HomeMy WebLinkAboutResolution - 2204 - Contract - TDOH - 1986 Local Health Services - 12/12/1985J
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Resplution #,2204
December 12, 1985
Agenda Item #33
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the Mayor of the City of Lubbock BE and is hereby authorized and
directed to execute for and on behalf of the City of Lubbock a Contract by
and between the City of Lubbock and the Texas Department of Health for the
1986 Contract for Local Health Services and associated documents, 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 12th day of December , 1985.
ATTEST:
anett q Boyd, City Secretary
APPROVED AS TO CONTENT:
v
R. D. oodman, Public Hea
Administrator
APPROVED AS TO FORM:
Do ald G. Vandiver, Assistant City
Attorney
ATTACHMENT NO. 7
This Attachment constitutes an amendment to and becomes a part of that
certain contract between the TEXAS DEPARTMENT OF HEALTH
Rece v ng Agency SEXUALLY
Program
TRANSMITTED DISEASE CONTROL' DIVISION .and LUBBOCK CITY HEALTH DEPARTMENT
within TDH
Performing Agency
=bearing TDH Document No. C6000541.
TERMS DECEMBER 1. 1985
SCOPE OF WORKS
through NOVEMBER 30. 1986
The Texas Department of Health strives to prevent the transmission of syphilis
and gonorrhea and their resultant complications. This is accomplished in
cooperation with public health regional offices and local health departments
through the deployment of trained personnel whose responsibilities include
case interviewing and contact invest i gat ion, surve i 1 lance, maintenance of
screening programs. reporting compliance, consultation, and education of high-
risk patient populations. All activities of these sup
venereal disease control program are to be conducted in ccord ncestaff andthe wiithothe
established standards and objectives described in the current federal venereal
d i s etse control project.
Established program morbidity and activity reo
rts for monitoring the services provided under thisgreement be used as the basis
Performing Agency shall:
(1) Submit periodic activity reports to the Sexually Transmitted Disease
Control Program Central Off ice, including:
a) Detail of public STD clinic attendance (male and female) and
morbidity by disease (Form CDC 73.688) monthly=
b) Texas Department of Health Form VD-lA (or approved
equivalent) daily, or as dispositioned=
c) Centers for Disease Control Form 73.54 (or subsequent
revisions) daily. or as completed;
d) Centers for Disease Control Form 73.126 as completed=
e) Centers for Disease Control Forms
Department of Health GPI D and Syph i I is S-100 .21•Fo9rms2month 1 y=s
f) Quarterly Narrative/Objectives Report and other routine
Program reports.
ize c i n i c Si o f f
[DIS] (excluding Disease Intervention Specialist
personnel) to counsel NGU, MPC, NSV, and uncomplicated
gonorrhea patients regarding self referral of contacts, and
compliance with treatment and test—of—cure procedures.
(3) Utilize. DI S personnel for Sexually
Program act i vit ies. When non—Program I izat ion' fasefu ded DoIS
personnel is anticipated, contact will be established with the
Sexual ly Transmitted Disease Control Program Division Director to
ensure continuity and compliance with Program operations.
(4) Provide approval for DIS personnel to extend
activities beyond Performing Agency's
s Performance of Program
geographic required to ensure statewide disease i n er ent on activities. '' on when
Since this contract is supported in whole, or in
par, byvenereal disease grant funds, this contract is c nting nt on cateavailabileityrof
these federal funds.
LEGAL AUTHORITY: Current Appropriations r i at i ons B i 1 l; P.L. 95-626 (42 USC 247c) 42
C F R 5 1 b; T""` Pero
Part 74, PHS Grants Policy Statement, and Grants
Administration Manual
BUDGET:
Personnel $ 20,112.00 _
Fringe Benefits 4,800.00
Travel
Equipment �—
—0—
Supplies —0—
Contractual —0—
Other _0_
Total $ 24 12.00
Total amount of this Attachment shall not exceed $ 24 12.00
2
, d
e r '
EXECUTED IN TRIPLICATE ORIGINALS ON THE DATES INDICATED.
CONTRACTING ENTITY
FOR AND IN BEHALF OF
PERFORMING AGENCY'
RECEIVING AGENCY
TEXAS DEP RTMENT OF HEALTH
By B
Signat re of Person Aut y
rized to Sign Contract ermas L. Miller,
Deputy Commissioner
Title Mayor Management and Administration
Date March 25, 1986
------------
Recommended:
By
(PERFORMING AGENCY Director.
if different from above)
Print or Type
PERFORMING AGENCY Address:
Mailing Address
(Street Address, if different
C;ty, Zip Cod
s
Date APR. — 41986
:
Recommended
BY
Carl E elge, Jr
Ating %� s late Cp missioner
C nrnuni(tyja id Rural "e Ith
,erH. Greenberg,
ss ;ate Commission
rev ntable Diseases
Approved as to Form:
BY
Offce of General Counse ._
ATTACHMENT 6 $
This Attachment constitutes an amendment to and becomes a part of that certain
contract between the TEXAS DEPARTMENT OF HEALTH (RECEIVING AGENCY)(TDH), Bureau of
E idemiolo (PROGRAM WITHIN TDH), and the Lubbock City
PERFORMING AGENCY), bearing TDH Document No. C50005 Health Department
TERM: April 26, 1985 through October 22, 1985.
SCOPE OF WORK: During thel80-day Perio_d_.of the award the Lubbock City -County Health
Department will publicize in high risk communities the availability of the HTLV-III
antibody testing through its clinics as an alternative to obtaining the test
via donation of a unit of blood or plasma; results
provide written and verbal information,
precounseling about the test and its interpretation to individuals requesting the
test= collect blood on those who elect testing after precounseling; ship i
Texas Department of Health laboratory; and communicate results and provide at to the
dditional
specific counseling to the patient.
The following data must be collected and reported to the Texas Department of Health
In a manner and form approved by the Texas Department of Health (Bureau of
Epidemiology): number of patients tested; number tested without charge; number
(each) of negative, positive, borderline test results; number of pre- and post-test
counseling sessionst and personnel hours devoted to the program. A report and budget
will be required within 90 days of the end of the grant period.
Where permitted, fees will be charged in accordance with the policy of the Lubbock
CityrCounty Health Department. The following section applies to all fees collected
under this giant.
The Lubbock City -County Health Department hereby gives assurances that, 1) Resources
required are only to defray costs for services to those who could not otherwise
afford them except in those situations where the requirement conflicts with state or
local law or other established policiest 2) it has reduced its request by taking into
consideration funds expected to be collected from patients, where such collections
are permissible; 3) the resources requested are limited to those required for a180 -
day period from the date of the budget period; and 4) local resources are
insufficient to provide for HTLV -111 testing without charge at alternate sites.
Billing and financial reporting shall be in accordance with Article 16 of the
contract and be submitted to the TDH Associateship for Community and Rural Health.
LEGAL AUTHORICooperative
TYr This contract is funded from the Federal Notice of
Agreement Award No. U62/000600903-01; Section 311, PHS Act. (See attached
BUDGET:
Personnel
Fringe benefits $ 4,666.00
Other expenses $ 1,166.50
$ 919.94
Total $ 6,7` 5? 44
The total amount of this Attachment shall not exceed $ 6,752.44.
CONTRACTING ENTITY FOR
AND 1N BEHALF OF
PERFORMING AGENC
By
Title Mayer,
Date///ao f$�
APPROVED AS TO FORM:
BY
Office of General Counsel
TEXAS DEPARTMENT OF HEALTH
By
As�Ml
Deputy Commissioner
Management and Administration
Date DEC - 6 1985
RECOMMENDED:
By�� 1i1��0
�.v. raves, M,D, - —T —
Associate Commissioner
Community and Rural Health
REC MME E :
c,
Je ome Greenber D.
As ociate Commis one for
Pr ventable Disease
0
This attachment permits continuance of the activities previously funded
through Attachment No. 6B of the Fiscal Year 85 Local Health.Department
Contract (TDH DocumentNo. 05000541 ). The total funding level for
this activitiy for the time period April 26, 1985 through'April 22, 1986
shall not exceed $ 6,752.44
FLXt rtil
�L DEC 20 ,revs,n; U3
CM �-'! _
I'!ii 1 ri 7 �[ (i V+`"at �.l T'it tt
�:1 .:' :LNi..�fi
�ESQ111 EN -1986
1886-1986
Robert Bernstein, M. D,, F A.C.P.
Commissioner
,SP F
5 r
Texas Department of Health
1100 West 49th Street
Austin, Texas 787.56
(512) 458-7111
Date. February 5 1986
Robert A. MacLean, M.D.
Deputy Commissioner
Professional Services
Hermas L. Miller
Deputy Commissioner
Management and Administration
TDH Doc. No. 06000541
Att. No(s) 1 - 6
FROM C.C. v .D.
Asso i ssioner
Comm nd ral Health
TO Director, Lubbock City Health Department
SUBJECT Transmittal of 1986 Contract Document(s)
This communication transmits contract document or documents for
the purpose indicated below. Your assistance in expediting any
document requiring signature will be appreciated.
signature for authorized contracting entity
on all copies and return to this office
X file copy of fully executed document (s)
Please contact the monitor for your area or the contracts section
of Regional and Local Health Services Division, 612-458-7772, if
you have any questions.
Thank you.
(tw)
Attachments
CC: Program(s)*
P.H. Region*
RLHS Div.
-Final distribution only
S'T'ATE OF TEXAS
COUNTY OF TRAVIS
TDH Document No. C 6000541
LOCAL HEALTH SERVICES
C O N T R A C T
The Texas Department of Health, hereinafter referred to as RECEIVING AGENCY,
acting through its Deputy Commissioner for Management and Administration,
and CITY OF LUBBOCK
(Authorized Contracting Entity)
acting through LUBBOCK CITY HEALTH DEPARTMENT
(Name of PERFORMING AGENCY)
hereinafter referred to as PERFORMING AGENCY, acting through
ALAN HENRY
(Name of Person Authorized to Sign Contracts)
its MAYOR
(Title of Person Authorized to Sign Contracts)
mutually agree as follows:
ARTICLE 1. Scope of Work
PERFORMING AGENCY shall perform the work outlined in the Scope(s) of Work
which is/are hereby incorporated and made a part of this contract as
Attachment(s) 1-6 plus amendments which may be added by
additional Attachment(s) from time to time as hereinafter provided.
ARTICLE 2. Terms
The term of this contract shall be governed by the time period on the
Attachment(s). No commitment of contract funds is permitted prior to the
first day of the Attachment term nor subsequent to the last day of the
Attachment term. The term may be extended by amendment(s).
ARTICLE 3. Applicable Laws and Standards
This contract shall be governed by the laws of the State of Texas.
PERFORMING AGENCY agrees that the Uniform Grant and Contract Management
Standards (UGCMS), Article 4413, Section 32g, V.A.C.S., will apply as terms
and conditions of this contract, and the standards are adopted by reference
in their entirety. If there is a conflict between the provisions of' this
contract and UGCMS, the provisions of UGCMS will prevail unless expressly
stated otherwise. A copy of this manual and its references are provided to
PERFORMING AGENCY by RECEIVING AGENCY upon request.
UGCMS contains requirements in OMB Circulars No. A-102 and A-87 that pass-
through with State and Federal monies including but not limited to:
1. allowable costs in applicable Cost Principles, A-87;
2. financial management standards, A-102, Attachment G;
3. procurement, A-102, Attachment O; and
4. audit requirements, A-102, Attachment P.
In addition, A-102, Attachment 0, sets out provisions that must be in all
contracts. Those provisions are hereby adopted when applicable, and
include but are not limited to: audit and record access and retention;
Equal Employment Opportunity; environmental and energy protection laws and
regulations.
PERFORMING AGENCY will comply with the requirements set forth in the
enabling Federal legislation, as set out in the Attachment(s) hereto,
Treasury Circular 1075 (31 CFR Part 205) and all other Federal laws and
regulations applicable to Federal funding source(s) in this contract.
PERFORMING AGENCY will utilize RECEIVING AGENCY policies and procedures for
hiring and promoting individuals into state budgeted positions funded by
this contract. Qualifications of any individuals filling these positions
will be subject to approval of RECEIVING AGENCY Bureau of Personnel
Management. The purpose of the approval is to insure that individuals
occupying these state budgeted positions meet minimum educational and
experience requirements.
PERFORMING AGENCY shall have in place legally sufficient Due Process
Hearing Procedures for all of its state budgeted employees.
The Director of PERFORMING AGENCY shall have full authority to employ,
promote, suspend, demote, discharge, and transfer any and all state
budgeted personnel funded by Attachment(s) to this contract; provided,
however, that any demotions, suspension, or discharge of such state
budgeted employees shall be in accordance with the Due Process Hearing
Procedures -as set out above. All personnel funded by Attachment(s) to this
contract are employees of PERFORMING AGENCY which shall be responsible for
their direction and control and liable for any of their acts or omissions.
The only distinction between state budgeted and local paid employees is
that employees on state budgeted positions receive state benefits, and are
subject to certain obligations as state employees, as contained in state
law. These obligations include provisions that no employee paid on a State
budgeted position may receive a salary supplement from any other source.
PERFORMING AGENCY agrees to defend and indemnify RECEIVING AGENCY for any
and all claims and/or judgements taken against any employees, state or
local, or against said RECEIVING AGENCY, arising out of any claims or cause
of action against any such employees.
ARTICLE 4. Compensation and Payment
For services satisfactorily performed pursuant to the Scope(s) of Work,
PERFORMING AGENCY shall have furnished or be reimbursed by RECEIVING AGENCY
an amount not to exceed the total of all Attachment(s) which are attached
hereto. Allowable costs shall be only as outlined in the Attachment(s).
2
PERFORMING AGENCY will not bill RECEIVING AGENCY for any costs under this
contract which have also been billed or should have been billed to any
other funding source.
Costs claimed for reimbursement must be substantiated. With proper
justification, and concurrence of RECEIVING AGENCY, PERFORMING AGENCY may
request advance payment under this contract in accordance with the
applicable provisions of this contract.
PERFORMING AGENCY may be reimbursed for local personnel costs or other
categories of expense used to fulfill the scope of work of an Attachment in
lieu of being furnished state payroll warrants after a state budgeted
position becomes vacant. Reimbursement shall not exceed the balance of
funds on the state budgeted position after all benefits, obligations,
and/or other entitlements are met. RITA P. HARMON ASSISTANT CITY
MANAGER (title and name of person) is authorized
Eo— request such transfer for PERFORMING AGENCY, the method and format of
which shall be prescribed by RECEIVING AGENCY.
PERFORMING AGENCY shall submit certified vouchers according to the
procedures set out in this contract. At the close of each quarter, a signed
financial report, the format of which is in the UGCMS, must be submitted.
ARTICLE 5. Funding
PERFORMING AGENCY shall use funds from this contract to supplement its
budget. These funds will in no event supplant existing funds currently
available to PERFORMING AGENCY.
PERFORMING AGENCY agrees to assign to RECEIVING AGENCY expenditures of
local funds for public health services as matching for Federal funds. Such
assigned local matching funds shall be reported to RECEIVING AGENCY on the
annual final report (Form 270). In the event such assigned funds are
required by PERFORMING AGENCY to match other Federal funds, prior written
approval must be obtained from RECEIVING AGENCY to Withdraw the assigned
funds from RECEIVING AGENCY.
This contract is contingent upon funding being available for the term of
the Attachment(s) and PERFORMING AGENCY shall have no right of action
against RECEIVING AGENCY in the event that RECEIVING AGENCY is unable to
perform its obligations under this contract as a result of the suspension,
termination, withdrawal, or failure of funding to RECEIVING AGENCY or lack
Of sufficient funding of RECEIVING AGENCY for any Attachment(s) to this
contract. If funds become unavailable, provisions of the Termination
Article in this contract shall apply.
ARTICLE 6. Program Income
All revenues received from the delivery of contract services shall be
identified and reported and shall be utilized as provided in this article.
Such program income shall be retained by PERFORMING AGENCY and; (1) be
used by PERFORMING AGENCY for any purposes which further the objectives of
legislation under which the contract was made and be deducted from total
project costs, or (2) be deducted from total project costs, according to
3
RECEIVING AGENCY policy interpreting UGCMS,
supplementary material to the UGCMS manual.
a copy of which is provided as
PERFORMING AGENCY shall develop a fee For service system.and a schedule of
fees for personal health services in accordance with the provisions of
Article 4414c, V.C.S., and the Texas Board of Health rules covering Fees
for Clinical Health Services (25 TAC, Sec. 1.19) and other applicable laws;
provided, however, that a patient may not be denied a service due to
inability to pay.
ARTICLE 7. Records
PERFORMING AGENCY will have a system in effect to protect from
inappropriate disclosure of patient records maintained in connection with
the activities funded under this contract.
ARTICLE 8. Reports and Inspections
PERFORMING AGENCY shall make financial, program, progress, and other
reports as requested by RECEIVING AGENCY in the format agreed to by the
parties hereto and will arrange for onsite inspections by RECEIVING AGENCY.
PERFORMING AGENCY shall participate fully in any required evaluation study.
PERFORMING AGENCY
will
furnish RECEIVING AGENCY an
annual budget of
PERFORMING AGENCY on
forms
provided by RECEIVING AGENCY.
The budget shall
be for PERFORMING AGENCY current fiscal year ending SEPTEMBER 30, 1986
The budget shall be
shown
by object of expense category
and include all
funding sources.
The
personnel category shall
include position
classification and
gross
salary for all employees.
4
ARTICLE 9. Amendments
This contract may be amended as provided in Article 4, or by the addition
of Attachments(s) containing additional Scope(s) of Work and Budget(s)
related to same, or by revision of existing Attachment(s) and the Scope(s)
of Work and/or Budget(s); such Attachment(s) to be duly executed by the
parties as hereinabove provided.
Thies- contract
instrument in
hereto.
shall not be altered, changed, or amended except by
writing executed by authorized officials of the parties
ARTICLE 10. Property and Supplies
Subject to the obligations and conditions set forth in this contract and
UGCMS, title to all. property purchased from funds provided herein shall
vest upon acquisition with PERFORMING AGENCY. PERFORMING AGENCY shall
maintain a property and supplies inventory and administer a program of
maintenance, repair, and protection of assets provided under this contract
so as to assure their full availability and usefulness for performance
under this contract.
RECEIVING AGENCY retains the option to recover all unused supplies and
useable equipment furnished under this contract upon the termination of
relationship of the parties hereto. This also includes acquisitions
through lease -purchase agreements with funds provided under this contract
or with funds provided by program income attributable to the programs
provided for under this contract.
In the event PERFORMING AGENCY is indemnified, reimbursed, or otherwise
compensated for any loss of, destruction of, or damage to, the assets
provided under this contract during the period of this contract, it shall
use the proceeds to repair or replace said assets.
ARTICLE 11. Discrimination Prohibited
No person in the United States shall on the grounds of race, creed, color,
handicap, age, ability to pay, sex, or national origin be excluded from
participation in, be denied the proceeds of, or be subject to
discrimination in the performance of this contract. The parties will comply
with the regulations promulgated by the Secretary of DHHS, with ''the
approval of the President of the United States, pursuant to Title VI of the
Civil Rights Act of 1964 (45 CFR Part 80).
In addition, PERFORMING AGENCY shall comply with the provisions of the
Rehabilitation Act of 1973, Public Law 93-112, Section 504, which ensures
that no individual "shall, solely by reason of handicap, be excluded from
the. participation in, be denied the benefits of, or be subject to
discrimination in this program."
ARTICLE 12. Severability
If any provision(s) of this contract shall be construed to be illegal or
invalid, it shall not affect the legality or validity of any of the other
provisions hereof, and the illegal or invalid provision(s)shall be deemed
stricken and deleted herefrom to the same extent and effect as if never
incorporated herein, but all other provisions shall continue.
ARTICLE 13. Scope of Agreement
This contract incorporates all of the agreements, convenants, and
understandings between the parties hereto concerning the Attachment(s) and
all such covenants, agreements, and understandings have been merged into
this written contract. No prior agreement or understanding, oral or
otherwise, of the parties or their agents shall be valid or enforceable
unless embodied in this contract.
ARTICLE 14. Termination
This contract or any Attachment(s) hereto may be terminated by either of
the parties hereto for noncompliance by the other party. A party intending
to terminate for noncompliance by the other party shall provide written
notice to the other party at least thirty (30) days prior to the intended
date of termination. Such notice shall include the reasons for the
1r
termination and shall provide the other party an opportunity to rebut the
reasons in writing. A hearing may be requested on the proposed termination
if such request is made in writing within ten (10) days from any final
notification of termination. By such termination, neither party may
nullify obligations already incurred for performance or failure to perform
prior to the date of termination. Such termination shall not be an
exclusive remedy but shall be in addition to any other rights and remedies
provided by law or under this contract.
This contract or any Attachment(s) hereto may be terminated in whole, or in
part, when both parties agree that continuation would not produce results
commensurate with further expenditure of funds. Both parties shall agree
on the effective date and, in the case of partial termination, the portion
to be terminated. RECEIVING AGENCY shall immediately send PERFORMING
AGENCY written notice of the terms agreed to and such notice shall become a
part of the contract. PERFORMING AGENCY shall not incur new obligations
for the terminated portion after the effective date and shall cancel as
many outstanding obligations as possible. RECEIVING AGENCY shall allow
full credit to PERFORMING AGENCY for noncancelable obligations which were
properly incurred prior to the termination date.
This contract or any Attachment(s) hereto may be terminated if funds
allocated for any Attachment(s) hereto should become reduced, depleted, or
unavailable during any Attachment(s) budget period, and RECEIVING AGENCY is
unable to obtain additional funds for such purposes. RECEIVING AGENCY
shall immediately provide written notification to PERFORMING AGENCY of such
fact and such Attachment(s) to this contract is/are terminated upon receipt
of that notification. PERFORMING AGENCY shall not incur new obligations
after the effective date and shall cancel as many outstanding obligations
as possible. RECEIVING AGENCY shall allow full credit to PERFORMING AGENCY
for noncancelable obligations which were properly incurred prior to the
termination date.
This contract or any Attachment(s) hereto may be terminated in the event
that Federal or state laws or other requirements should be amended or
judicially interpreted so as to render continued fulfillment of this
contract, on the part of either party, unreasonable or impossible. If the
parties should be unable to agree upon amendment which would therefore be
needed to enable the substantial continuation of the services contemplated
herein, then, upon written notification by RECEIVING AGENCY to PERFORMING
AGENCY, the parties shall be discharged from any further obligations
created under the terms of this contract, except for the equitable
settlement of the respective accrued interests or obligations incurred up
to the date of termination.
ARTICLE 15. Financial Reporting Requirements
The following prescribes uniform procedures and the standard forms for
PERFORMING AGENCY to:
1. request reimbursements and/or advance payment, and
2. summarize and report expenditures and unexpended funds.
C
Reimbursements
Monthly, or as needed, PERFORMING AGENCY shall submit a State of Texas
Purchase Voucher (TDH Form #AG -37).
Advance Payment
PERFORMING AGENCY may request an advance with proper justification and
concurrence of RECEIVING AGENCY. Amount of the advance shall be
determined by the amount and term of the Attachment(s); however, for
each Attachment, the amount of the advance shall not exceed one-sixth
(1/6th) of the Attachment amount. The advance will be requested on a
State of Texas Purchase Voucher at the beginning of the Attachment
period or at a single later time in the Attachment period if
circumstances so warrant and the request is approved. Advance funds
will be liquidated in the final months of the Attachment period so
that, after final monthly billing, PERFORMING AGENCY Will not have
advance funds on hand. Advance funds may be drawn only to meet
immediate cash needs for disbursement (UGCMS and Federal Circulars).
Reports
Quarterly - PERFORMING AGENCY shall submit a Financial Status Report State
Supplemental Form 269a (TDH Form #GC -4) by the twentieth
(20th) of the month following a quarter. Reporting
requirements apply regardless of whether or not costs have
been incurred.
Annual/Final-PERFORMING AGENCY shall submit no later than 90 days after the
end of the Attachment period final quarterly Financial Status
Report State Supplemental Form 269a and Request for Advance or
Reimbursement Form 270. If necessary, a State of Texas
Purchase Voucher will also be submitted if all costs have not
been recovered or a refund will be made of excess monies if
costs incurred were less than funds received.
7
EXECUTED IN TRIPLICATE ORIGINALS ON THE DATES INDICATED.
CONTRACTING ENTITY
FOR AND IN BEHALF OF
PERFORMING AGENCY RECEIVING AGENCY
By
(Sign re of P rson rorized
to Sign Contracts)
Title MAYOR
c/
By
H rmas L. Miller
Deputy Commissio er
Management and Administration
Date/a -13 -'F 5 Date .DAM 31 1986
Recommended-
BN
4—�z ,(PERFORMING AMCY—Directaf,
if different from above)
Print or Type
PERFORMING AGENCY Address:
P. 0. Box 2548
(Mailing Address)
1902 Texas Avenue
(Street Address,if different)
LUBBOCK, TEXAS 79418
(City, Zip Code)
-APPROVED AS T ON 7 FN7: _.
%iw3i&.uli2 (.'iiJ ,'-i'(FOfI?��
E
Recommended:
By
C -'C .' ave sM M. D .
Associate Commissioner
Community and Rural Health
61�/By 2�
ift Price, M.D.
Associate Commissioner
Personal.-*alth Services
'ro a n. yreenner
so iate Commiss'oner
ev ntable Diseases
Approve a to orm:
By_
Office of General Counsel
ATTACHMENT NO. 1
PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT
PROGRAM WITHIN RECEIVING AGENCY (TDH): COMMUNITY AND RURAL HEALTH
TERM: September 1 1985 through August 31 1986
SCOPE OF WORK:
The state direct assistance and other funds to health departments are
intended to supplement in the delivery of comprehensive public health
services to protect the health of all citizens in the department's
jurisdiction. Personal health serviceA may include, but are not limited to,
immunizations, maternal and child health, crippled children, adult health,
tuberculosis control, chronic disease, dental health, public health
education, and venereal disease control. Environmental health services may
include, but are not limited to, food inspections, wastewater control,
vector control, premise inspections, swimming pool inspections, and other
services as related to the particular problems of the jurisdiction.
Required personnel, payroll, and time records on state budgeted personnel
as the basis for issuance of state payroll warrants shall be submitted to
RECEIVING AGENCY.
Reports of services performed under this attachment shall be submitted to
the Office of Community and Rural Health. Also, evidence that a public
hearing was held on expenditure of health block grant funds and an annual
audit report shall be submitted.
LEGAL AUTHORITY:
Current Appropriations Bill.
BUDGET:
The attached list of positions and budgetary amounts, exclusive of category
41 if applicable, is an integral part of Attachment 1. A state warrant
will be issued for each filled position in the amount of monthly net salary
earnings.
Total amount of this Attachment shall not exceed $109,673.52.
OFcRATING BUDGET FOR YEAR ENDING A U as J S I .51" 1 Y h 8
ASOF '_',EPT7M6ER 019 19aS BUDGET NO. LC000
/K130 6
FUND
SALARIES' ONLY
\ GLORY DESCRIPTION OR TITLE OE8C, ENDING ITEM JOB PAY Pyr EPiECTIVE MONTHLY BUDGETED AMOUNT
MONTH NO. CLA89 OP 3TE� GATE RATE
1 PUBLIC HEALTH DENTIST II STATE AUG 001D02 4 0
025.000% a 3750.91 SEP R5 937.73 11.252.7E
125.000% a 3750.91
;URSE II
WQSE II
IC VOCATIONAL NURSE II
ECPETARY III
ENTAL ASSISTANT I
A
P51 93
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TATE; AUGOZ 4385 13 02SEP 8S 1,&r4.
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TATE AuG08 441 102SCP 8S 1 •488: 0
TATE AUG 104013 07 3SEP 85 1 •271.00
TATE AUG12 4491''4 31SEP AS 977.001
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21 #648.GG
17*832.00
15 •252.00
11 •724.MCI
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ATTACHMENT NO. 2
PERFORMING AGENCY: LUBBOCK CITY HEALTH DEPARTMENT
PROGRAM WITHIN RECEIVING AGENCY (TDH): COMMUNITY AND RURAL HEALTH
TERM: October 1, 1985 through August 31 1986
SCOPE OF WORK:
This allocates funds in support of the scope of work in Attachment No. 1.
LEGAL AUTHORITY:
Current Appropriations Bill and Title XIX, Public Health Services Act,
Omnibus Budget Reconciliation Act of 1981, DHHS final regulations on block
grants.
BUDGET: Personnel
$21,032.00
Fringe Benefits
-0-
Travel
-0-
Equipment
-0-
Supplies
-0-
Contractual
-0-
Other
-0-
Total $21,032.00
Total amount of this Attachment shall not exceed ;21,032.00, except as
adjusted under provisions of Article 4 of the contract.
ATTACHMENT 3
PERFORMING AGENCY: Lubbock City Health Department
PROGRAM WITHIN RECEIVING AGENCY (TDH): Bureau of Maternal and child Naalth
TERM: September 1, 1985 through August 31, 1986
SCOPE OF WORK: To provide clinical services to meet the needs of low income
women and children with particular reference to family
planning services. These services shall be provided in
accordance with the standards for family planning services
as promulgated by the Bureau of Maternal and Child Health,
Texas Department of Health.
Services performed under this Attachment shall be reported
monthly by submission of Family Planning Clinic Reports.
Required personnel, payroll, and time records on state
budgeted personnel as the basis for issuance of state
payroll warrants shall be submitted to Receiving Agency,
Community and Rural Health.
If fees for services are imposed as provided in Article 6 of this
contract, charges will not be imposed for the provision of health
services to low income mothers or children. The term "low income"
refers to an individual or family with an income determined to be
below the nonfarm income official poverty line defined by the Office
of Management and Budget and revised annually in accordance with
Section 624 of the -Economic Opportunity Act of 1964.
LEGAL AUTHORITY: Title V, Social Security Act, -Omnibus Budget Reconciliation
Act of 1981; DHHS regulations on block grant.
BUDGET: The attached list of personnel and budgetary amounts,
exclusive of category 41 if applicable, is an integral
part of this Attachment. A state warrant will be issued
for each filled position in the amount of monthly net
salary earnings.
Total amount of this Attachment shall not exceed $126,300.00
OPERATING BUDGET FOR YEAR ENDING -;AUGUST 31t 1986
ASOF SEPTEMBER Ol, 19'85
IK 13028 BUDGET N0. LC301
CATS
GORY
-
DESCRIPTION OR TITLE
FUND
SALARIES ONLY
BUDGETED AMOUN
DESC
ENDING
MONTH
ITEM
NO.
JOS
CLASS
AY
GP
PAY
Tv
EFFECTIVE
DATE
MONTHLY
RATE
I
NURSE III
!BURSE III
MC HLT
MC HLT
SF -P0234386150
AUG0234386
SEP 85.2.142.00
OCT 85
2 142.00
25,7„u.':
E II
NURSE IT
MC HLTI
MC HLT
SEP
AUG0454395
04
438 5
13011SEP
gS
OCT 85
1,726,on
1,726.00
209712.'
NURSE II
NURSE II
MC HLT
MC HLT
SEP046438
AUG
464385
1
OiSEP
85
OCT 85
1,726.00
1,726.On
CLERK TYPIST II
MC HLT
SEP08810106r14031SEP
85
1 058.Cl
CLERK TYPIST ILI
MC HLT
AUG0880106
OCT 85
1#058.00
COMMUNITY SERV AIDE I
COMMUNITY SERV AIDE I
MC HLT
MC HLT
SEP1315501n2
AUG131550
1SEP
95
OCT 85
904.C!2
904.00
10,84,,.'l
CLERK I
MC HLT
SEP1530051i12
1S
P 85
864.nn
CLERK I
MC HLT
AUGIS30051
OCT 85
864.00
10,36F.r-
101,0401..^,f
4
' EE
-M
':9
EMPLOYEE 6ENEf I TS
EMPLOYEE BENEFITS
MC HLT
MC HLT
SEP
AUG
SEP 85
OCT RS
23, 2 �.C7
FUND
SUMMARY
MC HLT
SEP
l0 S�S.00
MC HL
AUG
I 1 ,3t,t
141,$3O.00
ATTACHMENT 4
PERFORMING AGENCY: __Lubbock City Health Department
PROGRAM WITHIN RECEIVING AGENCY (TDH):
TERM: October 1, 1985
r
Bureau of Maternal and Child Health
through September 30, 1986
SCOPE OF WORK: To provide clinical services to meet the needs of low income
women and children with particular reference to family
planning services. These services shall be provided in
accordance with the standards for family planning services
as promulgated by the Bureau of Maternal and Child Health,
Texas Department of Health.
Services performed under this Attachment shall be reported
monthly by submission of Family Planning Clinic Reports.
If fees for services are imposed as provided in Article 6 of
this contract, charges will not be imposed for the provision
of health services to low income mothers or children. The
term "low income" refers to an individual. -or family with an
income determined to be below the nonfarm income official
poverty line defined by the Office of. Management and Budget
and revised annually in accordance with Section 624 of the
Economic Opportunity Act of 1964.
LEGAL AUTHORITY: Title V, Social Security Act, Omnibus Budget Reconciliation
Act of 1981; DHHS regulations on block grant.
BUDGET: Personnel $ -0-
Fringe Benefits -0-
Travel -0-
Equipment -0-
Supplies 16,880
Contractual 18,480
Other -0-
Total Direct Cost $35,360
Total amount of this Attachment shall not exceed $ 35,360.00
ATTACHMENT 5
PERFORMING AGENCY: Lubbock City Health Department
PROGRAM WITHIN RECEIVING AGENCY (TDH): Bureau of Laboratories
TERM: September 1, 1985 through August 31, 1986
SCOPE OF WORK:
This laboratory agrees to provide reports on testing on approximately 35,500
specimens annually as indicated in the categories below in support of Texas
Department of Health programs.
A. Water bacteriology
B. Milk bacteriology and chemistry
C. Syphilis serology
D. Gonorrhea testing
E. Other approved analyses
11,000
12,000
12,000
500
Total 35,500
Performing Agency agrees to meet the standards for such analyses as set forth
by the Texas Department of Health, Bureau of Laboratories, the Clinical
Laboratories Improvement Act, the Safe Drinking Water Act, The National
Conference of Interstate Milk Shippers, and/or the Public Health Service Grade
A Pasteurized Milk Ordinance.
Support for this scope of work is provided in part by the Bureau of
Laboratories through supplies, equipment and training and by other Receiving
Agency programs.
m
ATTACHMENT 6
PERFORMING AGENCY: Lubbock City Health Department
PROGRAM WITHIN RECEIVING AGENCY (TDH): Bureau of Epidemiology
TERM: October 23, 1985 through April 22, 1986.
SCOPE OF WORK: During the 365 -day period of the award the Lubbock City Health
Department will publicize in high risk communities the availability of the HTLV-III
antibody testing through its clinics as an alternative to obtaining the test results
via donation of a unit of blood or plasma; provide written and verbal information,
precounseling about the test and its interpretation to individuals requesting the
test; collect blood on those who elect testing after precounseling; ship it to the
Texas Department of Health laboratory; and communicate results and provide additional
specific counseling to the patient.
The following data must be collected and reported to the Texas Department of Health
in a manner and form approved by the Texas Department of Health (Bureau of
Epidemiology): number of patients tested; number tested without charge; number
(each) of negative, positive, borderline test results; number of pre- and post-test
counseling sessions; and personnel hours devoted to the program. A report and budget
will be required within 90 days of the end of the grant period.
Where permitted, fees will be charged in accordance with the policy of the Lubbock
City Health Department. The following section applies to all fees collected under
this grant.
The Lubbock City Health Department hereby gives assurances that: 1) Resources
required are only to defray costs for services to those who could not otherwise
afford them except in those situations where the requirement conflicts with state or
local law or other established policies; 2) it has reduced its request by taking into
consideration funds expected to be collected from patients, where such collections
are permissible; 3) the resources requested are limited to those required for a 365 -
day period from the date of the budget period; and 4) local resources are
insufficient to provide for HTLV-III testing without charge at alternate sites.
LEGAL AUTHORITY: This contract is funded from the Federal Notice of Cooperative
Agreement Award No. U62/CCU600903-01; Section 311, PHS Act.
BUDGET:
Personnel
$
4,666.00
Fringe Benefits
$
1,166.50
Travel
$
0
Equipment
$
0
Supplies
$
0
Contractual
$
0
Other
$
919.94
Total $ 6,752.44