HomeMy WebLinkAboutContract 30447 a CITY SECRETARY
• CONTRACT NO. 'i"
DEPARTMENT OF STATE HEALTH SERVICES
1100 WEST 49TH STREET
AUSTIN,TEXAS 78756-3199
STATE OF TEXAS DSHS Document No.7560005286 2005
COUNTY OF TRAVIS Contract Change Notice No.03
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.03 : TX DIAB PRG-COMM DIAB SRVC PROJ
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 WO#TH DEPARTMENT OF PUBLIC DEPARTMENT OF STATE HEALTH SERVICES
HEALTH
—4 By: By:
(sijdature of s authorized to sign) (Signature of person authorized to sign)
Libby Watson, Assistant City Manager Bob Burnette,Director
Procurement and Contracting Services Division
(Name and Tide) (Name and Title)
Date: V Date: O�
RECOMNI�:"1lLD:
By. ( ) '
(PERFORMING AGENCY Director,if different
from person authorized to sign contract
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AS TO FORM AND LEGALITY: AT[E3TED BY
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W"N f "�i Cover Page 1
Date
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*
OIA IMM/LOCALS 01/01/04 12/31/04 State 93.268 38,203.00 0.00 38,203.00
0000001764
02 ZOONOSIS 09/01/04 08/31/05 11,664.00 0.00 11,664.00
C038065000
03 DIAB/CDSP 09/01/04 08/31/05 State 80,000.00 0.00 80,000.00
0038790000
DSHS Document No.7560005286 2005 Totals
Chan e No. 03 $129,867.00 $ 0.00 $129,867.00
*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.
DD`
Cover Page 2 � ' i � ��
DOCUMENT NO. 7560005286-2005
ATTACHMENT NO. 03
PURCHASE ORDER NO. C038790000
PERFORMING AGENCY: FORT WORTH DEPARTMENT OF PUBLIC HEALTH
RECEIVING AGENCY PROGRAM: ASSOCIATESHIP FOR DISEASE CONTROL AND
PREVENTION
TERM: September 01, 2004 THRU: August 31, 2005
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.
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ATTACHMENT—Page 1 ����
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All activities shall be performed in accordance with RECEIVING AGENCY'S Request for
Proposal (RFP), Community Diabetes Services Projects, RFP D02 0001.1 issued April 15, 2003,
and Renewal Application issued April 30, 2004, PERFORMING AGENCY'S objectives,
activities, work plan, timeline, detailed budget and revisions, if any, as adopted by RECEIVING
AGENCY 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 including, but not limited to the following:
• Health and Safety Code, Chapters 12.012 and 103;;
• Healthy People 2010, United States (U.S.) Department of Health and Human Services,
November, 2000; 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
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—Page 2
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 6 organizational activities leading to changes in community systems,
policy, and/or environments that reduce the burden of diabetes;
• Provide a minimum of 1 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 4 self-management classes (e.g., Stanford University's Chronic Disease
Self Management, CDC's diabetes self management program, or other TDH approved
models) or activities to reduce the burden of diabetes;
• Provide a minimum of 4 physical activity events and ongoing activity groups to reduce
the burden of diabetes;
• Conduct at least 4 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;
• Publish a minimum of 80 diabetes-related articles;
• Provide a minimum of 8 diabetes-related radio activities;
• Provide a minimum of 8 diabetes-related television activities; and
• Distribute at least 5,000 pieces of diabetes material (e.g., National Diabetes Education
Program and Texas Diabetes Program/Council literature such as foot posters).
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)
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
ATTACHMENT—Page 3
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 Diabetes Program,
Department of State Health Services."
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ATTACHMENT—Page 4
FINANCIAL ASSISTANCE
CURRENT
OBJECT CLASS CATEGORIES NEW OR REVISED APPROVED CHANGES
BUDGET BUDGET REQUESTED
a. PERSONNEL................................ 41,496.00 38,938.00 2,558.00
b. FRINGE BENEFITS............... ... 10,374.00 9,735.00 639.00
c. TRAVEL................................... 3,920.00 2,747.00 1,173.00
d. EQUIPMENT................................ 0.00 832.00 -832.00
e. SUPPLIES................................. 1,200.00 1,733.00 -533.00
f. CONTRACTUAL.............................. 23,010.00 0.00 23,010.00
g. OTHER.................................... 0.00 9,956.00 -9,956.00
h. TOTAL DIRECT CHARGES..................... 80,000.00 63,941.00 16,059.00
i. INDIRECT CHARGES......................... 0.00 0.00 0.00
'. TOTAL.................................... 80,000.00 63,941.00 16,059.00
k. RECEIVING AGENCY SHARE................... 80,000.00 63,941.00 16,059.00
1. PERFORMING AGENCY SHARE(Includes m.PI) 0.00 0.00 0.00
m. PROGRAM INCOME:
0.00 0.00 0.00
m.2.Program Income(projected)......... 0.00 0.00 0.00
m.3.Other Match......................... 0.00 0.00 0.00
CONTRACT TERM
Begin Date.................................... 9/1/2004
End Date...................................... 8/31/2005
DETAIL ON INDIRECT COST:
TYPE OF RATE PROVISIONAL................
PREDETERMINED.............
FINAL......................
FIXED......................
RATE...................................... 0.00000 0.00000 0.00000
BASE...................................... 0.00 0.00 0.00
TOTAL INDIRECT CHARGES.................... 0.00 0.00 0.00
Financial status reports are due the 30th of December,30th of March,30th of June,and the 30th of November.
4Yo
City of Fort Worth, Texas
Mayor and Council Communication
COUNCIL ACTION: Approved on 6/15/2004 - Ordinance No. 16004
DATE: Tuesday, June 15, 2004
LOG NAME: 50DIABETES REFERENCE NO.: **G-14389
SUBJECT:
Approval for a Grant Contract with the Texas Department of Health, Bureau of Chronic Disease and
Tobacco Prevention for Community Based Diabetes Prevention and Management Programs and
Adoption of Appropration Ordinance
RECOMMENDATION:
It is recommended that the City Council:
1. Authorize the City Manager to apply for, accept if awarded and execute a grant contract with the
Texas Department of Health (TDH), Bureau of Chronic Disease and Tobacco Prevention (BCDTP) in the
amount of$80,000 to be used to provide community-based diabetes prevention and management programs
from September 1, 2004 through August 31, 2005; and
2. Adopt the attached appropriation ordinance increasing estimated receipts and appropriation 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 of this grant pending contract execution to secure program
continuation.
DISCUSSION:
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#1 as their greatest household health problems.
Nutrition and overweight issues are increasingly being cited as growing epidemics among American
adults. The City of Fort Worth is no exception. In 2002, Fort Worth, was ranked the eighth fattest city by
Men's Fitness magazine and climbed to the sixth spot as the fattest city in 2004. 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 indentified eating fewer than five servings of fruits and
vegetables a day.
Current grant funding for the Diabetes Program includes but is not limited to the following:
Organizational activities leading to changes in community systems, policy, and/or
environments;
Organizational changes in community systems, policy, and /or environment in different sectors
of the community (e.g. schools, worksites/businesses, faith-based communities, neighborhoods,
non-profits, health care institutions and food industry);
Logname: 50DIABETES Page 1 of 2
Self-management classses (e.g. Stanford's Chronic Disease Self Management, CDC diabetes
self-management program and other TDH approved models) or self management activities;
Physical activity ongoing groups and activity events;
Support groups;
A series of food and nutrition classes;
Activities led by community health workers;
Provider education (risk reduction, standards of care, etc.);
Public information activities (e.g. TV activities; radio activities; articles in newspapers, church
bulletins, business inserts or newsletters; website; kiosks, etc.); and
Materials distribution (e.g. foot posters, National Diabetes Education Program and Texas Diabetes
Council literature)
This community-based diabetes program targets uninsured/underinsured adults 18-64 years of age and
their families in areas of Fort Worth with populations with high prevalence and burdens of diabetes,
including mortality in their family. If this grant is awarded, it will be the second year this program is funded
by the State.
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. Upon execution of the grant
contract, the interim inter-fund loan will be returned to the General Fund.
TO Fund/Account/Centers FROM Fund/Account/Centers
GR76 451923 050301944000 $80,000.00 GG01 136076 0000000 $25.000.00
GR76 5XXXXX 050301944010 $80,000.00
GR76 220001 000301944000 $25,000.00
Submitted for City Manager's Office by. Libby Watson (6183)
Originating Department Head: Daniel B. Reimer (8903)
Additional Information Contact: Barbara Murph (6213)
Markena Conway (6053)
Logname: 50DIABETES Page 2 of 2