hereto have executed (his Agreetrient as of the last date and year written
below.
ATTEST:
DAISY GOMEZ
Clerk of the Council
APPROVE D AS TO FORM:
SONIA R. CARVALTIO
City Attorney
By: PAY N UJHODGE
Assistant'6ty Attorney
SUB RECFPIENT-.
Wanda Seang, Ancillary Agreements Officer
The Regents of the University of California
Tax ID: 91-2047245
DUNS # 064521169
In
CITY OF SANTA ARIA
KRIqTINE RIDGE
City Manager
EXHIBIT A
Health Equity and Literacy (HEAL) Project: University of California, Irvine
Scope of Work
The Evaluation and QI core at UCI (an MSI) will used mixed methods approaches (quantitative and
qualitative) to assess process (adherence to DIS framework and National CLAS Standards; group dynamics;
alignment with community priorities), reach (number of units of service offered or individuals reached; changes
in knowledge and attitudes), and outcomes (COVID-19 resource access, HP2030 indicators). Evaluation leads
Tanj asiri and Billimek are experts in National CLAS Standards adherence and will develop, with input from the
TAG, Program Manager and CSB, a logic model for the Population Health and CHC Tracks of
Implementation. UCI will establish a dedicated Data Coordination Center led by an experienced data manager
to collect and manage all evaluation data from partners and public sources using the REDCap data management
platform.
Key outcomes of COVID-19 testing and vaccination rates and adults with vaccination records in an
information system (HP2 - will e collected at the local area level (zip code or census tract, when
available) from State and County datasets that the UCI team is already receiving and compiling on a weekly
basis. These values will be mapped to SVI categories for analysis of gap reductions between high and lower
SVI areas (Outcome 3).
Appropriate, validated measures of HP2030 objectives HC/HIT-01, HC/HIT-02 and HC/HIT-03 will be
identified from existing HRSA Health Center Patient Survey and Medical Expenditure Panel Survey items and
collected on a monthly basis by CHCs participating in the Health Literacy Working Group as an augmentation
to their routine Patient Experience Survey data collection, supported with a promotional campaign and small
incentives to patients to increase participation in the surveys. CHC Track interventions will be implemented on
a phased schedule to allow for comparisons of change in UP2030 measures in CHCs with and without active
intervention for health literacy objectives; we will survey n=500 project participants annually. Analysis of the
reduction in the gap between baseline values and the HP2030 national target value across a WG CHCs will
be conducted at Month 18 (Outcome 6).
Qualitative assessment of process and reach, including interorganizational dynamics and alignment with
community priorities, will be led by expert community engaged researchers at UCI, Drs. Alana LeBron and
Salvador Zarate, in collaboration with community interviewers identified by RADIATE, OCAPICA and
LHA. LeBron and Zarate will oversee development and implementation of in-depth interviews (n=40 in year 1;
n=35 in year 2) and focus groups (n=10 focus groups per year, stratified by ethnicity/race, language and age) to
assess and analyze interview transcripts to generate recommendations tbr the Partnership.
As part of the QI process, all process, reach and outcome measures will be shared quarterly with the
Program Manager, CSB and Implementation Core leaders. Data will be stratified y key demographic
characteristics including race/ethnicity, zip code, language, gender and age group to support targeted adaptation
of approaches in the rapid cycle QI processes.
Health Equity and Literacy (HEAL) Project: University of California, Irvine
Budget Justification
Personnel:
Sora Park Tanjasiri (multiple PI, 10% effort): Dr. Tanjasiri will be responsible for shared oversight of the
entire project, including population track evaluation design, instrument and interview development, data
collection, data management and analyses, community and scientific dissemination, liaising with the funder and
report writing. She will oversee the work of the evaluation coordinator.
John Billimek (multiple PI, 10% effort): Dr. Billimek will be responsible for shared oversight of the entire
project, including clinical track evaluation design, instrument development, data collection, data management and
analyses, presentations to inform further quality improvements, community and scientific dissemination, and
funder and report writing. He will also oversee the work of the evaluation coordinator and quantitative evaluation
assistant.
Evaluation Coordinator (GSR V, 50% effort academic year + 100% summer months): will be responsible
for oversight of all day-to-day activities, including facilitating meetings of the multiple PIs, technical advisory
group (TAG), and with community partners; creation and/or maintenance of data collection protocols, REDCap
databases, and codebooks; oversight of two evaluation assistants; creation of community presentations and report -
backs; maintenance of all project files.
Evaluation Assistants (GSR 1, 50% effort academic year + 70% summer months in year 1; 33% summer
months in year 2): two bilingual evaluation assistants will support evaluation needs of the two tracks:
population/community, and clinic/quality improvement. They will support development of data collection
instruments, REDCap programming and testing, oversee language translations, document and report on data
processes, and conduct preliminary descriptive data analyses.
Statistical Expert (TBN, 5% effort): will provide input into the population and clinic data processes, including
design, participant recruitment, and analyses.
Data Manager (TBN, 10% effort): will provide support to the statistician, including IRB applications for
approval, and REDCap programming and maintenance.
Technical Assistance Group (1% effort, unless otherwise noted): Drs. Abigail Reyes (advisor with effort as
needed), Jun Wu, Brittany Morey, Daniel Parker, Candice Taylor -Lucas, and Cynthia Haq will provide guidance
on technical aspects of the planned evaluation, including in the areas of environmental measurements and
analyses, racism and ethnic enclaves, epidemiology and GIS mapping, pediatric and adult clinical analyses.
Furthermore, Drs. Alana LeBron (28% of summer effort) and Salvadore Zarate (33.3% of summer effort) will
provide greater assistance with the qualitative aspects of the evaluation plan, including tracking collaborative
capacity building and impacts on health disparities.
Salary and Fringe: Salaries for all personnel are based upon current University of California academic and staff
salary scales. All personnel budget calculations include salary range adjustments (3%) as applicable for each year
of support in accordance with published University guidelines. Fringe benefit rates for personnel were derived
using composite benefit rates agreed upon by the University of California Office of the President and the DHHS
Audit Agency, the Cognizant Audit Agency for the University of California. http://research.uci.edu/sponsored-
proj ects/rates-fees/fringe-benefits.html. Vacation leave accruals are excluded from the composite benefit rate and
are assessed at 7%.
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Part °1,. Pt«�uirpose of iIIIiie EvaIII« aiiarii MIarii
As described in the AHL NOFO, the HEAL-OC evaluation will determine whether:
1. The health literacy interventions were implemented in adherence with the National CLAS
Standards.
2. The health literacy interventions reached their target population described in the Disparity
Impact Statement.
3. There were any changes in access, use and outcomes of program activities, especially
COVID-19 testing, contact tracing, vaccination.
The City of Santa Ana and the OC Health Equity COVID-19 Community Academic Partnership
(OCHEC-CAP) have partnered to implement the Health Equity And Literacy in OC (HEAL-OC)
Initiative. The participating member institutions of OCHEC-CAP include two established
organizations dedicated to advancing the health and wellbeing that serve the minority communities in
central OC, Latino Health Access (LHA) and the Orange County Asian and Pacific Islander
Community Alliance (OCAPICA); a grassroots community advocacy group, Radiate Consulting
(Radiate); a consortium of safety net providers and community health centers, the Coalition of Orange
County Community Health Centers (The Coalition); and a minority serving academic institution, the
University of California, Irvine (UCI).
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%jCON SU LTING
The goal of HEAL-OC is to address inequities related to COVID-19 and overall health literacy in
surrounding communities with high social vulnerability index (SVI) scores. The goal will be met
through attainment of four objectives: (1) developing community -based partnerships, including
establishing a Community Stewards Board, (2) developing a Disparities Impact Statement as a
framework for intervention and evaluation, (3) developing and implementing a Health Literacy Plan in
adherence with National CLAS Standards and (4) conducting rigorous and timely Evaluation and
Quality Improvement.
O LJh t MI ri V 11 fi,'�',°u
By achieving these four objectives, HEAL-OC aims to realize the following six objectives:
Outcome 1: Capacity
1.1 In the first 3 months, co -develop with community partners and stakeholders a Disparity Impact
Statement as a framework to guide the development, implementation and evaluation of a Population
Health Literacy Plan.
Outcome 2: COVID 19 Education
2.1 In the first 6 months, develop and implement a Population Health Literacy Plan to deliver
linguistically and culturally appropriate (i.e. aligned with National CLAS Standards) COVID-19
education and resources to Latino and Asian American and Pacific Islander (AAPI) residents in the
targeted communities.
2.2 By the end of the project period, deliver education to residents in the targeted communities.
Outcome 3: COVID-19 Services
3.1 In the first 6 months, achieve a 25% gap reduction in COVID-19 testing and vaccination access
for 4th quartile SVI areas, predominantly in Santa Ana and surrounding areas, compared to the rest
of the County.
3.2 By the end of the project period, achieve a 50% gap reduction, and achieve a 50% increase in the
proportion of residents with a confirmed vaccination in an information system (HP2030 measure
I I D-D02).
Outcome 4: Health Literacy Surveillance
4.1 In the first 4 months, establish a Health Literacy Working Group including at least 4 community
health centers and conduct baseline measurement of Healthy People 2030 health literacy objectives
HC/HIT-01, HC/HIT-02, and HC/HIT-03. Continue ongoing surveillance and inter -organizational
information exchange and solution -building for these objectives throughout the project period.
Outcome 5: Health Literacy Intervention
5.1 In the first 9 months, co -develop and implement a feasible, culturally competent intervention in
alignment with National CLAS standards at two community health centers (CHCs).
5.2 By the end of the project period, implement the intervention at two or more additional CHCs.
Outcome 6: Health Literacy Outcome
6.1 By month 18 of the project period, achieve HP2030 target values for health literacy objective
HC/HIT-01 or reduce the gap between the baseline value and the target value by at least 20%.
6.2 By month 18 of the project period, achieve HP2030 target values for health literacy objective
HC/HIT-02 or reduce the gap between the baseline value and the target value by at least 20%.
6.3 By month 18 of the project period, achieve HP2030 target values for health literacy objective
HC/HIT-03 or reduce the gap between the baseline value and the target value by at least 20%.
OOm"4";1Ii,vmVew acthm"II IVaiy"s
To achieve these outcomes, the HEAL-OC initiative includes two tracks of implementation activities
First, a Population Health (PH) track, led by LHA and OCAPICA, will implement a Population Health
Literacy Plan (PHLP) in community settings to improve access and use of COVID-19 health
resources (Outcome 2) and reduce gaps in COVID-19 testing and vaccination (Outcome 3). Building
on decades of work within high-SVI Latino and AAPI communities in North and Central OC, the PHLP
will leverage the resources and expertise of HEAL-OC to augment and expand ongoing, feasible,
data -driven and culturally and linguistically appropriate efforts including community forums, mobile
vaccination hubs, call centers and direct outreach.
Second, a Community Health Center (CHC) track, led by The Coalition of OC CHCs will target
HP2030 Health Literacy objectives (Outcome 6) in health care settings in high-SVI areas. The
Coalition will establish a Health Literacy Working Group (HLWG) consisting of four CHCs (two
Latino -serving and two AAPI-serving) during its monthly Leadership Task Force meetings. With
guidance and funding from HEAL-OC, HLWG members will develop and implement a Health Literacy
Surveillance and Intervention Plan (Figure 1; Outcomes 4 & 5).
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Convene Health Literacy Working
Group with at least 4 CHC
Developclinic-based
Phased implementation of
members, guided by CHC Track
Coordinator at the Coalition
interventions, including
provider and patient -focused
p p
interventions, first at 2 CHCs followed
by 2 more CHCs after 3 months to
Broader
education, following ODPHP
serve as "waitlist controls" for
dissemination
Use existing validated
National Framework for
comparative evaluation of impact.
of
questionnaire measures of
HP2030 Health Literacy Objectives
Health Literacy and CDC
Making Health Literacy Real
Analyze gap reductions in HP2030
interventions
to other CHC
HC/HIT-01, 02 & 03, following
workbook.
measures at CHCs vs. national targets
members
National CLAS Standards, in clinic
sites to establish baseline &
Continue adding Working
Continue adding Working Group
g g P
member CHCs
ongoing surveillance.
Group member CHCs
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Figure 1. CHC Track Health Literacy Surveillance & Intervention Plan overview
As of August 2021, the PH and CHC Track members are submitting their preliminary HLP to OMH for
review and feedback, and are simultaneously refining it to ensure adherence with CLAS Standards
and to include input from the Community Stewards Board and the UCI Technical Advisory group.
They expect to finalize the plan by October.
Part 3. Logic Mod&II [YaiiliilaII°ive
Although the PH and CHC Tracks will interact and support each other, we have developed separate
logic models for main focus of each track.
The first logic model (Table 1a) guides the evaluation of the PH Track, with a focus on COVID-19
service access, utilization and outcomes (Outcome 3), including HP2030 indicator IID-D02. The
second logic model (Table 1b) focuses on the activities and outcomes of the Community Health
Center Track, emphasizing a process to engage two cohorts of CHCs (four CHCs total) to conduct a
current state assessment of HP2030 Health Literacy metrics and CLAS Standard adherence, set
targets for gap reductions in those indicators and select existing evidence -based interventions to
implement, phased implementation of interventions across 2 cohorts for robust causal analysis of
intervention effects on outcomes and preparation of a "Health Literacy Playbook" for dissemination to
the remaining CHC members of the Coalition.
Table la. POPULATION HEALTH TRACK LOGIC MODEL
(Link to CLAS Standards: https://thinkculturalhealth.hhs.aov/clas/standards)
INPUTS
ACTIVITIES
OUTPUTS
OUTCOMES
IMPACTS
Funding
1) Communication: Meetings of the
- CBOs participate in
- Increased city capacities for
- Decreased
$2M per year, Year 1 & 2
Steering Committee, CSB,
Communication and
public health
COVID
institutional stakeholders, and
Assessment Phase to
incidence
Human Resources
broader community for planning,
assess baseline
- Increased community
PI; Project Manager;
implementation, dissemination
outcomes and
capacities for collaborative
- Decreased
Community Stewardship
and sustainability through CLAS
enhanced health
COVID equity
COVID mortality
Board (CSB) with
standards 2-4, 13 & 15.
equity interventions
RADIATE;
- Increased community
- Increased
Implementation Leads
2) Assessment: identify baseline
- Phased rollout of HL
education and resource
quality of life
and Personnel at two
levels of health literacy,
interventions by SVI
navigation
CBOs (LHA and
vaccinations (IID-D02 target),
zip code with ongoing
OCAPICA); Evaluation
gaps and opportunities that
surveillance of
- Increased numbers of
Leads and Personnel at
promote CLAS standards 9-13.
outcomes
community members
UCI; Technical Advisory
educated, tested, contact
Group
3) Ramp-UIphase: Develop or
- # of materials
traced
refine materials for enhanced
Information Resources
health equity; set initial targets
- Repository of
- Increased implementation
National CLAS
for gap reductions, and rollout in
messages and
of preventive behaviors
Standards and
high SVI zip codes and
materials to share
self -assessment tools;
timeframe for focused
with other institutional
-Increased proportion of
Advancing Health
community events.
stakeholders
individuals with COVID-19
Literacy intervention
vaccination completed and
resources
4) HL Intervention phase: via
-# of outreach,
recorded in an information
in -person and virtual outreach
navigation, and
system (HP2030 indicator
Organizations
education, navigation to
vaccination events
IID-D02).
Other institutional
resources, and vaccinations via
and participating
stakeholders at the
CLAS standards 5-8.
community members
- Dissemination of best
county, health care, and
practices beyond HEAL-OC
community agencies
MODERATORS
Changing environment of COVID prevalence and precautions in the community orgs (CBOs); competing urgent demands at CBOs
Table 1 b. COMMUNITY HEALTH CENTER TRACK LOGIC MODEL
(CLAS Standards: htt s://thinkculturalhealth.hhs. ov/clas/standards
INPUTS
ACTIVITIES
OUTPUTS
OUTCOMES
IMPACTS
Funding
1) Current State Assessment at 4 CHCs to
-4 CHCs participate in
-Increased
-Increased
$2M per year, Year 1
identify baseline levels of Health Literacy
Current State
adherence to
utilization of
& 2
(HL; HP2030 targets), adherence to CLAS
Assessment and
National CLAS
preventive health
Standards, gaps and opportunities.
Planning Phase to
Standards in
services
Human Resources
assess baseline
CHCs
PI; Project Manager;
2) Ramp -Up phase: Set baseline targets for
outcomes and select
-Dissemination if
Community Stewards
gap reductions, opportunities to enhance
HL Interventions
-Gap reduction
Health Literacy
Board with RADIATE;
adherence to CLAS Standards
in HP2030
Promotion playbook
Implementation Leads
(emphasizing standards 4, 5-9) and select
-Phased rollout of HL
health literacy
of strategies to
and Personnel at
HL interventions from Menu in HLP.
Intervention in 2 CHCs
indicators
promote HL in
Coalition & 4
(Phase 1) followed by 2
HC/HIT-01,
CHCs
community health
3) HL intervention Phase 1 in 2 of 4
more CHCs (Phase 2)
HC/HIT-02 and
centers (CHCs);
participating CHCs; ongoing surveillance of
with ongoing
HC/HIT-03
-Increased trust in
Evaluation Leads and
HP2030 HL and CLAS adherence
surveillance of
medical providers
Personnel at UCI;
measures at all 4 sites
outcomes
Technical Advisory
-Improved health
Group
4) HL Intervention Phase 2 in all 4 CHCs
-Approximately
and quality of life
with; ongoing surveillance
patients and providers
Information Resources
5) HL Playbook Development and
to participate
National CLAS
Standards and
Dissemination to other Coalition member
-Health Literacy
self -assessment tools;
CHCs
Promotion playbook
Advancing Health
created to disseminate
Literacy intervention
to other Coalition
resources
member CHCs
MODERATORS
Changing environment of COVID prevalence and precautions in the clinics; Competing QI demands at clinics
4, OIh.JAt,4„+01r114;s & V11eafiulUi,' Py"s
Aligned with the initiative conceptual model, at the end of each quarter we will report on the following:
1. AHL Conceptual Model Domain: Health Promotion
A. Outcome: ensure the identification of effective approaches for improving health
outcomes with the ultimate goal of promoting dissemination, adoption and
sustainability of these approaches.
AHL NOFO Performance Measure Requirement: the specific evidence -based
health literacy intervention(s) implemented
B. Outcome: reduce the differences in health that occur by particular categories:
gender, race or ethnicity, income and education, disability, living in a rural locality,
or sexual orientation with the target population in the Disparity Impact Statement.
AHL NOFO Performance Measure Requirement: the demographic
characteristics of the populations reached through the evidence -based health
literacy intervention and how the populations reached align with the target
population in the Disparity Impact Statement.
2. AHL Conceptual Model Domain: Disease Prevention
A. Outcome: measure the impact on health outcomes, participation, empowerment,
equity and sustainability.
AHL NOFO Performance Measure Requirement: current project data, stratified
by demographic characteristics, on changes in the access, use and outcomes of
COVID-19 vaccination, testing, and related activities (e.g., contact tracing,
preventive behaviors)
B. Outcome: improve health indicators align with Healthy People 2030 objectives
HC/HIT-01, HC/HIT-02, HC/HIT-03 and IID-D02.
AHL NOFO Performance Measure Requirement: Current project data related
to Healthy People 2030 objectives HC/HIT-01, HC/HIT-02, HC/HIT-03 and
IID-D02.
3. AHL Conceptual Domain: Health Care
Outcome: improve access and utilization of health care.
AHL NOFO Performance Measure Requirement: the number of individuals
impacted by the health literacy intervention.
IDe rt u u g iY°ii 11 a IR°: II a a a ii d IN a a i�,'a i hle
Key components: The population health literacy intervention relies on community health education
by lay health worker/promotores and navigation to COVID and social determinants of health (SDOH)
resources by lay health navigators. Both intervention components align closely with the National
CLAS standards that promote assistance via linguistically and culturally competent education
(standards #5-8).
The community health center interventions will be developed by a Health Literacy Working Group
including representatives of 4 community health centers, the Coalition and the Technical Advisory
Group from UC Irvine.
Stakeholders: Community members in high SVI zip codes, community leaders, and other
institutional supporters (e.g., representatives from county, hospital, academic and other non-profit
agencies within and outside of these zip codes). Representatives of 4 community health centers will
join a Health Literacy Working Groups to conduct the current state assessment and intervention
selection/design for the Community Health Center track.
Evaluation foci: The evaluation design and measures include individual and community level
changes assessed through qualitative and quantitative methods. Although some elements of the
evaluation plan are still being developed, the broad approach for Goals 1, 2 and 3 of the initiative are
described in the evaluation table below.
Domain: Health Promotion
Performance Measure: Highest quartile SVI zip codes in Santa Ana and surrounding cities
HP 2030 Objective (if applicable):
Goal # 1
Outcome
Study Design
Measurement Tool
Frequency
Performance Target
Eval Ques
Increase
Does
Modified stepped
Monthly outreach education & navigation logs
Monthly
At least 500 people
access to,
tailored
wedge, starting
(process)
process
reached per month with
and
education
with highest SVI
Process tool: case stories of how education
measures
education & navigation
adoption of,
&
zip codes for
and navigation resulted in individual I<AB
Monthly
o
At least 90 /o positive
health
navigation
Latinos and AAPIs
(knowledge/attitude/ behavioral) and
post-tests
knowledge, attitudes,
promotion,
increase
prevention
in OC.
community norm change (process)
Quarterly
and behavioral
norm
at
Cross -sectional
Post-test surveys on changes in knowledge,
focus
intentions at post-test
change and
capacity
individual
focus groups with
residents and
attitudes, and behavioral intentions regarding
groups.
At least two stories per
building
and
leaders to identify
mask -wearing and physical distancing
focus group regarding
activities.
community
persuasive
(outcome)
how CLAS intervention
levels?
messages and
Post-test surveys on changes in intention to
components influenced
intervention
post positive social media messages (outcome)
community members
components and
Post-test surveys on changes in intention to
and spread within
community
diffusion
seek housing, food, employment or other
throughout
services (outcome)
community
Focus group discussions with residents and
leaders to assess essential CLAS components,
beliefs, messages, and diffusion of innovations
(outcome)
Domain: Disease Prevention
Performance Measure: Current project data related to Healthy People 2030 objectives IID-D02
HP 2030 Objective (if applicable): IID-D02: Increase the proportion of people with vaccination records in an information system.
Goal # 2
Outcome
Study Design
Measurement Tool
Frequency
Performance Target
Eval Ques
Increase
Does
Modified stepped
Outreach education & navigation logs (process)
Monthly
At least 500 people
access to,
tailored
wedge, starting
Staff time, materials used, and other resources
process
reached per month with
and
education
with zip codes of
(process)
(p )
measures
testing and/or
adoption of,
&
highest disparities
Monthly
vaccination
disease
navigation
for Latinos and
Before/after rate of increase of testing &
testing and
o
gap reduction in
prevention
increase
AAPIs in OC
vaccination in HEAL-OC zip codes vs. OC
vaccination
testing
testing and vaccinations
behaviors.
testing and
Cross -sectional
(outcome)
numbers
in first six months; 50%
vaccination
focus groups with
g p
Focus group discussions to describe essential
g p
and rates
gap reduction by end of
among
most
leaders and
CLAS (eg., linguistic and org) capacities and
Quarterly
two years
vulnerable?
HEAL-OC staff to
partnership to get people vaccinated (outcome)
focus groups
At least 2 stories per
identify perceived
focus group regarding
impactful activities
how intervention
and sustainability
components influenced
plans
community members.
Cost analysis
Domain: Disease Prevention
Performance Measure: Current project data related to Healthy People 2030 objectives HC/HIT-01, HC/HIT-02, HC/HIT-03
HP 2030 Objective (if applicable): HC/HIT-01 Increase the proportion of adults whose health care provider checked their
understanding, HC/HIT-02, HC/HIT-03
Goal # 3
Outcome Eval
Study Design
Measurement Tool
Frequency
Performance Target
Ques
Increase
Do targeted,
Cluster randomized trial
National CLAS Standards
Baseline (prior to
Introduce HL
performan
co -developed
(clinic level) with waitlist
adherence assessment by
Cohort 1 HL
intervention at 4 CHCs
ce on
clinic -level
controls comparing HL
evaluation team, before and
intervention launch)
Health
interventions
intervention to usual
after implementation
3 month follow-up
Literacyfocused
on
care.
(process)
(after Cohort 1 launch
Target for National
measures
CLAS Standard
and just prior to Cohort
CLAS Standards
at CHCs
adherence
2 launch; Primary
adherence to be
improve health
-2 CHCs will be
Implementation logs of
Endpoint)
determined by Health
literacy in CHC
randomly allocated to
intervention activities at 4
Literacy working group
patients?
Cohort 1 and will
CHC sites (process)
6 month follow-up
introduce HL
intervention
Achieve HP2030 target
Medical Expenditures Panel
values for health
Survey (MEPS)
literacy objectives or
-2 remaining CHCs will
questionnaire Items for
reduce the gap
be randomly allocated
HC/HIT-01, HC/HIT-02 and
between the baseline
to waitlist control and
HC/HIT-03, translated into
value and the target
will delay
preferred languages for CHC
value by at least 20%
implementation of HL
patients (including Spanish,
for
intervention to allow
Vietnamese and Korean;
- HC/HIT-01
comparison
outcome)
- HC/HIT-02
- HC/HIT-03
Evaluation results will be disseminated in the following ways:
• With the guidance of the Community Stewards Board, the Steering Committee is developing a
communication plan outlining the timing, content and audiences for scheduled
communications about HEAL-OC activities and results to key stakeholders including funders,
champions, allies, working group members and community residents.
• For the CHC Track, the Coalition team will develop a playbook of tools, best practices and a
model workplan for adopting and evaluating successful health literacy interventions developed
in the community health centers.
t° au I TAppeiYii&�ces
As development of the Evaluation Plan continues in parallel with the development of the
Health Literacy Plans, the following details will be considered and added to the evaluation
plan.
a. sample instruments as appropriate (questionnaires, interview guides, protocols)
b. psychometric characteristic of selected measures
C. the reliability of data collection instruments
d. plans for submission of proposed evaluation design to IRB(s)
e. confidentiality procedures
EXHIBIT B
Budget Table —University of California, Irvine (UCI)
Object Class
Year 1 Proposed
Year 2 Proposed
Total Budget
Personnel
$180,454
$180,454
$360,908
Fringe Benefits (20%)
$25,025
$25,025
$50,050
Travel
$0
$0
$0
Equipment
$0
$0
$0
Supplies
$23,000
$23,000
$46,000
Contractual
$0
$0
$0
Construction
$0
$0
$0
Other
$57,018
$57,018
$114,036
Total Direct Charges
$285,497
$285,497
$570,994
Indirect Charges (36.5%, salaries only)
$59,405
$59,405
$118,810
TOTALS
$344,902
1 $344,902
$689,804
Certification Regarding
Debarment, Suspension, Ineligibility and Voluntary Exclusion
Lower Tier Covered Transactions
This certification is required by the regulations implementing Executive Order 12549, Debarment and
Suspension, 29 CFR Part 98, Section 98.510, Participants' responsibilities. The regulations were published
as Part VII of the May 26, 1988 Federal Register _ (pages 19160-19211).
(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS FOR CERTIFICATION -
Attached)
(1) The prospective recipient of federal assistance funds certifies, by submission of this proposal, that
neither it nor its principals are presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from participation in this transaction by any federal department or
agency.
(2) Where the prospective recipient of federal assistance funds is unable to certify to any of the
statements in this certification, such prospective participant shall attach an explanation to this
proposal.
Wanda Seang, Ancillary Agreements Officer
Name and Title of Authorized Representative
wa4W,a, �5� 11/19/2021
Signature Date
EXHIBIT C
Page 1 of 2
INSTRUCTIONS FOR CERTIFICATION
By signing and submitting this proposal, the prospective recipient of federal assistance funds is
providing the certification as set out below.
2. The certification in this clause is a material representation of fact upon which reliance was placed
when this transaction was entered into. If it is later determined that the prospective recipient of
federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies
available to the Federal Government, the Department of Labor (DOL) may pursue available
remedies, including suspension and/or debarment.
3. The prospective recipient of federal assistance funds shall provide immediate written notice to the
person to which this proposal is submitted if at any time the prospective recipient of federal
assistance funds learns that its certification was erroneous when submitted or has become erroneous
by reason of changed circumstances.
4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and
"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the person to
which this proposal is submitted for assistance in obtaining a copy of those regulations.
5. The prospective recipient of federal assistance funds agrees by submitting this proposal that, should
the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier
covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily
excluded from participation in this covered transaction, unless authorized by the DOL.
6. The prospective recipient of federal assistance funds further agrees by submitting this proposal that
it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
voluntary exclusion - Lower Tier Covered Transactions," without modification, in all lower tier
covered transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective participant in a
lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded
from the covered transaction, unless it knows that the certification is erroneous. A participant may
decide the method and frequency by which it determines the eligibility of its principals. Each
participant may, but is not required to check the List of Parties Excluded from Procurement or Non -
Procurement Programs.
Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge and
information of a participant is not required to exceed that which is normally possessed by a prudent
person in the ordinary course of business dealings.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal Government, the DOL may pursue available
remedies, including suspension and/or debarment.
EXHIBIT C
Page 2 of 2
Certification Regarding Lobbying
Certification for Contracts, Grants, Loans, and Cooperative Agreements
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 for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with the awarding of any Federal
contract, the making of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal contact, 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, an officer or employee 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 subcontract, 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 fact upon which reliance was placed
when this transaction was made or entered 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 person who fails 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.
The Regents of the University of California, Irvine
Grantee/Contactor Organization
Wanda Seang �� 11/19/2021
Name of Certifying Officer Signature Date
EXHIBIT D
Page 1 of 2
SUBRECIPIENT warrants the following:
1. SUBRECIPIENT will comply with Public Law 88-352, Title VI of the Civil Rights
Act of 1964 (42 U. S. C. section 2000 et seq.) and implementing regulation in 24 CFR
Part 1.
2. No person in the United States shall on the ground of race, color, religion, national
origin, or sex, be excluded from participation in, or be denied the benefits of, or be
subjected to discrimination under any program or activity funded in whole or in part with
community development funds made available pursuant to the ACT.
3. All laborers and mechanics, employed by contractors or subcontractors in the
performance of construction work financed in whole or in part with community
development funds shall be paid wages at rates not less than those prevailing on similar
construction in the locality as determined in accordance with the Davis -Bacon Act, as
amended, 40 U. S. C. Sections 276 a 1-5, except for individuals who perform services for
which they volunteered; do not receive compensation for such services; or are paid
expenses, reasonable benefits, or a nominal fee for such services; and are not otherwise
employed at any time in construction work.
4. SUBRECIPIENT will comply with all Federal statutes applicable to projects funded
with community development funds, except that (a) SUBRECIPIENT does not assume
CITY'S environmental responsibilities described at 24 CFR 570.604; and (b)
SUBRECIPIENT does not assume CITY'S responsibility for initiating the review process
under Executive Order 12372.
EXHIBIT D
Page 2 of 2
Certification Regarding Drug -Free Workplace Requirements
The certification set out below is a material representation upon which reliance is placedby the
U.S. Department of Housing and Urban Development in awarding the grant. If it is later
determined that the contractor knowingly rendered a false certification, or otherwise violates the
requirements of the Drug -Free Workplace Act, the U.S. Department of Housing and Urban
Development, in addition to any other remedies available to the Federal Government, may take
action authorized under the Drug -Free Workplace Act.
CERTIFICATION
A. The contractor certifies that it will provide a drug -free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture,
distribution, dispensing, possession or use of a controlled substance is prohibited
in the contractor's workplace and specifying the actions that willbe taken against
employees for violation of such prohibition;
(b) Establishing a drug -free awareness program to inform employees about —
(1) The dangers of drug abuse in the workplace;
(2) The contractor's policy of maintaining a drug -free workplace;
(3) Any available drug counseling, rehabilitation, and employee
assistance program; and
(4) The penalties that may be imposed upon employees for drug abuse
violations occurring in the workplace;
(c) Making it a requirement that each employee who will be engaged in the
performance of the grant be given a copy of the statement required by
paragraph (a);
(d) Notifying the employee in the statement required by paragraph -(a) that,as a
condition of employment under the contract, the employee will -
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a
violation occurring in the workplace no later than five days after such
conviction.
(e) Notifying the U.S. Department of Housing and Urban Development within ten
days after receiving notice under subparagraph (d)(2) from an employee or
otherwise receiving actual notice of such conviction;
EXHIBIT E
Page 1 of 3
(f) Taking one of the following actions, within 30 days of receiving notice
under subparagraph (d)(2), with respect to any employee who is so
convicted -
( 1) Taking appropriate personnel action against such an employee, upto and
including termination; or
(2) Requiring such employee to participate satisfactorily in a drug abuse
assistance or rehabilitation program approved for such purposes by a
Federal, State, or local health, law enforcement, orother appropriate
agency;
(g) Making a good faith effort to continue to maintain a drug -free workplace
through implementation of paragraphs (a), (b), (c), (d), (e) and (f).
B. The contractor shall insert in the space provided on the attached "Place of
Performance" form the site(s) for the performance of work to be carried out withthe
grant funds (including street address, city, county, state, and zip code) .the contractor
further certifies that, if it is subsequently determined that additional sites will be used
for the performance of work under the contract, it shall notify the U.S. Department of
Housing and Urban Development immediately upon thedecision to use such additional
sites by submitting a revised "Place of Performance" form.
The Regents of the University of California, Irvine
Organization
Authorized Signature
11/19/2021
Date
EXHIBIT E
Page 2 of 3
PLACE OF PERFORMANCE
FOR CERTIFICATION REGARDING DRUG-
FREEWORKPLACE REQUIREMENTS
Name: Sora Park Tanjasiri
Date: June 24. 2022
The Contractor shall insert in the space provided below the site(s) expected to be usedfor the
performance of work under the contract covered by the certification:
Place of Performance (include street address, city, county, state, zip code for each site):
University of California, Irvine
653 E. Peltason Drive, AIRB 3072
Irvine, CA 92697
EXHIBIT E
Page 3 of 3
UNIVERSITY OF CALIFORNIA
PROOF OF SELF-INSURANCE COVERAGE
The Regents of the University of California are often requested by outside parties to provide evidence
of the University's self-insurance coverage in conjunction with agreements and contracts negotiated
by its employees on UC campuses and medical centers. Examples of situations where the University
may be required to provide evidence of insurance include:
• Using an off -campus location to host an event, ceremony, athletic event, theatre production,
practice space, job fair, educational outreach event, etc.
• Leasing or renting equipment, motor vehicle(s), or real estate
• Research grant sub -awards
• Affiliation (non-healthcare/medical related) and Professional Services Agreements
The University of California self -funds its liability exposures, so does not issue individual certificates
of insurance. The UC Office of Risk Services has developed a Certificate of Self -Insurance Coverage
document (COC) to illustrate the self -funded retention levels maintained for each liability program.
The COC is available on-line for use by entities conducting business with the university as evidence
of the self -funded retention levels, coverage terms, and limits routinely requested. The self-insurance
limits accepted in each specific written agreement or contract shall be the limits that apply should a
loss arise, regardless of the limits provided in the on-line Certificate of Self -Insurance Coverage
document.
The UC COC Site is solely for the use and benefit of the vendors and organizations which contract
with the University of California and not for resale or other transfer to or use by or for the benefit of
any other person or entity. You may print copies for use within your organization, provided that you
do not modify the COC in any way, nor distribute any copies outside your organization. You may not
use any of the University of California's names or marks in any manner that creates the impression
such names or marks belong to or are associated with you or imply any endorsement by the University
of California, and you acknowledge that you have no ownership rights in and to any of these names or
marks. You will not use the Site, the information contained therein or any of the University's names or
marks in unsolicited mailings or spam material. You may not link directly to the COC ("deep link") or
bring up or present the COC or other content of this site within another web site ("frame").
Official Correspondence must be sent via postal mail to:
Chief Risk Officer
Office of Risk Services
Office of the President
University of California
1111 Franklin St., IOth Floor
Oakland, CA 94607-5200
510-987-9832
RiskServices@ucop.edu
Please contact the local Risk Manager at the specific University of California location where you are
contracting if you have insurance coverage questions:
• Campus Risk Managers Directory
• Hospital Risk Managers Directory
1?d&ManagonadDivisian
E
oy N,`P' REVIEWED & RPPROVM BY.
'�w Risk Management Specialist
CERTIFICATE OF
Date: June 15, 2022
SELF-INSURANCE COVERAGE
Regents
The - University of California
PresidentOffice of the
Office • Risk Services I�I
I
Floor
Oakland, CA 44.1 1
510-987-9832
issuedThis Certificate is as a matter of • r only • authorized viewers for
their internal use only -rs no rights upon any viewer of
CertificateThe does o. amend, extend or described below.
This Certificate may only be copied, printed and distributed by an authorized
viewer for its internal use, Any other use, duplication or distribution of the
Certificate without the written consent of the Regents of the University of California
is Drohibited.
ENTITIES AFFORDING • a
PARTICIPATION
The Reqents of the University of M I +,, ,
oil
DOES NOTANY ASSUMPTION OF AC DOES NOT RESULT FROMACTS OR • ISSIONS OF
OFFICERS,OR EMPIL •
flli'1'Z�i3i1{iE3Ai>T'�'S
ERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADEr X '1 OCCURRENCE
Ej
4 1'
ALL OWNED
AUTOS
SCHEDULED
AUTOS
HIRED AUTOS
NON -OWNED
AUTOS
GARAGE LIABILITY
iPE TY
FIRE & EXTENDED PERILS
I�rI�C�I'L:iiIF1'-I�i�3"rPllUi�L����+Ii�l*f�7�SSrIRCrli(J1:7_tiiR� .7��+7�tii'
GENERAL AGGREGATE m Not applicable
PRODUCTS-COMP/OP AGO $ 5,000,000
Self -Insured July 1, 2022 July 1, 2023 PERSONAL&ADV INJURY $ 5,000,000
CONTRACTUAL LIABILITY $ 5,000,000
EACH OCCURRENCE $ 5,000,000
COMBINED SINGLE LIMIT la Not applicable
BODILY INJURY
$ 2,500.000
(PER PERSON)
Self -Insured
July 1, 2022
July 1, 2023
BODILY INJURY
$ 2,500,000
(PER ACCIDENT)
PROPERTY DAMAGE
$ 2,500,000
EACH OCCURRENCE
$ 10,000,000
Self -Insured
July 1, 2022
July 1, 2023
AGGREGATE
$ Not applicable
Self -Insured July 1, 2022 July 1, 2023 EACH ACCIDENT $ As required by
California Law
DISEASE - POLICY LIMIT $ As required by
California Law
DISEASE - EACH EMPLOYEE $ As required by
California Law
OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL, ITEMS
ZTIFIC TE HOLDER CANCELLATION
'LICA LE PARTY AS REQUIRED BY WRITTEN CONTRACT SHOULD THE REGENTS ELECT TO DISCONTINUE SELF -INSURING ITS
AGREEMENT LIABILITIES, THE REGENTS WILL UPDATE PROOF OF SELF-INSURANCE ON ITS
WEBSITE. THE REGENTS SHALL NOT BE OBLIGATED TO PROVIDE INDIVIDUAL
NOTICE TO VENDORS OR OTHERS.
By: ,
..R... ide RDivisian
KEVI CONFETTI, AVP & CHIE 3 e° REVIexrEO&aPPROVm®Y:
Afe Acevda
'�--'Risk Management Specialist