HomeMy WebLinkAbout20131987.tiffRESOLUTION
RE: APPROVE TASK ORDER CONTRACT FOR DTAP WINNABLE BATTLE AND CIIS
SENTINEL SITE PROJECTS AND AUTHORIZE CHAIR TO SIGN
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, on July 29, 2013, the Board was presented with a Task Order Contract for
the DTaP Winnable Battle and CIIS Sentinel Site Projects 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 Public Health and Environment, and the Colorado Department of Public Health
and Environment, commencing August 1, 2013, and ending June 30, 2015, with further terms
and conditions being as stated in said task order contract, and
WHEREAS, at said meeting the Board continued the matter to July 31, 2013, to allow
staff to be present, and
WHEREAS, after review, the Board deems it advisable to approve said task order
contract, 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 Task Order Contract for the DTaP Winnable Battle and CIIS
Sentinel Site Projects 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 Public Health and
Environment, and the Colorado Department of Public Health and Environment, be, and hereby
is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said task order contract.
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2013-1987
HL0040
APPROVE TASK ORDER CONTRACT FOR DTAP WINNABLE BATTLE AND CIIS SENTINEL
SITE PROJECTS
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 31st day of July, A.D., 2013.
BOARD • COUNTY COMMISSIONERS
WELD O NTY, COLORADO
ATTES
William F. Garcia, Chair
Weld County Clerk to the Board
Date of signatu4LG 15 2013
arbara Kirkmeyer
2013-1987
HL0040
Memorandum
TO: William F. Garcia, Chair
Board of County Commissioners
FROM: Mark E. Wallace, MD, MPH, Director
Department of Public Health & Environment
DATE: July 16, 2013
SUBJECT: Immunization Combined Projects Task Order
Contract
Enclosed for Board review approval is a renewal contract between the Colorado Department of
Public Health and Environment and the Board of County Commissioners of Weld County. This
contract allows the Weld County Department of Public Health and Environment to continue
providing immunization support in the following two areas: DTaP Winnable Battle and CIIS
Sentinel Site Projects.
Funding for DTaP Winnable Battle will be used to continue to provide nursing staff and supplies
to support local efforts to decrease the burden of Pertussis disease and improve childhood
immunization rates in our communities. The CIIS Sentinel Site Projects portion of this contract
will be used to continue to provide a Public Health Nurse to serve as the Field Coordinator for
immunization reporting activities Larimer and Weld Counties. This would include educating
providers in using CIIS, consulting and technical assistance in Weld and Larimer counties.
The two year term of the contract is from August 1, 2013, through June 30, 2015. Funding for
this period will not exceed $83,480. Maximum amount per fiscal year is $41,740.
I recommend approval of this renewal contract.
2013-1987
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
ROUTING NO.14 FEU 58487
APPROVED TASK ORDER CONTRACT — WAIVER #154
This Task Order Contract is issued pursuant to Master Contract made on 01/17/2012, with routing number 13 FAA 00051
STATE:
State of Colorado for the use & benefit of the
Department of Public Health and
Environment
Disease Control and Environmental
Epidemiology Division
Immunization
4300 Cherry Creek Drive South
Denver, Colorado 80246
TASK ORDER MADE DATE:
06/28/2013
PO/SC ENCUMBRANCE NUMBER:
PO FHA EPI1458487
TERM:
This Task Order shall be effective upon
approval by the State Controller, or designee,
or on 08/01/2013, whichever is later. The
Task Order shall end on 06/30/2015.
PRICE STRUCTURE:
Cost Reimbursement
CONTRACTOR:
Board of County Commissioners of Weld
County
915 106 Street
Greeley, Colorado 80632-0758
for the use and benefit of the
Weld County Department of Public Health
and Environment
1555 North 17th Avenue
Greeley, Colorado 80631
CONTRACTOR ENTITY TYPE:
Colorado
BILLING STATEMENTS RECEIVED:
Monthly
STATUTORY AUTHORITY:
N/A
Political Subdivision
CONTRACT PRICE NOT TO EXCEED:
$83,480.00
PROCUREMENT METHOD: FEDERAL FUNDING DOLLARS:
Exempt
STATE FUNDING DOLLARS:
$0.00
$83,480.00
BID/RFP/LIST PRICE AGREEMENT NUMBER: MAXIMUM AMOUNT AVAILABLE PER FISCAL YEAR:
Not Applicable FY 14: $41,740.00
FY 15: $41,740.00
LAW SPECIFIED VENDOR STATUTE:
Not Applicable
STATE REPRESENTATIVE:
Teri Lindsey
Department of Public Health and Environment
DCEED
Immunization
4300 Cherry Creek Drive South
Denver, CO 80246
CONTRACTOR REPRESENTATIVE:
Tammy Nunnally
Weld County Department of Public Health and
Environment
1555 North 17th Avenue
Greeley, Colorado 80631
SCOPE. OF WORK
The Colorado Immunization Section (CIS) at the Colorado Depalhuent of Public Health and
environment (CDPHE) will support immunization activities throughout the state through the
following three projects: DTaP Winnable Battle, 317 Policy Transition, Child Care Inspections
Standards (CHINS).
Page 1 of 6
Rev 6/25/09
The following exhibits are hereby incorporated:
Exhibit A - Additional Provisions (and its attachments if any — e.g., A-1, A-2, etc.)
Exhibit B - Statement of Work (and its attachments if any — e.g., B-1, B-2, etc.)
Exhibit C - Budget (and its attachments if any — e.g., C-1, C-2, etc.)
Exhibit D - Grant Funding Letter
GENERAL PROVISIONS
The following clauses apply to this Task Order Contract. These general clauses may have been expanded upon or made
more specific in some instances in exhibits to this Task Order Contract. To the extent that other provisions of this Task
Order Contract provide more specificity than these general clauses, the more specific provision shall control.
1. This Task Order Contract is being entered into pursuant to the terms and conditions of the Master Contract
including, but not limited to, Exhibit One thereto. The total term of this Task Order Contract, including
any renewals or extensions, may not exceed five (5) years. The parties intend and agree that all work shall
be performed according to the standards, terms and conditions set forth in the Master Contract.
2. In accordance with section 24-30-202(1), C.R.S., as amended, this Task Order Contract is not valid until it
has been approved by the State Controller, or an authorized delegee thereof. The Contractor is not
authorized to, and shall not; commence performance under this Task Order Contract until this Task Order
Contract has been approved by the State Controller or delegee. The State shall have no financial obligation
to the Contractor whatsoever for any work or services or, any costs or expenses, incurred by the Contractor
prior to the effective date of this Task Order Contract. If the State Controller approves this Task Order
Contract on or before its proposed effective date, then the Contractor shall commence performance under
this Task Order Contract on the proposed effective date. If the State Controller approves this Task Order
Contract after its proposed effective date, then the Contractor shall only commence performance under this
Task Order Contract on that later date. The initial term of this Task Order Contract shall continue through
and including the date specified on page one of this Task Order Contract, unless sooner terminated by the
parties pursuant to the terms and conditions of this Task Order Contract and/or the Master Contract.
Contractor's commencement of performance under this Task Order Contract shall be deemed acceptance of
the terms and conditions of this Task Order Contract.
3. The Master Contract and its exhibits and/or attachments are incorporated herein by this reference and made
a part hereof as if fully set forth herein. Unless otherwise stated, all exhibits and/or attachments to this Task
Order Contract are incorporated herein and made a part of this Task Order Contract. Unless otherwise stated,
the terms of this Task Order Contract shall control over any conflicting terms in any of its exhibits. In the event
of conflicts or inconsistencies between the Master Contract and this Task Order Contract (including its exhibits
and/or attachments), or between this Task Order Contract and its exhibits and/or attachments, such conflicts or
inconsistencies shall be resolved by reference to the documents in the following order of priority: 1) the
Page 2 of 6 Rev 6/25/09
Special Provisions of the Master Contract; 2) the Master Contract (other than the Special Provisions) and its
exhibits and attachments in the order specified in the Master Contract; 3) this Task Order Contract; 4) the
Additional Provisions -_Exhibit A, and its attachments if included, to this Task Order Contract; 5) the
Scope/Statement of Work - Exhibit B, and its attachments if included, to this Task Order Contract; 6) other
exhibits/attachments to this Task Order Contract in their order of appearance.
4. The Contractor, in accordance with the terms and conditions of the Master Contract and this Task Order
Contract, shall perform and complete, in a timely and satisfactory manner, all work items described in the
Statement of Work and Budget, which are incorporated herein by this reference, made a part hereof and
attached hereto as "Exhibit B" and "Exhibit C".
5. The State, with the concurrence of the Contractor, may, among other things, prospectively renew or extend
the term of this Task Order Contract, subject to the limitations set forth in the Master Contract, increase or
decrease the amount payable under this Task Order Contract, or add to, delete from, and/or modify this
Task Order Contract's Statement of Work through a contract amendment. To be effective, the amendment
must be signed by the State and the Contractor, and be approved by the State Controller or an authorized
delegate thereof. This contract is subject to such modifications as may be required by changes in Federal
or State law, or their implementing regulations. Any such required modification shall automatically be
incorporated into and be part of this Task Order Contract on the effective date of such change as if fully set
forth herein.
6. The conditions, provisions, and terms of any RFP attached hereto, if applicable, establish the minimum
standards of performance that the Contractor must meet under this Task Order Contract. If the Contractor's
Proposal, if attached hereto, or any attachments or exhibits thereto, or the Scope/Statement of Work -
Exhibit B, establishes or creates standards of performance greater than those set forth in the RFP, then the
Contractor shall also meet those standards of performance under this Task Order Contract.
7. STATEWIDE CONTRACT MANAGEMENT SYSTEM [This section shall apply when the Effective
Date is on or after July 1, 2009 and the maximum amount payable to Contractor hereunder is $100,000 or
higher]
By entering into this Task Order Contract, Contractor agrees to be governed, and to abide, by the
provisions of CRS §24-102-205, §24-102-206, §24-103-601, §24-103.5-101 and §24-105-102 concerning
the monitoring of vendor performance on state contracts and inclusion of contract performance information
in a statewide contract management system.
Contractor's performance shall be evaluated in accordance with the terms and conditions of this Task Order
Contract, State law, including CRS §24-103.5-101, and State Fiscal Rules, Policies and Guidance.
Evaluation of Contractor's performance shall be part of the normal contract administration process and
Contractor's performance will be systematically recorded in the statewide Contract Management System.
Areas of review shall include, but shall not be limited to quality, cost and timeliness. Collection of
information relevant to the performance of Contractor's obligations under this Task Order Contract shall be
determined by the specific requirements of such obligations and shall include factors tailored to match the
requirements of the Statement of Project of this Task Order Contract. Such performance information shall
be entered into the statewide Contract Management System at intervals established in the Statement of
Project and a final review and rating shall be rendered within 30 days of the end of the Task Order Contract
term. Contractor shall be notified following each performance and shall address or correct any identified
problem in a timely manner and maintain work progress.
Should the final performance evaluation determine that Contractor demonstrated a gross failure to meet the
performance measures established under the Statement of Project, the Executive Director of the Colorado
Department of Personnel and Administration (Executive Director), upon request by the Colorado
Department of Public Health and Environment and showing of good cause, may debar Contractor and
Page 3 of 6 Rev 6/25/09
prohibit Contractor from bidding on future contracts. Contractor may contest the final evaluation and result
by: (i) filing rebuttal statements, which may result in either removal or correction of the evaluation (CRS
§24-105-102(6)), or (ii) under CRS §24-105-102(6), exercising the debarment protest and appeal rights
provided in CRS §§24-109-106, 107, 201 or 202, which may result in the reversal of the debarment and
reinstatement of Contractor, by the Executive Director, upon showing of good cause.
8. If this Contract involves federal funds or compliance is otherwise federally mandated, the Contractor and
its agent(s) shall at all times during the term of this contract strictly adhere to all applicable federal laws,
state laws, Executive Orders and implementing regulations as they currently exist and may hereafter be
amended. Without limitation, these federal laws and regulations include the Federal Funding
Accountability and Transparency Act of 2006 (Public Law 109-282), as amended by §6062 of Public Law
110-252, including without limitation all data reporting requirements required there under. This Act is also
referred to as FFATA.
Page 4 of 6 Rev 6/25/09
THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT
* Persons signing for Contractor hereby swear and affirm that they are authorized to act on Contractor's
behalf and acknowledge that the State is relying on their representations to that effect.
CONTRACTOR:
Board of County Commissioners of Weld
County
(a political subdivision of the state of Colorado)
for the use and benefit of the
Weld County Department of Public Health and
Environment
Legal Name of Contracting Entity
Signature o uthorized Officer
William F. Garcia
JUL 3 1 2013
Print Name of Authorized Officer
STATE OF COLORADO:
John W. Hickenlooper, GOVERNOR
For Executive Directo
Department of Public Health and Environment
Chair By
Print Title of Authorized Officer
ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER
CRS §24-30-202 requires the State Controller to approve all State Contracts. This Contract is not valid until
signed and dated below by the State Controller or delegate. Contractor is not authorized to begin performance until
such time. If Contractor begins performing prior thereto, the State of Colorado is not obligated to pay Contractor
for such performance or for any goods and/or services provided hereunder.
STATE CONTROLLER:
Robert Jaros, CPA, MBA, JD
By /�/ sett of
Date /i
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Page 6 of 6 Rev 6/25/09
EXHIBIT A
ADDITIONAL PROVISIONS
To Contract Dated 06/28/2013 - Contract Routing Number 14 FHA 58487
These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above.
1. To receive compensation under this Task Order Contract, the Contractor shall submit a signed monthly
customized CDPHE Reimbursement Invoice Form called "IMM FY 2014-15 Combined Projects Invoice".
This form is accessible from the CDPHE intemet website http://www.colorado.gov/cs/Satellite/CDPHE-
Main/CBON/1251622941228 under Customized Invoice Forms. The CDPHE will provide technical
assistance in accessing and completing the form. The CDPHE Reimbursement Invoice Form must be
submitted within forty five (45) calendar days of the end of the billing period for which services were
rendered. Expenditures shall be in accordance with the Statement of Work attached hereto as Exhibit B
and incorporated herein and the associated Budget attached hereto as Exhibit C and incorporated herein.
Submit completed CDPHE Reimbursement Invoice Form to the Immunization Section email box:
Cdphe.cisinvoice@state.co.us
To be considered for payment, billings for payments pursuant to this Task Order Contract must be received
within a reasonable time after the period for which payment is requested, but in any event no later than s
forty five (45) calendar days after the relevant performance period has passed. Final billings under this
Task Order Contract must be received by the State within a reasonable time after the expiration or
termination of this Task Order Contract; but in any event no later than forty five (45) calendar days from
the effective expiration or termination date of this Task Order Contract.
Unless otherwise provided for in this Task Order Contract, "Local Match", if any, shall be included on all
invoices as required by funding source.
The Contractor shall not use federal funds to satisfy federal cost sharing and matching requirements unless
approved in writing by the appropriate federal agency.
2. Time Limit For Acceptance Of Deliverables.
a. Evaluation Period. The State shall have forty five (45) calendar days from the date a deliverable
is delivered to the State by the Contractor to evaluate that deliverable, except for those
deliverables that have a different time negotiated by the State and the Contractor.
b. Notice of Defect. If the State believes in good faith that a deliverable fails to meet the design
specifications for that particular deliverable, or is otherwise deficient, then the State shall notify
the Contractor of the failure or deficiencies, in writing, within forty five (45) calendar days of: 1)
the date the deliverable is delivered to the State by the Contractor if the State is aware of the
failure or deficiency at the time of delivery; or 2) the date the State becomes aware of the failure
or deficiency. The above time frame shall apply to all deliverables except for those deliverables
that have a different time negotiated by the State and the Contractor in writing pursuant to the
State's fiscal rules.
c. Time to Correct Defect. Upon receipt of timely written notice of an objection to a completed
deliverable, the Contractor shall have a reasonable period of time, not to exceed forty five (45)
calendar days, to correct the noted deficiencies.
3. Health Insurance Portability and Accountability Act (HIPAA) Business Associate Determination. The
State has determined that this contract does not constitute a Business Associate relationship under HIPAA.
To be attached to CDPHE
Version 1.0 (3/12) contract template
Page 1 oft Revised: 07/17/12
EXHIBIT A
4. The State may increase or decrease funds available under this contract using a Grant Funding Letter
substantially equivalent to Exhibit D. The Grant Funding Letter is not valid until it has been approved by
the State Controller or designee.
To be attached to CDPHE
Version 1.0 (3/12) contract template
Page 2 of 2 Revised: 07/17/12
EXHIBIT B
STATEMENT OF WORK
To Task Order Dated 06/28/2013 - Contract Routing Number 14 FHA 58487
These provisions are to be read and interpreted in conjunction with the provisions of the contract
specified above.
I. Project Description: Immunization Combined Projects
The Colorado Immunization Section (CIS) at the Colorado Department of Public Health and Environment
(CDPHE) will support immunization activities throughout the state through the following projects:
A. DTaP Winnable Battle
As one of Colorado's 10 Winnable Battles, and to reduce infectious disease that can be prevented
with vaccination, Colorado will increase the percentage of children who are up to date on their
diphtheria, tetanus and pertussis (DTaP) immunizations when they enter kindergarten.
B. CIIS Sentinel Site
The project goal is to improve immunization rates and reduce unnecessary re -vaccination through
accurate usage of and improved data quality in CIIS for a variety of healthcare providers: public
health agencies, pediatricians, family practice, OB/GYN, internal medicine, community/rural health
centers, hospitals, schools and childcare centers, community vaccinators, pharmacies, university
health clinics and correctional facilities in Weld and Larimer counties.
C. Funding Period: August 1, 2013 through June 30, 2014
II. Definitions:
CDC
Center for Disease Control and Prevention
CDPHE
Colorado Department of Public Health and Environment
CIIS
Colorado Immunization Information System
CIS
Colorado Immunization Section
DTaP
Diphtheria, Tetanus and acellular Pertussis
DTaP WB
DTaP Winnable Battle
EHR
Electronic Health Record
1Z
Immunization
LPHA
Local public health agency
RFA
Request for application
SOW
Scope of work
SPIDR
Site Progress and Implementation Database for the Registry
WCDPHE
Weld County Department of Public Health and Environment
III. Performance Requirements/Deliverables:
1. DTaP Winnable Battle
a) Quarterly online progress reports shall be completed, for both contract years, using this link:
http: //fs 9. formsite. com/Co lorado IMMprogram/lZCombinedProj ectsPR/index.html
b) Online report due dates are:
July -Sept due Oct 15
Page 1 of 8
EXHIBIT B
Oct -Dec due Jan 15
Jan -March due April 15
April -June due July 15
c) A mid -project progress report shall be due July 15, 2014. The link will be provided by the CIS
no later than July 1, 2014.
a) A final, comprehensive progress report shall be due to the CIS by July 30, 2015. The link will
be provided by the CIS no later than July 1, 2015.
Goal 1
Our goal for this project is to collaborate with community partners
(including daycare providers, head -start, pre-school, elementary
school districts, and private medical providers) to improve
immunizations rates within Weld County for children entering
Kindergarten particularly DTaP.
Deadline
Objective 1-
1:
Immunization Coordinator shall establish partnership with (10) community partners to
improve immunization rates within Weld County for children entering Kindergarten
especially DTaP.
Activities to
complete the
objective
1. Immunization Coordinator shall connect with (10) community
partners within Weld County primarily daycare, Head -start and
school districts, to coordinate electronic recalls on 750 children. This
will target a reduction of missing immunization, particularly DTaP,
using the CIIS database, for children entering Kindergarten. This
coordination of community partner will increase DTaP coverage by
10% for children entering Kindergarten which would be
approximately (1,800) in Weld County for the 2013-14 school year.
2. Immunization Coordinator shall connect with (10) community
partners within Weld County primarily daycare, Head -start and
school districts, to coordinate electronic recalls on 750 children. This
will target a reduction of missing immunization, particularly DTaP,
using the CIIS database, for children entering Kindergarten. This
coordination of community partner will increase DTaP coverage by
10% for children entering Kindergarten which would be
approximately (1,800) in Weld County for the 2014-15 school year.
3. Quarterly reports shall be submitted for each conducted recall.
Recalls shall be conducted quarterly. The information that will be
captured on each report will be based on number of children
identified as missing immunizations.
July 30, 2014
June 30, 2015
Quarterly
July -Sept
Oct -Dec
Jan- Mar
Apr - Jun
Reporting
Requirements
/
Deliverables
For developing Partnerships, report the following:
• List of the partner agencies and/or organizations.
• Summary of the partnership agreement.
• Summary of partnership outcomes or successes.
For CIIS reminder/recall, report the following:
• Number of children by age group identified as needing a DTaP immunization.
• Number of recall notices returned undeliverable.
• Percent of children by age group that were recalled then subsequently brought up
to date for DTaP.
Objective 1-
2:
IZ Coordinator shall establish special immunization clinics by completing a cycle of
advertisements using school websites and ongoing partnerships with schools healthcare
staff.
Page 2 of 8
EXHIBIT B
Activities to
complete the
objective
1. By school return Aug. 30, 2014, special immunizations clinics shall
be advertised using Weld County Department of Public Health and
Environment (WCDPHE) website, individual school websites.
Website ad shall be designed for the immunization program
providing basic clinic information, time date location and basic
immunization schedule for 4-6 year olds.
2. By school return, Aug. 30, 2015 special immunizations clinics shall
be advertised using WCDPHE website, individual school websites.
Website ad shall be designed for the immunization program
providing basic clinic information, time date location and basic
immunization schedule for 4-6 year olds.
3. Immunization advertisement (eflyers/pamphlets) shall be designed
regarding WCDPHE special clinics, date and time, and school
required vaccination for the 2013-2014 school year. Ad shall be
reader friendly, no more than 8`h reading level, in English and
Spanish.
4. Ads shall be distributed to designated location around Weld County
including Global Refugee Center, Lutheran Family Services and 15
schools for use on their appropriate media use.
Aug. 30, 2014
Aug. 30, 2015
Aug. 30, 2013
Aug. 15, 2013
Reporting
Requirements
/
Deliverables
• Number of school websites where immunization related information was advertised.
Objective 1-
3:
WCDPHE RN shall schedule special immunization clinics 4-6 weeks prior to pivotal
school events, start of school, exclusion letters (beginning of school, before Christmas
break) and end of the school year.
Activities to
complete the
objective
1. Using CIIS, Weld County shall identify up to 150 kindergartner's
who are not up to date with DTaP. This time will coordinate with
the first exclusion letters, from the school district being sent to the
identified students.
2. RN shall coordinate with school health staff of up to (10)
elementary schools to advertise special walk-in clinics, designed for
optimum flexibility for working families. This will increase the
opportunity to connect with these families and ensure students are
up to date on school required immunization, specifically DTaP.
3. RN shall coordinate with school health staff of up to (10)
elementary schools to advertise special walk-in clinics, designed for
optimum flexibility for working families. This will increase the
opportunity to connect with these families and ensure students are
up to date on school required immunization, specifically DTaP.
4. Using CIIS, Weld County shall identify up to 150 kindergartner's
who are not up to date with DTaP. This time will coordinate with
the first exclusion letters, from the school district being sent to the
identified students.
5. RN shall coordinate with school health staff of up to (10)
elementary schools to advertise special walk-in clinics, designed for
optimum flexibility for working families. This will increase the
opportunity to connect with these families and ensure students are
up to date on school required immunization, specifically DTaP.
Oct. 15, 2013
Feb. 28, 2014
May 15, 2014
Aug. 15, 2014
Feb. 28, 2015
Page 3 of 8
EXHIBIT B
6. RN shall coordinate with school health staff of up to (10)
elementary schools to advertise special walk-in clinics, designed for
optimum flexibility for working families. This will increase the
opportunity to connect with these families and ensure students are
• up to date on school required immunization, specifically DTaP.
May 15, 2015
Reporting
Requirements
/
Deliverables
• Number of children identified as needing DTaP immunization and the percentage that
were subsequently brought up to date after the clinic.
Goal,2
p...-:,..,"I:,schools
;.,;
Our goal for this project is to collaborate with (2) rural cotmm unity elementary
in rural school districts to improve immunizations rates within Weld
County for children entering Kindergarten particularly DTaP.
Objective 2-
J.:
Partnering with the (2) rural community elementary school districts, to improve
immunizations rates for rural Weld County for children entering Kindergarten particularly
DTaP.
Activities to
complete the
objective
1. WCDPHE RN shall make contact with (1) rural School Districts to
investigate and strategize the immunization needs of these rural
school districts and.what can be done to ensure that school age are
up to date on school required immunization, specifically DTaP.
2. WCDPHE RN shall coordinate a meeting with these rural school
districts, to educate them on the most recent ACIP
recommendations regarding required immunization, specifically
DTaP for entry into school.
3. WCDPHE RN shall make contact with (1) rural School Districts to
investigate and strategize the immunization needs of these rural
school districts and what can be done to ensure that school age are
up to date on school required immunization, specifically DTaP.
4. WCDPHE RN shall coordinate a meeting with the rural school
district, to educate them on the most recent ACIP recommendations
regarding required immunization, specifically DTaP for entry into
school.
Sept. 30, 2013
Nov. 30, 2013
Sept. 30, 2014
Nov. 30, 2014
Reporting
Requirements
/
Deliverables
• List of the partner agencies and/or organizations.
• Summary of the partnership agreement.
• Summary of partnership outcomes or successes.
• •Specific information included in each education or training event.
• Results of pre and post testing for each education or training event by type of group
being trained.
Objective 2-
2:
By the end of each contract year, up to (1) Special immunizations clinics shall be
advertised using media that is appropriate for these rural school districts.
Flyer/pamphlets/eflyers shall be designed for the immunization program providing basic
clinic information, time date location and basic immunization schedule for 4-6 year olds.
Activities to
complete the
objective.
1. Immunization advertisement (eflyers/pamphlets) shall be designed
regarding WCDPHE special clinics, date and time, and school
required vaccination for the 2013-2014 school year. Ad shall be
reader friendly, no more than 8th reading level, in English and
Spanish. .
2. Ads shall be distributed to rural locations.
3. Immunization advertisement (eflyers/pamphlets) shall be designed
Jan. 30, 2014
Mar. 30, 2014
Jan. 30, 2015
Page 4 of 8
EXHIBIT B
regarding WCDPHE special clinics, date and time, and school
required vaccination for the 2014-2015 school year. Ad shall be
reader friendly, no more than 8`h reading level, in English and
Spanish.
4. Ads shall be distributed to rural locations.
Mar. 30, 2015
Reporting
Requirements
/
Deliverables
• Number of clinics advertised.
Objective 2-
3:
For the 2013-14 and 2014-15 school years, WCDPHE RN shall schedule special
immunization clinics at one or more elementary school for (1) rural school district to
administer vaccines to children who have to complete the s required school
immunizations, specifically DTaP
Activities to
complete the
objective
1. Using CIIS or immunization information from rural school RN, we
shall identify Kindergartners who are not up to date with DTaP.
2. At least (2) special clinics shall be scheduled for those children who
are preparing for the next school year, or are behind on DTaP.
3. At least (2) special clinics, shall be scheduled, and coordinated with
school RN for the most effective time to get the maximum number
of student up to date on DTaP.
4. Using CIIS or immunization information from rural school RN, we
shall identify Kindergartners who are not up to date with DTaP.
5. At least (2) special clinics shall be scheduled for those children who
are preparing for the next school year, or are behind on DTaP.
Mar. 15, 2014
May 30, 2014
Sept. 30, 2014
Mar. 15, 2015
May 30, 2015
Reporting
Requirements
/
Deliverables
• Number of children identified as needing DTaP immunization and the percentage that
were subsequently brought up to date after the clinic.
2. CIIS Sentinel Site
a) Quarterly online progress reports will be completed, for both contract years, using this link:
http://fs9. formsite. com/ColoradolMMpro gram/CIIS Sentinel S itesReport/index.html
b) Online report due dates are:
Aug -Sept 2013 due Oct 15, 2013
Oct -Dec 2013 due Jan 15, 2014
Jan -March 2014 due April 15, 2014
April -June 2014 due July 15, 2014
c) A final, comprehensive progress report will be due to the CIS by July 30, 2015. The link will
be provided.
Goal 1
Among immunization service providers in Larimer and Weld counties,
increase and improve access to CIIS.
Deadline
Objective 1-
1:
Facilitate and educate providers in using CIIS. The following activities shall be
completed on a monthly basis unless otherwise stated.
Activities to
complete the
objective
1. Serve as the CIIS Field Coordinator for all CIIS users by providing
consulting and technical assistance services (in person or by phone)
in Weld and Larimer counties. Be proficient in CIIS policies,
Monthly
Page 5 of 8
EXHIBIT B
implementation documents, and training materials and processes.
2. Utilize latest implementation documents (Letter of Agreement,
Clinic Information form, etc) provided by CIIS for 100% of new
sites interested in joining CIIS.
3. Identify non -clinical sites that would benefit from access to the CIIS
School application such as schools (public, private and charter),
licensed childcare centers, Head Start programs, etc. and provide
contact information to CIIS School Coordinator for follow-up
4. Ensure General User training for 100% of new CIIS users and
follow-up as needed. Utilize new training webinar service,
computer -based training and other training materials provided by
CIIS.
5. Attend relevant CIIS meetings and trainings (by phone or in person)
to provide current up-to-date information to providers in Weld and
Larimer counties.
6. Train new public health staff (as needed) in Weld and Larimer
counties on CIIS.
Monthly
As required,
when new
staff is hired
Reporting
Requirements
Deliverables
• Number and type of consulting and technical services offered by type of provider
• Number of new sites enrolled in CIIS through this funding
• Number of non -clinical sites identified and number enrolled
• Number of new CIIS users trained by type of service provider
• Number of new public health staff trained by staff position
Goal 2 'i
Ensure the quality of CIIS data for Larimer and Weld counties.
Objective 2-
1:
Identify, maintain and/or improve child and provider data for Weld and Larimer counties
through data usage and data clean-up activities. The following activities shall be
completed on a monthly basis unless otherwise stated.
Activities to
complete the
objective
1. Identify clinics that have data quality issues and work with CIIS
Data Quality Coordinator and clinic to rectify issues.
2. Run `Patients with Possible Duplicate Vaccinations', `Possible
Patient Duplicates' reports for Weld County Department of Public
Health and Environment and reconcile any duplicates found.
3. Run the `Patient Roster' report for Weld County Department of
Public Health and Environment and MOGE any patients that do not
belong.
4. Conduct data quality reviews (completeness, accuracy and
appropriate vaccination administration) for at least two clinics per
month using CIIS's Data Quality Procedures. Provide feedback to
clinic and follow-up with training and guidance as appropriate.
5. Identify potential patient duplicate records within CIIS by using the
Duplicates feature.
6. Work with the Interface Coordinator to facilitate the implementation
of new Electronic Health Record (EHR) interfaces for clinics in
Weld and Larimer counties as part of the EHR Interoperability grant.
7. Maintain and update provider information and CIIS implementation
progress within SPIDR for Weld and Larimer counties within three
days of activity.
8. Perform transfer of information (re: outstanding activities) to the
CIIS program at the conclusion of the grant.
Monthly
June 30, 2014
Page 6 of 8
EXHIBIT B
Reporting
Requirements
Deliverables
IV: Personnel:
• Number of clinics with data quality issues by type of issue
• Number of duplicates identified monthly
• Number of patients classified as MOGE monthly
• Summary of data quality reviews (completeness, accuracy and appropriate
vaccination administration) for each clinic
• Number of clinics that implemented the EHR interface
a) Agency information:
Agency name
Weld Count Department of Public Health and Environment
Agency mailing
address
1555 N. 17' Ave , Greeley CO 80631
Phone number
970-304-6420
Fax number
970-304-6416
Agency DUNS #
0755757955
Agency FEIN #
84-6000813
b) Agency DTaP contact person:
Name
Tracy Nunnally
Phone
number
970-304-6420 X2302
Email address
tunnally@co.weld.co.us
c) Agency CHS contact person:
Name
Belita Marine, RN, BSN
Phone
number
970-304-6420 ext. 2415
Email address
bmarine@co.weld.co.us
d) CIS DTaP Winnable Battle Project Manager:
Name
Jennifer Yara-Zelenski
Phone number
303-692-2661
Email address
Jennifer.Yara-zelenski@state.co.us
e) CIIS Project Contact:
Name
Heather Shull
Phone number
303-692-2289
Email address
Heather.Shull@state.co.us
V: Monitoring:
CDPHE's monitoring of this contract for compliance with performance requirements will be conducted
throughout the contract period by the CIP Project Manager, Contract Monitor and/or Evaluation
Coordinator. Methods used will include review of documentation reflective of performance to include
progress reports and invoices. The Contractor's performance will be evaluated at set intervals and
Page 7 of 8
EXHIBIT B
communicated to the contractor. A Final Contractor Performance Evaluation will be conducted at the
end of the life of the contract.
VI: Resolution of Non -Compliance:
The Contractor will be notified by email within 15 days of discovery of a compliance issue. Within 30
days of discovery, the Contractor and the State will collaborate, when appropriate, to determine the
action(s) necessary to rectify the compliance issue and determine when the action(s) must be completed.
The action(s) and time line for completion will be documented by email and agreed to by both parties.
If extenuating circumstances arise that require an extension to the time line, the Contractor must email a
request to the Contract or Project Monitor and receive approval for a new due date. The State will
oversee the completion/implementation of the action(s) to ensure time lines are met and the issue(s) is
resolved. If the Contractor demonstrates inaction or disregard for the agreed upon compliance
resolution plan, the State may exercise its rights under the Remedies section of the General Provisions
of this contract.
Page 8 of 8
EXHIBIT C
BUDGET
To Contract Dated 06/28/2013 - Contract Routing Number 14 FHA 58487
The Budget shall govern the Contractor's expenditure of funds for the term through and including June 30, 2014.
Weld
DTaV Winnable Battle
Expenses
Describe in detail
CDPHE
funding
In -kind
. Total
-°Budget
Personal services
including fringe
benefits
0.025 FTE Office Technician at approx. 4 hours a
month
0.075 FTE RN (1) at approx 14 hours a month
.025 FTE RN (2) at approx.4 hours a month ea.
Fringe included at 38.93%
$10,484
:::$71 .
510.555
Supplies & operating
expenses
Misc. Office Supplies, Medical Waste Disposal,
Electronic Medical Records
$200
$200
Travel
Travel to local and rural Schools, Headstart
Programs and Daycare Centers
$1,000
$1,000
Other Costs:
Incentives
Equipment
Marketing
Flyer, Web -advertisement design
$125
. $125
Training
Contractual
Indirect
11.98% FY13
$1,256
fit67
$1,423
TOTAL
$11,740
$4,563
$13,303
CHS Sentinel Site
Expenses
Describe in detail
CDPHE
funding
In-
kind
Total
Budget
Personal services
including fringe
benefits
CIIS Coordinator (RN) 13 hours per week (676)
hours per year, annual salary of $50,241 FTE
(.33) plus fringe (a, 38.93%
$30,000
$30,000
Supplies & operating
expenses
Travel
Other Costs:
Incentives
Equipment
Marketing
Training
Contractual
Indirect
.
TOTAL
$30,000
' `
-$30,000
Total funding for combined projects listed above: $41,740.00
Page 1 of 1
EXHIBIT D
GRANT FUNDING CHANGE LETTER
Date:
State Fiscal Year:
TO: Insert Grantee's name
Grant Funding Change Letter #
CMS Routing #
In accordance with Section of the Original Contract routing number , [insert the following
language here if previous amendment(s), renewal(s) have been processed] as amended by [include all
previous amendment(s), renewal(s) and their routing numbers], [insert the following word here if
previous amendment(s), renewal(s) have been processed] between the State of Colorado, Department
of Public Health and Environment and Contractor's Name beginning Insert start date <insert start date of
original contract> and ending on Insert ending date <insert ending date of current contract amendment>,
the undersigned commits the following funds to the Grant:
The amount of grant funds available and specified in Section of <insert contract amendment
number and routing number> is ❑ increased or ❑ decreased by $amount of change to a new total
funds available of $ <insert new cumulative total> for the following reason: . Section
is hereby modified accordingly.
This Grant Funding Change Letter does not constitute an order for services under this Grant.
The effective date of hereof is upon approval of the State Controller or , whichever is later.
j
STATE OF COLORADO
John W. Hickenlooper, GOVERNOR
Department of Public Health and Environment
PROGRAM APPROVAL:
BY:
By: Lisa Ellis, Purchasing & Contracts Unit Director
Date:
ALL GRANTS REQUIRE APPROVAL BY THE STATE CONTROLLER
CRS §24-30-202 requires the State Controller to approve all State Grants. This Grant is not valid until signed and dated below by
the State Controller or delegate. Grantee is not authorized to begin performance until such time. If Grantee begins performing prior
thereto, the State of Colorado is not obligated to pay Grantee for such performance or for any goods and/or services provided
hereunder.
By:
STATE CONTROLLER
David J. McDermott, CPA
Date:
Page 1 of 1
Effective Date: 1/6/09 -Rev 8/25/09
STATE OF COLORADO
John W. Hickenlooper, Governor
Kahn McGowan
Interim Executive Director
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr. S.
Denver, Colorado 80246-1530
Phone (303) 692-2000
Located in Glendale, Colorado
http://www.cdphe.state.co.us
08/16/2013
Laboratory Services Division
8100 Lowry Blvd.
Denver, Colorado 80230-6928
(303) 692-3090
Weld County Department of Public Health
1555 North 17th Avenue
Greeley, CO 80631
Hi Tracy,
Colorado Department
of Public Health
and Environment
Enclosed is your copy of the fully executed Colorado Department of Public Health and
Environment Contract listed below. You may begin work on 08/16/2013.
Contractor Name: Weld County Department of Public Health
Contract Number: 14 FHA 58487
Original Contract Number: 14 FHA 58487
Division: DCEED
Program Name: Immunization
Project Name: Combined Projects
Reason for Contract: New Contract
Please contact me with questions or concerns. My contact information is listed below.
Sincerely,
Aaron Vigil
Contracts Coordinator
DCEED-A3
4300 Cherry Creek Drive South
Denver, CO 80246
303-692-6306 office
303-782-0904 fax
Hello