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AMENDMENT NO. I TO CITY SECRETARY CONTRACT NO. 40910
CONTRACT BETWEEN
CITY OF FORT WORTH AND TARRANT COUNTY ASSOCIATION FOR
MENTAL HEALTH, INC.
This AMENDMENT NO. 1 TO CONTRACT ("Amendment") is made and
entered into by and between the CITY OF FORT WORTH ("City"), a home rule
municipal corporation organized under the laws of the State of Texas, and TARRANT
COUNTY ASSOCIATION FOR MENTAL HEALTH, INC ("Contractor"),
The following introductory provisions are true and correct and for the basis of this
Amendment:
A. As of October 11, 2010 the City and Contractor entered into that certain Contract
on file in the City Secretary's Office as City Secretary Contract No. 40910 (the
"Contract"). Under the Contract, Contractor agreed, among other things, to provide
services and activities under Exhibit A.
B. The City and Contractor now wish to amend the Agreement in order to more
accurately reflect the classification of Contractor's services under CDBG regulations.
NOW, THEREFORE, for good and valuable consideration, the receipt and
adequacy of which are hereby acknowledged, the City and Contractor hereby agree as
follows:
1. Exhibit A is hereby deleted in its entirety and replaced with the attached Exhibit
A —Revised.
2. All terms and conditions of the Agreement that are not expressly amended
pursuant to this Amendment shall remain in full force and effect.
IN WITNESS WHEREOF, the undersigned have caused this Amendment to be
executed as of the later date below:
[SIGNATURES FOLLOW IMMEDIATELY ON NEXT TWO (2) PAGES]
®FFICi�L REC®RD
FT. WORTH, ` `it
Page 1
Amendment No. 1 to CSC No. 40910
Tarrant County Association for Mental Health, Inc.
CITY OF FORT WORTH:
Assistant City Manager
Date: 6 11 0 I I,
r
ATTEST:
By:
City Secretary
STATE OF TEXAS §
COUNTY OF TARRANT §
APPROVED AS TO FORM AND
LEGALITY:
Vicki Ganske
Assistant City Attorney
M&C: C-24401
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BEFORE ME, the undersigned authority, on this day personally appeared Susan
Alanis, Assistant City Manager of the CITY OF FORT WORTH, a municipal
corporation organized under the laws of the State of Texas, known to me to be the person
and officer whose name is subscribed to the foregoing instrument, and acknowledged to me
that the same was the act of the CITY OF FORT WORTH, that he was duly authorized to
perform the same by appropriate resolution of the City Council of the City of Fort Worth
and that he executed the same as the act of the CITY OF FORT WORTH for the
purposes and consideration therein expressed and in the capacity therein stated.
GIVEN UNDER MY HAND AND SEAL OF OFFICE this day of
m am, , 2011.
n
ary Public in acid
State of Texas
I
Notary
Printed Name
Page 2
Amendment No. I to CSC No. 40910
Tarrant County Association for Mental Health, Inc.
LINDA M. HIRRUNGER
MY COMMISSION EXPIRES
February 2, 2014
OFFICE�,�t�CORD
CITY '��CR�TARY
FT ORTH, TX
TARRANT COUNTY ASSOCIATION FOR MENTAL HEALTH:
By:
Dr. Lee LeGrice
Executive Director
ATTEST:
By:
STATE OF � KCc� §
COUNTY OF 7&CCo_A §
BEFORE ME, the undersigned authority, on this day personally appeared Dr. Lee
Legrice, Executive Director of Tarrant County Association for Mental Health, Inc.,
known to me to be the person whose name is subscribed to the foregoing instrument, and
acknowledged to me that s/he executed the same for the purposes and consideration therein
expressed, in the capacity therein stated and as the act and deed of Tarrant County
Association for Mental Health, Inc.
GIVEN UNDER MY II1�ND AND SEAL OF OFFICE this
day of Lj..K .rc�� , 2011.
Notary Public in and for
the State of TAGS
Notary's Printed Name
TUNYA RENEE GUIN
Notary Public, State of Texas
My Commission Expires
AUGUST 612014
Page 3
Amendment No. 1 to CSC No. 40910
Tarrant County Association for Mental Health, Inc.
Mental Health Association of Tarrant County
EXHIBIT A - REVISED
Long Term are Ombudsman SCOPE OF SERVICES
PROGRAM SUMMARY
COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG)
40910
CONTRACT NO.
SCOPE OF SERVICES
June 1, 2010 - May 31, 2011
PERIOD
$15,750
AMOUNT
This Scope of Services is based on the proposal prepared and submitted by the Subrecipient through the City of Fort
Worth's annual Request for Proposal (RFP) process. The Subrecipient agrees to operate this Community Development
Block Grant (CDBG) program in a manner consistent with the program delivery stated in the approved proposal.
However, in the event of any conflict between the proposal and any provision contained, herein, this Agreement shall
control.
The Mental Health Association of Tarrant County will provide long term care ombudsman services to seven or more
inner city nursing homes located within the City of Fort Worth. The Long Term Care Ombudsman program will include
the following tasks and activities; 7 weekly monitoring visits to nursing facilities, conduct resident interviews,
investigate and resolve complaints, and provide in-service educational programs for nursing home staff. All services
will be provided at the identified nursing homes primarily during business hours Monday through Friday. From time to
time, services may be provided on the weekends or in the evenings, as needed by the facilities and their residents.
The purpose of the program will be to prevent abuse and neglect of residents of inner city nursing homes. The specific
objectives, goals and level of services to be provided are listed below along with the geographical location of clients
served. All services will be provided from June 1, 2010 to May 31, 2011.
The CDBG funds will be used to pay for• salary of the ombudsman staff which is consistent with Exhibit C-Detailed
Budget.
REGULATORY CLASSIFICATION:
National Objective Citation: 24 CFR 570.208(a)(2)(A) Presumed Benefit
Regulatory Citation: 24 CFR 570.201(e) Public Service
Based on the nature of the service provided, Mental Health Association of Tarrant County will maintain documentation
that verifies that clients served by the Long Term Care Ombudsman program are elderly and/or severely disabled as
defined by the Department of Housing and Urban Development (HUD).
GEOGRAPHICAL LOCATION:
Site Address: 7 or more inner city nursing homes located within Fort Worth city limits.
Client Beneficiary Location (Neighborhood, District, Citywide...): Citywide
PROGRAM GOALS:
Prevent abuse and neglect of residents in long-term care facilities.
PROGRAM OBJECTIVES.
Resolve 959/o of substantiated complaints
PROGRAM SERVICES and ACTIVITIES Total Units of Services for Year
Level of service should be identified in a quantifiable unit and directly related to specified objectives. These
activities should be consistent with activities listed on Exhibit B- Program Schedule. Activities should also be
consistent with those required by IDIS.
Number of Unduplicated Clients Served 850
Conduct weekly monitoring visits to 7 nursing homes 350
Conduct resident interviews 1200
Investigate/resolve complaints 125
Provide in-service educational programs for facility staff 7