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Resolution - 3856 - Grant Application - Robert Woods Johnson Foundation - Immunization Services - 04/09/1992
Resolution No. 3856 April 9, 1992 Item #23 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 Grant Appli- cation and all related documents by and between the City of Lubbock and the Robert Wood Johnson Foundation of Atlanta, Georgia, for the "All Kids Count" program of health immunization tracking, 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 9th , u,ty secre APPROVED AS TO CONTENT: Z20. Rita Harmon, Assistant City Manager APPROVED AS TO FORM: Do ald G. Vandiver, First Assistant City Attorney DG V :da/AGENDA-D2/GA-] HNFN. res day of April , 1992. c • " eo - . C. McMINtf, MAYOR 1' Resolution No. 3856 April 9, 1992 Item #23 APPLICATION GUIDELINES The Robert Wood Johnson Foundation ALL KIDS COUNT PROGRAM National Program Office The Task Force for Child Survival and Development One Copenhill Atlanta, Georgia 30307 (404) 872-4122 February 1992 ri Go I. INTRODUCTION This is the application guidance package and forms for the ALL KIDS COUNT Program, a new national program of The Robert Wood Johnson Foundation. Since its inception as a national philanthropy in 1972, the mission of The Robert Wood Johnson Foundation has been to improve the health and health care of all Americans. Its role in performing that mission is to help the Nation and its health care system identify and pursue new opportunities to address persistent health problems and to anticipate and respond to significant emerging problems. Today, with assets of more than $3 billion, the Foundation concentrates its grantmaking in three broad areas: (1) to assure that Americans of all ages have access to basic health care; (2) to improve the way services are organized and provided to people with chronic health conditions; and (3) to promote health and prevent disease by reducing harm caused by substance abuse. The Foundation will also seek opportunities to help the Nation address the problem of rising health care costs. The purpose of this initiative, called ALL KIDS COUNT, is to establish immunization monitoring and follow-up systems that --when combined with other local, State, and Federal immunization efforts --will help increase immunization rates among preschool children and reduce rates of illness, disability, and death from vaccine -preventable diseases. Under the program, as many as 20 projects will receive 1 -year planning grants of up to $150,000 each. The 20 projects then will be eligible to compete for as many as 12, 4 -year implementation grants of up to $525,000 each. H. PROGRAM BACKGROUND Immunizations are one of the most effective public health interventions available, and immunization rates are a key indicator of the adequacy of child health services in a community. The eradication of smallpox worldwide and the near eradication of poliomyelitis in the Western Hemisphere illustrate how effective immunization efforts can be. Ironically, the very success of immunization programs has led to complacency about childhood diseases, one factor thought to have contributed to the decline in immunization rates. Recent outbreaks of vaccine -preventable diseases in the United States demonstrate clearly the shortcomings of our present immunization delivery system: 1. In 1983, 20 years after the introduction of the measles vaccine, there were 1,497 cases of measles in the United States. In 1989, there were 18,193 cases and in 1990, 27,672 cases and 89 deaths (mostly among children). 1 2. Measles epidemics have been particularly severe in the inner cities. Outbreaks in Los Angeles, Dallas, New York City, and San Diego accounted for more than 40 percent of all reported measles cases in 90. Because all States require certain immunizations as a condition of entry into school, 95 percent or more of children over age 5 are fully immunized. But immunization rates are much lower among preschool children: The Centers for Disease Control estimates that 40-60 percent of children under age 2-4.6 to 2.4 million infants and toddlers --have not received all the immunizations recommended for their age group. In response, public -and private -sector agencies --the National Vaccine Advisory Committee, the Centers for Disease Control, State and local governments, the American Academy of Pediatrics, the EVERY CHILD BY TWO initiative started by Mrs. Rosalyn Carter and Mrs. Betty Bumpers and the Junior League, among others --have undertaken a variety of activities with the immediate goal of immunizing all U.S. children. Their interventions will help to increase access to immunization services by reducing some financial and organizational barriers. There is also the need to improve the permanent infrastructure to monitor immunization rates and provide adequate follow-up services that will sustain these activities beyond the immediate crisis. Although the need for this infrastructure is recognized, much more information is required in order to know which type of system would be most effective today, how such a system could best be developed or what it would cost to plan, implement, and maintain. It is also important that any system developed for immunization purposes be structured so as to make a maximum contribution to public health and children's services overall. In the 1960s and 1970s, many local public health agencies maintained immunization records for all newborns in their community. Public health nurses monitored immunization status and followed up on infants who did not receive age-appropriate immunizations. They provided reminders and referrals to private physicians and to immunization and well -baby clinics. As funding declined, these monitoring and follow-up services gradually decreased, which contributes to today's lower immunization rates. New methods of organizing these services --using computer technology and less labor-intensive follow-up, now offer the prospect of reinstating this vital system more cost-effectively. III. THE ALL KIDS COUNT PROGRAM A. Program Description The ultimate goal of the ALL KIDS COUNT program is to increase immunization rates among preschool children in. selected local or regional health agency areas where vaccine -preventable diseases are an identified public health priority. 2 jVJ Expected outcomes include: 1. A decrease in the incidence of vaccine -preventable diseases in these groups; 2. a documented increase in the rates of immunization among preschool children in target populations reached by the projects; and 3. an opportunity for funded communities to look beyond immunizations to the broader needs of their children for preventive services. To achieve this, projects will develop and implement monitoring and follow-up systems to assure that preschool children have access to immunization services. Projects will be expected to develop and implement: (1) A computerized system for entering and monitoring the immunization status of the target population that builds on any existing local or state systems, (2) defined policies and procedures for managing the data base and following the target population, including assurance of confidentiality, and (3) formal links to community-based agencies and practitioners. The ALL KIDS COUNT program will have two phases. In the first phase, 1 -year planning and development grants of up to $150,000 each will be awarded competitively to as many as 20 eligible health agencies. Agencies receiving planning grants will be eligible to apply for up to 12 implementation grants of up to $525,000 each. These grants will be awarded based on the strength of the implementation plans proposed. They will be funded in two, 24 -month cycles, with declining Foundation support during the 4 -year period. Funding of the second 24 -month grant will be contingent upon grantee performance. B. Proposal Requirements All applicants are required to submit a written proposal describing their 12 -month planning and development phase, work plan, time line and budget for that year (see Appendix 1. for budget guidelines). The proposal narrative should describe the planning necessary for implementation of a comprehensive plan for assuring immunization of preschool children, which should be tailored to 3 0 the target community or population and should include at the following activities: 1. Convening an advisory committee of public and private providers, public officials, and community leaders committed to reducing vaccine -preventable diseases, in order to guide the project's progress and keep it visible in the public and private sectors. 2. Clearly identifying the target population to be served. 3. Identifying all existing private and public immunization services and ways for improving access to and use of these services. - 4. Identifying service gaps and barriers - including sociocultural barriers - and developing strategies to overcome them. 5. Identifying existing immunization record-keeping system that can be adapted or linked to regional, State, or Federal systems. 6. Determining how demographic and immunization data on all children under age 5 will be obtained and entered into the computer system and how it will be kept up-to-date. 7. Determining how these data will be analyzed and communicated to parents, providers, and public officials. 8. Establishing guidelines for maintaining confidentiality of client records. 9. Developing a system for follow-up (letters, phone calls, home visits) and referral. 10. Developing a financial plan that will enable the project to continue past the grant period. 11. Developing plans for institutionalizing the new system generated under the grant within ongoing State and local programs. 4 f� Approaching the end of the planning year, agencies receiving planning grants will be eligible to apply for implementation grants. Proposal applications for the implementation phase will be made available in April 1993. IV. ELIGIBILITY AND SELECTION CRITERIA Eligible to apply are organizations responsible for assuring access to immunization services to total populations of at least 200,000. In general, applicants will be public health agencies serving cities or counties of this size, but other agencies responsible for providing public health services at the community level also may apply. In addition, state, multi -county, or other regional health agencies are eligible, provided they can demonstrate their authority and capacity to plan and implement an immunization monitoring and follow-up system at the local level. An applicant agency must be either a public entity or a tax exempt organization under Section 501(c)(3) of the Internal Revenue Code and should not be a private foundation under Section 509(a). Priority will be given to applicants that: 1. Provide evidence that the community immunization rates need to be improved and that the issue is a high public health priority for the community, as evidenced by support from appropriate public and private sector entities and State and local health agencies; 2. have demonstrated ability to manage projects that link public and private agencies; 3. have local resources, cash and in-kind, available to assist in the development and implementation of the monitoring and follow-up system; 4. provide evidence that this system can be continued beyond the period of Foundation support; and 5. plan to use their immunization activity as an opportunity to improve access to other preventive services for children. V. USE OF GRANT FUNDS Grant funds are to be used to plan, develop, implement, and coordinate an immunization monitoring and follow-up system. Funds may be used for initial project administration, partial support of computer hardware and software purchases, and the hiring of consultants and staff to conduct the project's activities. 5 f Applicants are encouraged to obtain additional public and private support for various components of their projects. For example, computer hardware and software might be donated by a local business, or a local insurer might provide funds for a public health nurse to conduct follow-up home visits. Grant funds may not be used for the direct support of immunization services or puchase of vaccines, to construct new facilities, to renovate existing facilities, to substitute for funds currently being used to support similar services, or to reduce organizational deficits from pre- existing operations. VI. APPLICATION PROCESS Applications for an ALL KIDS COUNT grant must be received by April 17, 1992 and should include: A. The official name of the public entity or the non-profit organization that will be the lead agency, official applicant and fiscal agent for the grant. B. The official name(s) of other organizations that will collaborate and participate in the program. C. The name(s) and title(s) of the person(s) who will manage and direct the program together with appropriate addresses, phone numbers and fax numbers. D. A summary description of the proposed program approximately two pages (600 words) in length. E. A project narrative including a work plan and time table. G. Certification of public or non-profit status. F. Budget and Budget Justification. The application must be no longer than thirty (30) pages, double spaced , excluding forms and appendices. Twelve (12) copies, of which two (2) should have original signatures shall be submitted to the Program Office at the following address: THE TASK FORCE FOR CHILD SURVIVAL AND DEVELOPMENT The Carter Center One Copenhill Atlanta, Ga. 30307 2 Phone: (404) 872-4122 Fax: (404) 872-9611 If you have any questions about the application process please contact the Program Staff who are: Dr. William H. Foege, Director William C. Watson, Deputy Director Charlotte Yuille-Barnes, Program Assistant VII. SELECTION PROCESS After the applications are received they will be reviewed by the National Program Office, Robert Wood Johnson staff and members of the Advisory Committee. The Advisory committee will meet in late May to select projects for site visits. These visits will take place in June and early July probably by meeting with the selected applicants in a series of regional locations. The Advisory Committee will meet in late July or early August to recommend projects to receive planning grants. The Robert Wood Johnson Foundation Board of Trustees will meet in late October to make final decisions with respect to grants and awards will be announced in November. VIII. WORKSHOP FOR APPLICANTS A workshop for applicants will be held at The Carter Center in Atlanta on February 24, 1992. Staff from the Program Office and the Foundation will conduct the workshop. Applicants will have the opportunity to raise questions and seek clarification' of concerns prior to completing their applications. Applicants or their representatives will participate at their own expense. Arrangements have been made at a hotel in the proximity of The Carter Center for rooms at group rates. Information about the meeting can be received by calling the Program Office (see section VIII). A summary of the workshop will be provided to all prospective applicants. IX. PROGRAM DIRECTION Direction and technical assistance for the program will be provided by William H. Foege, MD, Executive Director, and William C. Watson, Jr. Associate Executive Director of The Task Force for Child Survival and Development, The Carter Center. Dr. Foege will serve as Director and Mr. Watson as Deputy Director of the ALL KIDS COUNT program. At The Robert Wood Johnson Foundation, the responsible officers are Ruby P. Hearn, Ph.D., Vice President; Marguerite Johnson, Program Officer; and Helen Dundas, Program Assistant. 7 THE TEAS PAlUfA1 LE AND Scum Pum nmanzTIOA PLMM PROJECT THE ROBERT HOOD JOM= FOMMOM LIM ITEM BUDGET Grant Period: (from 11/01/92 to 10/31/93) Budget Period: (from 11/01/92 to 10/31/93) PROJECT YEAR 1 I. PFBSCIM: Name Position Base Salary %Time M. Strange Pers. Health Ser. Coord. $44,000 10% J. Henderson Administrative Technician $21,000 10% To Be Hired Project Director $24,000 100% To Be Hired Outreach Worker (S. Plains) $21,000 50% To Be Hired Secretary $14,200 100% Fringe Benefits (Variable) II. OFFICE OPERATIONS Supplies Printing Duplicating Telephone Postage Software M. PROJECT STAFF TRAVEL IV. INDIRECT COSTS V. EQUHMM! vi. OOR,SUIIIAHT i011ORAM VII. SUBCMMCTS TOTAL Resolution No. 3856 April 9, 1992 Item 423 RHJF OTHER TOTAL SUPPORT SUPPORT 4,400 0 4,400 2,100 0 2,100 24,000 24,000 0 10,500 10,500 0 14,200 14,200 0 8,840 7,586 1,254 1,200 1,200 0 2,500 2,500 0 2,500 2,500 0 3,400 3,400 0 1,200 1,200 0 3,360 3,360 0 15,550 15,550 0 8,440 7,740 700 3,725 0 3,725 9,000 9,000 0 39,290 30,190 91100 154,205 132,926 21,279 Page 1 of 8 ATTACHMENT 2 GRANT PROPOSAL EVALUATION FORM COVER SHEET GRANT NAME: The Texas Panhandle and South Plains All Kids Count Program GRANT AGENCY: The Robert Wood Johnson Foundation GRANT FISCAL PERIOD: 11/01/92 - 10/31/93 MONTH/DATE/YEAR TO MONTH/DATE/YEAR CITY DEPARTMENT/INDIVIDUAL PREPARING GRANT: Health Department Nancy Haney (Whom to contact in case of questions) APPROVALS: 41 0 DEPARTMENT -HEAD DAT DIVISION DIRECTOR DATE ASSISTANT CITY MANAGER OR CHIEF OF POLICE- DATE Jlll- - 30- g1 BUDGET & RESEARCH DIRECTOR DATE �c" DEPUTY CITY MANAGER DATE Upon completion of approvals, return to: Nancy Haney / Health by 04/06/92 INDIVIDUAL CITY DEPARTMENT OR SECTION DEADLINE DATE (IF APPLICABLE) A25-1 CITY OF LUBBOCK GRANT PROPOSAL EVALUATION FORM INSTRUCTIONS: Page 2 of 8 This form must be completed and signed by the appropriate individuals in order for a grant application to be evaluated and approved by the City Manager. 1. State, as clearly as possible, the goals and objectives of the proposed project for which a grant is being sought. To develop a comprehensive plan which addresses immunization needs of preschoolers in the Texas Department of Health Region 2. Activities to be addressed during the development of the plan include at the least: a. Convene an advisory committee. b. Identify target population. c. Identify existing immunization services and the means of improving access to these services. d. Identify service gaps and barriers. e. Identify existing immunization record-keeping systems. f. Determine how immunization records can be tracked via computer. g. Determine how to make computer records available to parents, service providers, and public officials. h. Establish confidentiality guidelines: i. Develop system for referrals and follow-up. j. Develop a financial plan for implementation of plan. k. Develop plan for institutionalizing the new system within ongoing State and local programs. A. Is this the fulfillment of an identifiable community (Lubbock) goal? If so, list the source of the identified goal. Yes. In the FY 1988 - 1989 City of Lubbock Health Plan developed by the Board of Health, the lack of coordination among the agencies providing immunizations and the lack of monitoring ofpre-school children for immunizations were both listed as problems in Lubbock's health care system which needed to be addressed. A25-2 Page 3 of 8 B. Is this the fulfillment of an identifiable community (Lubbock) need? If so, please provide quantifiable data (studies, etc.) that illustrate the community need and how this grant will meet that need: One of the needs stems from the fact that there is no way to adequately track immunizations among preschoolers. We know that once a child enters school, the immunization rate is around the 95% rate. We do not know what the rate is for children under five. One element of the plan would be to develop a method to track children from birth through five to ensure timely immunizations. We do have some evidence that preschoolers are not receiving adequate immunizations at the appropriate times. The rate of immunizations at the City of Lubbock Health Department, based on a retrospective review of records of two -year-olds, is 43%. It is possible that some of the children in the 57% of two -year-olds who have not completed their immunizations did receive their last immunization from a source other than the health department. There is no way of knowing, however, without a better tracking system. In 1989 Lubbock had 335 cases of measles. This year Amarillo has had 22 cases of mumps. In 1992 Corpus Christi is having a large outbreak of measles. It is quite possible that after Spring Break Lubbock will experience either an outbreak of measles, mumps, or both. This grant proposal would be instrumental in developing a plan to produce a more efficient way of tracking the immunization rate among preschoolers. This money would also enable the production of a plan to make immunizations more readily available to children all over the region, including the rural areas where there is not a physician in residence. 2. List at least three measures by which City Staff and City Council might be able to evaluate the program in order to determine that it has reached the goals and objectives described in Question 1. a. At the end of the year there will be a written plan for monitoring, tracking, and providing immunizations to pre-school children. b. A written needs assessment and evaluation for the region which can be used as a baseline to evaluate the implementation of the plan. c. An existing immunization task force will be in place which can utilize the plan to proceed with its implementation. A25-3 Page 4 of 8 3. Will this program benefit the Lubbock community as a whole? If not, please provide a detailed profile of the individuals or groups that will benefit from the program. This program is primarily directed at pre-school children, birth through five. There are 20,553 preschoolers in Lubbock according to the 1990 census. There were 58,325 preschoolers in the region. This plan will effect all preschoolers irregardless of sex, race or the economic level of the family. This program will indirectly effect the entire Lubbock community, in that if we can increase public awareness regarding the need for immunizations, we will see fewer vaccine -preventable diseases in Lubbock at all age levels. They will effect the community from a health standpoint as well as from a financial standpoint. 4. Are other agencies (other than the City of Lubbock) available to administer this program? If so, list the agencies: There is no other agency eligible to administer this program, due to the fact that no other agency submitted a letter of intent to the Robert Mood Johnson Foundation. Lubbock is the only city/county in Region 2 who was eligible to apply due to the minimum population criteria of 200,000. 5. Are other agencies administering similar programs? If so, list the other agencies. If not, why not? There is not any type of coordinated effort to monitor and track immunizations. There are several agencies, as well as private physicians, who provide immunizations to patients. There has not been the opportunity (or interest) to coordinate immunization efforts before now. 6. Is the program or activity provided by this grant required by state or federal law or required as a condition of other ongoing state or federal programs? Please explain: No - Although immunizations has been recognized by the federal government as a priority health service. It is one of the few areas of the budget of the Center For Disease Control in Atlanta that received a major increase this year. A25-4 7. Does the grant require a in the form of cash or an Page 5 of 8 local match? If so, in what amount? Is the match in-kind contribution? The planning grant does not require a local match; however, if a match is provided, it will improve the overall proposal by showing local support for the project. The match can be cash or in-kind. We are proposing a match of $21,279, which will be composed of in- kind contributions of personnel time and equipment. Amarillo will provide $9,100 of the match with their own in-kind contributions. 8. Is the grant for capital or operating programs? Please describe specifically what the funds will be used for (personnel, supplies, services, capital outlay, capital project, etc.). Operating Programs Personnel: 48,700 Fringe Benefits: 7,586 Supplies: 14,160 Travel: 15,550 Indirect Costs: 7,740 Consultant N-noraria: 9,000. Subcontract to Amarillo: 30,190 A. If the grant is for capital outlay or a capital project, will it result in ongoing City operational costs? If so, explain in detail. N/A B. If the grant is for an operating program or programs, is it a one-time grant which will result in ongoing City expenses, if the program is to be continued in the future? This grant proposal is for a one-year planning grant. At the end of the year a plan will have been developed for immunization monitoring and tracking which can then be implemented. This planning grant can be followed by two two-year implementation grants. If Lubbock receives the planning grant, we will be eligible to apply for the implementation grants. This grant should not result in continuing costs for the City since it is a planning grant. One aspect of the plan, would be to determine how to finance the implementation of the plan. That might include the use of state money. It might be looking for private donations. It might call for the utilization of the programs already in existence, but with the addition of more dialogue and cooperation. The plan could be written in such a way as to negate the further expenditure of City funds. A25-5 Page 6 of 8 C. Does the grant require continuation of the program, at City expense, after grant funding has expired? If so, how long will the City be obligated to expend local funds, and in what areas? Be specific. The grant does not require continuation at City expense. It does ask for a commitment to the plan by the City. The City just has to show that it will work to try to implement the plan in a cooperative fashion. 9. Is the grant a one-time grant, a one-time grant with an option to renew the grant, or an on-going grant? If the grant is ongoing, how many years has the grant been provided to the City, and what year does the upcoming period represent (2nd year, 5th year, etc.). If the grant has an option to renew, how often can it be renewed, and what are the terms of renewal? Please explain. The planning grant is a one-time grant. If we receive the planning grant, we can compete for an implementation grant. The implementation grant would come in the form of two two-year grants. Of the 20 planning grants supported by Robert Wood Johnson, 12 will receive implementation grants of $525,000. The implementation grant would require an increasing match over the four years. 10. Are indirect costs reimbursed by the grant? Yes, at a rate of 9% of the cost of personnel, supplies, and travel. A25-6 Page 7 of 8 11. Are grant audit costs reimbursed by the grant? Possibly - This will be determined during the budget negotiations. Robert Wood Johnson does not always require independent audits. It depends on the financial structure of the funded organization. 12. What is the immediate (twelve-month) impact of the grant program on City employee allocation and utilization? How will this affect their work hours, productivity, etc. on City programs and activities? New temporary staff will be hired to meet the needs of this project. Two current staff positions will be asked to do some additional work, if the grant is awarded. Judy Henderson will be asked to perform the financial administration of the grant, including submitting the appropriate reports to the Robert Wood Johnson Foundation. Mary Strange would supervise the Project Director. 13. What is the long-term (five-year) financial and manpower impact of the grant program both on the community and on the City organization? Hopefully in five years the plan will have been implemented, more individuals will be immunized, and we will fewer incidences of vaccine -preventable diseases in the City. Health Department staff may be giving more immunizations, but they should be seeing more people throughout the year. Currently, many people wait until August to have their children immunized. This puts a tremendous burden on the nursing staff. With better tracking and follow-up, more children will come to the Health Department throughout the year at the proper time for their immunization. Citizens should experience less wait and have a better experience when being seen at the imunization clinic. A25-7 Page 8 of 8 14. Provide, in as much detail as possible, a 5 -year Revenue and Expenditure Projection for the grant related program beginning with the current year or the first year this grant will be in effect. Show any on-going costs to the City, even if the grant is only for one year. If the grant is renewable or ongoing, show the estimated revenues and expenditures for future years that you intend to renew/continue the grant (up to five ,rears). Be sure to fully explain the source and type of revenues (in-kind contribution, reimbursement of expenses, etc.) and fully explain the specific types of expenditures (payroll for 1/2 time clerk, purchase desk, capital project construction, etc.). Attach additional sheets if necessary. FOR GRANT YEAR (FROM 11/01/92 TO 10/31/93): Revenues 1992 Local Match 21,279 Other 132,926 TOTAL REVENUES 154,205 Expenditures Personnel 64,040 Supplies 10,760 Other Charges 79,405 TOTAL EXPENDITURES 154,205 A25-8 _ Y MS]l THE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM SUBMITTED TO: THE ROBERT WOOD JOHNSON FOUNDATION NATIONAL PROGRAM OFFICE THE TASK FORCE FOR CHILD SURVIVAL AND DEVELOPMENT ONE COPENHILL ATLANTA, GEORGIA 30307 SUBMITTED BY: CITY OF LUBBOCK HEALTH DEPARTMENT P.O. BOB 2548 LUBBOCK, TEXAS 79408 ADMINISTRATOR: R. DOUG GOODMAN (806) 767-2900 CONTACT PERSON: NANCY JENKINS HANEY (806) 767-2950 DATE OF PROPOSAL: APRIL 17, 1992 REQUESTED FUNDING: $132,926 SIGNATURE: .� »\ I TEXAS PALE AND Som PLAINS ALL RDS COUNT PROGRAM . « TABLE of CONTENTS ©©: » Project sunwiary .........................................Pg, 1 - 2 . \ . Project Narrative......... ....... oo—o—o—ooPg. $ - 25 ©w�K \ Z\\ Goals and Objectives.... ...... ..... 000.pg. 16 } °d Work Activity Plan Timeline.......... .... ... opg. 17 - 19 ! Work Activity Plan,,...,,,., ■g, 20 - 22 � ^| ` < Budget and Budget Justification........ .... oo--0000 ... Pgo A - ■ . 2\:y Appendix As Re■ume■.....................................Pg. Al - ag Eva \ »2 � ■s Consultant Information ......................Pg. sl - B5 " » . . .= ».. Appendix c■ Letters ofSupport ,,,,,,,,,,,,,,,,,,,,,,,,,,pg. Cl - cls : �w » » Appendix Dt Certification of ilio Status ..............Pg. 01 - Dg a � { vv ( \ � \ • . ./ THE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM PROJECT SUMMARY Lead Agency: City of Lubbock Health Department P.O. Box 2548 Lubbock, Texas 79408 (806) 767-2900 Administrator: R. Doug Goodman Contact: Nancy Haney Area to be Served: Region 2 of the Texas Department of Health (the Panhandle and South Plains of Texas) ! Total Amount Needed for Project: $154,205 Amount Requested: $132,926 In-kind Provided: $ 21,279 Subcontractor: Amarillo Bi -City -County Health Department Amarillo, Texas a. - Problem Statement: In 1989 11% of all the measles cases which were reported in Texas were reported in Region 2 of t Texas Department of Health. The average rate of immunization for the communities located in this Ai- Y region is 58%. This average is based on six retrospective studies performed in various locations of the region using the available information, which may not accurately reflect th true number of children with incomplete immunizations. Currently there is not a reliabl method in place to track immunizations among preschoolers. There is a great need to develop system to monitor the immunization status of ver -' young children throughout the 41 counties of the region. Purpose: The Texas Panhandle and South Plains All Kids Ccx Project will link the communities of this 38,000 square mile region in an effort to determine how best to lower the incidence of vaccine-preventab disease and to raise the immunization rate of preschoolers. The project will utilize outreach workers, local task forces, and a regional advisc committee in the planning process. Public and private, for profit and not-for-profit health cju providers will be asked (and have agreed) to cooperate in developing a plan for this largely rural area. Use of Funds: The grant monies will be used to pay personnel, travel, consultant fees and to provide the necessary supplies and equipment for the required studies to be conducted and a plan to produced. A subcontract with the Amarillo Bi -Ci County Health Department will be entered into by xkj' x b'. THE TERAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM Plan -of -Action: the lead agency which will provide an additional staff person to perform outreach specifically in` the Panhandle area. The Project Director and Outreach Workers, with the assistance and guidance of the local task forces and the regional advisory committee, will develo and conduct a needs assessment', a survey of curr nt providers, retrospective immunization surveys, d brain -storming sessions to gather the appropriat information needed to formulate the plan. A consultant will be hired to advise the project s regarding computer hardware and software and the adaptability of a system for region -wide access. The consultant may develop a program specifically for the tracking of immunizations to preschoolJan in the region. The resultant data gathered fr this variety of sources will then be complied a plan for immunization tracking developed by thparticipating staff and volunteers. The plan 1 emphasize the existing services in the region the manner in which they can be linked to prov the tracking as cost -efficiently as possible. 2 7 A 32 THE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM NEEDS ASSESSMENT Naas! of Project: The Texas Panhandle and South Plains All Rids Count Poroject { 't s Location: Texas Department of Health (TDH) Region 2 (see Tables 1) t Lead Agency: City of Lubbock Health Department j. 3990 Population Region 2: _# Armstrong County: 2,021 Bailey County:- 7,0641 Briscoe County: 1,971 Carson County: 6,576 Castro County: 9,070 Childress County: 5,953 Cochran County: 4,377 Collingsworth County: 3,573 Crosby County: 7,304 Dallam County: 5,461 Deaf Smith County: 19,153 Dickens County: 2,571 Donley County: 3,696 Floyd County: 8,497 Garza County: 5,143 Gray County: 23,967 Hale County: 34,671 Hall County: 3,905 Hansford County: 5,848 Hartley County: 3,634 >. Hemphill County: 3,720 Hockley County: 24,199 . ;a Hutchinson County: 25,689 King County: 354 R Lamb County: 15,072 Lipscomb County: 3,143 x Lubbock County: 222,636 Lynn County: 6,758 Moore County: 17,865 Motley County: 1,532 Ochiltree County: 9,128 Oldham County: 2,278' Parmer County: 9,863 Potter County: 97,874 Randall County: 89,673 Roberts County: 1,025 " Sherman County: 2,858 Swisher County: 8,133 4 Terry County: 13,218 Wheeler County: 5,879• Yoakum County: 8,786 r til ryry � k: y Y TEXAS DEPARTMENT OF HAI.-TH TABLE 1 OkLm A OLOMAM POTTO CANN- GbM O p ow WN "Mu MMUMA Ofte M �v■aP��w r �4"Mml S" 1 nm 1 LMw A am& Ei PUBLIC HEALTH REGIOl Fi THE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM TOTAL POPULATION REGION 2: 734.138 rTOTAL POPULATION, BIRTH THROUGH FIVE REGION 2: 70.716 ' TOTAL SQUARE MILES REGION 2: 38.000' �v 1. Total population of Texas: 2. Percentage of population of Texas in Region 2: ' _3. Total Number of Measles cases in 1989: :`4. Percentage of Texas Measles Cases in Region 2 in 1989: k5 :-S Percentage of pre-school children fully immunized at age 2: 58% n (Based on average of estimated immunization rates.) b.'Number of communities with retrospective study available: 6 { Sealth Care Providers/Project Collaborators Serving the Texas Panhandle and South Plainss 1. Texas Department of Health (TDH) Region 2 s 2. City of Lubbock Health Department � ` :3. Amarillo -Bi -City -County Health Department e 4. South Plains Health Providers S. Plainview Hale County Health Department 6. South Plains Public Health District 7. Lubbock Community Health Clinic S. Private Physicians THS TEXAS PANHANDLE AND SOUTH PLAINS ALL KIDS COUNT PROGRAM Application Narrative Description of Service Area: The South Plains and Panhandle region of Texas covers a land area Of approximately 38,000 square miles, which is 5,000 square miles more thanthat E P. -.contained in the combined states of New Hampshire, Vermont, Massachusetts, erode Island, and Connecticut. This vast region is predominantly grassland prairies and rangelands. The major industries of this region are ranch g, �' tara3nq, and oil and natural gas exploration. This area of Texas is one of this largest cotton producers in the United States. The population of this large region is three quarters of a million § le, only 46 of the entire 'poop y population of Texas. There are only two cit V. }- is the region which have populations close to 200,000, Lubbock and Amari to mjority of the region is composed of small towns and rural communit es -which are located 20 to 50 miles from one another. The average poverty ata the region is high, 266. 10 of the 20 poorest counties in Texas are located in this 41 county region. 236 of the region is Hispanic,•56 Afr "4'erican, and 726 is Anglo. In Lubbock, as in the remainder of the regi , ,,. the fastest growing segment of the population is the Hispanic population �r ,�lccordinq to the Comprehensive Housing Affordability Strategy (CHAS) recontly subaitted by the City of Lubbock, the annual population growth for the C y of xbbock is .56. The annual population growth for the Hispanic p populatio in ,, Lubbock is 3.56. The annual population growth for the African American casmuait is 1 26 y This large, poor, rural area is relatively underserved by physicians, "nurses, and other health professionals. Four of the forty-one counties ve no patient care physicians located within the county. 13 counties have 5 THE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM Texas Department of Health licensed hospital, while 13 additional counties have only one hospital with 50 or less licensed beds. Four counties have had r ms's_ one or more hospitals closed in the last decade. The majority of the_,. hospitals in the region are small (less than 50 beds) and have a low occ0pancy ' rate (average 41%). The major hospitals in Lubbock and Amarillo have beon { ,instrumental in keeping several small hospitals open by "adopting" the hospitals, helping both financially and with staffing. As an example, �� +ing T Aarch, 1992, the only physician at one small hospital was injured in an ','antosrobile accident. The associated Lubbock hospital provided a physics for small hospital until a temporary physician could be secured. It is Ibis 1the 1;' --cooperation among the medical entities in the Panhandle and South Plains which - .#asures the best possible medical coverage for the most people. „. With large areas of Region 2 designated as physician manpower shazi Age - Rs Y areas (see Table 2) much of the work involved with preventive medicine, l umluding the administration of immunizations, falls on the shoulders of the ` WM41 Department of Health _�. Departure Region 2 clinics. These clinics and their �.tellite clinics, primarily staffed by nurses acting under standing or s, or._srs located in 28 of the 41 counties. A large number of these clinics ax a R -�oftly open a few days each week or each month, which can create another barrier =:to service for the rural patient with inadequate transportation. Zommisation hate and Rate of Vaccine -Preventable Disease The rate of immunizations for the preschoolers in this region is <a ., difficult to pinpoint. The only immunization records in the region on computer are at the regional office of the Texas Department of Health. Tie '-%standard operating procedure for other clinics in the region is to file immunization records of the children in alphabetical order. As long astho 6 mom mom moomonlommu 'MEMO IF OFA I A m K111i��uuu N■ 1::Num� , lisuuu. .......... THE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM child is current in his/her immunizations, or until the age of five, the records are kept in a separate file according to the year of birth. Aftler the age of five, or whenever the record is determined to be delinquent, the record it filed alphabetically, but not by year of birth. A retrospective studir of current records, filed by year of birth, leads one to believe that the immunization rate for this region is relatively high (586). It must be poted, k:,now6ver, that the majority of the delinquent records could possibly havelbeen '�,Vurged from the current records, leading the investigator to a false #,. conclusion. At the current time, neither the state health department noi the � t= local health departments have the staff necessary to do an accurate retrospective survey, which would include searching the delinquent files for rr:#ppropriate records. In preparation for the grant proposal, the Texas Department of Health Region Z office conducted retrospective studies on two -year-olds in 6 0asmtunities in the region. The studies found immunization rates ranging from a low of 456 to a high of 706. In Lubbock a retrospective study of two- ar- olds is mized at the City Health Department found the immunization rate to be . The variance in these percentages may be due to the methods in whi the T records; are filed. The Lubbock Independent School District (L.I.S.D.) is in the process of c�on�tctinq a retrospective survey of the children in the school system. Bashe �t ,rTWeliudjwwy results of the survey indicate that many children do not r ve #heir immunizations at the appropriate times. In September of 1991, 61 students on all grade levels, out of a total student population of 31,000 enrolled in the school district, had no record of over having received anr ' inolunizations. According to the survey, 116 of the kindergarten children in 7 . 4. 4 TSE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM L.I.S.D. had not received their first immunization (either DPT or MMR) before their second birthday. As these random pieces of information indicate, at this point in time we do not have a time -efficient and cost-efficient means of tracking the roe of immunizations among preschoolers in the Panhandle and South Plains of T4as. -. The incidence of vaccine -preventable diseases in this region has ben ; high during the past several years, especially in proportion to our t P Po . IT population. In 1989 113 of all the measles cases in Texas were reported in ,..our region (335 out of 3313), which consists of only 43 of the population, of Texas. The City of Amarillo has experienced an outbreak of mumps in 199 with cases reported as of March 13. In 1991, Amarillo had no reported cas s of �- F_ . For fiscal y reported � year 1989-1990, the Cit of Lubbock re rted 342 incl ces<; x of measles alone, other vaccine -preventable diseases also reported incl 'pertussis and mumps. The Panhandle and South Plains region is an area of small commmites `which rely on each other for survival. There is a large amount of trave frog- �r eine community to the next. People shop in one town, meet in another, at . 3� aburch in another, recreate in another, visit friends and family in still _r0thW towns. most people in this region are quite used to driving 100 UJ108 ,tort& Saturday visit or shopping trip. Duringthe fall football seasons fan*,'' -fallow their high school teams all over the region to attend the games. ALWant farmworkers are a traditional part of life in the farming and ramahLng poswuaities. Many people follow the crops, spending a few weeks in one RI location thea moving on to another. This accepted mobility of the people in, the region effects both the immunization rates of local areas as well as he spread of vaccine -preventable disease. A family may have their infant vaccinated in the town where the child was born, then as the child grows lder 9L Q THE TLXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM the place of vaccination may change with each immunization. Without ad ate staff to follow the infants who have not completed their immunization series, `. most clinics must close the file and hope the child went to another location. Based on anecdotal evidence supplied by the immunization nurses, many ch�ldren a receive adequate immunizations from a variety of sources. There is not 3 t "system in place at this point in time to confirm that theory. E III. High Public Health Priority: t ;' The City of Lubbock Board of Health developed a five year plan to --M-address the current and future health needs in Lubbock. The first problem listed in the health plan under pediatric care is the lack of coordinat n oVr<,-'S. j existing services. Another priority listed in the top five priorities of the -; lddiatric Health Plan is the need to develop a system to monitor the iwounisation status of preschool children. A recommendation made by the Board of Health which links both of these needs is to develop a formal structui Vfor Rhe coordination of services, which would include the sharing of information - ,;by existing agencies to better monitor•the immunization status of the yotag Uhlld. The Texas Department of Health is currently proposing "Project Protect" -" R -which has a'goal "that every child in Texas be optimally protected against -.vaccine preventable diseases." This proposal is still in the draft stags but , It ang"sizes the importance which is placed on the immunization of 5 -preschoolers at the state and regional level. The All Rids Count Proj 4 dweloped in this proposal would enhance Project Protect if.it is implemomted an the state level. s l d - g: THS TEAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM I9. Available Resources: In the larger metropolitan areas of Lubbock and Amarillo, the local health departments provide the majority of the immunizations to children. In fiscal year 1990-1991, the City of Lubbock Health Department admini 46,165 immunizations to 14,485 individuals, the great majority of whom w young children. According to the Texas Department of Health, the Lubboc k7owaunity Health Clinic administered 18,000 doses of vaccine to children Lubbock, while the Texas Tech University Health Sciences Center Pediatri Clinic administered 5,600 doses of vaccine. As noted earlier, the Texas Department of Health Region 2 clinics provide many of the immunizations -to children in the rural areas of this region. In 1991 29,534 people were immunized in the TDH regional clinic with 49,384 doses of vaccine administered. •. Carreat Coordination of services The City of Lubbock Health Department, the Amarillo Si -City -County 8�alth Department, and the Texas Department of Health Region 2 have dew a history of cooperating when planning for the long term health care of patients in the region. In 1989-1990 Texas Tech University Health Scien Center conducted the West and South Texas HIV Services Planning Project .``rias funded by a grant from the Health Resources and Services Administrat the O.S. Public Health Service. This planning grant required the cooper, efforts of five major communities in Texas to produce a plan for serving infected individuals in our area. The cooperating communities included Lubbock, Amarillo, Harlingen, 31 Paso, and Odessa. The resultant plan t this planning grant is being implemented in both Amarillo and Lubbock. in • 10 in • THE TEXAS PANHANDLE AND SOUTH PLAINS ALL KIDS COUNT PROGRAM HIV planning grant also produced the model upon which the Texas Panhandl* and South Plains All Kids Count Project has been drafted. The success of this HIV Planning Grant in enlisting the cooperation of smaller communities in the region, in regards to HIV and AIDS, leads one to believe that even more cooperation can be expected when the topic in the noncontroversial one of early childhood immunizations. The City of Lubbock Health Department, the Amarillo Bi -Ci Health Department, and the Texas Department of Health Region 2 'Onchange a limited amount of information regarding patients and patient Using the TDR regional office as the intermediary, pregnancy information can be exchanged, as well as STD information, and other clin -.,lufamation. This system of exchanging information could be used in the of a system to exchange immunization information. All the c ,,'exchange organizational information, attend in -services with personnel ,:,.the different clinics, and model programs after programs at the other c The City of Lubbock has boon actively involved in the creation of "XndLgent Health care Coalition of Lubbock, along with agencies and fain both the private and public sectors of the community. Recently the "Indigent Health Care coalition of Lubbock incorporated and became the Commomity Health Center of Lubbock. This private/public partnership in making plans to most the health care and social service needs 4ndigent patients in Lubbock County. The combining of health care and �Yices under one umbrella organization will facilitate meeting the no individual client. The City of Lubbock Health Department has been involved in seeking funding for the Community Health center of Lubbock. The City of Lubbock currently houses two primary health care cl by the private nonprofit Guadalupe Economic Services corporation of L the Al of Aft THE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM GBSC . GESC operates a Homeless Primary unary Health Care Clinic and an Early Intervention Clinic for persons infected with HIV, both of which are fur4ded by the Health Resources and Services Administration of the U.S. Public Hea*h Service. These clinics are located at the City of Lubbock Health Departjaent:-*; and are staffed, through subcontract arrangement, either partially oren hely =by City of Lubbock staff. This cooperative effort between the City and ESC n has provided a much needed service for these special populations. r„.. `..YI. . Proposed Planning structure ,£ The proposed structure for developing a plan to better track the unisation status of young children is based on the model used to create the ,last and South Texas HIV Plan. The project director will be based in LuJobock.±' fl �� <1Eis/Her duties will include supervising the overall project; compiling ajA; pteparinq written summaries of the needs assessments, the care provider swrMs, and the brain-storming sessions; and preparing the referral b ;to be distributed in the region. The project director will also be ,,,responsible for writing the various drafts and, ultimately, the final sien 'of the plan. The project director will file the required reports and will saphrvise the remaining personnel. The outreach workers will each be assigned a section of the region to a$ ,assist in conducting the needs assessments, the health provider surveys, and ,ths brainstorming sessions. The outreach worker will be res ponsible for „:. key personnel in their section, for publicising the im 1,0ontacting project ” t?;eir assigned counties, and for assuring that their section's needs and � -strategies for solutions are covered in the final .draft. The project director and the outreach workers will divide each as on into smaller units from which the local planning teams will be derived. hese off YF sialler units may consist of a single city, a county, or a group of count t 12 THE TEXAS PANHANDLE AND SOUTH PLAINS ALL KIDS COUNT PROGRAM ORGANIZATIONAL FLOW CHART CITY OF LUBBOCK HEALTH DEPARTMENT PROJECT DIRECTOR SXCRZTART OUTREACH WORKER LUBBOCK I RMIOMM ADVISORY COMMITTEE I 13 OUTREACH WORKER AMARILLO LOCAL IMMUNIZATION TASK FORCES —SOUTH PLAINS a Aoi 'fiA- t THE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM .; In some areas we may ask the local council of governments (COG) to act as the smaller unit. These local task forces will be composed of local volunt"rs `i who are active in their community and have an interest in immunizing preschool children. The local task force will assist in distributing the needs 3 R assessments and the surveys of health care providers. They will plan B* _ E Conduct the brainstorming sessions. They will also be responsible -for encouraging community support for the plan and the implementation of the plana ' The local task forces will select representatives to be on the regLonal - Advisory Committee. The advisory committee will oversee the entire . �j x: They will compile the final plan and take it back to the local task forc s fooe`' approval. The advisory committee will be responsible for the evaluation phase of the planning project. VII. staffing: ,. The project director and the outreach workers will be recruited free the Lubbock (see Table 3) and Amarillo (see Table 4) communities. We believe that we can find individuals who believe in the project and who have previous writing and/or research experience. There are schools of nursing both in ;... tnbbock and in Canyon (a small town near Amarillo) which might have $1;l tudents/professors who would be interested in this project. Mary StranSe. 'Personal Health services Coordinator for the City of Lubbock Health r; -.:Depastment, will be responsible for supervising the Project Director. �..0trange will provide continuity to the planning project and to the „..:implementation phase of the project. Claudia Blackburn, the Director of Personal Health for the Amarillo Health Department will provide local jY supervision and pery guidance to the outreach worker in Amarillo. Judy v w Administrative Technician for the City of Lubbock Health Department, willbe 14 THE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM responsible for the financial management gement of the grant monies. Currently Ms. yHenderson is responsible for the more than $600,000 in grant monies received by the City of Lubbock Health Department from the Texas Department of Heialth. (see Appendix A for resumes) TABLE 3 i City of Lubbock, Medical and Osteopathic Clinics and Hospitals in Designated and Proposed HMSA eis Ave. °:: } Kent 4.01. {3A�;t:. Y .`��. • Y �•�. ��^.: �, - } - Jj:U'NM1F;•{%:'�V }Y;i.�:}f fi'{•.:•-•::ti �: T:i: :n�`C}`):ti'.Y' :J}v'�'vi�,{•;}^-•} :.J]i{:+y :�i: ;'Zs Y �' _ - � .�: n,.7�.,r ..;?r`•.{t{.:}!cn?' it�:y`3z�� }..• '',,.�•.,-�,'-••. j:}:i:••<:-"::. �f �Wa ?•:!•: �}C;::�' i>ii:��v^.�' � - h4 vvn : J:C 1 - .v �. 3 5 A°8 Y•ttt tt�k2 tt} r,} Y :Y: yy}: j� 4 tM - v. .• v 4th S[ 4.02 4A3 s= 19th St .Y4 - 17.02 16A1 6.02 IS 14 122J�Z <f -•; ' Y kF � :\ 4 -- •L' Y 34th St. ? Y #4a Y r ISAI 19.01 20 23 yr ' 17.43 v SOth Sc. e s I= V 19.03 21AI 22.01 r - i Y J IL04 289 19A4 21A2 22.02 > y bsx ' ,t„tt} } „ > itcu { 105.02 105.03 Proposed HMSA Tracts (1,6.01, 6.02, 7,13, 24) 98th Sc. .w HMSA Designated Tracts t m (2.01,2-02,3,8,9,10,11,12.01, 2M.251,-'; . im ® Medical or Osteopathic' or Hospital (refer to key, nex page) Nomxbv 1989 -1990 Southwestern Bdl Telephone Book by R&W A. Varnta, Arjun V. Gururaj, lily 1990 #7 is closed } #8 city Health ;N TABLE 4 91� 77 3•',�;i it g 10- I� Wr , '` 1",-1 i s as _m a v( W �, fg` W t , CC V W !t CJ, - ca o ca ci Go w a. s H - O 1 - cc W" : SLU 3 S x W C S N e p C3 W p Wr , '` 1",-1 i s THE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM VIII. GOALS AHD OBJECTIVES A. To create a region -wide network of agencies, which provide immunisations to patients, creating a formalized structure for sharing information, *'. coordinating services, and planning strategies to meet common needs. f To develop and conduct a survey in the Texas Department of Health �egion 2 which will determine the immunization rate of preschool childre in f r the region. To develop a comprehensive plan for the Texas Department of Health Region 2 which will result in an increase in the rate of inmunizat on of preschool children and in a decrease of vaccine -preventable diseas s when implemented. To investigate and evaluate possible computerized systems of monitoring the iamunization status of preschool children in the Texas Departaint of Health Region 2. To investigate and develop a plan enabling the care.providers in Region, who provide immunizations, access to the computerized syst4s, including development of a policy regarding confidentiality. To develop a formalized network of care providers which could face itate the distribution of primary health care to young children in the rigion, especially in the rural and medically underserved areas of the Tex Panhandle and South Plains. 16 TBE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM IX. WORK ACTIVITY PLAN TINELINE 1990/1991 Activity No De Ja Fe Ma Ap Ma Ju Ju Au Se Oc ------------------------ -- -- -- -- -- -- -- -- -- -- -- -- A. Region -wide Network 1. Recruit local task forces, xx xx xx 2. Convene local task forces. xx xx xx xx xx xx 3. Recruit advisory Committee. xx xx xx 4. Convene advisory Committee. ' D. Immunization survey re pmhonsive plan I. Conduct meds <: assessment 2. Health care provider iurwv. xxxx 3. Brainstorminv xx 17 ; Y THE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM WORK ACTIVITY PLAN TIMELINE 1990/1991 Activity No De Ja Fe Ma Ap Ma Ju Ju Au Se Oc ------------------------ -- -- -- -- -- -- -- -- -- -- -- -- S. Evaluate draft at local levels. xx 6. Modify and finalize r D. C mpaterised monitoring 1. Evaluate existing *. access to system 2. Develop plan for g' all agencies to access system. 2. Evaluate effectiveness of local task forces and regional advisory committee. xx WORK ACTIVITY PLAN TIMELINE 18 1 THE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM Z. WORK ACTIVITY PLAN A:1-2. A:3-4. C:2. Recruit multiple immunization task forces in the various communities and/or community groups in the Texas Department of Health Region 2 who would be responsible for conducting a needs assessment and�a survey of health care providers in their community. (Project Directors and Outreach Workers) �. Recruit -and convene an advisory committee composed of representiLtives from the various task forces across the region to guide the overall F project, provide input from their local efforts, and promote t e need for the project to their communities. (Project Director) Identify, evaluate, and utilize a gystem for conducting a surver to determine the immunization rate of preschool children in the rogion. (Project Director, Local Task Forces, Advisory Committee, outr Workers.) Develop and conduct a needs assessment in each local community 10 identify the target population, identify existing immunization services -and the means of improving access to these services, identify the existing methods of tracking and follow-up, and identify the service gaps and barriers. (Outreach Workers, Loc Task Forces) Develop and conduct a survey of health care providers which qi immunizations to preschool children to identify service gaps as barriers, to develop strategies to overcome the identified gapsand barriers, to identify current efforts towards coordinating service 20 THE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM provision, to identify service coordination gaps and barriers, and to develop strategies for overcoming the service coordination gaps and barriers. (Outreach Workers, Project Director) k C:3. Convene brain -storming sessions in each local community to dim the meds assessments and the provider surveys in order to cr more avenues of coordination and communication and to develop strategies which could be implemented in the overall plan. (0 Workers, Local Task Forces, Project Director) C:4-6. <.: 0 2 Based on immunization rates, needs assessments, provider suY brain -storming sessions create a comprehensive immunization preschool children which would ultimately increase the immu rate and decrease the'incidence of vaccine -preventable dise+ the Texas Department of Health Region 2. (Project Director, committee) and : for in sort', Identify existing immunization record-keeping systems currently in use in the region or in other areas of the state of Texas.(out Workers, Consultant) Determine how demographic and immunization information on all children under age 5 can be obtained, entered into a computer system, and updated regularly. (Project Director, Consultant) Determine how local birth information can be utilized to assist the tracking of preschool children for immunization purposes. (Project Director) 21 D:3 r:1. !s C TNN TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM Develop computer system/network which can be utilized by most providers in the region to access immunization records and to track patients as to immunization compliance. (Consultant) Establish confidentiality guidelines. (Project Director, Advisory Committee) Determine how to make computer records available to parents, serv: providers, and public officials (including school officials). tttt (Project Director, Advisory Committee, Consultant) Prepare and distribute a brochure detailing the available hea11 services for young children in the region, listing referral se eligibility guidelines, and other pertinent information. (Proj Director, Outreach Workers) Evaluate the effectiveness of the organization in regards to cr a plan for the region; expanding the focus, if successful, to < a regional children's health care network. (Project Director, Advisory Committee) Develop a financial plan for the implementation of the immunize plan at the end of the grant year. (Project Director, Advisory Committee) Develop a plan for institutionalizing the new system within state, regional, and local programs. (Project Director, Ad` Committee.) 22 Gr, v THE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM XII. Role of Consultants Dr. Audrey Kathleen Hennessey of Texas Tech University (see Appendix A) has agreed to consultant with the City of Lubbock Health Department on this project. Dr Hennessey has extensive experience designing computer syst�ms for private and public organizations. Currently Dr. Hennessey has been worling with the Lubbock Health Department has we have been attempting to computerize our immunization records. Dr. Hennessey and her staff developed a prog€z m for the records to be placed into a computer system. They have been working on developinq a program that would assist the City in producing the needed .reports, in tracking the patients.for compliance, and in producing foll up Letters for patients who are late in returning for their next immunizat n. Dr. Hennessey and her staff will be able to build on the work that they ve started at the Lubbock Health Department as they develop a similar progrus for the region. (see Appendix B for further information) ZXXX. Rvaluation: The planning grant will be evaluated in two ways. The project director and his/her supervisor will evaluate the timeliness of the mom of the activity measures listed previously. The project director and b supervisor will evaluate the quality of the needs assessment and the he care providers survey. The regional advisory committee and the local t forces will be responsible.for evaluating the viability of the final pl They will also be responsible for developing the resources to implement plan. Dr. Hennessey and her staff will be responsible for evaluating t; computer system. 23 phase. Again following the HIV planning model, it is imperative in rura( areas where there is not a large source of financial assistance that the local s resources currently in existence work to meet the largest part of the need. #. It will be important in the plan to address the issue of the needed su rt from current providers. It may be that much of the plan can be implemen ed ' with little additional funds. XV. Access to Priaari Health Care i An anticipated outcome of the cooperative effort which will be neeled to' produce a plan to monitor the immunization status of young children is a losaalized system of health care for young children in the Panhandle and South $lams of Texas. The health care providers who will be joining forces t .Assure that young children receive proper immunizations are the same ent ties z _.. . who provide primary care to children. It is possible that many of the activities needed to implement the plan will be the same activities need4d to coordinate other health concerns. The building of relationships whichw 11 =j corse from the work necessary to develop the plan, should enable the care • providers to cooperate more readily in the future. It is our goal that at the and of the planning year for the immunization project, we will have developed a plan that specifically addresses the immunization needs of young chil , as well as one that addresses the overall health care needs of children. 24 ,. THE TEXAS PANHANDLE AND SOUTH PLAINS ALL RIDS COUNT PROGRAM XXV. Future Funding The local task forces and the regional advisory committee will be responsible for developing a plan to provide the needed money to implement the"9 F' program. With the regional office of the state health department, the 30cal " health departments, and leading citizens involved in the planning phase pf the' -. #.. project, we believe that resources will be forthcoming for the im lemenk tion phase. Again following the HIV planning model, it is imperative in rura( areas where there is not a large source of financial assistance that the local s resources currently in existence work to meet the largest part of the need. #. It will be important in the plan to address the issue of the needed su rt from current providers. It may be that much of the plan can be implemen ed ' with little additional funds. XV. Access to Priaari Health Care i An anticipated outcome of the cooperative effort which will be neeled to' produce a plan to monitor the immunization status of young children is a losaalized system of health care for young children in the Panhandle and South $lams of Texas. The health care providers who will be joining forces t .Assure that young children receive proper immunizations are the same ent ties z _.. . who provide primary care to children. It is possible that many of the activities needed to implement the plan will be the same activities need4d to coordinate other health concerns. The building of relationships whichw 11 =j corse from the work necessary to develop the plan, should enable the care • providers to cooperate more readily in the future. It is our goal that at the and of the planning year for the immunization project, we will have developed a plan that specifically addresses the immunization needs of young chil , as well as one that addresses the overall health care needs of children. 24 ,. THE TEXAS PALE .SOUTH PLAINS ALL KIDS COUNT PaOGRAN A goal of the All Iia■ count Project is to produce a resource directory . y - �� \\ of children's health services in our region. This directory can be used an a -t referral guide for children's service provider■. The intent of the airkgtory = \ \ in to make children's health services more accessible to the family, - � - | - � in k'; 111. PROJECT STAFF TRAVEL IV. INDIRECT COSTS V. EQUIPMENT Vt. CONSULTANT HONORARIA VII. SUBCONTRACTS TOTAL 3,725 0 3,725 9,000 9,000 0 39,290 30,190 9,100 Man AM JIM THE TEXAS PANHANDLE AND SOUTH PLAINS ALL KIDS COUNT PROGRAM THE ROBERT WOOD JOHNSON FOUNDATION LINE ITEM BUDGET Grant Period: (from 11/01/92 to 10/31/93) Budget Period: (from 11/01/92 to 10/31/93) PROJECT YEAR I RWJF OTHER TOTAL SUPPORT SUPPORT! 1. PERSONNEL: Nam Position Base Satary %Tim N. Strange Pars. Health Ser. Coord. $44,000 10% 4,400 0 4,400 J. Henderson Administrative Technician $21,000 10% 2,100 0 2,100 To Be Hired Project Director $24,000 100% 24,000 24,000 To 8* Hired Outreach Worker (S. Plains) $21,000 50% 10,500 10,500 0 To Be Hired Secretary $14,200 100% 14,200 14,200 0 Fringe Benefits (Variable) 8,840 7,586 1,254 11. OFFICE OPERATIONS Suppl. i so 1,200 1,200 0 Printing 2,500 2,500 0 Duplicating 2,500 2,500 0 T*Lq*orw 3,400 3,400 0 Postage 1,200 1,200 0 Software 3,360 3,360 0 111. PROJECT STAFF TRAVEL IV. INDIRECT COSTS V. EQUIPMENT Vt. CONSULTANT HONORARIA VII. SUBCONTRACTS TOTAL 3,725 0 3,725 9,000 9,000 0 39,290 30,190 9,100 Man AM JIM BUDGET NARRATIVE Other Support: The funding in this column wilt be provided by the City of Lubbock Health Department. It ill primarily be in-kind funding consisting of personnel time and equipment (computers and off ce furniture). The Other Support listed in the Subcontract will be provided by the Amarillo i - City -County Health Department in the form of in-kind personnel time and equipment. I. Personnel: The Personal Health Services Coordinator will supervisethe project director, wilt ensurehat the project is complying with all City of Lubbock policies and procedures, and will offer er expertise to ensure the success of the project. The Administrative Assistant will be responsible for managing the budget, providing back - for all financial expenditures, producing the required financial reports, and operating th grant following all City of Lubbock financial policies and procedures.; I The Project Director wilt be accountable for planning, organizing, and directing the ` implementation and operations of the planning project. This person will be responsible for compiling and writing the final plan. He/She will develop and evaluate the needs t. and the patient surveys utilized in the field. The Project Director will supervise the tM half-time outreach workers and the secretary. The Project Director will coordinate the planning activities with the staff, the consultant and the volunteers from the local level The Project Director will organize a regional advisory committee comprised of individuals the local task forces. The Project Director will act as staff liaison to the regional t force as it develops a regional plan based an the local plans. The Outreach Worker will work in Lubbock and the surrounding counties of the South Plains Texas, coordinating with the Immunization providers in the region, holding local planning meetings, conducting local needs assessments and surveys of patients, and facilitating the dislogua between the different agencies and individuals in the region portieipating in the project. The Secretary wilt be responsible for clerical and data processing tasks. Ne/She will coordinate the schedules of the staff, be a consistent presence in the Lubbock office to e ewer inquiries, and type, duplicate and distribute surveys, reports, brochures, etc. Fringe Benefits: The fringe be efits provided by the City of Lubbock Health Department include Federal. Yithhoiding Tax, FICA, Workman's Compensation, life insurance, health insurance, dental insurance, and retirement for full-time equivalent staff members. The fringe was figured based on the following rates: Pere. Health Services Coordinator 18% rate for SM (In -Kind) Administrative Technician 22% rate for SW (In -Kind) Project Director 18% rate for $4320 Secretary 23% rate for MM TOTAL FRINGE$: 4 II. Office Operations: Supplies: The requested supply budget is $1,200 for the planning grant. This am" will b used for general office supplies for two and one/half full time equivalent staff positions. The rhaeded supplies include tape and tape disposers, stationary, paper clips, pens, pencil B bl` i� 6' Y rolodex cards, staplers, calendars, notepads, typewriter ribbons, computer paper, diskettes, and ribbons for printers Printing: The requested printing budget is $2,500 for the planning year. This money will cover the cost of -printing business cards and/or rotodex cards for the staff to distribut` to the toast volunteers in the region (approximately $500 for 2,000). The money would also ve the cost of printing an educational brochure, to be distributed region -wide, describing t project, the participating organizations and agencies, and the services available to pr ool children in the region ($2,000 for 5,000.) Duplicating: The requested duplicating budget is $2,500. This will include the cost of duplicating surveys, needs assessments, and drafts of the plan for all the volunteers throughout the region. The cost includes copy paper, toner, and dispersant for the copier Telephone: The requested telephone budget is $3,400. We are anticipating numerous tatephnies calls between the Lubbock staff and the Amarillo staff as well as to volunteers around the region. Based an previous phone bills for various telephone calls to other cities in the region, we are estimating a monthly phone bill of $280. Postage: The requested postage budget is $1,200. This money will be used to provide post go betreen the staff in Lubbock and Amarillo and between Lubbock and individual volunteers, well as postage to the Robert Wood Johnson Foundation. Software: The requested budget for software is $3,860. This will be used to purchase the aOn-Lina• software package used by the state of Texas and the local hospitals to electronically record birth certificates. This software package will enable the Lubbock Realth Department to incorporate the births, as recorded by the local hospitals, into an iamnizatian prospect list without the need for additional data entry, while still wintai ins confidsntiatity. III. Project Staff Travel: Local Travel: The requested budget for local travel is $12,630. W are defining local trivet ` as any trawl within the region which is cooperating in the planning project. This region covers spproucimshty 38,000 square miles. The outreach worker and the project director mal nod to spend the night an the road when contacting some of the local communities. We included hotel and a per diem in the local travel budget to cover this necessity. The tocal travel breakdown for the Lubbock staff is as fotlowsr Mileage ($.27 per mite X 2750 miles per month) _ $ 8,910 Rotel ($55 par night for 24 nights) _ $ 1,320 Per Diem ($25 per day for % days) _ $ 2,400 TOTAL $1 Mon -local Trawl: The requested budget for non -local travel is $2,920. This includes for two people to attend one national muting sponsored by the Robert Wood Johnsan Faundati for two nights and two days. It also includes two trips for one person in Tom, 'but outsi the region, to observe and assess other immunization programs. The Project Director will ewtuato these programs and make recommendations to the planning task force as to bowel s of thane programs could be implemented in our region. Thane trips wilt be one night trips. The non -local trawl breakdown is as follows: C National Trip ($1,140 X 2) S 2,280 In -State Air Fare ($240 X 2) S 480 Hotel ($55 X 2) $ 110 Per Dila (25 X 2) S 50 TOTAL S 920 IV. Indirect Costs: 9% time amount requested in items I through III. V. Equipment: The City of Lubbock Health Department will supply an IN Compatible Personal Computer and printer for use by the staff for this project. 4' VI. Consultant Honoraria: The requested budget amount for this category is $9,000. Dr. Kathleen Hemessay of Texas ed University will provide expertise in the field of computers and data processing. She will be examining the different hardware and software currently available at the participating , . agencies and will be making recomwandatione to the planning task force regarding the lk development of a computer network for accessing immunization records of children through the region. The $9,000 estimate is based on thirty (30) days/year at $300 per day. There _ will be no travel expense as she is based in Lubbock. VII. Subcontracts: See separate narrative. A i� D SUBCONTRACT WITH AMARILLO BI -CITY -COUNTY HEALTH DEPARTMENT LINE ITEM BUDGET Grant Period: (from 11/01/92 to 10/31/93) Budget Period: (from 11/01/92 to 10/31/93) PROJECT YEAR 1 I. PERSONNEL: Name Position Base Salary Vim C. Blackburn Dir. of Per. Health Services $40,000 5% To Be Nired Outreach Yorker (Panhandle) $21,000 SOX RYJF OTHER TOTAL SUPPORT SUPPORT 2.000 _ 0 10-500 10,500 440 __ 0 Fringe Benefits (22X) h II. OFFICE OPERATION: Supplies Y Duplicating .`' Telephone Postage Software III. PROJECT STAFF TRAVEL IV. INDIRECT COSTS ` V. EQUIPMENT TOTAL Y Kir, 53 F •_ i RYJF OTHER TOTAL SUPPORT SUPPORT 2.000 _ 0 10-500 10,500 440 __ 0 C SUBCONTRACT WITH AMARILLO BI -CITY -COUNTY HEALTH DEPARTMENT BUDGET NARRATIVE Introduction: The subcontract with the Amarillo Bi -City -County Health Department is a necessity due to gest area that this Brant proposes to bring together to plan a better way of tracking immunizations. It would be very difficult for an outreach worker based in Lubbock to effectively cover the entire Panhandle. Some of the towns in the Panhandle are more than six (6) hour drive from Lubbock. The distance would require the worker to spend more ti driving than meeting with people and developing a workable plan. Placing a worker in llo would cut most of the.troveling time in half, at least. We believe this would provide g ter cost effectiveness for the grant dotter. We have therefore developed a proposal which subcontracts the Panhandle outreach worker to the Amarillo Health Department. '} Other Support: The funding in this column will be provided by the Amsritto Bi -City -County Health Departme it in the form of in-kind personnel time and equipment (computers and office furniture). I. 'Personnel: The Director of Personal Health Services will supervise the outreach worker assigned to Panhandle Texas, of will ensure that the project is complying with all City of Amoritto policies and procedures, and will offer her expertise to ensure the success of the project The Outreach Worker will work in Amarillo and the surrounds ng counties of the PaMardle of Texas, coordinating with the immunization providers in the region, holding local planning meetings, conducting local needs assessments and surveys of patients, and facilitating the y� dialogue between the different agencies and individuals in the region eg participating in the project. The Panhandle of Texas is a larger geographical area than the South Plains of d Texas, although the population is roughly equivalent. This larger geographical area will �- necessitate that this worker will be traveling more and spending the night on the road am often than the outreach worker covering the South Plains. Fringe Benefits: The fringe benefits would be provided as in-kind by the Amarillo Health.Depertuent es the 3 outreach worker is a half-time position*. it. Office Operations: �-- . Supplies: The requested supply budget is $300 for the planning grant. This many wilt be used for gearal office supplies for the one/half full time equivalent staff position. needed supplies include tape and tape dispensers, stationary, paper clips, pas, pencils, rotodex cards staplers, calendars not computer paper, diakett . ten eq epode, typewriter ribbons, and ribbons for printers j Duplicating: The requested duplicating budget is $500. This will include the cost of duplicating surveys, needs assessments, and drafts of the plan for the Amarillo staff. The cost includes copy paper, toner, and dispersant for the copier. Telephone: The requested telephone budget is $1,600. We are anticipating numerous telephones calls between the Amarillo staff and the Lubbock staff as well as to volunteers around the region. Based on previous phone bills for various telephone colts to other cities in the region, we are estimating a monthly phone bill of $133. Postage: The requested postage budget is SM. This money will be used to provide postale between the staff in Amarillo and Lubbock and between Amarillo and individual volunteers. Software: The requested budget for software is 53,360. This will be used to purchase the =On -Line• software package used by the State of Texas and the local hospitals to electronically record birth certificates. This software package will enable the Amarillo ` Health Department to incorporate the births, as recorded by the local hospitals, into an ; iamnization prospect list without the need for additional data entry, while still enintailning confidentiality. The remaining $500 will be used to purchase a word processing package tfiet g:= is compatible to the one used by the City of Lubbock. 111. Project Staff Travel: Local Travel: The requested budget for local travel is $12,630. We are defining local t a any travel within the region which is cooperating in the planning project. This region covers approximately 38,000 square mites. The outreach worker may deed to spend the night an the road when contacting sor of the local co mmnitia. We included hotel and a per diem n the local trawl budget to cover this necessity. The local travel breakdown for the Mari to staff is as follow: Nilage (s.27 per site X 2750 miles per month) = 5 8,910 Motet 055 par night for 24 nights) = 5 1,320 Per Diem (SM par day for 96 days) 5 2,400 TOTAL 51 Iv. Indirect Costs: Sit time mount requested in items I through III to be provided as in-kind by the Ammritl+ City -County Nalth Department. Y. Equipment: The Amorilto Nealth Department will supply an IN Compatible Personal Computer and prints use by the staff for this project. El. S i L �s • R � t e� APPIMIB A REBUXES Y A^ •y f 4 iyfJ "ems r as � I� C RESUME �- MARY M. STRANGE 7906 KNOXVILLE AVENUE LUBBOCK, TEXAS 79423 ( 806) 793-3517 LL SUMMARY: Administrator -- Plans, coordinates and directs personnel f And programs for the Personal Health Services Section of the ",'City of Lubbock Health Department. Includes verbal and writt n communication in budget preparation and implementation; emplo 9e :*valuations; coordination with other sections and departments short and long term program planning; and development of goal , Dbj.ectives and outcome measures. Practitioner -- Experience as a Registered Nurse in pediatrics, obstetrics/gynecology, nursing education, ambulatory ''clinics, public health, and administration. Military Service -- Served in progressively more responsi le positions as Head Nurse, Nursing Supervisor, and Chief Nurse f rit 300 bed Station Hospital. Current rank of Colonel. .BDUCATIONAL EXPERIENCE; �'r r University of Kansas, Lawrence, Kansas B. S. , Nursing - 1968 K' Certified. Nurse Administrator, American Nurses, Association h. January 1, 1988 - December 31, 1992 Graduate studies in Economics, Accounting Texas Tech University, Lubbock Texas . WORK EXPERIENCE: 1/80 to Present City of Lubbock Health Department Lubbock, Texas Clinic Supervisor (80-82) . Section Coordinator (82 - Present): As Clinic Supervisor, had direct supervisory responsibility for 15 employees; provided direct patient care; planned and prepared short and long term goals for clinical programs; and participated in budget preparation. Was promot d in April, 1982. A-1 Poa As Coordinator for Personal Health Services, I oversee all operations of this Section. Develop plans for clinical and home health services; direct utilization of personnel; develop and Y: implement an annual $835,000 City budget; provide direct supervision for 8 program supervisors; advise the Health Department Administrator about clinical and home health services, and the impact of adding, changing and deleting services; and represent the Section and the Health Departmentp for private and public groups desiring information. I currently manage a $400,000 contract with Texas Department � of Health; and clinical services and statistical reports for two -t different grants totaling $560,000. 2/77 - 12/79 Texas Tech University Health Sciences Center Lubbock, Texas Staff Nurse: Position was in an ambulatory OB-Gyn gout -patient clinic. Prepared patients for physical exams and `s.peeial tests: conducted preliminary interviews to obtain hea history; assisted physicians with the patient. 1/75.- 9/77 Saginaw County Department of Health Saginaw, Michigan Special Programs Supervisor: Planned, directed, '..;coordinated and evaluated programs and employees offering �Sout-patient clinical services in prenatal care, pediatrics, I- physical screening of children (EPSDT) , family planning and Nutrition counseling (WIC). Services were provided at 6 'different clinical sites, inter -city as well as rural. Provi i=i8tatistical. and budgetary data to my immediate supervisor, wh were used to develop short and long term goals and objectives end the annual budget. 9/74 to 12/75 Staff Nurse: _assessment and direct Central Michigan District Health Dept Mt. Pleasant, Michigan Provided education, evaluation, care services as a Public Health Nurse. 5/72 to 6/74 Mercywood Hospital bx Ann Arbor, Michigan Head Nurse: Administered medications for patients on a closed male psychiatric ward; ataff in patient care. and counseling directed ward 8/69 to 4/72 Newman Hospital School of Nursing Emporia, Kansas Medical -Surgical Instructor: Provided didactic and clinical instruction to diploma nursing students; in respirat4 ndocrine and nervous systems, and in nursing leadership. A-2ti, nth ted eh pry �R Practice, 1989. United Way of Lubbock Agency Volunteer of the Year for 1939. PUBLICATION: "The Dichotomy of the Nurse Manager," Texas Nurse, July, ' qw\ resume A-3 s�t 8/68 to 7/69 St. Francis Hospital Wichita, Kansas Staff Nurse: Administered direct patient care for pediatric patients four years and younger. Supervised 1-4 nurses' aides. y' HONORS/AWARDS: Sigma Theta Tau, Delta Chapter, 1968 to present. Board Member and Chairperson, South Plains.Chapter of the, American Red Cross, 1986 to present. Cooperating Clinician, Texas Tech University School of �1Nursing. Member, American Nurses Association. *- City of Lubbock Representative, Leadership Lubbock, class of 1986. Steering Committee, Leadership Lubbock, 1986-87. Winner of the AJN/TNA Excellence in Writing Competition, 1984. Listed in Who's Who in American Nursing, 1984, 1988, 1990 Listed in National Registry of Certified Nurses in Advanced Practice, 1989. United Way of Lubbock Agency Volunteer of the Year for 1939. PUBLICATION: "The Dichotomy of the Nurse Manager," Texas Nurse, July, ' qw\ resume A-3 s�t VITAE it^, IL f s Claudia Blackburn, R.N.C., M.P.H Director of Nursing Amarillo Bi -City -County Health Department EDUCATION 1977 B.S.N. University of Connecticut,. Storrs, CT 1984 M.P.H. University of Texas School of Public Health, Houston, TX 1985 Women's Health Care Nurse Practitioner University of Texas Health Sciences Center, Da TX J!ROFESSIONAL EXPERIENCE 1977-78 Staff Nurse: General Surgery, Ben Taub General Hosp Houston, Texas 1978-82 Public Health Nurse/Clinic Manager, Harris County H Department, Houston, Texas 1982-83 Nurse Consultant: Intercare Corporation, Houston, 1983 Clinical Research Nurse: Texas Clinical Research Ce Houston, Texas 1983-84 Head Nurse: Internal Medicine/Surgery Clinic, Texas Tech Health Sciences Center, Amarillo, 1984-10- `986 Prenatal Nurse Coordinator: Amarillo Bi -City -C Health Department, Amarillo, Texas 10 -86 - Present Director of Nursing: Amarillo Bi -City County H Department, Amarillo, Texas 1989- Priwasant Adiunt-t Prnfdatmanr A+ Went Tovse Ctntn Ilr�iver�Q�*.. PUBLICATIONS 1984 A Needs Assessment of Obstetrical Services in Re Texas (Master's Thesis) A-4 � z las, tal. alth PROFESSIONAL ORGANIZATIONS American Public Health Association . Texas Public Health Association - Section Council 1988 - Pre0ent .Texas Perinatal Association - State Advisory Board 1984-1986' High Plains Perinatal Association - President 1986-1988 ;. American Nurses' Association Sigma Theta Tau =rr' NAACOG American Nurses' Association Texas Nurses' Association - Amarillo RN PAC - Chairperson X89 - Present Panhandle Aids Su g Support Organization - Board of Directors 198 -90 d� Texas Board of Health State Primary Care Advisory Committee - 989- present, currently Vice -Chair i,,�Amarillo Women's Network CERTIFICATION JNAACOG - Women's Health Care Nurse Practitioner, 1986-presen Recognized by the Board of Nurse Examiners for the state of exas -as an Advanced Nurse Practitioner SPECIAL ACHIEVEMENTS Recognized by Texas Nurses Association, Region II, as Mi f<Child Health Nurse of the Year - 1985 " Subinvestigator - "Low -Dose Oral Interferon (IFN) in HIV-1 :;-positive individuals and contacts", Amarillo Bi -City -County Dept., 1987-1991 Vice -chair of the Texas Public Health Association West :`Regional Meeting 1990 Presented Sexually Transmitted Diseases/AIDs in Women for I Issues Course, West Texas State University, 1990 oordinated the development of the Health Plan for Amarillo ity-County Health Dept. published in "The Best of the E ®rformance-Based Contract Objectives and Monitoring and Evalua lane", texas Department of Health, Community Health Services, A-5 �.. ro- a th' 9n' s < Bi - Set : tion 1991. Judy Henderson 3408 60th Street Lubbock, Texas 79413 Enlovs►ent Experience December 1979 - Present Lubbock City Health Department P.O. Box 2548 Lubbock, Texas 79408 Administrative Technician I ,, March, 1970 - July, 1978 Dictaphone Sales Agency 1620 13th Street �=- Lubbock, Texas. 79401 Co-owner August, 1967 -March, 1970 Texas Employment Commission 1625 16th Street Lubbock, Texas 79401-' `'. Employment Interviewer October, 1963 - May, 1966 Kansas State Welfare Division Kansas Department of WelfarG Topeka, Kansas .. §y Quality Control Worker ;. August, 1959 - October, 1963 Sedgwick County Welfare Sedgwick County Courthouse Wichita, Kansas 'k .z Social Worker 1956 - 1959 Wichita State University Bachelor .>' Psychologyz Snecial shills monitoring of grants including overseeing expenditures, keeping accur e submitting vouchers for reimbursement, completing quarterly and ammo .:' reconciling expenditures and revenues with City of Lubbock Accounting, , General Ledger and arrange for the receipt of applicable reports from Payroll. A A-6 3 �4 r Audrey Kathleen Hennessey Information Systems and Quantitative Sciences ter' College of Business Administration} Texas Tech University (806) 742-1609 i` EDUCATION: ' -Ph.D., Systems, University of Lancaster, UO; HSA (B) University of Toronto, (CanadaBA, Stanford University. dor, Institute for Studies of Organizational Automation, Associate Professor in tion ins, College of Business Administration, Texas Tech University and Coordinator of of ice Programs in Heath Computing and Knowledge -Based Systems, Texas Tern Uri to present aSate Professor of Computer Science, College of Engineering, Texas Tech University. 1986 i er in Computation, University of Manchester Institute of Science and TechnologyI UX). ' 1962 N Leftrer in Data Processing, John Dalton College of Technology, Manchester Pol ?. 1970-1980 Wer in Office Systems, Salford College of Technology. Manchester (U.K.). 1970 CONSULTANCIES AND INDUSTRIAL RESEARCH PROJECTS: 'etas Advanced Technology Program, automated visual inspection (continuation); US. Navy Knowledge -Based Image , ge-Based ge Analysis; U.S. Department of Education, minority • Opecakr Services, data communication; Electroglasand Xerox Corp., automated Sun Microsystems, Beta testing of Sun COBOL compiler; Lubbock Ares database; Texas Advanced Technology Program, automated visual inspection turn British Airways Engineering �.K.), production control; Trustee State Bank, (U.X), system' ys (U.K.), on-line reservations; British Mail Order (U.K), on -lite Teens Instruments, user interface design and software testing; Xerox Corporations Hewlett-Packard, network database design, IBM, graphical V,d k system and facilities scheduling; Digital Equipment Corporation, user ase package; Commodore Systems, educational computing; U.S. Navy, education Vital Law Bnfomcement Training Center, on-line test management system. BARQi INTERESTS: Sys; Analysis and Design Techniques; Open Systems; Document i i # rPuter-based System Design; Office and Factory Automation, Medical InformationSYS u IRCH GRANT: ccs ATP, 1991, $396,200. U.S. Navy Space Systems, 1991, $100,000. U.S. v `- tion,1991, $24,000. Texas ATP Minority Supplementary, 1990, $24,000; Operator 0, $10,000 Xerox Corp., 1990, $10,000. Electroglas,1990, $126,000. Sun Microsystems, 990, Criswell Leasing Inc., 1969,$2,M. Texas ATP, 1989,$394,000. Texas ATP, 1988, Lubbock Area Foundation, 1988, $5,000. Texas Instruments, 1982-83,1984,1987-8, bc&radon,1989-5, $99,000. Texas ATP, 1987,$34,000. Furr's Supermarkets, 1980, Law Training Center, 1986,$11,000. Computer System Services, 1966,$30,=. Corporation, 1985, $92,000. 3 � u: A-7 C A. Kathleen Hennessey 2 .. PATENT APPLICATION (PENDING): Optical Recognition of Distorted on a Noisy Background (filed with Texas Instruments, _ Texas); Knowledge-based Measurement of Interlayer Registration (filed with Texas Ins :` Lubbock, Texas), Automated Visual Alignment (filed with Industrial Scientific Office Auto Lubbock, Texas). PROFESSIONAL ASSOCIATIONS: . IBBB Computer Society, Association for Computing Machinery, Data Processing Managernent Association, Society of Manufacturing Engineers, Phi Beta Delta. 4 'NONORSIAWARDS: Halliburton Award for Excellence in Teaching and Research, 19m; Data Processing ° Aiwo iation Distinguished Information Sciences Award,1991; cited in Foremost Women 1985; International Book of Honor, 2nd ed,1985. Notable Women of Texas. l 196g► ' _ ]Wgs Who in Education 1981-1985. Who's Who: Women of the World,1 lii.._ of Whos Who of American omen 1991. American Men and K= Mof World Wide. Platinum Edition 1992 g , .,,S$LEC= RECENT PUBLICATIONS/WORKING PAPER: }.' 'Knowledge -Based Image Analysis in Symbolic Space, (with Y. Lin), Techmml RedW- LI, =Han gM $ b= and David Sarnoff Laboratory, January 1992* :4 'Graphical User Interface using Query by Graph for Grammar Generation in Au CV11mal Inspection,'t (with Y. Lin, W. Wong, eal), Technical Report to Texas Instruments. Jarruary 992. '150 8613 Office Document Architecture/A Multidimensional Architecture for Frye ' tion of User View of the � , � Enterprise Knowledge -Base; DPMA SIGAI Newsletter, K X591. .. 'lmplem ODA within the X400 protocols, AIA E -Mail Panal Meeting Dallas, 1anting 4� 1991. F ` : 'Automated Visual Inspection' (with K S. Hahn and Y. Lin), Conference on Semiconductor Manufactudng,199o. 'Expert System in Error Recovery of Syntactic Pattern Recognition; (with Y. Lin), ; Studies of QMHORMNal Automation Working Ell Series (LSOAWPS) No. %-W,1 " 'Knowledge Acquisition for Expert Visual Systems, (with S. Unrein and D. 'y joint National Meeting. Las Vegas NV, 1990. . 'A Fuzzy Grammar for Representation of Imprecise Expert Knowledge: (with XS,N' National M Las Vegas NV, 1990:' - 'Preprocessing and Parse Table Generation of a CAI based Image Grammar,' (with Rpt► R G. icon), 6th Annual Conference on the Advancement of Women in Higher Education. e R University Lubbock TX, 1990.* y' 'Distributed Immunization Database Records for Pediatric Clinics in Lubbock„' ( L ,urja. and P. Randolph), ft Annual Conference on the AdrArWement of Women in Texas Tech University Lubbock TX, 1990. 'An Artificial Intelligence Based System Dynamic Rescheduling of iVlanuiacturir►g Processes', First ASME International Con erence on 46ndecturine,1989. 'Direct Acquisition of Expert Knowledge for Semiconductor Inspection' Vapwuver,1989.* *patent application in prq amfiWpaWing A--8 A. Kathleen Hennessey 'Automated Knowledge Acquisition for Visual Inspection Systems' (with L. M Catanich and K S. Hahn), ISOAWPS No.1,1989.* 'Image Parsing of Context -Free Fuzzy Grammar for Automated Visual Inspection' Usmani, K S. Hahn), ISOAWPS 4-1989.* 'Image Primitives and a Sample Image Grammar for Automated Visual Inspectic K S. Hahn), ISO,_ 5-1989.* 'Automatic Generation of an Image Parser' (with K S. Hahn), ISOAWPS 81989.* 'Symbolic Image Decomposition' (with Y. L. Lin and P. Randolph), LSO_ AWPS la 'Low -Cost Medical Document Interchange; ORSA/TIMS Toint National Meeting L '.'NV, 1988. d 'The Gamma Network as a Neural Net Interconnection Structure', (with B.T. Fart 1�� IEEE -Conference on Neural Nets 1987. 'OSIWEY: An Open Systems Task Distribution Protocol' (with T. Wey), Pr nal Conte on Circuits and Systems 1987. 'L IUS 1-2-3 Macro for Artificial Intelligence Applications' ORSA/mc St. Louis I 1987. 'A 3X3 Bidirectional Crossbar Switch for the Gamma Network' (with B: Fa . $ WQ= IBBB Region V Conference 1987. A1,19G66. pal Document Interchange' (with KS. Hahn), ORSA/TIMS International M 'The Gamma Network An Electronic Circuit as a Data Structures (with J. Wab .�... .�L-- _! •L _ SMI lwww w � � _ `A Microcomputer Based Laboratory Information System' (with L. A. Robert, r% Y. s),1 arna1 of MiMOCOMytiter APP 1985. 'A Biologically -Based Approach to Information System Modeling' 1985 WE200M and Qd=290. Conferi x. 'Proximity -Based Delineation of Browsing Clusters in the ICD9-CM Ordered ' oo ba ' (with J. Walrath et al.), in Proceedines of the 1985 IEEE Can&rpnro m, Unn _ Q—# - 'A *mdaheet-Based Information System for the Laboratory Scientist, ' (with S, Roberts) in Proceedings of the 27th Annual 5MROMM�Mpaxug&UM in bledidne and on Alia 1984 'Medical Diagnosis Coding by Microcomputer' (with P. Randolph in Pte' *Patent aPPlicatiaa in preparation/pending f A-9 i 3 S. l ith FL (with n& i� 89 , APPENDIX B Knowledge-Based Systems Research Laboratory S The Knowledge-Based Systems Research Laboratory (KBSRL) is a unique entity #� housed in the College of Business Administration under the Information Systeir s and Quantitative Sciences Area. The Laboratory is involved in research on open systems interconnection automated curriculum anal ysis museum science, geosciences,ical -information systems, industrial automation and electrical/industrial engineeri rig in t `19611aboration with faculty and students throughout the campus. Additional facili ' and equipment are made available on loan by researchers in these areas to meet sh term .. `needs of the Laboratory's research projects. The Laboratory is administered titute for Studies of Organizational Automation which coordinates =the' ' .SYStems research programs at Texas Tech and other institutions, operates a vi' 'ting ' program, administers interdisciplinary Master'see ams � programs, gn' an R#udtistrial internship program, and publishes a Working Paper Series in Inf tion r F y Facilities in the Knowledge-Based Systems Research Laboratory (a 1000 sq area ;th fully furnished accommodation for 12 research assistants). Hardware the ` aborrtbory includes: a Sun 3/26 with 16Mb memory and 280W hard disk, a Sun 470 M 16Mb memory and 680Mb hard disk and TAAC accelerator board, a Sun 4/ (Z56 #?} RISC workstation), two Sun 3/80s with 16Mb memory, four 80486-33 p stations with 4 Mb RAM, 135 Mb hard drive, Image Capture Targa Board b menory); two 386SX desktops and one 386SX laptop (80386SX processor with ' eaory 100Mb hard drive, 1.2Mb floppy disk), four ATs (80286 processor with a 40Mb hard disk, and 12Mb floppy disk), three XTs with 30Mb hard di a VT 220 terminal, a DEC Rainbow with 1OMb hard drive, a Sentry 2000tical 'k Benner, Computer eyes digitizer with camera, 16 Televideo 950 terminals, :I.arnbs Microzoom Microscope with manual prober unit Model MPO001, _ 7 Station Model 2001 Voice Mail System, A-W Pro' � Y . Sharp Q lection Panel, TC /FAX %W baud, and Data Translation color and monochrome image ° with RGB and monochrome monitors. All desktop computers, JoHnnsand ninals are linked on a LAN in the Laboratory using XWindoiws as well as to the Jniversity's main network and to Telnet. Printers include Apple LaserWilter w .Panasonic KX P4455 Postscript laser printer, Xerox 4045 Laser Printer and four _ � Deskjet 500x. Packard =; r rlf . B-1 Software available in the KBSRL includes: Operating Systems SunOS Uniyy, MS-DOS 2.0, 3.1 and 3.2; PC MOS -386; Unix V; Xenix V; System; and Concurrent PC -DOS Compilers Turbo C, Turbo C++, PASCAL, UCSD PASCAL, Prolog, Sidekick, Toolbox, InterLISP D, Turbo Halo, Golden Common LISP, .Microsoft C, FORTRA] COBOL with development aids, Microsoft BASIC, Microfocus COBOL 14 (Enhanced Technology), Microsoft Assembler, and MANX C. Communication Kermit, Smartcom, ProComm, PC -Talk and Fast Wire Link. Texas Tech: University Network Services to DEC VAX 11 /750, 11/780, 8650, IBM ,: and Telnet, XWindows. Ait�ed Prt�cessors/Editors WordPerfect ver 4.2, 5.0 and 5.1, EasyWriter II, Visiword, Samna, Write, Peachtext 5000, PowerEdit, Qedit and Emacs. Lotus 1-2-3, Multiplan, VisiCalc, Peachcalc, Reflex, Enable, SuperCalc 3� Quattro Pro 4.0. -�iabases ' dBASE III, ZIM entity -relation database, PC -BOSS, and Paradox rul AutoCAD, Graphwrite, Dr. Logo and BPI Business Graphics i B-2 and 3 Packages Microsoft Windows, CARO Integrated Accounting Package, Fr ork, Desgview, PC -Paintbrush, Turbo Lightning, BPI General Accountin BPI Accounts Payable, BPI Accounts Receivable, Market Analyzer, Ventura Pu lisher and Savvy PC Expert system and SPSS/PC+. 4GIS Object Vision, Texas Instruments IEF. There is also an extensive library of C function modules. Z A 2800 -volume technical reference library on artificial intelligence,Y` engineering,knowledge bases, image processing, graphics, office and ind ', automation data communication and medical information systems supports. vourse work and research; the library is also available to provide technical assis and advice about information systems. The College of Business Administration's Computer Learning Center has i own VAX Cluster computer system and microcomputer laboratories. The College ' a m connected to the University's Central Computing Facilities, which include direct :,-.1D the IBM -3081, VAX 11/780 and 8650 systems. A local. area network, ajob 3' station, and substantial numbers of computer terminals provide access fo E 3`# dlifwm In addition, a large library software packages, including SAS, SM., `P56 IIT GRES, SEED, MODEL, IFPS, and LOTUS. ART and others, is a i� student and faculty use. .fig history for last five (5) years: Advanced Technology Progr rim. AM1993 $396,200 Automated Visual Insvection: Defect Analvsis and Prnd Prototype p-W&1AIY WZ-14 0 - - M" . Overator Services, Inc., Lubbock TX: 1990 $10,000 Scholarships and data communication internship �t State of Texas Advanced Technology Suppl_taa Prog—am for Minority Si 1940 $24,000 The award is the largest in the University g sity for support of one graduate student involves participation in the Institute's advanced technology 1990 $10,000 Prober Station for Automated Visual Inspection image capture $140,000 Prober Station for Automated Visual Inspection system $12,000 Beta Testing of SUN COBOL Compiler, Software grant AM WM Med Te logy Proaa ".96-1991 $394,000 Automated Visual Inspection of VLSI wafers using syntactic eesentation of images (Continuation). Y4111 •_• 1 • •1 a a. Zz`_i'f:��•1'!it•..r�i�•11��1•1• •'•'N" 111 Pediatric Document •r indigent clinics in Lubbock i Advanced Technol �,,, Prov 1990 $320,000 Automated visual inspection of VLSI wafers using syntactic sentation of images. B-4 r Texas Instruments. Lubbock IA; 1988 $7500 Conversion of VLSI Manufacturing front-end schedule simulato=06 'DOS) to C(MVS-150) environment; provision of evaluation program in C tor' s otoapo ndence of simulation to actual front-end performance data. F ' Inc.: s fig= `19V $5000 Database for Furr's Supermarket Warehouse in aNi (MS-DOS) �asavaaw.cu ictiluwit7� rpt rogam• $34,000 Artificial intelligence -based Dynamic Scheduling System VLSI adoring in LISP (MS-DOS). s_r_�nvrauynI DSn L J1eQp_ UA• $12,500 Conversion of PROMIS+REQ system into Austec, Microsoft, and focus {MS-DOS and UNDO) COBOL: re -coding and implementation. B-5 .� �.y:a.. . . . .. APPENDIX c LETTERS OP SUPPORT April y9,v1992 Item f23 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 aut' razed and directed to execute for and on behalf of the City of Lubbock a G nt Appl 5etween the City of Lubb k and t i, Georgia, for the "All ids icking, attached herewit which '.ouncil and as spread up the and be a part of this R olutioru day of April im , City of Lubbock 1902 Texas Avenue P.O. Box 2548 ock. Taxes 79408-9961 April 10, 1992 William H. Foege, MD Executive Director Task Force for Child Survival and Development The Carter Center One Copenhill Atlanta, Georgia 30307 Dear Dr. Foege: Health DepArtment As chairman of the City of Lubbock Board of Health I am pleased to wr T' this letter endorsing the Health Department's proposal to the Robert Wood Johnson Foundation for the All Kids Count Program. We at the Ci of Lubbock are committed to the good health of all the residents in o community. When it comes to our attention that such a vital need as ionization of preschoolers is not being adequately addressed, we as Board of Health feel responsible for enacting a new solution_ ;,. The City of Lubbock also has a responsibility to assist our nei.ghbori communities with preventive health care when it is possible. Lubbock currently serves as the medical center for this area of the state. M people came to our city for primary, secondary, and tertiary health care. The Texas Panhandle and South Plains All Kids Count Project gi, the City of Lubbock Health Department the opportunity to facilitate << preventive health services to young children in the surrounding rural cow. sties at. the same time we are providing these benefits to local children. The Board of Health believes that we must take the lead in this and in similar projects to ensure the health of the citizens in I community. The City of Lubbock Board of Health is committed to the immunization monitoring planning project outlined in this proposal. We are also committed to implementing the resultant plan. The Board of Health of the City of Lubbock will take a leadership role in the development of plan and of a method of implementation of the plan. Sinter , =Greg trrHn--Chaff bbock Board of Health to Texas Department of Health Public Health Region 2 "37Commissioner A. MacLean, M.D. 1109 Kemper Lubbock, Texas 79403 (806) 7443577 Fax: (806) 741-1366 April 7, 1992 William H. Foege, M.D. Executive Director Task Force for Child Survival and Development The Carter Center One Copenhill Atlanta, Georgia 30307 Dear Dr. Foege: ` The Texas Department of Health Region 2 office has long been a leader in w this area of Texas when it comes to preventive health care. We provi e the majority of the immunizations to preschool children in the rural areas of our region. We recognize that access to the clinics can be difficult for many families. We also realize that the current monito - ing.system is inadequate, in that we do not have easy access to the immunization records of the other public health clinics in the region and to the records of the private physicians in our area. This lack cf information sharing can lead to under utilization of services as well as to duplication of services. An integrated system of accessing immuni a- tion records would greatly improve the services we offer the children in x, our region. <; The Texas Department of Health Region 2 supports the Texas Panhandle 4nd �} South Plains All Kids County Project submitted to the Robert Wood Johnson Foundation for possible funding by the City of Lubbock Health Department. We are pleased to observe that this project has created r, interest in continued cooperation among health care providers in the community. We believe that the planning that will go into this project can only serve to enhance the total health services provided in our region to both children and adults. Texas Department of Health Regio .` 2 will cooperate in this planning project.. We will provide representj3 tives to the local task force and to the regional advisory committee. '. Eventually we will be able to provide convenient locations in which tte plan can be implemented. We will provide input as to what we are currently doing in monitoring the children we immunized. 't Sincerely, Jame Keith Morgan, M.D. X.. Pub is Health Regional Director lic Health Region 2 f :DLW:rmb C-3 g 7. d Lubbock ,fir April 7, 1992 CACI W ' William H. Foege, MD Executive Director Task Force for Child Survival and Development The Carter Center One Copenhill Atlanta, Georgia 30307 ' Dear Dr. Foege: ' The Community Health Center of Lubbock is a newly incorporated nonprofit entity in Lubbock, Texas whic striving to provide more adequate health service to one indigent population of our community. The vast majc our indigent population is medically underserved 7" The Community Health Center of Lubbock is dedicated providing preventive health care as well as primary care to this population. The high incidence of vacc preventable disease in this community, as well as tb current inadequate method of monitoring the immuniza status of preschool children requires that we as a c cooperate in solving these problems. The Community Center of Lubbock supports the Texas Panhandle and 8 Plains All Kids Count Project and will cooperate in planning project if funded. We will provide repress to the local task force and to the regional advisory committee, if needed. Eventually we will be able to one convenient location in which the plan can be implemented. The Community Health Center of Lubbock hopes that the Wood Johnson will look favorably at funding this neer project. sincerely, C-4 123 North Avom N, Lubbock, Trrxas 79401 Y k - tr, (808)786-"75 s ty t i TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER Sciooi of Medidnc Depar=wt of Pediatrics Lubbock, Tans 79430 (806) 743-2310 April 7, 1992 Robert Wood Johnson Foundation The Task Force for Child Survival and Development " One Copenhill Atlanta, Georgia 30307 .,' RE: LETTER OF SUPPORT FOR PROPOSED LUBBOCK HEALTH DEPARTMENT z PROJECT: ALL RIDS COUNT Having reviewed the objectives of the proposal by the Lubbock Health :0epartment, I fully support the objective of this project to insure that all :- preschool children are able to obtain current immunizations in a timely And ,efficient manner. Such a communiy wide system should be maintained with demographic and immunization data on all children in the target area prior to -:--starting school. ` Int is hoped that such a project will develop educational material which may '-,'Zieve a widespread usefullness. In addition, a mobile immunization van, ihich is one eventual objectives of this program, would provide, not only immunizations to underserved areas where there is lack of access in transportation, but also to screen young children to identify developmental ,;problems prior to starting school. Previous studies, in this area, have shown that children attending community clinics have nearly a 50% rate of deficiency .on their immunization numbers or proper timing of immunizations. . I consider this a worthwhile project to support. I am willing to serve as a representative on the Advisory Committee. My chairman, Dr. Chappell, also is in support of such a pp project. Sincerely, F Wallace W. Marsh, M.D. V `Associate Professor a . Department of Pediatrics/Microbiology WWM/bb A £ °s ' C-5 .; Apx4 0 Acauo kmmtutiam ¢� April 6, 1992 Robert Wood Johnson Foundation { The Task Force for Child Survival and Development One Copenhill Atlanta, Georgia 30307 Dear Foundation Members: This letter demonstrates support of the Lubbock Health Department in itsl proposal, All Rids Count. I know that the purpose of this project is to! ensure that all pre-school children have a current immunization status. Clearly, there is a need for such a project. Immunizations are of critical concern everywhere, but especially in West Y.?4was. The migration to this area provides a constantly changing popula Couple this factor with the impact of healthy children or ill children i *tura and it is evident that this project is critical. The School of NU _f ¢'is so committed to this endeavor that we intend to have someone from they pool serve on the advisory committee. The Lubbock Health Department has been instrumental in numerous endeavo Telated to communicable diseases including pre-school immunization acts -Ibrpugh a strong affiliation with the Health Department, our students c eantribute to this project. -With pleasure, we endorse the Lubbock Health Department's submission of grant and hope that we can continue to provide on-going support for the Department in general and in this project specifically. =� Sftr8erely, ro Patricia S. Yoder Wise, R.N., C., Ed.D., C.N.A.A. Interim Dean SYecutive Associate Dean and Professor PSYW/sc An Air Athan Iaumniam C-6 on. the sing `e &F March of Dimes Birth Defects Foundation Northwest Texas Chapter 2345 -50th Street #109 Lubbock, Texas 79412 (806) 797-6771 April 8, 1992 Healthier Babies Robert Wood Johnson Foundation The Task Force for Child Survival and Development One Copenhill Atlanta, Georgia 30307 Dear Sirs, The Northwest Texas Chapter of the March of Dimes glad endorses and recommends support for the All Rids Coun project, developed by the Lubbock Health Department. T mission*of the March of Dimes is healthy babies and th prevention of birth defects. Education and loving concern are the tools used by the of Dimes in our struggle to complete this mission. Th educating process, designed to promote prenatal and ne care, must be extended to early childhood. Our health will become our healthy preschoolers only if consisten to educate parents and the children themselves are mai. Proper immunization and immunization records are imper that end. The March of Dimes office will .gladly provide a repres to serve on the advisory committee. Any input of a he that the March of Dimes might provide, will be extends Northwest Texas Chapter will take into consideration a all future support of the grant, beyond the first year Education, the process of teaching and learning should unending. A program of such a noble nature, the All R project, must be provided the financing to be brouht i. infancy, and strongly supported thereafter in its grow maturation. The Northwest Texas Chapter of the March e will proudly support this birth. You s in healthier babies, Rim Ring Chapter Director { _ Research - Education - Medical Care - The Salk Institute C-7 ►bout of -- .tivt'_' nta. P&I y be ds to h f ID Y. r i GUADALUPE �\G E S C ECONOMIC SERVIC15S CORPORATION April 7, 1992 William H. Foege, MD Executive Director Task -Force for Child Survival and Development The Carter Center, z One Copenhill Atlanta, GA 30307 Dear Dr. Foege: Guadalupe Economic Services Corporation (GESC) supports the grant request made by the City of Lubbock Health Department to the Robert Wood Johnson Foundation. GESC is a private non-profit organization in Lubbock, Texas which primarily serves the minority population of our community. We work with special populations such as migrant farm workers, homeless and HIV-infected individuals. GESC operates two clinics at the City Health Department and knows how successful the Health Department has been in 'reaching their goals and objectives. We also are aware of the difficulties our clientele have in accessing medical care, including immunizations. Our farm workers often do not stay in town long enough to complete an immunization series on their young children. It is easy to lose records when traveling as they do. Many of the young children receive duplicate immunizations because they cannot prove they have been immunized before. Other parents do not have the means to access the proper medical care for their children; therefore, these children receive no immunizations. Guadalupe Economic Services Corporation wil cooperate in this planning project if funded. We will provide representatives to the local task force and to the regional advisory committee, if needed. Eventually we will be able to provide one convenient location in which the pla can be implemented. We will provide input to the planning process regarding our special needs populations and will ,,,,:,process when the plan is implemented, to assure that these populations are using the system. �x Sincerely, Richard Lopez Executive Director C-8 1416 First Street • Lubbock, Texas 79401 (806) 744-4416 Y r Y" Equal Opportunity Employer • Lubbocl fI tHealth Commu (806) 763-5906 102 AVENUE J LUBBOCK, TEXAS 7940 i I-OR:1IERLY LUBBOCK WELL BA, S � . , April 8, 1992 liam H. Foege, M.D. `cutive Director ' Force for Child Survival and Development Carter Center .Copenhill nta, Georgia 30307 r Dr. Foege bock Community Health Clinic, formerly Lubbock Children's Hea pi.c, is one of the largest providers of immunizations to pres �dren in our area. From personal experience we know that man plot receive their immunizations on a timely basis. The reaso se delays are varied, need to be investigated, and possible s a`to be identified and acted upon. ock Community Health Clinic has long tried to educate its cl rding the necessity of following the proper immunizations sc of funds and staff have prevented the tracking of our effor that reason, and for the improved health of the children in unity, that Lubbock Community Health Clinic supports the gra I�y the City of Lubbock Health Department to the Robert Wood dation. I aded, Lubbock Community Health Clinic will provide represent local task force and the regional advisory committee. Additi rill provide statistical information and will gladly be a test ag the implementation phase. Lubbock Community Health Clinic ingly committed to the success of this project. ZeSinrely, A +Y nn S. Shapley Executive Director W #�V of the Plains Hospital, United Supermarkets, The United Way of Lubbock Un 7 lty ,- nic Y CLINIC d S <., h ool childrl for utions: nts du l e I V" r rest ohns` site is to " Affiliated with Texas State Department of Health Tenth k Ash Streets — Box 1738 PLAINVIEW. TEXAS 79073 April 6, 1992 Robert Wood Johnson Foundation The Task Force for Child Survival and Development One Copenhill Atlanta, Georiga 30307 Dear Sir: We are in support of the Lubbock Health Department' All Kids Count grant proposal. It is important that we immunize pre-school childre as early as possible to prevent the cause of Vaccin preventable illnesses we still see in'our pre-schoo population. Ann Mc Adams, R.N., of our staff, will be pleased ti - work with the Advisory Committee to identify the tai - get population and to define, imporve and implement ways to provide Preventive Health Care Services, be- ginning with immunizations, to an underserved popula- tion. We appreciate the opportunity to work more cohesive in the coming years. Sincerely, Mar '�2�/esdale R.N., B. S.N. Health Program Specialist I Administrator/Nursing Supervisor C-10 Nancy Haney Administrative Assistant City of Lubbock Health Dept. P.O. Box 2548 f 1902 Texas Avenue Lubbock, TX 79408 March 30, 1992 Dear his. Haney, The Amarillo Bi -City -County Health Dept. strongly- supports he Cite of Lubbock's "Ail Kids Count" proposal to the Robert Wood Jolinso Foundation. The importance of improving the pr -schoo immunization rate in rural Region II cannot be stressed enough. W see it as an indicator of the general health and well-being of thi+ hard to reach population and the first line of def nse 16 preventing developmental disabilities. The Amarillo Bi -City -County Health Dept. is willing to house supervise an outreach worker who will cover the Panhandle o Tex the upper portion of Public Health Region II. Staff with e. ,pert in conducting needs assessments, health planning and c alit building will be available to advise and support the. worker. Office space and the use of a computer willjutre, lso provided. Thank you for including the Amarillo Bi -City County -Health ptthis proposal. Please do not hesitate to call if you need1;�ur th information. Sincerely-, Robert. C rson, M.P.H. Public Health Administrator C-11 PHONE (806)" 378-3000 • AMABILI.Q, TzX ` T.` RECEIVED 3 0 199 March 20, 1992 William H. Foege, MD ' Executive Director. Task Force for Child Survival and Development -The Carter Center One Copenhill QQ AlUanta, Georgia 30307 ' t J, c➢Dear Dr. Foege: � ,"With a population of 734,138 and a square mileage of appproximately 38,CDO, rAegion 2 of the Texas Department of Health is as large as several stats. ' # tis region consists primarily of rural counties, with only one county in the sYagion having a population of over 200,000. There are over 58,000 childr in .;the region under four years of age. The vast majority of these children are s dically underserved. d` my county, we have a population of 23,967, with 27 physicians to s ! 'phis population. Preventive health care, whether a priority with indivi s 'Or not, is not convenient. I believe that immunizing children is import Mt the residents of my county are in agreement with me. At this point in t; tia�s, we do not have an adequate tracking system for pre-school children to ptirmine their immunization status. Our efforts have primarily focused on #4exuring that school -aged children have been immunized. Dine we are or have recently experienced outbreaks of both mumps and me es `iu our region, our children have been or will be exposed to these dissas Sven though we are a rural area, our citizens travel widely in the regi -_.People from this area of Texas often drive two or three hours to a 1 er r towtt to shop, eat, and relax. Many of our residents are related to otter _46milies in other towns in the region, whom they visit regularly. Y tidrezr, therefore, need. to be protected from the vaccine-preventA 3le eases which occur anywhere in our region. , It is time to begin this focus on g• prevention in this younger group.. a =, #,:+county of Gray will pledge to participate in this planning grant. We w 11 And someone to represent us on theplanning task force. We will cooperate in the effort to determine the true statistics. We will evaluate the poss le 'solutions to the reporting and tracking problems, and will strive to fi a solution that we can implement. Y. Sincerely, r4 Ir r' -�' �-� • C-12 r „ .il, mom" s. KNOX, M.D. Director *4 1hains ]Jublir Xealt4 Vistrirt P.O. BOX 112 :-: 919 EAST MAIN Probinfielb, `texas 79318 FY HOCKLEY COUNTY GAINES COUNTY YOAKUM COUNTY :9331 LEVELLAND, TEXAS 79336 SEMINOLE, TEXAS 79360 DENVER CITY, TEXAS 79323 I 1212 HOUSTON P.O. BOX 1713 - 704 HOBBS HWY. P.O. BOX 315 PHONE 694-4045 PHONE 756-2212 PHONE 592-2706 PLEASE REPLY TO: April 2, 1992 To Whom It May Concern: `The purpose of this letter is to show South Plains Public Health District's support for the'Texas Department of Health Region 02's application for funds to improve immunization services in our area. South Plains Public Health District ( SPPHD) is a five county, seven `city rural public health district in West Texas. SPPHD will work with TDH Region 02 personnel in any activities which will improve immunizations among high risk groups in our mutual service area. We strongly encourage funding of their proposal. 'Sinc rely, �rris S. Knox, M. D. Medical Director SPPHD F` MSK/db C-13 TERRY' COUINTY BRFIELD. TEX/1s P.O. X 112-91• PHON 637-2164 Texas Department of Health Bernstein, M.D., F.A.C.P. A. MacLean, M.D. onal Services L Miller Commissioner meet and Administration >30, 1992 Public Health Region 2 n H. Foege, M.D. ve Director Wce for Child Survival and Development r er Center Georgia 30307 Foege: F James Keith." i Regional Direct tion of 734,138 and a square mileage of approximately 38,000, -`Z of the Texas Department of Health is as large as several states. on consists primarily of rural counties, with only one county in having a population of over 200,000. There are over 58,000 in the i region under four years of age. The vast majority of these are medically underserved. Ons county, the population is 3295 with no physicians serving this ion. In Motley county, the population is 1965 with one physician r=;phis population. In Ring County, the population is 503 with no MS serving this population. Preventative health care, whether a -Y,--with individuals or not, is not convenient. I believe that immunizing n is important and the residents of these counties are in agreement At this point in time, we do not have an adequatetracking system Ochool children to determine their inmiaunization.status. Our efforts trily focused on ensuring that school -aged children have been ad. 0eVxe or have recently experienced outbreaks of both mumps and measles region, our children have been or will be exposed to these diseases. K,tugh we are a rural area, our citizens travel widely in the region. 9mm this area of Texas often drive two or three hours to a larger town -� gat, and relax. Many of our residents are related to other families � gowns in the region, whom they visit regularly. Our children, therefore °)fie protected from the vaccine -preventable diseases which occur anywhere kegion. C-14 �_r z William H. Foege, M.D. page 2 March 30, 1992 y`"R It is time to begin this focus on prevention in this younger group. The . counties of 'ckens, Motley, and King will pledge to participate in this planning g nt. We will send someone to represent us on the planning task force. will cooperate in the effort to determine the true statistics. will luate the possible solutions to the reporting and tracking problems_ and will s rive to find a solution that we can implement. yr4 idler, D.O. Support Person iunizations C-15 APPENDIX D CERTIFICATION OF PUBLIC STATUS PART I CHARTER* Chapter One g [BASIC CHARTERt] Art. L In General, if 1-4 herein established, or may hereafter be established, shall be a body politic, incorporated une Art. II. General Powers, #11-25 ArL II -A. Street Improvements, if 1-2 . °; 'Art. III. Judicial, if 1-10 approve Charter amendments. Amendment No. 7 was adopted and reads as follows: "All sectioO ArL IV. Initiative; Referendum; Recall, § § 1, 2 Art. V. Taxation Generally, if 1-4 ; Ark VL Occupation Taxes; Licenses, If 1-7 { a = ArL VIL Finance Generally, If 1-9 t. Art. VIIL fonds, 111-5 .: ArL IX. Council; Elections; Administration, if 1-31: . Ark X. City Manager, ;;1-7 '. ArL XI. Legal Status, ¢ f 1-6 ment election, hek. May 7, 1988. The electorate approved propositions 1-3, 5, 6, 8-11, reflected in the Resolution and Order passed by council on May 26, 1988. Such amendmen ARTICLE I. [IN GENERAL] paragraph, and the Charter Comparative Table on page 101 lists the disposition of See. 1. Corporate name. The City of Lubbock, Lubbock County, Texas, as the boundaries and limits of said City al a } herein established, or may hereafter be established, shall be a body politic, incorporated une s and known by the name and style of the "City of Lubbock," with such powers, rights and duties hereinafter provided. . °; 'Editor's note—Ord. No. 4247, § 1 ordered a special election on December 27, 1917, „ : approve Charter amendments. Amendment No. 7 was adopted and reads as follows: "All sectioO - of the Charter of the City of Lubbock which refer or have reference to and now read 'Ci Commission,' 'Commission,' 'Commissioner,' 'Commissioners,' be amended to hereafter.. y 'City Council,' 'Council; 'Councilman,' and 'Councilmen,' respectively. The term 'Councilmen N < and 'Councilman' shall include females, who shall be known as'Councilwomen' or'Councilwom an.' "The changes necessitated by said amendment have been made. References in the Charter to the "corporation court" and the "recorder" should be read "municipal court" and "judge" respec tively, pursuant to VTCS Art. 1194 et seq., and particularly Art.1200gg. Catchlines for .: sections in the Charter have been placed on one line for purposes of clarity, consistency with the Code ot Ordinances and space saving. Also, for the same purposes, a dash [—] in a Charter catchline been changed to a semicolon (J. _ tEditor's note—Ord. No. 9175, adopted Feb. 25, 1988, called a special charter amend ment election, hek. May 7, 1988. The electorate approved propositions 1-3, 5, 6, 8-11, reflected in the Resolution and Order passed by council on May 26, 1988. Such amendmen are included herein, indicated by a history note to the date of election following each aff paragraph, and the Charter Comparative Table on page 101 lists the disposition of amendatory material. Supp. No. 15 r, D-1 , Ch. 1, Art. I, 12 LUBBOCK CODE See. 2. Boundaries. The boundaries and limits of said corporation shall be as follows: Beginning at the .- corner of SurveyNo. 1, Block "O " which is also the southeast corner of Survey No. 79 B � Y " f _. � Thence north 165 feet along the east line of said Survey No. 79; Thence west on a line with, and 165 feet north of the south line of said Survey No. 79, a distance of 2129.25 fee the east line of the Sanders Addition to the City of Lubbock; Thence north alon�t the east line said Sanders Addition a distance of 1037 feet to the northeast corner of the said Sanders Ad ' ' Thence west along the north line of the Sanders Addition and Acuff Heights Addition to City of Lubbock, a distance of 1639.75 feet to the northwest corner of said Acuff Heights which point is in the east line of the Wm. Tubbs Addition to the City of Lubbock; 16W&, r r.. along the east line of the said Wm. Tubbs Addition, a distance of 1438 feet to the northeast of said Wm. Tubbs Addition; which point is in the north line of Survey No. 79, Block "A;" west along the north line of said Survey No. 79, and the center line of Survey 19, Block A," a - _ distance of 6791 feet to the west line of said Survey No. 19; Thence south along the west of said Survey No. 19, Survey No. 2, Block "O;" and Survey No. 9, Block "B," a distance of fist _ ' to the southwest corner of Block 100 in McCrummen's 2nd Addition to the City of Thence east following the south lines of Blocks 100 and 95, and the center line of 5th Street said McCrummen's Addition, a distance of 5280 feet to the east lines of said Survey No, 9, B ~ which is also the line of Survey No. 7, Block "B;" Thence south along the west line of said Na 7 a distance of 1263 feet to the centei line of said Survey No. 7• Thence eastalong the } line of said Survey No. 7, and the center line of Survey No. 5, Block "O," a distance of fiat~ <E __ Thence north on a line parallel with and 1200 feet east of the west line of said Survey No. 5, v "O," and the west line of Survey No. 3, Block "O," a distance of 3696 feet to a point dna the == -i northeast corner of Block 4 in Wheelock's 1st Addition to the City of Lubbock; Thence 376 feet to the northeast corner of said Block 4 in Wheelock's ist Addition; Thence north the F, east line of said Wheelock's Addition a distance of 3606 feet to the northeast corner of !8 m the said Wheelock's Addition; Thence west along the north lino of said Block 18 in few Wheelock's Addition a distance of 825 feet to the northwest corner of said Block 18, which ' t is , y�t in the west line of Survey 3, Block "O," and the east line of Survey 1, Block "O;" Thence 9 t: along the east line of said Survey No. 1, Block "O," a distance of 470 feet to the place of Sea 3. Extension of boundaries. ¢ The limits of said Corporation may be hereafter extended by adding additional territ NY to the same in the manner provided in the Municipal Annexation Act [Vernon's Ann. Civ. S Art: 970x]. Editor's note—The following ordinances which changed the city boundary are on file n the office of the city secretary -treasurer. - ' Ord. No. Date Ord. No. Date 2533 9-11-58 6517 12.14-72 2535 9-11-58 6596 4-26.73 2536 9-11-58 6631 5-10-73 ` 2544 9-11-58 7310 9-9-76 Al 2545 9-11-58 7340 10-14-76 ;. 6201 10-28-71 7361 11-18-76 app. No. 15 . 2 D-2 s CHARTER Ch. 1, Art.- H, § 1 7504 8-11-77 7903 8-23-79 7667 12- 8-77 7991 2-14-80 7747 10-12-78 8025 4-10-80 7900 8-23-79 8074 8-14-80 Amendment note—The above section 3 was amended by the electors at a special elects held January 24, 1967 (effective February 9, 1967) to read as set out above. Prior to said section provided for the extension -of the corporation limits whenever the majority of qualified electors of the territory to be added indicated a desire to be included within the limits the corporation in ..is manner provided in Article 781, Chapter 1, Title 22 of the Revised Ci Statutes of the state. Sea 3A. [Repealed.] Editor's note—Section 3A, providing for alteration and extension of the boundary limits the City Council, was repealed by the electors at a special election held January 24,1967. Sec. 4. Platting of property. Should any property lying within or adjacent to the city limits, as established by tb Charter, be hereafter platted into blocks and lots, the owners of said property shall plat a3 Jay the same off to conform to the streets and alleys abutting on same, and shall file with tl City of Lubbock a correct map thereof, and such act or acts performed by said owner or owns of such land is and shall be considered the vote of such owner or owners to place such laic within the city limits of said City of Lubbock, under this Charter and all its requirement provided, that in no case shall the City of Lubbock be required to pay for any of said streets+ alleys, at whatever date opened, but when opened by reason of the platting of said property, , whatever date platted, they shall become, by such act, the property of the City of Lubbock, fi use as a public highway. (As amended May 7, 1988) ARTICLE II. [GENERAL POWERS] Sea 1. Corporate powers generally. The City of Lubbock, made a body politic and corporate by the legal adoption of this Charts shall have perpetual succession, may use a common seal, may sue and be sued, may contract al be contracted with, plead and be impleaded in all courts and places and in all matters whatsv, may take, hold and purchase lands and any character of lands, within or without the city limits may be needed for the corporate purposes of said city and may sell any real estate or person property owned by it; perform and render all public services and when deemed expedient, in condemn property for corporate use, and hold, managb and control the same, and shall be subie to all the duties and obligations now pertaining to or incumbent upon said city as a corporatie not in conflict with the provisions of this Charter, and shall enjoy all the rights, immunitim powers, privileges and franchises now possessed by said City and herein conferred and granted. 3 D-3 C 'A Ch. 1, Art. V, $ 1 LUBBOCK CODE ARTICLE V. [TAXATION GENERALLY*] Sec. 1. Levies, etc„ when taxes to be levied; amount. It shall be the duty of the governing authorities at the first regular meeting in Marc and every year to levy such ad valorem and occupation taxes as may be necessary to i expenses of the City government for the current year; provided, however, that failure to taxes at such meeting shall not prevent the same being levied at any subsequent meeth authorities; and, provided, further, that if the governing authorities shall fail or neglect tax ordinance for any one year, levying the taxes for that year, that the tax ordinance Is will be considered in force, and the failure to pass such ordinance shall in nowise inval collection of the tax. Sea 2. City may foreclose lien against any taxpayer. The tax levied by the governing authorities is hereby declared to be a lien, c encumbrance upon the property on which the tax is due, not only as against any resin State, but entitled to enforce and foreclose in any court having jurisdiction of the san lien, charge and encumbrance on the property in favor of the City for the amount of to such property is such as to give the State courts jurisdiction to enforce and foreclose s the property on which the tax is due, not only as against any resident of this State, but s persons who are nonresidents of this State, or whose residence is unknown, and a unknown heirs of any person who owns the property on which the tax is due. Sec. 3. All property not specially exempted subject to taxation. All property, real, personal or mixed, except as may be hereinafter expressly exe subject to taxation, and the same shall be rendered and listed in the manner prescrib general laws in regard to general State taxation, when applicable. The definition of prq terms, as defined by the general laws under the head: "Taxation' and what is subject to as prescrib- i, by the general laws of the State, shall apply to the taxation of this City. shall be payable at the office of the Assessor and Collector, and no demand by hin necessary or requisite to enforce the collection thereof by any proceedings herein presa for any taxes due before the adoption of this Charter. State law reference—Definitions relating to property taxes, VTCA Tax Code § Sea 4. Remedies to collect taxes. The City of Lubbock shall have all other remedies for the levy and collection of cit are given by the Constitution and Statute of Texas to State and County for the levy and of state and county taxes. (As amended April 1, 1930) State law reference—Tax collections and remedies, VTCA Tax Code, Title 1, seq. 'State law reference—Property Tax Code, VTCA Tax Code § 1.01 et seq. Supp. Na 15 22 D-4 of each ver the VT SU& ; of ssiid peas a passed date the rp ane# t� l Iiat�es boas ia�t tll� =�x 31 a: CHARTER Ch. 1, Art. 1X, 1.22 Sec. 18. Publication of ordinances. All ordinances carrying a penalty shall be published once a week for two consecutive weeks some newspaper regularly published in the City of Lubbock, and no such ordinance shall e effective until ten (10) days after the date of its last publication, provided that eine measures shall take effect according to their terms. Sea 19. Recording of ordinances. Every ordinance, or resolution, upon its becoming effective, shall be recorded in a nently bound book kept for that purpose and shall be authenticated by the signature of the e or presiding member of the Council, and the person exercising the duties of City Secretary. f Sea 20. Investigations by Council. The Council may investigate the financial transactions of any officer or department of t City government and the acts and conduct of any official or employee. In conducting su investigation, the Council may compel the attendance of witnesses, the production of books a papers, and other evidence, and for that purpose may issue subpoenas or attachments on whi shall be signed by the Mayor—if the Mayor should be under investigation, then by the Mayor P Ten —or in the absence of both the Mayor and Mayor Pro Tem, then by the Councilman next order according to his numerical standing, and which may be executed and served by any offic authorized by law to serve subpoenas or other process, or any peace officer of the City. If a witness shall refuse to appear or to testify to any facts within his knowledge, or to produce a papers or books in his possession or under his control, relating to the matter under invsstigab before the Council, the Council shall have the power to cause the witness to be punted as i contempt, not to exceed a fine of One Hundred Dollars ($100.00) and three days confinement the City prison. No witness shall be excused from testifying, touching his knowledge of the matt under investigation in any such inquiry, but such testimony shall not be used against him in 0 criminal prosecution except for perjury committed upon such inquiry. Sec. 21. Contracts for services. No contract shall ever be made which binds the City to pay for personal services to rendered for any stated period of time, but all officers and' employees of the City, other than Mayor and Councilmen, shall be appointed and shall be subject to peremptory discharge as in t Charter provided Sea 22. Creation and consoUdation of departments. The City Council shall create and consolidate such appointive offices as [and] may divide the administration of the City affairs into such departments, as it may deem advisable, and may discontinue any such appointive officers or departments at its discretion, except the office of City Manager. (As amended Nov. 7,1961) Annotation—The commission, under this section, having the power to consolidate the offices of secretary and collector and to assign the duties to one person, and having, by long course of dealing, recognized the authority of the accused to act as collector, was not, precluded from', SOW Na 15 31 D-5 CHARTER Sec. 6. - Governing body's relations with city manager. Ch. 1, Art. )I, 14 The governing body and each of its members shall hold the City Manager responsible proper administration of all affairs of the City, but neither the governing body nor any be commission.created by it, nor any members thereof, shall dictate the appointment of any to or his removal from office or employment within the City, or in any manner interfere appointment of officers and employees in the departments of the administrative service vee the City Manager by this Charter. Except for the purpose of inquiry, the governing body i members shall deal with the administrative service solely through the City Manager, and 1 the governing body nor any member thereof shall give orders to any subordinate of th Manager either publicly or privately. Sec. 7. Nepotism; city manager. No person related within the second degree by affinity or within the third degree by a guinity, to the City Manager, shall be appointed to any official position, clerkship or service City. ARTICLE XI. [LEGAL STATUS] Sec. 1. Construction; home rule provision. All powers vested in cities of exceeding One Thousand (1,000) population by the provisi Title 22, or other provisions of the Revised Statutes are hereby retained and are cumulative powers vested by.this Charter in the City of Lubbock, and the enumeration of the powers m this Charter shall never be construed to preclude -by implication or otherwise, the City exercising all the powers incident to the enjoyment of local self-government and from doh and all things not inhibited by the Constitution -and laws of the State of Texas. rthe rd or I the ®d in d its ither City See. 2 Ratification of ordinances. All ordinances and resolutions in force at the time of the taking effect of this Charte, not inconsistent with its provisions, shall continue in force until amended or repealed. Sec. 3. Amendments to Charter. This Charter, after adoption, may be amended in accordance with provisions of an Act the Thirty-third Legislature of the State of Texas, entitled, "An Act Authorizing Cities Having ore Than 5000 Inhabitants, by a Majority Vote of the Qualified Voters of Said City, at an Held for That Purpose, to Adopt and Amend Their Charter, etc." [VTCS Art. 1165 st .j approved April 7th, 1913, and any acts amendatory thereof. Sec. 4. Savings clause. Should any provision or portion of this Charter be declared unconstitutional by theof this State, the remainder thereof shall be unimpaired by such holding and shall be in full ores and effect until amended or repealed, as herein provided. i 37 D-6 Ch. 1, Art. XI, § 5 LUBBOCK CODE Sea 5. Past elections. If this Charter shall fail of adoption at which the Charter is submitted as herein this shall be regarded as a rejection of the Charter, or if a majority of the votes cast at s e are in favor of the Charter it will then be the duty of the qualified electors of the City of to vote for and elect a Mayor, Councilman No. 1, Councilman No. 2, Councilman N 3, and Councilman No. 4, as provided for by this Charter, at the regular municipal election to b held in the City of Lubbock on the first Tuesday of April, 1918, and on said day every two yesn thereafter. i Sea 6. Designation of governing body. Upon their qualification, such Mayor and Council shall be and constitute thek9tion oder and authority of the City of Lubbock and shall thereafter administer its affairs tba provisions of this Charter, provided, that the present officers at the regular m held on the first Tuesday in April, 1917, may, if they so desire, hold and retain their re pectivis offices and enjoy the emoluments thereof as now provided, until the expiration of said of office in April, A.D. 1919, subject, however, to all of the provisions of this Charter and all ordinances � id resolutions hereafter passed and adopted under its provisions. [The next p 38 D-7 .vv [The next p 38 D-7 e CHARTER Chapter Two [REFERENDUM; RECORD] Ch. 2, Art. I, 14 Art. I. In General, 1-4 ARTICLE I. [IN GENERAL] k Sec. 1. Vote on proposed Charter, Charter committee instructions. f This Charter shall be submitted to the qualified votersof the City of Lubbock for sodlopt ionor '. rejection on the 27th day of December, 1917. �A. Sea 2 Form of ballot; 1917 election. 3" It is hereby prescribed that the form of ballot for use in such election shall be as foW m, to wit: FOR THE ADOPTION OF THE CHARTER: AGAINST THE ADOPTION OF .:, CHARTER. Sec. S. Election; 1917. The present City Council shall call such election, and same shall be coed ucted. the Y returns made and result declared as provided by the laws of the State of Tens x. municipal elections, and in case a majority of the votes cast at such election shall be in favor tai Charter, then an official order shall be entered upon the records of said City by the City :. Lubbock, declaring the same adopted, in case said Charter shall receive a majority in favor c f the s, adoption thereof at such election. Sea 4. Record of Charter. The City Secretary shall record, at length, upon the records of the City, in a permanently bound book to be kept in his office for such purpose, this Charter if adoptedat ' election, and such Secre tary shall furnish to the. Mayor a copy of such Charter as. authenticated by his signature and the seal of the City, which copy of the Charter be ' forwarded by the Mayor of the City of Lubbock to the Secretary of State, and shall'shov the approval of such Charter by a majority vote of the qualified voters of the City of Lubbock. By Charter Commission, duly elected: _ R * . - J. H. Moore Geo. C. WohYarth, Chairman W. S. Posey Room Wilson J. (.Jones Percy Spencer Jas. L. Dow H. A..)avidson J. D. Lindley W. F. Schenck E. B. Green R. K. Henderson K L. Klett C. E. Parks M. T. Jacobs, Acting Secret 89 ; D-8 3 •• -- -- � \ H' Haz! P .a q W' : . CzA a e x a P4 H E- z > 04 - Gi - -- 4C H ..7 �a H � rx z H W x zl A C w Ha z o e W U C as � cv w x � -wN H E+ 94 V � x -- -- -- -- - -- -- - E o s a o � a -- -- -- q -- -- � \ H' Haz! P .a q W' : . CzA E x a P4 H E- 4 W > 04 - -- -- -- q -- -- -- -- -- U H _ - Gi - -- 4C H ..7 �a H -- rx z H W x zl A C w Ha z o fA a W U C as a o� Hd q _ - z> -- 0. 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