HomeMy WebLinkAboutContract 30201 7Y STCRETARY
A C
TEXAS DEPARTMENT OF HEALTH
1100 WEST 49TH STREET
AUSTIN,TEXAS 78756-3199
STATE OF TEXAS TDH Document No. 7560005286 2005
COUNTY OF TRAVIS Contract Change Notice No.01
The Texas Department of Health,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.01A: IMMUNIZATION DIVISION-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: .,,,
4" 7/(" 'e
PERFORMING ENCY: RBEEII'V N AGENCIIV;/�
FORT WOR EPARTMENT OF PUBLIC TEXAS DEPARTMENT OF HEALTH
HEALT44-"'
By:, By:
(Signature of person orized to sign) (Signature of person authorized to sign)
Libby Watson, Assistant City Manager Bob Burnette,Director
Procurement and Contracting Services Division
(Name and Title) (Name and Title)
Date: Date: �O (�
RECOMME ED
By: MA't�� '� Contract Authorizatio*
(PERFORMING AGENCY Director, if different
from person authorized to sign contract
Date
SC PCSD-Rev.2/03
C
.............
Cover Page 1
DETAILS OF ATTACHMENTS
Att/ TDH Program ID/ Term Financial Assistance Direct Total Amount
Amd TDH Purchase Order Assistance (TDH Share)
No. Number Begin End Source of Amount
Funds*
OIA IMM/LOCALS 01/01/04 12/31/04 State 93.268 38,203.00 0.00 38,203.00
16000001764 1 1 1
TDH Document No.7560005286 2005 Totals $38,203.00 $ 0.00 $38,203.00
-Change No.OI
*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
DOCUMENT NO, 7560005286-2005
ATTACHMENT NO. 01 A
PURCHASE ORDER NO. 0000001764
PERFORMING AGENCY: FORT WORTH DEPARTMENT OF PUBLIC HEALTH
RECEIVING AGENCY PROGRAM: IMMUNIZATION DIVISION
TERM: January 01, 2004 THRU: December 31, 2004
It is mutually agreed by and between the contracting parties to amend the conditions of
Document No. 7560005286 2005 -01 as written below. All other conditions not hereby
amended are to remain in full force and effect.
SECTION I. SCOPE OF WORK is replaced with the following:
The goal of RECEIVING AGENCY Program is to prevent, control, and eliminate
vaccine-preventable diseases by providing and administering biologicals, promoting
immunizations, conducting vaccine-preventable disease surveillance, assessing vaccine
coverage levels, and applying principles of epidemiology and outbreak control measures
within budgetary constraints.
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, 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 PERFOMING AGENCY.
PERFORMING AGENCY shall implement an immunization program for children,
adolescents, and adults, with special emphasis on accelerating interventions to improve
the immunization coverage of children two years of age or younger (less than 36 months
of age). PERFORMING AGENCY shall incorporate traditional and non-traditional,
systematic approaches designed to eliminate barriers, expand immunization delivery, and
establish uniform policies. A
PERFORMING AGENCY shall report all reportable conditions as specified in 25 TAC
Part 1 §§97.1 - 97.6 and 97.101 - 97.102.
PERFORMING AGENCY shall report all vaccine adverse event occurrences in
accordance with the National Childhood Vaccine Injury Act of 1986.
PERFORMING AGENCY shall inform and educate the public about vaccines and
vaccine-preventable diseases.
ATTACHMENT—Page I
PERFORMING AGENCY shall develop policies and plans that support individual and
community-based immunization strategies and evaluate effectiveness, accessibility, and
quality of personal and population-based immunization services and program activities.
PERFORMING AGENCY shall ensure a health care workforce that is knowledgeable
about vaccines, vaccine-preventable diseases, and delivery of vaccination services.
PERFORMING AGENCY shall comply with written policies and procedures provided
by RECEIVING AGENCY Program in managing state-supplied vaccines, including
guidelines for proper storage and handling of vaccines.
PERFORMING AGENCY shall not deny vaccinations to recipients because they do not
reside within PERFORMING AGENCY'S jurisdiction.
PERFORMING AGENCY shall maintain an accurate, up-to-date list of clinics and sites
where public sector (free or low cost) immunization services are offered in
PERFORMING AGENCY'S local area.
PERFORMING AGENCY shall not charge a fee for vaccines provided by RECEIVING
AGENCY Program. All vaccines obtained from RECEIVING AGENCY Program shall
be used solely for purposes of this contract Attachment and shall not be sold to agencies
or individuals.
PERFORMING AGENCY shall not collect vaccine administration fees from Medicaid
recipients. Vaccine administration fees collected from non-Medicaid patients shall be
kept within guidelines established by RECEIVING AGENCY. In accordance with 25
TAC §1.91, no one shall be denied immunization services in public clinics because of
inability to pay the administration fee. Fee schedules shall not be based on vaccine type,
formulation, or dose in series. A copy of PERFORMING AGENCY'S fee schedule shall
be submitted to RECEIVING AGENCY Program by April 151.
All equipment and vaccine used by PERFORMING AGENCY which are provided by
RECEIVING AGENCY Program, shall be accounted for as public property.
RECEIVING AGENCY Program will investigate equipment or vaccine loss, destruction,
spoilage, or other waste and may require PERFORMING AGENCY to replace or
reimburse RECEIVING AGENCY Program.
PERFORMING AGENCY shall provide the parent, managing conservator, or guardian
of each patient with a form that is approved by RECEIVING AGENCY Program in
compliance with 25 TAC, Chapter 100 to authorize participation in the statewide
immunization registry (ImmTrac).
PERFORMING AGENCY shall provide RECEIVING AGENCY Program weekly data
transfers of all vaccines administered in a format that is compatible for inclusion in the
statewide immunization registry (ImmTrac).
ATTACHMENT—Page 2
PERFORMING AGENCY shall comply with all applicable federal and state laws, rules,
regulations, standards, and guidelines in effect on the beginning date of this contract
Attachment unless amended. The following documents are incorporated by reference and
made a part of this contract Attachment.
0 PERFORMING AGENCY'S approved 2004 Interlocal Application for
Immunization Services, and any revisions;
0 Human Resources Code §42.043, VTCA;
0 Education Code §§38.001-38.002, VTCA;
* Health and Safety Code §§81.023 and 161.001-161.009, VTCA;
* 25 TAC Chapter 97;
0 25 TAC, Chapter 96;
0 25 TAC, Chapter 100;
• 42 USC §§247b and 300 aa-25;
• Omnibus Budget Reconciliation Act of 1993, 26 USC §498013;
RECEIVING AGENCY'S Client Services Standards for Public Health and
Community Clinics, revised June 1997;
• RECEIVING AGENCY'S Vaccine-Preventable Disease Surveillance guidelines,
http://www.tdh.state.tx.us/immunize/docs/guide.htm;
• RECEIVING AGENCY'S Pharmacy guidelines;
• Centers for Disease Control and Prevention's Advisory Committee on
Immunization Practices (ACIP) guidelines, including the statement:
"Immunization of Health-Care Workers"; and
• Standards for Pediatric Immunization Practices, February 1996, recommended by
the National Vaccine Advisory Committee, approved by the United States Public
Health Service, and endorsed by the American Academy of Pediatrics.
Within thirty (30) days of receipt of an amended standard(s) or guideline(s),
PERFORMING AGENCY shall inform RECEIVING AGENCY Program, in writing, if
it will not continue performance under this Attachment in compliance with the amended
standard(s) or guideline(s). RECEIVING AGENCY may terminate the contract
Attachment immediately or within a reasonable period of time as determined by
RECEIVING AGENCY.
PERFORMANCE MEASURES:
All activities shall be performed in accordance with PER-FORMING 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. The following
performance measures 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:
PERFORMING AGENCY shall submit to RECEIVING AGENCY Program the
...........
monthly reports of doses administered and the monthly biologi 1s pi-derloTin
ATTACHMENT— Page 3
accordance with the schedule provided to PERFORMING AGENCY by
RECEIVING AGENCY Program.
PERFORMING AGENCY shall implement an immunization reminder and/or
recall system to notify parents or guardians of children less than 36 months of age
when immunizations are 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 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 will perform the following applicable required activities:
1. By December 31, 2004, PERFORMING AGENCY will implement a plan to
improve vaccine coverage levels.
2. During 2004, PERFORMING AGENCY will work with the local WIC
agencies for referral of under-vaccinated WIC enrollees.
3. By December 31, 2004, PERFORMING AGENCY will ensure that expired,
wasted, and unaccounted for vaccines do not exceed 5% for DTaP, fbb,
hepatitis B, IPV, MMR, PCV7, and varicella vaccines.
4. By December 31, 2004, PERFORMING AGENCY will decrease the
proportion of duplicate records or questionable matches in ImmTrac by a
minimum of 5%.
5. By December 31, 2004, PERFORMING AGENCY will increase the
percentage of children less than six years of age participating in ImmTrac by a
minimum of 5%.
6. By December 31, 2004, PERFORMING AGENCY will increase the number
of registered provider sites for ImmTrac by a minimum of 5%.
7. By December 31, 2004, PERFORMING AGENCY will increase TVFC
provider enrollment by a minimum of 5%.
8. By December 31, 2004, PER-FORMING AGENCY will increase the
educational opportunities on vaccine-preventable diseases to public and
private providers.
9. By December 31, 2004, PERFORMING AGENCY will complete 100% of
TVFC follow-up site visits as assigned by RECEIVING AG
ATTACHMENT—Page 4
...........
using the RECEIVING AGENCY'S monitoring tool and methodology.
PERFORMING AGENCY shall submit monitoring report to RECEIVING
AGENCY Program within two (2) weeks after completion of monitoring
activities or site visits.
10. During 2004, PERFORMING AGENCY will promote and ensure
immunization services are provided for all age groups with emphasis on
pockets of need.
11. By December 31, 2004, PERFORMING AGENCY will increase the reporting
of varicella cases by a minimum of 10%.
12. During 2004, PERFORMING AGENCY will complete 90% of vaccine-
preventable disease investigations within 30 days from date reported.
13. By December 31, 2004, PERFORMING AGENCY will identify all infants
boat to hepatitis B surface antigen-positive pregnant women. PERFORMING
AGENCY shall investigate 100% of suspected hepatitis B infections in
pregnant women to assure appropriate treatment and follow-up as directed by
Health and Safety Code §81.090 and RECEIVING AGENCY'S Vaccine-
Preventable Disease Surveillance Guidelines.
14. During 2004, PERFORMING AGENCY will ensure all reported infants born
to HBsAg positive women receive hepatitis B vaccine and HBIG within seven
(7) days of birth.
15. By December 31, 2004, PERFORMING AGENCY will complete 100% of
assigned childcare facility assessments or surveys.
16. By December 31, 2004, PERFORMING AGENCY will complete 100% of
assigned public or 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 11. SPECIAL PROVISIONS is replaced with the following:
PERFORMING AGENCY shall comply with Texas Health and Safety Code, Chapters 81
and 161.
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.
Travel expenses shall be reimbursed according to State of Texas trave reguIatiolisa"
ATTACHMENT—Page 5
Monthly billings must be submitted on a State of Texas Voucher Request form no later
than the close of the following month.
Programmatic reports shall be completed in the format provided by RECEIVING
AGENCY Program and submitted within thirty (30) days from the end of each quarter of
the contract Attachment term. A final summary report detailing all programmatic activity
that occurred during the contract term shall be submitted to RECEIVING AGENCY
Program within sixty (60) days from the end date of the contract Attachment.
For immunization activities performed under this contract Attachment, General
Provisions, Overtime Compensation Article is not applicable. In addition,
PERFORMING AGENCY shall comply with the following paragraphs:
PERFORMING AGENCY is authorized to pay employees who are not exempt
under the Fair Labor Standards Act (FLSA), 29 USC, Chapter 8, §201 et seq., for
overtime or compensatory time at the rate of time and one-half per FLSA.
PERFORMING AGENCY is authorized to pay employees who are exempt under
FLSA on a straight time basis for work performed on a holiday or for regular
compensatory time hours when the taking of regular compensatory time off would
be disruptive to normal business operations.
Authorization for payment under this provision is limited to work directly related
to immunization activities and shall be in accordance with the amount budgeted in
this contract Attachment. PERFORMING AGENCY shall document proper
authorization or approval for any work performed by exempt or non-exempt
employees in excess of forty (40) hours per work week.
ATTACHMENT—Page 6
TEXAS DEPARTMENT OF HEALTH
RECEIVING AGENCY PROGRAM: IMMUNIZATION DIVISION
PERFORMING AGENCY: FORT WORTH DEPARTMENT OF PUBLIC HEALTH
CONTRACT TERM:01/01/04 THRU: 12/31/04 BUDGET PERIOD:01/01/04 THRU 12/31/04
TDH DOC,NO. 7560005286 200501A CHG.01
REVISED CONTRACT BUDGET
FINANCIAL ASSISTANCE
OBJECT CLASS CATEGORIES CURRENT APPROVED CHANGE NEW OR REVISED
BUDGET(A) REQUESTED(B) BUDGET(C)
Personnel $20,954.00 $9,103.00 $30,057.00
Fringe Benefits 5,134.00 ( 561.00) 4,573.00
Travel 1,260-00 433.00 1,693.00
Equipment 0.00 0,00 0.00
Supplies 1,750.00 ( 367.00) 1,383.00
Contractual 0.00 0.00 0.00
Other 1,579.00 1,082.00) 497.00
Total Direct Charges $30,677.00 $7,526.00 $38,203.00
Indirect Charges 0,00 0.00 0.00
TOTAL $30,677.00 $7,526.00 $38,203.00
PERFORMING AGENCY SHARE:
Program Income 0.00 0.00 0.00
Other Match 0.00 0,00 0.00
RECEIVING AGENCY SHARE $30,677.00 $7,526.00 $38,203.00
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 is to add funds to conduct services through 08/31/2004.
Form No.GC-9
Financial status reports are due the 30th of April, 30th of July, 30th of October,and the 30th of March.
..................
City of Fort Worth, Texas
"Cl.goir I1nd council col"I"U"icatio"
DATE REFERENCE NUMBER LOPAG
G NAME E
8/7/03 **C-196 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
"61.4or and council 4:01"municatian
%awe
DATE REFERENCE NUMBER LOG NAME
8/7/03 **C-19693 � 50IMMUNIZA-1-IONS PAGE
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.
LW:k
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