09-C Health Contract CO 6
DRAFT
F:ALICEIRESWORKICURRNETI Health Contract change Order No.6 - 2005
December 30, 2004
RESOLUTION NO.
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PARIS,
PARIS, TEXAS, APPROVING AND AUTHORIZING THE EXECUTION OF
CONTRACT CHANGE ORDER NOTICE NO.6 FOR PUBLIC HEALTH
SERVICES, TDH DOCUMENT NO. 7560022067-2005 (ATTACHMENT NO.
OIC) IMMUNIZATION BRANCH - LOCALS; 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, Contract Change Notice No.6,
TDH Document No. 7560022067-2005 (Attachment No. OlC) Immunization Branch - Locals,
is the conduit through which the state funds are received; and,
WHEREAS, it is appropriate that the form of said Contract Change Notice No.6,
attached hereto as Exhibit A, be approved, and that the 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, Contract Change
NoticeNo. 6DHDocumentNo. 7560022067-2005 (Attachment No. OlC) Immunization Branch
- Locals, attached hereto as Exhibit A, be, and the same is hereby, approved.
Section 3. That the 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, Contract Change Notice No. 06, 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 10th day of January, 2005.
Curtis Fendley, Mayor
ATTEST:
Sherian Dixon, Assistant City Clerk
APPROVED AS TO FORM:
Larry W. Schenk, City Attorney
. \
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DEPARTMENT OF STATE HEALTH SERVICES
1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
ST ATE OF TEXAS
COUNTY OF TRAVIS
DSHS Document No. 7560022067 2005
Contract Change Notice No. 06
The Department of State Health Services, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in
writing with PARIS-LAMAR COUNTY HEALTH DEPARTMENT hereinafter referred to as PERFORMING AGENCY. The
arties thereto now desire to amend such contract attachment(s) as follows:
SUMMARY OF TRANSACTION:
ATT NO. OlC: IMMUNIZATION BRANCH - LOCALS
All terms and conditions not hereb amended remain in full force and effect.
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:
PERFO RMIN GAG EN CY :
RECEIVING AGENCY:
PARIS-LAMAR COUNTY HEALTH DEPARTMENT
DEPARTMENT OF STATE HEALTH SERVICES
By:
(Signature of person authorized to sign)
By:
(Signature of person authorized to sign)
Tony N. Williams, City Manager
(Name and Title)
Bob Burnette, Director
Procurement and Contracting Services Division
(Name and Title)
Date:
January 10, 2005
Date:
JC PCSO - Rev. 6/04
EXHIBIT .A
Cover Page 1
,-
DET AILS OF A TT ACHMENTS
Attl DSHS Program IDI Term Financial Assistance Direct Total Amount
Amd DSHS Purchase Assistance (DSHS Share)
No. Order Number Begin End Source of Amount
Funds*
OlC IMMILOCALS 01/01/04 08/31/05 State 93.268 83,433.00 0.00 83,433.00
0000001782
02 ACFHlPHC 09/01/04 08/31/05 State 151,558.00 0.00 151,558.00
CO38917000
03 OPHPILPHS 09/01/04 08/31/05 State 93.991 120,519.00 0.00 120,519.00
C039254000
04 BNSIWIC-CARD 1 % 1/04 09130/05 10.557 93.268 0.00 0.00 0.00
C0395 12000
DSHS Document No.7560022067 2005 Totals $355,510.00 $ 0.00 $355,510.00
Change No. 06
*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. 7560022067-2005
ATIACHMENT NO. OlC
PURCHASE ORDER NO. 0000001782
PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
RECEIVING AGENCY PROGRAM: IMMUNIZATION BRANCH
TERM: January 01,2004 THRU: August 31,2005
It is mutually agreed by and between the contracting parties to amend the conditions of
Document No. 7560022067 2005 -OlB as written below. All other conditions not hereby
amended are to remain in full force and effect.
SECTION I. SCOPE OF WORK, 2nd paragraph, is replaced with the following:
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, and subsequent renewal applications, incorporated herein
and made part of this contract Attachment. Any revisions to these documents shall be
approved by RECEIVING AGENCY Program and transmitted in writing to
PERFORMING AGENCY.
SECTION I. SCOPE OF WORK, 8th paragraph, is replaced with the following:
PERFORMING AGENCY shall ensure a health care workforce that is knowledgeable
about vaccines, vaccine safety, vaccine-preventable diseases, and delivery of
immunization services.
SECTION I. SCOPE OF WORK, 16th paragraph, is replaced with the following:
PERFORMING AGENCY shall provide to RECEIVING AGENCY Program periodic
data transfers of all vaccines administered in a format that is compatible for inclusion in
the statewide immunization registry, ImmTrac, and in accordance with the schedule
provided by RECEIVING AGENCY.
SECTION I. SCOPE OF WORK, 17th paragraph, bullets 1, 10, and 14, are replaced with
the following:
. PERFORMING AGENCY'S approved 2004 Interlocal Application for
Immunization Services, and any revisions or subsequent renewal applications;
. RECEIVING AGENCY'S Standards for Public Health Clinic Services, revised
August 31, 2004;
. Standards for Child and Adolescent Immunization Practices, February 8, 2002,
recommended by the National Vaccine Advisory Committee, approved by the
ATTACHMENT - Page 1
. '
United States Public Health Service, and endorsed by the American Academy of
Pediatrics.
SECTION I.
following:
PERFORMANCE MEASURES, is replaced in its entirety with the
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
lnterlocal Application for Immunization Services, dated June 16, 2003 and any
subsequent renewal applications. The following performance measure(s) will be used, in
part, to assess PERFORMING AGENCY'S effectiveness in providing the services
described in this contract Attachment to the service area, without waiving the
enforceability of any of the terms of the contract Attachment.
PERFORMING AGENCY shall submit to RECEIVING AGENCY Program the
monthly reports of doses administered and the monthly biological order form in a
format provided by RECEIVING AGENCY and in accordance with the schedule
provided to PERFORMING AGENCY by RECEIVING AGENCY Program.
PERFORMING AGENCY shall implement an immunization reminder and recall
system to notify parents or guardians of children less than 36 months of age when
immunizations are due or past due. The notifications may be automated or manual
and may consist of mail or telephone contacts.
PERFORMING AGENCY shall complete 100% of annual assessments in sub-
contracted entities and local Women, Infant and Children (WIC) clinics using the
Assessment, Feedback, Incentives, and eXchange (AFIX) methodology as assigned
by RECEIVING AGENCY. PERFORMING AGENCY shall submit assessment
results to RECEIVING AGENCY Program within two (2) weeks after completion.
PERFORMING AGENCY shall recruit and enroll providers into the Texas Vaccines
for Children (TVFC) program.
PERFORMING AGENCY will perform the following applicable required activities:
1. Implement a plan to improve vaccination coverage levels;
2. Work with the local WIC agencies for referral of under-vaccinated WIC
enrollees;
3. Ensure that expired, wasted, and unaccounted for vaccines do not exceed 5%
for DTaP, Rib, hepatitis B, IPV, MMR, PCV7, and varicella vaccines;
4. Decrease the proportion of duplicate records or questionable matches in
ImmTrac;
5. Increase the percentage of children less than six (6) years of age participating
in ImmTrac;
6. Increase the number of registered provider sites for ImmTrac;
7. Increase TVFC provider enrollment;
8. Increase the number of educational opportunities on vaccine-preventable
diseases available to public and private providers;
A IT A CHMENT - Page 2
9. Complete 100% of assigned TVFC follow-up site visits;
10. Promote and ensure immunization services are provided for all age groups
with emphasis on pockets of need;
11. Increase the reporting of varicella cases;
12. Complete 90% of vaccine-preventable disease investigations within thirty (30)
days from date reported;
l3. Identify all infants born to hepatitis B surface antigen (HBsAG)-positive
pregnant women. PERFORMING AGENCY shall investigate 100% of
suspected hepatitis B infections in pregnant women to ensure appropriate
treatment and follow-up as directed by Health and Safety Code §8l.090 and
RECEIVING AGENCY'S Vaccine-Preventable Disease Surveillance
Guidelines;
14. Ensure all reported infants born to HBsAg positive women receive hepatitis B
vaccine and Hepatitis B Immune Globulin (HBIG) within seven (7) days of
birth;
1~. Complete 100% of assigned childcare facility assessments or surveys; and,
16. Complete 100% of assigned private school assessments or surveys.
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, 2nd, 3rd, and 5th paragraphs are replaced with the
following:
Funds shall not be used for purchase of vaccines, inpatient care, construction of facilities,
or debt retirement in accordance with RECEIVING AGENCY Interlocal Application for
Immunization Services, dated June 16, 2003 and any subsequent renewal applications.
Travel expenses shall be reimbursed according to current state travel regulations and shall
not exceed the reimbursement for mileage allowed under the Appropriations Act.
PERFORMING AGENCY is required to complete and submit the following reports
utilizing a format provided by RECEIVING AGENCY Program:
Re ort T e
Pro rammati c
Pro rammatic
Pro rammatic
Pro rammatic
Pro rammatic
Programmatic
Final Summar
Re ortin Period
1/ 1/04 - 3/31/04
4/1/04 - 6/30/04
7/1/04 - 9/30/04
10/1/04 - 12/31/04
1/1/05 - 4/30/05
5/1/05 - 8/31/05
1/ 1/04 - 8/31/05
Re ort Due Date
4/30/04
7/30/04
10/30/04
1/30/05
5/30/05
9/30/05
10/30/05
A TT A CHMENT - Page 3
, . .
DEPARTMENT OF STATE HEALTH SERVICES
RECEIVING AGENCY PROGRAM: IMMUNIZATION BRANCH
PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
CONTRACT TERM: 01101104 THRU: 08131/05 BUDGET PERIOD: 01/01/04 THRU 08131/05
DSHS DOC. NO. 7560022067 20050lC CHG.06
REVISED CONTRACT BUDGET
FINANCIAL ASSISTANCE
OBJECT CLASS CATEGORIES CURRENT APPROVED CHANGE NEW OR REVISED
BUDGET (A) REQUESTED (B) BUDGET (C)
Personnel $29,309.00 $19,499.00 $48,808.00
Fringe Benefits 10,275.00 6,850.00 17,125.00
Travel 1,000.00 667.00 1,667.00
Equipment 0.00 0.00 0.00
Supplies 6,000.00 4,000.00 10,000.00
Contractual 500.00 333.00 833.00
Other 3,000.00 2,000.00 5,000.00
Total Direct Charges $50,084.00 $33,349.00 $83,433.00
Indirect Charges 0.00 0.00 0.00
TOTAL $50,084.00 $33,349.00 $83,433.00
PERFORMING AGENCY SHARE:
Program Income 0.00 0.00 0.00
Other Match 0.00 0.00 0.00
RECEIVING AGENCY SHARE $50,084.00 $33,349.00 $83,433.00
PERFORMING AGENCY SHARE $0.00 $0.00 $0.00
Detail on Indirect Cost Rate Type:
Rate 0.00 Base $0.00 Total $0.00
Budget Justification: Amendment to extend contract term and increase contract amount with 8 months of funding in order to return
contract term to the State Fiscal Year. No revision to number served.
Form No, GC-9 ECPS - Rev. 10/04
Financial status reports are due the 30th of April, 30th of July, 30th of October, 30th of January, 30th of April, 30th of July, and the
30th of November.