HomeMy WebLinkAbout20121564.tiff RESOLUTION
RE: APPROVE TASK ORDER CONTRACT FOR TUBERCULOSIS PROGRAM 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,the Board has been presented with a Task Order Contract for the Tuberculosis
Program between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County,on behalf of the Weld County Department of Public Health and
Environment,and the Colorado Department of Public Health and Environment,commencing July 1,
2012,and ending June 30,2013,with further terms and conditions being as stated in said contract,
and
WHEREAS,after review,the Board deems it advisable to approve said 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 Tuberculosis Program between the County
of Weld,State of Colorado,by and through the Board of County Commissioners of Weld County,on
behalf of the Weld County 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 contract.
The above and foregoing Resolution was,on motion duly made and seconded,adopted by
the following vote on the 25th day of June,A.D.,2012.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY,COLORADO
ATTEST: EXCUSED
Sean P. ay,Chair
Weld County Clerk to the Board
William .Ga ' ,Pro-Tern
BY:
Deputy CI k to the Board 'F \, l•.11,„ XCUSED
r ara Kirk Qmeyer
APPRO EDA M. IeI FTW `
vid .Long
r ney
. Doug=s Rademacher
Date of signature: 1-/(D-(a-
3 oviGt 4 1
5-/Q- CC LPL 2012-1564
1 j$-I a HL0039
86 Zo Memorandum
1TO: Sean Conway, Chair
Board County
�" .. of Co Commissioners
W E L DEC O U N T Y FROM: Mark E. Wallace,MD, MPH,Director
Department of Public Health and
Environment
DATE: June 1,2012
SUBJECT: Tuberculosis Task Order Contract
Enclosed for Board review and approval is contract amendment between the Colorado Department of
Health and Environment and the Board of County Commissioners of Weld County on behalf of the
Department of Public Health and Environment(WCDPHE). This contract is for continuation of the
Tuberculosis(TB) Prevention and Control Program.
If approved, the funding for this contract will allow the Department to provide TB prevention and control
activities in Weld County. WCDPHE staff members will collect specimens for testing on all persons
suspected of having TB (skin testing or QuantiFERON testing), provide for interpretation of chest x-rays,
provide active TB treatment including Directly Observed Therapy (this is a process where staff assures
that TB clients comply with and complete TB therapy), ensure contacts to all newly identified infectious
TB cases receive appropriate evaluation, and follow-up with active patients to ensure they receive
appropriate information and education.
The term of this contract is one year, beginning July I, 2012, and ending on June 30, 2013. The TB
contract funding is determined on the basis of the number of active TB cases in the county that have been
treated over a period of time. Our number of active cases has diminished, demonstrating the success of
our efforts. However,the result is a diminished contract disbursement from State and Federal funding.
Funding for this contract amendment period will not exceed $46,030. Of this amount, $42,280 is from
State sources and $3,750 is from Federal sources. Although this appears to be a$29,000 cut in funding,
CDPHE has separately encumbered $23,000 for the purpose of enhanced (QuantiFERON)testing, the
cutting edge blood screening test for both active and latent TB. Last year the amount for the enhanced
(QuantiFERON)testing($17,000)was included in the WCDPHE contract allocation. The State is now
handling all enhanced (QuantiFERON)testing by reimbursement. We will bill them for the testing that
we do up to the encumbered $23,000. The State will also encumber funds for the service of Tuberculosis
Directly Observed Therapy, for the same one year renewal term.
I recommend your approval of this task order amendment.
Enclosure
2012-1564
•
•
DEPARTMENT OF PUBLIC I lEAUl1 i AND I SNA'IRONMI INI
ROUTING NO.13 FHA 44718
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 0051
si CONTRACTOR:
State of Colorado for the use& benefit of the Board of County Commissioners of Weld County
Department of Public Health and 915 10111 Street
Environment Greeley,Colorado 80632-0758
DCEED For the use and benefit of the
Tuberculosis Weld County Department of Public Health and
Rnr
4300 Cherry Creek Drive South North 1
Denver, Colorado 80246 1555 North 17'1'Avenue
Greeley,CO 80631
TASK ORDER MADI:DATE: CONTRACTOR ENITI Y 7YI'I?
06/07/2012 Colorado Political Subdivision
PO/SC ENCUMBRANCE NUMBER:
PO FHA EPI1344718
TERN. BITTING STAIP:MIN"IS RECEIVED:
This Task Order shall be effective upon Monthly
approval by the State Controller, or designee,
or on 07/01/2012,whichever is later. The STAI FU TORY ALIT'IORPI Y:
Task Order shall end on 06/30/2013. Not Applicable
PRICI!STRUCTURE: CONTRACT PRICI:NOT TO EXCEED:
Cost Reimbursement $46,030.00
PROCURIiMISNT MI/GOOD: I'I:DI:RAI.FUNDING DOI JARS: $3,750.00
Exempt STATE FUNDING DOIJ ARS: $42,280.00
BID/RI'P/LIST PRICIi A<iRIil iMINT NUMBER MAXIMUM AMOUNT AVAILABLIt PER FISCAL YEAR
Not Applicable FY 13: $46,030.00
(Plus a portion of the two blanket
TAW SP1:CIFI IT)VENDOR STATUTE: Encumbrances identified in Exhibit A)
Not Applicable
STATE RI:PRI4SI iN"I:A'TI VE: CONTRACTOR REPRESENTATIVE:
Mary Goggin Judy Nero
Department of Public Health and Environment Weld County Department of Public Health and
DCEED Environment
TB 1555 North 17th Avenue
4300 Cherry Creek Drive South Greeley,CO 80631
Denver,CO 80246
SCOPIi CI'WI)RK:
Provide or coordinate the Tuberculosis (1B) prevention and control activities for individuals within
its service area.
Page 1 of 6 Rev 6/25/09
IiXI Hsu :
The following exhibits arc 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 1ll- 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.
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: STATE OF COLORADO:
Board of County Commissioners of Weld County John W.Hickenlooper, GOVERNOR
(a political subdivision of the state of Colorado)
for the use and benefit of the
Weld County Department of Public Health and
Environment - n
Legal Name of Contracting Entity //a)
For Executive Director - ---
Department of Public Health and Environment
Signature of Authorized Officer JUN
22012
William F. Garcia L
Print Name of Authorized Officer
Department Program p oval:
Chair Pro—Tem 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:
\ David J.McDermott,CPA
By
Date 7- 3 /Z
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EXHIBIT A
ADDITIONAL PROVISIONS
To Task Order Contract Dated 06/07/2012 - Contract Routing Number 13 FHA 44718
These provisions are to be read and interpreted in conjunction with the provisions of the
Task Order Contract specified above.
1. 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.
2. This Task Order Contract contains federal funds(see Catalog of Federal Domestic Assistance(CFDA)
number 93.1 160)
3. The United State Department of Health and Human Services("USHHS"),through the Centers for Disease
Control and Prevention("CDC')has awarded federal funds under Award number 5U52PS800512,
hereinafter"Award".
If the underlying Award authorizes the State to pay all allowable and allocable expenses of a contractor as
of the effective date of that Award,then the State shall reimburse the Contractor for any allowable and
allocable expenses of the Contractor that have been incurred by the Contractor since the proposed effective
date of this Task Order Contract. If the underlying Award does not authorize the State to pay all allowable
and allocable expenses of a contractor as of the effective date of that Award,then the State shall only
reimburse the Contractor for those allowable and allocable expenses of the Contractor that are incurred by
the Contractor on or after the effective date of this Task Order Contract,with such effective date being the
later of the date specified in this Task Order Contractor the date the Task Order Contract is signed by the
State Controller or delegee.
4. To receive compensation under this Task Order Contract,the Contractor shall submit a signed Monthly
CDPHE Reimbursement Invoice Form. This form is accessible from the CDPHE internet website
http://www.cdnhe.state.coms/StanclardizedInvoiedinclex.litml CDPHE will provide technical assistance
in accessing and completing the form. The CDPHE Reimbursement Invoice Form must be submitted
within sixty(60)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:
Mary Goggin,TB Program Manager
DCEED-TB
Colorado Department of Public Health and Environment
A3-TB-DCEED
4300 Cherry Creek Drive South
Denver,Colorado 80246
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 no event no later than sixty
(60)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
To be attached to CDPHE Page 1 oft Revised: 12/19/06
Task Order v1.0(3/12)contract template
EXHIBIT A
Task Order Contract;but in no event no later than sixty(60)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.
5. Time Limit For Acceptance Of Deliverables.
a. Evaluation Period. The State shall have thirty(30)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 thirty(30)calendar days of: I)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 thirty(30)
calendar days,to correct the noted deficiencies. If the Contractor fails to correct such deficiencies
within thirty(30)calendar days,the Contractor shall be in default of its obligations under this
Task Order Contract and the State,at its option,may elect to terminate this Task Order Contract or
the Master Contract and all Task Order Contracts entered into pursuant to the Master Contract.
6. Pursuant to 25-4-501, 8 C.R.S.,as amended,the General Assembly has declared that tuberculosis is an
infectious and communicable disease,that it endangers the population of this state,and that the treatment
and control of said disease is a state responsibility and further, pursuant to 25-4-511, 8 C.R.S.,assistance
under section 25-4-501, shall be given to any applicant who is suffering from tuberculosis in any form
requiring treatment and is without sufficient means to obtain such treatment. The State,through the
Tuberculosis Program has a mandate to provide care coordination services for the residents of the State
of Colorado.
7. The State Promises to make available to the Contractor a portion of the Twenty Thousand Dollars,
($20,000.00) Statewide funds for the Tuberculosis Direct Observed Therapy and Twenty Three
Thousand Dollars($23,000.00) Statewide funds for the Tuberculosis Quantiferon(QTF)Diagnostic
Testing,for the same one year renewal term, in exchange for the promise of the Contractor to perform the
work described herein. Of the total financial obligation of the Stated referenced above,one hundred
percent is derived from the State General Fund. The liability of the State,at any time, for such payments
shall be limited to the unencumbered remaining balance of such funds. If there is a reduction in the total
funds appropriated for the purposes of this Contract,then the State, in its sole discretion,may
proportionately reduce the funding for this Contract or terminate this Contract in its entirety.
8. The State may increase of 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 Page 2 of 2 Revised: 12/19/06
Task Order v1.0(3/12)contract template
• EXHIBIT B
STATEMENT OF WORK
To Task Order Contract Dated 06/07/2012-Contract Routing Number 13 FHA 44718
These provisions are to be read and interpreted in conjunction with the provisions of the Task Order Contract specified above.
I. Project Description:
Funds provided under the purchase order are to assist in supporting tuberculosis(TB)prevention and control activities as
stated in Colorado Revised Statues(CRS)25-4-501-Part 5 Tuberculosis(et seq)and Rules and Regulations Pertaining to
Epidemic and Communicable Disease Control(6-CCR-1009-1, Regulation 4). Contractor shall provide or coordinate the
following services for all individuals within its service area according to the statutes and regulations listed above and
according to Colorado Department of Public Health and Environment(CDPHE)Tuberculosis Manual,but in no event less
than those duties required by statute and rules(listed above). Use of funds shall be prioritized as follows: priority I)
finding all patients with active TB and ensuring completion of appropriate therapy,priority 2)finding and evaluating
contacts of TB patients and ensuring completion of appropriate therapy,3)evaluation of newly arrived immigrants and
refugees with Class B TB designation,and priority 4)targeted testing of high-risk persons and ensuring completion of
therapy for latent TB infection(LTBI). If available, use patient's medical insurance as primary payment source. CDPHE
will reimburse for diagnostic and clinical services at current Medicaid rate, unless prior approval has been given by the
CDPHE TB Program.
II. Performance Requirements/Deliverables:
a. The Contractor shall provide, or arrange for, chest x-rays and interpretations.
b. The Contractor shall collect, or arrange for the collection of, specimens for mycobacteriology testing on
all persons suspected of having tuberculosis. Assure appropriate testing is performed, e.g., smears for
acid-fast bacilli,(using concentrated fluorescent method), isolation of mycobacteria(using rapid
methods), identification of Mycobacterium tuberculosis complex(MTB)(using rapid methods), and
susceptibility testing(isoniazid, rifampin, ethambutol, and pyrazinamide)on isolates of MTB. Contractor
should use the CDPHE Laboratory for testing. The CDPHE Laboratory will, at no charge to the
Contractor, supply specimen containers and perform the above testing for the Contractor. The Contractor
shall arrange for the transportation of the specimens to the CDPHE Laboratory for testing.
c. The Contractor shall provide,or arrange for,the placement of patients who require isolation. The
Contractor shall contact CDPHE TB Program for assistance, if needed, and to request reimbursement
from CDPHE for those costs incurred by the Contractor in isolating a patient.
d. The Contractor shall provide, or arrange for,all other necessary laboratory testing and medical evaluation
services.
e. The Contractor shall order TB medications through the CDPHE TB Program.
f. The Contractor shall provide,or arrange for,the treatment of patients with suspected or confirmed active
TB, including directly observed therapy, and ensure adherence to treatment.
g. The Contractor shall provide, or arrange for,the treatment of patients with LTBI.
h. The Contractor shall provide, or arrange for,a Human Immunodeficiency Virus(HIV)antibody test for
all persons diagnosed with TB disease, regardless of their age or the apparent absence of risk factors for
HIV infection. In accordance with section 25-4-1401, et seq.,C.R.S., as amended,the Contractor shall
report all known HIV antibody test results to the CDPHE. The Contractor shall inform those individuals
whom refuse testing of the risks associated with HIV/TB co-infection.
Page I oft
Exhibit B-Statement of Work
V 1/MAR2012
EXHIBIT.B
i. The Contractor shall monitor and evaluate those persons with suspected or confirmed active TB at least
bi-monthly.
j. The Contractor shall monitor and evaluate those persons with Latent Tuberculosis Infection(LTBI)at
least monthly.
k. The Contractor shall provide culturally appropriate patient education and information pertaining to TB
treatment and/or follow-up plan. The Contractor shall provide services in patient's language using
medical interpretation resources such as AT&T language line as needed.
I. All reports of suspected or confirmed active TB shall include: reason for initiating, patient name, date of
birth, country of birth, date arrived in U.S.,demographic information, locating information,provider
information, TB risk factors,results of diagnostic testing,results of mycobacteriology including
susceptibility results,dates of infectious period,treatment information, changes in patients' status,
diagnosis, or any other information as appropriate. The Contractor shall report to CDPHE when a TB
patient completes treatment,moves,or transfers out of the Contractor's service area. Information may be
reported via web-based TB case/contact management system(TBdb)or via"Tuberculosis Surveillance
and Case Management Report"(TB 17).
m. The Contractor shall ensure that all contacts to newly identified infectious TB cases are identified,
investigated,and receive appropriate evaluation. Contact investigation and any follow-up needed as a
result of an occupational exposure shall be conducted by the employer.
n. The Contractor shall submit a preliminary Contact Investigation Report. The Contractor shall submit a
final report to CDPHE when a contact investigation is completed.
o. Reports for those persons identified,as part of a contact investigation,with latent TB infection,or those
with suspected latent TB infection requiring treatment recommendations from the CDPHE shall include:
reason for initiating,patient name, date of birth, country of birth, date arrived in U.S.,demographic
information, locating information,provider information, TB risk factors, results of diagnostic testing,
treatment information,or any other information as appropriate. The Contractor report to CDPHE when a
LTBI patient completes treatment, moves,or transfers out of the Contractor's service area. Information
may be reported via web-based TB case/contact management system (TBdb)or via"Tuberculosis
Surveillance and Case Management Report"(TB 17).
III. Monitoring:
CDPHE's monitoring of this contract for compliance with performance requirements will be conducted throughout the
contract period by the Program's TB Manager. Methods used will include review of documentation reflective of
performance to include progress reports and review of documentation reflective of performance to include progress reports,
quality of Tuberculosis Database(TBdb)data,completion of therapy rates, and known HIV status.The Contractor' s
performance will be evaluated at set intervals and communicated to the contractor. A Final Contractor Performance
Evaluation will be conducted at the end of the life of the contract.
IV. Resolution of Non-Compliance:
The Contractor will be notified by email within 14 of discovery of a compliance issue. Within 30 calendar 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 requires an extension to the
time line,the Contractor must email a request to the Assistant TB Program Manager 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 2 of 2
Exhibit B-Statement of Work
V I/MAR2012
Exhibit C
Budget
Weld County Department of Ilealth
Description Funding Source Amount
Tuberculosis Control and State $42,280
Prevention
Tuberculosis Control and Federal $3,750
Prevention
DOT and Diagnostic Blanket Funds As Administered
Contract Total Total $46,030
Page 1 of 1
Exhibit D
GRANT FUNDING CHANGE LETTER
Date: State Fiscal Year: Grant Funding Change Letter# CMS Routing #
TO: Insert Grantee's name
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.
STATE OF COLORADO
John W. Hickenlooper, GOVERNOR
Department of Public Health and Environment PROGRAM APPROVAL:
By: Lisa Ellis, Purchasing & Contracts Unit Director By:
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.
STATE CONTROLLER
David J. McDermott, CPA
By:
Date:
Page 1 of 1
Effective Date: 1/6/09-Rev 8/25/09
6 6 1 2 0 1 1 Memorandum
1TO: Office of Clerk to the Board to the
i Weld County Commissioners
W E L DEC O U N T Y FROM: Administration Division-Department of
Public Health and Environment
DATE: .51)1 Is, a 01 a
SUBJECT: -n5 aorrheact
Attached to this memo is the finalized contract that the Health Department has received.
Please sign and date below indicating you have received the finalized contract and return
this signed memo to the Administration Division of the Health Department.
Please send the confirmation receipt to my attention. Thank you for your assistance with
the processing of this document.
ATTN: Lir
Contract Name: oerCU 1OS15Tetvcnti o►J Corteact
Resolution Number: c9O)a— 15th q
Finalized Contract Received By: Toys± QtSYlt1
Date Received: 30,,� b o�O1'd
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Enclosure IC [3rn rn--i
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STATE OF COLORADO
John W. Hickenlooper,Governor
Christopher E. Urbina, MD, MPH /oc•Col._
Executive Director and Chief Medical Officer FQ �tt .To)
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr.S. Laboratory Services Division '
Denver, Colorado 80246-1530 8100 Lowry Blvd. /
Phone(303)692-2000 Denver,Colorado 80230-6928 Colorado Department
Located in Glendale, Colorado (303)692-3090 of Public Health
http://www.cdphe.state.co.us and Environment
7/03/12
Weld County Department of Public Health and Environment
1555 North 17`h Avenue
Greeley CO 80631
Hi Judy,
Enclosed is your copy of the fully executed Colorado Department of Public Health and
Environment Interagency Agreement listed below. You may begin work on 7/1/12.
Contractor Name: Weld County Dept of Public Health and Environment
Contract Number: 13 FHA 44718
Original Contract Number: 13 FHA 44718
Division: DCEED
Program Name: TB
Project Name: Tuberculosis Prevention
Reason for Contract: New Contract
Please contact me with questions or concerns. My contact information is listed below.
Sincerely,
CiaeaCIAD
Contracts Administrator
DCEED-A3
4300 Cherry Creek Drive South
Denver, CO 80246
303-692-2702 office
303-782-0904 fax
Hello