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Home My WebLink AboutResolution - 4264 - Contract - TDOH - Public Health Services - 09_23_19930g Resolution No. 4264 September 23, 1993 Item f 28 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock BE and is hereby authorized and directed to execute for and on behalf of the City of Lubbock a Contract for Public Health Services by and between the City of Lubbock and the Texas Department of Health, attached herewith and all associated documents, which shall be spread upon the minutes of the Council and ats spread upon the minutes of this Council s onstitute and be a part of this Resolution as if fully copied herein detai . Passed by the City Coun6\1 this ?Ard day Qf�Se , 1993. ter ....... ...... ATTEST: - Aoz�'..'u c�r Betty R4- Johnsdfi, CftyJohns Secretary APPROVED AS TO CONTENT: oug oo n, u is -A-tfi t Administ a or N AS TO FORM: uom is u. vanaiver, City Attorney DGV.dw/agenda-D2/TDB.res rev. September 9, 1993 David R. Smith, M.D. Commissioner April 11, 1994 Texas Department of 1100 West 49th Street Austin, Texas 7875&3199 (512)458-7111 Health Carol S. Daniels Deputy Commissioner for Programs Roy L. Hogan Deputy Commissioner for Administration RECEI ,El) 1 51gg4 DOUG GOODMAN �U��'N CITy fiEAL PUBLIC HEALTH ADMIN. ]H �FfT. LUBBOCK CITY HEALTH DEPARTMENT P. 0. BOXi 2548 LUBBOCK, TX 79408-2548 TDH Document No. C4000133 Cha0ge No. 05 Dear Mr. Goodman: I have enclosed an approved copy of your public health services contract. Please file it with the office of record for your agency. If we maybe of further assistance, please call us at 512/458-7470. Sincerely; Glenn W. Rust, Acting Director Grants Management Division GWR:gd Enclosure An Equal Employment Opportunity Employer STATE OF TEXAS COUNTY OF TRAVIS TEXAS DEPARTMENT OF' HEALTH 1100 WEST 49TH STREET AUSTIN, TEXAS 78756-3199 CONTRACT CHANGE NOTICE NO. 5 TDH Document No. C4000133 The Texas Department of Health, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in writing with LUBBOCK CITY HEALTH DEPARTMENT hereinafter referred to as PERFORMING AGENCY. The parties thereto now desire to amend such contract as follows: SUMMARY OF TRANSACTION: ; Revision to public health services contract. ; Attachment No. 06B - Institutional Prior Approval to purchase two Hematastat ; II Centrifuges for Women, Infants and Children program ; assisting individuals identified as having nutritional ; deficiencies and/or nutritional risk. All terms and conditions not hereby amended remain in full force and effect. , , RECEIVING AGENCY ; Texas Department of Health BY: W " (Signature of person authorized ; to sign) ; , Glenn W. Rust, Acting Director ; Grants Management Division ; (Name and Title) ; Date: , Cover - Page 1 ..�:A _ 7E Z:L3 0c ATTaCHN:N'S ' AtL; Financial Assistance Am. ''IH Term ` Source of Direct Total Assistance No. ` Program Begin ' End Fundsx Amount Assistance Amount iTDH Share) G1 NCRlFHS-LHS 91 1j93; 3i3ti94; STATE 364,9a1.00; 32.61 ,30; .9T.�97.CC; 22A � CRH-LHS 1 9( ii3; a131/94; STATE �19,1a2.OG; i �3.44G. G; t 12.622.00; 03 LAB-LHS 9j 1;'93; 3j31194; STATE 00; 76,CG;.?0; 76.000.00; ; G4 `, HIV./EDUC-LHS ; 9/ 1/13; I a 31.i94; STATE 43,471.00; I I rG; 43,4i1.00 , 05 T8/OUTR-LHS 9/ 1/93; aj3?i94; I STATE 1 20,073.00; 1 GO; 20!073.00 i 068 WIC/CARD-LHS 410/ 1/93; 1 9/30/94; 10.557 STATE I 00; ! .CO; I .00; 07 INN/OPTS-LHS 9/ 1/93; 8j31j94; STATE 68,356.001 140,011,00; 208,367.00; I t i I 1 I 1 ! 1 t 1 t I I 1 i 1 1 f 1 I 1 I 1 ! 1 1 I 1 i 2 7 t I ! 1 1 i t ! i 1 I 1 1 1 i I i I t t 1 I I 1 t i i 1 1 I 1 1 I I i 1 i 1 1 i I ! r I I 1 I I 1 I 1 t I I I 1 1 1 I 1 1 I 1 1 { 1 1 1 I 1 1 t 1 I I 1 1 ! { 1 1 1 1 ! 1 1 1 ! i 1 1 ! 1 t I 1 i 1 I 1 1 1 I t I 1 I 1 I I t I 1 I 1 1 1 1 1 i l I I I t I 1 1 1 1 I 1 I 1 I f I 1 I i I I 1 i I 1 I i I I 1 1 I 1 1 1 I i I i l 1 1 1 i i 1 I I i I 1 I F f I 1 1 1 1 1 1 I 1 1 1 t 1 I 1 1 1 1 I t I t I r i I i i 1 1 I I 1 I i t 1 1 1 1 1 ! I 1 I 1 1 I 1 1 I f 1 1 1 1 I I 1 I 1 ! I 1 1 t 1 1 I 1 11 1 1 1 t I 1 t i ! ! 1 1 1 1 ( f 1 1 I 1 1 1 1 t 1 1 1 1 1 F t 1 I I t ! I 1 1 1 1 1 I 1 1 I 1 1 t t 1 i 1 I } 1 t t 1 i 1 i i I 1 1 1 ! 1 1 1 i I t I f I 1 ! I 1 I 1 1 t t 1 t i 1 t ! I I I I i 1 I ! 1 ! I 1 1 1 1 1 I 1 t 1 1 I 1 I 1 1 I t 1 1 1 I 1 I 1 i I 1 1 1 f f 1 i 1 ---------------------------------------------------------------------------------------------------------------------1 1 TOR Document No. C4000133 TOTALS f $16,063.00: f 292,061.00: 1 $ 908,130.00: Change No. 05 sFederal funds are indicated by a number from the Catalog of Federal Domestic Assistance (CFDA), if applicable. REFER TO BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS. COVER - Page 2 TEXAS DEPARTMENT OF HEALTH Austin, Texas INTER -OFFICE TO: Glenn Rust, Acting Director, Grants Management Division THRU: vices THRU: mac �� '� in er RQr nAM1 iil � ,J c rovivcu a r� �c �� u L Y —�. � +u FROM: Dennis H. Bach, Chief Bureau of Nutrition Services DATE: February 23, 1994 SUBJECT: Institutional Prior Approval - Contract # C4000133-06 The City of Lubbock, WIC Project #75, Contract #C4000133-06, is requesting approval to purchase two Hematastat II Centrifuges. The local agency obtained the required bids, and the low bid of $852.79 for each, was submitted by the Baxter Company. We support this expenditure and await. your approval at your earliest convenience. If you have any questions, please contact this office. RJ TEXAS DEPARTMENT OF HEALTH 1100 WEST 49TH STREET AUSTIN, TEXAS 78756-3199 CONTRACT CHANGE NOTICE NO. 1 STATE OF TEXAS TDH Document No. C4000133 COUNTY OF TRAVIS The Texas Department of Health, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in writing with LUBBOCK CITY HEALTH DEPARTMENT hereinafter referred to as PERFORMING AGENCY. The parties thereto now desire to amend such contract as follows: SUMMARY OF TRANSACTION: ; Revision to public health services contract. ; Attachment No. 03 - Amendment to add a new attachment to test and provide ; annual reports on the workload indicated for the Bureau of; Laboratories. ; All terms and conditions not hereby amended remain in full force and effect. ; EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN, C'.TY ZF L UBBGCK ' Authorized Contracting Entity (type above ` , if different frog PERFORMING AGENCY) ; in behalf of: ' I LUSSOCK CITY KXTH TEPARTXE TEXAS DEPARTAEKT OF HEALTH ' PE AG NCY RECEIVING AGENCY ; ( ay. By: (Sign tore of person a thorized (Signature of person authorized ; to sign contracts) to sign contracts) ; Linda Farrow, Chief ; David R. Langston, Mayor Bureau of Financial Services ; (Name and Title) (Name and Title) ' Date: September 23, 1993 RECOMMENDED: ay: a& y (:i� (PERFORMING A.GEN irector, if different fr erson authorized to sign contract) Cover - Page 1 Date: APPROVED AS TO FORM: By: Office of General Counsel 3ETAILS OF ATTACHMENTS Att,'; ; ;inanval assistance ; A�. TDH Tern ; Source of ; ; Direct ; Total Assistance ; Pro Grilm 3ev" Ell ; Funos= ; 4r0unt 4Ss151:31,.a _; Amcunt lT;� :hare; 91 4CH/FHS-LHS 9/ 1193; ?;31/9d; STATE 36d,381.00; 32.616.00; � 1 1 I I • 2 ; V'RH114M-LHS ; 91 1/93; 8/31/94; STATE ; 119,182.00; 193,4,1.Ju; 102,633.10: ! I 1 1 1 1 93 ; LAB-LHS ; 9/ 1193, 8131/94, STATE ; .00; 1150t.00, +6,000.3G; I 1 I 1 I 1 1 1 1 1 I i I i � 1 i I 1 1 I 1 I 1 1 I 1 1 1 t 1 I 1 1 1 I I 1 1 , � 1 1 1 1 1 1 I 1 I 1 1 1 1 1 , I 1 , 1 1 / 1 ! i 1 1 t 1 t 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 t 1 1 1 1 f 1 1 1 1 I 1 1 1 1 1 I $Federal funds are in REFER TO BUDGET SECTI' I 1 1 , 1 1 1 I 1 1 1 t 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 I 1 1 1 1 1 I I 1 1 I I I, I 1 I 1 1 , 1 I 1 1 I t 1 i I 1 1 I 1 1 I I 1 1 I I 1 1 I I 1 1 I I I 1 1 1 I 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 i 1 t 1 I 1 i I 1 1 1 1 1 1 1 I 1 I 1 1 1 1 1 1 1 1 I 1 1 1 1 1 I 1 ------------------------------------ 1 1 1 i I0133 TOTALS ; I 1 licated by a number from the Catalog )N OF ANY ZERO AMOUNT ATTACHMENT FOR I 1 , 1 1 1 1 1 t 1 1 1 1 1 1 1 1 I 1 1 1 I 1 1 1 f 1 1 1 1 I , I 1 I I I 1 I 1 I I 1 1 I I I 1 1 1 1 1 1 I 1 1 1 1 1 I 1 i 1 I 1 I 1 I 1 I 1 I I I I 1 1 1 I 1 I 1 I 1 1 1 I 1 1 1 I I I I 1 1 I 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 -------------------------------------- 484,163.00: ; 292,067.00: 1 1 of Federal Domestic Assistance (CFDA) DETAILS. 1 � I 1 1 1 I 1 1 I 1 I 1 1 I I 1 I 1 I 1 1 I I 1 1 1 1 I I I I I I I 1 1 1 1 I 1 1 I I 1 I 1 1 1 I 1 I I I I I I I I 1 I 1 1 1 I ; 1 1 i 1 1 1 1 1 1 1 1 I 1 1 1 I I 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 -----------------------t 776,230,00; t , if applicable. DOCUMENT NO. C4000133 ATTACHMENT NO. 03 PERFORMINu AGENCY: L':?30Ck CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: BUREAU OF LABORATORIES TERM: September 1393 THROUGH August 31, 1994 SECT113N I. SCOPE OF WORK: PERFORMING AGENCY laboratory agrees to test and provide reports on tests annually on the approximate workload indicated in the categories below in support of RECEIVING AGENCY statewide programs: A. Milk bacteriology and chemistry B. Syphilis serology C. Gonorrhea testing D. Other approved analyses 0 12,000 12,000 22,500 TOTAL 46,500 PERFORMING AGENCY agrees to meet standards for such analyses as set forth by RECEIVING AGENCY, Bureau of Laboratories, the Clinical Laboratories Improve- ment Act, the Safe Drinking Water Act, the National Conference of Interstate Milk Shippers, and/or the Public Health Service Grade A Pasteurized Milk Ordinance. PERFORMING AGENCY will provide an estimated 46,500 specimen/samples in or benefiting the geographic area defined as LUBBOCK COUNTY AND BORDERING COUNTIES. SECTION II. LEGAL AUTHORITY TO CONTRACT: Chapters 12 and 121, Health and Safety Code. SECTION III. SPECIAL PROVISIONS: GENERAL PROVISIONS, Program Income Article, paragraph two, is not applicable to this Attachment, however, additional instructions regarding program income follow in the next three paragraphs. PERFORMING AGENCY is required to bill Medicaid for the following laboratory tests performed for Medicaid eligible patients: syphilis serology screening, syphilis serology confirmation, and gonorrhea and chlamydia diagnosis. PERFORMING AGENCY may use their own billing system or may use RECEIVING AGENCY's match -up system. RECEIVING AGENCY, Bureau of Laboratories, will reduce the Total Allotment set out in Section IV. Budget, by the number of Medicaid reimbursed tests multi- plied by the respective cost of the reagents (syphilis screening-$0.95; confirmation-$1.45; GC/CHL-$4.25). The balance of program income earned by PERFORMING AGENCY from Medicaid reimbursements and other sources will be identified, reported, and utilized to further the program objectives of the -1- State statute under which the Scope of Work for the Attachment was made. All program income generated by activities supported by this Attachment will be reported on a quarterly laboratory report. Laboratory reports are due no later than 20 days after the end of each quarter. General Provisions, Financial Reports Article, is not applicable to this Attachment. SECTION IV. BUDGET: Support for this scope of work is provided in part by the RECEIVING AGENCY, Bureau of Laboratories, through supplies ordered directly from RECEIVING AGENCY warehouse stocks or through reagents drop -shipped from vendors or from RECEIVING AGENCY to the value limit set out below. Requisitions for supplies will be processed in accordance with RECEIVING AGENCY guidelines. Any change in the allotment amount must be approved by RECEIVING AGENCY, Chief, Bureau of Laboratories. WAREHOUSE ALLOTMENT-$6,100.00 REAGENT ALLOTMENT-$69,900.00 TOTAL ALLOTMENT-$76,000.00 :PM TEXAS DEPARTMENN7 OF HEALTH CONTRACT 1100 'Nest 49th Street Austin. Texas 78756-3199 STATE OF TEXAS COUNTY OF TRAVIS This contract is between the as RECEIVING AGENCY. and includes general provisions special provisions. TDH Document No. C4000133 Texas Department of Health, hereinafter referred to the party listed below as PERFORMING AGENCY and and attachments detailing scope(s) of work and PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT (PRINT or TYPE) I Mailing Address: P. 0. BOY 2548 LUBBOCK TX 79408-25481 (City) (ST)-77 1 P) I Street Address: 1902 TEXAS AVENUE LUBBOCK TX 79405-11171 (11 different) (City) (t)(ZiPT-1 _i Authorized I Contracting Entity: CITY OF LUBBOCK(11 1 t_ different from _---I Payee Name: CITY OF LUBBOCK HEALTH DEPARTMENT 1 Must match with vendor identification number s own a ow) I Payee Address: P. 0. BOX 2000 LUBBOCK TX 79457 00001 I(Must match with vendor identification number s own Be-low)I State of Texas Vendor Identification No. (14 digits): 1'7560005906037 Finance Officer/Contact: DOUG GOODMAN Type of Organization: Cit I 1 Designate: Elementary secon ary school, junior college, senior college universe y city, county, other political subdivision, council of governments, judicial i I district, community services program, individual, or other (define) I Is this a small business No (Yes/No)) and/or minority/woman owned No (Yes/No) I Is this a non-profit business Yes (Yes/No) I PAYEE AGENCY Fiscal Year Ending Month: SEPTEMBER 1 _1------------------------------------------------------------------------------------ SUMMIARY OF TRANSACTION: Contract for Public Health services. I I I I I COVER - Page 1 'In. ' T`L _ Term Source of „ rest Total Assistance --e3:n n ►UR.-j1 =TCun; -03:3:yice Amount ITDH S^are; W5 33; A;5% 94: STATE :6..3?t.JO: I �2.cIS.',0' ?9i.59'•:: 1 .. • 1 • b34laG4—_4� � �:J :/,. '9 • r 1 Jin _ � I;.i;1.0 '1 t I I 1 18,i..51.00. t 1 1 ' i 1 I I 1 1 1 1 1 1 I 1 1 1 I I 1 f I 1 i 1 1 1 1 1 1 1 , I f 1 1 1 ! ! 1 1 1 1 I 1 1 1 1 1 1 -------------------------------------------------------------------------------------------------------------------- TDH Do:ument No. C4000133 TOTALS ; 484,163.00; S 216,061.00; ; 700,230.00' I 1 I *Federal funds are indicated by a number from the Catalog of Federal Domestic Assistance iCFDAi, if aopiicable. REFER TO BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS. COVER - Page 2 EXECUTED !N DUPLICATE ORIGINALS ON THE DATES SHOWN. CITY OF LUBBOCK TDH Document No.: C4000133 Authorized Contracting Entity (type above if different from PERFORMING AGENCY) for and in behalf of: By: 1NG AG . /i (Sikature of person to sign contracts) orized David R. Langston, Mayor (Name and Title) TEXAS DEPARTMENT OF HEALTH RECEIVING AGENCY By: (Signature of person authorized to sign contracts) Linda Farrow, Chief Bureau of Financial Services (Name and Title) Date: September 23, 1993 Date: RECOMMENDED: By: DE" cc�� (PERFORMING AGENCY( A ector, if different from krs a authorized to sign contract) APPROVED AS TO FORM: By: Office of General Counsel COVER - Page 3 GENERAL PROVISIONS FOR TEXAS DEPARTMENT OF HEALTH CONTRACTS PERFORMING AGENCY and RECEIVING AGENCY agree this contract, assurances, general and/or special provisions, and Attachment(s) with detailed scope(s) of work and budget(s), as applicable, incorporate all covenants and agreements pertaining hereto. No prior agreement or understanding, oral or otherwise, of the parties or their agents will be valid or enforceable unless embodied in this contract. The person or persons signing and executing this contract on behalf of PERFORMING AGENCY, or representing themselves as signing and executing this contract on behalf of PERFORMING AGENCY, do hereby warrant and guarantee that he, she, or they have been duly authorized by PERFORMING AGENCY to execute this contract on behalf of PERFORMING AGENCY and to validly and legally bind PERFORMING AGENCY to all terms, performances, and provisions herein set forth. PERFORMING AGENCY hereby assures compliance with the following terms and conditions unless otherwise specified in the Attachment(s) hereto: ARTICLE 1. Scope of Work PERFORMING AGENCY will perform the work outlined in the Scope(s) of Work contained in the Attachment(s) hereto which is/are referenced in the Details of Attachments and hereby incorporated and made a part of this contract, plus amendments which may be added by additional Attachment(s) from time to time as hereinafter provided. Satisfactory performance of this contract will be measured in part by: (1) adherence to the contract; (2) results of CPA or State Auditor reports; and, 3) timeliness, completeness, and accuracy of required reports. ARTICLE 2. Term The time period of this contract will be governed by the term(s) on the Attachment(s). No commitment of contract funds is permitted prior to the first day nor subsequent to the last day of the term. The term may be extended or shortened by amendment(s). ARTICLE 3. rending This contract is contingent upon funding being available for the term of the Attachment(s) and PERFORMING AGENCY will have no right of action against RECEIVING AGENCY in the event that RECEIVING AGENCY is unable to perform its obligations under this contract as a result of the suspension, termination, withdrawal, or failure of funding to RECEIVING AGENCY or lack of sufficient funding of RECEIVING AGENCY for any Attachment(s) to this contract. If funds become unavailable, provisions of the Termination Article will apply. ARTICLE 4. Amendments Contract Attachment(s,) may be amended, and such amendments will be in writing and duly executed by the parties hereto. ARTICLE S. Severability If any provision of this contract will be construed to be illegal or invalid, this will not affect the legality or validity of any of the other provisions hereof. The illegal or invalid provision will be deemed stricken and deleted herefrom to the same extent and effect as if never incorporated herein, but all other provisions will continue. 1994 GENERAL PROVISIONS - Page 1 (5/93) ARTICLE 8. Assurances PERFORMING AGENCY will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. PERFORMING AGENCY will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. SS 4728-4763) relating to prescribed standards for merit systems for programs funded under one of the nineteen statutes or regulations specified in Appendix A of the Office of Personnel Management's Standards for a Merit System of Personnel Administration (5 CFR 900, Subpart F). PERFORMING AGENCY will comply with all federal and state statutes relating to nondiscrimination. These include but are not limited to: Title VI of the Civil Rights Act of 1964, as amended (42 USC Sec. 2000e, et. seq.) which prohibits discrimination on the basis of race, color or national origin; Title IX of the Education Amendments of 1972, as amended (20 USC Sec. 1681-1683 and 1685-1686), which prohibits discrimination on the basis of sex; the Rehabilitation Act of 1973, as amended (29 USC Sec. 794), which prohibits discrimination on the basis of handicaps; The Americans with Disabilities Act of 1990 (42 USC Sec. 12101 et. seq.), which prohibits discrimination on the basis of disabilities; The Age Discrimination Act of 1975, as amended (42 USC Sec. 6101-6107), which prohibits discrimination on the basis of age; The Drug Abuse, Prevention, Treatment, and Rehabilitation Act, as amended (21 USC Sec. 1101 et. seq.), relating to discrimination on the basis of drug abuse; the Age Discrimination in Employment Act of 1967, as amended (29 USC Sec. 621-634), which prohibits discrimination in employment on the basis of age; the Comprehensive Alcohol Kbuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970, as amended (42 USC Sec. 4541 et. seq.), relating to nondiscrimination on the basis of alcohol abuse or alcoholism; The Public Health Service Act of 1912, as amended (42 USC Sec. 290dd- 3 and 290ee-3), relating to confidentiality of alcohol and drug abuse patient records; any other nondiscrimination provisions in the specific statute(s), pertaining to applicable federal assistance; and the requirements of any other nondiscrimination federal or state statute(s) which might apply to this contract. PERFORMING AGENCY will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91- 190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. SS 7401 et seq.); and (d) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, P.L. 93-523. PERFORMING AGENCY will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by any applicable award of federal assistance. PERFORMING AGENCY will comply with the Clinical Laboratory Improvement Amendments of 1988 (CLIA), P.L. 100-578 (42 U.S.C. 263 a), which establish Federal requirements for the regulation and certification of clinical laboratories. PERFORMING AGENCY will comply with the OSHA Regulations on Bloodborne Pathogens, 56 Fed. Reg. 64175 (1991), 29 C.F.R. 1919.030, which set safety standards for those workers and facilities who may handle bloodborne pathogens. PERFORMING AGENCY assures it will not transfer or assign its interest in this contract without the written consent of the RECEIVING AGENCY. 1994 GENERAL PROVISIONS - Page 3 (5/93) ARTICLE 12. Terms and Conditions of Payment For services satisfactorily performed pursuant to the Scope(s) of Work, PERFORMING AGENCY will receive reimbursement for allowable costs. Reimbursements will not exceed the total of each Attachment(s) hereto and are contingent on a signed contract. Claims for reimbursement will be made on a State of Texas Purchase Voucher (TDH Form IAG-37). Vouchers for reimbursement of actual expenses will be submitted monthly within 20 days following the end of the month covered by the bill. A make-up claim may be submitted as a final close-out bill not later than 45 days following the end of Attachment term(s). Advance payment may be requested in accordance with the applicable provisions of this contract. Payments made for approved claims or notice of denial of claims submitted against Attachment(s) to this contract will be mailed not later than 60 days after receipt of monthly vouchers. Payment is considered made on the date postmarked. Any reimbursements made by PERFORMING AGENCY to subcontractors will be made in accordance with Article 601f, V.T.C.S. Funding from this contract will not be used to supplant state or local funds, but PERFORMING AGENCY will use such funds to increase state or local funds currently available to PERFORMING AGENCY for a particular activity. PERFORMING AGENCY further agrees to maintain to the best of its ability its current level of support, if any. PERFORMING AGENCY will refund to RECEIVING AGENCY any funds PERFORMING AGENCY claims and receives from RECEIVING AGENCY for the reimbursement of costs which are determined by RECEIVING AGENCY to be ineligible for reimbursement. RECEIVING AGENCY will have the right to withhold all or part, of any future payments to PERFORMING AGENCY to offset any reimbursement made to PERFORMING AGENCY for any ineligible expenditures not refunded to RECEIVING AGENCY by PERFORMING AGENCY. Payment may be denied for noncompliance if required financial reports are not on file for previous quarters or for the final period, or for failure to respond to financial compliance monitoring reports, or if program requirements are not met as specified in the Scope(s) of Work. ARTICLE 13. Advance Payment PERFORMING AGENCY may request, in writing, a one time advance with proper justification and the concurrence of RECEIVING AGENCY. Amount of advance will be determined by the amount and term of the Attachment(s)f however, for each Attachment, the amount of the advance will not exceed one -sixth (1/6th) of a twelve-month Attachment. Advance will be requested on a State of Texas Purchase Voucher at the beginning of Attachment period or at a single later time in the Attachment period if circumstances so warrant and the request is approved. Advance funds will be liquidated during the Attachment term so that, after final monthly billing, PERFORMING AGENCY will not have advance funds on hand. Advance funds may be drawn only to meet immediate cash needs for disbursement (UGCMA and federal circulars). Amendments to this Attachment(s) may require upward or downward adjustment to the allowable advance until it equates 1/6th of a twelve-month Attachment or approximates two months operating costs. In the case of a downward adjustment, PERFORMING AGENCY and RECEIVING AGENCY will agree on the amount of adjustment to the advance. RECEIVING AGENCY retains the option to reduce future claims by the required amount. In the case of an upward adjustment and PERFORMING AGENCY needs additional funds to meet immediate operating expenses, PERFORMING AGENCY may submit to RECEIVING AGENCY a written justification and State of Texas Purchase 1994 GENERAL PROVISIONS - Page 5 (5/93) submitted if all costs have not been recovered or a refund will be made of excess monies if costs incurred were less than funds received. ARTICLE 16.• Reports and Inspections PERFORMING AGENCY will submit financial, program, progress, and other reports as requested by RECEIVING AGENCY in the format agreed to by the parties hereto. RECEIVING AGENCY and, when federal funds are involved, any authorized represent Ative(s) of the federal government have the right, at all reasonable times, to inspect or otherwise evaluate the work (including client or patient records) performed or being performed hereunder and the premises in which it is being performed, including subcontractors. PERFORMING AGENCY will participate in and provide reasonable access, facilities, and assistance to the representatives. All inspections and evaluations will be performed in such a manner as will not unduly delay the work. PERFORMING AGENCY agrees that RECEIVING AGENCY and the federal government, or any of their duly authorized representatives, will have access to any pertinent books, documents, papers, and client or patient records of PERFORMING AGENCY for the purpose of making audit, examination, excerpts, and transcripts of transactions related to contract Attachment(s). RECEIVING AGENCY will have the right to audit billings both before and after payment. Payment under Attachment(s) will not foreclose the right of RECEIVING AGENCY to recover excessive or illegal payments. Any deficiencies identified by RECEIVING AGENCY upon examination of PERFORMING AGENCY's records will be conveyed in writing to PERFORMING AGENCY. PERFORMING AGENCY's resolution of findings will also be conveyed in writing to RECEIVING AGENCY within 30 days of receipt of RECEIVING AGENCY's findings. A determination by RECEIVING AGENCY of either an inadequate or inappropriate resolution of the findings may result in the withholding of funds or suspension of the contract Attachment(s). Any such withholding of funds or suspension will remain in effect until the findings are properly remedied as determined by RECEIVING AGENCY. PERFORMING AGENCY will retain all such records for a period of three years from the date of the last expenditure report submitted under contract Attachment(s) or until resolution of all audit questions, whichever time period is longer. ARTICLE 17. Client Records At the end of the Attachment term, all client records (including patient records) are the property of PERFORMING AGENCY. RECEIVING AGENCY retains the right to have access to the records or obtain copies for audit, examination, evaluation, inspection, litigation, or other circumstances that may arise. If at any time during the Attachment term(s), PERFORMING AGENCY and/or RECEIVING AGENCY should decide to suspend or terminate the agreement, RECEIVING AGENCY may require the transfer of client records (including patient records) upon written notice to PERFORMING AGENCY, either to another entity that agrees to continue the service or to RECEIVING AGENCY. ARTICLE 18. Confidentialit PERFORMING AGENCY will have a system in effect to protect client or patient records and all other documents deemed confidential by law which are maintained in connection with the activities funded under contract. Any disclosure or transfer of confidential client or patient information by PERFORMING AGENCY, including information required by the Reports and Inspections Article, will be in accordance with applicable law. 1994 GENERAL PROVISIONS - Page 7 (5/93) ARTICLE 21. Copyricthts, Publications, and Patent PERFORMING AGENCY understands and agrees that where activities supported by the contract Attachment(s) produce original books, manuals, films, computer programs (including executable computer programs and supporting data in any form), or other original material, PERFORMING AGENCY may copyright such material subject to any rights to same reserved by or vested in the federal government or any agency thereof; however, RECEIVING AGENCY may grant to PERFORMING AGENCY limited rights to produce, publish, and use such materials as appropriate. PERFORMING AGENCY may publish at its expense the results of contract performance with prior RECEIVING AGENCY review and approval. Any publication (written, visual, or sound) should include acknowledgment of the support received from RECEIVING AGENCY and the appropriate federal agency, if applicable. At least three copies of any such publication must be provided to RECEIVING AGENCY. RECEIVING AGENCY reserves the right to require additional copies before or after the initial review. PERFORMING AGENCY and any subcontractor, as appropriate, must comply with the standard patent rights clauses in 37 CFR Sec. 401.14 or FAR 52.227.11. ARTICLE 22. Hold Harmless PERFORMING AGENCY, which is not a state agency, assures that it is an independent contractor and not an agent, servant, or employee of the state. Except to the extent that Chapter 104 of the Texas Civil Practice and Remedies Code is applicable to this contract, PERFORMING AGENCY agrees to hold RECEIVING AGENCY and/or federal government harmless and to indemnify them from and against any and all claims, demands, and causes of action of every kind and character which may be asserted by any third party occurring or in any way incident to, arising out of, or in connection with the performance of services by PERFORMING AGENCY under this contract to the extent allowed by law, and to the extent of damages permitted under Chapter 101 of the Texas Civil Practice and Remedies Code. PERFORMING AGENCY, by acceptance of funds provided through contract Attachment(s), agrees and ensures that personnel paid from these funds are duly licensed and/or qualified to perform the required services. ARTICLE 23. Bonding Each person employed by PERFORMING AGENCY who handles funds under this contract, including persons authorizing payment of such funds, will be covered by the terms of a fidelity bond providing for indemnification of losses occasioned by: (1) any fraudulent or dishonest act or acts committed by any of PERFORMING AGENCY's employees either individually or in concert with others, and/or, (2) failure of PERFORMING AGENCY or any of its employees to perform faithfully his/her duties or to account properly for all monies and property received by virtue of his/her position or employment. This fidelity bond will be in the amount of not less than Ten Thousand Dollars ($10,000). In the event that PERFORMING AGENCY, being an independent contractor, maintains a self-insurance program that provides for the indemnification of losses as described in the above paragraph regarding fidelity bonds, then PERFORMING AGENCY will provide the RECEIVING AGENCY a certified statement which summarizes its self-insurance plan. The certified statement will be submitted at the time this contract is submitted for approval. Any changes to said plan, which occur during the term of this contract period, will be reported to RECEIVING AGENCY. The self-insurance program should be based on the determination that the coverage can be provided at a cost no greater than the cost of obtaining equivalent coverage from an insurance company. 1994 GENERAL PROVISIONS - Page 9 (5/93) equitable settlement of the respective accrued interests or obligations as of the date of termination. ARTICLE 25. Personnel All personnel funded by Attachment(s) to this contract are employees of PERFORMING AGENCY which will be responsible for their direction and control and liable for any of their acts or omissions. PERFORMING AGENCY will have in place legally sufficient Due Process Hearing Procedures for all of its employees filling state budgeted positions. PERFORMING AGENCY will have full authority to employ, promote, suspend, demote, discharge, and transfer within its organization any and all state budgeted personnel funded by Attachment(s) to this contract provided, however, that any demotion, suspension, or discharge of such state budgeted employees will be in accordance with the Due Process Hearing Procedures as set out above. The only distinction between state budgeted and local paid employees is that employees on state budgeted positions receive state benefits and are subject to certain duties, obligations, and restrictions as state employees as contained in state law. one such restriction, as contained in the State Appropriations Act, is that no employee paid on a state budgeted position may receive a salary supplement from any source unless specifically authorized in the Appropriations Act or other state law. This prohibition includes, but is not limited to, the payment to such employee of a so-called "flat rate" car allowance or travel allowance. Any such travel or per diem to these employees must be on a reimbursement basis, supported by appropriate records, and may not exceed the reimbursement for mileage and/or per diem allowed under the Appropriations Act and current state travel regulations. This restriction will apply whether travel funds are provided in Attachment(s) under this contract or from any other source. PERFORMING AGENCY will utilize RECEIVING AGENCY's policies and procedures for hiring and promoting individuals into state budgeted positions funded by Attachment(s) to this contract. Qualifications of any individuals filling these positions will be subject to approval of RECEIVING AGENCY's Bureau of Personnel Management. The purpose of the approval is to ensure that individuals occupying these positions meet minimum educational and experience requirements. PERFORMING AGENCY will maintain required records and submit documents necessary to process personnel, payroll, leave and time records, and travel claims on state budgeted positions. PERFORMING AGENCY will be furnished by RECEIVING AGENCY state warrants for salary compensation or travel reimbursement for issuance to employees on state budgeted positions. An independent audit is not required as a condition of this contract if the Attachment provides assistance through assignment of state budgeted positions and no funds are budgeted for local costs. PERFORMING AGENCY may be reimbursed for local personnel costs or other categories of expense used to fulfill the scope of work of Attachment(s) in lieu of being furnished state payroll warrants after a state budgeted position becomes vacant. Reimbursement will not exceed the balance of funds on the state budgeted position after all benefits, obligations, and/or other entitlements are! met. PERFORMING AGENCY's Director, or other person(s) authorized elsewhere in this contract, may submit a request for conversion. RECEIVING AGENCY will transmit formal approval and a revised budget to PERFORMING AGENCY to complete the conversion. ARTICLE 26. Funding Participation Requirement PERFORMING AGENCY agrees funds provided through this contract will not be used for matching purposes in securing other funding unless otherwise directed or approved by RECEIVING AGENCY. 1994 GENERAL PROVISIONS - Page 11 (5/93) For state fiscal year 1994, the parties recognize and agree that the performance -based objectives for the pilot program areas are negotiable. If PERFORMING AGENCY'S achievement is below the established levels, it will not affect the right of PERFORMING AGENCY to funds provided through Attachment(s) when the basic program Scope of Work has been fulfilled. It is understood and agreed upon by both parties that PERFORMING AGENCY will be required to append approved performance -based objectives for the pilot program areas to the local health services contract for state fiscal year 1994. RECEIVING AGENCY contact for matters pertaining to the performance -based public health services project is the Office of the Associate Commissioner for Community and Rural Health. 1994 GENERAL PROVISIONS - Page 13 (5/93) DOCUMENT NO. C4000133 ATTACH�EW NO. 01 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: BUREAU OF MATERNAL AND CHILD HEALTH TERM: September 1, 1993 THROUGH August 31, 1994 SECTION I. SCOPE OF WORK: PERFORMING AGENCY will provide or assure the provision of the following health services to women and children: prenatal care. family planning services, especially during the first year post partum, and preventive child health services. Special emphasis should be given to low income women and children. In addition, the PERFORMING AGENCY will provide case management services to these women and children with emphasis on services to high risk individuals. Case management services include an assessment of the individual's and family's service needs and the development, implementation and evaluation of a plan to meet these needs. Services will be performed in accordance with the guidelines for maternity, family planning, child health, and case management services as promulgated by RECEIVING AGENCY, Bureau of Maternal and Child Health. The Maternal and Child Health Service Plan is incorporated herein and made a part of this contract. Maternity, Family Planning, Child Health Clinic, and Case Management services reports will be submitted to RECEIVING AGENCY, Bureau of Maternal and Child Health, in a format and time frame to be agreed upon by both parties. PERFORMING AGENCY will participate in the coordination of Maternal and Child Health services under the leadership of RECEIVING AGENCY'S Public Health Regional Director. The Public Health Region (PHR) will invite a broad -based participation to its meetings to include community -based providers, city and county officials, community health center personnel, migrant health center personnel, medical schools and agricultural extension agents. PERFORMING AGENCY will work with the PHR in order to coordinate services, avoid duplication, report unmet needs of the community, and help to develop "One Stop Shopping Care Centers" where possible. SECTION II. LEGAL AUTHORITY TO CONTRACT: Chapters 12 and 121, Health and Safety Code. SECTION III. SPECIAL PROVISIONS: General Provisions, PROGRAM INCOME Article, is modified for the purposes of this attachment to comply with Section 2192(a), Title V, Social Security Act, Maternal and Child Health Block Grant, which does not allow low income mothers and children to be charged a fee for health services provided under this attachment. The term "low income" refers to an individual or family on Medicaid, income eligible for Medicaid, or with an income determined to be below the nonfarm income official poverty line defined by the Office of Management and Budget and revised annually in accordance with Section 624 of -1- the Economic Opportunity Act of 1964. No individual may be denied services because of the person's inability to pay. General Provisions, REPORTS AND INSPECTIONS Article, is modified to include the following: PERFORMING AGENCY will provide unduplicated reports based on: Patients receiving maternity, child health, family planning and case management services including total number of patients seen. SECTION IV. BUDGET: FINANCIAL ASSISTANCE Financial assistance involves payment of funds to PERFORMING AGENCY for costs incurred in carrying out approved activities. Personnel $276,315.00 Fringe Benefits 50,733.00 Travel .00 Equipment .00 Supplies 16,733.00 Contractual 21,200.00 Other .00 Total Direct Costs $364,981.00 Indirect - .00 TOTAL $364,981.00 Financial status reports (FSRs) are due the 30th of December, March, June, September and the 15th of October. RECEIVING AGENCY financial assistance will not exceed $364,981.00. -2- DIRECT ASSISTANCE Direct assistance involves the assignment of state funded positions or the provision of materials or supplies such as vaccines in lieu of cash. Personnel [ 2 position(s)] $32,616.00 TOTAL $32,616.00 Direct assistance for personnel in the amount of $32,616.00 is shown on the attached list of positions and budgetary amounts which is an integral part of this attachment. State salary warrants for net earnings will be issued in accordance with state regulations. Financial status reports (FSRs) are not required on direct assistance. Program income generated from activities supported with direct assistance will be reported on FSRs required for financial assistance provided through this attachment, if applicable, or through other program attachment(s) benefiting from this assistance. RECEIVING AGENCY direct assistance will not exceed $32,616.00. Total RECEIVING AGENCY assistance will not exceed $397,597.00. -3- LUBBOCK CITY / FAMILY HEALTH SERV PAGE 705 TEXAS DEPARTMENT OF HEALTH PHR 2 ' I)PERATING BUDGET FOR YEAR ENDING AUGUST 31. 1994 i IS OF MARCH 31 1993 BUDGET NO. LC301 H21311/K1i028 CATE- DESCRIPTION OR TITLE FUND END ITEM JOB PAY PAY EFFECTIVE MONTHLY GORY DESC. MONTH NO. CLASS GP STP DATE RATE 1 CLERICAL SUPERVISOR II STATE AUG 088 0063 07 01 SEP 93 1,397.00 COMMUNITY SERV AIDE III STATE AUG 131 5503 06 01 SEP 93 1,321.00 BUDGETED AMT 16,764.00 15,852.00 32,616.00 DOCUMENT NO. C4000133 ATTACHMENT NO. 02 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: COMMUNITY AND RURAL HEALTH TERM: September 1, 1993 THROUGH August 31, 1994 SECTION I. SCOPE OF WORK: Comprehensive Public Health Services PERFORMING AGENCY will use direct assistance and/or financial assistance from RECEIVING AGENCY to supplement the delivery of comprehensive public health services. Comprehensive health services encompass a wide variety of personal health services, environmental health services, and other needs of the jurisdiction. Personal health services may include but are not limited to adult health/chronic disease, HIV/AIDS, chronically ill/disabled children, dental, immunization, laboratory, maternal and child health, public health promotion/education, sexually transmitted disease control, and tuberculosis control. Environmental health services/inspections may include but are not limited to food, premise, swimming pool, vector control, and wastewater control. Other services may be provided as needed when agreed to by both parties. PERFORMING AGENCY has prepared outcome and process objectives, if they are applicable and relative to the local needs and resources, for the following program areas: HIV/AIDS Public Health Promotion Immunization Refugee Health Food Protection Sexually Transmitted Disease Maternal and Child Health Tuberculosis Chronic Disease Prevention and Control These performance -based objectives are incorporated and made a part of this attachment and are hereinafter referred to as Exhibit A. PERFORMING AGENCY agrees to maintain a monitoring system and report progress towards these objectives on a quarterly and annual basis. Quarterly monitoring reports are due no later than 45 days after the end of each quarter, and a cumulative annual report is due no later than 60 days after the end of the attachment term. All performance monitoring reports will be submitted by PERFORMING AGENCY to the respective RECEIVING AGENCY Public Health Region. The Public Health Region will review and forward the reports to RECEIVING AGENCY Community and Rural Health. The format for performance -based monitoring reports will be agreed upon by both parties prior to the due date of the first quarterly report. Immunization Vaccine Support Direct assistance will be provided by RECEIVING AGENCY to PERFORMING AGENCY -1- for the implementation of an Immunization program. The goal of the immunization program is to prevent, control, and eradicate vaccine -preventable disease by providing administering biologicals, promoting immunization, and applying epidemiologic/outbreak controls within budgetary constraints. This will be accomplished by performing the following activities and reperts. A. Investigations/Control Measures PERFORMING AGENCY will investigate 100% of suspected cases of measles, rubella, pertussis, poliomyelitis, and diphtheria within 24 hours after a report is received. PERFORMING AGENCY will investigate 90% of suspected mumps cases and 100% of suspected tetanus cases within 48 hours after a report is received. For the above diseases, PERFORMING AGENCY will implement the most current outbreak control procedures/measures and contact RECEIVING AGENCY, Immuniza- tion Division, within 48 hours after an investigation is initiated. B. Reporting Requirements PERFORMING AGENCY understands that all vaccines used in RECEIVING AGENCY Immunization Programs are purchased with public funds and must be accounted for the same as other public property. PERFORMING AGENCY further understands that vaccine loss, destruction, spoilage, or other waste, may be investigated by the RECEIVING AGENCY, Immunization Division, which may then require reimbursement or replacement of the lost vaccines. PERFORMING AGENCY agrees to provide RECEIVING AGENCY, Immunization Division, by January 31st, of each year, a report detailing storage measures and methods used to control vaccine loss including method to monitor and record daily vaccine storage temperatures. The report will be submitted in a format provided by RECEIVING AGENCY, Immunization Division. PERFORMING AGENCY agrees to provide RECEIVING AGENCY, Immunization Division, monthly reports of vaccine utilization/loss, within ten working days after the end of each month, on forms provided by RECEIVING AGENCY (forms C5, CSA, C33, C33A). PERFORMING AGENCY will obtain monthly biological reports from private physician offices and others who receive state supplied biologicals. PERFORMING AGENCY will be evaluated on both the total number of doses admin- istered and the number of DTP 4 administered to children who are two years old or younger. PERFORMING AGENCY agrees to comply with the following: Texas Immunization Laws, Rules, and Regulations; Chapter 42, Human Resources Code; Sections 2.09 and 2.09A, Texas Education Code; and Section 317 of the PHS Act as amended. PERFORMING AGENCY agrees to closely adhere to both the spirit and intent of the "Standards for Pediatric Immunization Practices," as recommended by the National Vaccine Advisory Committee, approved by the U.S.P.H.S. and endorsed by the American Academy of Pediatrics. PERFORMING AGENCY agrees to provide immunization services outside usual clinic hours (8am to 5pm) or on week -ends -2- at least once each month or as needed to insure barrier free access to immun- ization clinics. PERFORMING AGENCY will provide services/units of service in or benefiting the county(ies)/area defined as: LUBBOCK. SECTION II. LEGAL AUTHORITY TO CONTRACT: Chapters 12 and 121, Health and Safety Code. SECTION III. SPECIAL PROVISIONS: Immunization Program Requirements: PERFORMING AGENCY understands that federal law guarantees access to immuniza- tion services in public clinics regardless of ability to pay. PERFORMING AGENCY further understands that the bilingual poster "Fees for Vaccine Admin- istration," (Form 6-36, available from the Immunization Division) must be posted where it may be easily seen by patients in each immunization waiting room. PERFORMING AGENCY understands that Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) physicians and other private physicians authorized to administer state -supplied vaccines in their practices are vital members of the Texas Immunization Initiative. Accordingly, PERFORMING AGENCY agrees to assist in distributing state -supplied vaccines to EPSDT providers, medicaid providers, physicians, and other providers and organizations within PERFORMING AGENCY's local area. PERFORMING AGENCY agrees that fees collected will be kept within guidelines established by RECEIVING AGENCY and that no one may be denied immunization services because of inability to pay the fee. Fee schedules will not be based on per dose charges. For immunization activities performed under this attachment, General Provisions, Overtime Compensation Article, is replaced to read as follows: PERFORMING AGENCY is authorized to pay employees who are exempt or not exempt for purposes of the Fair Labor Standards Act of 1938 (29 U.S.C. Section 201 et. seq.) on a straight -time basis for work on a holiday or for regular compensatory time hours when the taking of regular compensatory time off would be disruptive to normal business operations. Authorization for payment under this section is limited to work directly related to immunizations. - 3- SECTION IV. BUDGET: FINANCIAL ASSISTANCE Financial assistance involves payment of funds to PERFORMING AGENCY for costs incurred in carrying out approved activities. Personnel $81,766.00 Fringe Benefits 13,416.00 Travel .00 Equipment .00 Supplies .00 Contractual 24,000.00 Other .00 Total Direct Costs $119,182.00 Indirect .00 TOTAL $119,182.00 Financial status reports (FSRs) are due the 30th of December, March, June, September and the 15th of October. RECEIVING AGENCY financial assistance will not exceed $119,182.00. Qi: DIRECT ASSISTANCE Direct assistance involves the assignment of state funded positions or the provision of supplies such as vaccines in lieu of cash. Personnel CO2 position(s)] $43,440.00 Vaccine 140,011.00 TOTAL $183,451.00 Direct assistance for personnel in the amount of $43,440.00 is shown on the attached list of positions and budgetary amounts which is an integral part of this attachment. State salary warrants for net earnings will be issued in accordance with state regulations. Financial status reports (FSRs) are not required on direct assistance. Program income generated from activities supported with direct assistance will be reported on FSRs required for financial assistance provided through this attachment, if applicable, or through other program attachment(s) benefiting from this assistance. RECEIVING AGENCY direct assistance will not exceed $183,451.00. Total RECEIVING AGENCY assistance will not exceed $302,633.00. -5- TEXAS DEPARTMENT OF HEALTH LUPBOCK CITY HEALTH DEPARTMENT PAGE 729 OPERATING BUDGET FOR YEAR ENDING AUGUST 31, 1994 'AS OF APRIL 30 1993 BUDGET NO. L0000 821311/K1i028 CATE- DESCRIPTION OR TITLE FUND END ITEM JOB PAY PAY EFFECTIVE MONTHLY BUDGETED AMT GORY DESC. MONTH NO. CLASS GP STP DATE RATE I LIC VOCATIONAL NURSE II STATE AUG 083 4412 10 04 SEP 93 1.839.00 22,068.00 ADMINISTRATIVE TECH I . STATE AUG 104 1501 08 07 SEP 93 1.781.00 21,372.00 FY 1994 PERFORMANCE -BASED CONTRACT OBJECTIVES EXHIBIT A FOR ATTACHMENT FOR LUBBOCK CITY HEALTH DEPARTMENT PERFORl1iA,`'CE-BASED CO,�TRACT OBJECI't% FOR FY 1994 DISCLAIMER SHEET List programs you DO NOT provide. If there is more than one program, use a separate dis. claimer sheet for each one. LOCAL HEALTH DEPARTMENT:--�-o c*e- C PROGRAM NOT PROVIDED: SIGNATURE: TITLE: PHONE NUMBER: REASON THE ABOVE PROGRAM IS NOT PROVIDED: 'I'�S� �•� `l�K oa--i- t,�"o (U e PC` 10&r` 6L"^ S �— Z'aSj C7` C-aA,,.V., LA- lec. T Gi 0� 41 e UL Oc-aQ S,4 0 PERFORYiAINCE-BASED CONTRACT OBJECTIVES FOR FY 1994 DLSCLARAER SHEET List programs you DO NOT provide. If there is more than one program, use a separate dis. claimer sheet for each one. LOCAL HEALTH DEPARTMENT. PROGRAM NOT PROVIDED: C C s sects SIGNATURE: PHONE NUMBER: REASON THE ABOVE PROGRAM IS NOT PROVIDED: w CL -6 +v PER.FORNIANCE-BASED CONTRACT OBJECTIVES FOR FY 1994 DISCLAWER SHEET List programs you DO NOT provide. If there is more than one program, use a separate dis. claimer sheet for each one. LOCAL HEALTH DEPARTMENT: ��.b `o a cie ev"c Y PROGRAM NOT PROVIDED: .!J t SIGNATURE: A!41WA !: �►� PHONE NUMBER: Cfrl REASON THE ABOVE PROGRAM IS NOT PROVIDED: � pr�v jai Same • Scre��C A+�b c-� a e c.5 Ve� 'e-0 42 tl To: CRH/KSHIELDS From: RGN2/PJOHNSON Date: 26 Mar 93 14:29:12 Subject: PBCO FORM CC: TSNELL COMMENT/VERIFICATION FORM PBCOs FOR FY 1994 LOCAL HEALTH DEPARTMENT:L_1" - PROGRAM: PP REVIEWER: REVIEWER'S PHONE NUMBER: DATE: Please place an "X" in front of one of the following items and fill in any pertinent blanks: - Listed revisions were negotiated with: NAME: TITLE: DATE: X Comments only. No revisions necessary. - Suggestion for FY 95. No revisions necessary at this time. - No comments, suggestions and/or revisions. Objectives stand as written. Please list below any revisions, comments, and/or suggestions. Use a new form for each program. From: Robert M. Badger, R.S. TO: Tommy Snell DATE: February 22, 1993 SUBJECT: Comments on Performance Based Contract Objectives from Lubbock Health Department I have reviewed the objectives from the City of Lubbock Health Department which you provided for me and offer the following comments: 1. Outcome objective: The intent to keep the number of critical violations noted per inspection to less than 1.3 violations per inspection is laudable. However, the health department cannot and should not pre -determine the outcome of regulatory inspections. Critical violations are definitely an item of concern in a food protection program, but a reduction in the number of critical items noted during inspections can be a result ONLY from enforcement actions and education of the regulated industry, and not a result of the inspection program, per se. The flaw that I see with the objective as stated is that it appears to be artificially controllable. It would be very convenient to limit the number of critical violations "seen" in order to stay within the parameters specified by the objective. In order to overcome this possible flaw, I suggest that additional process objectives be formulated to address enforcement whenever critical violations are encountered as well as to address the enlightenment of the regulated industry regarding the significance of critical violations. I also suggest that a periodic audit be included in the activities to help ensure that inspectors are noting all the ciritcal items that exist during the time of their inspections. In this regard, it might be beneficial to state in the outcome objective that "the average number of critical violations per AUDIT inspection will be less than 1.3." 2. Process objective: Standardization of inspectors is of paramount importance in the maintenance of a comprehensive and effective food protection program. However, our records indicate that the only "standardized food service training officer" who has been certified as being standardized by an outside agency is no longer affiliated with the Environmental Health program. I suggest that an additional process objective should be formulated to ensure that there is at least one "food service training officer" who has been standardized by a state or federally certified training officer. In addition, I suggest that ALL inspectors should receive standardization training in accordance with FDA guidelines either by the specified time limit of January, 1994, or within one year of their employment date, whichever is later. 3. Process objective: My only comment regarding the objective which deals with complaints of foodborne illness is that the•24-hour time limit may be TOO restrictive. I would suggest a less rigid time limit such as ensuring that the investigation is initiated before the close of business on the next working day following the receipt of the complaint. This would allow some flexibility in dealing with routine reports which occur at 4:50 p.m. on Friday afternoon, but would not restrict activities which, by their nature, should begin immediately. The inclusion of the term "investigation is initiated" is intended to recognize that certain investigations cannot be completed in a day. 4. The objectives which deal with wastewater management are no longer within the purview of the Texas Department of Health in that all wastewater regulatory functions were transferred from the Texas Department of Health to the Texas Water Commission in March, 1992. ENVIRONMENTAL HEALTH PROGRAM OBJECTIVES LUBBOCK CITY HEALTH DEPARTMENT FOCUS: FOOD PROTECTION Outcome Objectives INDICATORS - During fiscal 1993-94, the - Average number of average number of critical critical violations violations per inspection per food service for food service establish- establishment. ments will be less than 1.3. Process Objectives - By January 1994, at least 80% Percent of of all sanitarians conducting Standardized retail food inspections will Sanitarians. receive field Standardization training in accordance with FDA guidelines. - During fiscal 1993-94, all - Elapsed times between foodborne illness complaints report of illness and will be documented properly subsequent investiga- to identify complainant's tions. illness and investigated within 24 hours. FOCUS: WASTEWATER MANAGEMENT Outcome Objectives —During fiscal 1993-94, at least 95% - Percent of investi- of all complaints regarding malfunctioning gations within time or illegal wastewater disposal systems allotment. will be investigated within 48 hours. Process Objectives - During fiscal 1993-94, all - Percent of appli- residential OSSF applications cations processed which do not require pro- within designated fessional design submittals time. shall be processed within 3 working days. Rev. 2/93 To: CRH/KSHIELDS From: STD/WHODGSON Date: 7 May 93 08:18:11 Subject: PBCO FORM CC: rgn2/tsnell, rgn2/bray COMMENT/VERIFICATION FORM PBCOs FOR FY 1994 LOCAL HEALTH DEPARTMENT: Lubbock City Health Department PROGRAM: HIV/AIDS REVIEWER: Wes Hodgson REVIEWER'S PHONE NUMBER: (512) 458-7304 DATE: May 7, 1993 ------------------------------------------------------------------- Please place an "X" in front of one of the following items and fill in any pertinent blanks: - Listed revisions were negotiated with: NAME: TITLE: DATE: x - Comments only. No revisions necessary. - Suggestion for FY 95. No revisions necessary at this time. - No comments, suggestions and/or revisions. Objectives stand as written. -------------------------------------------------------------- Please list below any revisions, comments, and/or suggestions. Use a rew form for each program. I core-ur with the findings of Billie Ray. In addition, I would like some mention of referral for Early Intervention. To: CRH/KSHIELDS From: RGN2/BRAY Date: 9 Mar 93 13:46:02 Subject: PBCO FORM COMMENT/VEP,IFICATION FORM PBCOs FOR FY 1994 LOCAL HEALTH DEPARTMENT: Lubbock City Health Department PROGRAM: HIV REVIEWER: Billie L. Ray REVIEWER'S PHONE NUMBER: (806) 744-3577 ext.299 DATE: 3/9/93 ------------------------------------------------------------------- Please place an "X" in front of one of the following items and fill in any pertinent blanks: - Listed revisions were negotiated with: NAME: TITLE: DATE: - Comments only. No revisions necessary. X. - Suggestion for FY 95. No revisions necessary at this time. - No comments. suggestions and/or revisions. Objectives stand as written. ------------------------------------------------------------------- Please list below any revisions, comments, and/or suggestions. Use a new form for each program. No problem statement is listed. I suggest a problem statement be listed for next year to define just what PFCO will accomplish. HIV/AIDS Program FY 93-94 Outcome Objective Evaluation Formula Monitoring Plan Strategies 1. By 1995, the annual Incidence of newly diagnosed AIDS and HIV infection will be no more than 35 new cases per year. Process Objectives 1. During FY 93-941,000 individuals Identified at high risk will be provided with pre -test HIV counseling. 2. During FY 93-94, 100% of clients with an Identified risk for HIV Infection will be offered HIV pre- test counseling, testing and post- test from a TDH certified counselor, either on -site or through specific referral to an appropriate counsel- ing and testing site. 3. During FY 93-94, 80% of those tested will receive post-test counseling. M Cases # Pre -test Counseled M referred for CTPN X 100 M Identified with HIV risk M receiving post-test X 100 counseling M HIV tested Annually Process Objectives and Activities Quarterly Provide on -going CTPN program. Annually Administer high -risk question- naire to all patients in women's health clinics. Assess risk of all patients in STD clinic. Quarterly See Process Objective M. Annually Quarterly Stress Importance of post-test Annually counseling Educate patient regarding meaning of positive and negative test results. Provide convenient appointment date and time; and confidential setting. To. From: Date: Sub iec t : CRH/KSHIELDS DISCON/MKEENAN 27 Apr 93 17:14:3-1 PBCO FORM COMMENT/VERIFICATION FORM PBCOs FOR FY lQQ4 LOCAL HEALTH DEPARTMENT: LUBBOCK CITY HEALTH DEPARTMENT PROGRAM: IMMUNIZATION REVIEWER: MIKE KEENAN REVIEWER"S PHONE NUMBER: 6454 DATE: 04/27/93 Please place an "X" in front of one of the following items and fill in any pertinent blanks: - Listed revisions were neciotiated with: NAME: + TITLE: DATE: Comments only. No revisions necessary. - Suggestion for FY 95. No revisions necessary at this time. X - No comments. suggestions and/or revisions. Objectives stand as written. Please list below any revisions, comment., and/or suggestions. Use a new form for each program. Mae: twoje=t: Cc. CRHzK3wiZL�§ RAW MALSON 26 Aar 52 1),K = RSCO FQNM RGN2ZTSNELL COMMEN UVERIFICATIUM FORM PBCes FOR FY 19?4 LO§AL HEALTH DEPARTMENT;/UBBO. CITY HEALTH DEPARTMENT PROBRAW IMMUNIZATIONS PEVIEWER:DL WILSON REVIEWER'S PHONE NUMBER;TEX-AN 842-5296 DATE;2Z2 Q 93 ------------------------------------------------------------------- Pleaae place an "x" In front of one of the following Items and fill In any pertinent blanks: . Listed revisions were negotiated with: NAME; TITLE: DAM - Comments only. No revisions necessary. -Suggaztlom for P' K . No revision\ necessary at Ehls time. X- No cow Hants, suggestions and/or revisions. Onjectives start EI written. ---------------------------------------------------------------------- > ese Ilat below any revisions,.commerns, and/or s ggestiona. gs= a new form fQr eaC , Program. Immunizations (Vaccine -Preventable Diseases) FY 93-94 Outcome Objective Evaluation Formula Monitoring Plan Strategies 1. By 1995. the vaccine -preventable disease rate will not exceed 20 per 100,000 population. Process Objectives 1. By the end of FY 93-94, at least 80% of the two year old population attending the Health Department Clinic will have completed primary Immunizations, as recommended by AAP/CDC. # vaccine -preventable diseases X 100 Annually 1.87 # 2 year olds in compliance X 100 # 2 year olds Annually Process Objectives and Activities Conduct surveillance of records of 2 year olds. 2. By the end of FY 93-94, 100% of # investigated Win vaccine preventable diseases will 1 working day X 100 Annually Train several nurses in the be investigated within 1 working # diseases reported investigation of vaccine pre - day of reporting. ventable diseases. 3. By the end of FY 93-94, 100% of # receiving information X 100 Annually Prepare sufficient quantities of the area independent School . # requests Information flyers for use by Districts will receive information area school districts. about the Health Dept. Immunization Clinic hours. Activities 1. Survey 100% immunization records # records surveyed X 100 Monthly Conduct on -going review of records of two year olds attending the # records of children two years old. Health Department. To: CRH/KSHIELDS From: CRH/KSHIELDS Date: 14 May 93 09:26:29 Subject: Lubbock City Health D'epartmer►t. MCH comments CC: rgn2 /tsne ll COMMENT/VERIFICATION FORM PBCOs FOR FY 1994 LOCAL HEALTH DEPARTMENT: Lubbock. City Healt• Departmen PROGRAM: MCH REVIEWER: Carol Pavilka REVIEWER'S PHONE NUMBER: 512-455-7700 DATE:05-14-93 ------------------------------------------------------------------- Please place an "X" in front of one of t•he following items and fill in any pertinent blanks: - Listed rev is ions were negotiated with: NAME: TITLE: DATE: X - Comments only. No revisions necessary. - Suggestion for FY 95. No revisions necessary at this time. - No comments, suggestions and/car revisions. Objectives stand as written. Please list below any revisions, comments, and/or suggestions. Use a new farm for each program. Lubbock's family planning objective not an outcome. !&: SRHIkSH110% From: ROW/SRHg)Es Date. 26 mar 93 10:4410: Sunject: @BCD FORM CC: RGM2Mnell COMMENTZVERIRICAT ICN FORM PBCOZ FCR RY 1994 LOCAL HEALTH DEPARTMENT;Lubbock City eealtn Department. PROGRAM naternit% REVIEWER;Joan Herfmast■r CNm REVIEWER'S PHONE NUMBER;Tax An 824-5204 DATE:S-26-§S ------------------------------------------------------------------- Please plats an "k" in front of one of the following Items and fill In any Pertinent blanks: - Listed revisions were negotlateo with: NAME. TITLE: DATE: - Comments only. No Revisions necessary. Suggestion for FY 95. No revislome necessary at knzE time, k - No Comment£, 3QggeEtions and/or revisions. ow ycllves stand as written. -------------------------------------------------------------------------- Please lift Wow any revlslcns. comments, and/or suggestisrs. Use a new form for each program. Maternity FY 93-94 Outcome Objective Evaluation Formula Monitoring Plan Strategies 1. By 1995. 60% of patients enrolled In the maternity- clinic will ex- hibit adequate prenatal care by having a minimum of 9 clinic visits. Process Objectives # patients with 9 Annually Process Objectives and Activities or more visits X100 # patients 1. During FY 93-94, 100% of pregnant # patients counseled X 100 women enrolled in maternity clinic # patients clinic be counseled on the import- ance of regular clinic visits. 2. During FY 93-94 90% of patients requesting prenatal care at health dept. will receive an appointment within two weeks of request. Activities 1. During FY 93-94 100% of patients seen in pregnancy testing clinic will be counseled regarding early and on -going prenatal care. 2. Video tapes on the importance of prenatal care will be played in the waiting area during clinic hours. # enrollments X 100 # requests # patient counseled X 100 # tested # hours Monthly Ensure adequate nurse coverage for counseling. Monthly Provide adequate appointments to accommodate demand. Monthly All patients seen will be counseled by a licensed nurse. Daily Provide up to date video tapes. 3. Pamphlets on prenatal care will # pamphlets On -going BI-weekly restocking of pamphlet be available to all clients. racks. Women's Health Services FY 93-94 Outcome Objective Evaluation Formula Monitoring Plan Strategies 1. By 1995, 50% of women will exhibit preventive health care practices by returning for annual or post partum exams. Process Objectives 1. During Fy 93-94, 100 % of patients seen will be counseled regarding importance of annual preventive health care. 2. During FY 93-94, 50% of patients seen in maternity clinic will return for post partum exam. Activities 1. 90% of patients who receive prenatal care at the health dept. will be contacted by phone or visit and offered post partum exam appointment. 2. Provide at least 20 hours per week of women's health services. # patients returning within 15 months of last visit X 100 Annually # patients seen # counseled X 100 # seen # post partum exams X 100 # delivered maternity patients # contacted # receiving care and delivered # hours Process Objectives Monthly Stress Importance of yearly examinations. Provide Information on SBE and and pap smears. Quarterly Provide adequate appointments for post partum exams. Quarterly Assign personnel 4 hours/week to contact patients. On --going Provide clinics at varying hours to accommodate working clients and students. 3. 100% of women seen will receive # counseled Monthly Monthly audits information on preventive health # seen issues and yearly exams. PERFOPWANCE- BASED CONTRACT OBJECTIVES FOR FY 1994 DISCLARv ER SHEET List programs you DO NOT provide. If 'there is more than one program, use a separate dis- claimer sheet for each one. LOCAL HEALTH DEPARTMENT`. t--AL-crzy, PROGRAM NOT PROVIDED: u L t` SIGNATURE: PHONE REASON THE ABOVE PROGRAM IS NOT PROVIDED: � ��[` � ft ra t � C 6e-A€' �• �"�' j e��e,-.s l sQe rQf�S PERFORM ANC&BASED COsS;f KAL1 U`WtL ti v r..- FOR FY 1994 DISCLAIMER SHEET List programs you DO NOT provide. If there is more than one program, use a separate dis. claimer sheet for each one. LOCAL HEALTH DEPARTMENT: L",o �c -z- t/ PROGRAM NOT PROVIDED: I C e.� e�C SIGNATU TITLE: PHONE NUMBER: 4 <c-G.7 'N 6 `) 2 q a0 REASON THE ABOVE PROGRAM IS NOT PROVIDED: "'; t II From: TP/HPAMEEY 2: Apr- 93 14:24:49 sun;ec*-: CRH/KSHIELI S FEi= � i FORM COMMENT/VERIFICATION FORM PBCOs- FOR FY 1994 LOCAL HEALTH DEPARTMENT:Lubbock City HD PROGRAM:STD REV I EWER: HRamsey REVIEWER'S PHONE NUMBER: 51 ' 451-7:' '5 DA i 0 4/2S/93 Please place an "X" in front of one of the following items and fill in any pertinent blanks: - Listed revisions were negotiated with: NAME: TITLE: DATE: X - Comments only. No revisions necessary. - Suggestion for FY 95. No revisions necessary at this time. - No comments, suggestions and/car revisions. Objectives stand as written. Please list- below any revisions, comments, and/or suggestions. Use a new farm for each program. A ree with previous reviewer. Process objectives and activities are good, however.the outcome objective could be achieved by closing the Health Dept.. Next year outcome should addr-es:., reducing specific STD rates. To: From: Date: Subject: CC: CRH/KSHIELDS David L. Hoehns <RGN2/DHOEHNS> 2 Apr 93 11:33:16 PBCO FORM tsnell COMMENT/VERIFICATION FORM PBCOs FOR FY 1994 LOCAL HEALTH DEPARTMENT: Lubbock City Health Department PROGRAM:STD Control REVIEWER:David L. Hoehns REVIEWER'S PHONE NUMBER:Texann 842-5294 DATE:04/01/93 Please place an "X" in front of one of the following items and fill in any pertinent blanks: - Listed revisions were negotiated with: NAME: TITLE: DATE: — Comments only. No revisions necessary. X - Suggestion for FY 95. No revisions necessary at this time. - No comments, suggestions and/or revisions. objectives stand as written. Please list below any revisions, comments, and/or suggestions. Use a new form for each program. Lubbock City consolidated all their STD PBO work into one objective. My concern with this was 1)it was not disease specific, 2) not being disease specific it does not specifically address the Year 2000 Objectives, and 3)it will attempt to measure activity that can be manipulated by lack of work, i.e. it will measure the value of patient education by looking at patients returning with reinfection. While I know that Lubbock City operates a caring and concerned STD clinic, this parameter, in an objective sense, could be made to appear excellent if patients did not return for new infection when in fact they did not return because clinic hours were inconvenient, they perceived they were not treated well, or (because the study is not blinded in any way) could be influenced not to return by a staff person who wants to do well in the objective. I know that Lubbock has put a lot of time a effort into their PBO work, and I do not want to cause confusion by creating a whole new PBO in a few days. Too, very little STD funds go to Lubbock. Therefore, I have offered to work with them for new objectives for 1995. Sexually Transmitted Disease FY 93-94 Outcome Objective Evaluation Formula Monitoring Plan Strategies 1. By 1995, 75% of persons treated the STD clinic for a reportable sexually transmitted disease will not return with a reportable STD within one year of treatment. Process Objectives 1. During FY 93-94, 100% of persons treated or examined in the STD clinic will receive information on the prevention of sexually trans- mitted diseases. 2. During FY 93-94, 100% of persons treated for a reportable sexually transmitted disease will be Interviewed for contacts or be given contact slips to get sex partners tested and treated. Activities 1. 100% of persons examined and/or treated will receive education regarding disease intervention. 2. Pamphlets on sexually transmitted diseases will be available to # persons re -treated within last 12 months X 100 # persons treated # persons treated or examined X 100 # persons provided STD information # persons treated for a reportable STD X 100 # persons interviewed or given contact slips # persons receiving education X 100 # persons examined and/or treated # pamphlets Annually Process Objectives and Activities Monthly Written as Standard of Care in Policy and Procedure Manual Annually DIS available during clinic hares as often as possible. Provide contact slips to all clinicians. Monthly Monthly Audit On Going Bi-weekly restocking of pamphlet racks. w all clients. PERF0RNWNCE-BASED CONTRACT 0B,JECTIVES FOR FY 1994 DISCLAIMER SHEET List programs you DO NOT provide. If there is more than one program, 'use a separate dis- claimer sheet for each one. LOCAL HEALTH DEPARTMENT. L4� OC.4< CcT PROGRAM NOT PROVIDED: - SIGN 7T. PH REASON THE ABOVE PROGRAM IS NOT PROVIDED: -- t� -S lie I TEXAS DEPARTMENT OF HEALTH 1100 WEST 49TH STREET AUSTIN, TEXAS 78756-3199 CONTRACT CHANGE NOTICE NO. 1 STATE OF TEXAS TDH Document No. C4000133 COUNTY OF TRAVIS The Texas Department of Health, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in writing with LUBBOCK CITY HEALTH DEPARTMENT hereinafter referred to as PERFORMING AGENCY. The parties thereto now desire to amend such contract as follows: SUMMARY OF TRANSACTION: ` Revision to public health services contract. ` Attachment No. 03 - Amendment to add a new attachment to test and provide ; annual reports on the workload indicated for the Bureau of; Laboratories. ; , All terms and conditions not hereby amended remain in full force and effect. ; , , EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN, ; CITY OF LUBBOCK Authorized Contracting Entity (type above ; if different from PERFORMING AGENCY) ; ' o in behalf of: LUBBOCK CIT EALTH TMENT TEXAS DEPARTMENT OF HEALTH P G •ENCY RECEIVING AGENCY (Si nature of person aut orized (�1�t re of person authorizedto sign contracts) ign contracts) Linda Farrow, Chief ; David R. Langston, Mayor Bureau of Financial Services ; (Name and Title) (Name and Title) ; Date: September 23, 1993 Date: Q— RECOMMENDE By: APPROVED AS T FORM: ; By: (PER ORMING A ector, Office of General Counsel ; if different ro person authorized to sign contract) ; Cover - Page t No Text DETAILS OF ATTACHMENTS Atti; ; ; Financial Assistance Am. ; TDH Term ; Source of ; ; Direct ; Total Assistance No. ; Program ; 8ecin ' End ; Funds* ; Amount ; Assistance `; Amount (TDH Share) 01 ; NCH/FHS-LHS ; 9/ 1/93; 8/31/94: STATE 364,981.00; 32,616.00: 397,59T.00; t 1 i 1 I 1 I I , 02 ; CRH/IMM-LHS ; 9/ 1/93: 9/31/94: STATE ; 119,182.00, 183,451.00; 302,633.00; 1 1 1 1 I 1 t I 03 ; LAB-LHS ; 9/ 1/93; 8/31/W, STATE ; .00; 76,000.00: 76,000.00 [ 1 1 I t t 1 ! I 7 1 1 1 1 I I 1 1 1 1 1 I t 1 t r 1 1 ! 1 1 I 1 I 1 1 1 1 1 t l 1 1 1 1 1 1 1 I I 1 I 1 1 1 1 1 1 1 1 1 I I t 1 I I ! 1 1 1 1 i 1 1 t 1 1 1 1 t 1 I I 1 I 1 1 1 1 1 f 1 1 1 1 1 1 I f 1 I 1 I 1 1 I i 1 I 1 I t 1 1 1 I I 1 t 1 I 1 1 1 I 1 f 1 1 1 1 1 1 I 1 1 1 I 1 1 1 I 1 { 1 1 1 f I 1 i 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I i 1 I I 1 1 1 1 I 1 1 I 1 1 f I I 1 1 1 1 1 1 1 1 ( 1 1 1 t I 1 1 1 1 1 1 1 I I 1 1 1 1 I ! ! 1 1 1 f 1 1 I 1 i 1 f 1 1 I 1 1 t 1 1 i 1 t 1 1 1 1 1 1 f 1 1 1 1 t 1 I 1 1 1 1 ! ! I 1 I 1 1 1 t 1 1 1 I 1 1 1 t 1 I 1 i 1 I I { 1 1 1 1 1 1 1 f t 1 1 1 1 1 1 1 1 1 i I 1 I 1 i 1 I 1 1 1 1 f 1 t 1 ► 1 ! 1 I i 1 1 1 1 I 1 I I 1 1 1 1 1 1 1 1 1 1 1 1 1 t t 1 I 1 I I I { 1 1 I I 1 1 I 1 1 1 1 I 1 1 1 1 I 1 1 i 1 I 1 1 I I 1 1 1 I 1 t I 1 1 1 1 1 1 t 1 1 i 1 1 I 1 1 1 t 1 1 f 1 1 t 1 f 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 i I I 1 I 1 I ! I 1 l I I 1 I 1 1 I 1 1 I 1 I f 1 1 1 1 1 1 1 I 1 1 1 I 1 1 I I I 1 1 1 1 1 I 1 I 1 1 I 1 I 1 1 1 I 1 I 1 I 1 1 I 1 I I 1 I I 1 1 1 1 1 I I I I 1 I I t I I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 I 1 1 f I 1 1 1 1 t 1 1 I t 1 1 1 1 t 1 1 1 1 I 1 I 1 1 I 1 1 I 1 1 1 1 1 1 1 1 1 1 I I 1 I 1 I 1 1 I 1 1 1 1 1 1 1 1 ------------------------------------------------------------- TON Document No. C4000133 TOTALS ; : 494,163.00: : 292,061.00: S 716,230.00; Change No. 01 { I 1 1 1 #Federal funds are indicated by a number from the Catalog of Federal Domestic Assistance (CFDA), if applicable. REFER TO BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS. COVER - Page 2 DOCUMENT NO. C4000133 ATTACHMENT NO. 03 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: BUREAU OF LABORATORIES TERM: September 1, 1993 THROUGH August 31, 1994 SECTION I. SCOPE OF WORK: PERFORMING AGENCY laboratory agrees to test and provide reports on tests annually on the approximate workload indicated in the categories below in support of RECEIVING AGENCY statewide programs: A. Milk bacteriology and chemistry B. Syphilis serology C. Gonorrhea testing D. Other approved analyses 0 12,000 12,000 22,500 TOTAL 46,500 PERFORMING AGENCY agrees to meet standards for such analyses as set forth by RECEIVING AGENCY, Bureau of Laboratories, the Clinical Laboratories Improve- ment Act, the Safe Drinking Water Act, the National Conference of Interstate Milk Shippers, and/or the Public Health Service Grade A Pasteurized Milk Ordinance. PERFORMING AGENCY will provide an estimated 46,500 specimen/samples in or benefiting the geographic area defined as LUBBOCK COUNTY AND BORDERING COUNTIES. SECTION II. LEGAL AUTHORITY TO CONTRACT: Chapters 12 and 121, Health and Safety Code. SECTION III. SPECIAL PROVISIONS: GENERAL PROVISIONS, Program Income Article, paragraph two, is not applicable to this Attachment, however, additional instructions regarding program income follow in the next three paragraphs. PERFORMING AGENCY is required to bill Medicaid for the following laboratory tests performed for Medicaid eligible patients: syphilis serology screening, syphilis serology confirmation, and gonorrhea and chlamydia diagnosis. PERFORMING AGENCY may use their own billing system or may use RECEIVING AGENCY's match -up system. RECEIVING AGENCY, Bureau of Laboratories, will reduce the Total Allotment set out in Section IV. Budget, by the number of Medicaid reimbursed tests multi- plied by the respective cost of the reagents (syphilis screening-$0.95; confirmation-$1.45; GC/CHL-$4.25). The balance of program incoma earned by PERFORMING AGENCY from Medicaid reimbursements and other sources will be identified, reported, and utilized to further the program objectives of the -1- State statute under which the Scope of Work for the Attachment was made. All program income generated by activities supported by this Attachment will be reported on a quarterly laboratory report. Laboratory reports are due no later than 20 days after the end of each quarter. General Provisions, Financial Reports Article, is not applicable to this Attachment. SECTION IV. BUDGET: Support for this scope of work is provided in part by the RECEIVING AGENCY, Bureau of Laboratories, through supplies ordered directly from RECEIVING AGENCY warehouse stocks or through reagents drop -shipped from vendors or from RECEIVING AGENCY to the value limit set out below. Requisitions for supplies will be processed in accordance with RECEIVING AGENCY guidelines. Any change in the allotment amount must be approved by RECEIVING AGENCY, Chief, Bureau of Laboratories. WAREHOUSE ALLOTMENT-$6,100.00 REAGENT ALLOTMENT-$69,900.00 TOTAL ALLOTMENT-$76,000.00 -2- STATE OF TEXAS COUNTY OF TRAVIS TEXAS DEPARTMENT OF HEALTH CONTRACT 1100 West 49th Street Austin, Texas 78756-3199 TDH Document No. C4000133 1k This contract is between the Texas Department of Health, hereinafter referred to as RECEIVING AGENCY, and the party listed below as PERFORMING AGENCY and includes general provisions and attachments detailing scope(s) of work and special provisions. PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT I_ ----------------------------------------------------------------------------------- _I (PRINT or TYPE) I Mailing Address: P. O. BOX 2548 LUBBOCK 48 1 y (TX )7940 ` Street Address: 1902 TEXAS AVENUE LUBBOCK TX 79405-11171 I(If different) ity I_ ----------------------------------------------------------------------------------- (R-) (Zip) l _I ! Authorized 1 Contracting Entity: CITY OF LUBBOCK I_ different from -_-_-----_I Payee Name: CITY OF LUBBOCK HEALTH DEPARTMENT I(Must match with vendor identification number shown a ow) I I Payee Address: P. 0. BOX 2000 LUBBOCK TX 79457 00001 (Must match with vendor identification num er sFown 5elo—w-T —� State of Texas Vendor Identification No. (14 digits): 17560005906037 ! Finance Officer/Contact: DOUG GOODMAN I Type of Organization: Cit ! Designate: Elementary/secondary sc oo , junior college, senior college universi y city, county, other political subdivision, council of governments, judicial I district, community services program, individual, or other (define) { I Is this a small business No (Yes/No) and/ r minority/woman owned No business (Yes/No) 1 ' Is this a non-profit Yes ( es/No� PAYEE AGENCY Fiscal Year Ending Month: SEPTEMBER ------------------------------------------------------------------------------------ _I SUMMARY OF TRANSACTION: Contract for Public Health services. I I 1 COVER - Page 1 RED` ��"` i'�`�5 �V151t� s D E T A I L S 0 'F a A T, T A C H M E N T a - •, L Attl; ;FFinancial Assistance ;s ' a Am. TON Term Source of Direct Total Assistance No. Pracram Beoin End Funds* Amount Assistance ; Amount fTDH Share) 01 MCH1'rHS-LHS 91' 1113, 8/31194; STATE 364.3811v0; 32,6i6.00; 397,597.0C 02 CRHIIMM-LHS 314' 193; 8131194; STATE 119,t22.00; 183,451.00; 302,633.06' ! ! ! I 1 I ! 1 t t t ! I ! 1 1 1 1 1 I 1 I I 1 1 I t 1 1 t 1 1 1 1 ! • I 1 I 1 I 1 t I I t I 1 1 ! I I I 1 I 1 I 1 1 ! 1 t t ! 1 1 I I 1 1 1 1 I I ! 1 1 } 1 I ! 1 1 I I I I 1 ! I 1 t 1 ! 1 1 1 1 t t I 1 ! 1 I S 1 I 1 1 I 1 1 1 1 1 I i I 1 1 I ! I 1 1 1 1 t 1 1 I ! ! 1 I 1 1 1 1 i I ! I ! I 1 ! 1 1 I 1 1 I t i I 1 t t 1 I 1 I I I 1 1 l i 1 1 1 1 1 1 t ! 1 ! I I 1 t 1 I t t ! 1 1 1 1 1 1 t 1 1 i I ! I I f 1 1 I 1 1 1 1 1 I I I 1 I t I I ! 1 1 1 f 1 I ! 1 I I I 1 L 1 I 1 t 1 1 I ! I 1 1 1 t 1 1 r i 1 1 t ► ! 1 I t ! I ! t t 1 I 1 1 t 1 i ! 1 I 1 1 1 t 1 I 1 1 1 I 1 I 1 t 1 I ! I 1 1 t ! I } f I ! 1 I 1 t 1 1 1 t 1 1 ! ! I ! 1 1 ! I 1 1 I I I 1 I I 1 I 1 1 1 I I I 1 1 I 1 I I i I t 1 I I 1 1 I I 1 1 1 1 ! I ! ) 1 1 I '---------------------------------------------------------------------------------------------------------------------I t TDH Document No, C4000133 TOTALS ; $ 484,163.00; ; 2151061.00: E 700,230.00: 1 I 1 I *Federal funds are indicated by a number from the Catalog of Federal Domestic Assistance 1CFDAI, if applicable. REFER TO BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS. COVER - Page 2 { EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN. CITY OF LUBBOCK TDH Document No.: C4000133 Authorized Contracting Entity (type above if different from PERFORMING AGENCY) for and in behalf of: ING / . (Si ature of person Whorized to sign contracts) David R. Langston, Mayor (Name and Title) Date: September 23, 1993 TEXAS DEPARTMENT OF HEALTH RECEIVING AGENCY B�Lj ignature of person authorized to sign contracts) Linda Farrow, Chief Bureau of Financial Services (Name and title) Date: %o —t/q _ % 3 RECOMMENDED: APPROVED AS TO FORM: By: � By: (PERFORMING AGENCY ctor, Office of General Counsel if different from rs a authorized to sign contract) COVER - Page 3 Y v s ! r1 +a 1 GENERAL PROVISIONS FOR TEXAS DEPARTMENT OF HEALTH CONTRACTS PERFORMING AGENCY and RECEIVING AGENCY agree this contract, assurances, general and/or special provisions, and Attachment(s) with detailed scope(s) of work and budget(s), as applicable, incorporate all covenants and�agreements pertaining hereto. No prior agreement or understanding, oral or otherwise, of the parties or their agents will be valid or enforceable unless embodied in this contract. The person or persons signing and executing this contract on behalf of PERFORMING AGENCY, or representing themselves as signing and executing this contract on behalf of PERFORMING AGENCY, do hereby warrant and guarantee that he, she, or they have been duly authorized by PERFORMING AGENCY to execute this contract on behalf of PERFORMING AGENCY and to validly and legally bind PERFORMING AGENCY to all terms, performances, and provisions herein set forth. PERFORMING AGENCY hereby assures compliance with the following terms and conditions unless otherwise specified in the Attachment(s) hereto: ARTICLE 1. Scope of Work PERFORMING AGENCY will perform the work outlined in the Scope(s) of Work contained in the Attachment(s) hereto which is/are referenced in the Details of Attachments and hereby incorporated and made a part of this contract, plus amendments which may be added by additional Attachment(s) from time to time as hereinafter provided. Satisfactory performance of this contract will be measured in part by: (1) adherence to the contract; (2) results of CPA or State Auditor reports; and, 3) timeliness, completeness, and accuracy of required reports. ARTICLE 2. Term The time period of this contract will be governed by the! term(s) on the Attachment(e). No commitment of contract funds is permitted prior to the first day nor subsequent to the last day of the term. The term may be extended or shortened by amendment(s). ARTICLE 3. Funding This contract is contingent upon funding being available for the term of the Attachment(s) and PERFORMING AGENCY will have no right of action against RECEIVING AGENCY in the event that RECEIVING AGENCY is unable to perform its obligations under this contract as a result of the suspension, termination, withdrawal, or failure of funding to RECEIVING AGENCY or lack of sufficient funding of RECEIVING AGENCY for any Attachment(s) to this contract. If funds become unavailable, provisions of the Termination Article will apply. ARTICLE 4. Amendments Contract Attachments) may be amended, duly executed by the parties hereto. ARTICLE S. Severability and such amendments will be in writing and If any provision of this contract will be construed to be illegal or invalid, this will not affect the legality or validity of any of the other provisions hereof. The illegal or invalid provision will be deemed stricken and deleted herefrom'to the same extent and effect as if never incorporated herein, but all other provisions will continue. 1994 GENERAL PROVISIONS - Page 1 (5/93) ARTICLE 6. Applicable Laws and Standards This contract will be governed by the laws of the State of Texas and enabling state/federal regulations, including federal grant requirements applicable to funding sources as set out in Attachment(s) hereto, and Treasury Circular 1075 (31 CPR Part 205) as applicable to advance of funds. If PERFORMING AGENCY is a local governmental public health entity, this `contract will also be governed by the Local Public Health Reorganization Act, Chapter 121, Health and Safety Code. PERFORMING'AGENCY agrees Chapter 783, Texas Government Code Annotated (Vernon's Pamphlet 1992), (Uniform Grant and Contract Management Act (UGCMA)), as may be amended by revised federal circulars to be incorporated in UGCMA by the Governor's Budget and Planning Office, applies as terms and conditions of this contract, and the standards are adopted by reference in their entirety. If a conflict arises between the provisions of this contract and UGCMA, the provisions of UGCMA will prevail unless expressly stated otherwise. A copy of this manual and its references are provided to PERFORMING AGENCY by RECEIVING AGENCY upon request. PERFORMING AGENCY must obtain prior approval from RECEIVING AGENCY for major project changes which are specified in RECEIVING AGENCY's institutional prior approval procedures. These procedures are incorporated by reference as a condition of this contract. In accordance with Section 1352 of Public Law 101-121, effective December 22, 1989, PERFORMING AGENCY is prohibited from using funds granted under this contract for lobbying Congress or any agency in connection with a particular contract. In addition, if at any time a contract exceeds $100,000, the law requires certification that none of the funds provided by RECEIVING AGENCY to PERFORMING AGENCY have been used for payment to lobbyists. Regardless of funding source, and if a contract exceeds $100,000, a disclosure form must be completed if PERFORMING AGENCY has any agreement with a lobbyist. This certification and/or form is available upon request and must be forwarded to RECEIVING AGENCY within 90 days of receipt. PERFORMING AGENCY certifies by execution of this contract that its payment of franchise taxes is current or, if PERFORMING AGENCY is exempt from payment of franchise taxes, that it is not subject to the State of Texas franchise tax. A false statement regarding franchise tax status will be treated as a material breach of this contract and may be grounds for termination at the option of RECEIVING AGENCY. If franchise tax payments become delinquent during the Attachment term, payments under this contract will be held until PERFORMING AGENCY's delinquent franchise tax is paid in full. ARTICLE 7. Debarment and Suspension PERFORMING AGENCY further certifies by execution of this contract that it is not ineligible for participation in federal or state assistance programs under Executive Order 12549, Debarment and Suspension. PERFORMING AGENCY certifies, by submission of this contract, that neither it nor its principals is presently debarred, suspended,'proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. Where the PERFORMING AGENCY is unable to certify to any of the, statements in this certification, PERFORMING AGENCY shall attach an explanation. PERFORMING AGENCY specifically asserts that it has not knowingly failed to pay a single substantial debt or a number of outstanding debts to a federal or state agency or it is not subject to an outstanding judgment in a suit against PERFORMING AGENCY for collection of the balance. A false statement regarding PERFORMING AGENCY's status will be treated as a material breach of this contract and may be grounds for termination at the option of RECEIVING AGENCY. 1994 GENERAL PROVISIONS - Page 2 (5/93) ARTICLE 8. Assurances PERFORMING AGENCY will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. PERFORMING AGENCY will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. SS 4728-4763) relating to prescribed standards for merit systems for programs funded under one of the nineteen statutes or regulations specified in Appendix A of the Office of Personnel Management's Standards for a Merit System of Personnel Administration (5 CFR 900, Subpart F). PERFORMING AGENCY will comply with all federal and state statutes relating to nondiscrimination. These include but are not limited to: Title VI of the Civil Rights Act of 1964, as amended (42 USC Sec. 2000e, at. seq.) which prohibits discrimination on the basis of race, color or national origin; Title IX of the Education Amendments of 1972, as amended (20 USC Sec. 1681-1683 and 1685-1686), which prohibits discrimination on the basis of sex; the Rehabilitation Act of 1973, as amended (29 USC Sec. 794), which prohibits discrimination on the basis of handicaps; The Americans with Disabilities Act of 1990 (42 USC Sec. 12101 at. seq.), which prohibits discrimination on the basis of disabilities; The Age Discrimination Act of 1975, as amended (42 USC Sec. 6101-6107), which prohibits discrimination on the basis of age; The Drug Abuse, Prevention, Treatment, and Rehabilitation Act, as amended (21 USC Sec. 1101 at. seq.), relating to discrimination on the basis of drug abuse; the Age Discrimination in Employment Act of 1967, as amended (29 USC Sec. 621-634), which prohibits discrimination in employment on the basis of age; the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970, as amended (42 USC Sec. 4541 at. seq.), relating to nondiscrimination on the basis of alcohol abuse or alcoholism; The Public Health Service Act of 1912, as amended (42 USC Sec. 290dd- 3 and 290ee-3), relating to confidentiality of alcohol and drug abuse patient records; any other nondiscrimination provisions in the specific statute(s), pertaining to applicable federal assistance; and the requirements of any other nondiscrimination federal or state statutes) which might apply to this contract. PERFORMING AGENCY will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91- 190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. SS 7401 at seq.); and (d) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, P.L. 93-523. PERFORMING AGENCY will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by any applicable award of federal assistance. PERFORMING AGENCY will comply with the Clinical Laboratory Improvement Amendments of 1988 (CLIA), P.L. 100-578 (42 U.S.C. 263 a), which establish Federal requirements for the regulation and certification of clinical laboratories. PERFORMING AGENCY will comply with the OSHA Regulations on Sloodborne Pathogens, 56 Fed. Reg. 64175 (1991), 29 C.F.R. 1919.030, which set safety standards for those workers and facilities who may handle bloodborne pathogens. PERFORMING AGENCY assures it will not transfer or assign its interest in this contract without the written consent of the RECEIVING AGENCY. 1994 GENERAL PROVISIONS - Page 3 (5/93) ti t z ARTICLE 9. Standards For Financial_ Management PERFORMING AGENCY will develop, implement, and maintain financial management and control systems that meet or exceed the requirements of UGCMA. Those requirements include at a minimum: 1. Financial planning including the development of budgets that adequately reflect all functions and resources necessary to carry out authorized activities and the adequate determination of costs; 2.- Financial management system 'including accurate, correct, and complete payroll, accounting, and financial reporting records, cost source documentation, effective internal and budgetary controls, determination of reasonableness, allowability, and allocability of costs, and timely and appropriate audits and resolution of any findings; and, 3. Billing and collection policies including a charge schedule, a system for discounting`or adjusting charges based on a person's income and family size, and a mechanism capable of billing and making reasonable efforts to collect from patients and third parties. In addition, PERFORMING AGENCY agrees to bill third party payors for services provided under the Attachment(s), at no cost to the client. These potential payors include, but are not limited to, Medicaid,private insurance carriers, other available federal, state, local and private funds, etc. PERFORMING AGENCY is required to become a Medicaid provider for applicable program activities funded in the Attachment(s) hereto, and will maximize efforts to obtain payment from Medicaid and all other available sources. ARTICLE 10. Allowable Costs and Audit Requirements Only those costs allowable under UGCMA and any revisions thereto, plus any applicable federal cost principles are eligible for reimbursement under this Attachment(s). Applicable cost principles, audit requirements and administrative requirements are as follows: Audit Administrative Applicable Cost Principles Requirements Requirements A-87, State & Local Governments Circular A-128 UGCMA To be eligible for reimbursement under this Attachment(s) a cost must have been incurred within the Attachment term and paid by PERFORMING AGENCY prior to claiming reimbursement from RECEIVING AGENCY or encumbered by the last day of the Attachment term and liquidated no later than 45 days after the end of the Attachment term. Each PERFORMING AGENCY/AUTHORIZED CONTRACTING ENTITY receiving $25,000 or more in total federal/state financial assistance during their fiscal year shall arrange for an agency -wide financial and compliance audit of the PERFORMING AGENCY'S/AUTHORIZED CONTRACTING ENTITY'S fiscal year. The audit must be conducted by an independent CPA and must be in accordance with the applicable OMB Circulars and Government Auditing Standards. Procurement of audit services will comply with state procurement procedures, as well as provisions of UGCMA. Within 30 days of receipt of audit report, PERFORMING AGENCY/AUTHORIZED CONTRACTING ENTITY will submit a copy to RECEIVING AGENCY'S Internal Audit Division. ARTICLE 11. Overtime Compensation None of the funds provided by Attachment(s) will be used PERFORMING AGENCY will be responsible for'any obligations of employees. 1994 GENERAL PROVISIONS - Page 4 (5/93) to pay overtime. overtime pay due ARTICLE 12. Terms and Conditions of Payment For services satisfactorily performed pursuant to the Scope(s) of Work, PERFORMING AGENCY will receive reimbursement for allowable costs. Reimbursements will not exceed the total of each Attachment(s) hereto and are contingent on a signed contract. Claims for reimbursement will be made on a State of Texas Purchase Voucher (TDH Form 1AG-37). Vouchers for reimbursement of actual expenses will be submitted monthly within 20 days following the end of the month covered by the bill. A make-up claim may be submitted as a final close-out bill not later than 45 days following the end of Attachment term(s). Advance payment may be requested in accordance with the applicable provisions of this contract. Payments made for approved claims or notice of denial of claims submitted against Attachment(s) to this contract will be mailed not later than 60 days after receipt of monthly vouchers. Payment is considered made on the date postmarked. Any reimbursements made by PERFORMING AGENCY to subcontractors will be made in accordance with Article 601f, V.T.C.S. Funding from this contract will not be used to supplant state or local funds, but PERFORMING AGENCY will use such funds to increase state or local funds currently available to PERFORMING AGENCY for a particular activity. PERFORMING AGENCY further agrees to maintain to the best of its ability its current level of support, if any. PERFORMING AGENCY will refund to RECEIVING AGENCY any funds PERFORMING AGENCY claims and receives from RECEIVING AGENCY for the reimbursement of costs which are determined by RECEIVING AGENCY to be ineligible for reimbursement. RECEIVING AGENCY will have the right to withhold all or pairt- of any future payments to PERFORMING AGENCY to offset any reimbursement made to PERFORMING AGENCY for any ineligible expenditures not refunded to RECEIVING AGENCY by PERFORMING AGENCY. Payment may be denied for noncompliance if required financial reports are not on file for previous quarters or for the final period, or for failure to respond to financial compliance monitoring reports, or if program requirements are not met as specified in the Scope(s) of Work. ARTICLE 13. Advance Payment PERFORMING AGENCY may request, in writing, a one time advance with proper justification and the concurrence of RECEIVING AGENCY. Amount of advance will be determined by the amount and term of the Attachment(s); however, for each Attachment, the amount of the advance will not exceed one -sixth (1/6th) of a twelve-month Attachment. Advance will be requested on a State of Texas Purchase Voucher at the beginning of Attachment period or at a single later time in the Attachment period if circumstances so warrant and the request is approved. Advance funds will be liquidated during the Attachment term so that, after final monthly billing, PERFORMING AGENCY will not have advance funds on hand. Advance funds may be drawn only to meet immediate cash needs for disbursement (UGCMA and federal circulars). Amendments to this Attachment(s) may require upward or downward adjustment to the allowable advance until it equates 1/6th of a twelve-month Attachment or approximates two months operating costs. In the case of a downward adjustment, PERFORMING AGENCY and RECEIVING AGENCY will agree on the amount of adjustment to the advance. RECEIVING AGENCY retains the option to reduce future claims by the required amount. In the case of an upward adjustment and PERFORMING AGENCY needs additional funds to meet immediate operating expenses, PERFORMING AGENCY may submit to RECEIVING AGENCY a written justification and State of Texas Purchase 1994 GENERAL PROVISIONS - Page 5 (5/93) Voucher in the amount necessary to correct the ratio. ARTICLE 14. Procrram Income PERFORMING AGENCY will develop a fee for service system and a schedule of fees for personal health services in accordance with the provisions of Chapter 12, Sub -chapter D, Health and Safety Code and the Texas Board of Health rules covering Fees_ for Clinical Health Services (25 TAC, Section 1.91) and other applicable laws provided, however, that a patient may not be denied a service due to inability to pay.' Both parties agree all revenues directly generated by an Attachment(s) supported activity or earned only as a result of the Attachment(s) during the term of the Attachment(s) are considered program income. This income will be identified and reported quarterly and annually utilizing the report forms identified in the Financial Reports Article of these provisions. PERFORMING AGENCY will retain the program income and use one of the following alternatives: 1. Where the PERFORMING AGENCY is reimbursed by RECEIVING AGENCY under a cost reimbursement method, the additive or deductive alternatives for program income may be used. Under the additive method, PERFORMING AGENCY will add the program income to the funds already committed to the project by both the RECEIVING AGENCY and PERFORMING AGENCY. Funds will be used to further the program objectives of the State/Federal statute under which the Scope of Work for the Attachment(s) was made. Program income earned in a current budget period and not expended in that budget period may be carried forward to the next budget period but must be spent in the next budget period, or deducted from program expenditures. This policy will apply unless specifically stated otherwise in the Special Provisions of the contract Attachment(s)._ Under the deductive method, the PERFORMING AGENCY will deduct the program income from the total allowable costs to determine the net allowable costs. 2. Where the PERFORMING AGENCY is reimbursed by RECEIVING. AGENCY under a fixed price arrangement, only the deductive alternative for program income will be used. PERFORMING AGENCY deducts the program income from the total allowable project costs to determine the net allowable costs. It is further understood that RECEIVING AGENCY will base future funding levels, in part, upon the PERFORMING AGENCY's proficiency in identifying, billing, collecting, and reporting income, and in utilizing it for the purposes and conditions of the applicable Attachment(s). Additional information is contained in RECEIVING AGENCY's Program Income Policy interpreting UGCMA, which is incorporated by reference as a part of this contract. ARTICLE 15. Financial Reports Financial reports are required as provided in UGCMA and will be filed regardless of whether or not expenses have been incurred. ouarterly Financial Status Report, State of Texas Supplemental Form 269a (TDH Form GC-4a), will be submitted within 30 days following the end of each quarter. Annual/Final A final financial report, Request for Advance or Reimbursement, Form 270 (TDH Form GC-10) will be submitted not later than 45 days following the end of Attachment term(s). If necessary, a State ,of Texas Purchase Voucher will be 1994 GENERAL PROVISIONS — Page 6 (5/93) r submitted if a.11 costs have not been recovered or a refund will be made of excess monies if costs incurred were less than funds received. ARTICLE 16. Reports and Inspections PERFORMING AGENCY will submit financial, program, progress, and other reports as requested by RECEIVING AGENCY in the format agreed to by the parties hereto. RECEIVING AGENCY and, when federal funds are involved, any authorized representatives) of the federal government have the right, at all reasonable times, to inspect or otherwise evaluate the work (including client or patient records) performed or being performed hereunder and the premises in which it is being performed, including subcontractors. PERFORMING AGENCY will participate in and provide reasonable access, facilities, and assistance to the representatives. All inspections and evaluations will be performed in such a manner as will not unduly delay the work. PERFORMING AGENCY agrees that RECEIVING AGENCY and the federal government, or any of their duly authorized representatives, will have access to any pertinent books, documents, papers, and client or patient records of PERFORMING AGENCY for the purpose of making audit, examination, excerpts, and transcripts of transactions related to contract Attachment(s). RECEIVING AGENCY will have the right to audit billings both before and after payment. Payment under Attachment(s) will not foreclose the right of RECEIVING AGENCY to recover excessive or illegal payments. Any deficiencies identified by RECEIVING AGENCY upon examination of PERFORMING AGENCY's records will be conveyed in writing to PERFORMING AGENCY. PERFORMING AGENCY's resolution of findings will also be conveyed in writing to RECEIVING AGENCY within 30 days of receipt of RECEIVING AGENCY's findings. A determination by RECEIVING AGENCY of either an inadequate or inappropriate resolution of the findings may result in the withholding of funds or suspension of the contract Attachment(s). Any such withholding of funds or suspension will remain in effect until the findings are properly remedied as determined by RECEIVING AGENCY. PERFORMING AGENCY will retain all such records for a period of three years from the date of the last expenditure report submitted under contract Attachment(s) or until resolution of all audit questions, whichever time period is longer. ARTICLE 17. Client Records At the end of the Attachment term, all client records ( including patient records) are the property.of PERFORMING AGENCY. RECEIVING AGENCY retains the right to have access to the records or obtain copies for audit, examination, evaluation, inspection, litigation, or other circumstances that may arise. If at any time during the Attachment term(s), PERFORMING AGENCY and/or RECEIVING AGENCY should decide to suspend or terminate the agreement, RECEIVING AGENCY may require the transfer of client records (including patient records) upon written notice to PERFORMING AGENCY, either to another entity that agrees to continue the service or to RECEIVING AGENCY. ARTICLE 18. Confidentiality PERFORMING AGENCY will have a system in effect to protect client or patient records and all other documents deemed confidential by law which are maintained in connection with the activities funded under contract. Any disclosure or transfer of confidential client or patient information by PERFORMING AGENCY, including information required by the Reports and Inspections Article, will be in accordance with applicable law. 1994 GENERAL PROVISIONS - Page 7 (5/93) If providing direct client care, services, or programs, PERFORMING AGENCY agrees to implement workplace policies based on the model guidelines adopted by RECEIVING AGENCY and to educate employees and clients concerning the human immunodeficiency virus (HIV) and its related conditions including acquired immunodeficiency syndrome (AIDS). PERFORMING AGENCY agrees to develop and implement policies regarding confidentiality of AIDS and HIV -related medical information for employees of _PERFORMING AGENCY and for clients, inmates, patients, and residents served by PERFORMING AGENCY. Further, PERFORMING AGENCY agrees to develop and implement an anti -discrimination policy assuring all privileges and opportunities for any employee or client with a communicable disease. HIV -related. policies will be based on accurate scientific information. Such policies will be consistent with the model guidelines published by RECEIVING AGENCY and with state and federal laws and regulations. A PERFORMING AGENCY that does not adopt a confidentiality policy as herein required is not legally eligible to receive state funds until the policy is developed and implemented. "ARTICLE 19. Equipment and Supplies Equipment is defined as tangible nonexpendable property with an acquisition cost of over $500 and a useful life of more than one year. In accordance with Article 601b, V.T.C.S., Section 8.02(c), title to all equipment purchased from funds provided herein will be in the name of PERFORMING AGENCY throughout the Attachment(s) terms) Unless initially listed and approved in the Attachment(s), prior written approval from RECEIVING AGENCY is required for any additions to or deletions of approved equipment purchases having an acquisition cost exceeding $500. To receive approval for data processing hardware and software purchases with an acquisition cost over $500, PERFORMING AGENCY must submit a detailed justification which includes description of features, make and model, and cost, etc. PERFORMING AGENCY will maintain an annual property and inventory listing and submit a report (TDH Form GC-11) to RECEIVING AGENCY not later than 45 days from the end of the Attachment(s) term(s). PERFORMING AGENCY will administer a program of maintenance, repair, and protection of assets under this Attachment(s) so as to assure their full availability and usefulness. In the event PERFORMING AGENCY is indemnified, reimbursed, or otherwise compensated for any loss of, destruction of, or damage to the assets provided under this Attachment(s), it will use the proceeds to repair or 'replace said assets. PERFORMING AGENCY agrees that upon termination of Attachment(s), title to any remaining equipment purchased from funds as hereinabove provided will be transferred to the RECEIVING AGENCY or any other party designated by the RECEIVING AGENCY; provided, however, that RECEIVING AGENCY may, at its option and to the extent allowed by law, transfer title to such property to the PERFORMING AGENCY. ARTICLE 20. Subcontractin PERFORMING AGENCY may enter into agreements with subcontractors unless restricted or otherwise prohibited in specific Attachment(s). Subcontracts, if any, entered into by PERFORMING AGENCY will be in writing and subject to the requirements of this contract. PERFORMING AGENCY agrees that it will be responsible to RECEIVING AGENCY for the performance of any subcontractor. In addition, if PERFORMING AGENCY elects' to enter into an agreement which subcontracts out a substantial portion of PERFORMING AGENCY's Scope of Work, prior written approval must be obtained from RECEIVING AGENCY. 1994 GENERAL PROVISIONS - Page 8 (5/93) 4 ARTICLE 21. Copyrights, Publications, and Patents PERFORMING AGENCY understands and agrees that where activities supported by the contract Attachment(s) produce original books, manuals, films, computer programs (including executable computer programs and supporting data in any form), or other original material, PERFORMING AGENCY may copyright such material subject to any rights to same reserved by or vested in the federal government or any agency thereof; however, RECEIVING AGENCY may grant to PERFORMING AGENCY limited rights to produce, publish, and use such materials as appropriate. PERFORMING AGENCY may publish at its expense the results of contract performance with prior RECEIVING AGENCY review and approval. Any publication (written, visual, or sound) should include acknowledgment of the support received from RECEIVING AGENCY and the appropriate federal agency, if applicable. At least three copies of any such publication must be provided to RECEIVING AGENCY. RECEIVING AGENCY reserves the right to require additional copies before or after the initial review. PERFORMING AGENCY and any subcontractor, as appropriate, must comply with the standard patent rights clauses in 37 CFR Sec.'401.14 or FAR 52.227.11. ARTICLE 22. Sold Harmless PERFORMING AGENCY, which is not a state agency, assures that it is an independent contractor and not an agent, servant, or employee of the state. Except to the extent that Chapter 104 of the Texas Civil Practice and Remedies Code is applicable to this contract, PERFORMING AGENCY agrees to hold RECEIVING AGENCY and/or federal government harmless and to indemnify them from and against any and all claims, demands, and causes of action of every kind and character which may be asserted by any third party occurring or in any way incident to, arising out of, or in connection with the performance of services by PERFORMING AGENCY under this contract to the extent allowed by law, and to the extent of damages permitted under Chapter 101 of the Texas Civil Practice and Remedies Code. PERFORMING AGENCY, by acceptance of funds provided through contract Attachment(s), agrees and ensures that personnel paid from these funds are duly licensed and/or qualified to perform the required services. ARTICLE 23. Bonding Each person employed by PERFORMING AGENCY who handles funds under this contract, including persons authorizing payment of such funds, will be covered by the terms of a fidelity bond providing for indemnification of losses occasioned by: (1) any fraudulent or dishonest act or acts committed by any of PERFORMING AGENCY's employees either individually or in concert with others, and/or, (2) failure of PERFORMING AGENCY or any of its employees to perform faithfully his/her duties or to account properly for all monies and property received by virtue of his/her position or employment. This fidelity bond will be in the amount of not less than Ten Thousand Dollars ($10,000). In the event that PERFORMING AGENCY, being an independent contractor, maintains a self-insurance program that provides for the indemnification of losses as described in the above paragraph regarding fidelity bonds, then PERFORMING AGENCY will provide the RECEIVING AGENCY a certified statement which summarizes its self-insurance plan. The certified statement will be submitted at the time this contract is submitted for approval. Any changes to said plan, which occur during the term of this contract period, will be reported to RECEIVING AGENCY. The self-insurance program should be based on the determination that the coverage can be provided at a cost no greater than the cost of obtaining equivalent coverage from an insurance company. 1994 GENERAL PROVISIONS - Page 9 (5/93) ARTICLE 24. suspension/Termination If PERFORMING AGENCY fails to comply with RECEIVING AGENCY's reporting requirements, the program objectives, or the contract award conditions, RECEIVING AGENCY may withhold payments. RECEIVING AGENCY will provide advance written notice to PERFORMING AGENCY which will identify the deficiency and RECEIVING AGENCY's intent to withhold payments if the deficiency is not corrected within a specific number of days. When the deficiency is corrected, RECEIVING AGENCY will release any withheld payments with no further action. If PERFORMING AGENCY fails to comply with the terms, conditions, or standards of this contract, RECEIVING AGENCY may suspend the contract Attachment(s) and prohibit PERFORMING AGENCY from incurring additional obligations of funds pending either., corrective action or termination. RECEIVING AGENCY will provide written; notice to PERFORMING AGENCY at least thirty (30) days in advance of the,suspension,date. Such notice will detail the nature of noncompliance and specify a correction date. PERFORMING AGENCY may request a'hearing on the proposed suspension if such request is made in writing within ten (10) days from any final notification of suspension. This contract or any Attachment(s) hereto may be terminated by either of the parties hereto for noncompliance by the other party. A party intending to terminate for noncompliance by the other party will provide written notice to the other party at least thirty (30) days prior to the intended date of termination. Such notice will include the reasons for the termination and will provide the other party an opportunity to rebut the reasons in writing. A hearing may be requested on the proposed termination if such request is made in writing within ten (10) days from any final notification of termination. By such termination, neither party may nullify obligations already incurred for performance or failure to perform prior to the date of termination. Such termination will not be an exclusive remedy but will be in addition to any other rights and remedies provided by law or under this contract. This contract or any Attachment s) hereto may be terminated in whole, or in part, when both parties agree that continuation would not produce results commensurate with further expenditure of funds. Both parties will agree on the effective date and, in the case of partial termination, the portion to be terminated. RECEIVING AGENCY will immediately send PERFORMING AGENCY written notice of the terms agreed to and such notice will become a part of the contract. PERFORMING AGENCY will not incur new obligations for the terminated portion after the effective date of termination and will cancel as many outstanding obligations as possible. RECEIVING AGENCY will allow full credit to PERFORMING AGENCY for noncancelable obligations which were properly incurred prior to the termination date. This contract or any Attachment(s) hereto may be terminated if funds allocated for any Attachment(s) hereto should become reduced, depleted, or unavailable during any Attachment(s) budget period, and RECEIVING AGENCY is unable to obtain additional funds for such purposes. RECEIVING AGENCY will immediately provide written notification to PERFORMING AGENCY of such fact and such Attachment(s) to this contract is/are terminated upon receipt of that notification. PERFORMING AGENCY will not incur new obligations after the effective date of termination and will cancel as many outstanding obligations as possible. RECEIVING AGENCY will allow full credit to PERFORMING AGENCY for noncancelable obligations which were properly incurred prior to the termination date. This contract or any Attachment(s) hereto may be terminated in the event that federal or state laws or other requirements should be amended or judicially interpreted so as to render continued fulfillment of this contract, on the part of either party, unreasonable or impossible. If the parties should be unable to agree upon amendment which would therefore be needed to enable the substantial continuation of the services contemplated herein, then, upon written notification by RECEIVING AGENCY to PERFORMING AGENCY, the parties will be discharged from any further obligations created under the terms of this contract, except for the 1994 GENERAL PROVISIONS - Page 10 (5/93) t equitable settlement of the respective accrued interests or obligations as of the date of termination. ARTICLE 25. Personnel All personnel funded by Attachment(s) to this contract are employees of PERFORMING AGENCY which will be responsible for their direction and control and liable for any of their acts or omissions. PERFORMING AGENCY will have in place legally sufficient Due Process Hearing Procedures for all of its employees filling state budgeted positions. PERFORMING AGENCY will have full authority to employ, promote, suspend, demote, discharge, and transfer within its organization any and all state budgeted personnel funded by Attachment(s) to this contract provided, however, that any demotion, suspension, or discharge of such state budgeted employees will be in accordance with the Due Process Hearing Procedures as set out above. The only distinction between state budgeted and local paid employees is that employees on state budgeted positions receive state benefits and are subject to certain duties, obligations, and restrictions as state employees as contained in state law. One such restriction, as contained in the State Appropriations Act, is that no employee paid on a state budgeted position may receive a salary supplement from any source unless specifically authorized in the Appropriations Act or other state law. This prohibition includes, but is not limited to, the payment to such employee of a so-called "flat rate" car allowance or travel allowance. Any such travel or per diem to these employees must be on a reimbursement basis, supported by appropriate records, and may not exceed the reimbursement for mileage and/or per diem allowed under the Appropriations Act and current state travel regulations. This restriction will apply whether travel funds are provided in Attachment(s) under this contract or from any other source. PERFORMING AGENCY will utilize RECEIVING AGENCY's policies and procedures for hiring and promoting individuals into state budgeted positions funded by Attachment(s) to this contract. Qualifications of any individuals filling these positions will be subject to approval of RECEIVING AGENCY's Bureau of Personnel Management. The purpose of the approval is to ensure that individuals occupying these positions meet minimum educational and experience requirements. PERFORMING AGENCY will maintain required records and submit documents necessary to process personnel, payroll, leave and time records, and travel claims on state budgeted positions. PERFORMING AGENCY will be furnished by RECEIVING AGENCY state warrants for salary compensation or travel reimbursement for issuance to employees on state budgeted positions. An independent audit is not required as a condition of this contract if the Attachment provides assistance through assignment of state budgeted positions and no funds are budgeted for local costs. PERFORMING AGENCY may be reimbursed for local personnel costs or other categories of expense used to fulfill the scope of work of Attachment(s) in lieu of being furnished state payroll warrants after a state budgeted position becomes vacant. Reimbursement will not exceed the balance of funds on the state budgeted position after all benefits, obligations, and/or other entitlements are met. PERFORMING AGENCY's Director, or other person(s) authorized elsewhere in this contract, may submit a request for conversion. RECEIVING AGENCY will transmit formal approval and a revised budget to PERFORMING AGENCY to complete the conversion. ARTICLE 26. Funding Participation Requirement PERFORMING AGENCY agrees funds provided through this contract will not be used for matching purposes in securing other funding unless otherwise directed or approved by RECEIVING AGENCY. 1994 GENERAL PROVISIONS - Page 11 (5/93) ARTICLE 27. Performance -Based Attachments History RECEIVING AGENCY is responsible for developing performance -based public health services contracts in response to the State Auditor's Report and requirements of the Legislature. This system will enhance service delivery, and improve accountability and efficiency in the management of public health dollars. Plans for initial implementation were designed to use the model objectives format stemming from recommendations of the Committee on Model Objectives for Local Public Health in Texas. The committee was.composed of representatives of local health departments and RECEIVING AGENCY's central and public health region offices in consultation with the University of Texas School of Public Health in Houston. Purpose The overall goal of performance -based contracts is improved public health practices in Texas. The project is intended to: identify public health needs and establish priorities which provide a rational basis for resource allocation; - project realistic outcomes based on activities which can be accomplished with current or planned resources, communicate needs, and build consensus at all levels regarding directions to be taken in specific programs; and, institute a system for planning, implementing, managing, and evaluating programs and monitoring progress toward reducing and/or alleviating public health problems. Required Program Areas PERFORMING AGENCY has prepared outcome and process objectives, if they are applicable and relative to the local needs and resources, for the following program areas: Food Protection HIV/AIDS Public Health Promotion Refugee Health Immunization Sexually Transmitted Diseases Maternal and Child Health Tuberculosis Chronic Disease Prevention & Control These objectives are appended to the Community and Rural Health Attachment and incorporated verbatim and made a part of this contract. PERFORMING AGENCY agrees to monitor and.report progress towards these objectives on a quarterly and annual basis. The reporting requirements and format will be agreed upon by both parties. Pilot Program Areas RECEIVING AGENCY will provide training, written documentation, and ongoing technical assistance to PERFORMING AGENCY in the development of performance -based objectives for the following pilot program areas: Dental Health Services Women, Infants, and Children Nutrition (WIC) 1994 GENERAL PROVISIONS - Page 12 (5/93) n s t For state fiscal year 1994, the parties recognize and agree that the performance -based objectives for the pilot program areas are negotiable. If PERFORMING AGENCY'S achievement is below the established levels, it will not affect the right of PERFORMING AGENCY to funds provided through Attachment(s) when the basic program Scope of Work has been fulfilled. It is understood and agreed upon by both parties that PERFORMING AGENCY will be required to append approved performance -based objectives for the pilot program areas to the local health services contract for state fiscal year 1994. RECEIVING AGENCY contact for matters pertaining to the performance -based public health services project is the office of the Associate Commissioner for Community and Rural Health. 1994 GENERAL PROVISIONS - Page 13 (5/93) � l � DOCUMENT NO. C4000133 ATTACHMENT NO. 01 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: BUREAU OF MATERNAL AND CHILD HEALTH TERM: September 1, 1993 THROUGH August 31, 1994 SECTION I. SCOPE OF WORK: PERFORMING AGENCY will provide or assure the provision of the following health services to women and children: prenatal care, family planning services, especially during the first year post partum, and preventive child health services. Special emphasis should be given to low income women and children. In addition, the PERFORMING AGENCY will provide case management services to these women and children with emphasis on services to high risk individuals. Case management services include an assessment of the individual's and family's service needs and the development, implementation and evaluation of a plan to meet these needs. Services will be performed in accordance with the guidelines for maternity, family planning, child health, and case management services as promulgated by RECEIVING AGENCY, Bureau of Maternal and Child Health. The Maternal and Child Health Service Plan is incorporated herein and made a part of this contract. Maternity, Family Planning, Child Health Clinic, and Case Management services reports will be submitted to RECEIVING AGENCY, Bureau of Maternal and Child Health, in a format and time frame to be agreed upon by both parties. PERFORMING AGENCY will participate in the coordination of Maternal and Child Health services under the leadership -of RECEIVING AGENCY'S Public Health Regional Director. The Public Health Region (PHR) will invite a broad -based participation to its meetings to include community -based providers, city and county officials, community health center personnel, migrant health center personnel, medical schools and agricultural extension agents. PERFORMING AGENCY will work with the PHR in order to coordinate services, avoid duplication, report unmet needs of the community, and help to develop "One Stop Shopping Care Centers" where possible. SECTION II. LEGAL AUTHORITY TO CONTRACT: Chapters 12 and 121, Health and Safety Code. SECTION III. SPECIAL PROVISIONS: General Provisions, PROGRAM INCOME Article, is modified for the purposes of this attachment to comply with Section 2192(a), Title V, Social Security Act, Maternal and Child Health Block Grant, which does not allow low income mothers and children to be charged a fee for health services provided under this attachment. The term "low income" refers to an individual or family on Medicaid, income eligible for Medicaid, or with an income determined to be below the nonfarm income official poverty line defined by the Office of Management and Budget and revised annually in accordance with Section 624 of -1- � � r 1 . r i the Economic Opportunity Act of 1964. No individual may be denied services because of the person's inability to pay. General Provisions, REPORTS AND INSPECTIONS Article, is modified to include the following: PERFORMING AGENCY will provide unduplicated reports based on: Patients receiving maternity, child health, family planning and case management services including total number of patients seen. SECTION IV. BUDGET: FINANCIAL ASSISTANCE Financial assistance involves payment of funds to PERFORMING AGENCY for costs incurred in carrying out approved activities. Personnel $276,315.00 Fringe Benefits 50,733.00 Travel .00 Equipment .00 Supplies 16,733.00 Contractual 21,200.00 Other .00 Total Direct Costs $364,981.00 Indirect - .00 TOTAL $364,981.00 Financial status reports (FSRs) are due the 30th of December, March, June, September and the 15th of October. RECEIVING AGENCY financial assistance will not exceed $364,981.00. -2- DIRECT ASSISTANCE Direct assistance involves the assignment of state funded positions or the provision of materials or supplies such as vaccines in lieu of cash. Personnel [ 2 position(s)] $32,616.00 TOTAL $32,616.00 Direct assistance for personnel in the amount of $32,616.00 is shown on the attached list of positions and budgetary amounts which is an integral part of this attachment. State salary warrants for net earnings will be issued in accordance with state regulations. Financial status reports (FSRs) are not required on direct assistance. Program income generated from activities supported with direct assistance will be reported on FSRs required for financial assistance provided through this attachment, if applicable, or through other program attachment(s) benefiting from this assistance. RECEIVING AGENCY direct assistance will not exceed $32,616.00. Total RECEIVING AGENCY assistance will not exceed $397,597.00. -3- i LUBBOCK CITY / FAMILY HEALTH SERV PAGE 705 TEXAS DEPARTMENT OF HEALTH PHR 2 I)PERATING BUDGET FOR YEAR ENDING AUGUST 31, 1994 %S OF MARCH 31 1993 BUDGET NO. LC301 H21311/K1i028 CATE- DESCRIPTION OR TITLE FUND END ITEM JOB PAY PAY EFFECTIVE MONTHLY GORY DESC. MONTH NO. CLASS GP STP DATE RATE 1 CLERICAL SUPERVISOR II STATE AUG 088 .0063 07 01 SEP 93 1,397.00 COMMUNITY SERV AIDE III STATE AUG 131 5503 06 01 SEP 93 1,321.00 BUDGETED AMT 16,764.00 15,852.00 32,616.00 Texas Department of Health David R. Smith, M.D. Commissioner October 27, 1993 DOUG GOODMAN PUBLIC HEALTH ADMIN. LUBBOCK CITY HEALTH DEPARTMENT P. 0. BOX 2548 LUBBOCK, TX 79408-2548 TDH Document No. C4000133 Dear Mr. Goodman: 1100 West 49th Street Austin, Texas 78756-3199 (512) 458-7111 Robert A. MacLean, M.D. Deputy Commissioner I have enclosed an approved copy of your public health services contract. Please file it with the office of record for your agency. Due to Senate Bill 266 and recent policy decisions made by TDH, three (3) changes have been made to your CRH/IMM Attachment. The first change is located in the first paragraph at the top of page 3 of the Attachment, and addresses residency requirements. The second change is also located on page 3, in paragraph 2 of Section III, Special Provisions. This change references TDH's vaccine distribution plan. The third and final change is located at the bottom of Page 3 and the top of Page 4, and addresses the payment of overtime and straight time for nonexempt and exempt employees performing immunization activities. Provisions in this contract require you to submit financial reports quarterly and no later than 30 days after the end of each quarter. I am providing preprinted Financial Status Reports 269a (TDH Form GC-4a) for the entire term of your contract. If the enclosed constitutes an amendment to an existing contract, only the necessary number of FSRs are being provided to report on the remainder of your contract term. You are reminded that reports are required regardless of whether or not expenses have been incurred. If you have any questions regarding the above -referenced changes, or if we may be of further assistance, please call us at 512/458/7470. Sincerely, Glenn W. Rust, Acting Dir or Grants Management Division GWR:am Enclosure RECEIVED Nov 0 41993 LUBBOCK CITY fIEALTH DEPL A I DOCUMENT NO. C4000133 ATTACHMENT NO. 02 F PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: COMMUNITY AND RURAL HEALTH TERM: September 1, 1993 THROUGH August 31, 1994 SECTION I. SCOPE OF WORK: Comprehensive Public Health Services PERFORMING AGENCY will use direct assistance and/or financial assistance from RECEIVING AGENCY to supplement the delivery of comprehensive public health services. Comprehensive health services encompass a wide variety of personal health services, environmental health services, and other needs of the jurisdiction. Personal health services may include but are not limited to adult health/chronic disease, HIV/AIDS, chronically ill/disabled children, dental, immunization, laboratory, maternal and child health, public health promotion/education, sexually transmitted disease control, and tuberculosis control. Environmental health services/inspections may include but are not limited to food, premise, swimming pool, vector control, and wastewater control. Other services may be provided as needed when agreed to by both parties. PERFORMING AGENCY has prepared outcome and process objectives, if they are applicable and relative to the local needs and resources, for the following program areas: HIV/AIDS Public Health Promotion Immunization Refugee Health Food Protection Sexually Transmitted Disease Maternal and Child Health Tuberculosis Chronic Disease Prevention and Control These performance -based objectives are incorporated and made a part of this attachment and are hereinafter referred to as Exhibit A. PERFORMING AGENCY agrees to maintain a monitoring system and report progress towards these objectives on a quarterly and annual basis. Quarterly monitoring reports are due no later than 45 days after the`end of each quarter, and a cumulative annual report is due no later than 60 days after the end of the attachment term. All performance monitoring reports will be submitted by PERFORMING AGENCY to the respective RECEIVING AGENCY Public Health Region. The Public Health Region will review and forward the reports to RECEIVING AGENCY Community and Rural Health. The format for performance -based monitoring reports will be agreed upon by both parties prior to the due date of the first quarterly report. Immunization Vaccine Support Direct assistance will be provided by RECEIVING AGENCY to PERFORMING AGENCY 3C for the implementation of an immunization program. The goal of the immunization program is to prevent, control, and eradicate vaccine -preventable disease by providing/administering biologicals, promoting immunization, and applying epidemiologic/outbreak controls within budgetary constraints. This will be accomplished by performing the following activities and reports. A. Investigations/Control Measures PERFORMING AGENCY will investigate 100% of suspected cases of measles, rubella, pertussis, poliomyelitis, and diphtheria within 24 hours after a report is received. PERFORMING AGENCY will investigate 90% of suspected mumps cases and 100% of suspected tetanus cases within 48 hours after a report is received. For the above diseases, PERFORMING AGENCY will implement the most current outbreak control procedures/measures and contact RECEIVING AGENCY, Immuniza- tion Division, within 48 hours after an investigation is initiated. B. Reporting Requirements PERFORMING AGENCY understands that all vaccines used in RECEIVING AGENCY Immunization Programs are purchased with public funds and must be accounted for the same as other public property. PERFORMING AGENCY further understands that vaccine loss, destruction, spoilage, or other waste, may be investigated by the RECEIVING AGENCY, Immunization Division, which may then require reimbursement or replacement of the lost vaccines. PERFORMING AGENCY agrees to provide RECEIVING AGENCY, Immunization Division, by January 31st, of each year, a report detailing storage measures and methods used to control vaccine loss including method to monitor and record daily vaccine storage temperatures. The report will be submitted in a format provided by RECEIVING AGENCY, Immunization Division. PERFORMING AGENCY agrees to provide RECEIVING AGENCY, Immunization Division, monthly reports of vaccine utilization/loss, within ten working days after the end of each month, on forms provided by RECEIVING AGENCY (forms C5, CSA, C33, C33A). PERFORMING AGENCY will obtain monthly biological reports from private physician offices and others who receive state supplied biologicals. PERFORMING AGENCY will be evaluated on both the total number of doses admin- istered and the number of DTP 4 administered to children who are two years old :or younger. PERFORMING AGENCY agrees to comply with the following: Texas Immunization Laws, Rules, and Regulations; Chapter 42, Human Resources Code; Sections 2.09 and 2.09A, Texas Education Code; and Section 317 of the PHS Act as amended. PERFORMING AGENCY agrees to closely adhere to both the spirit and intent of the "Standards for Pediatric Immunization Practices," as recommended by the National Vaccine Advisory Committee, approved by the U.S.P.H.S. and endorsed by the American Academy of Pediatrics. PERFORMING AGENCY agrees to provide immunization services outside usual clinic hours (8am to 5pm) or on week -ends -2- at least once each month or as needed to insure barrier free access to immun- ization clinics. PERFORMING AGENCY residency requirements are not applicable under this Attachment for the purpose of providing immunizations. PERFORMING AGENCY cannot deny vaccinations to recipients because they do not reside within PERFORMING AGENCY's jurisdiction. PERFORMING AGENCY will provide services/units of service in or benefiting the county(ies)/area defined as: LUBBOCK. SECTION II. LEGAL AUTHORITY TO CONTRACT: Chapters 12 and 121, Health and Safety Code. SECTION III. SPECIAL PROVISIONS: Immunization Program Requirements: PERFORMING AGENCY understands that federal law guarantees access to immuniza- tion services in public clinics regardless of ability to pay. PERFORMING AGENCY further understands that the bilingual poster "Fees for Vaccine Admin- istration," (Form 6-36, available from the Immunization Division) must be posted where it may be easily seen by patients in each immunization waiting room. PERFORMING AGENCY understands that Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) physicians and other private physicians, authorized by the RECEIVING AGENCY's vaccine distribution plan to administer state -supplied vaccines in their practices, are vital members of the Texas Immunization Initiative. Accordingly, PERFORMING AGENCY agrees to assist it distributing state -supplied vaccines to EPSDT providers, medicaid providers, physicians, and other providers and organizations within PERFORMING AGENCY's local area. PERFORMING AGENCY agrees that fees collected will be kept within guidelines established by RECEIVING AGENCY and that no one may be denied immunization services because of inability to pay the fee. Fee schedules will not be based on per dose charges. For immunization activities perforrllad under this Attachment, General Provisions, Overtime Compensation Article, is not applicable and PERFORMING AGENCY agrees to comply with the following paragraphs: PERFORMING AGENCY is authorized to pay employees who are not exempt under the Fair Labor Standards Act (FLSA), 29 U.S.C., Section 20 et. seq., for overtime or compensatory time at the rate of time and one-half per FLSA. PERFORMING AGENCY is authorized to pay employees who are exempt under FLSA on a straight time basis for work performed on a holiday or for regular compensatory time hours when the taking of regular compensatory time off would be disruptive to normal business operations. -3- Y . I t .w 1 Authorization for payment under this provision is limited to work directly related to immunization activities and has to be in accordance with the amount budgeted in this contract Attachment. PERFORMING AGENCY is responsible for documenting proper authorization or approval for any work performed by exempt or non-exempt employees in excess of 40 hours in a workweek. SECTION IV. BUDGET: FINANCIAL ASSISTANCE Financial assistance involves payment of funds to PERFORMING AGENCY for costs incurred in carrying out approved activities. Personnel $81,766.00 Fringe Benefits 13,416.00 Travel .00 Equipment .00 Supplies .00 Contractual 24,000.00 Other .00 Total Direct Costs $119,182.00 Indirect .00 TOTAL $119,182.00 Financial status reports (FSRs) are due the 30th of December, March, June, September and the 15th of October. RECEIVING AGENCY financial assistance will not exceed $119,182.00. -4- DIRECT ASSISTANCE Direct assistance involves the assignment of state funded positions or the provision of supplies such as vaccines in lieu of cash. Personnel (02 position(s)] $43,440.00 Vaccine 140,011.00 TOTAL $183,451.00 Direct assistance for personnel in the amount of $43,440.00 is shown on the attached list of positions and budgetary amounts which is an integral part of this attachment. State salary warrants for net earnings will be issued in accordance with state regulations. Financial status reports (FSRs) are not required on direct assistance. Program income generated from activities supported with direct assistance will be reported on FSRs required for financial assistance provided through this attachment, if applicable, or through other program attachment(s) benefiting from this assistance. RECEIVING AGENCY direct assistance will not exceed $183,451.00. Total RECEIVING AGENCY assistance will not exceed $302,633.00. 1. MI: LUBBOCK CITY HEALTH DEPARTMENT PAGE 729 TEXAS DEPARTMENT OF HEALTH PHR 2 OPERATING BUDGET FOR YEAR ENDING AUGUST 31, 1994 .-'AS OF APRIL 30 1993 BUDGET NO. LCOOO H21311/K1i028 CATE- DESCRIPTION OR TITLE FUND END ITEM JOB PAY PAY EFFECTIVE MONTHLY BUDGETED AMT GORY DESC. MONTH NO. CLASS GP STP DATE RATE 1 LIC VOCATIONAL NURSE II STATE AUG 083 4412 10 04 SEP 93 1,839.00 22.068.00 ADMINISTRATIVE TECH I _ STATE AUG 104 1501 08 07 SEP 93 1,761.00 21,372.00 FY 1994 PERFORMANCE -BASED CONTRACT OBJECTIVES EXHIBIT A FOR ATTACHMENT FOR LUBBOCK CITY HEALTH DEPARTMENT ` . PERFORhLA NC&BASED CO\TRACT OBJECTIVES,; • FOk FY 1994 DISCLAEWER SHEET List programs you DO NOT provide. If there is more than one program, use a separate dis- claimer sheet for each one. LOCAL HEALTH DEPARTMENT:_L PROGRAM NOT PROVIDED: SIGNATURE: TITLE: PHONE NUMBER: REASON THE ABOVE PROGRAM IS NOT PROVIDED: PERFORYiANCtBASED CONTRACT OBJECTIVES IPOR FY 1994 , ' DISCLA 1 ER SHEET List programs you DO NOT provide. If there is more than one program, use a separate dis- claimer sheet for each one. LOCAL HEALTH DEPARTMENT. I-...l act C. PROGRAM NOT PROVIDED: C(". P C 4. s eaL% SI( PHONE NUMBER: C am) l0"1 - -4 i 6 0 REASON THE ABOVE PROGRAM IS NOT PROVIDED: es1S6 CL �_ V s PERFORYIANCIi$ASED CONTRACT OBJECTIVES ` - r FOR FY 1994 DISCLAWER SHEET List programs you DO NOT provide. If there is more than one program, use a separate dis. claimer sheet for each one. LOCAL HEALTH DEPARTMENT: L& h a cxe ev`Y PROGRAM NOT PROVIDED: teS •.� sa'r� PHONE r REASON THE ABOVE PROGRAM IS NOT PROVIDED: V t �...es- a. �.e.c.•e.5 t� � t tic � N �� eS-�-��..,� w,�� v To: CRH/KSHIELDS From: RGN2/PJOHNSON Date: 26 Mar 93 14:29:12 Subject: PBCO FORM CC: TSNELL COMMENT/VERIFICATION FORM PBCOs FOR FY 1994 LOCAL HEALTH DEPARTMENT : L_11�� PROGRAM: PP REVIEWER: REVIEWER'S PHONE NUMBER: DATE: Please place an "X" in front of one of the following items and fill in any pertinent blanks: - Listed revisions were negotiated with: NAME: TITLE: DATE: X Comments only. No revisions necessary. - Suggestion for FY 95. No revisions necessary at this time. - No comments, suggestions and/or revisions. Objectives stand as written. Please list below any revisions, comments, and/or suggestions. Use a new form for each program. From: Robert M. Badger, R.S. TO: Tommy Snell DATE: February 22, 1993 SUBJECT: Comments on Performance Based Contract Objectives from Lubbock Health Department I have reviewed the objectives from the City of Lubbock Health Department which you provided for me and offer the following comments: 1. Outcome objective: The intent to keep the number of. critical violations noted per inspection to less than 1.3 violations per inspection is laudable. However, the health department cannot and should not pre -determine the outcome of regulatory inspections. Critical violations are definitely an item of concern in a food protection program, but a reduction in the number of critical items noted during inspections can be a result ONLY from enforcement actions and education of the regulated industry, and not a result of the inspection program, per se. The flaw that I,see with the objective as stated is that it appears to be artificially controllable. It would be to limit the number of critical violations "seen" in within the parameters specified by the objective. In very convenient order to stay order to overcome this possible flaw, I suggest that additional process objectives be formulated to address enforcement whenever critical violations are encountered as well as to address the enlightenment of the regulated industry regarding the significance of critical violations. I also suggest that a periodic audit be included in the activities to help ensure that inspectors are noting all the ciritcal items that exist during the time of their inspections. in this regard, it might be beneficial to state in the outcome objective that "the average number of critical violations per AUDIT inspection will be less than 1.3." 2. Process objective: Standardization of inspectors is of paramount importance in the maintenance of a comprehensive and effective food protection program. However, our records.indicate that the only "standardized food service training officer" who has been certified as being standardized by an outside agency is no longer affiliated. with the Environmental Health program. I suggest that an additional process objective should be formulated to ensure that there is at least one "food service training officer" who has been standardized by a state or federally certified training officer. In addition, I suggest that ALL inspectors should receive standardization training in accordance with FDA guidelines either by the specified time limit of January, 1994, or within one year of their employment date, whichever is later. 3. Process objective': My only comment regarding the objective which deals with complaints of foodborne illness is that the•24-hour time limit may be TOO restrictive. I would suggest a less rigid time limit such as ensuring that the investigation is initiated before the close of business on the next working day following the receipt of the complaint. This would allow some flexibility in dealing with routine reports which occur at 4:50 p.m. on Friday afternoon, but would not restrict activities which, by their nature, should begin immediately. The inclusion of the term "investigation is initiated" is intended to recognize that certain investigations cannot be completed in a day. 4. The objectives which deal with wastewater management are no longer within the purview.of the Texas Department of Health in that all wastewater regulatory functions were transferred from the Texas Department of Health to the Texas Water Commission in March, 1992. ENVIRONMENTAL HEALTH PROGRAM OBJECTIVES LUBBOCK CITY HEALTH DEPARTMENT FOCUS: FOOD PROTECTION Outcome Obiectives INDICATORS During fiscal 1993-94, the - Average number of average number of critical critical violations violations per inspection per food service for food service establish- establishment. ments will be less than 1.3. Process Objectives By January 19940 at least 80% - Percent of of all sanitarians conducting Standardized retail food inspections will Sanitarians. receive field Standardization training in accordance with FDA guidelines. During fiscal 1993-94, all - Elapsed times between foodborne illness complaints report of illness and will be documented properly subsequent investiga- to identify complainant's tions. illness and investigated within 24 hours. FOCUS: WASTEWATER MANAGEMENT Outcome Objectives During fiscal 1993-94, at least 95% - Percent of investi- of all complaints regarding malfunctioning gations within time or illegal wastewater disposal systems allotment. will be investigated within 48 hours. Process Objectives - During fiscal 1993-94, all - Percent of appli- residential OSSF applications cations processed which do not require pro- within designated fessional design submittals time. shall be processed within 3 working days. Rev. 2/93 i • i 1 • . t 1 ENVIRONMENTAL HEALTH PROGRAM OBJECTIVES LUBBOCK CITY HEALTH DEPARTMENT FOCUS: FOOD PROTECTION Outcome Objectives During fiscal 1993-94, the average number of critical violations per inspection for food service establish- ments will be less than 1.3. Process Obiectives By January 1994, at least 80% of all sanitarians conducting retail food inspections will receive field Standardization training in accordance with FDA guidelines. During fiscal 1993-94, all foodborne illness complaints will be documented properly to identify complainant's illness and investigated within 24 hours. FOCUS: WASTEWATER MANAGEMENT Outcome Objectives During fiscal 1993-94, at least 9.5$ of all complaints regarding malfunctioning or illegal wastewater disposal systems will be investigated within 48 hours. Process Objectives During fiscal 1993-94, all residential OSSF applications which do not require pro- fessional design submittals shall be processed within 3 working days. Rev. 2/93 41 INDICATORS Average number of critical violations per food service 'establishment. -.Percent of Standardized Sanitarians. Elapsed times between report of illness and subsequent investiga- tions. - Percent of investi- gations within time allotment. - Percent of appli- cations processed within designated time. To: GRH/KSHIELDS From: STDfWHODGSON Date: 7 May 93 08:18:11 Subject: PBCO FORM CC: rgn2/tsnell, rgn2/bray COMMENT/VERIFICATION FORM PBCOs FOR FY 1994 LOCAL HEALTH DEPARTMENT: Lubbock City Health Department PROGRAM: HIV /AIDS REVIEWER: Wes Hodgson REVIEWER'S PHONE NUMBER: (512) 458-7304 DATE: May 7, 1993 Please place an "X" in front of one of the following items and fill . in any pertinent blanks: - Listed revisions were negotiated with: NAME: TITLE: DATE: X - Comments only. No revisions necessary. Suggestion for FY 95. No revisions necessary at this time. No comments, suggestions and/or revisions. Objectives stand as written. Please list below arty revisions, comments, and/or suggestions. Use a new form for each program. I concur with the findings of Billie Ray. In addition, I would like some mention of referral for Early Intervention. To: CRH/RSHIELDS From: RGN2/BRAY Date: 9 Mar 93 13:46:02 Subject: PBCO FORM COMMENT/VERIFICATION FORM PBCOs FOR FY 1994 LOCAL HEALTH DEPARTMENT: Lubbock City Health Department PROGRAM: HIV REVIEWER: Billie L. Ray REVIEWER'S PHONE NUMBER: (806) 744-3577 ext.299 DATE: 3/9/93 ------ --------------------------------------------------------- Please place an "X" in front of one of the following items and fill in any pertinent blanks: - Listed revisions were negotiated with: NAME: TITLE: DATE: - Comments only. No revisions necessary. X - Suggestion for FY 95. No revisions necessary at this time. No comments, suggestions and/or revisions. Objectives stand as written. -------------------------------------------------------------------- Please list below any revisions, comments, and/or suggestions. Use a new form for each program. No problem statement is listed. I suggest a problem statement be listed for next year to define Just what PSCO will accomplish. HIV/AIDS Program FY 93-94 Outcome Objective Evaluation Formula Monitoring Plan Strategies 1. By 1995, the annual incidence of newly diagnosed AIDS and HIV infection will be no more than 35 new cases per year. Process Objectives 1. During FY 93-941,000 individuals Identified at high risk will be provided with pre -test HIV counseling. 2. During FY 93-94, 100% of clients with an identified risk for HIV infection will be offered HIV pre- test counseling, testing and post- test from a TDH certified counselor, either on -site or through specific referral to an appropriate counsel- ing and testing site. 3. During FY 93-94, 80% of those tested will receive post-test counseling. # Cases # Pre -test Counseled # referred for CTPN X 100 # Identified with HIV risk # receiving post-test X 100 counseling # HIV tested Annually Process Objectives and Activities Quarterly Provide on -going CTPN program._ Annually Administer high -risk question- naire to all patients in women's health clinics. Assess risk of all patients in STD clinic. Quarterly See Process Objective M. Annually Quarterly Stress importance of post-test Annually counseling Educate patient regarding meaning - of positive and negative test results. Provide convenient appointment date and time; and confidential setting. Process Objectives Evaluation Formula Monitoring Plan Strategies 4. By the end of FY 93-94, 95% of # groups provided Annually Provide on -going activities of HIV groups requesting presentations on speakers X100 AIDS Education Coordinator to: HIV/AIDS will be provided with # groups requesting Identify groups needing education knowledgeable speakers. speakers arrange for knowledgeable speakers coordinate w/ other agencies thru: personal contact quarterly newsletter Anfivlf(on 1. At least 30 hours of testing and counseling will be provided to identified high risk groups per week; to include on -site and off - site locations. 2. Identified high risk individuals In STD and Women's Health clinics will receive counseling by ap- propriately trained staff. 3. Appointments will be scheduled for 800 persons to receive post- test counseling. 4. During FY 93-94, 5.000 persons will receive HIV/AIDS education arranged by HIV/AIDS Education Coordinator # hours # individuals # appointments # persons Quarterly Provide 20 hours of testing at Annually Health Dept. per week, excluding holidays. Provide 10 hours of testing at off -site locations, per week, excluding holidays Quarterly See Process Objectives #1. Annually Provide on -going training of staff as HIV counselors, by approved Counselor -Trainer. - Quarterly Provide convenient appointments Annually for patient counseling. Quarterly See Process Objective #4. Annually To: CRH/KSHIELDS From: DISCON/MKEENAN Date: 27 Apr 93 17:14:37 Sub iect: PBCO FORM COMMENT/VERIFICATION FORM PBCGs FOR FY 1994 LOCAL HEALTH DEPARTMENT: LUBBOCK CITY HEALTH DEPARTMENT PROGRAM: IMMUNIZATION REVIEWER: MIKE KEENAN REVIEWER'S PHONE NUMBER: 6454 DATE: 04/27/93 Please place an "X" in front of one of the following items and fill in any pertinent blanks: Listed revisions were negotiated with: NAME: TITLE: DATE: Comments only. No revisions necessary. Suggestion for FY 95. No revisions necessary at this time. X - No comments. suggestions and/or revisions. Objectives stand as written. Please -list below any revisions, comments, and/or suggestions. Use a new form for each program. _ • f 26 Mar 92 !3:i05:00 subject: PBCO FORM C C : RGN2 / T SNELL COMMENUVERIFICATION FORM PBC Os FOR FY 19?4 LOCAL HEALTH DEPARTMENT:LUBBOCK K CITY HEALTH .DEPARTMENT PROGRAM : I MMI ►N I ZAT I ON S RE:V I EWER: DL W I LSON REVIEWER'S PHONE NUMBER: TEX-AN 42-=296 DATE:3i 6 0_ --------- Please Place an "n" in front of one of the following items and rill ].n any pertinent blar"iiss: •- List•ed revisions were negotiated with: NAME: TITLE: DATE: - Comments only. No revisions necessary. - Suggestion for FY ? . Na r"_`ii_.ions necessary at this time. X- No comrl ent•=•. 4.Jggest:•i+=+ns arid/or" revisions. Oviectives stand SS written. ---------------------------------------------------------------------- ( i=-c'.'se list. QeiQw any revisions, comments, ctr"d%i_r suggestions. . Use a new farm for ea+_h`, program. Immunizations (Vaccine -Preventable Diseases) FY 93-94 Outcome Objective Evaluation Formula Monitoring Plan Strategies 1. By 1995, the vaccine -preventable disease rate will not exceed 20 per 100,000 population. Process Objectives 1. By the end of FY 93-94, at least 80% of the two year old population attending the Health Department Clinic will have completed primary Immunizations, as recommended by AAP/CDC. 2. By the end of FY 93-94, 100% of vaccine preventable diseases wilt be investigated within 1 working day of reporting. # vaccine -preventable diseases X 100 1.87 # 2 year olds in compliance X 100 # 2 year olds # investigated Win 1 working day X 100 # diseases reported Annually Process Objectives and Activities Annually Conduct surveillance of records of 2 year olds. Annually Train several nurses in the investigation of vaccine pre- ventable diseases. 3. By the end of FY 93-94, 100% of # receiving Information X 100 Annually Prepare sufficient quantities of the area Independent School . # requests information flyers for use by Districts will receive information area school districts. about the Health Dept. Immunization Clinic hours. r Activities 1. Survey 100% immunization records # records surveyed X 100 Monthly Conduct on -going review of records of two year olds attending the # records of children two years old. Health Department.. Activities Evaluation Formula Monitoring Plan Strategies 2. Send reminders to 100% those with # sent reminders X 100 Monthly Mail post cared reminders to all delinquent Immunizations. # delinquent 2 year olds with delinquent - Immunizatons. ' 3. Provide immunization Information # information sent X 100 Annually See Process Objective #3 =' to 100% of schools requesting it to # Information requested . dispense at the time of spring kindergarten enrollment. 4. Provide at least 28 hours of # hours On -going Provide clinics at various hours Immunization clinic each week to accomodate working parents. Excluding holidays. i To: eFH/K! 5HIELDS r From: GRH/KSHIELDS Date: 14 t4ay 93 09:26:29 Subject: Lubbock City Health Department. MCH comments CC: rgn2/tsne ll COMMENT/VERIFICATION FORM PBCOs FOR FY 1994 LOCAL HEALTH DEPARTMENT: Lubbock City Healt Departmen PROGRAM: MCH REVIEWER: Carol Pav ilka REVIEWER'S PHONE NUMBER: 512-450-7700 DATE:05-14-93 ------------------------------------------------------------------ Please place an "X" in front of one of the fallowing items and fill in any pertinent blanks: - Listed revisions were negotiated with: NAME: TITLE: . .DATE: X - Comments only. No revisions necessary. - Suggestion for FY 95. No revisions necessary at this time. - No comments, suggestions and/or revisions. Objectives stand as written. Please list below any revisions, comments, and/or suggestions. Use a new form for each program. Lubbock's family Planning objective is not an outcome. r -I o : CRH / KSH l ELD From: ROW/SRHODK.; Date". 26 filar 93 10 : 44: 1, : CC: F:� 142/TSnel1 COMMENUVEF; IFICAT1i ;N FORM F'E QOs FOR FY 1994 LOCAL HEALTH VEPARTML=NT:Lumocr City Health Department. PROGRAM:Maternity REVIEWER; Joan Hoffmast•er CNM REVIEWER'S PHONE rdUMBEh:Tax An 824-5204 }ATE: 26-9 ------------------------------------------------------------------- Please place an "X" in front of one of the following items and fill in any pertinent blanks: - Listed revisions were negotiated with: NAME: TITLE: DATE: - Comments only. No revisions necessary. _. Suggestion for FY 95. No revisionnecessary at Uhis time. comments suggestions and/or" revisions. objectives stand as written. ----------------------------------------------------------------------- Please list below any revisions, commentsand/or susseations. a new form for each prosram. Maternity FY 93-94 Outcome Objective Evaluation Formula Monitoring Plan Strategies 1. By 1995. 60% of patients enrolled # patients with 9 Annually Process Objectives and Activities in the maternity- clinic will ex- or more visits X100 hibit adequate prenatal care by # patients _ having a minimum of 9 clinic visits. - Process Objectives 1. During FY 93-94, 100% of pregnant # patients counseled X 100 women enrolled in maternity clinic # patients clinic be counseled on the import- ance of regular clinic visits. 2. During FY 93-04 90% of patients requesting prenatal care at health dept. will receive an appointment within two weeks of request. Activities 1. During FY 93-94100% of patients seen in pregnancy testing clinic will be counseled regarding early and on -going prenatal care. 2. Video tapes on the importance of prenatal care will be played In the waiting area during clinic hours. 3. Pamphlets on prenatal care will be available to all clients. # enrollments X 100 # requests Monthly Ensure adequate nurse coverage for counseling. Monthly Provide adequate appointments to accommodate demand. # patient counseled X 100 Monthly All patients seen will be # tested counseled by a licensed nurse. # hours Daily Provide up to date video tapes. # pamphlets On -going Bi-weekly restocking of pamphlet racks. Women's Health Services r FY 93-94 Outcome Objective Evaluation Formula Monitoring Plan Strategies 1. By 1995, 50% of women will # patients returning within exhibit preventive health care 15 months of last visit X 100 Annually Process Objectives practices by returning for annual # patients seen or postpartum exams. Process Objectives 1. During Fy 93-94, 100 % of patients seen will be counseled regarding Importance of annual preventive health care. 2. During FY 93-94, 50% of patients seen in maternity clinic will return for post partum exam. Activities 1. 90% of patients who receive prenatal care at the health dept. will be contacted by phone or visit and offered post partum exam appointment. 2. Provide at least 20 hours per week of women's health services. 3. 100% of women seen will receive information on preventive health issues and yearly exams. # counseled X 100 # seen # post partum exams X 100 # delivered maternity patients # contacted # receiving care and delivered # hours # counseled # seen Monthly Stress importance of yearly examinations. Provide information on SSE and and pap smears. Quarterly Provide adequate appointments for post partum exams. Quarterly Assign personnel 4 hours/week to contact patients. On -going Provide clinics at varying hours to accommodate working clients and students. Monthly Monthly audits 03/15/93 12:15 Ml buo roc aauo l PERFOR1vL4JNCE-BASED CONTRACT OBJECTIVES FOR FY 1994 DLSCLAWER SHEET . List programs you DO NOT provide.. If 'there is more than one program, use a separate dis- claimer sheet for each one. LOCAL HEALTH DEPARTMENT`. L bLv_ C-71v PROGRAM NOT PROVIDED: PU-Llt tin_ keal _ Pt'6'L.;:f" SI( PHONE REASON THE ABOVE PROGRAM IS NOT PROVIDED: S Cyr L-�t U3/1J/`,!J 1L:1/ rr►.� ovv u� .rw.r a.y.......,.,, __ ___ � l PERFORh•IANC,E-18aSED CONTRACT OBJECTIVES FOR FY 1994 DLSCLAIlvfER SHEET , List programs you DO NOT provide. If there is more than one program, use a separate dis- claimer sheet for each one. LOCAL HEALTH DEPARTMENT: o14e- -c--r t/ _ PROGRAM NOT PROVIDED: e jLoex 0 R. SIGNATU TITLE: PHONE NUMBER: REASON THE ABOVE PROGRAM IS NOT PROVIDED: el tl To: arh/kshi►-=lds From: 1 Tj:+f Hi;AhiSEY + _J +, Date: ':-C Apr- 9 14:24:45 Sub j ect : CP+J/ k::SH I ELI:+S PBCO FORM COMMENT/VERIFIi_ATION FORM PBCOs FOR FY 1`_ 94 LOCAL HEALTH DEPARTMENT: Lubbock City HD PROGRAM : STD REVIEWER:HRamsey REVIEWER'S PHONE NI USER: 512 45L -7225 DATE: 4/2S/93 -------------------------------------------- 7---------------------- Please place an "X" in front of one of the following items and fill in any pertinent blanks: - Listed revisions were negotiated with: NAME: TITLE: DATE: X - Comments only. No revisions necessary. - Suggestion for FY 95. No revisions necessary at this time. - No comments, suggestions and/or revisions. Objectives stand as written. -------------------------------------------------------------------- Please list below any revisions, comments, and/or suggestions. Use a new form for each program. Asree with previous reviewer-. Process objectives and activities are good, however,the outcome objective could be achieved by closing the Health Dept:. Next years outcome should address reducing specific STD rates. To: •CRHjKSHIELDS From: David L. Hoehns <RGN2/DHOEHNS> Date: 2 Apr 93 11:33:16 Subject: PBCO FORM CC: tsnell COMMENT/VERIFICATION FORM PBCOs FOR FY 1994 LOCAL HEALTH DEPARTMENT: Lubbock City Health Department PROGRAM:STD Control REVIEWER:David L. Hoehns REVIEWER'S PHONE NUMBER:Texann 842-5294 DATE:04/01/93 Please place an "X" in front of one of the following items and fill in any pertinent blanks: - Listed revisions were negotiated with: NAME: TITLE: DATE: - Comments only. No revisions necessary. X - Suggestion for FY 95. No revisions necessary at this time. - No comments, suggestions and/or revisions. Objectives stand as written. Please list below any revisions, comments, and/or suggestions. Use a new form for each program. Lubbock City consolidated all their STD PBO work into one objective. My concern with this was 1)it was not disease specific, 2) not being disease specific it does not specifically address the Year 2000 Objectives, and 3)it will attempt to measure activity that can be manipulated by lack of work, i.e. it will measure the value of patient education by looking at patients returning with reinfection. while I know that Lubbock City operates a caring and concerned STD clinic, this parameter, in an objective sense, could be made to appear excellent if patients did not return for new infection when in fact they did not return because clinic hours were inconvenient, they perceived they were not treated well, or (because the study is not blinded in any way) could be influenced not to return by a staff person who wants to do well in the objective. I know that Lubbock has put a lot of time a effort into their PBO work, and I do not want to cause confusion by creating a whole new PBO in a few days. Too, very little STD funds go to Lubbock. Therefore, I have offered to work with them for new objectives for 1995. Sexually Transmitted Disease FY 93-94 Outcome Objective Evaluation Formula Monitoring Plan Strategies 1. By 1995, 75% of persons treated the STD clinic for a reportable sexually transmitted disease will not return with a reportable STD within one year of treatment. Process Objectives 1. During FY 93-94, 100% of persons treated or examined in the STD clinic will receive information on the prevention of sexually trans- mitted diseases. 2. During FY 93-94, 100% of persons treated for a reportable sexually transmitted disease will be interviewed for contacts or be given contact slips to get sex partners tested and treated. Activities 1. 100% of persons examined and/or treated will receive education regarding disease intervention. 2. Pamphlets on sexually transmitted diseases will be available to all clients. # persons re -treated within last 12 months X 100 # persons treated # persons treated or examined X 100 # persons provided STD information # persons treated for a reportable STD X 100 # persons interviewed or given contact slips # persons receiving education X 100 # persons examined and/or treated # pamphlets Annually Process Objectives and Activities Monthly Written as Standard of Care in Policy and Procedure Manual Annually DIS available during clinic hours as often as possible. Provide contact slips to all clinicians. Monthly Monthly Audit L• On Going Bi-weekly restocking of pamphlet racks. t Activities Evaluation Formula Monitoring Plan Strategies 3. Video tapes on STDs will be # hours On Going Provide STD video tapes to be played in the lobby during clinic played during clinic hours. ` hours. 03/laiaa ie:tr raA ouu \u& uvvw..---- (. PERFORIYLA.NCE-BASED CONTRACT OBJECTIVES FOR FY 1994 9 \ DISCLARVUER SHEET List programs you DO NOT provide. If there is more than one program. ,use a separate dis- claimer sheet for each one. LOCAL HEALTH DEPARTMENT: L..�dcx< Cc / PROGRAM NOT PROVIDED: • — a REASON THE ABOVE PROGRAM IS NOT PROVIDED: -we ,e `� 1 cr3�� Sery STATE OF TEXAS COUNTY OF TRAVIS TEXAS DEPARTMENT OF HEALTH 1100 WEST 49TH STREET AUSTIN, TEXAS 78756-3199 CONTRACT CHANGE NOTICE NO. 3 TDH Document No. C4000133 The Texas Department of Health, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in writing with LUBBOCK CITY HEALTH DEPARTMENT hereinafter referred to as PERFORMING AGENCY. The parties thereto now desire to amend such contract as follows: SUMMARY OF TRANSACTION: ; Revision to public health services contract. ' ; Attachment No. 06A — Amendment for Women, Infants and Children (WIC) program ; to provide group nutrition education, individual ; counseling and prescribe foods at no cost to individuals ; identified as having nutritional deficiencies. ; All terms and conditions not hereby amended remain in full force and effect. ; EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN. ; CITY OF LUBBOCK ; Authorized Contracting Entity (type above ; if different from PERFORMING AGENCY) of: rf,411,.inbehalf CK TN w TEXAS DEPARTMENT OF HEALTH ; ERF AGE CY RECEIVING AGENCY ; 7treof By: By (SigR- ure of person auth ized 0 i person authorized ; to sign contracts) to sign contracts) ; Linda Farrow, David R. Langston, Mayor ofFiChief Bureau of Financial Services (Name and Title) , (Name and Ti ; Date: 03/09/94 Date: RECOMMENDED: APPROVED AS T ORR• ; BY: By: (PERFORMING AGENCY Director, Off' e'of General Counse ; if different from person ; authorized to sign contract) ; Cover - Page 1 DETAILS OF AT'TACHNENTS Att/; ; ; Financial Assistance Am. ; TDH Term Source of ; ; Direct Total Assistance ; Na. ; Program ; Begin End ; Funas# ; Amount ; Assistance Amount (TDH Share) 01 ', NCH/FHS-LHS ; 9/ 1193; 8/31/94; STATE ; 384,981.00; 32,615,00: 397,597.00; 02 1 ; � CRH/IHN-LHS ; 9/ 1193; 1 8131/94 1 1 I STATE ; 119,182.00 183,451,00: 1 302,633.00: i 1 03 i I ;LAB-LHS 1 I 9/ 1/93; i ! 8131/94; t 1 I I I 1 STATE ; 00; i6,000.00, i 1 76,000.00; f 04 1 ; HIV/EDUC-LHS 9/ 1/93: I 8/31194; i 1 i STATE 43,471.00; .00; i 43,471.00; I t i i I 1 05 TB/OUTR-LHS 9/ 1/93; 8/31/941 STATE ; 20,073.00, .00; 20,073.001 06A ; WIC/CARD-LHS ;10/ 1/93; 9/30/94; 10.557 STATE ; 00; .OG; .00: i 1 1 I I 1 t 1 1 1 I I I I I 1 1 1 1 i i 1 I 1 I I I I ! 1 1 1 I 1 i 1 1 I 1 i i 1 i I 1 1 i 1 I i i i 1 1 I 1 3 1 1 I 1 1 f i 1 I t 1 I I I 1 1 1 ! 1 I 1 f i 1 1 i 1 1 1 1 1 1 1 i 1 I 1 1 I t i i 1 i 1 i 1 1 1 i 1 1 I I i I i t 1 1 1 I 1 I 1 t ! I 1 I I 1 1 1 .fix SC;T' wry$gc e�-s+.nT'u hm, 1 l i a 1 i f 1 a 1 1 1 1 I 1 t Sandoglobuliho 1 1 1 I 1 1 i 1 I I t I P Immune Globulin 1 1 1 1 i I I I I intravenous (Human) 1 ; 1 I i I I t i I I 1 1 I t 1 1 ! 1 I 1 I I 1 =1 I I 1 1 1 i 1 1 t 1 t 1 I 1 1 1 I 1 I i 1 1 I I 1 i 1 1 1 I 1 I I i 1 1 ! i 1 t 1 1 I I 1 I 1 I 1 1 t I i 1 1 1 1 i 1 I i 1 1 t 1 1 I 1 1 I I 1 I 1 1 I 11 1 1 1 1----------------------------------------------------------------------------------------------------------------------1 1 1 1 i 1 1 1 TDH Document No. C4000133 TOTALS ; $ 541,101.00: 292,061.00; 839,114.00: Change No. 03 1 i 1 1 1 1 1 I i I Federal funds are indicated by a number from the Catalog of Federal Domestic Assistance (CFDA), if applicable. REFER TO BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS. COVER - Page 2 i DOCUMENT NO. C4000133 ATTACHMENT NO. 06A PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: BUREAU OF WOMEN, INFANTS, AND CHILDREN'S NUTRITION TERM: October 1, 1993 THROUGH September 30, 1994 It is mutually agreed by and between the contracting parties to amend the conditions of Document No. C4000133-06 as written below. All other conditions not hereby amended are to remain in full force and effect. SECTION III. SPECIAL PROVISIONS, General Provisions, TERMS & CONDITIONS OF PAYMENT Article, Paragraph 4 is hereby amended as follows: PARTICIPANTS SERVED PER MONTH MAXIMUM REIMBURSEMENT First 500 participants served $ 9.48 per participant Next -1000 participants served $ 7.77 per participant Next 8500 participants served $ 5.25 per participant All additional participants served $ 5.00 per participant -1-