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Home My WebLink AboutResolution - 2004-R0406 - Contract Change For Health System Improvements - TX Dept. Of Health - 08_26_2004Resolution No. 2004-RO406 August 26, 2004 Item No. 24 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock is hereby authorized and directed to execute for and on behalf of the City of Lubbock a Contract Change No. 05 to a Contract with the Texas Department of Health (TDH Document No. 7560005906 2005) for OPHP- Local Public Health System improvements and any associated documents by and between the City of Lubbock and the Texas Department of Health, a copy of which Contract Change No. 05 and associated documents are attached hereto and which shall be spread upon the minutes of this Council and as spread upon the minutes of this Council shall constitute and be a part hereof as if fully copied herein in detail. Passed by the City Council this 26th day of August , 2004. ATTEST: Q, a'--r-e --0- 1 Reb cca Garza, City Secretary APPROVED AS TO CONTENT: Tommy C den, Health Director APPROVED AS TO FORM: Donald G. Vandiver, Attorney of Counsel DDres/TDHcon05Chg5Res August 5, 2004 STATE OF TEXAS COUNTY OF TRAVIS Resolution No. 2004-RO406 August 26, 2004 Item No. 24 DEPARTMENT OF STATE HEALTH SERVICES 1100 WEST 49TH STREET AUSTIN, TEXAS 78756-3199 DSHS Document No. 7560005906 2005 Contract Change Notice No. 05 The Department of State Health Services, 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 attachment(s) as tonows: SUMMARY OF TRANSACTION: ATT NO. 05 : OPHP - LOCAL PUBLIC HEALTH SYSTEM All terms and conditions not hereby amended remain in full force and effect. EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN. CITY OF LUBBOCK HEALTH DEPARTMENT Authorized Contracting Entity (type above if different from PERFORMING AGENCY) for and in behalf of: PERFORMING AGENCY: LUBBOCK C HEAL EPARTMENT By: (Si ture of pers authorized to sign) i nrc d al., %yor (Name and Title) Date August 26, 2004 RECOMMENDED: By: (PERFORMIN GENCY Director, i different from person authorized to sign contract Approved as to form: Gity Attorney RECEIVING AGENCY: DEP NT OF STATE HEALTH SERVICES By ;A� (Signature of person au Rrized�osign) Bob Burnette, Director Procurement and Contracting Services Division (Name and Title) Date: DL PCSD - Rev. 6/04 Cover Page 1 DETAILS OF ATTACHMENTS Att/ DSHS Program ID/ Term Financial Assistance Direct Total Amount Amd DSHS Purchase Assistance (DSHS Share) No. Order Number �gm End Source of Amount Funds* 01A IMM/LOCALS 01/01/04 12/31/04 State 93.268 92,176.00 0.00 92,176.00 0000001776 02 HIV/SURV 09/01/04 08/31/05 50,251.00 0.00 50,251.00 C038578000 03 ACFH/POP 09/01/04 08/31/05 45,977.00 0.00 45,977.00 C038805000 04 ZOONOSIS 09/01/04 08/31/05 10,886.00 0.00 10,886.00 C038061000 05 OPHP/LPHS 09/01/04 08/31/05 118,559.00 0.00 118,559.00 C039236000 DSHS Document No.7560005906 2005 Totals $317,849.00 $ 0.00 $317,849.00 Change No. OS *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 Resolution No. 2004-R0406 August 26, 2004 DOCUMENT NO.7560005906-2005 Item No. 24 ATTACHMENT NO. 05 PURCHASE ORDER NO. C039236000 PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT RECEIVING AGENCY PROGRAM: OFFICE OF PUBLIC HEALTH PRACTICE TERM: September 01, 2004 THRU: August 31, 2005 SECTION I. SCOPE OF WORK: PERFORMING AGENCY shall improve or strengthen local public health infrastructure within the State of Texas by: • Developing objective(s) to address a public health issue; • Utilizing resources provided through this contract attachment to conduct activities and services that provide or support the delivery of essential public health services; • Assessing, monitoring, and evaluating the essential public health activities and services provided through this contract attachment; and • Developing strategies to improve the delivery of essential public health service(s) to identified service area. These tasks shall be performed in accordance with PERFORMING AGENCY'S FY 05 Local Public Health System (LPHS) Service Delivery Plan, dated May 27, 2004 and the FY 05 Texas Application for Preventive Health and Health Services Block Grant Funds, dated June 15, 2004. The assessment and/or evaluation activities must include a standard that is identified in PERFORMING AGENCY'S FY 05 LPHS Service Delivery Plan. Acceptable standards include the National Public Health Performance Standards approved by the Centers for Disease Control and Prevention, Performance Standards developed by the Texas Association of Local Health Officials, Healthy People 2010, and any federal, state or local law or regulation governing the delivery of essential public health services. Other evaluation methods utilizing standards not listed in this contract Attachment must be pre -approved by RECEIVING AGENCY. PERFORMING AGENCY shall comply with all applicable federal and state laws, rules, regulations, standards including, but not limited to, the following: • Chapter 23-11 of the Healthy People 2010; • Section 121.002, Texas Health & Safety Code, definition of ten essential public health services; and • Government Code, Section 403.1055, "Permanent Fund for Children and Public Health". • Texas Administrative Code, Title 25, Chapter 83, Subchapter A "Permanent Fund for Children and Public Health". ATTACHMENT — Page 1 PERFORMING AGENCY shall comply with all applicable regulations, standards, and guidelines in effect on the beginning date of this contract Attachment. The following documents are incorporated by reference and made a part of this contract Attachment: • PERFORMING AGENCY'S FY 05 LPHS Service Delivery Plan; and • FY 05 Texas Application for Preventive Health and Health Services Block Grant Funds. PERFORMING AGENCY may not use funds from the Permanent Fund for Children and Public Health for lobbying expenses under the Government Code, Section 403.1067. RECEIVING AGENCY shall inform PERFORMING AGENCY in writing of any changes to applicable federal and state laws, rules, regulations, standards and guidelines. PERFORMING AGENCY shall comply with the amended law, rule regulation, standard or guideline except that PERFORMING AGENCY shall inform RECEIVING AGENCY Program in writing if it shall not continue performance under this Attachment within thirty (30) days of receipt of an amended standard(s) or guideline(s). RECEIVING AGENCY may terminate the Attachment immediately or within a reasonable period of time as determined by RECEIVING AGENCY. PERFORMANCE MEASURES PERFORMING AGENCY shall complete the PERFORMANCE MEASURES as stated in the FY 05 LPHS Service Delivery Plan, and as agreed upon by RECEIVING AGENCY, and hereby attached as Exhibit A. PERFORMING AGENCY shall provide activities and services as submitted by PERFORMING AGENCY and approved by RECEIVING AGENCY in the FY 05 LPHS Service Delivery Plan in the following county(ies)/area: Lubbock. SECTION II. SPECIAL PROVISIONS: General Provisions, Reports Article, is revised to include the following paragraphs: PERFORMING AGENCY shall submit quarterly progress reports which describe progress toward completing the activities and services contained in PERFORMING AGENCY'S FY 05 LPHS Service Delivery Plan and any written revisions. PERFORMING AGENCY shall submit the first, second and third quarter's progress reports to RECEIVING AGENCY no later than thirty (30) days after the end of each quarter, and the final report and improvement plan to RECEIVING AGENCY sixty (60) days after the end of this contract Attachment term in a format specified by RECEIVING AGENCY. ATTACHMENT — Page 2 PERFORMING AGENCY shall submit an Annual Budget and Expenditures Report in a format specified by and to RECEIVING AGENCY by December 15, 2005. ATTACHMENT — Page 3 Resolution No. 2004-RO406 August 26, 2004 Item No. 24 FINANCIAL ASSISTANCE CURRENT OBJECT CLASS CATEGORIES NEW OR REVISED APPROVED CHANGES BUDGET BUDGET REQUESTED a. PERSONNEL ................................ 89,608.00 0.00 89,608.00 b. FRINGE BENEFITS .......................... 28,946.00 0.00 28,946.00 c. TRAVEL ................................... 0.00 0.00 0.00 d. EQUIPMENT ................................ 0.00 0.00 0.00 e. SUPPLIES ................................. 0.00 0.00 0.00 f. CONTRACTUAL .............................. 0.00 0.00 0.00 g. OTHER .................................... 0.00 0.00 0.00 h. TOTAL DIRECT CHARGES ..................... 118,554.00 0.00 118,554.00 i. INDIRECT CHARGES ......................... 0.00 0.00 0.00 .. TOTAL .................................... 119,554.00 0.00 118,554.00 k. RECEIVING AGENCY SHARE ................... 118,554.00 0.00 118,554.00 1. PERFORMING AGENCY SHARE (Includes m. PI) 0.00 0.00 0.00 m. PROGRAM INCOME: 0.00 0.00 0.00 m.2. Program Income (projected)......... 0.00 0.00 0.00 m.3.Other Match ......................... 0.00 0.00 0.00 CONTRACT TERM Begin Date .................................... 9/1/2004 End Date ...................................... 8/31/2005 DETAIL ON INDIRECT COST: TYPE OF RATE PROVISIONAL ................ PREDETERMINED ............. FINAL ...................... FIXED ...................... RATE ................. .................... 0.00000 0.00000 0.00000 BASE ...................................... 0.00 0.00 0.00 TOTAL INDIRECT CHARGES .................... 0.00 0.00 0.00 Financial status reports are due the 30th of December, 30th of March, 30th of June, and the 30th of November. Exhibit A PERFORMANCE MEASURES: PERFORMING AGENCY: City of Lubbock Objective #1: PERFORMING AGENCY shall ensure clients seen in the sexually transmitted disease clinic (STD) at the City of Lubbock Health Department (CLHD) receive education regarding STD's and are properly tested and treated. Performance Measure: 90% if clients seen in the STD clinic at the CLHD receive education and are properly tested and treated. Objective #2: PERFORMING AGENCY shall ensure clients seen in the STD clinic at the CLHD requesting hepatitis B vaccine are educated and provided vaccine or referred to agencies to secure vaccine. Performance Measure: 90% of clients requesting hepatitis B vaccine thru the STD clinic at the CLHD will be educated and proved vaccine or referred to agencies to secure vaccine. Objective #3: PERFORMING AGENCY shall workers of child-care agencies and schools receive education on proper hand washing procedures as requested. Performance Measure: 90% of workers in child-care centers and schools will receive hand -washing education as requested. Objective #4: PERFORMING AGENCY shall ensure participants attending seminars and health fairs have increased cancer awareness. Performance Measure: On a yearly basis, 750 citizens will receive cancer education and/or material with participation in ten health fairs regarding cancer awareness. Objective #5: PERFORMING AGENCY shall all participants of blood pressure screening receive education on hypertension. Performance Measure: Provide blood pressure screenings at 9 different local grocery stores twice a month and refer 100% of all blood pressure screening participants with hypertension to their physician. Exhibit A — Page 1 CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or an employee of any agency, a member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-111, "Disclosure Form to Report Lobbying," in accordance with it's instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,0_00 aid not more than $100,000 for each such failure. August 26, 2004 Date Print Name of Authorized Individual 7560005906 2005-05 Application or Contract Number LUBBOCK CITY HEALTH DEPARTMENT Organization Name and Address 1902 TEXAS AVENUE LUBBOCK, TX 79457-0000 7 f as to form: G City Attorney 1100 West 49th Street Austin, Texas 78756-3199 Department of State Health Services FINANCIAL STATUS REPORT FSR269A Fiscal Division/Accounts Payable Phone f512145R-7435 Contractor Name: LUBBOCK CITY HEALTH DEPARTMENT DSHS Program: OPHP/LPHS DSHS Document # Year Attachment # Payee Acct. No.: 7560005906 2005 05 Payee Vendor ID No.: 17560005906001 Basis: [ ] Cash [ ] Accrual Payee Name: CITY OF LUBBOCK Address: PO BOX 2000 City, ST, zip: LUBBOCK, TX 79408-2000 Contract Term: (Month/Day/Year) From:09101/2004 To: 08/31/2005 Period Covered by this Report: From: 09/01/2004 To: 11/30/2004 PO Number: C039236000 Final Report? [ ] Yes [ X No (i) Budget Categories (ii) Approved Budget Project Cost per General Ledger (v) Remaining Budget Balance (ii minus iv) (iii) This Period (iv) Cumulative a. Personnel [ ] 89,608.00 b. Fringe Benefits [ ] 28,946.00 c. Travel 0•00 d. EGuiDment [ 0•00 e. Supplies [� 0•00 f. Contractual [� 0•00 g. Other [ ] 0.00 h. Total Direct Charges 118,554.00 i. Indirect Charges [� 0•00 '. Total Charges 118,554.00 LESS:k. Program Income Collected ( ) ( ) 1. Non-DSHS Funding( ) m. ADVANCE:Received (Col. iii)/ Repaid (Col. ivy Balance Owed Col, v ) n. Total Reimbursement Requested o. Total Reimbursement Received Prepared by: Title: Phone #: CERTIFICATION:1 certify to the best of my knowledge and belief that this report is correct and complete and that all outlays and unliquidated obligations are for the purposes set forth in the award documents. Signature of Authorized Certifying Official Date Submitted: Typed or Printed Name and Title of Certifying Official Telephone: DSHS Form GC-4a (269a) Revised 6104 1100 West 49th Street Austin, Texas 78756-3199 Department of State Health Services FINANCIAL STATUS REPORT FSR269A Fiscal Division/Accounts Payable Phone (512) 45R.7d';-; Contractor Name: LUBBOCK CITY HEALTH DEPARTMENT DSHS Program OPHP/LPHS DSHS Document # Year Attachment # Payee Acct. No.: 7560005906 2005 05 Payee Vendor ID No.: 17560005906001 Basis: [ ] Cash [ ] Accrual Payee Name: CITY OF LUBBOCK Address: PO BOX 2000 City, ST, Zip: LUBBOCK, TX 79408-2000 Contract Term: (Moutb/Day/Year) From:09/01/2004 To: 08/31/2005 Period Covered by this Report: From: 12/01/2004 To: 02/28/2005 PO Number: C039236000 Final Report? [ ] Yes [ X No r (i) Budget Categories Approved Budget Project Cost per General Ledger („) Remaining Budget Balance (ii minus iv) (iii) This Period (iv) Cumulative a. Personnel [ ] 89,608.00 b. Frin a Benefits 28,946.00 c. Travel 0.00 d. E ui ment 0•00 e. Supplies j 0•00 f. Contractual 0•00 .Other [ ] 0.00 h. Total Direct Charges 118,554.00 i. Indirect Charges 0.00 '. Total Charges 118,554.00 LESS:k. Program Income Collected 1. Non-DSHS Funding in. ADVANCE:Received (Col. iii)/ Repaid (Col. ivY Balance Owed Col. v n. Total Reimbursement Requested o. Total Reimbursement Received Prepared by: Title: Phone #: CERTIFICATION:I certify to the best of my knowledge and belief that this report is correct and complete and that all outlays and unliquidated obligations are for the purposes set forth in the award documents. Signature of Authorized Certifying Official Date Submitted: // Typed or Printed Name and Title of Certifying Official Telephone DSHS Form GC-4a (269a) Revised 6/04 1100 West 49th Street Austin, Texas 78756-3199 Department of State Health Services FINANCIAL STATUS REPORT FSR269A Fiscal Division/Accounts Payable Phone M 21 d4R.'7d';4 Contractor Name: LUBBOCK CITY HEALTH DEPARTMENT DSHS Program: OPHP/LPHS DSHS Document # Year Attachment # Payee Acct. No.: 7560005906 2005 05 Payee Vendor ID No.: 17560005906001 Basis: [ ] Cash [ ] Accrual Payee Name: CITY OF LUBBOCK Address: PO BOX 2000 City, ST, Zip: LUBBOCK, TX 79408-2000 Contract Term: (Month/Day/Year) From:09/01/2004 To: 08/31/2005 Period Covered by this Report: From: 03/01/2005 To: 05/31/2005 PO Number C039236000 Final Report? [ ] Yes [ X No (i) Budget Categories (ii) Approved Budget Project Cost per General Ledger (v) Remaining Budget Balance (ii minus iv) (iii) This Period (iv) Cumulative a. Personnel [ ] 89,608.00 b. Frin a Benefits [ ] 28,946.00 c. Travel 0•00 d. Ecluipment [ 0.00 e. Supplies [ 0.00 f. Contractual [ 0.00 g. Other [ ] 0.00 h. Total Direct Charges 118,554.00 i. Indirect Charges [ 0•00 '. Total Charges 118,554.00 LESS:k. Program Income Collected 1. Non-DSHS Funding m. ADVANCE:Received (Col. iii)/ Repaid (Col. ivy Balance Owed Col. v n. Total Reimbursement Requested o. Total Reimbursement Received Prepared by: Title: Phone #: CERTMCATION:I certify to the best of my knowledge and belief that this report is correct and complete and that all outlays and unliquidated obligations are for the purposes set forth in the award documents. Signature of Authorized Certifying Official Date Submitted: Typed or Printed Name and Title of Certifying Official Telephone: DSHS Form GC-4a (269a) Revised 6/04 1100 West 49th Street Austin, Texas 78756-31" Department of State Health Services FINANCIAL STATUS REPORT FSR269A Fiscal Division/Accounts Payable Phone 0912) 459-7435 Contractor Name: LUBBOCK CITY HEALTH DEPARTMENT DSHS Program: OPHP/LPHS DSHS Document # Year Attachment # Payee Acct. No.: 7560005906 2005 05 Payee Vendor ID No.: 17560005906001 Basis: [ ] Cash (] Accrual Payee Name: CITY OF LUBBOCK Address: PO BOX 2000 City, ST, zip: LUBBOCK, TX 79408-2000 Contract Term: (Month/Day/Year) From:09/01/2004 To: 08/31/2005 Period Covered by this Report: From: 06/01/2005 To: 08/31/2005 PO Number: C039236000 Final Report? [ XYes [ ] No (i) Budget Categories (ii) Approved Budget Project Cost per General Ledger (v) Remaining Budget Balance (ii minus iv) (iii) This Period (iv) Cumulative a. Personnel [) 89,608.00 b. Fringe Benefits [ ] 28,946.00 c. Travel [ 0.00 d. E ui ment [ ] 0.00 e. Supplies [� 0.00 f. Contractual [� 0.00 g. Other [ ] 0.00 h. Total Direct Charges 118,554.00 i. Indirect Charges [ 0.00 '. Total Charges 118,554.00 LESS:k. Program Income Collected 1. Non-DSHS Funding in. ADVANCE:Received (Col. iii)/ Repaid (Col. ivy Balance Owed Col. v n. Total Reimbursement Requested o. Total Reimbursement Received Prepared by: Title: Phone #: CERTIFICATION:I certify to the best of my knowledge and belief that this report is correct and complete and that all outlays and unliquidated obligations are for the purposes set forth in the award documents. Signature of Authorized Certifying Official Date Submitted: // Typed or Printed Name and Title of Certifying Official Telephone: DSHS Form GC-4a (269a) Revised 6/04