2004-063-RES AUTHORIZING THE EXECUTION OF A CONTRACT FOR PUBLIC HEALTH SERVICES, TDH DOCUMENT NO. 7560022067-2005 (ATTACHMENT NO. 01)
RESOLUTION NO. 2004-063
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PARIS,
PARIS, TEXAS, APPROVING AND AUTHORIZING THE EXECUTION OF
A CONTRACT FOR PUBLIC HEALTH SERVICES, TDH DOCUMENT NO.
7560022067-2005 (ATTACHMENT NO. 01); MAKING OTHER FINDINGS
AND PROVISIONS RELATED TO THE SUBJECT; AND PROVIDING AN
EFFECTIVE DATE.
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-
2005 (Attachment No. 01), is the conduit through which the state funds are received; and,
WHEREAS, it is appropriate that the form of said Contract, attached hereto as Exhibit A,
be approved, and that the Interim City Manager 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, PARIS,
TEXAS:
Section 1. That the findings set out in the preamble to this resolution are hereby in all
things approved.
Section 2. That the form of the Contract for Public Health Services, TDH Document No.
7560022067-2005 <Attachment No. 01), attached hereto as Exhibit A, be, and the same is hereby,
approved.
Section 3. That the Interim City Manager 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, the Contract for Public Health
Services, under the terms and conditions and in the form shown in Exhibit A, attached hereto.
Section 4. That this resolution shall be effective from and after its date of passage.
PASSED AND APPROVED this 12th day of April, 2004.
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ATTEST:
Mattie Cunningham, City Clerk
APPROVED AS TO FORM:
.
CONTRACT FOR PUBLIC HEALTH SERVICES
Contract Issued by:
(RECEIVING AGENCY)
TEXAS DEPARTMENT OF HEALTH
1100 WEST 49TI1 STREET
AUSTIN, TEXAS 78756-3199
TDH DOCUMENT NO. 7560022067 2005
LF
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: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
MAILING ADDRESS: PO BOX 938 PARIS TX 75460-0938
STREET ADDRESS: 740 SOUTHWEST 6TH PARIS TX 75460-0000
NAME OF AUTHORIZED
CONTRACTING ENTITY: CITY OF PARIS
(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:
ADDRESS:
State of Texas Vendor Identification No. (14 digits)
17560022067001
PAYEE AGENCY Fiscal
Year Ending Month: September
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 1- Receiving and Performing Agency Data
COVER PAGE 2 - Details of Attachment(s)
COVER PAGE 3 - Authorized Signatures
GENERAL PROVISIONS - 1112003
A IT ACHMENT(S)
EXHIBITS, IF APPLICABLE
EXHIBIT Ll.
Cover Page 1
DET AILS OF A TT ACHMENTS
Aul TDR Program 101 Term Financial Assistance Direct Total Amount
Amd TDR Purchase Order Assistance (TDR Share)
No. Number Begin End Source of Amount
Funds.
01 IMMlLOCALS 01/01/04 12/31/04 State 93.268 25,012.00 0.00 25,012.00
0000001782
TDR Document No.7560022067 2005 Totals $ 25,012.00 $ 0.00 $ 25,012.00
*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 DETAll..S.
Cover Page 2
EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN.
CITY OF PARIS
Authorized Contracting Entity (type above if different
from PERFORMING AGENCY) for and in behalf of:
PERFORMING AGENCY NAME:
PARIS-LAMAR COUNTY HEALTH
DEPARTMENT
By:
(Signature of person authorized to sign contracts)
(Name and Title)
Date:
By:
RECEIVING AGENCY NAME:
TEXAS DEPARTMENT OF HEALTH
By:
(Signature of person authorized to sign contracts)
Bob Burnette, Director
Procurement and Contracting Services Division
(Name and Title)
Date:
l :7--o.3-~D3
TDH Document No: 7560022067 2005
Cover Page 3
'.
DOCUMENT NO. 7560022067-2005
ATTACHMENT NO. 01
PURCHASE ORDER NO. 0000001782
PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: IMMUNIZATION DIVISION
TERM: January 01,2004 THRU: December 31,2004
SECTION 1. SCOPE OF WORK:
PERFORMING AGENCY will provide essential public health services as specified in
PERFORMING AGENCY'S approved 2004 Interlocal Application for Immunization Services,
dated June 16, 2003, incorporated herein and made part of this contract Attachment.
Immunization public health services include one or more of the following eight immunization
core component areas:
1. Program management activities to include program planning, staffing and training, and
partnerships and collaborations.
2. Vaccine management activities to include ordering, storage, and vaccine accountability.
3. Immunization registry activities to include provider participation and training.
4. Provider quality assurance activities to include provider education, site visits, and access
to information on perinatal hepatitis B prevention.
5. Service delivery activities to include targeting under-served populations and promoting a
medical home.
6. Consumer information to include information development and dissemination and
vaccine benefit and risk education.
7. Surveillance activities of vaccine preventable diseases to include surveillance, response,
and reporting, screening for perinatal hepatitis B, and vaccine safety.
8. Population assessment activities to include assessment of communities, child-care
facilities, Head Start Programs, Kindergarten, and 7th grade entrants.
PERFORMING AGENCY shall perform the following activities to comply with the National
Childhood Vaccine Injury Act of 1986, and the Omnibus Budget Reconciliation Act of 1993 and
Section 1928 of the Social Security Act:
1. Distribute Vaccine Information Statements (VIS) to clients.
2. Record required information regarding vaccine administration m permanent medical
record.
3. Report adverse events relating to vaccine administration.
4. Recruit and enroll providers into the Texas Vaccines For Children (TVFC) program.
5. Obtain a signed provider enrollment form from each provider participating in the TVFC
program that includes name, medical license number and Medicaid provider number (if
applicable) of each provider practicing at an enrolled site.
6. Maintain TVFC provider enrollment records and provider profiles for at least three (3)
years.
ATTACHMENT - Page 1
PERFORMING AGENCY agrees that alterations, vanatIons or additions to the important
vaccine information statements may not be made without the prior written approval of
RECEIVING AGENCY Program.
PERFORMANCE MEASURES
All activities shall be performed in accordance with PERFORMING AGENCY'S Annual Plan
and detailed budget as approved by RECEIVING AGENCY Program based on the Interlocal
Application for Immunization Services, dated June 16, 2003. PERFORMING AGENCY will
perform the following applicable required activities:
1. By December 31,2004, PERFORMING AGENCY will implement a plan to improve
vaccine coverage levels.
2. During FY 2004, PERFORMING AGENCY will work with the local WIC program
to implement documentation criteria for referral of under-vaccinated WIC enrollees.
3. By December 31,2004, PERFORMING AGENCY will ensure that expired, wasted,
and unaccounted for vaccines do not exceed 5% for DTaP, Rib, hepatitis B, IPV,
MMR, PCV7, and varicella vaccines.
4. By December 31,2004, PERFORMING AGENCY will decrease the proportion of
duplicate records or questionable matches in ImmTrac by a minimum of 5%.
5. By December 31, 2004, PERFORMING AGENCY will increase the percentage of
children less than six years of age participating in ImmTrac by a minimum of 5%.
6. By December 31, 2004, PERFORMING AGENCY will increase the number of
registered provider sites for ImmTrac by a minimum of 5%.
7. By December 31, 2004, PERFORMING AGENCY will increase TVFC provider
enrollment by a minimum of 5%.
8. By December 31, 2004, PERFORMING AGENCY will increase the educational
opportunities on vaccine-preventable diseases to public and private providers.
9. By December 31,2004, PERFORMING AGENCY will complete 100% of assigned
TVFC follow-up site visits.
10. During FY 2004, PERFORMING AGENCY will promote and ensure immunization
services are provided for all age groups with emphasis on pockets of need.
11. By December 31, 2004, PERFORMING AGENCY will increase the reporting of
varicella cases by a minimum of 10%.
12. During FY 2004, PERFORMING AGENCY will complete 90% of vaccine-
preventable disease investigations within 30 days from date reported.
ATTACHMENT - Page 2
13. By December 31, 2004, PERFORMING AGENCY will identify all infants born to
hepatitis B surface antigen-positive pregnant women.
14. By June 30, 2004, PERFORMING AGENCY will ensure all reported infants born to
HBsAg positive women receive hepatitis B vaccine and HBIG within seven (7) days
of birth.
15. By December 31,2004, PERFORMING AGENCY will complete 100% of assigned
childcare facility assessments.
16. By December 31,2004, PERFORMING AGENCY will complete 100% of assigned
private school assessments.
Activities may be subsequently amended as directed by the Centers for Disease Control and
Prevention and RECEIVING AGENCY Program. RECEIVING AGENCY Program must
approve, in writing, any revisions to the PERFORMING AGENCY'S Annual Plan.
SECTION II. SPECIAL PROVISIONS:
PERFORMING AGENCY shall comply with Texas Health and Safety Code, Chapters 81 and
161.
Funds shall not be used for administering vaccines, inpatient care, construction of facilities, or
debt retirement in accordance with RECEIVING AGENCY Interlocal Application for
Immunization Services, dated June 16,2003.
Travel expenses shall be reimbursed according to State of Texas travel regulations.
Monthly billings must be submitted on a State of Texas Voucher Request form no later than the
close of the following month.
Programmatic reports shall be completed in the format provided by RECEIVING AGENCY
Program and submitted within thirty (30) days from the end of each quarter of the contract
Attachment term. A final summary report detailing all programmatic activity that occurred
during the contract term shall be submitted to RECEIVING AGENCY Program within sixty (60)
days from the end date of the contract Attachment.
A IT ACHMENT - Page 3
SECTION III. BUDGET:
PERSONNEL
FRINGE BENEFITS
TRAVEL
EQUIPMENT
SUPPLIES
CONTRACTUAL
OTHER
$14,541.00
4,362.00
1,090.00
0.00
3,464.00
250.00
1,305.00
TOTAL
$25,012.00
Total reimbursements will not exceed $25,012.00.
Financial status reports are due the 30th of April, 30th of July, 30th of October, and the 30th of
March.
A'IT ACHMENT - Page 4