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Home My WebLink AboutResolution - 4081 - Application - Health Department - WIC Nutrition Program - 02_11_1993Resolution No. 4081 February 11, 1993 Item #32 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Health Department of the City of Lubbock BE and is hereby authorized and directed to execute for and on behalf of the City of Lubbock an application for the WIC (Wgmen,—i<ant, Children) Nutrition Program. Passed by the City Council tlis 11th ATTEST: Sally e, Acting City Secretary APPROVED AS TO CONTENT: ou oo n u c Health Administra r ED AS TO FORM: \ vqpxd G. Vandiver, first ASS1stan Ci y Attorney DGV:dw/agenda-D2/WIC.rea February 4, 1993 1993. TEXAS DEPARTMENT OF HEALTH APPLICATION FOR PARTICIPATION IN THE SPECIAL SUPPLEMENTAL FOOD PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC PROGRAM) 1/23/93 (Date of Application) GENERAL INFORMATION Applicant's Name: Address: Phone Humbert (Area Code) Official responsible for Program at local level: Sponsoring Organization (If different than applicant): Sponsor's Address: GENERAL INFORMATION Geographic Boundaries City of Lubbock Health Dept. P.O. Box 2548 Lubbock, TX 79408 (806) 767-2900 R. Doug Goodman Description of the geographic boundaries which the applicant proposes as its project area. It is preferable to cover at least one county. (Attach a map defining boundaries if possible). Lubbock County - See Attachment A 5 List an estimate of the total population of the proposed project area. 222,636 List a percentage of the population of the proposed project area with incomes at or below 185t of the poverty level. 36 t Economic Conditions Describe any significant information on economic conditions affecting the proposed project area (Include attachments if necessary). The majority of the women served by the Lubbock Health Department are low income, single heads of households. Approximately 95% of our patients qualify for free services. The average poverty rate for Lubbock County is 19%. According to a study conducted by the Lubbock Homeless Consortium in 1992, it is estimated that between 23%-39% (11,500-19,500) of the 50,000 residents of north and east Lubbock were marginally homeless, living "doubled up" with a high level of precariousness. (The northern and eastern census tracts studied comprise the county's lowest income neighborhoods). 57% of the participants in the study were / women. 56% of the individuals self -identified as marginally homeless were children. Provide a brief description of the financial, residential and other economic criteria applied to determine the eligibility of such individuals for health care at no cost or at less than the customary full charge for such services. (Include attachments if necessary) (If income criteria are used, please explain.) The City of Lubbock Health Department uses a sliding fee scale which is based on both income level and the size of the family to determine the fee charged. Individuals with income at 201% poverty or greater pay 100%. Patients with income between 186% and 200% of poverty pay 50%. Patients with income at 185% of poverty or less pay 0%. The Health Department will not refuse service to anyone based on ability to pay. See Attachment a. 6 •Kutritional and Health Factors List available data which indicate the incidence (number per 1,000 population) of the following within, the proposed pro ect are s. 991 1990 Factors xps Total Live Births 3935 3983 18 Adult Live Births (20 and above) 3624 3713 17 Teenage Live Births (30 and younger) 311 (7.9%) 270 (6.8%) Premature Births (before the 38th week gestation) 671 Low Birth -Weight Infants (less than or equal 7 4% 7 9% to 5 1/2 lbs.) Infant Death (during the first year) 8.4i1000 8.8i1000 Neonatal Deaths (during the first 27 days) 3.8i1000 4.3i1000 Fetal Deaths (at or after 20 weeks gestation) 8.9i1000 I 3.8i1000 Describe any additional health problems known to exist among women, infants and children in the proposed project area. 10% rate of Abnormal PAP Smears in the Maternity anti wnmPn,e Health c-l-i-niss at the Health Department. Immunization Rate for Children at 2 years of age is 58% in Lubbock. Proposed Participation Estimate the number of participants by race the applicant expects to serve each month under the WIC Program. 7 Please estimate the number of migrants • the applicant expects to serve each month under the WIC Program. # TO BE SERVED JAN FES MAR APR MAY JUNE JUL AUG SEPT i OCT NOV DEC 10 !0 10 10 10 10 to 10 10 10 10 1C Migrant farmworkers("Migrants' are those individuals and families who within theast two years ve left their home for rkerims of time to pursue farmwork or food processing work In another are. Reauirement For Onnoina Child and Matemal Health Services Local agencies are required to provide ongoing, routine pediatric and obstetric care. If services are not through the local agency, the applicant agency must have a written agreement with other agencies and must submit the agreement(s) with the application. [Federal Regulations 246.5(e)(1), 246.6(b)(3) and 246.6(b)(8)(d.e)]. Present Operations and Staffing Patterns Aooticant agencies with health services Indicate the services presently offered by the applicant agency, the recipients of these services and the county(s) serviced. Appricant agencies without health services Indicate what services by other agency(s)health provider(s) will be provided. Be specific as to type of services, location, name, title and address of provider. Guadalupe Economic Services Corporation will provide some primary carp for women an c I ren - 1.414 ISr., LUDDOCk, T TTU-Health Sciences Center - primary care and specialty care - women, infants, and children - 3601 4th different Primary Care Clinics from University Medical Center and Community Health Center of Lubbock - Primary Care - when they begin operations. S Indicate which of the`foliowino medical data is presently obtained for each client catecory. 'MEDICAL DATA r CPI rGNANTATVdG OR POSTPARTUM WOMt3N WFANTS Cs4iJ1 DRt7r * • Height Measuuements x Weight Measurements x Hand Circumference (infants Only) Hemoglobin Count x Hematocrit Count x Swum or Plasma Concentrations of kon, Albania, Vitamin A, and Ascorbic Acid x Other Laboratory Tests Routinely Performed UA. Chemstrip x PPD x Specific Gravity x Urinalysis (Micro) x S® Rate x WBC x RRC x Deutrostbc x PREG Test x VDRL x GC Culture x PAP Smear x PKU Rubella Titer x CSC x Differential x _ Other Pertinent Medical Data Routinely Obtained Hepatitis B Screen x HIV upon request x t the agencies from which you accept referrals an ose to whom you refer clients fore ons services. Describe the sere to which clients are referred. **See Attachment C 9 Provide the following information on current staff members. POSITION NUMBER ::FIELD OF DIITIE3. SPECIALIZATION Physicians D 18 OB/GYN, STD, Community Direct client service Registered Nurses Health Immunization Nutritionists - Dietitians Nutrition Aides Licensed 4 Women's Health, STD Interview, examine and educate clients Vocational Nurses Others Prgposed Operations and Staffing Patterns If the event that this application is approved, provide the following information for WIC Program operations and staffing. Indicate which Program operation(s) will occur to each proposed site. Prcpos;ed Sites' Food Issuance Nutrition Applicant } {Address'es) .. _.: _:.:Education Screening: Slaton X X X Wolfforth X X X REESE AFB X X X New Directions X X X CHCL X X X rimary Care X X X Clinics Idalou X X New Deal/Abernathy X X, X 5hallowater X X X 10 "A . Indicate proposed staffing patterns for WIC Program operations. - ..... Proposed WIC Duties PositionMda Number Currently On Staff .., To Be Full Or Exanirfe Issue Food Deliver Hired Part-time Vouchers Nutrition Interview ;.. Education Director 1 1 F x X X Nutritionist 5 5 F x X Ad. Tech (Acct. Exp.) 1 1 F X X Comm. Serv. Aide I 9 9 F X I X I Clerk 1 1 F X X Aaency Grant Support If the applicant agency is funded by grants, provide the following information. Indicate N/A if the applicant agency has no grant funds. H the applicant is a PRIVATE NON-PROFIT ORGANIZATION, record the assigned IRS tax-exempt certificate number here and attach a copy of the certificate to this application. 11 PROGRAM INITIATION AGREEMENT The applicant agrees to the following requirements as specifically defined by the USDA WIC Program Req_ulations: 1. Implement a food delivery system approved by USDA and the state of Texas. 2. Provide the supplemental food to all three categories of eligible participants - pregnant, lactating, and six-month postpartum women, infants and children - unless the applicant does not normally provide health services to one or more categories of recipients. 3. Serve only those participants who reside in the geographical area as defined in this application. 4. Provide safeguards in applicant's operations to ensure that no participant receives food from more than one WIC Program in Texas. The applicant also agrees to adhere to all other USDA regulations and state directives with respect to the operation of the WIC Program in Texas. The information contained in this application for a WIC Program is true and accurate to the best of my knowledge. Signature of loca official responsible supervising the WIC Program Date 13 1 LAMB I 1 I I I 114 I HOCKLEY/ I I I � I I I I TERRY I 62 I 4 MAP 2 MAP 5 MAP 3 MAP 2 MAP 5 MAP 1 SPRINCLAKE 1 i LITTLEFIELD I -- AB*ERNAT 7 aA iN LLAND I W20ROiWNIIELD 1ES EW HALE i 7a 27 I I 1 87 LUBBOCK I LL WATER 1 z I BOCK RANSOM 4 • CANYON SLATON I� I PLAINS D FLOYD MOTLEY `MATADOR =LOYDADA. 62 I RALLS I 8Z CROSBY I I I ROARINC SPRINCS 4— DICKENS I DICKENS I I CIRARD— YQS Qas ��ATTOMR I ST LAIREINO "u I LYNN I \84Ila7GARZAIOURC KENT O'DONNELLrDAWSON BORDEN SCURRY T 1TAHOKA MAP INDEX LUBBOCK ... MAPS 7,8 MORTON ...... MAP 7 MULESHOE ..... MAP 1 PLAINVIEW.... MAP 9 POST .......... MAP 3 RALLS ......... MAP 3 RANSOM CANYON........ MAP ' 8 SHALLOWATER, MAP 2 SLATON ...same. MAP 4 TAHOKA........ MAP 5 WOLFFORTH.... MAP 4 1 ATTACHMENT B FEES FOR CLINICAL SERVICES, BASED ON INCOME Income : pay 201: poverty or greater 100: 186-200% of poverty 50:. 185: of poverty or less 0% compe ext. ltd. $60 $30 $15 $30 $15 $ 8 no charge CLINIC CHARGES 1• Prenatal Clinic Maternity Enrollment - extended charge Complete Physical Exam - comprehensive charge Returns (all other) - limited charge Staff has option of "no charge" for certain visits, i.e. fetascope documentation. 2. Women's Health Complete Physical Exam (Annual, Post-Partum, New) - comprehensive charge Returns (all other) limited charge Pill pick-up no charge for visit - charge for pharmacy 3. S.T.O. Well check - extended charge Return for treatment - no charge 4. H.I.V. Initial counseling, testing - limited charge Return for results - no charge 5. Dental All visits limited charge ,Tooth brushing instruction - no charge 6. Immunizations Flat rate - $5 7. Pregnancy Testing Flat rate - $5 Adopted 1/92 Revised 3/92 4W\medi$ /V(ki% .a- r-�w��n�t.��`�•- Family* Size ' 1 2 3 4 5 6 7 8 Yr. $000 - $12,223 Mo. $000 - $ 11019 WK. $000 - $ 235 Yr. $000 - $15,388 Mo. $000 - $ 1,282 Wk. $000 - $ 296 Yr. $000 - $18,554 Mo. $000 - $ 1,546 Wk. $000 - $ 357 Yr. $000 - $21,719 Mo. $000 - $ 1,810 Wk. $000 - $ 418 Yr. $000 - $24,884 Mo. $000 - $ 2,074 Wk. $000 - $ 479 Yr. .J00 - $28,050 Mo. $000 - $ 2,338 Wk. $000 - $ 539 Yr. $000 - $31,215 Mo. $000 - $ 28601 Wk. $000 - $ 600 Texas Department of Health income Guidelines and Schedule of Charges Clinical Health Services ** 200+ Poverty ncome $13,620 $135 1�262 $18,380 $ 1,532 356 $12,224 - $18,379 $ 1,020 - $ 1,531 $ 236 - $ 355 $15,389 - $23,139 1,297 979 $ 1�444 $ - $18,555 - $27,899 $ 1,547 - $ 2,324 $ 358 - $ 536 $21,720 - $32,659 $ 1,811 - $ 2,721 $ 419 - $ 629 $24,885 - $37,419 $ 2,075 - $ 3,117 $ 480 - $ 719 $28,G51 - $42,179 $ 2,339 - $ 3,514 $ 540 - $ 810 $31,216 - $46,939 2,601 911 3�902 $ - $ $000 - $15,152 $000 - $ 1,263 $000 - $ 291 $000 - $21,405 $000 - $ 1,784 $000 - $ 412 $000 - $25,808 $000 - $ 2,151 $000 - $ 496 $000 - $30,211 $000 - $ 2,518 $000 - $ 581 $000 - $34,614 $000 - $ 2,885 $000 - $ 666 $000 - $39,017 $000 - $ 3,251 $000 - $ 750 $000 - $43,420 $000 - $ 3,618 $000 - $ 835 For each additional member in family units with more than 8 members add: 0 - 132% Poverty Level Yr. $3,165 Mo. $ 364 Wk. $ 61 5-o 7 a 21, 140 $980 $ 445 $27,900 $ 2,325 $ 537 $32,660 $ 2,722 $ 628 $37,420 $ 3,118 $ 720 $42,180 $ 3,515 $ 811 $46,940 $ 3,912 $ 903 I ** For pregnant women or infants whose family income is at or below the 185% level of poverty income. March, 1992 0% thru 132% 13A thru 199-y M thru 185 Poverty ncome Eoverty Income eovert Income Yr. $000 - $ 9,057 $ 9,058 - $13,619 $000 - $12,599 Mo. $000 - $ 755 $ 756 - $ 1,134 $000 - $ 1,050 Wk. $000 - $ 174 $ 175 - $ 261 $000 - $ 242 ATTACHMENT C The Personal Health`Section is in the process of starting complete well -checks for infants and children. Currently these services are limited and are part of the immunization clinic. As staff is hired and trained in providing these services, the services will be expanded.