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R-92-1743 - 8/27/1992ATTEST: WHEREAS, the City Council wishes to enter into a cooperative agreement with Williamson County, Georgetown, Taylor and Cedar Park for the purpose of providing and furnishing county -wide public health programs, Now Therefore BE IT RESOLVED BY THE COUNCIL OF THE CITY OF ROUND ROCK, TEXAS That the Mayor is hereby authorized and directed to execute on behalf of the City the Williamson County and Cities Health District Cooperative Agreement, a copy of said Agreement being attached hereto and incorporated herein for all purposes. RESOLVED this 27th day of August, 1992. RS08272E LAND, City Secretary RESOLUTION NO. 11 L3 R MIKE ROBINSON, Mayor City of Round Rock, Texas WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT COOPERATIVE AGREEMENT WHEREAS, Article 4436b, Texas Vernon's Civil Statutes, THE LOCAL PUBLIC HEALTH REORGANIZATION ACT, authorizes the establishment of health districts within and among counties, cities and other governmental entities for the purpose of providing and furnishing county -wide public health programs; and, WHEREAS, parties to this agreement desire a coordinated public health program throughout Williamson County, THEREFORE, for and in consideration of mutual promises, covenants and other invaluable considerations, THIS AGREEMENT by and between various units of government, acting by and through their duly authorized governing bodies, herein collectively referred to as "member governments" do hereby create the WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT in accordance with the following: 1. The parties agree to create the WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT (hereinafter the "DISTRICT "). The DISTRICT shall be under the direction and supervision of the WILLIAMSON COUNTY BOARD OF HEALTH (hereinafter the "BOARD ") which shall be an administra- tive public health board and shall have the authority to adopt substantive and procedural rules which are necessary and appropri- ate to promote and preserve the health and safety of the public within its jurisdiction; provided that no rule shall be in conflict with the laws of the State of Texas. 2. The BOARD shall consist of six (6) voting members and the DIRECTOR of the HEALTH DISTRICT, who shall serve as an ex- officio non - voting member of the BOARD. Two members of the BOARD shall be appointed by the Williamson County Commissioners Court. One member each shall be appointed by the cities of Round Rock, Georgetown, Taylor and Cedar Park. BOARD appointees may be any citizen except: 1) elected officials of the appointing member governments, or their immediate families, or 2) employees of the appointing member governments, or their immediate families. These appointees shall serve honestly, to the best of their ability, without compensation. They shall not be held liable individually for acts, neglects, or defaults of any employee, agent, or representative of the DISTRICT, nor for anything the DISTRICT may do or refrain from doing in good faith, including errors in judgement or mistakes of fact or law. Furthermore, .should legal counsel be required to defend an appointee to the BOARD such legal counsel shall be provided by the Member Government making the appointment. HEALTH DISTRICT COOPERATIVE AGREEMENT PAGE 2 of 6 3. All members of the BOARD shall be appointed for a three year term. Reappointments to the BOARD will be staggered so that only one third of the BOARD is up for reappointment in any one year. A member may be removed from the BOARD for neglect of duty, malfea- sance, or unbecoming behavior by majority vote of the ruling body of the member government originally making the appointment. All vacancies caused by death, resignation or removal of a member shall be filled for the unexpired portion of the term by the appointing bodies as above prescribed. 4. The BOARD shall perform all public health functions pertaining to public health which any of its component members is authorized to perform, or which the Administrative BOARD is allowed to perform under State statutes. Each year the BOARD shall select a chairper- son, vice - chairperson, and a secretary from among its members. A majority of the members shall constitute a quorum for the transac- tion of business. The BOARD shall meet quarterly on a date to be fixed by the BOARD and shall hold such meetings as may be called by the chairperson or by the majority of the BOARD. The BOARD shall conduct an annual evaluation of the performance of the DIRECTOR. The BOARD shall comply with the Open Meetings Act and the Competi- tive Bid Statues. 5. The DIRECTOR shall be the Chief Executive Officer of the HEALTH DISTRICT and shall actively manage the day to day operations of the DISTRICT staff. The DIRECTOR shall also serve as the County Health Authority (formerly called the County Health Officer) and as the City Health Authority ( formerly the City Health Officer) for all member Cities, as needed. A Health Authority has certain duties prescribed by State Law which are necessary to implement and enforce to protect the public health. He shall aid the BOARD in all matters of local quarantine; disease prevention and suppres- sion, sanitation inspection and control of contagious, infectious, and dangerous epidemic diseases within the Health Authority's jurisdiction. 6. The DIRECTOR'S position is funded by the Texas Department of Health. If, during the annual evaluation of the DIRECTOR, two - thirds of the BOARD judge the DIRECTOR to be guilty of neglect of duty, malfeasance, or unbecoming behavior, a petition for his removal shall be addressed to the Texas Commissioner of Health (hereinafter Commissioner). In the event of death, resignation, or removal from office, the BOARD shall advertise the vacancy, submit the list of applicants to the Commissioner for a review of his or her qualifications, and then the BOARD shall select the new DIRECTOR from -a list of applicants approved by the Commissioner. HEALTH DISTRICT COOPERATIVE AGREEMENT PAGE 3 of 6 7. The BOARD and DIRECTOR shall maintain high quality programs in the following areas: A. PERSONAL HEALTH SERVICES 1. Primary Health Care to the Indigent a. Prenatal Clinics for the pregnant b. Child Development Monitoring up to age 5 c. Nutritional Education and Food Supplementation (WIC) d. Referral to Private Physicians for Diagnosis and Treatment 2. Infectious Disease Control for the entire Community a. Contact investigation, treatment, and counseling for Sexually Transmitted Diseases and Tuberculosis b. Immunizations for Vaccine Preventable Diseases c. AIDS Screening and Counseling d. Rabies post- exposure vaccination and counseling 3. Health Disease, Cancer, and Stroke Prevention a. Blood Pressure screening and counseling b. Cholesterol screening and counseling c. Health Education re: weight loss, exercise, and stress management. B. ENVIRONMENTAL HEALTH SERVICES 1. Food Sanitation a. Food - handler sanitation training b. Food service and food preparation sanitation surveillance 2. Waste Control, solid and hazardous 3. General Sanitation a. Vector Control b. Drinking water hygiene c. Swimming pool sanitation d. Wastewater disposal surveillance e. Water Pollution Control 4. Epidemiologic investigations of water borne and food poisoning outbreaks 1 C. INTEGRATED ELIGIBILITY SERVICES 1. Eligibility determination for medical assistance programs a. County Indigent Health Care Program - b. Primary Health Care Program HEALTH DISTRICT COOPERATIVE AGREEMENT c. Women, Infants and Children (WIC) Supplemental Food Program (financial and residential) d. Prenatal clinics e. Presumptive Hedicaid for pregnant women 2. Eligibility screening for medical assistance programs a. Hedicaid and Food stamp programs b. Supplementary Security Income (SSI) c. Chronically I11 and Disabled Childrens Program (CIDC) d. HIHIA (Maternal'and Infant Health Improvement Act) 3. Casemanagement services for pregnant women and children 4. Information and referral services for county residents PAGE 4 of 6 8. The member governments agree that the DISTRICT shall have the authority to set and collect fees for nursing services and for the issuance of health and sanitation related licenses and permits as authorized by law. Representatives of the DISTRICT shall also have authority to conduct health and sanitation inspections for member governments or as authorized by law. However, any fees so set or collected must be approved in advance by a majority of the members of the BOARD. Where the DISTRICT requires a permit, the member governments agree not to, require their own Health or Sanitation Permits. 9. DISTRICT is a State - participating local unit of the Texas Department of Health and as such derives its budget from four principal sources: A) the Member governments, B) the Texas Department of Health, C) the collection of Fees, and D) Grants. A) The amount of contributions from each member government shall be determined by the ruling body of each member government. B) The State's participation will be determined by contracts negotiated annually between the BOARD and the Texas Department of Health. C) Fees will be collected as a result of activities from environmental services and from nursing services. Because it is expected that annual collections will vary considerably due to economic conditions, the DISTRICT shall maintain sufficient cash reserves to prevent untimely disruptions in services or loss of highly trained personnel. D) The DIRECTOR and the BOARD will actively seek to obtain Federal and private grants available in health related areas. HEALTH DISTRICT COOPERATIVE AGREEMENT PAGE 5 of 6 10. The DISTRICT shall maintain its own bank accounts for the collection and deposit of all fees and contributions and for the payments of all operating expenses. The BOARD shall require that an independent audit of the DISTRICT "S financial records be made annually. The Uniform Grant and Contract Management Act of 1981 (Article 4413(32g), Vernon's Texas Civil Statutes) and standards adopted pursuant to that Act shall control where applicable. The annual audit shall be available for public inspection during all normal business hours. The DISTRICT'S employees shall be eligible to participate in any group health insurance, workman's compensa- tion program, and retirement system made available by any member government for its employees. The BOARD shall annually select the member government's programs in which the DISTRICT'S employees will be included. This selection must be made prior to when the selected member government makes its decision as to which group health policy to purchase. 11. Member governments and other governmental entities as well as private institutions both within and without Williamson County, may contract for the HEALTH DISTRICT to provide Rabies Control Services, Environmental Health Services, Water Pollution Control Services, or upgrading of any appropriate public health or environmental activity. 12. The BOARD may in some years grant a cost of living increase to each DISTRICT employee, except that the size of the increase shall not exceed the increase granted by the County Commissioners to each county employee for that fiscal year. DISTRICT employees will not be granted an automatic pay raise based upon longevity. Instead the BOARD may from time to time grant a merit increase based on Job performance and /or promotion in job responsibility. 13. The provisions of Articles 4,436b, and 4477 -7e, Texas Vernon's Civil Statutes, and House Bill 2125, Texas 70th Legislature Regular Session, shall be applicable -to the DISTRICT. In the event of a conflict between Article 4436b and this Agreement, Article 4436b shall control. 14. A member government may withdraw from the Agreement. The withdrawal shall become effective at the end of the current fiscal year after the withdrawing member government has given written notice of its decision to withdraw to the BOARD. Such termination shall not relieve such member government of any obligation incurred by such member government prior to termination. 15. Modification of this Agreement shall be in writing and effective upon approval by a majority of the member governments. 16. This Agreement shall remain in effect indefinitely unless modified or canceled by a majority of the members•. 1 HEALTH DISTRICT COOPERATIVE AGREEMENT PAGE 6 of 6 1 17. New member governments may become parties to this Agreement, with the consent of the BOARD, by accepting in writing all of the terms and provisions of this Agreement. 18. This Agreement constitutes the entire Agreement, and supersedes all prior agreements between the parties. 19. This Agreement shall become effective on October 1, 1992. ATTEST: County Deputy Clerk ATTEST: ATTEST: City Secretary ATTEST: .4V) d y Secretary Mayor COUNTY OF WILLIAMSON County Judge CITY OF ROUND ROCK CITY OF GEORGETOWN Mayor CITY OF TAYLOR City Clerk Chairman ATTEST: CITY OF CEDAR PARK City Secretary Mayor DATE: August 25, 1992 SUBJECT: City Council Meeting, August 27, 1992 ITEM: 12.E. Consider a resolution amending the Williamson County Health District Cooperative Agreement. STAFF RESOURCE PERSON: Joanne Land STAFF RECOMMENDATION: In 1989 the Williamson County Health District was created. The Cooperative Agreement was enacted for a three year period with the understanding that the cities and boardmembers were to review the agreement prior to October 1, 1992. The boardmembers have reviewed the agreement and are proposing six amendments to the original agreement for your consideration. A summary of the six recommendations is as follows: 1. Change the name of the district from Williamson County Health District to Williamson County and Cities Health District. 2. In the original agreement the County Commissioners decided which of their two appointees would serve as the Chairperson of the BOARD OF HEALTH. In the new agreement, all six of the BOARD members would vote each year to determine who will serve as their Chairperson for that year. 3. The following words have been added to the end of Article 2 to indemnify your appointees from any personal liability: THESE APPOINTEES SHALL SERVE HONESTLY, TO THE BEST OF THEIR ABILITY, WITHOUT COMPENSATION. THEY SHALL NOT BE HELD LIABLE INDIVIDUALLY FOR ACTS, NEGLECTS, OR DEFAULTS OF ANY EMPLOYEE, AGENT, OR REPRESENTATIVE OF THE DISTRICT, NOR FOR ANYTHING THE DISTRICT MAY DO OR REFRAIN FROM DOING IN GOOD FAITH, INCLUDING ERRORS IN JUDGEMENT OR MISTAKES OF FACT OR LAW. FURTHERMORE SHOULD LEGAL COUNSEL BE REQUIRED TO DEFEND AN APPOINTEE TO THE BOARD OF HEALTH, SUCH LEGAL COUNSEL SHALL BE PROVIDED BY THE MEMBER GOVERNMENT MAKING THE APPOINTMENT. 4. This article appeared to the BOARD to be too brief and • therefore somewhat ambiguous. The changes are being proposed to more clearly spell out the BOARD'S policy concerning regulation of pay raises: Old Article 12: NO SALARY INCREASES GRANTED TO DISTRICT EMPLOYEES SHALL EXCEED THE SALARY INCREASES GRANTED TO COUNTY EMPLOYEES WITHIN ONE FISCAL YEAR. New Article 12: THE BOARD MAY IN SOME YEARS GRANT A COST -OF- LIVING INCREASE TO EACH DISTRICT EMPLOYEE, EXCEPT THAT THE SIZE OF THE INCREASE SHALL NOT EXCEED THE INCREASE GRANTED BY THE COUNTY COMMISSIONERS TO EACH COUNTY EMPLOYEE FOR THAT FISCAL YEAR. DISTRICT EMPLOYEES WILL NOT BE GRANTED AN AUTOMATIC PAY RAISE BASED UPON LONGEVITY. INSTEAD THE BOARD MAY FROM TIME TO TIME GRANT A MERIT INCREASE BASED ON JOB PERFORMANCE AND /OR PROMOTION IN JOB RESPONSIBILITY. 5. Article 16. Change from: THIS AGREEMENT SHALL REMAIN IN EFFECT UNTIL OCTOBER 1, 1992, AT WHICH TIME THIS AGREEMENT SHALL BECOME NULL AND VOID. To: THIS AGREEMENT SHALL REMAIN IN EFFECT INDEFINITELY UNLESS MODIFIED OR CANCELED BY A MAJORITY OF THE MEMBER GOVERNMENTS. 6. Article 19. Change from: THIS AGREEMENT SHALL BECOME EFFECTIVE ON OCTOBER 1, 1989. To: THIS AGREEMENT SHALL BECOME EFFECTIVE OF OCTOBER 1, 1992. Staff recommends approval of the recommended changes to the agreement. WX L L I AM S ON COUNTY HEALTH D Z S TR I CT P-0- BOX 570 GEORGETOWN, TEXAS 78627 CLARENCE SKROVAN, Y.D., DIRECTOR 512 869 -4390 MEMO TO: FROM: SUBJECT: Member Governments October 27, 1992 Clarence Skrovan, M.D., Direct Results of voting on Cooperative Agreement Attached is a summary of how each of you voted on each of the six proposed changes to our Cooperative Agreement. You will note that four of the six changes were approved unanimously. The name change to Williamson County & Cities Health District was approved by a narrow 3 -2 vote. After hearing the obJections that the Commissioners Court and the City of Taylor had to the proposed paragraph in Article 2 concerning legal defense, the Board decided to withdraw that amendment before Georgetown voted. Hence the paragraph is not Included in the final version of the Agreement. , Attached are five originals of the new Cooperative Agreement. Please sign all five and return to me. Thank you. 111431 ARTICLE 1. SUMMARY OF CHANGES TO HEALTH DISTRICT COOPERATIVE AGREEMENT: PAGE 1 OF 2 X GEORGETOWN CHANGE NAME FROM: WILLIAMSON COUNTY HEALTH DISTRICT TO: WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT APPROVED: DISAPPROVED: X COUNTY COMMISSIONERS X CEDAR PARK X ROUND ROCK X TAYLOR X GEORGETOWN ARTICLES 2 & In the original agreement the County Commissioners decided which of' their two appointees would serve as the Chairperson of the BOARD OF HEALTH. In the new agreement, all six of the BOARD members would vote' each year to determine who will serve as their Chairperson to that year. APPROVED: X DISAPPROVED: COUNTY COMMISSIONERS CEDAR PARK X ROUND ROCK X TAYLOR ARTICLE 2. • The following words have been added to the end of Article 2 to ide unify your appointees from any personal liability: • THESE APPOINTEES SHALL SERVE HONESTLY, TO THE BEST OF THEIR ABILITY, WITHOUT COMPENSATION. THEY SHALL NOT BE HELD LIABLE INDIVIDUALLY FOR ACTS, NEGLECTS, OR DEFAULTS OF ANY EMPOYEE, AGENT, OR REPRESENTATIVE OF THE DISTRICT, NOR FOR ANYTHING THE DISTRICT MAY DO OR REFRAIN FROM DOING IN GOOD FAITH, INCLUDING ERRORS IN JUDGEMENT OR MISTAKES OF FACT OR LAW. FURTHERMORE SHOULD LEGAL COUNSEL BE REQUIRED TO DEFEND AN APPOINTEE TO THE BOARD OF HEALTH, SUCH LEGAL COUNSEL SHALL BE PROVIDED BY THE MEMBER GOVERNMENT MAKING THE APPOINTMENT. . APPROVED: DISAPPROVED: X COUNTY COMMISSIONERS X ' CEDAR PARK X ROUND RUCK X TAYLOR GEORGETOWN • SUMMARY OF CHANGES TO HEALTH DISTRICT COOPERATIVE AGREEMENT: ARTICLE 12. PAGE 2 OF 2 This article appeared to the BOARD to be too brief and therefore somewhat ambiguous. The changes are being proposed to more clearly spell out the BOARD'S policy concerning regulation of pay raises: Old Article 12: NO SALARY INCREASES GRANTED TO DISTRICT EMPLOYEES SHALL EXCEED THE SALARY INCREASES GRANTED TO,COUNTY EMPLOYEES WITHIN ONE FISCAL YEAR. New Article 12: THE BOARD MAY IN SOME YEARS GRANT A COST -OF- LIVING INCREASE TO EACH DISTRICT EMPLOYEE, EXCEPT THAT THE SIZE OF THE INCREASE SHALL NOT EXCEED THE INCREASE GRANTED BY THE COUNTY COMMISSIONERS TO EACH COUNTY EMPLOYEE FOR THAT FISCAL YEAR. DISTRICT EMPLOYEES WILL NOT BE GRANTED AN AUTOMATIC PAY RAISE BASED OPON LONGEVITY. INSTEAD THE BOARD MAY FROM TIME TO TIME GRANT A MERIT INCREASE BASED ON JOB PERFORMANCE AND /OR PROMOTION IN JOB RESPONSIBILITY. APPROVED: X DISAPPROVED: COUNTVCOMMISSIONERS PARK X 1 ROUND ROCK X TAY LOR X GEORGETOWN ARTICLE 16. Change from: THIS AGREEMENT SHALL REMAIN IN EFFECT UNTIL OCTOBER 1, 1992, AT WHICH TIME THIS AGREEMENT SHALL BECOME NULL AND VOID. • To: THIS AGREEMENT SHALL REMAIN IN EFFECT INDEFINITELY UNLESS MODIFIED OR CANCELED BY A MAJORITY OF THE MEMBER GOVERNMENTS. APPROVED: X DISAPPROVED: COUNTY COMMISSIONERS X CEDAR PARK X 1 ROUND ROCK X. 1 TAYLOR X GEORGETOWN ARTICLE 19. Change from: THIS AGREEMENT SHALL BECOME EFFECTIVE ON OCTOBER 1, 1989. To: THIS AGREEMENT SHALL BECOME EFFECTIVE OF OCTOBER 1, 1992. APPROVED: X DISAPPROVED: COUNTY COMMISSIONERS X CEDAR PARK X ROUND ROCK X TAYLOR X GEORGETOWN WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT COOPERATIVE AGREEMENT WHEREAS, Article 4436b, Texas Vernon's Civil Statutes, THE LOCAL PUBLIC HEALTH REORGANIZATION ACT, authorizes the establishment of health districts within and among counties, cities and other govemmental entities for the purpose of providing and furnishing county -wide public health programs; and, WHEREAS, parties to this agreement desire a coordinated public health program throughout Williamson County, THEREFORE, for and in consideration of mutual promises, covenants and other invaluable considerations, THIS AGREEMENT by and between various units of government, acting by and through their duly authorized governing bodies, herein collectively referred to as "member governments" do hereby create the WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT in accordance with the following: 1. The parties agree to create the WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT (hereinafter the DISTRICT). The DISTRICT shall be under the direction and supervision of the WILLIAMSON COUNTY BOARD OF HEALTH (hereinafter the BOARD) which shall be an administrative public health board and shall have the authority to adopt substantive and procedural rules which are necessary and appropriate to promote and preserve the health and safety of the public within its jurisdiction; provided that no rule adopted shall be in conflict with the laws of the State of Texas. 2. The BOARD shall consist of six (6) voting members and the DIRECTOR of the HEALTH DISTRICT, who shall serve as an ex- officio non - voting member of the BOARD. Two members of the BOARD shall be appointed by the Williamson County Commissioners Court. One member each shall be appointed by the cities of Round Rock, Georgetown, Taylor, and Cedar Park. BOARD appointees may be any citizen except: 1)elected officials of the appointing member governments or their immediate families, or 2)employees of the appointing member governments or their immediate families. 3. All members of the BOARD shall be appointed for a three -year term. Reappointments to the BOARD will be staggered so that only one -third of the BOARD is up for reappointment in any one year. A member may be removed from the BOARD for neglect of duty, malfeasance, or unbecoming behavior by majority vote of the ruling body of the member government originally making the appointment. All vacancies caused by death, resignation or removal of a member shall be filled for the unexpired portion of the term by the appointing bodies as above prescribed. WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT Page 1 of 6 4. The BOARD shall perform all public health functions pertaining to public health which any of its component members is authorized to perform, or which the Administrative BOARD is allowed to perform under State statutes. Each year the BOARD shall select a chairperson, vice- chairperson, and a secretary from among its members. A majority of the members shall constitute a quorum for the transaction of business. The BOARD shall meet quarterly on a date to be fixed by the BOARD and shall hold such meetings as may be called by the chairperson or by the majority of the BOARD. The BOARD shall conduct an annual evaluation of the performance of the DIRECTOR. The BOARD shall comply with the Open Meetings Act and the Competitive Bid Statutes. 5. The DIRECTOR shall be the Chief Executive Officer of the HEALTH DISTRICT and shall actively manage the day -to -day operations of the DISTRICT staff. The DIRECTOR shall also serve and the County Health Authority (formerly called the County Health Officer) and as the City Health Authority (formerly the City Health Officer) for all member cities, as needed. A Health Authority has certain duties prescribed by State Law which are necessary to implement and enforce to protect the public health. He/she shall aid the BOARD in all matters of local quarantine, disease prevention and suppression, sanitation inspection and control of contagious, infectious, and dangerous epidemic diseases within the Health Authority's jurisdiction. 6. The DIRECTOR's position is funded by the Texas Department of Health. If, during the annual evaluation of the DIRECTOR, two- thirds of the BOARD judge the DIRECTOR to be guilty of neglect of duty, malfeasance, or unbecoming behavior, a petition for his /her removal shall be addressed to the Texas Commissioner of Health (hereinafter Commissioner). In the event of death, resignation, or removal from office, the BOARD shall advertise the vacancy, submit the list of applicants to the Commissioner for a review of his or her qualifications, and then the BOARD shall select the new DIRECTOR from a List of applicants approved by the Commissioner. 7. The BOARD and DIRECTOR shall maintain high quality programs in the following areas: A. PERSONAL HEALTH SERVICES 1. Primary Health Care to the Indigent a. Prenatal clinics for the pregnant , b. Child development monitoring up to age 5 c. Nutritional education and food supplementation (WIC) d. Referral to private physicians for diagnosis and treatment WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT Page 2 of 6 2. Infectious Disease Control for the Entire Community a. Contact investigation, treatment, and counselling for sexually - transmitted diseases and tuberculosis b. Immunizations for vaccine - preventable diseases c. AIDS screening and counseling d. Rabies post- exposure vaccination and counseling 3. Health Disease, Cancer, and Stroke Prevention a. Blood pressure screening and counseling b. Cholesterol screening and counseling c. Health education re: weight loss, exercise, and stress management B. ENVIRONMENTAL HEALTH SERVICES 1. Food Sanitation a. Food- handler sanitation training b. Food service and food preparation sanitation surveillance 2. Waste Control (solid and hazardous) 3. General Sanitation 4. Epidemiologic Investigations of Water -borne and Food Poisoning Outbreaks C. INTEGRATED ELIGIBILITY SERVICES 1. Eligibility Determination for Medical Assistance Programs a. County indigent health care program b. Primary health care program c. Women, Infants and Children (WIC) Supplemental Food Program (financial and residential) d. Prenatal clinics e. Presumptive Medicaid for pregnant women 2. Eligibility Screening for Medical Assistance Programs a. Medicaid and Food Stamp programs b. Supplementary Security Income (SSI) c. Chronically I11 and Disabled Childrens Program (CIDC) d. MIHIA (Maternal and Infant Health Improvement Act) WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT Page 3 of 6 3. Case Management Services for Pregnant Women and Children 4. Information and Referral Services for County Residents 8. The member governments agree that the DISTRICT shall have the authority to set and collect fees for nursing services and for the issuance of health and sanitation- related licenses and permits as authorized by law. Representatives of the DISTRICT shall also have authority to conduct health and sanitation inspections for member governments or as authorized by law. However, any fees so set or collected must be approved in advance by a majority of the members of the BOARD. Where the DISTRICT requires a permit, the member governments agree not to require their own Health or Sanitation Permits. 9. DISTRICT is a State - participating local unit of the Texas Department of Health and, as such, derives its budget from four principal sources: 1)the Member governments, 2)the Texas Department of Health, 3)the collection of Fees, and 4)Grants. A. The amount of contributions from each member government shall be determined by the ruling body of each member government. B. The State's participation will be determined by contracts negotiated annually between the BOARD and the Texas Department of Health. C. Fees will be collected as a result of activities from environmental services and from nursing services. Because it is expected that annual collections will vary considerably due to economic conditions, the DISTRICT shall maintain sufficient cash reserves to prevent untimely disruptions in services or loss of highly trained personnel. D. The DIRECTOR and the BOARD will actively seek to obtain Federal and private grants available in health - related areas. 10. The DISTRICT shall maintain its own bank accounts for the collection and deposit of all fees and contributions and for the payments of all operating expenses. The BOARD shall require that an independent audit of the DISTRICT's financial records be made annually. The Uniform Grant and Contract Management Act of 1981 (Article 4413(32g), Vernon's Texas Civil Statutes) and standards adopted pursuant to that Act shall control where applicable. The annual audit shall be available for public inspection during all normal business hours. The DISTRICT's employees shall be eligible to participate in any group health insurance, workers' compensation program, and retirement system made available by any member government for its employees. The BOARD shall annually select the member government's programs in which the DISTRICT's employees will be included. This selection must be made prior to when the selected member government makes its decision as to which group health policy to purchase. WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT Page 4 of 6 11. Member governments and other governmental entities, as well as private institutions both within and without Williamson County, may contract for the HEALTH DISTRICT to provide Rabies Control Services, Environmental Health Services, Water Pollution Control Services, or upgrading of any appropriate public health or environmental activity. 12. The BOARD may in some years grant a cost of living increase to each DISTRICT employee, except that the size of the increase shall not exceed the increase granted by the County Commissioners to each county employee for that fiscal year. DISTRICT employees will not be granted an automatic pay raise based upon longevity. Instead, the BOARD may, from time to time, grant a merit increased based on job performance and /or promotion in job responsibility. 13. The provisions of Articles 4436b, and 4477 -7e, Texas Vernon's Civil Statutes, and House Bill 2125, Texas 70th Legislature Regular Session, shall be applicable to the DISTRICT. In the event of a conflict between Article 4436b and this Agreement, Article 4436b shall control. 14. A member government may withdraw from the Agreement. The withdrawal shall become effective at the end of the current fiscal year after the withdrawing member government has given written notice of its decision to withdraw to the BOARD. Such termination shall not relieve such member government of any obligation incurred by such member government prior to termination. 15. Modification of this Agreement shall be in writing and effective upon approval by a majority of the member governments. 16. This Agreement shall remain in effect indefinitely unless modified or canceled by a majority of the members. 17. New member governments may become parties to this Agreement, with the consent of the BOARD, by accepting in writing all of the terms and provisions of this Agreement. 18. This Agreement constitutes the entire Agreement, and supersedes all prior agreements between the parties. 19. This Agreement shall become effective on October 1, 1992. WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT Page 5 of 6 ATTEST: County Deputy Clerk ATTEST: ATTEST' �= x.� 2r .✓lam / _ ��.Cx� City Secretary ( ATTEST: City Clerk City Secretary Mayor COUNTY OF WILLIAMSON County Judge CITY O�/ i�Nla ROCK Mayor CITY OF.GEORGETOWN Mayor CITY OF TAYLOR Chairman ATTEST: CITY OF CEDAR PARK WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT Page 6 of 6 Mayor Mike Robinson Mayor Pro -tem Charles Culpepper Council Members Robert Stluka Rod Morgan Rick Stewart Earl Palmer JimmyJoseph City Manager Robert L. Bennett, Jr. City Attorney • Stephan L. Sheets September. 14, 1992 Clarence Skrovan, Williamson County P.O. Box 570 Georgetown, Texas Dear Dr. Skrovan:, THE CITY OF ROUND ROCK 221 Eaat Main Street Round Rock, Texas 78664 • 512 -255 -3612 Sincerely, Resolution No. 1743R; was approved by the Round Rock City Council on August 27, 1992. Enclosed are two original Cooperative Agreements and a copy of the resolution. Please return on of the original agreements to me after the required signatures have been obtained. If you have any questions, please call. Joanne Land Assistant City Manager/ City Secretary JL:km Enclosures M.D.',Director Health District 78627 - . Fax 512-255-6676 ' 1- 800 - 735 -2989 (TDD) 1- 800 - 735 -2988 (Voice) ' WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT P.O. BOX 570 GEORGETOWN, TEXAS 78627 Charles Culpepper, Mayor City of Round Rock 221 East Main Street Round Rock, Texas 78664 Dear Mayor Culpepper: November 19, 1993 RECEIVED Nov 2 21993 Enclosed is another revision of items #5 and #6 of the Health District's Cooperative Agreement which requires approval by the member governments. As you recall, a revision of these items was first sent in May. As member governments reviewed the wording, a couple changes were requested. These changes are bolded and underlined in this second proposed revision which was approved by the Board of Health on November 4, 1993. Please contact me if you would like further clarification or discussion of these proposed revisions. I will contact you late December regarding the City Council's vote on this revision. Thank you for your consideration and attention to this. KW:ds Sincerely, Karen Wilson, MN, MPH Director WI LL I AM S ON COUNTY HEALTH DISTRICT P.O. BOX 570 GEORGETOWN, TEXAS 78627 CLARENCE SKROVAN, M.D., DIRECTOR 512 869 -4390 June 12, 1992 MEMO TO: FROM: SUBJECT: County Judge & County Commissioners City Managers of Member Cities Clarence Skrovan, M.D., Directo HEALTH DISTRICT COOPERATIVE AGREEMENT The BOARD OF HEALTH and the HEALTH DISTRICT which you helped create on October 1, 1989 are functioning well. The Cooperative Agreement which created the District was written as a temporary agreement (3 years). During these three years the Board Members were. o review the agreement and propose a permanent one by October 1, 1992. The Board Members have reviewed and discussed each of the 19 articles of the agreement and wish to propose to you several changes and additions for your consideration. The attached document bound in blue is the proposed new permanent Cooperative Agreement with all changes already included. The yellow attachment details each of the substantive changes which have been made and on which you are being asked to vote. _ Look them over. If you have any questions, give me and /or your Board Member appointee a call. We'd love to visit with you and discuss each of the changes in person. Please schedule a vote as soon as conveniently feasible. If you cannot approve the whole document as proposed, please vote on each proposed change separately. Thank you for your consideration of this matter. SUMMARY OF CHANGES TO HEALTH DISTRICT COOPERATIVE AGREEMENT: ARTICLE 1. ARTICLES 2 & 4. APPROVED: DISAPPROVED: ARTICLE 2. APPROVED: DISAPPROVED: PAGE 1 OF 2 CHANGE NAME FROM: WILLIAMSON COUNTY HEALTH DISTRICT TO: WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT APPROVED: DISAPPROVED: In the original agreement the County Commissioners decided which of their two appointees would serve as the Chairperson of the BOARD OF HEALTH. In the new agreement, all six of the BOARD members would vote each year to determine who will serve as their Chairperson for that year. The following words have been added to the end of Article 2 to idemnify your appointees from any personal liability: THESE APPOINTEES SHALL SERVE HONESTLY, TO THE BEST OF THEIR ABILITY, WITHOUT COMPENSATION. THEY SHALL NOT BE HELD LIABLE INDIVIDUALLY FOR ACTS, NEGLECTS, OR DEFAULTS OF ANY EMPOYEE, AGENT, OR REPRESENTATIVE OF THE DISTRICT, NOR FOR ANYTHING THE DISTRICT MAY DO OR REFRAIN FROM DOING IN GOOD FAITH, INCLUDING ERRORS IN JUDGEMENT OR MISTAKES OF FACT OR LAW. FURTHERMORE SHOULD LEGAL COUNSEL BE REQUIRED TO DEFEND AN APPOINTEE TO THE BOARD OF HEALTH, SUCH LEGAL COUNSEL SHALL BE PROVIDED BY THE MEMBER GOVERNMENT MAKING THE APPOINTMENT. SUMMARY OF CHANGES TO HEALTH DISTRICT COOPERATIVE AGREEMENT: ARTICLE 12. This article appeared to the BOARD to be too brief and therefore somewhat ambiguous. The changes are being proposed to more clearly spell out the BOARD'S policy concerning regulation of pay raises: Old Article 12: NO SALARY INCREASES GRANTED TO DISTRICT EMPLOYEES SHALL EXCEED THE SALARY INCREASES GRANTED TO COUNTY EMPLOYEES WITHIN ONE FISCAL YEAR. New Article 12: THE BOARD MAY IN SOME YEARS GRANT A COST -OF- LIVING INCREASE TO EACH DISTRICT EMPLOYEE, EXCEPT THAT THE SIZE OF THE INCREASE SHALL NOT EXCEED THE INCREASE GRANTED BY THE COUNTY COMMISSIONERS TO EACH COUNTY EMPLOYEE FOR THAT FISCAL YEAR. DISTRICT EMPLOYEES WILL NOT BE GRANTED AN AUTOMATIC PAY RAISE BASED UPON LONGEVITY. INSTEAD THE BOARD MAY FROM TIME TO TIME GRANT A MERIT INCREASE BASED ON JOB PERFORMANCE AND /OR PROMOTION IN JOB RESPONSIBILITY. APPROVED: DISAPPROVED: ARTICLE 16. APPROVED: DISAPPROVED: ARTICLE 19. APPROVED: DISAPPROVED: PAGE 2 OF 2 Change from: THIS AGREEMENT SHALL REMAIN IN EFFECT UNTIL OCTOBER 1, 1992, AT WHICH TIME THIS AGREEMENT SHALL BECOME NULL AND VOID. To: THIS AGREEMENT SHALL REMAIN IN EFFECT INDEFINITELY UNLESS MODIFIED OR CANCELED BY A MAJORITY OF THE MEMBER GOVERNMENTS. Change from: THIS AGREEMENT SHALL BECOME EFFECTIVE ON OCTOBER 1, 1989. To: THIS AGREEMENT SHALL BECOME EFFECTIVE OF OCTOBER 1, 1992.