HomeMy WebLinkAboutC2005-479 - 9/13/2005 - ApprovedDEPARTMI~NT OF STATE m~ALTH SERVICER
1100 WEST 49TH STREI~T
AUSTIN, TEXAS 78756.3199
~; r ^TF.. ~ )F q'I-'.X AS
~ 'O1.]%"1' ~ OF TRAVIS
DSHS Document No. 7'1~'~'~'741 2006
C__~u~ Clmnse No~e No. 0~
Tr~ ~mem ot Sta~e Health Serv~ce~ hm'mnaftcr rtl'cried m aa RECE]V]NO AC~P-N(.~', dkl heretofore mm' into · c~mr~ kn
wntiny, w~rh CORI~ O-IRI.~crI-NUF, r~-'~ COUNTY PUB! .~C I~A!.TH D].~RICT fCITY~ hcmimf~ ndermd m aa
PERPORMING A~. T'ng partiga thgrcm now dmire to m~nd such c~h ~ct atta~hmm~i) u foUow~
~}UMMARY OF TRAN~AC'HON:
· x'lT ~O {X~ : TB - PREVENTION AND CONTROL
.~1 ~m'u, ~ cxw~l~tiom nol hereby nmer~ renmn in full force and effect
F. XF.42! frED IN DI IPLICATE ORIOINW{ -~ ON Ti-iH DATES SHOWN.
CORPU~ CHRIS'I I (CITY
~.ulhortxgd ('o.b-.'dn~ l~.mity (type ebnte it different
rmm PERPORM~IO AOEN(~') for and in behalf off
CORIRJ$ CH~ASTI..NURCE8 COUNTY PUBLIC
HEALTH DiS'I~ICT (crrY)
· Nmm and Titlle)
''i
DSHS
RRCEaTING AGENCY:
DEPARTMENT OF STATE HEALTH
By:
(Name and Tide). ,
200~479
09/13/0~
DETAILS OF ATTACHMENTS
DSFIS Pm~am rD/ T,~'m F'u~ial A~l~mnc~ Dire~t Total /~nmum
B~n E~ ~ ~ A~
· ~i~ 03~ 939~ ~.7~.~ ~ ~,~
111.166-50 0.00 111,166.J0
144..t50.00 0.00 144,t50.00
142307.00 0~0 142,307.00
$5~7.131.50 $ 0~0 $597,131..~
· t~les:,l lunds .u~ ind~l~l by a nurnher from the Catalo~ of F,',~'~l Dommtic Assistam.'e (CIaDA), if applicable. ~ TO
BUIX,EI' SEI~'I'ION OF ANY x~RO AMOUNT A'I-I'.a. CtlMI~qT laOR DETAILS.
Cover P~? 2
DOCUMENT NO. 7460005741-2006
ATFACHIVIENr'F NO. 05
PURCHASE ORDER NO. 0000309464
PERFORMING AGENCY: CORPUS CHRISTI-NUECE, S COUNTY PUBLIC HEALTH
DISTRICT (CITY)
RECEIVING AGENCY PROGRAM: INFECTIOUS DISEASE INTER--ON AND
CONTROL BRANCH
TERM: September 01. 2005 THRU: August 31, 2006
SECTION I. SCOPE OF WORK:
PERPORMING AGENCY nhall develop nmi provide (!) basic services and aanociated activities
for tuberculosis (TI3) fnuvention and control and (2} expanded ouuunch srrvices to individ-al~ of
idenUfied ~p~al popuJation~ who have TB or who ar~ at high risk of d~teloping TB fl-ffoughout
PERFORMING AGENCY'S defined ge~rvice area of Nueces..
PERFORMING AGENCY shall perfo, m the following activities:
Prowde basic and exl:m~k:d oul~.ach ~rvices in compliance wiflu RECEIVING AGENCY
Progrm~'s moat cur~=nt vemicm of flue Sumdnx~ of P~fu,,,tance and the following ~'lm of
Amenc~m Thoracic Society (ARS) and the Cent.s for Disease CouU'ol and Pruvenlion (CDC)
"Joint Staten-,~ntn" on dias~nai~, t~..ntment and control of TB.
Di..mx~tic Stmmdm~ and Clarmfication of Tube~uloldn in bd,,l~ ~md Children.
IAmuricnn Journal of Respiratory and Critical Care Medicine, Vol. 161, pp. 1376-1395,
=-~)0);
'2 Treatment of Tuberculosia, (ATS/CDCJIDSA), 2003. Publicatio~ can be Iocalud at web
~it~ www,q;xi~.&ov/n,*~n~aL~n,,q;b/puba/mm,w~.hl~nl/ml~ guide.hun
3 Conm)l of Tuberculosis (American R~view Respiratory Di~,"~se., Vol. 146, pp. 1623-33,
1992);
4. T~ Tubemulin Testing and Treatxnent of l_~t~nt TB Infec6on, MMWR, Vol. 49,
No. RR-6. 2000: and
5 Updated: Adverse Event Dnt,, and Revised An'~rican Thoracic Socie~dCDC
R_~_'ommendations Against the Use of Rifumpin and Pyrazinamide for ~ of
I.~ent Tuberculosis Infection - United States. _9003. MMWR 52 (No. 31).
PF~RFORMING A(]ENCY shall comply with all applicable fexlm'al and stat~ laws, niles,
regulations, standards and guidelines including, but not limited to the followinl~
ATTACFI~ - Pagu I
'Fexns Tuberculosis Code. Health and Safety Cod~, Chapter 13, subchsp~ B;
Communicable Disease Prevention and Control Act, Health and Safety Code, Chapmr 81;
Screening and Trealxnent for Tuberculosis in Jails and Other Correctional Facilities.
I-le',dth and Safety Code. Chapter
Te,tns Ad,.inistr~iv~ Code. Title 25, Part 1, Chapter 97, Subchafxe~ H Tuberculosis
.~zreening for Jails and Other Correctional Facdities;
'Ferns Achninism~.ive Code. Title 25, Part 1, Chapter 97, Subchapter A Control of
RECEIVING AGENCY'S Standards for Public Health Clinic Services. Revised Augu~
3! 2004.
PERFORMING AGENCY shall perfu,., all activities in accordance with PER.PORMING
AGENCY'S object~ve~ work plans, and detailed budget ns approved by ~O AGENC~
comracl Attachmem. RF_CEIVING AGENCY'S Program must sppmvc, in writing, any
~vis~ons to thes= ck~cm'nenlS.
Within tluny (30) days of receipt of an amemted standard(s) or guideline(s), PER_laORMINO
AGENCY aludl inform RF~-'EIV1NO AGENCY'S Program, in writing, if it will not continue
performance under this contrsct Att, whrrm~t in compliance with the arnergled standings) or
guideline(s). RECEIVING AGENCY may terrninme the contrnct Attachn~nt immediately or
w,th,n a reasonable period-of-time as d~c,,,,~t~:d by RECEIVING AGENCY.
RECEIVING AG~'qCY reserv~ the righL where allowed by le~l authority, to n~direct fimds in
thc event of financial shortfalls. RECEIVING AGENCY'S Program will monitor
PERFORMING AGENCY'S expenditm'es on a q-nnerly bnsia. If e~penditures nrc below that
projected m PERFORMING AGENCY'S total contract nmounL ns shown in SEC'TR3N m_
BUDCtl=~. PERFORMING AGENCY'S budget may be subject to a decrease for the remainder
~1 the cootrnct Attachment term. Vacant positions existing after ninety (90) ctnys may result in a
de.Tease in funds
PERFORMING AGENCY'S approved ~-vice delivery plan shall meet or exc~d RECEIVING
A~CY Program's Sumdatd of Performance in the following mT. as:
Management of 'lB canes nnd suspects with emphasis on .muvin~on of cli;~xly observed
~herapy (DOT);
2. Mann?merit of contacts to known or st~pec~ed ca~e~ of mbetgxdos~s;
Management of patients on treatment of latent ~ infection (LTBI);
4 Surveillance to identify un~-p(~*ted individuals with LTBI and ~ diseame ns well ns
reporting of all ~ cnses, suspects, and contacts;
6. Tarl~__~_ t-sting of high riak gn;x~pa:
Professional education nnd training for new TB staff ttnd continuing education for curr~at
~taff.
A~AC~-~2
8 Pmi~nt and provid~ c. ommtmication aa it rela~ to limited Eagliah
,:licnta; mind
~ Qw, dity armuram:~.
pERPORMANCE
I'h~ tollowing ontcom~ p~u.mance measur~ will be ~ to asaeaa, in part. PER~RMINO
AGENCY'S eff~ativmmema in providing the am-vi¢~a d~m-ib~ in thin eontm~ A~
w~thout waiving the mmfon:~uility of uny of time oti'm.r tm'ma of the eontxa~
I. 90% of cases and suapecta under Ixeal:ment tm: on DOT.
" 02% of eligible TB cases completu a conrsc of cm'~ve TB u'uatmem within twelve (12)
months of initiation of tre, aln~nt;
3 q2% of TB patio-nm with initial positive cullmus aru rested for and have drug
susceptibility results documented in their medical fecund.;
4 qO% of smear positive TB cnses repormd in 2005 have at least one (1) contact idmmfl.fied;
5 70% of identified contacts to smear poaitive TB c.a~s repormd in 2005 ~all be cvaluamd
fo~ 'lB infection or diana.;
6. 61% of infe~n~d contacts (to smear po~tive ca~ea report~ in
Ir~atment for LTBI shall oo,~xp~ thmmpy;
7 The itc for U.S.-bom African Arrm'ieans will no~ eou:eed fifl~a (15) TB ea~a pm'
100.0(]0 population in PERFORMING AOENCY'S defined a~viee
8 81% of adults (n? >14) with TB diaea~ who ~re U~l'-d for HIV; and
9 R_,~quinxt vadablem reported on TB-400A, TB-4OOB, TB-340, and TB-341 fornm ahail be
05% ¢o,-,iplete at time of initial report and time of ¢loaure
RECi~¥ING AGENCY Program shall ealcuL, m- performance meaatn'us baaed on tbe information
maint,lnud in daiabanea kc, pt at RECEIVING AGENCY'S Program, through limittxl acope audit,
or msl~tiona, and ~c ._i',~'h,led tnuigm'n reviews of I:'ERFORIVflNG AGENCY.
PERFORMING AGENCY ahall p,uvide a nanative program ruimort on ~ p~ommnce goals,
objectivea, and screening activitiea annually. The r, anative r,~ort almall be rout drier
ele~n.ron,eally or mailed to ~INO AGENCY'S Pmsmu ~u tl~ El~uaxtummt of Stst~ Health
Serv~cus, Infectiotm Di~ea~ I~t,-~wenfion and Control Branch, Mail Code 1939, Il(W) Wmt 49m
Struet. Atmfin, Texas 78756-3199. PERMORMING AOENCY atufll maintain the doottmmmt~o~
used ~o calculate ontcome performance measures. Report period and due a,,,, is a~ fo{Iowa:
IPERIOD COVF_.RRI~ I DUE DATE
Jnntatry 2005 - December 2005 Marc:~ 1, 2006
RF_.CE.~[NO AGENCY'S Program ahall p, uvid~ adminialxafive and t~chrdcal a~i~ance for the
implemmmmtion and operation oftbe aervice d~livery plan.
SECTION II. SPECIAL PROVISIONS:
ATTACHMENT - P"? 3
General Pmvis~ons. ~ Article. ~s revised to mclu~ thc following:
PER!~RMING AOENCY shall city, lop and submit a ~ ~li~ pl~ ~ ~1~
h~ j~fific~ f~ ~fin,mfi~ of ~s c~ ~~t ~ng ~ ~t fi~ ~.
~ pl~ ~ ~ sh~l ~ ~ in ~ f~ ~ by ~O A~S
~; ~ ( i ) ~y ~1 ~ ~ m ~~G AGra'S ~ ~ ~ (1)
c~y ~1 ~ s~t~ to ~ ~ ~, ~ ~ ~ ~O
AG~CY'S ~. ~ p]~ ~1 ~ ~~O AO~'S ~ ~
a~ ~ t~ ~ng t~ ~ ~tlin~ in S~ON I. ~ OF WO~
a~ve. iml~ng u~ t~ ~~ ~ ~ ~ a ~1~ lira i~
~ {~fi~ti~.
PERIWIG AOENCY shall mail all initial r~aons of confi,.,~i TB ~ mad susp~'md
TB casm to RECEIVING AGENCY'S Program within ~ CO worlrin~ days of
~dent/hcntion or notificnfion. Any updntea w initial RECEIVING AGENCY'S Report of
£'uses and I~tiertt Service~ Form (TB ~00) (e.g., diagnosis, medic~io~ chnngm, x-rays, nm/
hacteriolo/D') and case closures shall be ma/led to RECEIVING AGENY'S Program.
PERPORMING AGENCY shall rn~l reports of contmas on all cl~a$ 3 TB m m~l ~n~ar
po~tixe clas~ 5 'I'B stmpc~ts wilhin thirty (30) day~ of id~mtific~tion using ~O
AGENCY'S ~ of C~mtaets Form CrB-340). All sub.lust comacm shall b~ ~ a~
c~mta~s are id~tifi~:L R~fer to the most curnmt v~sion of RECEIVINO AOENC~S
Programs Stanchud of l:Mrformance for acl~duling of r~aorting datea.
One (I) copy of each q,,,merly Financial Stmus R~aort, State of T~xas Supplr~,,mtal ~
269A, shall also b~ submitmd to RECEIVING AGENCY Pmgmrn. Cooiea ~ b~ mailod to
thc Depamm'nt of State H~tlth Services. Ane~ntion: Inf~cfio~ Disease Control Branch, Mail
('ode)939. ! 100 W~st 49m Street, Austin, Texas 78756. Report periods and du~ dama am aa
hdlow,:
PERIOD COVERED
Sep~emba', October, November
~, January. Februm'y
Mltrch, April, May
July. Ju]y, August
DU~ DATE
Man:h 31,2006
Jun~ 30, 2006
General Provisions, Funding Article, is r~visg~d to include tl~ following:
Funding from t~us Attachm~t shall not b~ ~ to auppl~nt O.c., u~d in place of fum~
~xl~ca~t, apprupri~ or expended for activities funded l/trough this contract Att~c~,,.m0
state o~ local fun6s, but PEPORMING AGENCY ahall usc such funds to in~'~a~ ~ o~
local funds currently available for n particuinr activity. PERPORMINO AtqHNCY shnll
maintmn local funding at a sufficient rate to support lhe local program. If the total co~ of the
ATTACHMF3~H~ -- Pa~ 4
project is gr~s~ than RECEIVING AGENCY'S Program shm~ set out in ~ON ITl'.
BUDGET, PERFORMI2~G AGENCY shall obtain funds for the rcrrmining costa in order to
a~comp~ish the objectives sei for~ in this contract Attachment.
C~-neral Provisions. Progr~n ln~ome Article, is re-vised to include lhe following:
All revenue directly generuted by this contract Attachment or em'n~ as a r~uit of thin
c~mtr~.'t Attachment during the term of Ibis contract Atm=hment is connidc~ progrmn
income, including income gcner~t,-d through Medicaid billings forTB related clinic sen'vices.
PERI~RMING AGENCY may use the program incomc, excluding proa~=m income earned
trorn Medicaid billings for 'lB drug~, to further the scope of work de. led in thi, contract
Atttichmcnt. This progrttm income may not be used to take the place of existing local, ~tnte,
Progrum income ~ from Medicaid billings for TB drug~, which have beer2 provided by
RECEIVING AGENCY to PERFORMINO AGENCY, must bc ~ and rci~ to
RF..CEIVING ACIENCY on a qttarlerly I~asis t~ follows:
PERIOD
Sep~mb~', October, Novemb~
D~c~.,her, January, Fetn'uttry
Jtme, July, August
DUE DATE
~ 31., 2005
Mm~ 31, 2006
June 30, 2006
Sel~'mber 30, 2006
RE(~IVING AGENCY'S Program has provided PERt~RMINO AGENCY with the formnt
to be used for r~porting. All ~imbm'se~lents from PERI~RMINO AOi~N~ nlutll be
mailed to: ~t of St.t,. Health Service~ At~mtioo: Accoortting Section/Claims
Proee~ing Unit, ! 100 West 49~ Street. Aunfin. Texas 78756-3199.
A final settl;,j~cnt of the rc~mbur~rnents to RECEIVING AGENCY for TB drugs will be
covnple~_~_ no laxer ~han ninety (90) day~ after the cool.ct Attachment term.
A'I~FAC~ - Pn~ 5
~JECFION ltl. BUDOET:
PF. RSONNEL $104,634.00
FRINGE BENEFITS 37,673.00
TRAVEL 0.00
EQUIPMENT 0.00
SUPP~ ~F_~ 0.00
CONTRACTUAL 0.00
OTHER 0.00
$142,..'~Y'/.00
Total rcimlxulgment~ will n(x ex_-_c~cd $142,307.00.
Financial st~m~ r~ort~ ax~ du~ the 30th of _Dec~__-mb~r. 3(Xh of March, 30th of Jurw. sad tho 30th
~f November.
A'I"FACH.M'b3~ - ps? 6
CERTIlqCATION RKGARDING LOBI~YING
CERTIFICATION FOR CONTRACT~ Gi~NT~
AND COO~TIVK AGRg_gMKN~
(I, Noreder,! appropriated run~tmvebem ~ orwm belmkl, by or on betmir ot the
,rnd~ ~ to any permon for ~ or mttt.aptl~ to i~ mn o~ or mn
(2~
Ifanyfnndsothtr than federal approprinh~l_ funds havebeen paid or wlll bt pild to
anyperntm for I-figPnrlqI or -lh'-..,dlng to I.fhn,wlte ne (II~CIr or~ofllly
a~ncy, a nmnt~ of Congrem, an
employu of a mmdn~ of Coagrtn In ctmnet'tion with thh fed--'nletmtrn~ grant,
Form-Ill, "Dkdoeur~ Form to Report Lobbytn~" in mssxdxnee with lt'e
This ___~tJl~mbaumtmqM reprmentatkmoffactuptm whichrdhnce mpiamiwhen
thb~wuma~eor etaeml Int~ S~bmlmion ofthb certlflcathm bm prerequld~
for nmklng orentertng t~t~ls tranmctJoa ltnlx~d, by Sectkm ].~2, Title31,
Any pmmm who bib to file the required certffimthm droll be mbJect to n dvll pemdty of not
less th~n $1 ~,1}~0 and m more than $100,000 for each such failur~
Appllmlionor Contt~ Number
C~LPU9 ~TBTT-muw,~,,~ ~ ~-uu~TC H]I~E DI~IC~
Or~~ Name and Addresn