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y CITY SECRETARY
CONTRACT No. �
CONTRACT FOR PUBLIC HEALTH SERVICES -,TDH DOCUMENT NO. 7560005286 200203
Contract Issued by: TEXAS DEPARTMENT OF HEALTH VW
(RECEIVING AGENCY) 1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
Legal Authority to Contract: Chapters 12 and 121,Health and Safety Code.
Venue: The provisions of this Contract shall be interpreted in accordance with Texas law. Venue for any court disputes shall be in Travis County,
Texas.
PERFORMING AGENCY NAME: FORT WORTH DEPARTMENT OF PUBLIC HEALTH
MAILING ADDRESS: 1800 UNIVERSITY DR FORT WORTH TX 76107-3405
STREET ADDRESS: 1800 UNIVERSITY DR FORT WORTH TX 76107-3405
NAME OF AUTHORIZED
CONTRACTING ENTITY: CITY OF FORT WORTH
(If different from PERFORMING AGENCY)
PAYEE DATA(If not the same as PERFORMING AGENCY or AUTHORIZED CONTRACTING ENTITY;must be on file with the Texas State
Comptroller's Office.):
NAME: CITY OF FORT WORTH
ADDRESS: 1000 THROCKMORTON ST FORT WORTH TX 76102-6311
(City,State, Zip)
State of Texas Vendor Identification No. (14 digits) PAYEE AGENCY Fiscal
17560005286051 Year Ending Month: December
PAYEE BUSINESS INFORMATION FOR STATISTICAL REPORTING: Please check the categories that apply to your business.
Small Business-A corporation,sole proprietorship, or other legal entity formed for the purpose of making a profit which.is
independently owned and operated and has fewer than 100 employees or has less than$1,000,000 in annual gross receipts.
X Historically Underutilized Business(HUB)-A corporation, sole proprietorship,or joint venture formed for the purpose of making
a profit in which at least 51% of all classes of the shares of stock or other equitable securities are owned by one or more persons
who have been historically underutilized(socially disadvantaged)because of their identification as members of certain groups:
Black American, Hispanic American, Asian Pacific American, Native American,and Women. The HUB must be certified by
General Services Commission or another entity.
For Profit Organization
SUMMARY OF CONTRACT DOCUMENTATION:
COVER PAGE 1 -Receiving and Performing Agency Data GENERAL PROVISIONS
COVER PAGE 2-Details of Attachment(s) ATTACHMENT(S)
COVER PAGE 3-Authorized Signatures EXHIBITS, IF APPLICABLE
0FROAd EICOORD
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Cover Page 1 [] woo
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V YG ����YY I
DETAILS OF ATTACHMENTS
Att/ TDH Term Financial Assistance Direct Total Amount
Amd Program Assistance (TDH Share)
No. ID Begin End Source of Amount
Funds*
01 DIAB/DAEC 09/01/01 08/31/02 State 100,000.00 0.00 100,000.00
02 BRLHO 09/01/01 08/31/02 93.991 40,000.00 0.00 40,000.00
03 IMM/LOCALS 09/01/01 1 08/31/02 1 State 100,000.00 0.00 100,000.00
TDH Document No.7560005286 2002 Totals
$240,000.00 $ 0.00 $240,000.00
Change No. 00
*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.
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Cover Page 2 �v�l�V` C� c"15UW�°j
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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 NAME: RECEIVING AGENCY NAME:
FORT WOR DEPARTMENT OF PUBLIC TEXAS DEPARTMENT OF HEALTH
HEALTH
By: By:
( ignature of pe(s&authorized to sign contracts) (Signature of person authorized to 49ign contracts)
Melanie A. Doyle, Director
Libby Watson, Assistant City Manager Grants Management Division
(Name and Title) (Name and Title)
Date: Date: �� Q
RECOMMENDED:
By:
(PERFORMING AGENCY Director, if different
from person authorized to sign contract)
Daniel B. Reimer
APPROVED AS TO FORM AND LEGALITY: TDH Document No: 756000528602
1
By:
s s ant Cttorne
ATTESTED BY
ContraG-t Authorization
Date Cover Page 3 w
CITY SECRETARY
CONTRACT NO .
DOCUMENT NO. 7560005286-2002
ATTACHMENT NO. 02
PERFORMING AGENCY: FORT WORTH DEPARTMENT OF PUBLIC HEALTH
RECEIVING AGENCY PROGRAM: BUREAU OF REGIONAL/LOCAL HEALTH
OPERATIONS
TERM: September 01, 2001 THRU: August 31, 2002
SECTION I. SCOPE OF WORK:
ESSENTIAL PUBLIC HEALTH SERVICES
PERFORMING AGENCY shall use direct assistance and/or financial assistance, as specified in
SECTION III., BUDGET, from RECEIVING AGENCY to deliver one or more of the following
essential public health services as specified in PERFORMING AGENICY'S FY 02 Service
Delivery Plan which is adopted by reference:
• Monitor the health status of individuals in the community to identify community health
problems;
• Diagnose and investigate community health problems and community health hazards;
• Inform, educate, and empower the community with respect to health issues;
• Mobilize community partnerships to identify and solve community health problems;
• Develop policies and plans that support individual and community efforts to improve
health;
• Enforce laws and rules that protect the public that protect health and ensure safety in
accordance with those laws and rules;
• Link individuals who have a need for community and personal health services to
appropriate community and private providers;
• Ensure a competent workforce for the provision of essential public health services;
• Research for new insights and innovative solutions to community health problems; and
• Evaluate the effectiveness, accessibility and quality of personal and population based
health services in a community.
Two types of support are available under this program: (1) direct assistance in the form of state-
paid positions and/or (2) financial assistance from General Revenue funds and the Preventive
Health and Health Services Block Grant.
DIRECT ASSISTANCE
ATTACHMENT—Page 1
t, r t 1El
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State-paid positions under this contract Attachment shall perform activities as specified in
PERFORMING AGENCY'S FY 02 Service Delivery Plan. Activities shall be specific to one or
more of the ten essential public health services or cardiovascular and cancer activities.
FINANCIAL ASSISTANCE
PERFORMING AGENCY shall direct General Revenue or 73.5% of the funds toward the
delivery of a broad range of essential public health services and the Preventive Health and Health
Services Block Grant or 26.5% of the funds for activities designed to reduce the incidence of
cancer and cardiovascular disease.
PERFORMANCE MEASURES
The following performance measures(s) will be used to assess, in part, PERFORMING
AGENCY'S effectiveness in providing the services described in this contract Attachment,
without waiving the enforceability of any of the other terms of the contract.
For the General Revenue funds the PERFORMING AGENCY shall submit quarterly progress
reports which describe accomplishments, challenges, barriers, impact and progress toward
achieving the work plan goals and objectives contained in PERFORMING AGENCY'S FY 02
Service Delivery Plan. These reports shall include the progress and activities of the employees
in state-paid positions under the "000" budget.
For the Preventive Health and Health Services Block funds the PERFORMING AGENCY shall
complete activities in the approved service delivery plan no later than August 31, 2002 to reduce
cardiovascular disease and cancer in your community. One report is required.
SECTION I1. SPECIAL PROVISIONS
General Provisions, Reports Article, is revised to include the following paragraph:
PERFORMING AGENCY shall submit quarterly reports to the appropriate RECEIVING
AGENCY Regional Director in the format specified by RECEIVING AGENCY Program
within thirty (30) days following the end of each quarter. PERFORMING AGENCY
shall submit an Annual Expenditures Report to RECEIVING AGENCY Program within
sixty (60) days following the end of PERFORMING AGENCY'S fiscal year.
General Provisions, Allowable Costs and Audit Requirements Article, is revised to include the
following:
RECEIVING AGENCY'S appropriate Public Health Region will provide staff to assess
PERFORMING AGENCY with an annual Quality Assurance Audit.
ATTACHMENT—Page 2
D
a
SECTION III. BUDGET:
PERSONNEL $8,000.00
FRINGE BENEFITS 2,000.00
TRAVEL 0.00
EQUIPMENT 0.00
SUPPLIES 10,658.00
CONTRACTUAL 0.00
OTHER 18,542.00
TOTAL DIRECT CHARGES $39,200.00
INDIRECT CHARGES $800.00
TOTAL $40,000.00
Total reimbursements will not exceed $40,000.00 .
Financial status reports are due the 30th of December, 30th of March, 30th of June, and the 30th
of November.
Based on UGMS' indirect cost may be recovered up to 10% of the direct salary and wage costs
of providing the service (excluding overtime, shift premiums, and fringe benefits).
ATTACHMENT—Page 3
N�CD L MC 0 P D
CATV EPM,RY
A G0"""'FIN, Va.
City of Fort Worth, Texas
4vaijor And Council conswuniention
DATE REFERENCE NUMBER LOG NAME PAGE
5/8/01 **C-18584 50WALKING 1 of 2
SUBJECT APPROPRIATION ORDINANCE AND CONTRACT WITH THE TEXAS DEPARTMENT
OF HEALTH BUREAU OF REGIONAL/LOCAL HEALTH OPERATIONS, PREVENTIVE
HEALTH AND HUMAN SERVICES BLOCK GRANT
RECOMMENDATION:
It is recommended that the City Council:
1. Authorize the City Manager to submit a grant application and, if offered, execute one grant contract
with the Texas Department of Health's Bureau of Regional/Local Health Operations (BRLHO) for
$40,000; and
2. Adopt the attached appropriation ordinance increasing appropriations and estimated receipts by
$40,000 in the Grants Fund; and
3. Apply an indirect cost rate of 10%, which represents the rate that the Texas Department of Health
agrees to.
DISCUSSION:
The Texas Department of Health (TDH) provides grant funds to local health departments across the
state to provide essential public health services. These funds are directed at reducing the incidence of
cardiovascular disease in the community.
Public Health staff will address these essential health functions, as defined by TDH:
• Inform, educate and empower people about health status; and
• Mobilize community partnerships to identify and solve health problems.
Walk for the Health of Itl, an incentive walking program in area parks, was originally approved by the
City Council on June 23, 1998 (M&C-16835). During 1998, four parks were marked, and 24 people
completed walking logs totaling 724.71 hours.
On June 15, 1999 (M&C-17470), the City Council renewed the program. Staff of the Parks and
Community Services Department marked the remaining 12 parks, and Health Promotion staff hosted 30
events from April to June.
On July 11, 2000 (M&C-18114), the City Council renewed the program a third year, which is currently
underway.
This is the fourth year for the collaborative program between the Public Health and Parks and
Community Services Departments. With the renewal of the grant, Public Health staff will continue to
initiate walking programs and educating citizens on the benefits of physical activity. The funding period
would begin September 1, 2001, and end August 31, 2002, for an amount not to exceed $40,000.
City of Fort Worth, Texas
"611jor and Council Communication
DATE REFERENCE NUMBER LOG NAME PAGE
5/8/01 **C-18584 1 50WALKING 2 of 2
SUBJECT APPROPRIATION ORDINANCE AND CONTRACT WITH THE TEXAS DEPARTMENT
OF HEALTH BUREAU OF REGIONAULOCAL HEALTH OPERATIONS, PREVENTIVE
HEALTH AND HUMAN SERVICES BLOCK GRANT
FISCAL INFORMATION/CERTIFICATION:
The Finance Director certifies that upon acceptance and execution of this grant contract and adoption
of the attached appropriation ordinance, funds will be available in the operating budget, as
appropriated, of the Grants Fund.
LW:k
Submitted for City Manager's FUND ACCOUNT CENTER AMOUNT CITY SECRETARY
Office by: (to) APPROVED
GR76 451923 050301709000 $40,000.00 CITY COUNCIL
Libby Watson 6183 GR76 516010 050301709010 $40,000.00
Originating Department Head: MAY 8 2001
Daniel Reimer 7201 (from)
Additional Information Contact: city Secretary ot'the
City of Fort Worth,Tesas
Daniel Reimer 7201
Adopted Ordinance No. l� 1�