HomeMy WebLinkAbout20130719.tiffRESOLUTION
RE: APPROVE NON -FINANCIAL PARTNERING MEMBER AGREEMENT AND
AUTHORIZE CHAIR TO SIGN - STATEWIDE CHRONIC DISEASE
SELF -MANAGEMENT PROGRAM COLLABORATIVE
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Non -Financial Partnering Member
Agreement between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Human Services, Area Agency
on Aging, and the Statewide Chronic Disease Self -Management Program Collaborative,
commencing as of signing date, and ending December 31, 2013, with further terms and
conditions being as stated in said agreement, and
WHEREAS, after review, the Board deems it advisable to approve said agreement, a copy
of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Non -Financial Partnering Member Agreement between the County of
Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on
behalf of the Department of Human Services, and Statewide Chronic Disease Self -Management
Program Collaborative be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said agreement.
4%,
2013-0719
HR0084
NON -FINANCIAL PARTNERING MEMBER AGREEMENT AND AUTHORIZE CHAIR TO SIGN -
STATEWIDE CHRONIC DISEASE SELF -MANAGEMENT PROGRAM COLLABORATIVE
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 18th day of March, A.D., 2013.
BOARD OF COUNTY COMMISSIONERS
WELD COUNORADO
Weld County Clerk to the Board
BY:
AP
ttorney
Date of signature:MAR 2 7 2013
William F. Garcia, Chair
c
Dougla
o-Tem
can P. Conway
Mike Freeman
n
2013-0719
HR0084
MEMORANDUM
DATE: Marchl4, 2013
TO: William F. Garcia, Chair, Board of County Comnpissi
FROM: Judy A. Diego, Director, Departmeutpf Hum n Se
ers
-s
RE: Non -Financial Partnering Member agreement between the
Statewide Chronic Disease Self -Management Program
Collaborative and the Weld County Department of Human
Services
Enclosed for Board approval is a Non -Financial Partnering Member Agreement between the
Statewide Chronic Disease Self -Management Program Collaborative and the Department's
Area Agency on Aging. This Non -Financial Agreement was reviewed under the Board's
Pass -Around Memorandum dated February 22, 2013, and approved for placement on the
Board's Agenda.
The Department's Area Agency on Aging is proposing to participate in a Statewide Chronic
Disease Self -Management Program Collaborative. The members of the collaborative have
all provided the evidence -based wellness program. It is an undertaking so that we can, as a
group, provide evidence -based programs effectively throughout the state.
If you have additional questions, please contact me at extension 6510.
2013-0719
The Statewide CDSMP Collaborative provides guidance to promote, implement, and coordinate the sustainability
and expansion of the Chronic Disease Self -Management Program Series statewide.
Statewide Chronic Disease
Self -Management Program Collaborative
Non -Financial Partnering Member Agreement
This agreement is entered into by the Statewide CDSMP Collaborative and
Name of Agency
The purpose of the Statewide CDSMP Collaborative is to acknowledge our common goals of implementing,
scaling, embedding, and sustaining chronic disease self -management education.
The intention is to collaboratively adopt best practices and standards that create a shared road map, and shared
opportunities, toward reaching our common goals.
The goal is to have the membership of the Statewide CDSMP Collaborative include CDSMP License Holders,
State agencies, community -based organizations, interested hosting agencies, adjunct professionals, and
others dedicated to the mission of the Collaborative.
By signing this agreement you indicate you agree with the stated mission of the CDSMP Collaborative:
The Statewide CDSMP Collaborative provides guidance to promote, implement, and coordinate the
sustainability and expansion of the Chronic Disease Self -Management Program Series statewide.
Toward fulfilling this shared mission you agree to become a Partnering Member within the Statewide
CDSMP Collaborative.
As a Partnering Member of the Statewide CDSMP Collaborative your responsibilities include:
a) Understanding that while offering the CDSMP Program Series workshop(s) at your site, you will
be jointly accountable to follow the rules and regulations regarding instruction and administration
of the CDSMP in accordance with the Stanford licensing requirements.
b) Conducting workshops in accordance with the CDSMP Leaders Manual without changes, and
creating no derivatives of the program.
c) Providing suitable space for workshops (complying with Americans with Disabilities Act
standards), healthy snacks and water for attendees for your classes.
d) Actively recruiting participants for classes and lay leaders.
e) Responding within the next business day to referrals received through the CDSMP Collaborative
Centralized Referral System when active.
Maintaining ongoing communication with the Statewide CDSMP Collaborative.
Submitting a calendar of classes on the attached forms including locations, projected group size,
target population for participation (general chronic disease or diabetes) and delivery language
(English or Spanish). This includes the identified lay leaders (2/class minimum). Submitting
updates and changes to the CDSMP Collaborative as early as possible.
h) Collecting data on the Statewide CDSMP Collaborative forms when available (estimated
availability is February 2013). To assist you we request you complete a data collection webinar
which will be available live and on the Statewide CDSMP Collaborative website (estimated
availability is February 2013).
i) Ensuring lay leaders submit required forms including the Workshop Information Cover Sheet,
Attendance Log, Participant Information Survey, and Participant Evaluation forms for all
0
g)
Statewide CDSMP Collaborative
Lynnzy McIntosh, Chair
c/o COAW
2575 S. Wadsworth Blvd.
Lakewood, Co 80227
303-984-1845
303-984-5962 Fax
Lynnzy@COAW.org
www.SeltManagementColorado.org
The Statewide CDSMP Collaborative provides guidance to promote, implement, and coordinate the sustainability
and expansion of the Chronic Disease Self -Management Program Series statewide.
j)
workshops within five business days after each workshop. Newly designed Statewide CDSMP
Collaborative forms will replace all existing forms once available (estimated availability is
February 2013).
As a Partnering member, you agree to participate in the fidelity program being designed by the
Statewide CDSMP Collaborative once approved (estimated availability is January 2013).
k) Participating by choice in specially funded projects and in joint funding. The specific information
will be made available on a per -project basis. Your organization agrees to actively participate in
Statewide CDSMP Collaborative planning events including conference calls, webinars and/or in -
person meetings for these joint opportunities.
1) Participating in the annual rotating coordination of the Statewide CDSMP Collaborative
including being willing to act as Chair (current chair serves through December 2013).
m) Understanding that adherence to data collection, paperwork, and fidelity rules as approved by the
Collaborative will determine the ability to receive funding and/or reimbursement for future
projects.
n) Working jointly with other organizations in planning for the sustainability and scalability of the
CDSMP series throughout Colorado.
Your organization in performing the services as specified in this agreement, shall act as an independent
voluntary participant. Any and all employees of your organization shall be considered to be, at all times, your
employees under your sole authority.
Further, your organization and the Statewide CDSMP Collaborative shall mutually indemnify and mutually
hold harmless from any and all claims, liabilities, losses and causes of action which may arise from acts,
errors or omissions of yours or any of its employees or agents in conjunction with its obligations under this
service agreement.
Responsibilities of the Statewide CDSMP Collaborative to the partnering members include:
a) Maintaining communications with Partnering Members.
b) Coordinating with appropriate governmental agencies, health systems, and funders for the benefit
of the entire Collaborative.
c) Maintaining the website www.SelfManagementColorado.org including the common calendar of
each offered CDSMP series, including contact person and location.
d) Publishing the Collaborative approved fidelity procedures (estimated availability is January
2013).
e) Recording and forwarding referrals received through the Statewide CDSMP Collaborative
Centralized Referral System (estimated availability is January 2013).
o) Providing technical assistance to Partnering Members on topics including data collection, new
paperwork procedures, new fidelity procedures, joint marketing efforts, embedding classes within
patient centered medical homes, handling referrals from health providers, and program
sustainability (estimated availability is January 2013).
Access to participant books and CDs at the Statewide CDSMP Collaborative rate. Once prices
and procedures are established you will be provided with this information (estimated availability
is December 2013).
f) Providing access to joint projects and funding opportunities.
p)
Page 2 of 3
Statewide CDSMP Collaborative
Lynnzy McIntosh, Chair
c/o COAW
2575 S. Wadsworth Blvd.
Lakewood, Co 80227
303-984-1845
303-984-5962 Fax
Lynnzy@COAW.org
www.SelfManagementColorado.org
The Statewide CDSMP Collaborative provides guidance to promote, implement, and coordinate the sustainability
and expansion of the Chronic Disease Self -Management Program Series statewide.
The terms of this agreement will be effective as of the date of signing and shall be effective through
December 31, 2013 and renewable annually thereafter.
Signatures affixed below indicate agreement to the terms and conditions stated:
Lynnz c� a �l, ZI G —�
Statewide CDSMP Collaborative Chair
onzm
Date
MAR 1 8 2013
Signature
William F. Garcia, Chair
Print Name
Board of Weld County Commissioners ( 970) 336-7204
Name of Agency/Partnering Member
Email wgarcia@co.weld.co.us
P.O. Box 758
Telephone
Fax 970-352-0242
Greeley CO 80632
Address
Statewide CDSMP Collaborative
Lynnzy McIntosh, Chair
c/o COAW
2575 S. Wadsworth Blvd.
Lakewood, Co 80227
City Zip Code
Page 3 of 3
303-984-1845
303-984-5962 Fax
Lynnzy@COAW.org
www.SelfManagementColorado.org
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