HomeMy WebLinkAboutContract 33563 06-02-06 X110 :51
CITY SECRETARY
CONTRACT NO.
9ar-
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. 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. 02A : DIABETES-COMM. DIABETES SERVICES
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 DEPARTMENT OF PUBLIC DEPARTMENT OF STATE HEALTH SERVICES
HEALTY)P&
By: _ By:
(Signatf of e s n rized to sign) (Signature of person authorized to sign)
Bob Burnette, Director
Joe Paniagua,'Assistant City Manager Client Services Contracting Unit
(Name and Title) Lo
(Name and Title)
Date: Date: 5IA4 I �
RECOMMENDED:
By:
X6C�/L'LLL��� Contract:. Authorizatiox
(PERFORMING AGENCY Director, if different _l I— I–
from
person authorized to sign-contract Date
MB CSCU-Rev. 6/05 4 '0 Attested By:
t�il I�Ux� 0-'
ii'j SECRERI °�� Cover Page 1 Marty Hendr -
FT. WWAVITH,
TEX. City Secretary
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*
0113 RLSS/LPHS 09/01/05 08/31/06 State 93.991 36,508.00 0.00 36,508.00
0000309849
02A DIAB/CDSP 09/01/05 08/31/06 State 93.988 84,000.00 0.00 84,000.00
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
Change No. 08 $695,276.00 $ 0.00 $695,276.00
*Federal funds are indicated by a number from the Catalcg of Federal Domestic Assistance (CFDA), if applicable. REFER TO
BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS.
0 F F 1 C r'I C1Ofii
Cover Page 2
DOCUMENT NO. 7560005286-2006
ATTACHMENT NO. 02A
PURCHASE ORDER NO. 0000309271
PERFORMING AGENCY: FORT WORTH DEPARTMENT OF PUBLIC HEALTH
RECEIVING AGENCY PROGRAM: TEXAS DIABETES PROGRAM
TERM: September 01, 2005 THRU: August 31, 2006
It is mutually agreed by and between the contracting parties to amend the conditions of
Document No. 7560005286 2006 -02 as written below. All other conditions not hereby
amended are to remain in full force and effect.
SECTION I. SCOPE OF WORK: PERFORMANCE MEASURES, is revised to increase the
value of the following bulleted items:
PERFORMING AGENCY shall provide the following:
• Conduct at least 8 organizational activities leading to changes in community systems,
policy, and/or environments that reduce the burden of diabetes;
• Provide a minimum of 2 organizational changes impacting community systems, policy,
and/or environments in different sectors of the community (e.g., health care,
worksite/businesses, faith-based communities, neighborhoods, recreations, schools, non-
profits, and food industry) to reduce the burden of diabetes;
• Conduct at least 78 self-management classes (e.g., Stanford University's Chronic
Disease Self Management, CDC's diabetes self management program, or other DSHS
approved models) or activities to reduce the burden of diabetes reaching 700 people;
• Provide a minimum of 32 physical activity events and ongoing activity groups to reduce
the burden of diabetes reaching 70 people;
• Conduct at least 0 support groups to reduce the burden of diabetes reaching 0 people;
• Conduct at least 12 series of food and nutrition classes to reduce the burden of diabetes
reaching 45 people;
• Conduct at least 130 provider education (risk reduction, standards of care, etc.) events
about diabetes;
• Publish a minimum of 100 diabetes-related articles (e.g., newspapers, church bulletins,
business inserts or newsletters);
• Provide a minimum of 80 diabetes-related radio activities;
• Provide a minimum of 50 diabetes-related television activities; and
• Distribute at least 3,500 pieces of diabetes material (e.g., National Diabetes Education
Program and Texas Diabetes Program/Council literature such as foot posters).
ATTACHMENT—Pae 1 rN. ;,� rrN�,o
DEPARTMENT OF STATE HEALTH SERVICES
RECEIVING AGENCY PROGRAM: TEXAS DIABETES PROGRAM
PERFORMING AGENCY: FORT WORTH DEPARTMENT OF PUBLIC HEALTH
CONTRACT TERM:09/01/05 THRU: 08/31/06 BUDGET PERIOD: 09/01/05 THRU 08/31/06
DSHS DOC.NO. 7560005286 200602A CHG. 08
REVISED CONTRACT BUDGET
FINANCIAL ASSISTANCE
OBJECT CLASS CATEGORIES CURRENT APPROVED CHANGE NEW OR REVISED
BUDGET (A) REQUESTED (B) BUDGET(C)
PPersonnel $44,894.00 $0.00 $44,894.00
Fringe Benefits 11,223.00 0.00 11,223.00
Travel 3,939.00 1,617.00 5,556.00
Equipment 0.00 0.00 0.00
Supplies 5,728.00 383.00 6,111.00
Contractual 0.00 0.00 0.00
Other 14,216.00 2,000.00 16,216.00
Total Direct Charges $80,000.00 $4,000.00 $84,000.00
Indirect Charges 0.00 0.00 0.00
TOTAL $80,000.00 $4,000.00 $84,000.00
PERFORMING AGENCY SHARE:
Program Income 0.00 0.00 0.00
Other Match 0.00 0.00 0.00
RECEIVING AGENCY SHARE $80,000.00 $4,000.00 $84,000.00
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: Increase in contract amount to proved additional services as outlined in the amended Scope of Work.
Form No.GC-9 ECPS-Rev. 10/04
Financial status reports are due the 30th of December, 30th of March, 30th of June, and he 30th of November.
2 ��i r'•'N'l�U' �i .o k
Page 1 of 2
City of Fort Worth, Texas
Mayor and Council Communication
COUNCIL ACTION: Approved on 11/1/2005 - Ordinance No. 16674-11-2005
DATE: Tuesday, November 01, 2005
LOG NAME: 50DIABETES REFERENCE NO.: **G-14982
SUBJECT:
Authorization to Accept Additional Funding from the Texas Department of State Health Services for
the Texas Diabetes Program's Community Diabetes Service Projects from September 1, 2005 to
March 29, 2006 and Adopt Appropriation Ordinance
RECOMMENDATION:
It is recommended that the City Council:
1. Authorize the City Manager to accept additional funding for an existing grant contract (M&C C-20790)
with the Texas Department of State Health Services (DSHS), formerly the Texas Department of Health, for
$10,000 to be used to provide additional community-based diabetes prevention and management programs
from September 1, 2005 to March 29, 2006;
2. Adopt the attached appropriation ordinance increasing estimated receipts and appropriation in the
Grants Fund by $10,000; and
3. Waive indirect costs of 18.34% of related salary and fringe benefits which are the most recent rates
indicated by the Finance Department.
DISCUSSION:
On June 14, 2005, (M&C C-20790) City Council authorized execution of a grant contract (CS32337) with
DSHS. This contract is funded for $80,000 to provide community based diabetes prevention and
management programs from September 1, 2005 to August 31, 2006. On September 26, 2005, DSHS
notified the city of the availability of more funds for this program. With an additional $10,000 the City will be
able to reach more citizens, who can increase their knowledge of diabetes self management, physical
activity and nutrition.
Diabetes is an epidemic and a public health crisis in Texas. During the 2003 City of Fort Worth Public
Health Department Community Needs Assessment, six out of the 12 Neighborhood Police Districts
surveyed ranked diabetes No.1 as their greatest household health problem.
Poor eating habits, being overweight and lack of physical activity attribute to 90% of diabetes
diagnosis. More than 60% of American adults do not get enough physical activity and more than 25% are
not active at all. The City of Fort Worth is no exception. According to the 2003 City of Fort Worth Public
Health Community Needs Assessment 21.3% to 40% surveyed identified not exercising. Along with 82.5%
to 90.8% surveyed identified eating fewer than 5 servings of fruits and vegetables a daily.
The City of Fort Worth Public Health Department Diabetes Program was awarded funding in September
2003 for a four-year program renewal to provide the following but not limited to:
. Organizational activities leading to changes in community systems, policy, and/or
environments,
http://www.cfwnet.org/council_packet/Reports/mc_print.asp 8/23/2006
Page 2 of 2
. Organizational changes impacting community systems, policy, and/or environments
in different community sectors (e.g. health care, worksites/businesses, faith-based communities,
neighborhoods, recreation, non-profits, food industry, etc.),
. Lifestyle classes in English (e.g., CDC Diabetes self management program or other DSHS
approved models) or similar activities,
. Lifestyle classes in Spanish (e.g., CDC Diabetes self management program or other DSHS
approved models) or similar activities physical activity ongoing groups and activity events,
. Physical activity events and ongoing activity groups,
. Support groups - English,
. Support groups - Spanish,
. A series of food and nutrition classes,
. Provider Education (risk reduction, standards of care, etc.),
. Public health information activities (e.g., television, radio, print media, outdoor mobile
advertising, websites, kiosks, displays, etc.),
. Material distribution (e.g. brochures, posters, etc. from National Diabetes Education Program,
Texas Diabetes Council/DSHS and other sources)
. Resources in Texas Information Referral Network (by Jan. 2006)
The City of Fort Worth Public Health Department provides community-based diabetes programs targeting
individuals with diabetes or those at risk and their families, those uninsured/underinsured and communities
in Fort Worth with high prevalence and burdens of diabetes, including mortality.
FISCAL INFORMATION/CERTIFICATION:
The Finance Director certifies that upon approval of the above recommendations and adoption of the
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 050301036000 $10,000.00
GR76 5XXXXX 050301036010 $10,000.00
Submitted for City Manager's Office by- Joe Paniagua (6140)
Originating Department Head: Daniel Reimer (7201)
Additional Information Contact: Markena Conway (6053)
http://www.cfwnet.org/council_packet/Reports/mc_print.asp 8/23/2006