HomeMy WebLinkAboutContract 31534 M
J i ' `T 'RETARY
NO.
DEPARTMENT OF STATE HEALTH SERVICES
1100 WEST 49TH STREET
03-24-05AO9 :55 RCVD AUSTIN, TEXAS 78756-3199
STATE OF TEXAS DSHS Document No.7560005286 2005
COUNTY OF TRAVIS Contract Change Notice No.08
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
parties thereto now desire to amend such contract attachment(s) as follows:
SUMMARY OF TRANSACTION:
ATT NO.OIC : IMMUNIZATION BRANCH-LOCALS
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 EP T T OF PUBLIC DEPARTM T OF STATE HEALTH SERVICES
HEALTH
4By: BY
(Signature f rs th rized to sign) (Signature of person authorized to sign)
Joe Paniagua, Assistant City Manager Bob Burnette,Director
Procurement and Contracting Services Division
(Name and Title (Name and Title)
Date: 3 d� Date:
RECOMME llED: Attested By.
BY
(PERFORMING AGENCY Director, if different 1
from person authorized to sign contract N(arty Hen
Citv Secretary
SC PCSD-Rev.6/04
44)- cont•- ct Auth ization
gate
A'A WHO
Cover Page 1 ,
WORN, YEN.
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*
01C IMM/LOCALS 01/01/04 08/31/05 State 93.268 95,508.00 0.00 95,508.00
0000001764
02 ZOONOSIS 09/01/04 08/31/05 State 11,664.00 0.00 11,664.00
C038065000
03A DIAB/CDSP 09/01/04 08/31/05 State 80,000.00 0.00 80,000.00
C038790000
04 OPHP/LPHS 09/01/04 08/31/05 State 93.991 40,000.00 0.00 40,000.00
C039223000
05OPHP/BIOTERR 09/01/04 08/31/05 93.283 495,512.00 0.00 495,512.00
0000300995
DSHS Document No.7560005286 2005 Totals
$722,684.00 $ 0.00 $722,684.00
Change No.08
*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.
CITY
Cover Page 2 0" �, ;� a�
Ff. ��Nll Y_U,
DOCUMENT NO. 7560005286-2005
ATTACHMENT NO. 01C
PURCHASE ORDER NO. 0000001764
PERFORMING AGENCY: FORT WORTH DEPARTMENT OF PUBLIC HEALTH
RECEIVING AGENCY PROGRAM: IMMUNIZATION BRANCH
TERM: January 01, 2004 THRU: August 31, 2005
It is mutually agreed by and between the contracting parties to amend the conditions of
Document No. 7560005286 2005 -01B as written below. All other conditions not hereby
amended are to remain in full force and effect.
SECTION 1. SCOPE OF WORK, 2nd paragraph, is replaced with the following:
PERFORMING AGENCY will provide essential public health services as specified in
PERFORMING AGENCY'S approved 2004 Interlocal Application for Immunization
Services, dated June 16, 2003, and subsequent renewal applications, incorporated herein
and made part of this contract Attachment. Any revisions to these documents shall be
approved by RECEIVING AGENCY Program and transmitted in writing to
PERFORMING AGENCY.
SECTION 1. SCOPE OF WORK, 8th paragraph, is replaced with the following:
PERFORMING AGENCY shall ensure a health care workforce that is knowledgeable
about vaccines, vaccine safety, vaccine-preventable diseases, and delivery of
immunization services.
SECTION 1. SCOPE OF WORK, 16`h paragraph, is replaced with the following:
PERFORMING AGENCY shall provide to RECEIVING AGENCY Program periodic
data transfers of all vaccines administered in a format that is compatible for inclusion in
the statewide immunization registry, ImmTrac, and in accordance with the schedule
provided by RECEIVING AGENCY.
SECTION I. SCOPE OF WORK, 17'paragraph, bullets 1, 10, and 14, are replaced with
the following:
• PERFORMING AGENCY'S approved 2004 Interlocal Application for
Immunization Services, and any revisions or subsequent renewal applications;
• RECEIVING AGENCY'S Standards for Public Health Clinic Services, revised
August 31, 2004;
• Standards for Child and Adolescent Immunization Practices, February 8, 2002,
recommended by the National Vaccine Advisory Committee, approved b
ATTACHMENT—Page 1 �� lU� � � ��
United States Public Health Service, and endorsed by the American Academy of
Pediatrics.
SECTION I. PERFORMANCE MEASURES, is replaced in its entirety with the
following:
All activities shall be performed in accordance with PERFORMING AGENCY'S Annual
Plan and detailed budget as approved by RECEIVING AGENCY Program based on the
Interlocal Application for Immunization Services, dated June 16, 2003 and any
subsequent renewal applications. The following performance measure(s) will be used, in
part, to assess PERFORMING AGENCY'S effectiveness in providing the services
described in this contract Attachment to the service area, without waiving the
enforceability of any of the terms of the contract Attachment.
PERFORMING AGENCY shall submit to RECEIVING AGENCY Program the
monthly reports of doses administered and the monthly biological order form in a
format provided by RECEIVING AGENCY and in accordance with the schedule
provided to PERFORMING AGENCY by RECEIVING AGENCY Program.
PERFORMING AGENCY shall implement an immunization reminder and recall
system to notify parents or guardians of children less than 36 months of age when
immunizations are due or past due. The notifications may be automated or manual
and may consist of mail or telephone contacts.
PERFORMING AGENCY shall complete 100% of annual assessments in sub-
contracted entities and local Women, Infant and Children (WIC) clinics using the
Assessment, Feedback, Incentives, and eXchange (AFIX) methodology as assigned
by RECEIVING AGENCY. PERFORMING AGENCY shall submit assessment
results to RECEIVING AGENCY Program within two (2) weeks after completion.
PERFORMING AGENCY shall recruit and enroll providers into the Texas Vaccines
for Children (TVFC) program.
PERFORMING AGENCY will perform the following applicable required activities:
1. Implement a plan to improve vaccination coverage levels;
2. Work with the local WIC agencies for referral of under-vaccinated WIC
enrollees;
3. Ensure that expired, wasted, and unaccounted for vaccines do not exceed 5%
for DTaP, Hib, hepatitis B, IPV, MMR, PCV7, and varicella vaccines;
4. Decrease the proportion of duplicate records or questionable matches in
ImmTrac;
5. Increase the percentage of children less than six (6) years of age participating
in ImmTrac;
6. Increase the number of registered provider sites for ImmTrac;
7. Increase TVFC provider enrollment;
8. Increase the number of educational opportunities on vaccine-prevent
diseases available to public and private providers; fN ; �'-�lC� ,(
ATTACHMENT—Page 2
9. Complete 100% of assigned TVFC follow-up site visits;
10. Promote and ensure immunization services are provided for all age groups
with emphasis on pockets of need;
11. Increase the reporting of varicella cases;
12. Complete 90% of vaccine-preventable disease investigations within thirty (30)
days from date reported;
13. Identify all infants born to hepatitis B surface antigen (HBsAG)-positive
pregnant women. PERFORMING AGENCY shall investigate 100% of
suspected hepatitis B infections in pregnant women to ensure appropriate
treatment and follow-up as directed by Health and Safety Code §81.090 and
RECEIVING AGENCY'S Vaccine-Preventable Disease Surveillance
Guidelines;
14. Ensure all reported infants born to HBsAg positive women receive hepatitis B
vaccine and Hepatitis B Immune Globulin (HBIG) within seven (7) days of
birth;
15. Complete 100% of assigned childcare facility assessments or surveys; and,
16. Complete 100% of assigned private school assessments or surveys.
Activities may be subsequently amended as directed by the Centers for Disease
Control and Prevention and RECEIVING AGENCY Program. RECEIVING
AGENCY Program must approve, in writing, any revisions to the PERFORMING
AGENCY'S Annual Plan.
SECTION II. SPECIAL PROVISIONS, 2nd 3rd and 5' paragraphs are replaced with the
following:
Funds shall not be used for purchase of vaccines, inpatient care, construction of facilities,
or debt retirement in accordance with RECEIVING AGENCY Interlocal Application for
Immunization Services, dated June 16, 2003 and any subsequent renewal applications.
Travel expenses shall be reimbursed according to current state travel regulations and shall
not exceed the reimbursement for mileage allowed under the Appropriations Act.
PERFORMING AGENCY is required to complete and submit the following reports
utilizing a format provided by RECEIVING AGENCY Program:
Report Type Reporting Period Report Due Date
Programmatic 1/1/04— 3/31/04 4/30/04
Programmatic 4/1/04—6/30/04 7/30/04
Programmatic 7/1/04—9/30/04 10/30/04
Programmatic 10/1/04— 12/31/04 1/30/05
Programmatic 1/1/05 —4/30/05 5/30/05
Programmatic 5/1/05 — 8/31/05 9/30/05
Final Summar 1/1/04— 8/31/05 10/30/05
CITY AK �F
ATTACHMENT—Page 3
DEPARTMENT OF STATE HEALTH SERVICES
RECEIVING AGENCY PROGRAM: IMMUNIZATION BRANCH
PERFORMING AGENCY: FORT WORTH DEPARTMENT OF PUBLIC HEALTH
CONTRACT TERM:01/01/2004 THRU: 08/31/2005 BUDGET PERIOD: 01/01/2004 THRU 08/31/2005
DSHS DOC.NO. 7560005286 200501C CHG. 08
REVISED CONTRACT BUDGET
FINANCIAL ASSISTANCE
OBJECT CLASS CATEGORIES CURRENT APPROVED CHANGE NEW OR REVISED
BUDGET (A) REQUESTED (B) BUDGET(C)
Personnel $40,320.00 $24,548.00 $64,868.00
Fringe Benefits 3,869.00 4,814.00 8,683.00
Travel 2,540.00 853.00 3,393.00
Equipment 0.00 0.00 0.00
Supplies 7,891.00 6,123.00 14,014.00
Contractual 0.00 0.00 0.00
Other 2,685.00 1,865.00 4,550.00
Total Direct Charges $57,305.00 $38,203.00 $95,508.00
Indirect Charges 0.00 0.00 0.00
TOTAL $57,305.00 $38,203.00 $95,508.00
PERFORMING AGENCY SHARE:
Program Income 0.00 0.00 0.00
Other Match 0.00 0.00 0.00
RECEIVING AGENCY SHARE $57,305.00 $38,203.00 $95,508.00
PERFORMING AGENCY SHARE $0.00 $0.00 $0.00
Detail on Indirect Cost Rate Type:
Rate 0.00 Base $0.00 Total $0.00
Budget Justification: Amendment to extend contract term and increase contract amount with 8 months of funding in order to return
contract term to the State Fiscal year. No revision to number served.
Form No.GC-9 ECPS—Rev. 10/04
Financial status reports are due the 30th of April, 30th of July, 30th of October, 30th of January, 30th of April, 30th of July, and the
30th of November.
City of Fort Worth, Texas
"Agar And 4:0uncit Communication
DATE REFERENCE NUMBER LOG NAME PAGE
8/7/03 **C-19693 50IMMUNIZATIONS 1 of 2
SUBJECT ADOPTION OF APPROPRIATION ORDINANCE AND AUTHORIZATION TO EXECUTE
A CONTRACT WITH THE TEXAS DEPARTMENT OF HEALTH TO PROVIDE
IMMUNIZATION OUTREACH TO THE COMMUNITY
RECOMMENDATION:
It is recommended that the City Council:
1. Authorize the City Manager to apply for and accept and execute a grant contract with the Texas
Department of Health for $100,000 to be used to increase immunization levels in pre-school aged
children and provide awareness and education at the community level; and
2. Adopt the attached appropriation ordinance increasing appropriations and estimated receipts by
$100,000 in the Grants Fund; and
3. Waive indirect costs of 36.32% of related salary and fringe benefits which are the most recent rates
as indicated by the Finance Department.
DISCUSSION:
• Texas immunization levels in 2000 for children aged 3-24 months who are up-to-date on immunizations
is 70.3%.
• The percentage of Tarrant County children aged 3-24 months who are up-to-date is 72.6%.
(Source: 2000 Texas Immunization Survey, Texas Department of Health).
• This is compared to national levels in 2000 of 75.3% (Source: National Immunization Survey,
Center for Disease Control).
The fundamental reason for under-immunization are factors related to poverty. These factors can be
overcome by removing financial and access barriers. Texas parents overwhelmingly believe in the
importance of immunizations for their children, yet may not consider the importance of timing, or may
not know when immunizations are due. Various focus groups revealed parental confusion about the
schedule, the need for numerous shots, and the low awareness about immunization services.
The goal of this proposal is to utilize immunization funds to achieve and maintain 90% vaccine
coverage for DtaP (pertussis or acellular pertussis), DT (diphtheria, tetanus), IVP (polio), MMR
(measles, mumps and rubella), HepB (hepatitis B), Varicella (chickenpox) and Hib (Haemophilus
influenzae type b) vaccines in pre-school age children.
The City's Public Health Department, Outreach Division is proposing a continued partnership with the
Fire Department to immunize more pre-school age children. This partnership with emergency
personnel makes sense for our community. The personnel are medically trained, know their
neighborhoods, and the stations are "safe havens" in the community. The fire stations are easily
accessible, Americans with Disabilities Act compliant, and appealing to young children. Enlisting
firefighters and paramedics to become immunization partners creates an innovative collaboration in
providing needed services to the community. There will be no charge for the immunizations.
City of Fort Worth, Texas
qV01.4or And Council Communication
DATE REFERENCE NUMBER LOG NAME PAGE
8/7/03 **C-19693 1 50IMMUNIZATIONS 2 of 2
SUBJECT ADOPTION OF APPROPRIATION ORDINANCE AND AUTHORIZATION TO EXECUTE
A CONTRACT WITH THE TEXAS DEPARTMENT OF HEALTH TO PROVIDE
IMMUNIZATION OUTREACH TO THE COMMUNITY
As part of the advocacy role, outreach staff is extremely aware of the lack of access to health services.
This is especially acute in the area of immunization. The target group of infants and pre-schoolers in
the City is caught in this lack of access. The immunization program provided 2,207 vaccines to 755
children from January 2002, through June 2003. There were 433 (57.4%) children not insured, 32
(4.2%) underinsured, 203 (26.9%) on Medicaid, and 31 (4.1%) on Children's Health Insurance Program
(CHIP).
The current locations for these immunizations are Station 15 (3100 Azle Avenue), Station 17 (212 East
Felix Street), with Station 3 (4700 Ramey) scheduled to open August 11, 2003. Protocol and standing
delegation orders are in place and quality assurance will come through a collaborative effort between
the Health Department and the Fire Department.
The Outreach staff distributes information about the availability of services to recreation centers,
apartments, neighborhood day-care centers, and faith-based organizations to assure the public is
informed of the immunization services. Data collection is done using the Statistical Package for the
Social Sciences (SPSS) Version 11.0. Data is entered in the Tarrant County Immunization registry and
downloaded to the Texas Department of Health's "ImmTrac" computer system.
Staff recommends the waiver of indirect costs to maximize the funds toward the grant objective.
FISCAL INFORMATION/CERTIFICATION:
The Finance Director certifies that upon adoption of the attached appropriation ordinance, funds will be
available in the current operating budget, as appropriated, of the Grants Fund.
LWA
Submitted for City Manager's FUND ACCOUNT CENTER AMOUNT CITY SECRETARY
Office by: (to)
GR76 451923 050301880000 $100,000.00
Libby Watson 6183 GR76 5(various) 050301881010 $100,000.00
Originating Department Head:
APPROVED 8/7/03
Daniel Reimer 7201 (from) ORDINANCE#15635
Additional Information Contact:
Barbara Murph 6213