HomeMy WebLinkAboutResolution - 3211 - Agreement - TDOH - Community Health Services - 09_28_1989Resolution # 3211
September 28, 1989
i Item #21,
DGV:dw
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 Public Health
Service Contract by and between the City of Lubbock and the Texas Department
of Health, attached herewith, which shall be spread upon the minutes of the
Council and as spread upon the minutes of this Council shall constitute and
be a part of this Resolution as if fully copied herein in detail.
Passed by the City Council this 28th
anktte Boyd, City SecrlVtar
APPROVED AS TO CO ENT:
Doug Goodman lic Hea th
Administrator
APPROVED AS TO FORM:
onAid G. Vandiver," First
Assistant City Attorney
day of September , 1989.
e `
B. C. Mc N, AYOR
Texas Department of Health
Robert Bernstein, M.D., F.A.C.P. 1100 West 49th Street Robert A. MacLean, M.D.
Commissioner Austin, Texas 78756-3199 Deputy Commissioner
(512) 458-7111 Professional Services
Hermas L. Miller
Deputy Commissioner
Management and Administration
December 28, 1989
Anthony B. Way, M.D.
Director
LUBBOCK CITY HEALTH DEPARTMENT
P.O.Box 2548
Lubbock, TX 79408 0000
TDH Document No. C0000541
Dear Doctor Way:
Enclosed is an approved copy of the above referenced document. Please file it with
the office of record for your agency.
If we may be of assistance, please call us at 512/458-7470.
Sincerely,
Julian M. Kosh, Jr., Director
Grants Management Division
JMK: hr
RECEIVED
k.
1 1
TEXAS DEPARTMENT OF HEALTH
r 1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
CONTRACT CHANGE NOTICE NO. 1
STATE OF TEXAS
COUNTY OF TRAVIS
TDH Document No. C0000541
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.
Att. 01A - Deletion of state position 12/89.
Att. 02A - Amendment to revise budget for contractual comprehensive health
services.
All terms and conditions not hereby amended remain in full force and effect.
RECEIVING AGENCY
Texas Department of Health
By: �K
ignature of person authoriz
to sign)
Julian M. Kosh, Jr., Director
Grants Management Division
(Name and Title)
Date:
Cover Page 1
D9TAII,S OF ATTACHMENTS
' Att/'
11
I
I
In.
; TDH
;
Tern ;
State Fos.
; Source of
No.
; Program
;
Begin
:
End ;
or Grant
; Funds*
; Amount
ITDH Share) ;
Oil
; COMMUNITY I RURAL HEALTH
;
9/
1/89;
8/31/901
Pos.( 3)
; STATE INIIND
; S
65,601.18 ;
02A
; COMMUNITY 1 RURAL HEALTH
;
9/
1/89;
8/31190;
Grant
; STATE
; =
86,528.00 ;
03
; MATERNAL I CHILD HEALTH
;
9/
1189;
8/31/90,
Pos.( 2)
; 13.994
; !
28,964.00 ;
1
1
1
f
1
!
I
I
1
1
!
04
; MATERNAL I CHILD HEALTH
;10/
1/89;
9130190;
Grant
; 13.994
; f
128,291.00
1
!
1
f
1
I
1
!
06
; MATERNAL I. CHILD HEALTH
;
9/
1/89;
8/31/90;
Grant
; STATE
;
70,981.00 ;
06
; IMMUNIZATION
;
9/
1/89;
8/31/90;
Grant
; INIIND 13.268
;
.00 ;
t
t
1
t
!
!
!
r
!
!
1
I
I
I
1
!
!
!
1
!
!
1
t
1
t
!
!
1
1
1
!
I
!
I
1
f
t
1
1
!
!
!
!
t
!
!
!
1
1
!
!
t
!
!
I
!
1
!
I
1
!
!
1
!
1
1
t
1
1
!
{
F
1
!
1
1
1
I
I
I
1
1
1
t
i
1
1
1
t
I
1
1
1
I
1
I
1
I
1
1
1
I
1
1
I
1
1
1
t
1
I
1
!
1
1
1
!
1
!
t
!
1
1
1
1
1
1
!
1
1
!
!
!
f
I
1
1
1
!
!
1
1
1
1
1
t
!
!
t
1
t
I
1
1
!
I
t
t
t
1
1
1
!
!
I
t
!
!
t
1
TDH Document No. C0000541;IIIIIIIIIIIIIIIIIIIItIIIIIIIII; TOTAL S 380,177.18 ;
Change No. 01
+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.
TEXAS DEPARTMENT OF HEALTH
Receiving Agency/Program: COMMUNITY & RURAL HEALTH
Performing Agency: LUBBOCK CITY HEALTH DEPARTMENT
TDH Document No. C0000541 Change # 1 Term: September 1. 1989 _August 31, 1990
Attachment/Amendment No 02A IAC No. ( - )
REVISEW BUDGET
APPLICATION FOR FEDERAL ASSISTANCE (Short Form)
PART II - BUDGET DATA
;
;
Current Approved ;Change Requested
; New or
Revised ;
;Object"Class Categories
; Budget (a) ; (b)
; Budget
i
i i
i
S U �/'16 • ss i
:1.
Personnel
; $50,476.00 ;-$9,036�
;
$r 9 , $12 . 9-0 ;
1
1 1
1
1
:2.
Fringe Benefits
; $13,416.00 ; .00
;
$13,416.00 ;
:3.
Travel
; .00 ; .00
;
.00 ;
:4.
Equipment
; .00 ; .00
;
.00 ;
1
1 r
1
1
:5.
Supplies
; $1,600.00 ; .00
;
$1,600.00 ;
1
1 1
1
1
6 .
CONTRACTUAL
; $12 , 000. 00 ; p ;$ ` .00
;
$VAT080:00
�
� �
�
.'l l d 3t,•ao i
:7.
Construction (N/A)
;XXXXXXXXXXXXXXXXXX ;XXXXXXXXXXXXXXXXXX
;XXXXXXXXXXXXXXXXXX ;
1
1 1
1
1
:8.
Other
; .00 ; .00
;
.00 ;
1
1 1
1
1
:9.
Total Direct Charges
; $77,492.00 ; $9,036.00
;
$86,528.00 ;
r
1 r
1
r
:10.
Indirect Charges
; .00 ; .00
;
.00 ;
1
1 1
1
1
:11.
TOTAL
; $77,492.00 ; $9,036.00
;
$86,528.00 ;
t
1 1
1
1
:12.
Federal Share
; $77,492.00 ; $9,036.00
;
$86,528.00 ;
1
I 1
1
1
:13.
Non -Federal Share
.00 ; .00
;
.00 ;
(Includes amt. in #14);
:14.
Program Income
; .00 ; .00
;
.00 ;
1
1 1
1
I
:15.
Detail on Indirect Costs:
;
Type of Rate (Mark
one Box) _ Provisional _ Predetermined ;
_ Final _ Fixed
;
Rate 0.00 Base
.00`,Total Amount
.00 ;
r
1
+
r
PART
III - Program Narrative Statement
;
(Attach
additional sheets, if necessary)
;
;Contractual comprehensive
health services; amendment to revise budget to
;increase funds for local personnel costs in lieu of state position. Funds
;
;converted from Att. 01A, deleted
state position, Dentist II .25 FTE,
;
;LC000-001, effective 12/89.
No change in level of support.
;
r
1
1
1
OMB No. 90-RO185 TDH CONTRACT BUDGET REVISION FORM, GC-9A
STATE OF TEXAS
COUNTY OF' TRAVIS
TEXAS DEPARTMENT OF HEALTH CONTRACT
1100 West 49th Street
Austin, Texas 78756-3199
TDH Document No. C0000541
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 wort: and
special provisions.
PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT
I
-------------------------------------------------------------------------------------
I
(F1iIN1' or TYPE)
I
!
Aiailing Address: P.O.Box 2548 Lubbock
TX 79408 0000
Street Address: 1902 Texas Avenue Lubbock
TX 79408 0000'
different) City
(St) Zips !
Authorized
I
Contracting Entity: CITY OF LUBBOCK
4
It different from PERFORMING AGENCY)
I
Type of Organization: City'
Designate: Elementary secondary sc oo , ,junior co ege, senior co ege
university t
city, county, other political subdivision, council of governments, judicial
!
district, community services program, individual, or other (define)
Is this a small business NO (Yes/No) and/or minority/woman owned NO -_ _(Yes/No)
-
!
I
PERFORMINU AGENCY Fiscal Year Ending Month: SEPTEMBER
i
I
1
Iendor Name: CITY OF LUBBOCK HEALTH DEPARTMENT
I
bust match with vendor identification number shown
ie ow)
I
Vendor Address: P.O. BOX 2000 LUBBOCK
TX 79457 00001
TMUSt match with vendor identification number shown
below---,
State of Texas Vendor Identification No. (14 digits): 17560005906037.
I
Finance Officer/Contact: Doug Goodman
1
I
SUMMARY OF TRANSACTION:
_1
Contract for public health services.
1
{
4
I
COVER - Page 1
DETAILS OF ATTACHMENTS
Atti;
;
;
1;
Am.
; TOR
;
Term ;
State Pos.
; Source of
No.
; Program
;
Begin
;
Bnd ;
or Grant
; Fundsr
;Amount
ITDA Sharel ;
01
; COMMUNITY t RURAL HEALTH
;
9/
1/89;
8/31/90;
Pos.( 4)
; STATE INKIND
; $
74,640.72 ;
1
1
!
1
1
1
1
02
; COMMUNITY E RURAL HEALTH
;
9/
1/89;
8/31/90;
Grant
; STATE
; $
77,492.00 ;
1
1
1
I
1
1
1
1
!
t
I
I
1
1
1
03
; MATERNAL A CHILD HEALTH
;
9/
1/89;
8/31/90;
Pos.( 2)
; 13.994
; $
28,764.00 ;
04
; MATERNAL A CHILD HEALTH
;10/
1/89;
9/30/90:
Grant
; 13.994
; $
128,297.00 ;
1
1
1
!
1
1
1
!
1
}
3
I
1
1
1
!
05
; MATERNAL A CHILD HEALTH
;
9/
1189;
8/31190;
Grant
; STATE
; $
70,984.00 ;
06
; IMMUNIZATION
;
91
1/89;
8/31190;
Grant
; INBIND 13.268
;
.00 ;
!
1
1
!
1
1
1
1
i
1
t
r
1
t
1
I
7
1
I
1
1
1
1
F
1
I
1
I
1
1
1
)
1
1
1
1
1
1
1
1
!
1
1
{
+
1
1
)
!
1
I
I
1
1
!
i
I
1
1
1
1
t
1
1
i
1
i
I
i
!
1
I
1
t
!
1
I
I
!
1
1
!
t
1
f
I
I
1
I
1
1
1
1
!
t
I
I
I
i
1
1
I
1
1
1
1
1
t
!
i
1
1
1
1
1
I
1
I
I
I
!
!
I
1
1
1
I
1
1
1
i
t
I
i
}
1
1
!
1
I
t
!
I
!
t
I
1
1
7
I
I
1
i
1
1
1
I
I
1
r
1
1
}
1
1
I
1
1
1
1
1
1
1
I
1
1
1
!
1
!
1
!
1
}
i
!
1
}
!
f
t
1
I
I
1
1
!
1
f
1
1
I
1
1
1
1
!
1
!
I
1
1
1
1
)
{
1
)
1
f
±
1
I
I
f
I
1
f
1
t
1
I
!
t
t
1
1
t
1
1
1
1
1
TOR Document No. C0000541 'mix%I%%%% xXxx%IIX%Ixxxi %I; TOTAL $ 380,177.72 ;
*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
EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN,
CITY OF LUBBOCK
Authorized Contracting Entity hype above
if different from PERFORMING AGENCY]
for and in behalf of:
LUBBOCK CITY HEALTH DEPAKM
PERFORMINJ AGEt:C Y
(Signature ot` person authorized
tc sign corcractsl
B. C. McMINN, MAYOR
(Name and isle)
Date: September 28, 1989
RECOMMENDED:
TDR Document No.: C0000541
TE AS DEPARTMEi.-T OF HEALTH
RECEIVING AGENCY
;Signs re e s authorized
to sign contracts)
hernias L. Miller
Deputy Commissioner
Management and Administration _
•Name and Title)
OCT 2 61989
;rate -
APPROVED AS TO FORM:
by:
(PERFORMING AGENC: Director,
if different from person
authorized to sign contract;
te :• • City Sedletary
APPROVED AS TO CONTENT:
0—
D• • G6arianfPwl(7i�c�Heh
Administrator
APPROVED AS TO FORA:
0A ? —) MQQ I
old G. Vandiver, .asst
Assistant City Attorney COVER - Page
)face of General Counsel
o
B. C. W-MW, MAYOR
40,
GENERAL PROVISIONS FOR
TEXAS DEPARTMENT OF HEALTH CONTRACTS
PERFORMING AGENCY and RECEIVING AGENCY agree this contract, assurances,
general and/or special provisions, and attachments(s) Frith 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 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 attachments(s) hereto:
ARTICLE 1. Scope of Work
PERFORMING AGENCY will perform the work outlined in the Scope(s) of Work
contained in the attachments(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 attachments(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
attachments(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 by amendment(s).
ARTICLE 3. Funding
This contract is contingent upon funding, being available for the term of the
attachments(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 attachments(s) to this contract. If
funds become unavailable, provisions of the Termination Article will apply.
ARTICLE 4. Amendments
This contract may be amended, and such amendments will be in writing and duly
executed by the parties hereto.
GENERAL PROVISIONS - Page 1
ARTICLE 5. Severabilit9
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.
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 attachments(s) hereto, and
Treasury Circular 1075 (31 CFR 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,
Article 4436b, V.T.C.S., and rules (25 TAC 85.11-85.14), as amended.
PERFORMING AGENCY agrees Article 4413 (32g), V.T.C.S., [Uniform Grant and
Contract Management Standards Manual (UGCMS)], as may be amended by, revised
federal circulars to be incorporated in UGCMS 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 UGCMS, the provisions of UGCMS
will prevail unless expressly stated otherwise. A copy of this manual and its
references are provided to PERFORMING AGENCY by RECEIVING AGENCY upon request.
An exception to UGCMS is made in that, Office of Management and Budget (OMB)
Circular A-102, Attachment P, Audit Requirements, is replaced. Audits will be
in compliance with OMB Circular A-128, Audits of State and Local Governments.
Such audits fulfill requirements of the Single Audit Act of 1984, P.L. 98-502.
Within 30 days of receipt of audit report, PERFORMING AGENCY will submit a
copy to RECEIVING AGENCY's Internal Audit Division.
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.
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.
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
specifically, asserts that it does not owe a single substantial debt or a
number of outstanding debts to a federal or state agency. A false statement
regarding PERFORMING AGENCY's status will be treated as a material breach of
GENERAL PROVISIONS`- Page 2
this contract and may be grounds for termination at the option of RECEIVING
AGENCY.
ARTICLE 7. Assurances
PERFORMING AGENCY assures that no person will, on the grounds of race, creed,
color, handicap, national origin, sex, political affiliation or beliefs, be
excluded from, be denied the benefit of, or be subjected to discrimination
under any program or activity funded in',whole or in part under this agreement.
Incorporated by reference the same as if specifically written herein are the
rules, regulations, and all other requirements imposed by law including, but
not limited to, compliance with those pertinent rules and regulations of the
State of Texas and those of United States agencies providing funds to the
State of Texas.
None of the funds, materials, property, or services contributed by the parties
under this contract will be used in the, performance of this contract .for any
partisan political activity or to further the election or defeat of any
candidate for public office. In addition, none of the funds reimbursed under
this contract will be used to pay the salary or the expenses of anyone for any
activity designed to influence legislation or appropriation pending before
legislative bodies of the state and/or federal government.
ARTICLE 8. Standards For Financial Management
PERFORMING AGENCY will develop, implement, and maintain financial management
and control systems that meet or exceed the requirements of UGCMS. 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
reas'onableness,'allowability, and al'locability of costs, and timely and
appropriate audits and resolution of any findingg; 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.
ARTICLE 9. Allowable Costs
Only those costs allowable under UGCMS and/or applicable federal cost
principles are eligible for reimbursement under this contract. Applicable
cost principles are:
I
1. OMB, Circular A-87, Cost Principles Applicable 'to Grants and Contracts
with State and Local Governments;
2. OMB Circular A-21, Cost Principles for Educational Institutions; and,
3. OMB 4ircular A-122, Cost Principles for Nonprofit Organizations.
GENERAL PROVISIONS - Page 3
To be eligible for reimbursement under this contract, 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.
ARTICLE 10. Overtime Compensation
None of the funds provided by attachments(s) will be .used to pay overtime.
PERFORMING AGENCY will be responsible for any obligations of overtime pay due
employees.
ARTICLE 11. 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 attachments(s) hereto and are
contingent on a signed contract.
Claims for reimbursement will be made on a State of Texas Purchase Voucher
'(TDH Form`#AG-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 attachments(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
currentlyavailable 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 and not refunded to RECEIVING AGENCY by
PERFORMING AGENCY.
Payment may be denied for noncompliance if required
on file for previous quarters or for the final
respond to financial compliance monitoring reports,
are not met as specified in the Scope(s) of Work.
GENERAL PROVISIONS - Page 4
financial reports are not
period, or for failure to
or if program requirements
ARTICLE 12. Advance Payments '
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 attachments(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 (UGCMS and federal circulars).
Amendments to this contract 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 Voucher in the amount necessary to correct the ratio.
ARTICLE 13. Program 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 Article
4414c, V.T.C.S., and the Texas Board of Health rules covering Fees for
Clinical Health Services (25 TAC, Sec. 1.91) and other applicable laws
provided, however, that a patient may not be denied a service due to inability
to pay.
All revenues received from the delivery of contract services will be
identified, reported, and deducted from total project costs.
ARTICLE 14. Financial Reports
Financial reports are required as provided in UGCMS 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-4), will be submitted within 20 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). An amended Form 269a will be submitted if the amount
of expenditures reported in the last quarter changed. If necessary, a State
of Texas Purchase Voucher will be 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.
GENERAL PROVISIONS - Page 5
ARTICLE 15. Reports and Inspectione
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
representative(s) of the federal government have the right, at all reasonable
times, to inspect or otherwise evaluate the work performed or being performed
hereunder and the premises in which it is being performed. 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 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 attachments(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 16. Client Records
At the end of the attachment term, all client records are the property of
PERFORMING AGENCY. RECEIVING AGENCY retains the right to have access to the
records or obtain copies for audit, 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 terminate the agreement, RECEIVING AGENCY
may require the transfer of client records upon written notice to PERFORMING
AGENCY. Records may be transferred to another entity that agrees to continue
the service or, .at the option of RECEIVING. AGENCY, the records may be
transferred to RECEIVING AGENCY headquarters.
GENERAL PROVISIONS -,Page 6
ARTICLE 17. Confidentiality
PERFORMING AGENCY will have a system in effect to protect from, inappropriate
disclosure of patient records and all other documents deemed confidential by
law which are maintained in connection with the' activities funded under
contract attachment(s). Any disclosure of confidential patient information by
PERFORMING AGENCY, including information required by the Reports and
Inspections.Article, will be in accordance with applicable law.
ARTICLE 18. 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
contract/attachment(s) term(s).
Unless initially listed and approved in the contract /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 and submit a
report to RECEIVING AGENCY at the end of the contract/attachment(s) term(s).
PERFORMING AGENCY will administer a program of maintenance, repair, and
protection of assets under this contract I 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 contract Iattachment (s), it
will use the proceeds to repair or replace said assets.
PERFORMING AGENCY agrees that upon termination of contract /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 19. Subcontractini
PERFORMING AGENCY may enter into agreements with subcontractors unless
restricted or otherwise prohibited in specific attachments(s). If PERFORMING
AGENCY elects to enter into an agreement which subcontracts out a substantial
1990 GENERAL PROVISIONS - Page 7 7/89
portion of PERFORMING AGENCY's Scope of Work, prior written approval must be
obtained from RECEIVING AGENCY. 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.
ARTICLE 20. Copvriahts and Publications
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 acknowledgement 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.
ARTICLE 21. 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.
PERFORMING AGENCY, by acceptance of funds provided through contract
attachments(s), agrees and ensures that personnel paid from these funds are
duly licensed and/or qualified to perform the required services.
ARTICLE 22. Termination
This contract or any attachments(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 notificationof 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.
1990 GENERAL PROVISIONS - Page 8 7/89
This contract or any attachments(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 attachments(s) hereto may be terminated if funds
allocated for any attachments(s) hereto should become reduced, depleted, or
unavailable during any attachments(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 attachments(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 attachments(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 equitable settlement of the respective accrued
interests or obligations as of the date of termination.
ARTICLE 23. Personnel
All personnel funded by attachments) 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 ell 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 attachments) 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
GENERAL PROVISIONS - Page 9
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 24. Funding Participation Requirement
PERFORMING AGENCY agrees funds provided through this contract will'not be used
for matching purposes in securiftg other funding.
ARTICLE:25. Performance -based Attachments
RECEIVING AGENCY is implementing a project for performance -based public health
service contracts. The goal of this project is to improve public health
practices in Texas. The primary objectives are to allocate program resources
based on need and, to account for funds used in providing services'in response
to identified needs. If PERFORMING AGENCY agrees to participate in RECEIVING
AGENCY's project to, implement a performance -based public health service
contract, such agreement will be incorporated as an addendum to this contract.
This addendum will be in writing and agreed to by both parties.
GENERAL PROVISIONS - Page 10
DOCUMENT NO. C0000541
ATTACHMENT NO. 01
PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: COMMUNITY AND RURAL HEALTH
TERM: September 1, 1989 THROUGH August 31, 1990
SECTION I. SCOPE OF WORK;
PERFORMING AGENCY will use state direct assistance and other funds to
supplement in the delivery of comprehensive public health services. Personal
health services may include but are not limited to adult health/chronic
disease, AIDS/HIV, chronically ill/disabled children, dental, immunization,
laboratory, maternal and child health, public health promotion/education,
sexually transmitted disease control, and tuberculosis control. Environ-
mental health services/inspections may include but are not limited to food,
premise, swimming pool, vector control, and wastewater control. Other
services related to the particular problems of the jurisdiction may be done
as needed and agreed to by both parties.
Reports of services performed will be submitted to RECEIVING AGENCY,
Community and Rural Health, and/or program(s).
PERFORMING AGENCY laboratory will provide tests and reports annually
as indicated in the categories below in support of RECEIVING AGENCY
programs.
A. Water bacteriology 11.000
B. Milk bacteriology and chemistry 0
C. Syphilis serology 12,000
D. Gonorrhea testing 12.000
E. Other approved analyses 500
TOTAL 35,500
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 8.510 clients with
services/units of service in or benefitting the county(ies)/area defined as:
LUBBOCK.
SECTION II. LEGAL AUTHORITY:
Current Appropriations Bill..
-1-
SECTION III. SPECIAL PROVISIONS:
The attached list of positions and budgetary amounts, exclusive of category
41 if applicable, is an integral part of this Attachment. A state warrant
will be issued for each filled position in the amount of monthly net salary
earnings.
Financial reports in the format and frequency prescribed by RECEIVING AGENCY
are required if program income is generated from activities funded through
this Attachment.
Support for laboratory work is provided in part by the RECEIVING AGENCY,
Bureau of Laboratories, through supplies, equipment, and training and by
other Attachments to this contract.
SECTION IV. BUDGET:
Total reimbursements for this Attachment shall not exceed $74,640.72.
-2-
LUBBOCK CITY HEALTH DEPARTMENT PAGE 604
TEXAS DEPARTMENT OF HEALTH PHR 2
OPERATING BUDGET FOR YEAR ENDING AUGUST 31, 1990
AS OF JULY 19 1989 BUDGET NO. LC000
H21311/KI3028
CATE- DESCRIPTION
OR TITLE
FUND
END
ITEM
JOB
PAY
PAY
EFFECTIVE
MONTHLY
GORY
OESC.
MONTH
NO.
CLASS
GP
STP
DATE
RATE
1 PUBLIC HEALTH
DENTIST II
STATE
AUG
001
D020
54
04
SEP 89
1,004.06
025.000% 0 4016.25
NURSE II
STATE
AUG
016
4385
14
01
SEP 89
1.995.00
L1C VOCATIONAL
NURSE II
STATE
AUG
083
4412
10
03
SEP 89
1,662.00
ADMINISTRATIVE
TECH I
STATE
AUG
104
1501
06
05
SEP 89
1,559.00
BUDGETED AMT
12,048.72
23,940.00
19,944.00
18,708.00
DOCUMENT NO. C0000541
ATTACHMENT NO. 02
PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: COMMUNITY AND RURAL HEALTH
TERM: September 1, 1989 THROUGH August 31, 1990
SECTION I. SCOPE OF WORK:
This allocates funds in support of the scope of work in Attachment No. 01
(That Attachment contains the number of clients and geographic area to be
served.)
SECTION II. LEGAL AUTHORITY:
Current Appropriations Bill.
SECTION III. SPECIAL PROVISIONS:
None.
SECTION IV. BUDGET:
Personnel
$50,476.00
Fringe Benefits
13,416.00
Travel
.00
Equipment
.00
Supplies
1,600.00
Contractual
12,000.00
Other
.00
Total Direct $77,492.00
Supplies $1600.00 nonrecurring.
Financial reports are due the 20th of December, March, June, and September and
the 15th of October.
Total reimbursements for this Attachment shall not exceed $77,492.00.
-1-
DOCUMENT NO. C0000541
ATTACHMENT NO. 03
PERFORMING AGENCY: LUBBOCI CITY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: BUREAU OF MATERNAL AND CHILD HEALTH
TERM: September i, 1989
SECTION 1. SCOPE OF 1,'O
THROUGH August 31, 1590
PERFORMING A(i1?NCY will provide clinical sari ices Lo mcvL. the needs of low
income women and children r.iLh particular iWer•eric:e to prenatal care for
pregnant women, ftalll ly planning surf ices, and pretCnr ite child iiva-101
services. Serf ives will Lru performed in UCC0r•c.l:.rllCC with Lire standards for
maLe.r'niLy, family planning, and child healLh slr t ices as OrUmul- aLed by We
RECEIVING AGENCY, Bur•enu of Maternal and Child Health.
Services will i1e I)er•furrneci and M.rl.c:r•ni 1.y; Faall.il.y 1'irinrling and [ifile} 11era1l.}I
Clinic reports subm,• LLed as required by RECEIVING AGENLY , Bureau of Maternal
and Child Heal L.h.
PERFORMING AGENCY will provide an W i ma Led ��.QQ ,- [ J en is with
services/uniLfa uf- Her•'.•ice in or bencl'iLLing the cculnl.; UesUarea Wined as:
LUBBciC1i .
SECTION i1. LEGAL SUTHORiTi:
P.L. 97-35, Wle 1, Social Security UL, 45 GFU 96, and P.L. 100 202.
SECTION 1 1 1 SPEc i AL PROVISIONS:
The ri nchud 1W u1 pc?KII 011E and QdgVLUVj aMIJUlfiS, exaluWa of cat.ag r•.,
41 if app1.icubJe, is an iritvgral post. Gt IIll:i. ALLac:hmcK. A Maio warrani
will be issued fur vach filled puSiLion III the amounL of monkl; net, sa., ,,:
enrn.ings.
Financial repurLs in the formal. and fl•cquenc:; prescuiL, d I1ti 1tF. EiViNU AGLIU1
are required if program income is ;ener•ai.ear; from acLiviLicss funded 1-hr.iugh
this ALLachmput.
In compliance with Article
6252-13e,
V.T.C..S., PEUPO11MING AGENLf Lill pru: ido
RKEI i I NG Ki:W) w i Lh E`1' dense
that. a
pUbl IC.: IIIVITt i ng
or heriP 09 WaS held LU
meek p"bl it c ommonL un Lhe
ncwds and
uses of federal
block grunt rum.
.
by IERFORMINS AGENCI under
this contract.
Uecurd of
public par•Licipution
error LS ni-idertaken musL be
f i l ud, % i Lh
}1.Ist EI Vl 1:, AGE'dc;l
.
If 1c.as for sur%ices are imposvd as protidcd in Lhv {i_'.nural Pro isioub,
charges ges will nu L he Made for health svr\ ices 1rrOv i r. "d Lo l oh I IrvoMe Mothers
and children. The term -lot income" refers to an individual ur family wii.h
an income determined Lu be belur+ the nunfarm income official povvrty lisle
defined by the Office of Management and Budget and rc i iced aunua.11 y . in accur-
danc e wi. Lh SccLion 624 of Lhv Economics 01yorinuiLy Act. of 1961.
SECTION7 IV. BUDGET:
Total reimbursementy, for Lhis Attachment shall not exceed S-98,764.00.
LUBBOCK CITY/FAMILY HEALTH SERVICES PAGE -605
TEXAS DEPARTMENT OF HEALTH PHR 2
OPERATING BUDGET FOR YEAR ENDING AUGUST 31, 1990
AS OF JULY 19 1989 BUDGET NO. LC301
H21311/K13028
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
MCH-LT
AUG
088
0063
07
01
OCT 89
1300.00
CLERICAL SUPERVISOR
II
MCH-LT
SEP
088
0063
SEP 89
1:300.00
COMMUNITY SERV AIDE
II
MCH-LT
AUG
131
5502
04
01
OCT 89
1097.00
COMMUNITY SERV AIDE
II
MCH-LT
SEP
131
5502
SEP 89
1:097.00
BUDGETED AMT
15.600.00
13,164.00
DOCUMENT NO. C0000541
ATTACIDfENT NO. 04
PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT
RECEIVIING AGENCY PROGRAM: BUREAU Of MATERNAL AND CHILD )lE,,%LT1I
'fEkM: October 1, 1989
SECTION 1. SCOPE OIL WORli:
THROUGH September 30, 1990
'.I`his allocates fundS i.rr suPPOL't. Of tiW scope of 601-h ill ALLachment No. 03___.
{That ALtachmetrt contains the number• of clients and geographic area to be
s('ry d. )
SEL7ION 11. LEGAL. AUTHOLI TY.
P.L. 97-35, Title V, SOCi.al ACL, 15 t:FY, 96, and P.L. 100-202.
SECT] U t 1 I 1 SPEL AL 1'11O i.:i 1 !''18:
Ill compliance with Ar•t ic.icr 6252- i3v, V.T.C.S., PERF�)PINIING AGENCY ctiil.l t.u•u�idc.
I&CEIVIN-6 AG1:.Rt;Y wiLlt c� idence I.haL a public tueet.iug or hearing was held t.e
seal: P1.1b..hC Comment on t.hc ueec.ls and use,, Of fedc!ral block grarrL funds
by PERFORMING AGENCY under Lhis conLr•act. Record of public participation.
of forts urcder•tal;en mu t be f i Ied w i t.li W CEi VI:NG AGENCY.
SECTIO-N IV. BUDGET:
Personnel
$79, 28.1:00
Frirrde Berrefih-,
18,216.00
frateI
.00,
Ly u i Pnterr 1.
. Ulf
SLlppIies
1 {,59/ ,Oo
Con LrartuaI
16,20U.OU
Ut:her
. 00
TuL11 Direct SI28,2, 7.00
I.ivancial reports are clue t.licr ZOt-h of Janllary, April-, July, and October and
Lhc 151..11 Of N-om eml.n, v.
Total reimbursements for tJhis "t.!-ac hment sha.l.i not exceed S128,297.00.
DOCUMENT NO. C0000541
ATTACHMENT NO. 05
PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: BUREAU OF MATERNAL AND CHILD HEALTH
TERM: September 1, 1989 THROUGH August 31, 1990
SECTION I. SCOPE OF WORK:
This allocates funds in support of the scope of work in Attachment No. 03
(That Attachment contains the number of clients and geographic area to be
served.)
SECTION II. LEGAL AUTHORITY:
State Legalization Impact Assistance provisions of the Immigration Reform and
Control Act of 1986.
SECTION III. SPECIAL PROVISIONS:
None.
SECTION IV. BUDGET:
Personnel $57,121.00
Fringe Benefits 13,863.00
Travel .00
Equipment .00
Supplies .00
Contractual .00
Other .00
Total Direct $70,984.00
Financial reports are due the 20th of December, March, June, and September and
the 15th of October.
Total reimbursements for this Attachment shall not exceed $70,984.00.
-1-
DOCUMENT NO. C0000541
ATTACHMENT NO. 06
PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: IMMUNIZATION DIVISION
TERM: September 1, 1989 THROUGH August. 31, 1990
SECTION I. SCOPE OF WORK:
PERFORMING AGENCY will conduct an immunization program Lo prvvenL, Control,
reduce and eradicate vaccine -preventable diseases LhroUgh the provision of'
vaccines, promotion of immunizations and application of epidomiologic and
outbreak control techniques within budgetary consLrainLs, as follows.
A. initiate investigations on 100 percent of suspecied cases of measles,
rubella, pertussis, poliomyelitis and diphLherja within 24 hours of
receipt of report by the PERFORMING AGENCY. 1niLiaLe in%eskgnLions o" 0.1
percent of suspected mumps cases and 100 percent of suspected Manus
cases within 48 houvs of receipL of rcpurL by We 11R[0VM1AU AGEALI.
1. Outbreak control measures must be implumunLed WjWn 46 hoUrS Of'
investigation for measles, rubclla, pert ussis, m"mps, poi juWIC510.
and diphtheria cases.
2. Outbreak ConLrul measures include:
a. appropriate anLlbioLic Lreai,WuL for CUSM and aonl.actS Of
perLussis and diphtheria cases.
b. assess the immunizuLion sLaLus of CUMUCLZ to vuspe&cd uasv6 Qi'
measles, rubella, perLussis, poliomycli0s, diph0pria and mumps.
C. in insWuLioual feLL!HgS (day ('arc, pU410 Whooly, prilaW
schools, eLu.), 1mpJcmvnC cxul"sio" piancdnres lor 102 vcrccnL oc
susceptible persons who are coatnrLs to suspecipd rasys uy ousu�i
of measles, rubella, poliomyeiiiis, mumps or diphtheria and who
are "nproLecLad because or religious/madhal vNemptioNs Gy W-L
proof of a %accine hiSLory/discasv.
d. offer appropriuLc vucci"e by agp (mousIns, r"Lclin, mumpF, diph
Lheria, poliumyelitim, perLussis) Lo Aw people in instil"Lio"ai
settings for boosters and primary immunizations.
B. Vaccine Accounting
1. By January 31, 1990, Vro%ide RECEIVING 4GL&CV, imm"&"al,ion Division,
6iLh a report to include: (a) age and locaLion WIHIC SjLQ Of eUCh
vaccine storage refrigerator, and (h) typu of koperaLurc moniLoring
s;sLem for each refrigeraLor and proundlirvs implemenLed Lo deLvci-
WerrupLion or PlecLriciLy, malfuncLiuning refriguraLor or other
causes of possible vaccine spoiluga.
2. Prot ide repous in Lhe format alld Qeq=Cy presurioed by Lhc
RECEIVING AGENCY, ImmunizaLion Division: (n) ending and heginnin4
vuccine/tuxoid inventories by caLegury, (h) n"mbvv of dosi:i
administered by specified age groups for each vaccine/Muid
-1-
category, (c) the number of each close, in a vaccine/Luxoid series,
(d) the amounts of vaccine/toxoid unaccounted for (wasted, lost,
destroyed and other reasons) , and (e) account, for all vaccines/
Loxoids using .lot numbers and expiration dates. Forms to report
Closes administered, vaccine use, `.'acclne transfers and Nauciae
waste are to be obtained from RECEIVING AGENCY, Immunization
Division, 1-800-252-9.152.
3. Ensure that daily temperatures arcs recorded for all refrigerators
storing vaccines/Loxoids.
a. a. Praiide RECEIVING AGM1, immunization Division, c. h semiannual
and annual reports on vaccine aucuunLing data indicating the
number and percent. of vaec i nc dusts t DI P, D1 , °Td, measles, mumps,
rubella, measies-r•ubvl.la, measles -mumps -rubella, llib, influenza,
pneumonia, hepatitis B, inactivated puliu vaccine, UPS') wrested or
unaccounted for during We puriod Se.l}Lumber• 1989 through august
1990. Tht semiannua i repor! j Sepi ember 089--Februar•1 19901 and
Lhe annual reporL IMpLember .198SAugust 1996) should he submiLLed
Lo RECEIVING AGENCY, tmmunizaKuu Wision, no later Lhan 30 W3;i
following the reporting period. To complete Lhe reports, use the
following:
A = v ac_ c i ne/Loxo i d W en t ur•y on hand Sie pLember• 1, 1989 ( i:oudue i.
physical court L of all storage s i tes) ,
Lt = uninucr r i doses received per l acuine/ Luxoid category during the
two reporLing periods,
C = number of doses per Mc:cine/Luxoid administered during Lhe Lwo
reporting periods,
U = number of doses per vac'c ine/to:•.uid disLribuLed to private
pro%idevs during the LOU reporting periods (include EINU1
tunw i dvr•s) ,
L = number of doses per %acc:ine/LoNoid in inventory can Fobruar,e _i,
1990 (semiannual report.), and on August. 31, 1990 (annual r"purt.),
1 = number of doses per taucine/to aid unaccounted for during Litt
Lc.o reporting periods,
--formula Lo cumpul.e anshvr for l.Mur 1 :
A+ B- L- l; -- E= r
G = per•c.enL of iacc.ines/LoNoicls curaCruiu Led fur during the Lao
reporting periods,
-for•mnria to compute pevcunL for each iacc.ine/toxold is:
F
------ X l t t1
A + B
b. The fEHFURMING AGENCY is responsible for monlLur•.ing vaccine usage
and obtaining the required %mcc:ine reports (doses administered,
waste, loss and inv nLur•y stock W els) rrom private physicians
who received sLaLe-supplied vaccines/Luxoids from PERFUR'.NING
:aGEN Y.
PERFOR.MIftiG AGENCY will provide all es Lima Lea 11,145 _ clients with
services/units of service in or benefiLLing the courlty (ic•s)/ar•ea defined as:
LUBBOCK.
SECTION 11. LEGAL AUTHORITY:
Current Appropr•iaLions Bill.
Texas lmmunizat.ion Laws, Rules and UcgulaLiorls: !Inman lt`esources Code,
Chapter 42, Section 42.043; Texas Education Code, Sec -Lion 2.09 and 2.09A.
t!. S. Depar•Lment of Health and Human Services, Childhood lmmunr,:alloll
42 CFti ParL alb, Section 317 PHS ACL (=12 t;SC _47u), as amended by P.L. 92-1-19
and P. L. 9I 3_ 31 I .
SEC-TION 111. SPECIAL PROVISIONS:
I'lllallcl r11 reports in the format. and f veyuenc itr•:escr.ii;k.-A 611[1:_E.I Vl iN;;
are r•c'cluiI•c9d if pI'ogram income. Is gerlerat.cd from aci. i., 11. is s unded 1)lr'<Y1igh
Lhis AtLachmenL.
SECTION I V . BUDGET
In roturn for inlcind set -vices, Life. Pk.RFOk?1tNG :;G M;Y recei�cis adult and
chi.lcll o(_,d vacciues !.if direct assisLanc e from 1.hc I.ECEItING AGE -CI'. The
aI>prc:>x i ulat.cr a.l.ue on an annual basis i s 0 3.00i
-3-
CITY .OF LUBBOCK
MEMO
TO: Rita Harmon, Assistant City Manager for Public Safety and
Services
FRW:C2C6 R. Doug Goodman, Public Health Administrator
SUBJECT: State Contracts
DATE: March 14, 1990
As normal the State Health Department has emended our contract. We have
two additional "Attachments":
07. Education, prevention, and risk reduction services.
This attachment is for Julie Moellering. The Grant approved by
City Council is to coordinate educational programs within the
community among the various agencies.
08. Prevention Services - Counseling, testing, and partner
notification.
This attachment is for Mike Springer. All these months of working
here has been without an actual. contract. As you are aware his'
primary responsible has been in the area of testing and
counseling.
Each year when we bring the State Health Department Contract to the City
Council we request that the Mayor be authorized to sign any future
attachments or amendments to the contract. When first signed the
Contract was for $380,178 but has increased by $45,355 to $425,533.
There are two copies of Attachment 07 and 08 that need the Mayor's
signature. If they are returned to I will send them to the State and
get a copy for the City Secretary. '7so attached is "Contract Change
Notice No. 3". This is to be filed with the original contract in the
City Secretary's Office. The State had made an error in the original. ,
The error was that $9,036 to pay for a dentist by contract was included
in the category of "Personnel". This money has been placed in the proper
category as indicated in Change Notice 3. No signatures are required on
this form.
lk
TEXAS DEPARTMENT OF HEALTH
1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
CONTRACT CHANGE NOTICE NO. 3
STATE OF TEXAS TDH Document No. C0000541
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. ;
Att. No. 02 8 - Amendment to grant institutional prior approval to reallocate ;
funds between authorized categories to provide contractual dental services_ ;
All terms and conditions not hereby amended remain in full force and effect. ;
RECEIVING AGENCY ;
Texas Department of Health ;
BY. .� lit.
Siuregnatof person autho ed ;
to sign) '
Julian M. Kosh, Jr., Director ;
Grants Management Division ;
(Name and Title) ;
Date: JAA90
i
Cover - Page 1
DETAILS OF ATTACHMENTS
Att/,'
Am'. ;
TDH
;-
Term ;
State Fos.
; Source of
No. ;
Program
;
Begin 1
End ;
or Grant
; Fundsm
; Amount (TDH Share)
OlA ;
COMMUNITY & RURAL HEALTH
;
9/
1/891
8/31/90:
Pas.( 3)
; STATE INKIND
; S
65,604.18
1 I
1 1
I
I
i
1
1
1
1
1
I
1
i
I
028 ;
COMMUNITY & RURAL HEALTH
;
9/
1/891
8/31/90:
Grant
; STATE
; E
86,528.00
1
I
1
1
I
I
1
03 ;
MATERNAL & CHILD HEALTH
;
9/
1/891
8/31/90:
Pas.( 2)
; 13.994
; S
28,764.00
1 I
1
I
1
I
1
1
04j ;
MATERNAL & CHILD HEALTH
110/
1/891
9/30/901
Grant
; 13.994
; E
128,297.00 ;
I OS'' I
MATERNAL & CHILD HEALTH
1
9/
1/891
8/31/90:
Grant
I STATE
I $
70,984.00 1
1 06 1
IMMUNIZATION
1
9/
1/891
8/31/90:
Grant
I INKIND 13.268
1
.00 1
1 1
1
i
1
1
1
I
1 07` I
HIV
1
1/
1/901
8/31/90:
Grant
1 STATE
1 =
22,747.00 '
t
108 1
HIV
11/
1/901
8/31/901
Grant
113.118
I E
22,609.00 '
1
t 1
1
1
1
I
t
t
1 1
1 '' 1
1
1
1
1
I
1
I
►
1
1
1
1
1 1
t I
1
1
1
1
1
1
1
I
1
1
I
1
1 I
I
I
I
1
1
1
i I
1
I
1
1
1
1
I 1
1
1
1
1
1
1
1 1
I
1
1
1
1
1
I I I
1
1
I
i
I
t
1 SI
1
1
1
1
1
1
1 1
1
I
1
1
I
I
1 1
1
1
1
1
1
I
1 1
1 I
1
1
1
1
1
1
1
1
1
1
1
t
1 {
1
t
{
1
I
1
1 1
1
1
1
1
I
f
1 '• t
I rl
1
1
I
1
1
1
i
1
1
1
t
1
1
-
1 1
1 11
1
1
t
1
1
1
i
1
1
1
1
1
1 Y
1
I
I
1
I
1
1 1
IL��I
I
1
I
I
1
1
1
1
1
1
1
1
TDH Document No. C0000541
1xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxI
TOTAL
S
425,533.18 I
Change
No. 03
I
I
I
1
I
1
I
1
1
1
1
;Federal
funds are indicated by a
number from
the Catalog
of Federal Domestic
Assistance (CFDA), if
applicable.
REFER'-TC BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT
FOR DETAILS.
TEXAS DEPARTMENT OF HEALTH
Receiving Agency/Program: COMMUNITY & RURAL HEALTH
Performing Agency: LUBBOCK CITY REALTH DEPARTMENT
TDH Document No. C0000541 Change # 3 Term: September 1. 1989 - August 31, 1990
Attachment/Amendment No 028 IAC No. ( -
REVISED BUDGET
it
1
APPLICATION FOR FEDERAL ASSISTANCE (Short Fora)
PART II - BUDGET DATA
;
;
1
1
Current Approved ;Change Requested
; New or
Revised ;
;Object
Class Categories
; Budget
(a) ; (b)
; Budget
(c) ;
!1
1
1
1
1
1
I
1
1
1
:1.
Personnel
;
$59,512.00 ; ($9,036.00)
$50,476.00 ;
1
1
1
1
1
42.
Fringe Benefits
;
$13.416.00 ; .00
;
$13,416.00 ;
1
1
1
1
1
1
1
1
1
1
3.
Travel
;
.DO ; .00
;
.00 ;
11
1
1
1
1
1
1
1
1
1
44.
Equipment
;
.00 ; .00
;
.00 ;
15.
Supplies
i
$1,600.00 .00
$1,600.00 i
it
it
1
1
1
1
1
1
t
1
;;6.
CONTRACTUAL
;
$12,000.00 ; $9,036.00
;
$21,036.00 ;
1
1
1
1
1
:7.
Construction (N/A)
;XXXXXXXXXXXXXXXXXX ;XXXXXXXXXXXXXXXXXX
;XXXXXXXXXXXXXXXXXX ;
l
tl
1
1
1
1
1
1
1
1
;8.
Other
;
.00 .00
.00
1
1
1
1
1
9.
Total Direct Charges
;
$86,528.00 ; .00
;
$86,528.00 ;
it
1
1
1
1
110.
Indirect Charges
;
.00 ; .00
;
_00 ;
41
•.1
1
1
1
1
1
1
1
1
E;11.
TOTAL
;
$86,528.00 ; .00
;
$86,528-00 ;
tl
tt
1
1
1
1
1
1
1
1
1;12.
Federal Share
;
$86,528.00 ; .00
;
$86,528-00 ;
1
1
1
1
1
413.
Non -Federal Share
;
.00 ; .00
;
.00 ;
!;
(Includes amt. in #14);
1;14.
Program Income
;
.00 ; .00
-OO
1
1
1
1
1
j:15.
Detail on Indirect Costs:
;
Type of Rate (Mark
one Box)
_ Provisional _ Predetermined ;
_ Final _ Fixed
;
Rate 0.00 Base-
.00 Total Amount
.00 ;
fl
it
,
1
PART III - Program
Narrative Statement
;
(Attach additional
sheets, if necessary)
;
" Att.
No. 02 B - Amendment
to grant
institutional prior approval to
reallocate ;
`;funds between authorized categories
to provide contractual dental services.
;
'1
1
it
1
1
i1
1
OMB No. 90-RO185 TDH CONTRACT BUDGET REVISION FORM, GC-9A