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TEXAS DEPARTMENT OF HEALTI-01TY BECRETARl� '
11.00 WEST 49TH STREET CONTRACT NO.
AUSTIN, TEXAS 78756-3199
STATE OF TEXAS TDH Document No.7560005286 2004
COUNTY OF TRAVIS Contract Change Notice No. 02
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. 03 : OPHP-LOCAL PUBLIC HEALTH SYSTEM
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 ENCY: RECEIVING AGENCY :
FORT WORT EPARTME OF PUBLIC TEXAS DEPARTMENT OF HEALTH
HEALTH
By: By:
(Sig ature of pers uthorized 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: 9 /�� Date: S/2.710.3
RECOMMENDED: Q ���; Ogg
iClITY
By. "!. Rim, EK.
(PERFORMING AGENCY Director, if different
from person authorized to sign contract
TP PCSD-Rev.2/03
ATTESTED BY
GContract Authorization
Cover Page 1 E),)4 J I13
4
Date
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"
01 DIAB/CDSP 09/01/03 08/31/04 State 63,941.00 0.00 63,941.00
0000001027
02 OPHPBIOTERR 09/01/03 08/31/04 93.283 500,517.00 0.00 500,517.00
0000000872
03 OPHP/LPHS 09/01/03 08/31/04 93.991 40,000.00 0.00 40,000.00
0000001483
TDH Document No.7560005286 2004 Totals
Change No.02 $604,458.00 $ 0.00 $604,458.00
`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
DOCUMENT NO. 7560005286-2004
ATTACHMENT NO. 03
PURCHASE ORDER NO. 0000001483
PERFORMING AGENCY: FORT WORTH DEPARTMENT OF PUBLIC HEALTH
RECEIVING AGENCY PROGRAM: OFFICE OF PUBLIC HEALTH PRACTICE
TERM: September 01, 2003 THRU: August 31, 2004
SECTION I. SCOPE OF WORK:
LOCAL PUBLIC HEALTH SUPPORT FUNDS
PERFORMING AGENCY shall use direct assistance and/or financial assistance, as specified in
SECTION III, BUDGET, from RECEIVING AGENCY to improve or strengthen local public
health infrastructure by:
• Developing objective(s) to address a public health issue;
• Utilizing resources provided through this contract to conduct activities and services
that provide or support the delivery of essential public health services; and
• Assessing, monitoring, and evaluating the essential public health services provided,
and developing strategies to improve the delivery of essential public health service(s).
These tasks shall be performed in accordance with PERFORMING AGENCY'S FY 04 Local
Public Health (LPHS) Service Delivery Plan and the FY 04 Texas Application for Preventive
Health and Health Services Block Grant Funds.
The assessment/evaluation activities must include a standard that is identified in the
PERFORMING AGENCY'S FY 04 LPHS Service Delivery Plan. Acceptable standards include
the National Public Health Performance Standards approved by the Centers for Disease Control
and Prevention, Performance Standards developed by the Texas Association of Local Health
Officials, Healthy People 2010 and any federal, state or local law or regulation governing the
delivery of essential public health services. Evaluation methods utilizing standards not listed in
this contract Attachment must be pre-approved by RECEIVING AGENCY.
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.
The following documents are incorporated by reference and made a part of this contract
Attachment:
• PERFORMING AGENCY'S FY 04 LPHS Service Delivery Plan;
• Chapter 23-11 of the Healthy People 2010;
ATTACHMENT — Page 1
Y
• Section 121.002, Texas Health & Safety Code, Definition of Ten Essential Public Health
Services; and
• FY 04 Texas Application for Preventive Health and Health Services Block Grant Funds.
Two types of support are available under this program:
(1) Direct assistance in the form of state-paid positions and/or
(2) Financial assistance from
a. General Revenue funds;
b. Federal Preventive Health and Health Services Block Grant; and
c. Earnings from the Permanent Fund for Children and Public Health under the
Government Code, Section 403.1055
DIRECT ASSISTANCE
State-paid positions under this contract Attachment shall perform activities as specified in
PERFORMING AGENCY'S FY 04 LPHS Service Delivery Plan.
FINANCIAL ASSISTANCE
PERFORMING AGENCY shall direct all resources authorized through this contract toward
supporting/providing, assessing, monitoring, and developing strategies to improve essential
public health services for addressing public health issues within the jurisdiction served.
Performing Agency may not use earnings from the Permanent Fund for Children and Public
Health for lobbying expenses under the Government Code, Section 403.1067.
PERFORMANCE MEASURES
RECEIVING AGENCY shall specify the performance measure(s) to be used to assess, in part,
PERFORMING AGENCY'S ability to meet the objectives outlined in the FY 04 LPHS Service
Delivery Plan without waiving the enforceability of any of the other terms of the contract.
PERFORMING AGENCY shall provide services in the following county(ies)/area: Tarrant.
SECTION II. SPECIAL PROVISIONS:
General Provisions, Reports Article, is revised to include the following paragraphs:
PERFORMING AGENCY shall submit quarterly progress reports which describe progress
toward completing the activities contained in PERFORMING AGENCY'S FY 04 LPHS Service
Delivery Plan and any written revisions.
PERFORMING AGENCY shall submit the first, second and third quarter's progress reports to
ATTACHMENT—Page 2
• r
RECEIVING AGENCY no later than thirty (30) days after the end of each quarter, and the
fourth quarter report to RECEIVING AGENCY sixty (60) days after the end of PERFORMING
AGENCY'S contract term in a format specified by RECEIVING AGENCY.
PERFORMING AGENCY shall submit an Annual Budget and Expenditures Report in a format
specified by to the RECEIVING AGENCY by January 31, 2005.
ATTACFUvIENT—Page 3
SECTION III. BUDGET:
PERSONNEL $31,616.00
FRINGE BENEFITS 8,304.00
TRAVEL 80.00
EQUIPMENT 0.00
SUPPLIES 0.00
CONTRACTUAL 0.00
OTHER 0.00
TOTAL $40,000.00
Total reimbursements will not exceed $40,000.00.
Financial status reports are due the 30th of December, 30th of March, 30th of June, and the 30th
of November.
ATTACHMENT — Page 4
City of Fort Worth, Texas
"agor And Council Communication
DATE REFERENCE NUMBER LOG NAME PAGE
8/26/03 **C-19731 50EDUCATEGRANT 1 of 2
SUBJECT ADOPTION OF APPROPRIATION ORDINANCE AND AUTHORIZATION TO EXECUTE
A CONTRACT WITH THE TEXAS DEPARTMENT OF HEALTH, OFFICE OF PUBLIC
HEALTH PRACTICE FOR "000" LOCAL PUBLIC HEALTH SYSTEM DEVELOPMENT
FUNDS THROUGH PREVENTIVE HEALTH AND HUMAN SERVICES BLOCK GRANT
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, Office of Public Health Practice for $40,000; and
2. Adopt the attached appropriation ordinance increasing estimated receipts and appropriations by
$40,000 in the Grants Fund; and
3. Waive the indirect cost rate of 10%, since expenditures of this nature negatively impact the delivery
of services to the community; and
4. 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:
The Texas Department of Health (TDH) provides grant funds to local health departments across the
state to provide essential public health services. Funds will be used to improve or strengthen our local
public health infrastructure by conducting activities and services that support the delivery of the
Essential Public Health Services.
Public Health staff will still address the following essential health functions, as defined by TDH:
a. Inform, educate and empower people about health status; and
b. Mobilize community partnerships to identify and solve health problems.
A Health Educator position will be funded by this grant to help educate the community in order to
increase awareness of the benefits of regular physical activity and proper nutrition, as they apply to
reducing the risk of developing or dying from some of the leading causes of death and illness (i.e.
cancer, high blood pressure and cardiovascular disease); to reduce overweight and obesity in both
children and adult populations; to assist the community in identifying risk behaviors that contribute to
the development or increase the burden of chronic diseases (alcohol and tobacco usage as well as self-
management of diseases such as asthma and diabetes); and to develop public health community
partnerships.
The funding period would begin September 1, 2003, and end August 31, 2004, for an amount not to
exceed $40,000.
City of Fort Worth, Texas
qvagor a"d cou"Cil commu"icatio"
DATE REFERENCE NUMBER LOG NAME PAGE
8/26/03 **C-19731 50EDUCATEGRANT 2 of 2
SUBJECT ADOPTION OF APPROPRIATION ORDINANCE AND AUTHORIZATION TO EXECUTE
A CONTRACT WITH THE TEXAS DEPARTMENT OF HEALTH, OFFICE OF PUBLIC
HEALTH PRACTICE FOR "000" LOCAL PUBLIC HEALTH SYSTEM DEVELOPMENT
FUNDS THROUGH PRF%ENTI'vE HEALTH AND HUMAN SERVICES BLOCK GRANT
FISCAL INFORMATION/CERTIFICATION:
The Finance Director certifies that upon acceptance and execution of this grant contract and adoption
of the attached appropriation ordinance, 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 4XXXXX 050301881000 $40,000.00
Libby Watson 6183 GR76 5XXXXX 050301881010 $40,000.00
Originating Department Head: GR76 220001 000301881000 $25,000.00
Daniel Reimer 7201 (from) APPROVED 08/26/03
GG01 136076 0000000 $25,000.00 ORD.#15665
Additional Information Contact:
Susan Whittenberger 6658