08-A Health Services ContractDRAFT
LISA~RESOLUTIONS\CURRENT~Health Contract 2001 CO4 Res
June 26, 2001
RESOLUTION NO.
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PARIS,
PARIS, TEXAS, AUTHORIZING THE EXECUTION OF CONTRACT
CHANGE NOTICE NO. 04 (ATTACHMENT NO. 0lA), REGARDING
COMMUNITY ORIENTED PUBLIC HEALTH, TO THE CONTRACT FOR
PUBLIC HEALTH SERVICES, TDH DOCUMENT NO. 7560022067-2001;
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 City Council of the City of Paris did heretofore, on the 14th day of August,
2000, in Resolution No. 2000-110, authorize the execution of a Contract for Public Health Services,
TDH Document No. 7560022067-2001, which is the conduit through which the state funds are
received; and,
WHEREAS, the City Council of the City of Paris did heretofore, on the 13th day of
November, 2000, in Resolution No. 2000-156, ratify the execution by the City Manager, on the 22nd
day of August, 2000, of Contract Change Notice No. 01 (Attachment No. 03), regarding the
Supplemental Nutrition Program for Women, Infants, and Children (WIC), to said Contract; and,
WHEREAS, the City Council of the City of Paris did heretofore, on the 13th day of
November, 2000, in Resolution No. 2000-156, authorize the execution of Contract Change Notice
No. 02 (Attachment No. 04), regarding Immunization, to said Contract; and,
WHEREAS, the City Council of the City of Paris did heretofore, on the 12th day of
February, 2001, in Resolution No. 2001-015, authorize the execution of Contract Change Notice No.
03 (Attachment No. 03A), regarding WIC Card Participation, to said Contract; and,
WHEREAS, said contract is in need of an additional amendment, and it is deemed
appropriate that the form of Contract Change Notice No. 04 (Attachment No. 0lA), regarding
Community Oriented Public Health, 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 Change Notice No. 04 (Attachment No. 0lA) to
the Contract for Public Health Services, TDH Document No. 7560022067-2001, 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, Contract Change Notice No. 04 (Attachment No. 01A),
regarding Community Oriented Public Health, to 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 9th day of July, 2001.
Michael J. Pfiester, Mayor
ATTEST:
Mattie Cunningham, City Clerk
APPROVED AS TO FORM:
Larry W. Schenk, City Attorney
TEXAS DEPARTMENT OF HEALTH
1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
STATE OF TEXAS TDH Document No.7560022067 2001
COUNTY OF TRAVIS CONTRACT CHANGE NOTICE NO. 04
The Texas Department of Health, 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. '[he parties thereto now
desire to amend such contract attachment(s) as follows:
,UMMARY OF TRANSACTION:
ATT. NO. 0lA: COMMUNITY ORIENTED PUBLIC HEALTH
All terms and conditions not hereby amended remain in full force and effect.
EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN.
Authorized Contracting Entity (type above if different
from PERFORMING AGENCY) for and in behalf of:
PERFORMING AGENCY:
PARIS-LAMAR COUNTY HEALTH DEPARTMENT
By:
(Signatureofpersonauthorizedmsignco~rac~)
MICHAEL E. MALONE, CITY MANAGER
(NameandTitle)
Date: 06-14-2001
RECOMMENDED:
RECEIVING AGENCY:
TEXAS DEPARTMENT OF HEALTH
By: '7~
(~ignatu~r~of person authorized to ~1~ contracts)
Date:
Melanie A. Doyle, Director
Grants Mananement Division
(Name and Title)
CN GMD - Rev. 12/(10
Cover Page i
DETAILS OF ATTACHMENTS
Att/ TDH Term Financial Assistance Direct Total Amount
Amd Program/ Assistance (TDH Share)
No. ID Begin End Source of Amount
Funds *
0lA COPH/PRIMARY 09/01/00 08/31/01 State 215,099.00 0.00 215,099.00
02 BRLHO/SURVEY 09/01/00 08/31/01 State 93.991 121,404.00 0.00 121,404.00
03A BNS/WIC-CARD 10/01/00 09/30/01 93.268 10.557 0.00 0.00 0.00
04 IMM/LOCALS 10/01/00 08/31/01 State 50,023.00 0.00 50,023.00
TDH Document No.7560022067 2001 Totals $386,526.00 $0.00 $386,526.00
Chan~e No. 04
*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
TEXAS DEPARTMENT OF HEALTH
RECEIVING AGENCY PROGRAM: BUREAU OF COMMUNITY ORIENTED PUBLIC HEALTH
PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
CONTRACT TERM: 09/01/2000 THRU: 08/31/2001 BUDGET PERIOD: 09/01/2000 THRU 08/31/2001
TDH DOC. NO. 7560022067 20010lA CHG. 04
REVISED CONTRACT BUDGET
FINANCIAL ASSISTANCE
OBJECT CLASS CATEGORIES CURRENT APPROVED CHANGE NEW OR REVISED
BUDGET (A) REQUESTED (B) BUDGET (C)
Personnel $128,147.00 $0.00 $128,147.00
Fringe Benefits 32,037.00 0.00 32,037.00
Travel 1,500.00 0.00 1,500.00
Equipment 0.00 0.00 0.00
Supplies 7,731.00 1,684.00 9,415.00
Contractual 36,000.00 0.00 36,000.00
Other 6,000.00 2,000.00 8,000.00
Total Direct Charges 211,415.00 3,684.00 215,099.00
Indirect Charges 0.00 0.00 0.00
TOTAL $211,415.00 $3,684.00 $215,099.00
PERFORMING AGENCY SHARE:
Program Income (Carryover) 0.00 0.00 0.0~
Program Income (Projected) 0.00 0.00 0.00
Other Match 0.00 0.130 0.00
RECEIVING AGENCY SHARE $211,415.00 $3,684.00 $215,099.00
PERFORMING AGENCY SHARE $0.00 $0.00 $13.00
Detail on Indirect Cost Rate Type:
Rate 0.00% Base $0.00 Total $0.00
Budget Justification: Increased number of clients served.
Revised Number to be Served: 1,033
Form No. GC-9
Financial status reports are due the 30th of December, 30th of March, 30th of June, and the 30th of November.
INSTRUCTIONS FOR QUARTERLY/FINAL FINANCIAL STATUS REPORT
FORM 269A (TDH FORM OC-4a)
SEC- ENTRY
TION
I Contractor Name: Legal name of contractor as reflected in the contract attachment
2 TDI[ Program: TDH program name as indicated in the contract attachment document
3 Payee Account No.: Account number or other identifying number assigned by the contractor for the contractor's
internal use. (not required by TDH)
4 Enter the unique identifying number that has been assigned to the contract attachment. The number normally consists
of your agency's 9 digit IRS's Employer ID//plus 1 digit assigned by TDH and the numbgr of tJte..fiscal y_ear in which
the attachment term ends plus a twodigit attachment number. (see "CoverPage2"ofyourcot~tractdocument.)
5 Payee 14 Diglt Vendor ID No: Number assigned by the State of Texas Comptroller's Office (which also
incor?orates your agency ~ 9 digit IRS Em?loyer ID#)
6 Accounting Basis: Indicate the principal accounting method used by your agency to account for the expenses relating
to the contract attactunent by placing an "X" in the appropriate space.
7 ! Payee: Enter the Payee's complete mailing address, This information must coincide with the State Comptroller's
Office recerds and Vendor ID number in Section 5 above.
8 Contract Term: Enterthebe~mningandendingdateofthecontractattachment.(e.g.,9/l/99-S/3t/OO).(See "Cover
, Page 2" of your contract document.)
9 ~ Per[od Covered by tills Report: Enter the beginning and ending dates of the contract quarter covered by this report.
(month, day and year)
10 Final Report: Check "No" for quarterly reports and preliminary, "finals"; check "Yes" for the final report.
(i) Standard Budget Categories
(ii) Approved Budget: Approved budget figures as reflected in the fully executed'contract attachment. The figures may
be changed only by a formal budget amendment.
(iii) Project Cost this Period: Contractor's allowable expenditures incurred o~ the attaghment during the quarterly
reporting period.
(iv) Cumulative Project Cost: Contractor's cumulative allowable expenditures incurred on the attaclunent from
inception through the current quarterly reporting period.
(v) Remaining Budget Balance: Subtract Cumulative Project Cost (Column iv) from the approved budget (Column ii).
k(iii) Program Income Collected: Enter the amount of program income (PI) collected during the quarter. The sum of
the proFram income deducted from the reimbursement vouchers for the quarter should equal this amount.
k(iv) Eater the cumulative program income collected during the attachment term. This amount should be equal to the total
pro.am income deducted from all reimbursement vouchers submitted under the attaelunent since inception.
l(iv) Non-TDH Funding: If the effort for this contract attachment is partially funded by non-TDH sources (from other
agencies or with local funds) and all costs of the effort are reflected in the report, enter the cumulative amount of non-
TDH funding here.
re(iii) Advance Received: Enter the amount of advance payment (if any) your agency has received from TDH.
m(iv) Advance Repaid: Enter the cumulative amount of the advance which has been repaid - either by reduction of
reimbursement request or by refund.
re(v) Balance Chved: Subtract the amount of the advance repaid (m(iv)) from the amount of the advance received. (m(iii))
ri(iv) Cumulative Reimbursement Requested: Enter the sum of all reimbursement vouchers submitted for
reimbursement of expenditures incurred since the be,sinning date of the attachment term
o(iv) Total Reimbursement Received: Enter the total of all cash received for both an advance (if any) and actual
cumulative re/mbm'sement payments since the beginning date of the attachment term
For additional information call the Grants Management Payntents Section (~ (512) 458-7520.
Send Reports to: Texas Department of Health
Grants Menagement Division
1100 West 49th Street
Austin, Texas 78756-3199