1999-112-PUBLIC HEALTH SERVICES CONTRACT CHANGE NOTICE NO. 01, DOC NO 7560022067 00
RESOLUTION NO. 99-112
WHEREAS, the State of Texas is a funding partner with the County of Lamar and the
City of Paris for the Paris-Lamar County Health Department; and,
WHEREAS, the Contract for Public Health Services, TDH Document No. 7560022067
00, and Contract Change Notice No. 01 to the same are the conduits through which the state funds
are received; and,
WHEREAS, it is appropriate that the form of Contract Change Notice No. 01 to said
Contract, attached hereto as Exhibit A, be approved, and that the City Manager, Michael E.
Malone, be authorized to execute the same on behalf of the City of Paris, which is the authorized
contracting entity for the performing agency, the Paris-Lamar County Health Department; NOW,
THEREFORE,
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PARIS, that the
form of Contract Change Notice No. 01 to the Contract for Public Health Services, TDH
Document No. 7560022067 00, attached hereto as Exhibit A, be, and the same is hereby,
approved; and,
BE IT FURTHER RESOLVED, that the City Manager, Michael E. Malone, be, and he
is hereby, authorized and directed to execute, on behalf of the City of Paris, which is the
authorized contracting entity for the performing agency, the Paris-Lamar County Health
Department, Contract Change Notice No. 01, under the terms and conditions and in the form
shown in Exhibit A, attached hereto.
PASSED AND ADOPTED this 9th day of September, 1999.
m4~()A1n0lt~
Mary Ann IS er, Mayor Pro Tern
ATTEST:
~~\ ~u~~~,,~smJ
Mattie Cunningham, City Clerk
APPROVED AS TO FORM:
St ph nie H. Harris,
Assistant City Attorney
f)
TEXAS DEPARTMENT OF HEALTH
1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
STATE OF TEXAS
TDH Document No. 75600220672000
CONTRACT CHANGE NOTICE NO. Ql
COUNTY OF TRAVIS
The Texas Department of Ilealtll, hereinafter referred to as RECEIVING AGENCY, did herelofore enter into a contract in writing with
PARIS-LAMAR COUNTY HEALTH DEI'ARTMENT hereinafter referred to as PERfoORMING AGENCY. TIle parties thereto now
desire to amend sueh contract attachment(s) as follows:
SUMMARY OF TRANSACTION:
ATT. NO. 03: DNS - WIC CARD PARTICIPATION
All terms and condilions not hereb amended remain in full force and effect.
EXECUTED IN DUPLICATE ORIGINALS ON TilE DATES SHOWN.
Authorized Contracting Entily (type above if different
from PERFORMING AGENCY) for and in behalf of;
PERFORMING AGENCY:
RECEIVING AGENCY:
I'ARJS-LAMAR COUNTY m~ALTII DEPARTMENT
(Signature or person aUlhorized (0 sign contracts)
TEXAS DEI'AI~TMEN1~.0: II?/ LL
Dy: /:~
person authorized 10 sign contracts)
Dy:
MICHAEL E. MALONE, CITY MANAGER
(Name and Title)
Sidney P. Shelton, Chief
nllrc3U or Financiill Services
(Name and Title)
Date:
Date:~'11
,...: 1..\
RECOMMENDED:
DM GMD - Rev. 3/9'J
Cover Page I
,
EXHIBIT A
DE \ILS OF ATTACHMEh 1'S
Aul TDH Term Financial Assistance Direct Total Amount
Amd Programl Begin Assistance (TDH Share)
No. m End Source of Amount
Funds.
01 COPHlPRIMARY 09/01/99 08/31/00 State 211,415.00 0.00 211,415.00
02 BRLHO/V AC 09101/99 08/31/00 Slate 93.991 121,404.00 0.00 121,404.00
03 BNSIWIC-CARD 10/0 I /99 09130/00 10.557 93.268 0.00 0.00 0.00
TDH Document No.7560022067 2000 Totals $332,819.00 $0.00 $332,819.00
Change No. 01
.Federal funds are indicated hy a number from thc Catalog of Federal Domestic Assistance (eFDA), if applicable. REFER TO
BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS.
.
,"': 1\
Cover Page 2
DOCUMENT NO. 756002206700
ATTACHMENT NO. 03
PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: BUREAU OF NUTRITION SERVICES
TERM: October 01, 1999 THRU: September 30,2000
SECTION 1. SCOPE OF WORK:
PERFORMING AGENCY shall provide supplemental food vouchers, nutrition education, and
immunizations to enhance good health care at no cost to low-income pregnant and postpllrtum
women, infants, and children identified to be at nutritional risk. In meeting this goal,
PERFORMING AGENCY shall:
A. Perform professional, administrative, and clerical services necessary to provide special
supplemental food vouchers and nUlrition education to qualified women, infants, and
children in a specified geographic area. Services shall be performed according to the terms
and specifications of RECEIVING AGENCY'S Special Supplemental Nutrition Program
for Women, Infants, and Children (WIC) and/or the United Slates Department of
Agriculture (USDA) as referenced below. During the term of this Attachment, USDA will
issue regulations, instructions, policies, and/or directives which may be incorporated into
the State WIC Policy and Procedures Manual.
PERFORMING AGENCY will provide services in the authorized geographic service
area(s) described in PERFORMING AGENCY'S application and agreed to by
RECEIVING AGENCY. PERFORMING AGENCY can change the authorized
geographic service area(s) with approval from RECEIVING AGENCY. If RECEIVING
AGENCY disagrees on change of geographic service area(s), PERFORMING AGENCY
may terminate this contract with at least thirty (30) days written notice.
B. Assist in the collection and evaluation of data which will identify medical benefits of this
nutrition-intervention program and furnish financial, dietary, medical, nutrition-education,
and any othef special reports in a timely manner as required by RECEIVING AGENCY
Program's written policies for the compilation of such data.
C.
Determine eligibility of applicants, register participants, collect data, conduct
measurements, provide nutrition education, and maintain records as required by
RECEIVING AGENCY Program's written policies.
,"" A
D. Make available appropriate health services to participants whose incomes do not exceed
those specified in RECEIVING AGENCY'S Program policies, and inform applicants of
available health services. PERFORMING AGENCY shall have a system in place to
provide participants with the available health services or provide the services through
referral(s) supported by written agreements with health care providers.
A IT ACHMENT - Page 1
.,
E. Issue pfenumbered food vouchers furnished by RECEIVING AGENCY to qualified
participants, who will use such vouchers to obtain specified food items from participating
vendors; maintain complete accountability and security of aU food vouchers received from
RECEIVING AGENCY; and be held financially responsible for all unaccounted for food
vouchefs and/or Ihose issued to ineligible participants. PERFORMING AGENCY shall
be held financially liable for issuance of infant formula vouchefs which are not authorized
or prescribed in the State WIC Policy and Procedures Manual.
F. Review the immunization record of WIC Program applicants/participants and provide
immuniz.1tions as needed, using staff funded under this Attachment in accordance with the
WIC Policy and Procedures Manual provided by RECEIVING AGENCY to
PERFORMING AGENCY or as othcrwise approvcd in writing by RECEIVING AGENCY
Program.
G. Offer services during cxtendcd hours of opcration outside the tnlditionaltimes of 8:00 a.m.
to 5:00 p.m., Monday through Friday, according to a plan approved by RECEIVING
AGENCY. .
H. Implemcnt or expand PERf-aRMING AGENCY'S brcastfecding peer counseling program
for training and salaries of pcer counsclors who assist prcgnant and breastfeeding WIC
participants in normal breastfceding situations, whcn funding is available, if participation
in this program is requestcd by PERFORMING AGENCY and approved in writing by
RECEIVING AGENCY.
I. Provide lactalion consultation scrviccs to WIC clients who have brcastfeeding problems
that are beyond the expertise of their local WIC staff and/or peer counselors using
International Board Certificd Lactation Consultants or the most qualified equivalent.
RECEIVING AGENCY will provide written approval of PERFORMING AGENCY'S
request for lactation consultation scrvices which must include qualifications if
PERFORMING AGENCY proposes to usc a non-certified lactation consultant.
J. Assure adequate stiff coverage and uninterrupted delivery of WIC services if any member
of PERFORMING AGENCY'S staff is approved in writing by the RECEIVING AGENCY
to participate in RECEIVING AGENCY'S dietetic internship program. This internship
will consist of no less Ihan 900 hours of superviscd learning experiences in a variety of
nutrition-related facilities and will prepare PERFORMIING AGENCY'S selected staff
member to better meet the needs of WIC participants.
K. RECEIVING AGENCY m.IY provide breastpumps for cligiblc WIC participants eilher by
purchasing and distributing breastpumps to PERFORMING AGENCY or by authorizing
PERFORMING AGENCY to purchasc or lease the breastpumps. If PERFORMING
AGENCY is authorized to purchase the breastpumps, RECEIVING AGENCY will provide
written notification of the specific types of breastpumps and collection kits, the inventory
levels permitted, and cost guidelines. If this requirement is implemented, then the actual
cost of breastpumps purchased by PERFORMING AGENCY will be reimbursed by
RECEIVING AGENCY utilizing WIC Food Grant funds. When PERFORMING
AGENCY receives or is authorized to purchase breastpumps, NUlrition Services and
Administration funds may not be uscd for that purpose. The cost for the purchase of the
~ A
A IT ACHMENT - Page 2
breastpumps will not affect administrative surplus calculations. The number and cost of
the breastpumps purchased must be identified separately on the face of the claim for
reimbursement (State of Texas Purchase Voucher, Form B-13).
PERFORMING AGENCY shall comply with all applicable federal and state laws, rules,
regulations, standards, and guidelines in effect on the beginning date of this Attachment untess
replaced by subsequent amendment. The following documents are incorporated by reference and
made a part of this contract AlIachment. These include:
.
1.
2.
3.
4.
5.
Child Nutrition Act of 1966, 42 USC 1786;
Uniform Federal Assistance Regulations, 7 CFR Parts 3015 and 3016;
Applicable federal regulations located in 7 CFR Part 246;
State WIC Policy and Procedures Manual located in 25 TAC * 31.1, ,md
RECEIVING AGENCY Client Services Standards for Public Health and Community
Clinics, revised June 1997.
All amended guidelines will become effective within thirty (30) days of receipt by' PERFORMING
AGENCY. If PERFORMING AGENCY does not consent to comply with these guidelines,
PERFORMING AGENCY may exercisc the termination option set out in the General Provisions.
PERFORMANCE MEASURES
The following performance measures will be used to assess, in part, PERFORMING AGENCY'S
effectiveness in providing the services described in this contract AlIachment, without waiving the
enforceability of any of the other terms of the contract.
98% of families who participate in the WIC program by receiving food vouchers shall also receive
nutrition education classes or individual counseling services to coincide with food voucher
issuance;
Of all pregnant women who enter the WIC program, at least 32 % shall be certified as eligible
during the period of the first trimester of their pregnancy;
87 % of clients who are enrolled in Ihe program, excluding dual parlicipants, transfer locked
and/or migrant clients, shall participate as food voucher recipienls each monlh (breast-feeding
infants are also included in the client count);
40% of infants whose mothers were participants in the program during pregnancy shall be breast- ,+ t-
fed at or before the time of their certification of eligibility; and
98 % of clients who indicale during the enrollment process that they have no source of health care
shall be referred to at least one source of health care at cerlification of eligibility.
A monthly activity report which demonstrates PERFORMING AGENCY'S efforts towards
meeting assigned annual targets shall be completed and submilled to RECEIVING AGENCY
within seven (7) working days after the end of each month.
SECTION II. SPECIAL PROVISIONS:
A IT ACHMENT - Page 3
General Provisions, Assuranccs Article, is hereby amended to include the following:
PERFORMING AGENCY hereby agrees that it shall comply with Title VI of the Civil Rights Act
of 1964, 42 USC ~~2000d et seq., Title IX of the Education Amendments of 1972, 20 USC
~~1681 et seq., Section 504 of the Rehabilitation Act of 1973, 29 USC ~794, Age Discrimination
Act of 1975,42 USC ~~6101 et seq.; all provisions required by implementing the regulations of
the Department of Agriculture, 7 CFR Part 246; Department of Justice Guidelines for
Enforcement of Title VI, Civil Rights Act of 1964; 28 CFR ~~50.3 and 28 CFR Part 42; and Food
& Nutrition Service (FNS) directives and guidelines, to the effect that no person will, on the
grounds of race, color, national origin, sex, age, or disability, be excluded from participation
under any program or activity for which PERFORMING AGENCY receives federal financial
assistance from FNS; and hereby gives assurance that it shall immediately take measures necessary
to implement this Attachment.
PERFORMING AGENCY shall compile data, maintain records and submit reports, as required,
to permit effective enforcement of the nondiscrimination laws and permit authorized USDA and
State of Texas personnel, during normal working hours, to review such records, books, and
accounts as needed to ascertain compliance with the nondiscrimination laws. The Department of
Agriculture, Food and Nutrition Service, has the right to seek judicial enforcement if
PERFORMING AGENCY violates any nondiscrimination laws. This Assurance is binding on
PERFORMING AGENCY, its successors, transferees, and assignees, as long as they receive
assistance or retain possession of any assistance from the Departmenl of Agriculture. The person
or persons whose signatures appear on the COVER PAGES of this Attachment are aulhorized to
sign this Assurance on behalf of PERFORMING AGENCY.
General Provisions, Standards for Financial and Programmatic Management Article, Item A,
regarding internal budgeting and Item C, regarding billing, collection, and fee schedules are not
applicable to this Attachment.
General Provisions, Advance Paymcnts Article, is not applicable to this Attachment. However,
PERFORMING AGENCY will be allowed the option of receiving a two-month cash advance in
accordance with WIC Program Policy and Procedures.
General Provisions, Ovcl-time Compensation Article, is not applicable to this Attachment.
General Provisions, Terms and Conditions of Paymcnt Article, is hereby modified to include
the following paragraphs:
The participant caseload will be assigned by RECEIVING AGENCY Program by giving written
notice to PERFORMING AGENCY and may be subject to change from time to time upon written
notice to PERFORMING AGENCY from RECEIVING AGENCY Program with PERFORMING
AGENCY'S concurrence. PERFORMING AGENCY assumes liability for all food costs resulting
from PERFORMING AGENCY exceeding assigned caseload. The number of individuals served
in excess of assigned case load are not to be included in the calculation of earned administrative
funds as described below.
~ '"
AITACHMENT - Page 4
RECEIVING AGENCY will reimburse PERFORMING AGENCY for administrative costs which
include participant referral, vendor evaluation, nutrition education, general administrative support,
start-up costs, outreach, applicant screening, and food voucher issuance.
.
Administrative costs will be reimbursed based on actual costs, but not to exceed the "maximum
reimbursement" set out below, based upon Ihe sum of the pafticipants who actually receive food
vouchers each month plus infants who do not receive any food vouchers whose breastfeeding
mothers were participants, to the extent that the total so derived docs not exceed PERFORMING
AGENCY'S total assigned caseload within any given month. Surplus funds (Ihe amount by which
maximum reimbursements exceed actual costs) can be accumulated and carried forward within the
Allachment term. Surplus encumbered by September 30 must be billed and vouchers received by
RECEIVING AGENCY no later than December 31.
PARTICIPANTS SERVED PER MONTH MAXIMUM REIMBURSEMENT:
During the term of Ihe AlIachment, PERFORMING AGENCY will earn admipistrative funds at
the rate of $~ for each participant served as defined above. .
PERFORMING AGENCY shall provide immuniz.1tions under the WIC Special Initiative through
December 31, 1999, unless otherwise notified in writing by RECEIVING AGENCY no later than
November 30, 1999. Immunizations administered and funded under the WIC Special Initiative
to WIC participants/applicants and their siblings will earn administrative funds at the rate of $5.26
pef immunization as reported to RECEIVING AGENCY via the Texas WIN automaled system.
The per-shot rate is based on actual cosl. When the study of cost-per-shot shows a different actual
cost, then lhe rate of compensation paid per-shot will change. The PERFORMING AGENCY will
be notified of the change and will have thirty (30) days to provide wrillen notice to the
RECEIVING AGENCY if it intends to terminate this conlracl.
PERFORMING AGENCY agrees that:
(1) PERFORMING AGENCY shall identify and document separately not less than 19% of
total administrative costs as expenditures directly related to nutrition education. Nutrition
education expenditures shall be supported by documentation of participant allendance or
non-allendance.
(2)
RECEIVING AGENCY will reimburse PERFORMING AGENCY for administrative
expenses at a rate not greater than 5.26 times Ihe amount of properly documented
expenditures for nutrition education, but not more than is earned based on actual
participation not to exceed PERFORMING AGENCY'S assigned participant caseload, plus
any incentive funds allocated to PERFORMING AGENCY by the RECEIVING
AGENCY.
,&.: (\.
.
(3) RECEIVING AGENCY will limit (cap) PERFORMING AGENCY'S indirect costs to the
lesser of the fate approved by RECEIVING AGENCY'S Fiscal Division or twenty (20)
percent applied to PERFORMING AGENCY'S total direct salaries plus benefits
reimbursed by RECEIVING AGENCY. However, approval shall be obtained from
RECEIVING AGENCY'S Fiscal Division before the recovery of any indirect costs will
be permilled with the exceplion of indirect costs recoveries using amounts contained in the
A IT ACHMENT - Page 5
Uniform Grants Management Slandards (UGMS) for which approval can be granted by the
WIC Program office.
(4) RECEIVING AGENCY will identify annually to PERFORMING AGENCY an amount
of funds Ihat must be spent for breastfeeding promolion. The allocation of breastfeeding
funds to PERFORMING AGENCY will be based on PERFORMING AGENCY'S
proportional share of Ihe slate wide combined total of pregnant and breastfeeding
participanls as reported to RECEIVING AGENCY.
(5) RECEIVING AGENCY also reserves lhe right 10 withhold a proportionale amount of
earned administralive funds when evidence exists Ihal nutrition education and/or
breastfeeding promolion is not being provided by PERFORMING AGENCY, or
PERFORMING AGENCY is not complying wilh lhe provisions of USDA and/or
RECEIVING AGENCY directives.
(6) RECEIVING AGENCY reserves lhe righlto ulilize a compelitive offering for the award
of any future contracts at the end of lhe lerm of Ihis Allachmenl. .
(7) RECEIVING AGENCY may amend or terminate this Allachmenl if available funds
become reduced, depleled, or unavailable during the term of the Allachmenlto the extent
that the WIC Program is unable to provide administrative funding at the rate(s) shown
above. RECEIVING AGENCY will provide writtcn nolificalion 10 PERFORMING
AGENCY of such facl.
(8) RECEIVING AGENCY may pay for additional scrviccs as specified in this Attachmenl
if provided by PERFORMING AGENCY during the lerm of Ihis Attachment (but not
otherwise paid during the term of this Allachmenl) if il is in the best interest of the State
and RECEIVING AGENCY Program to do so. If PERFORMING AGENCY exceeds the
amount of earned administrative funds as stated above, PERFORMING AGENCY will
continue to bill RECEIVING AGENCY for the services provided. If additional funds
become available at a laler date for the provision of these services, RECEIVING
AGENCY may pay PERFORMING AGENCY a share of lhese funds.
(9) In compliance with Rider 47, Current Appropriations Dill and Senate Bill 938, 75th
Legislature, RECEIVING AGENCY will provide incenlives to WIC local agencies to
increase participation in the WIC program to the extentlhat federal funding is available.
(10) RECEIVING AGENCY may adjust the base reimbursement rate defined above during the
term of this Attachment if it is in the best interest of the State and RECEIVING AGENCY
and if additional administrative WIC Grant funds are available.
J,.' i:..
,
PERFORMING AGENCY shall indicale separalely on lhe fitce of lhe claim for reimbursement
(Slate of Texas Purchase Voucher, TDH Form B-13) Ihe cosls associated Wilh nutrilion education,
breast-feeding, and olher administrative cosls.
General Provisions, Program Income, paragraph one, is nol applicable to lhis Allachmenl.
A IT ACHMENT - Page 6
..
General Provisions, Reports Article, second pafagraph, second sentence, is replaced with the
following:
A final report, Financial Status Report, Federal Form 269 (fOB Form GC-3), shall be submitted
no later than December 15, 2000.
General Provisions, Reports Article, paragraph one, is hereby modified to include the following:
PERFORMING AGENCY shall submit Immunization Dose Forms on a weekly basis.
PERFORMING AGENCY shall comply with instructions from RECEIVING AGENCY to
transmit immunization activity by diskelle or via modem at intcrvals specified by RECEIVING
AGENCY.
General Provisions, Equipment and Supplies Article, is replaced with the following:
PERFORMING AGENCY shall accept responsibility and financial liability for all equipment and
supplies purchased with RECEIVING AGENCY funds, whelher purchased locally by
PERFORMING AGENCY or by RECEIVING AGENCY and transferred to the care and custody
of PERFORMING AGENCY. PERFORMING AGENCY shall conduct an annual physical
inventory of all equipment purchased by RECEIVING AGENCY and submit it at a time to be
specified by RECEIVING AGENCY. RECEIVING AGENCY reserves the right to recover the
cost of equipment or supplies purchased by RECEIVING AGENCY and placed in the custody of
PERFORMING AGENCY if such articles are lost, stolen, or otherwise unaccounted for.
SECTION III. BUDGET:
All categories of costs billed to RECEIVING AGENCY, and allocation of such costs, must be in
accordance with the .Plan to Allocate Direct Costs" (PADC) submitted by PERFORMING
AGENCY and approved by RECEIVING AGENCY. This document is incorpofated herein by
reference and made a part of this Allachmenl.
,..: "
ATIACHMENT - Page 7
,
"
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS. GRANTS LOANS AND COOPERATIVE AGREEMENTS
The undersigned ceftifies, to Ihe besl of his or her knowledge and belief that:
(I) No federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or altempting 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 fcdcral contract, grant, loan, or cooperative
agreement.
(2) If any funds other than fcderal appropriated funds have been paid or will be paid to any
person for influencing or altcmpting 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 complcte and submit Standard Porm-I II, "Disclosure FornI to
Report Lobbying," in accordance with its instructions.
(3) The undersigned shall requirc 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 Icss than $10,000 and not more than $100,000 for each
such failure.
09-01-99
Date
Print Name of Authorized Individual
R
7560022067 2000-03
Application or Contract Number
J.' l,
I....
PARIS-LAMAR COUNTY HEALTH DEPARTMENT
Organization Name
P. 0 BOX 938
PARIS, TX 75460-0938