HomeMy WebLinkAboutC2006-166 - 4/11/2006 - Approved
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DEPARTMENT OF STATE HEALTH SERVICES
1100 WEST 49TH STREET
AUSTIN. TEXAS 78756-3199
STATE OF TEXAS
COU"iTY OF TRAVIS
DSHS Document No. 7460005741 2007
Contract Change Notice No. 01
The Department of State Health Services, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in
writing with CORPUS CHRISTI.NUECES COUNTY PUBLIC HEALTH DISTRICT (CITY) hereinafter referred to as
PERFORMING AGENCY, The parties thereto now desire to amend such contract attachment(s) as follows:
SUMMARY OF TRANSACTION
-\ IT NO 02 DIABETES.COMM, DIABETES SERVICES
All terms and con~itions~~~~eb)i~lended remain in full force and elfect,.____
EXECUTED IN DlPLlCATE ORIGI"iALS 01\ THE DATES SHOWN,
C.QRPUS.CHRISII (CITY. 91')
Authonzed Contractmg Entity (type above if different
from PERFORMING AGENCY) for and in behalf of:
PERFORMING AGENCY:
RECEIVING AGENCY:
CORPUS CHRISTI-NUECES COUNTY PUBLIC
HEALTH DISTRICT (CITY)
DEPARTMENT OF STATE HEALTH SERVICES
By:
,6....
Bv:
. (Signature of p~rson autoo~zelflto sign)
"
t."" ~J._ fJJ~._._ll~ .1)~tj~I'
(Name and Tnltll
__ ~\/lC_~\t
Bob Burnette, Director
Client Services ContractinJ1, Unit
(Name and Title)
Date 64t.
Date
RECOMMENDED
By: /-f~,...~.. f...~~'/L ~ H /.'1l'rl__.
(PERFO MING AC~f different
from person authonzed to sign contract
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~!~~!!..,~~{:. CHAPA ,
MB CSCU . Rev. 6/05
2006-166
04/11/06
Res026721
Cover Page 1
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[)ErAILS OF ATTACHMENTS
AU/ I DSHS Program 10/
Amd DSHS Purchase
\10. Order \lumber
~_~e~ _ 1_ _ Financial Assistance
Begin ' End -1~, Source of Amount
Funds*
,- "'------....---- --_..~ - --_._----~~
o '01/06 12/31/06193116 108,430.00
- - ---- -- - ,-------- ---+---
03/30/06 03/29/(l7 193.988
Direct
Assistance
Total Amount
(DSHS Share)
"- --,
fB/PC
')I
'1000313002
02 DlAB/CDSP
0000316069
c__ ___
DSHS Document No 746000574] 2007
Change No. 01
0.00
108,430.00
80,000.00
0.00
80,000.00
_1
$188,430.00
$ 0.00
$188,430.00
*FederaJ funds are mdicated by a number from the Catalq\ of Federal Domestic Assistance (CFDA), if applicable. REFER TO
Bl;DGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS.
('over Page 2
DOCl'MENT NO. 7460005741-2007
'\ TTACHMENT NO. 02
PURCHASE- ORDER NO. 0000316069
PERFORMING AGENCY CORPUS CHRISTI-NUECES COUNTY PUBLIC HEALTH
DISTRICT (CITY)
RECEIVING AGENCY PROGRAM: rEXAS DIABETES PROGRAM
TERM: March 30.2006 THRU: March 29. 2007
~ECTION [ SCOPE OF WORK:
PERFORMING AGENCY shall design, implement, and evaluate a Family Focused Community
Diabetes Services Project (FFCDSP). This project shall provide community-based diabetes
prevention and management interventions that implement population-based and evidence-based
programs and strategies at the community leveL and inform and educate community leaders
about eVldence-based community. systems. and environmental changes that support and impact
dIabetes primary and secondary preventive measures. This project shall target families in high-
risk populations - racial and ethnic minorities who have disproportionate rates and burdens of
diabetes and limited access 10 health care
PERFORMING AGENCY shall be responsible for designing, implementing, and evaluating the
FFCDSP project. PERFORMING AGENCY shall meet the following objectives through the
FFCDSP project and shall provide evidence that the FFCDSP project is meeting the following
ij b1 ecti ve.,:
· Increase opportumtJes for implementing positive behavior and lifestyle changes (e.g.,
increased and continuing ph) sical activity and healthy eating) in people who already have
diabetes and those \\ ho are at risk of developing diabetes;
· Increase community. environmental, and systems changes in various community sectors
(schools. businesse", faith communities, neighborhoods, health systems and food
industry) that facilitate ongomg, increased physical activity and healthy eating among the
general population, especiallv those with diabetes and "pre-diabetes";
· Institute project stralcgies or community policy and environmental changes conducive to
risk reduction.
· Increase public and provider knovvledge of the symptoms, risk factors and target goals of
dIabetes. pre-diabetes and gestational diabetes and the importance of physical activity and
healthy eating in preventing and delaying or managing the disease and its complications;
and
· Increase the knowledge 0" health care providers, payers, and their patients and
implementation of the Texas Diabetes Council's (TDC) Minimum Standards for Diabetes
Care in Texas and clinical guidelines (providers, payers) and National Diabetes
Education Program INDEP) resources.
'\TT ACl~MENT .... Page 1
PFRFOR\t1l'\je; AGENCY shall establish and/or maintain a broad-based community diabetes
cdalition that meets at least quarterly for the duration of this project
PERFORM (NG AGENCY -.;hall develop and submit the following products:
· hidence ofquarterlv coalition meetings (minutes with attendance rosters);
· 1\ program dcscnptiilO in a f(ll111at specified by RECEIVING AGENCY Program:
· E\aluation data and analysis to be specified by RECF:lVING AGENCY Program; and
· An) other items dgreed upon III writing between PERFORMING AGENCY and
R F( IIVINCi\( iE]'..CY
!JERFORMING AGFN( 'Y shall have and maintain procedures and tracking tools in a consistent,
[lmely manner to document activities, services, and persons served that are measured in reports.
PERFORMING '\GE'\j(\ also shall fulfill evaluation requirements as specified by
I<YCFIVIN( I ACiE\:('\'
PERFORMING AGENCY shall be listed 111 the Texas Information Referral Network (TIRN) and
-.;hall identiJ) other diabetes resources in their service area that are not listed with TIRN and
partner \vith them to ensure these resources are added to the database,
PERFORMING AGENCy shall prOVIde evidence through its formative evaluation that
PERFORMING AGENCY IS meeting project work plan's goals outlined in project's impact and
process objectives
PERFORMING AGENCY shall align any health care system components with the TDC's
\tinimum Standards of Care. All project interventions shall be consistent with the TDC's
strategic plan and RECEIVING AGENCY'S priorities for the health of Texans: fitness through
physical activity and nutrition, immunizations, and eliminating health disparities.
PEFORI'vtING AGENCY shall perform all activities in accordance with RECEIVING AGENCY
Program's Competitive Request for Proposal (RFP), Family-Focused Diabetes Prevention
Services Projects. RFP, DIABETES-Ol.2.2.1, issued I ]/04/2004, Renewal Application RFP-
[) IABETES-O 122 2 issued I 1/08/2005. any letters or memos with rules, policies or other
!t1structions given to PERFORMING :\GENCY, and PERFORMING AGENCY'S objectives,
\vork plan, and detailed budget as .1pproved by RECEIVING AGENCY Program. All of the
dbove named documents are incorporated herein by reference and made a part of this contract
\ttachment All revisions to said documents shall he approved by RECEIVING AGENCY
Program and transmitted in writing to PERFORMING AGENCY.
PERFORMING AGENCY shall comply with all applicable federal and state laws, rules,
regulations. standards. and guidelines in effect on the beginning date of this contract Attachment
unless amended
A TTACHMENT ~ Page 2
PERFORMING AGENCY shall comply with the following:
· Texas Health and Safety Code, ~]2012 and 103; and
· Healthy People 2010, United States (U.S.) Department of Health and Human Services,
November. 2000
\Vithin thirty (30) days of receipt of an amended standard(s) or guideline(s), PERFORMING
c\GENCY shall inform RLCEIVING AGENCY Program, in writing, if it will not continue
performance under thIs Attachment in compliance with the amended standard(s) or guideline(s).
RECEIVINCr AGENCY may terminate the Attachment immediately or within a reasonable
period 01time as determmed by RECEIVING AGENCY.
RECEIVINC; AGENCY reserves the right, where allowed by legal authority, to redirect funds in
the event ot financial shortfall. RECEIVING AGENCY Program will monitor PERFORMING
\GENCY'S expenditures ,)11 a quarterly basis. If expenditures are below that projected in
PERFOR:\1ING AGENCY'S total contract amount as shown in SECTION III. BUDGET,
PERFOR:\1ING AGENCY S budget may be subject to a decrease for the remainder of the
\ttachment tem1. Vacant positions existing after ninety (90) days may result in a decrease in
funds
I!ERFORMANCE MEASURES
Ihe folhming performance measures shall be used to assess, in part, PERFORMING
'\GENCY'S efTectiveness m providing the services described in this contract Attachment,
\\ithout \\al ving the enforceability of any of the other terms of the contract.
· Provide a minimum of 0 organizational activities leading to changes in community
systems. policy. and or environments;
· PrO\ ide a minimum of 0 organizational changes impacting community systems, and/or
environments in two (2) or more sectors of the community (e.g., health care,
worksites/business, t'aith-based groups, neighborhoods, recreation centers, schools, non-
profits, and food industry);
· Pro\ ide at least 46 self-management classes (e.g.. Centers for Disease Control and
Prevention (CDC) diabetes self management program - Diabetes Empowerment
Education Program (DEEPI, Stanford's Chronic Disease Self Management, or other
RECEIVING AGE!\CY approved models) or activities reaching at least 460 people;
· Prov ide a minimum l)f 20 provider education (risk reduction, TDC standards of care, etc.)
events about diabete<
· Clllduct at least 46 llngoing physical activity groups and/or events, reaching at least 460
people;
· Conduct at least 12 :;upport groups, reaching at least 120 people;
· Conduct at least 3 food and nutrition classes, reaching at least 30 people;
· Submit profile to TIRN for listing by August 2006 and identify 5 diabetes resources in
their service area to submit profile into the database; and
ATTACHMENT -- Page 3
. Public Information:
· Provide at least 1 television activities:
· Provide at least 1 radio actlvities;
· Publish at least 0 print advertisements (e.g., newspapers, church bulletins, business
Inserts or newsletters):
· Provide at least 10 websites, kiosks, etc.; and
· Distribute at least 0 printed materials (e.g.. NDEP, TDC, and other diabetes-related
literature
PERFORMING AGENCY "hall provide the following reports:
· Monthly performance reports accounting for key activities in work plan implementation
(anecodotal and statistical), prepared in a format approved by RECEIVING AGENCY
Program, and due ten (10) days after the end of each month;
· Quarterly reports analyzing progress on work plans and development of succussful
strategies, prepared 111 a fcmnat approved by RECEIVING AGENCY Program, and due
t\\entv (2()) days atkr the end ot'each quarter: and
· l\ Yt'ar-end project \ummar) of achievements and level of accomplishing objectives for
end iJ/' contract p,.-riod amI recommended practices and processes tor achieving
ohlCdivcs, prepared 111 a !c)f"lnat approved by RECEIVING AGENCY Program, and due
thirh (30) days after the end of the contract Attachment term.
rhe numbers above indicate the minimum for each performance measure. This value is subject
to change upon written agreement between RECEIVING AGENCY and PERFORMING
\GENC)'. Work plan activities and deadlines shall not be changed without prior approval from
RECEIVIN<; AGFNCY
PERFORMING AGENCY shall notify RECEIVING AGENCY Program Director, Diabetes
Program, of any changes in project staff or contact information within fourteen (14) days of such
change(s
PERFORMING AGENCYS Project Coordinator and support staff shall attend all scheduled
tramings held by RECEIVING AGENCY unless prior approval is obtained from authorized
RECEIV1NC; AGENCY Program stafffc)r absences.
PERFORMING AGENCY shall receive prior approval from RECEIVING AGENCY on any
proposed educational medla campaigns tor the public or health care professionals. This
requirement does not apply to promotional campaigns for local events. PERFORMING
\(TENCY shall use NDEP materials whenever possible. PERFORMING AGENCY shall
mclude the following credit on all printed. audio or visual materials developed as part of this
program: "Funding provided by the Department of State Health Services, Texas Diabetes
Pro gram,
~ECTION II SPECIAL PROVISIONS
ATTACHMENT ..~ Page 4
~-"-
None.
ATTACHMENT - Page 5
SECTION Ill. BUDGET:
PER.SONNEL
FRINGE BENEFITS
IR'\ VEL
I~Ql 'IPMENT
SllPPLIES
( 'ONTRACTUAL
inHER
$12,573.00
1,647.00
1,744.00
0.00
600.00
63,436.00
0.00
TOTAL DIRECT CHARGES
INDIRECT CHARGES
IOTAI
$80,000.00
$0.00
$80,000.00
lotal reimbursements will not exceed $80.000.00.
Financial status reports are due the ,Oth of July, 30th of October, 30th of January, and the 30th
n!' June.
ATTACHMENT .~. Page 6
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