HomeMy WebLinkAboutContract 33438 ��E F CITY SECRETARY
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CONTRACT NO
DEPARTMENT OF STATE HEALTH SERVICES
1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
STATE OF TEXAS DSHS Document No.7560005286 2006
COUNTY OF TRAVIS Contract Change Notice No.07
The Department of State Health Services,hereinafter referred to as RECEIVING AGENCY,did heretofore enter into a contract in
writing with FORT WORTH DEPARTMENT OF PUBLIC HEALTH hereinafter referred to as PERFORMING AGENCY. The
arties thereto now desire to amend such contract attachment(s)as follows:
SUMMARY OF TRANSACTION:
ATT NO.05 : DPIS-PUBLIC HEALTH NUTRITION
All terms and conditions not hereby amended remain in full force and effect.
EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN.
CITY OF FORT WORTH
Authorized Contracting Entity(type above if different
from PERFORMING AGENCY)for and in behalf of:
PERFORMING AGENCY: RECEIVING AGENCY :
FORT WORTH DEPARTMEN OF PUBLIC DEPARTMENT OF STATE HEALTH SERVICES
HEALTH
By:
By'
(Signature oVerskp4uth I
zed to sign) (Signature of person authorized to sign)
Joe Paniagua, Assistant City Manager Bob Burnette,Director
Client Services Contracting Unit
(Name and Title) (Name and Title)
Date: U d Date: hr2 4�'
RECO ED: Attested By.
By: C„� ,iWLL..
(PERFORMING AGENCY Director,if different
from person authorized to sign contract Marty Hen ix
City Secretary
VW CSCU-Rev.6/05
APPROVED AS TO ' ,4 RECORD
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F M AND LEGALITY: 1 C, LA IV
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ASSIST T CITY ATTMNEY Cover Page 1 contract but o i atioa.
Date j
DETAILS OF ATTACHMENTS
Att/ DSHS Program ID/ Term Financial Assistance Direct Total Amount
Amd DSHS Purchase Assistance (DSHS Share)
No. Order Number Begin End Source of Amount
Funds*
O1B RLSS/LPHS 09/01/05 08/31/06 State 93.991 36,508.00 0.00 36,508.00
0000309849
02 DIAB/CDSP 09/01/05 08/31/06 State 80,000.00 0.00 80,000.00
0000309271
03 IMM/LOCALS 09/01/05 08/31/06 State 93.268 57,305.00 0.00 57,305.00
0000309148
04A CPS/BIOTERR 09/01/05 08/31/06 93.283 497,463.00 0.00 497,463.00
0000310525
05 DPIS/NUTRIT 03/01/06 08/31/06 State 20,000.00 0.00 20,000.00
0000315842
DSHS Document No.7560005286 2006 Totals
$691,276.00 $ 0.00 $691,276.00
Change No.07
*Federal funds are indicated by a number from the Catalog of Federal Domestic Assistance(CFDA), if applicable. REFER TO
BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS.
Cover Page 2 CIS
FT, 0fl, YEN,
DOCUMENT NO. 7560005286-2006
ATTACHMENT NO. 05
PURCHASE ORDER NO. 0000315842
PERFORMING AGENCY: FORT WORTH DEPARTMENT OF PUBLIC HEALTH
RECEIVING AGENCY PROGRAM: DISEASE PREVENTION AND
INTERVENTION SECTION
TERM: March 01, 2006 THRU: August 31, 2006
SECTION I. SCOPE OF WORK:
PERFORMING AGENCY shall produce a continuing education curriculum in English
and Spanish for the purpose of training promotore(s) and community health workers
(CHWs) throughout Texas in promoting physical activity in the communities they serve.
PROGRAM RESPONSIBILITIES OF PERFORMING AGENCY
The physical activity curriculum must be developed in English/Spanish and:
• Within the core principles, goals, and competency areas of the DSHS certified
training programs curriculum framework; and,
• Be tested using participatory methods that include the target audience
(promotore(s) or community health workers) such as focus groups, and may
include expert consultation from local professional health educators and
evaluators.
The curriculum must meet, but is not limited to, the following learning objectives.
The promotor(a) or CHW will be able to:
• Assess the physical activity needs in a community;
• Identify gaps in physical activity opportunities or knowledge;
• Select, implement and evaluate a culturally and linguistically-appropriate
community physical activity intervention;
• Understand and communicate current physical activity recommendations in a
culturally- and linguistically-appropriate manner;
• Listen and appropriately respond to common barriers to physical activity (social,
cultural, physical, etc.); and,
• Work with community partners to increase physical activity opportunities
through information, instruction, or access to places/spaces for physical activity.
The PERFORMING AGENCY is required to work closely with the RECEIVING
AGENCY's Physical Activity Coordinator for technical assistance on the project, and all
RECEIVING AGENCY project staff will be available for bi-weekly (every two weeks)
conference calls to be scheduled by RECEIVING AGENCY by March 1, 2006.
PERFORMING AGENCY shall comply with the following:
• Health and Safety Code §12.011.
ATTACHMENT—Page 1 CITY k(lMy
T, "O RTH, T21
PERFORMING AGENCY shall perform all activities in accordance with RECEIVING
AGENCY Program's Competitive Request for Proposal (RFP) For A Promotor(a)/CHW
Physical Activity Continuing Education Training Curriculum, RFP DPIS/NUTRIT
0187.1, issued 1/3/2006, any letters or memos with rules, policies or other instructions
given to PERFORMING AGENCY, and PERFORMING AGENCY'S objectives, work
plan, and deliverables budget as approved by RECEIVING AGENCY Program. All of
the above named documents are incorporated herein by reference and made a part of this
contract Attachment. All revisions to said documents shall be approve by RECEIVING
AGENCY Program and transmitted in writing to PERFORMING AGENCY.
Within thirty (30) days of receipt of an amended standards(s) or guideline(s),
PERFORMING agency shall inform RECEIVING AGENCY Program, in writing, if it
will not continue performance under this contract Attachment in compliance with the
amended standard(s) or guidelines(s). RECEIVING AGENCY may terminate the
contract Attachment immediately or within a reasonable period of time determined by
RECEIVING AGENCY.
NETWORKING AND COORDINATION RESPONSIBILITIES
PERFORMING AGENCY shall:
• Be responsive to RECEIVING AGENCY via phone or email and reply to
questions, comments, or concerns within one business day. In the case of travel
or illness, a designated alternate contact will be assigned; and,
• Be available for bi-weekly phone conferences with RECEIVING AGENCY
Physical Activity Coordinator and assure that all project-related staff and partners
participate in the phone conferences.
RECEIVING AGENCY shall:
• Provide content-related technical assistance to the PERFORMING AGENCY in
the development, testing, and revision phases of the project throughout the
contract term; and,
• Respond to questions, comments, or concerns from PERFORMING AGENCY
within one business day. In the case of travel or illness, a designated alternate
contact will be assigned.
ADMINISTRATIVE AND STAFFING RESPONSIBILITIES
PERFORMING AGENCY shall:
• Assure that funding is used toward the project purpose outlined in RFP
DPIS/NUTRIT 0187.1;
• Provide RECEIVING AGENCY with the name(s) of any staff changes that
affect the implementation of this contract Attachment; and,
ATTACHMENT—Page 2
• Use RECEIVING AGENCY logos without any modification on curriculum
materials and with prior written approval by RECEIVING AGENCY Program
staff.
RECEIVING AGENCY reserves the right, where allowed by legal authority, to redirect
funds in the event of financial shortfalls. RECEIVING AGENCY Program will monitor
PERFORMING AGENCY'S expenditures on a monthly basis. If expenditures are below
that projected in PERFORMING AGENCY'S total contract amount as shown in
SECTION III. BUDGET, PERFORMING AGENCY'S budget may be subject to a
decrease for the remainder of the Attachment term. Vacant positions existing after ninety
(90) days may result in a decrease in funds.
PERFORMANCE MEASURES
The following performance measures will be used to assess, in part, PERFORMING
AGENCY'S effectiveness in providing services described in this contract attachment,
without waiving the enforceability of any of the other terms of the contract.
PERFORMING AGENCY shall complete each performance measure as defined in this
Attachment under SECTION I. SCOPE OF WORK.
The PERFORMING AGENCY shall:
1. Review existing physical activity curriculum for appropriateness of adaptation
into a physical activity training curriculum for promotore(s) and CHWs and
submit documentation of this review and rationale for selection of a benchmark
curriculum by April 1, 2006.
2. Engage the target audience in determining learning goals and objectives, general
content, implementation, and evaluation strategies of a curriculum and submit
formative process notes by May 31, 2006.
3. Submit a draft copy of curriculum in English/Spanish, with notations of teaching
methodologies and a draft evaluation instrument by June 1, 2006.
4. Test the curriculum in English/Spanish with a representative group of
promotore(s)/CHWs, and submit testing process notes and learning outcome
results by July 31, 2006.
5. Submit a draft copy of the curriculum distribution plan by August 15, 2006.
6. Submit a draft copy of the curriculum implementation and evaluation plan (with
all evaluation instruments included in English/Spanish) by August 15, 2006.
7. Revise training curriculum according to testing outcomes and submit final
training curriculum in hard-copy and electronic format on CD in English/Spanish
by August 31, 2006.
8. Develop and submit distribution plan for training curriculum in hard-copy and
electronic format on CD by August 31, 2006.
9. Develop and submit implementation and evaluation plan (with all evaluation
instruments included in English/Spanish) in hard-copy and electronic format on
CD by August 31, 2006.
ATTACHMENT—Page 3
DRA
SECTION II. SPECIAL PROVISIONS:
General Provisions, Terms and Conditions of Payment Article, is replaced with the
following:
PERFORMING AGENCY shall provide the services described in this contract in the
prescribed time and manner for the deliverable payments described herein.
PERFORMING AGENCY shall submit a State of Texas Purchase Voucher (Form B-13)
no later than 30 days after the submission of the deliverable(s) specified in the Section I.
Scope of Work and Section III. Budget. Upon receipt and approval of the deliverable(s),
RECEIVING AGENCY shall pay PERFORMING AGENCY an amount not to exceed
the amount for that deliverable as specified in Section III. Budget below.
PERFORMING AGENCY shall submit a copy of each voucher, marked "COPY," and
itemized documentation of expenditures by the 15`h of each month to RECEIVING
AGENCY, Nutrition, Physical Activity, and Obesity Prevention Program, 1100 West
49`h, T-402, Austin TX 78756.
General Provisions, Exhibit 1, Program Income, is not applicable to this Attachment.
SECTION III. BUDGET:
Deliverable Due Amount
Date
1. Documented review of training curricula 4/1/06 $3000.00
2. Bi-weekly hone conferences March-April 4/30/06 $50.00
3. Formative evaluation w/field or process notes 5/31/06 $2200.00
4. Bi-weekly hone conferences May-June 6/30/06 $50.00
5. Draft copy of curriculum and evaluation instruments 7/1/06 $3000.00
6. Curriculum testing,process notes, and learning outcomes 7/31/06 $4100.00
7. Draft copy of curriculum distribution plan 8/15/06 $1025.00
8. Draft copy of curriculum implementation and evaluation plan 8/15/06 $1750.00
9. Final copy of curriculum and evaluation instruments 8/31/06 $2000.00
10. Final copy of curriculum distribution plan 8/31/06 $1025.00
11. Final copy of curriculum implementation and evaluation plan 8/31/06 $1750.00
12. Bi-weekly hone conferences July-August 8/31/06 $50.00
Total Amount Not to Exceed $20,000.00
RECEIVING AGENCY will make payment to PERFORMING AGENCY upon
completion and approval of each deliverable referenced above and as described in
SECTION I. SCOPE OF WORK, PERFORMANCE MEASURES, and upon receipt of a
completed State of Texas purchase voucher as described in Section II. SPECIAL
PROVISIONS.
Total payments will not exceed $20,000.00.
Nul
ATTACHMENT—Pae 4 I C.�01a^Y
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City of Fort Worth, Texas
Mayor and Council Communication
m
COUNCIL ACTION: Approved on 1/31/2006 - Ordinance No. 16801-1-2006
DATE: Tuesday, January 31, 2006
LOG NAME: 50PHYACTGRANT REFERENCE NO.: **C-21279
SUBJECT:
Authorize Acceptance of Grant and Execution of Contract with the Texas Department of State
Health Services for a Community Physical Activity Promotion Training Curriculum and Adopt
Appropriation Ordinance
RECOMMENDATION:
It is recommended that the City Council:
1. Authorize the City Manager to accept, if offered and execute a grant contract with the Texas
Department of State Health Services (DSHS) for up to $20,000 for a period to begin March 1, 2006 and end
August 31, 2006 for the development and testing of a community physical activity promotion training
curriculum in English/Spanish for continuing education training of Promotores or community health workers
(CHW);
2. Adopt the attached appropriation ordinance increasing estimated receipts and appropriations by up to
$20,000 in the Grants Fund; and
3. Waive the indirect cost rate to allow maximum use of funds for delivery of services to the community.
DISCUSSION:
The Texas Department of State Health Services (DSHS) is providing grant funding to develop and test a
community physical activity curriculum to be used in training Promotores or community health workers. The
City of Fort Worth Public Health Department, Outreach Division, is already a certified Promotor/CHW
training institute. DSHS will give preference in awards for this grant to certified training institutes. The
Outreach Division is proposing development of this curriculum based on physical activity programs already
being utilized by department educators, "On the Trail to a Healthy Heart and "Walk for the Health of It". The
curriculum will teach workers to:
• Assess the physical activity needs in a community.
• Identify gaps in physical activity opportunities or knowledge.
• Select, implement and evaluate a culturally and linguistically-appropriate community physical activity
intervention.
• Understand and communicate current physical activity recommendations in a culturally and linguistically
appropriate manner.
• Listen and appropriately respond to common barriers to physical activity.
• Work with community partners to increase physical activity opportunities through information, instruction,
or access to places and spaces for physical activity.
This curriculum will also be used by workers to better promote physical activity in the communities they
serve. Once the curriculum is completed and evaluated it will be given to and become the sole property of
DSHS, who will make the curriculum available to any interested organization (s) involved in training
Logname: 50PHYACTGRANT Page 1 of 2
Promotores or CHWs.
FISCAL INFORMATION/CERTIFICATION:
The Finance Director certifies that upon acceptance and execution of this grant and adoption of the
attached appropriation ordinance, funds will be available in the current operating budget, as appropriated, of
the Grants Fund.
TO Fund/Account/Centers FROM Fund/Account/Centers
GR76 451923 050301083000 $20,000.00
GR76 5(VARIOUS) 050301083010 $20,000.00
Submitted for City Manager's Office by: Joe Paniagua (6140)
Originating Department Head: Daniel Reimer (871.8903)
Additional Information Contact: Dan Worley (999.6003)
Logname: 50PHYACTGRANT Page 2 of 2