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CONTRACT NO . [[
CONTRACT FOR PUBLIC HEALTH SERVICES TDH DOCUMENT NO. 7560005286 2004
Contract Issued by: TEXAS DEPARTMENT OF HEALTH Tp
(RECEIVING AGENCY) 1100 WEST 49'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.
_ 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 l -Receiving and Performing Agency Data GENERAL PROVISIONS— 11/2001
COVER PAGE 2-Details of Attachment(s) ATTACHMENT(S)
COVER PAGE 3-Authorized Signatures EXHIBITS,IF APPLICABLE
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Cover Page 1 ''�' i TEX.
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*
01 DIAB/CDSP 09/01/03 08/31/04 State 63,941.00 0.00 63,941.00
0000001027
TDH Document No.7560005286 2004 Totals $ 63,941.00 $ 0.00 $ 63,941.00
*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
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 WORT#DEPARTMENT OF PUBLIC TEXAS DEPARTMENT OF HEALTH
HEALTH
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B y: _ B y:
(Signature of pe authorized to sign contracts) (Signature of person authorized to sign contracts)
Bob Burnette,Director
Libby Watson, Assistant City Manager Procurement and Contracting Services Division
(Name and Title) (Name and Title)
Date: Z Z d Date:
RECOMMENDED:
By:
(PERFORMING AGENCY Director,if different
from person authorized to sign contract)
TDH Document No: 7560005286 2004
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Contrast Authorization
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Date
DOCUMENT NO. 7560005286-2004
ATTACHMENT NO. 01
PURCHASE ORDER NO. 0000001027
PERFORMING AGENCY: FORT WORTH DEPARTMENT OF PUBLIC HEALTH
RECEIVING AGENCY PROGRAM: ASSOCIATESHIP FOR DISEASE CONTROL AND
PREVENTION
TERM: September 01, 2003 THRU: August 31, 2004
SECTION I. SCOPE OF WORK:
PERFORMING AGENCY shall design, implement, and evaluate a Community Diabetes
Services Project (CDSP). This project shall provide community-based diabetes prevention and
management interventions that implement population-based and evidence-based programs and
strategies at the community level and create or advocate for community policy, systems, and
environmental changes that support and impact diabetes primary and secondary preventive
measures.
For the purpose of this contract Attachment, CDSP shall target adults 18-64 years old and
families in high-risk populations - racial and ethnic minorities - who have disproportionate rates
and burdens of diabetes and limited access to health care.
PERFORMING AGENCY shall meet the following objectives through the CDSP and shall
provide evidence that the CDSP is meeting the following objectives:
• Increase opportunities for implementing positive behavior and lifestyle changes (e.g.,
increased and continuing physical activity and healthy eating) in people who already have
diabetes and those who are at risk of developing diabetes;
• Increase community, environmental, and systems changes in various community sectors
(i.e., schools, businesses, faith communities, neighborhoods, health systems and food
industry) that facilitate ongoing, increased physical activity and healthy eating among the
general population, especially those with diabetes and "pre-diabetes";
• Institute project strategies or community policy and environmental changes conducive to
risk reduction;
• Increase public and provider knowledge of the symptoms, risk factors and target goals of
diabetes, pre-diabetes and gestational diabetes and the importance of physical activity and
healthy eating in preventing and delaying or managing the disease and its complications;
and
• Increase health care providers', payers', and their patients' knowledge and
implementation of the Texas Diabetes Council's Minimum Standards for Diabetes Care
in Texas.
ATTACHMENT—Page 1
All activities shall be performed in accordance with RECEIVING AGENCY'S Request for
Proposal (RFP), Community Diabetes Services Projects, RFP D02 0001.1 dated April 15, 2003,
and with PERFORMING AGENCY'S objectives, activities, work plan, timeline, detailed budget
and revisions, if any, as adopted by RECEIVING AGENCY'S and transmitted in writing to
PERFORMING AGENCY. These documents are incorporated by reference and made a part of
this contract Attachment.
PERFORMING AGENCY shall establish and maintain a broad-based community diabetes
coalition that meets at least quarterly for the duration of this project to perform the project
requirements outlined in Section F. of the RECEIVING AGENCY'S RFP dated April 15, 2003.
PERFORMING AGENCY shall have and maintain procedures and tracking tools in a consistent,
timely manner to document activities, services, and persons served that are measured in reports.
PERFORMING AGENCY also shall fulfill evaluation requirements as specified by
RECEIVING AGENCY.
PERFORMING AGENCY shall provide evidence through its yearly formative evaluations and
its end-of-project summative evaluation that PERFORMING AGENCY is meeting project work
plan's goals outlined in project's impact and process objectives.
PERFORMING AGENCY shall align any health care system components with the Texas
Diabetes Council's Minimum Standards of Care. All project interventions shall be consistent
with the Texas Diabetes Council's strategic plan and the TDH priorities for the health of Texans:
fitness through physical activity and nutrition, immunizations, and eliminating health disparities.
PERFORMING AGENCY shall comply with all applicable federal and state laws, rules,
regulations, standards, and guidelines:
• Chapters 12.012 and 103 of the Health and Safety Code;
• Healthy People 2010, United States (U.S.) Department of Health and Human Services,
November, 2000;
• RECEIVING AGENCY'S Quality Care: Client Services Standards for Public Health and
Community Clinics, Texas Department of Health, Community Health Nursing, revised
June 1997; and,
• Diabetes Today. A Course on How to Build Skills to Plan and Implement Community
Based Programs for Persons with Diabetes, U.S. Department of Health and Human
Services, September 2000.
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 Attachment immediately or within a reasonable
period of time as determined by RECEIVING AGENCY.
RECEIVING AGENCY reserves the right, where allowed by legal authority, to redirect funds in
the event of financial shortfalls. RECEIVING AGENCY Program will monitor PERFORMING
ATTACHMENT—Page 2
AGENCY'S expenditures on a quarterly basis. If expenditures are below that projected in
PERFORMING AGENCY'S total contract amount as shown in SECTION III. BUDGET,
PERFORMING AGENCY'S budget may be subject to a decrease for the remainder of the
Attachment term. Vacant positions existing after ninety (90) days may result in a decrease in
funds.
PERFORMANCE MEASURES
The following performance measures will be used to assess, in part, PERFORMING
AGENCY'S effectiveness in providing services described in this contract Attachment, without
waiving the enforceability of any of the other terms of the contract. PERFORMING AGENCY
shall complete each performance measure as defined in this attachment under SECTION I.
SCOPE OF WORK
PERFORMING AGENCY shall provide the following:
• Conduct at least 30 organizational activities leading to changes in community systems,
policy, and/or environments that reduce the burden of diabetes;
• Provide a minimum of 10 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 30 self-management classes (e.g., Stanfords' Chronic Disease Self
Management, CDC diabetes self management program or other TDH approved models)
or activities to reduce the burden of diabetes;
• Provide a minimum of 36 physical activity events and ongoing activity groups to reduce
the burden of diabetes;
• Conduct at least 0 support groups to reduce the burden of diabetes;
• Conduct at least 20 series of food and nutrition classes to reduce the burden of diabetes;
• Conduct at least 0 provider education (risk reduction, standards of care, etc.) events about
diabetes;
• Reach an estimated 848,900 people through public information (e.g., TV, radio,
newspaper, church bulletins, business inserts or newsletters, website, kiosks, etc.) about
diabetes; and
• Distribute at least 5,000 pieces of diabetes material (e.g., foot posters, National Diabetes
Education Program and Texas Diabetes Council literature).
The numbers above indicate the minimum for each performance measure. This value is subject
to change upon written agreement between RECEIVING AGENCY and PERFORMING
AGENCY. Work plan activities and deadlines shall not be changed without prior approval from
RECEIVING AGENCY.
PERFORMING AGENCY shall submit monthly performance reports that are prepared in the
format approved by RECEIVING AGENCY Program within ten (10) calendar days after the end
of each month. PERFORMING AGENCY shall also submit quarterly performance reports that
are prepared in the format approved by RECEIVING AGENCY Program within twenty (20)
ATTACHMENT—Page 3
calendar days after the end of each quarter. PERFORMING AGENCY shall also submit a year-
end summary, prepared in the format approved by RECEIVING AGENCY Program, within
thirty (30) calendar days after the end of the contract Attachment term. PERFORMING
AGENCY shall maintain the documentation used to calculate key outcome performance
measures.
SECTION 11. SPECIAL PROVISIONS:
PERFORMING AGENCY shall notify RECEIVING AGENCY Program Director, Diabetes
Program, of any changes in project staff or contact information within fourteen (14) calendar
days of such change(s).
PERFORMING AGENCY'S project coordinator and support staff shall attend all scheduled
trainings held by RECEIVING AGENCY unless prior approval is obtained from authorized
RECEIVING AGENCY'S Texas Diabetes Program staff for absences.
PERFORMING AGENCY shall request prior approval from RECEIVING AGENCY on any
proposed educational media campaigns for the public or health care professionals. This
requirement does not apply to promotional campaigns for local events. PERFORMING
AGENCY shall use National Diabetes Education Program (NDEP) materials whenever possible.
PERFORMING AGENCY shall include the following credit on all printed, audio or visual
materials developed as part of this program: "Funding provided by the Texas Department of
Health, Texas Diabetes Program."
ATTACHMENT—Page 4
SECTION III. BUDGET:
PERSONNEL $38,938.00
FRINGE BENEFITS 9,735.00
TRAVEL 2,747.00
EQUIPMENT* 832.00
SUPPLIES 1,73 3.00
CONTRACTUAL 0.00
OTHER 9,956.00
TOTAL $63,941.00
Total reimbursements will not exceed $63,941.00.
Financial status reports are due the 30th of December, 30th of March, 30th of June, and the 30th
of November.
* Equipment list attached.
ATTACHMENT—Page 5
PERFORMING AGENCY: FORT WORTH DEPARTMENT OF PUBLIC HEALTH
RECEIVING AGENCY PROGRAM: ASSOCIATESHIP FOR DISEASE CONTROL AND PREVENTION
TDH DOC. NO: 7560005286 2004
ATTACHMENT NO:01
Change No. 00
EQUIPMENT LIST
ITEM DESCRIPTION NO. OF UNIT EXTENSION
UNITS COST
001 OptiPlex GX150;Processor, 80526, IGHz,256, 133,Fiber Channel,DO, 1 832.00 $ 832.00
PWA,Planar(Motherboard),GX 150,FOXCONN,MLK, Keyboard 104,
Mouse,Dual In-Line Memory Module 256 133M 32X64 8K 168,Digital
Video Disk Drive 4G, IDE,Hard Drive 20GB IDE 7.2K 20/P IBM-ERC,
Floppy drive 1.44M, 3.5" form factor 3MD,Windows 2000 Professional.
Buying out at the end of the lease(8/31/03).
TOTALS $ 832.00
Items may be brand name, if specified,or equivalent.
Equipment List Page 1
City of Fort Worth, Texas
"agor And Council Communication
DATE REFERENCE NUMBER LOG NAME PAGE
6/10/03 C-19620 50DIABETES 1 of 2
SUBJECT ADOPTION OF APPROPRIATION ORDINANCE FOR A GRANT CONTRACT WITH
THE TEXAS DEPARTMENT OF HEALTH AND THE TEXAS DIABETES PROGRAM
FOR COMMUNITY-BASED DIABETES PREVENTION AND MANAGEMENT
PROGRAMS
RECOMMENDATION:
It is recommended that the City Council-
1.
ouncil:1. Authorize the City Manager to apply for and accept, if awarded, a grant contract with the Texas
Department of Health (TDH) and Texas Diabetes Program (TDP) in the amount of $80,000 to be
used to provide community-based diabetes prevention and management programs; and
2. Adopt the attached appropriation ordinance increasing estimated receipts and appropriations in the
Grants Fund by $80,000; and
3. Authorize a non-interest bearing interfund loan from the General Fund to the Grants Fund in the
amount of $25,000 for the interim financing for this grant, pending contract execution to ensure
program continuation.
DISCUSSION:
Diabetes is an epidemic and a public health crisis in Texas. During the City's 1998 Public Health
Department's Community Needs Assessment (a door-to-door survey) 7.1% of Fort Worth residents
reported diabetes as their greatest health problem and Hispanics reported diabetes as the greatest
household health problem. Unhealthy lifestyles can increase the risk of diabetes. For instance, 86% of
Fort Worth households eat less than the recommended fruit/vegetable daily intake. Diabetes is the 5th
leading cause of death for African-Americans and Hispanics, with approximately 18% of African-
American households in Fort Worth (about 6,942 households) having at least one family member living
with diabetes, and 17% of Hispanic households (about 26,296 households) having at least one family
member living with diabetes, compared to 9.7% of Anglo households. Nearly 60 Anglo, 40 African-
American, and 30 Hispanic Fort Worth residents die of diabetes each year.
In partnership with the University of North Texas Health Science Center (UNTHSC), the Public Health
Department reported nearly 23% of Fort Worth Independent School District fifth graders to be at high
risk of developing diabetes. The findings concerning risk factors are based on a representative
sampling of 1,056 fifth-graders at 17 elementary schools. Of that group, 240 had at least three red
flags for diabetes, such as high blood pressure or obesity. Of the 240 students with three or more risk
factors, 69 are African-American and 160 are Hispanic.
The Public Health Department's diabetes program has received funding for Diabetes Awareness and
Education in the Community (DAEC) through TDH/TDP for the last five years to provide education
presentations, cornm u n ity/co rpo rate health fairs, healthy food tours, cooking demonstrations, health
screenings, walking programs, community outreach, phone contacts, and Chronic Disease Self-
Management (CDSM) classes facilitated in English and Spanish reaching over 100,000 citizens in Fort
Worth.
City of Fort Worth, Texas
"A."Or And Council Communication
DATE REFERENCE NUMBER LOG NAME PAGE
6/10/03 C-19620 50DIABETES 2 of 2
SUBJECT ADOPTION OF APPROPRIATION ORDINANCE FOR A GRANT CONTRACT WITH
THE TEXAS DEPARTMENT OF HEALTH AND THE TEXAS DIABETES PROGRAM
FOR COMMUNITY-BASED DIABETES PREVENTION AND MANAGEMENT
PROGRAMS
The DAEC program partnered with the UNTHSC, Tarrant County Diabetes Collaboration, Inc., Texas
Cooperative Extension Program, Fort Worth Independent School District, the City of Fort Worth
Wellness Program, Parks and Community Services Department, Neighborhood Police Districts, Texas
Christian University/Harris School of Nursing, and The Boys & Girls Clubs of Greater Fort Worth.
Funding objectives of the TDH are to provide community-based diabetes prevention and management
interventions that implement evidence-based programs and strategies at the community level, targeting
adults 18-64 years of age and their families, uninsured/underinsured, and areas in Fort Worth with
populations with a high prevalence of diabetes, including mortality.
The Public Health Department, through its neighborhood-based Outreach Division, is proposing a
partnership with the Health Science Center and John Peter Smith Hospital to provide education
programs to the targeted population at their newly established community center located at 2106 North
Main Street. The program is also proposing to partner with the American Cancer Society "Church
Connection" that has access to over 250 faith-based communities. Referrals will be provided through
the United Way Call Center, and referrals to local diabetes education classes at Baylor All Saints
Medical Center on medical management, medications and general diet recommendations. Through
these education programs, we will strive to improve and reduce the prevalence of diabetes in the
community.
FISCAL INFORMATION/CERTIFICATION:
The Finance Director certifies that upon approval of the above recommendations and adoption of the
attached appropriation ordinance, funds will be available in the current operating budget, as
appropriated, of the Grants Fund. Upon execution of the grant contract, the interim interfund loan will
be returned to the General Fund.
LWA
Submitted for City Manager's FUND ACCOUNT CENTER AMOUNT CITY SECRETARY
Office by: (to)
GR76 451923 050301861000 $80,000.00
Libby Watson 6183 GR76 5(various) 050301861010 $80,000.00
Originating Department Head:
Daniel Reimer 7201 (from) APPROVED 06//10/03
ORD.# 15586
Additional Information Contact:
Rowena Wooters 6213
Markena Conway 6053