HomeMy WebLinkAboutContract 29025 P B F
s 0ul-25-03 A111 :47 Irl
TEXAS DEPARTMENT OF HEALT8TY SECRETARY
1100 WEST 49TH STREET CONTRACT NO . ba�
AUSTIN, TEXAS 78756-3199
STATE OF TEXAS TDH Document No. 7560005286 2003
COUNTY OF TRAVIS Contract Change Notice No. 04
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. 04A : 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:
PERFORMING AGENCY: RECEIVING AGENCY :
FORT WORTH DEPARTMENT_OF PUBLIC TEXAS DEPARTMENT OF HEALTH
HEALTH
BY: By: ,z-
(Signature of pers uthorized to sign) (Signature of person authorized to sign)
Bob Burnette,Director
Libby Watson, Assistant City Manager Procurement and Contracting Services Division
(Name and Title) (Name and Title)
O? .
Date: /-03 Date: �G-S
RECOMMENDED:
9
By: �— �Z b�e✓%t�
(PERFORMING AGENCY Director,if different
from person authorized to sign contract
TP PCSD- Rev.2/03
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Contract Authorization
Date AMMM BY
Cover Page 1
DETAILS OF ATTACHMENTS
AtU TDH Program ID/ Term Financial Assistance Direct Total Amount
Amd TDH Purchase Order Assistance (TDH Share)
No. Number Begin End Source of Amount
Funds*
OlA OPHP/BIOTERR 06/01/02 08/31/03 93.283 526,860.00 0.00 526,860.00
OO00011006
02 DIAB/DAEC 09/01/02 08/31/03 State 100,000.00 0.00 100,000.00
OO000I1307
03A OPHP/LPHS 09/01/02 08/31/03 93.991 40,000.00 0.00 40,000.00
OO000I1386
04A IMM/LOCALS 09/01/02 12/31/03 State 133,333.00 0.00 133,333.00
OO000I1580
TDH Document No.7560005286 2003 Totals
$800,193.00 $ 0.00 $800,19
Change No.043.00
*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.
Cover Page 2
TEXAS DEPARTMENT OF HEALTH
RECEIVING AGENCY PROGRAM: IMMUNIZATION DIVISION
PERFORMING AGENCY: FORT WORTH DEPARTMENT OF PUBLIC I-I:EALTH
CONTRACT TERM: 09/01/02 THRU: 12/31/03 BUDGET PERIOD: 09/01/02 THRU 12/31/03
TDH DOC. NO. 7560005286 200304A CHG. 04
REVISED CONTRACT BUDGET
FINANCIAL ASSISTANCE
OBJECT CLASS CATEGORIES CURRENT APPROVED CHANGE NEW OR REVISED
BUDGET(A) REQUESTED (B) BUDGET(C)
Personnel $49,422.00 $16,250.00 $65,672.00
Fringe Benefits 12,730.00 4,100.00 16,830.00
Travel 5,055.00 3,000.00 8,055.00
Equipment 0.00 0.00 0.00
Supplies 10,688.00 5,234.00 15,922.00
Contractual 0.00 0.00 0.00
Other 22,105.00 4,749.00 26,854.00
Total Direct Charges $100,000.00 $33,333.00 $133,333.00
Indirect Charges 0.00 0.00 0.00
TOTAL $100,000.00 $33,333.00 $133,333.00
PERFORMING AGENCY SHARE:
Program Income 0.00 0.00 0.00
Other Match 0.00 0.00 0.00
RECEIVING AGENCY SHARE $100,000.00 $33,333.00 $133,333.00
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 funds and number to be served due to extending contract end date from 8/31/2003 to 12/31/2003.
Revised Number to be Served/Units of Service: 33,250
Form No.GC-9
Financial status reports are due the 30th of December,30th of March, 30th of June,30th of September,and the 30th of March.
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS,
LOANS AND COOPERATIVE AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief that:
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or an
employee of any agency, a member of Congress in connection with the awarding of any
federal contract, the making of any federal grant, the making of any federal loan, the
entering into of any cooperative agreement, and the extension, continuation, renewal,
amendment, or modification of any federal contract, grant, loan, or cooperative
agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any
agency, a member of Congress, an officer or employee of Congress, or an
employee of a member of Congress in connection with this federal contract, grant,
loan, or cooperative agreement, the undersigned shall complete and submit Standard
Form-111, "Disclosure Form to Report Lobbying," in accordance with it's
instructions.
(3) The undersigned shall require that the language of this certification be included in the
award documents for all subawards at all tiers (including subcontracts, subgrants,
and contracts under grants, loans and cooperative agreements) and that all
subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when
this transaction was made or entered into. Submission of this certification is a prerequisite
for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code.
Any person who fails to file the required certification shall be subject to a civil penalty of not
less than 0,000 and not more than $100,000 for each such failure.
zz -3
Sig re Date
Libby Watson, Assistant City Manager
Print Name of Authorized Individual
7560005286 2003-04 AMUD by
Application or Contract Number
FORT WORTH DEPARTMENT OF PUBLIC HEALTH
Organization Name and Address
1800 UNIVERSITY DR
FORT WORTH, TX 76107-3405
S/�k, R _
City of Fort Worth, Texas
qvagor And Council commu"icatio"
DATE REFERENCE NUMBER LOG NAME PAGE
6/24/03 **C-19630 50IMMUNE 1 of 2
SUBJECT AUTHORIZATION TO EXTEND THE CONTRACT WITH THE TEXAS DEPARTMENT
OF PUBLIC HEALTH FOR THE CONTINUATION OF IMMUNIZATION OUTREACH TO
THE COMMUNITY (ORIGINAL MAYOR AND COUNCIL COMMUNICATION DATED
AND APPROVED AUGUST 9, 2001, REFERENCE M&C C-18705, ORDINANCE NO.
14742)
RECOMMENDATION:
It is recommended that the City Council:
1. Authorize the City Manager to accept and execute an extension of a grant contract with the Texas
Department of Health for $33,333.00 to be used to increase immunization levels in infant and pre-
school age children and provide awareness and education at the community level; and
2. Adopt the attached appropriation ordinance increasing appropriations and estimated receipts by
$33,333.00 in the Grants Fund; and
3. Waive indirect costs of 10% of related salary.
DISCUSSION:
This is an extension of a contract, originally approved on August 9, 2001 (MSC C-18705), between the
City of Fort Worth Public Health Department and the Texas Department of Health. The contract was
approved for a one-year extension on August 13, 2002 (MSC C-19195). This amendment is for the
extension of the contract term From September 1, 2003, to December 31, 2003. This extension will
enable the continuance of the Immunization Program for an additional 4 months.
Texas immunization coverage levels for two-year old children are significantly lower than the national
level of 81%. The Texas coverage for two-year olds reached a plateau in 1996 at 74%. Currently
immunization levels for Texas have only improved to 74.9%.
The goal of this proposal is to utilize Texas Department of Health 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), and Hib (Haemophilus influenza type-
b) vaccines in pre-school age children.
The City's Public Health Department, Outreach Division is proposing the continuation of a partnership
with the Fort Worth Fire Department to immunize more infants and pre-school age children. This
partnership with emergency personnel makes sense for our community. The personnel are medically
trained, know their neighborhoods, and the fire stations are "safe havens" in the community. The
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
"agor and Council Communication
DATE REFERENCE NUMBER LOG NAME PAGE
6/24/03 **C-19630 50IMMUNE 2 of 2
SUBJECT AUTHORIZATION TO EXTEND THE CONTRACT WITH THE TEXAS DEPARTMENT
OF PUBLIC HEALTH FOR THE CONTINUATION OF IMMUNIZATION OUTREACH TO
THE COMMUNITY (ORIGINAL MAYOR AND COUNCIL COMMUNICATION DATED
AND APPROVED AUGUST 9, 2001, REFERENCE M&C C-18705, ORDINANCE NO.
14742
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. In this program, so far, immunizations have been provided to
over 822 children, with 47% of those immunized between 2 to 4 years of age. This implies that these
infants and toddlers are not getting immunizations regularly from a primary care provider. According to
the 1998 Community Needs Assessment, 21.9% of children less than 5 years of age had no insurance.
The proposed locations are two fire stations and are located in different geographical quadrants of the
City. These locations will be near "pockets of need". Staff training will be coordinated with the Fort
Worth Fire Department and the Public Health Department nursing staff(using TDH guidelines), and the
Emergency Physicians Advisory Board's standing protocol from the Fire Department. Immunizations
will be offered by paramedics during the evening and weekend hours.
The Outreach staff will continue to distribute information about the availability of services to recreation
centers, apartments, neighborhood day-care centers, and faith-based organizations to ensure the
public is informed of the immunization services.
Staff recommends the waiver of indirect costs to maximize the funds directed toward the grant
objective.
FISCAL INFORMATION/CERTIFICATION:
The Finance Director certifies that upon adoption of the attached appropriation ordinance and receipt of
the executed contract amendment, funds will be available in the current operating budget, as
appropriated, of the Grants Fund.
LW:r
Submitted for City Manager's FUND ACCOUNT CENTER AMOUNT CITY SECRETARY
Office by: (to)
GR76 451953 050301799000 $33,333.00
Libby Watson 6183 GR76 5(various) 050301799010 $ 0.00
Originating Department Head:
Daniel Reimer 7201 (from) APPROVED 06/24/03
ORD.# 15603
Additional Information Contact:
Rowena Wooters 6213