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Home My WebLink About20101094 RESOLUTION RE: APPROVE AMENDMENT#3 TO TASK ORDER CONTRACT FOR COLORADO FAMILY PLANNING INITIATIVE 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 Amendment#3 to the Task Order Contract for the Colorado Family Planning Initiative 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, 2010, and ending June 30, 2011, with further terms and conditions being as stated in said amendment, and WHEREAS,after review, the Board deems it advisable to approve said amendment, 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 Amendment#3 to the Task Order Contract for the Colorado Family Planning Initiative 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 amendment. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 24th day of May, A.D., 2010. BOARD OF COUNTY COMMISSIONERS .,I4 ELaNWELD COUNTY COLORADO ATTEST: las "ademac'T'r, C air Weld County Clerk to the B'`• • - arbara Kirkmeyer, ' ro-Tem Dep Clerk . the Board ) Sean P. Co�wr APP�D AS TO FO (-(4 / William F. Garcia ounty A o ey EXCUSED HID David E. Long Date of signature: (0'11/ID yu.t>ki() once Au/J. -Lo ja4 LC lA 2010-1094 S•a4-1 ° pc'l IL) HL0037 Memorandum TO: Douglas Rademacher, Chair Board of County Commissioners I C FROM: Mark E. Wallace, MD, MPH, Director Department of Public Health and Environment COLORADO DATE: May 12, 2010 SUBJECT: Amendment for Task Orders #3 Colorado Family Planning Initiative Contract Enclosed for Board review and approval is Amendment#3 to a previously approved task order contract between the Colorado Department of Public Health and Environment and the Board of County Commissioners of Weld County on behalf of the Department of Public Health and Environment (WCDPHE) for funds to continue the Colorado Family Planning Initiative program. Under the provisions of the contract, WCDPHE will provide comprehensive family planning services with an emphasis on increasing the total number of men and women accessing services and increasing utilization of long acting reversible methods of contraception (LARC) among existing clients. For providing these services during the time period of July 1, 2010 through June 30, 2011 WCDPHE will be reimbursed an amount not to exceed $209,705. The funding is provided entirely by a private anonymous donor through the State of Colorado. I recommend your approval of this amendment. Enclosure 2010-1094 STATE OF COLORADO Bill Ritter,Jr.,Governor ofcow James B.Marlin,Executive Director Dedicated to protecting and improving the health and environment of the people of Colorado a">✓QRRrg h . R4300 Cherry Creek Dr.S. Laboratory Services DivisionJ» Denver,Colorado 80246-1530 8100 Lowry Blvd. •le76• Phone(303)692-2000 Denver,Colorado 80230-6928 TDD Line(303)691-7700 (303)692-3090 Colorado Department Located in Glendale.Colorado of Public Health http://www.cdphe.state.co.us and Environment WORK STATUS CONFIRMATION LETTER Vendor Name: Contract Routing Number: CRS §24-30-202 requires the State Controller to approve all State Contracts. The above referenced Amendment is not valid until it is signed and dated below by the State Controller or delegate.Therefore,your agency is not authorized to begin performance until you are notified that it's signed. If your agency begins performing Contract tasks prior to that date,the State of Colorado is not obligated to pay your agency for such performance or for any goods and/or services provided prior to the date signed. By signing below,your confirm that(Signature MUST be that of the person signing the Contract) a) No work has been performed under this contract b) No work will begin tinder this contract until the contract is signed by the State Controller or on the effective date,whichever is later. a as Arm ignature of A th -orized Officer Douglas Rademacher Print Name of Authorized Officer Chair Print Title of Authorized Officer MAY 242010 Date Signed RETURN THIS LETTER TO: jNatalie EI-Deiry,Contracts Manager Colorado Department of Public Health& Environment Center for Healthy Families and Communities 4300 Cherry Creek Dr So PSD-CHFC-A4 Denver CO 80246-1530 DEPARTMENT OR AGENCY NAME COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT PSD-CFPI DEPARTMENT OR AGENCY NUMBER FLA CONTRACT ROUTING NUMBER 11-15919 AMENDMENT FOR TASK ORDERS#3 This Amendment is made this 1st day of March,2010,by and between the State of Colorado,acting by and through the DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT,whose address or principal place of business is 4300 Cherry Creek Drive South,Denver,Colorado 80246,hereinafter referred to as the"State";and, BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY,for the use and benefit of the WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT,(a political subdivision of the state of Colorado),whose address or principal place of business is 1555 North 17`s Avenue,Greeley,Colorado 80631,hereinafter referred to as the"Contractor". FACTUAL RECITALS The parties entered into a Master Contract,dated January 23,2007,with contract routing number 08 FAA 0052. Pursuant to the terms and conditions of the Master Contract,the parties entered into a Task Order Contract,dated August 15,2008,with contract encumbrance number PO FLA FPP0900684, and contract routing number 09-FLA- 00684,amended by Contract Amendment#,contract routing number 09-FLA-00869,Grant Funding Letter#1, contract routing number 09-FLA-00930,Contract Amendment#2, contract routing number 10-FLA-00247, and Grant Funding Letter#2,contract routing number 10 FLA 11214 collectively referred to herein as the"Original Task Order Contract,whereby the Contractor was to provide to the State the following: Contractor will provide a comprehensive family planning program with an emphasis on increasing the total number of men and women accessing services and increasing utilization of long acting reversible methods of contraception(LARC)among existing clients. The State promises to pay the Contractor the sum of Two Hundred Nine Thousand Seven Hundred Five Dollars, ($209,705.00) in exchange for the promise of the Contractor to continue to perform the work identified in the Original Task Order Contract for the renewal term of 12 months,ending on June 30,2011. NOW THEREFORE, in consideration of their mutual promises to each other, stated below,the parties hereto agree as follows: 1. Consideration for this Amendment to the Original Task Order Contract consists of the payments and services that shall be made pursuant to this Amendment,and promises and agreements herein set forth. 2. It is expressly agreed to by the parties that this Amendment is supplemental to the Original Task Order Contract,contract routing number 09-FLA-00684,as amended by Contract Amendment#1, contract routing number 09-FLA-00869, Grant Funding Letter#1, contract routing number 09-FLA-00930, Contract Amendment#2,contract routing number 10-FLA-00247,and Grant Funding Letter#2,contract routing number 10-FLA-11214 collectively referred to herein as the Original Contract,which is by this reference incorporated herein. All terms, conditions, and provisions thereof,unless specifically modified herein, are to apply to this Amendment as though they were expressly rewritten, incorporated,and included herein. 3. It is expressly agreed to by the parties that the Original Task Order Contract is and shall be modified, altered,and changed in the following respects only: Page 1 of 3 Rev 3/16/2010 A. This Amendment is issued pursuant to paragraph 5 of the Original Task Order Contract identified by contract routing number 09-FLA-00684. This Amendment is for the renewal term of July 1, 2010,through and including June 30,2011. The maximum amount payable by the State for the work to be performed by the Contractor during this renewal term is Two Hundred Nine Thousand Seven Hundred Five Dollars,($209,705.00Ifor an amended total financial obligation of the State of SIX HUNDRED FORTY-NINE THOUSAND THREE HUNDRED FORTY DOLLARS,($649,340.00). This is an increase of Two Hundred Nine Thousand Seven Hundred Five Dollars,($209,705.00)of the amount payable from the previous term. The revised Additional Provisions and Statement of Work is incorporated herein by this reference and identified as"Exhibit J"and"Exhibit K". The Original Task Order Contract is modified accordingly. All other terms and conditions of the Original Task Order Contract are reaffirmed. 4. The effective date of this Amendment is July 1,2010,or upon approval of the State Controller,or an authorized delegate thereof,whichever is later. 5. Except for the Special Provisions and other terms and conditions of the Master Contract and the General Provisions of the Original Task Order Contract, in the event of any conflict, inconsistency,variance, or contradiction between the terms and provisions of this Amendment and any of the terms and provisions of the Original Task Order Contract,the terms and provisions of this Amendment shall in all respects supersede,govern,and control. The Special Provisions and other terms and conditions of the Master Contract shall always control over other provisions of the Original Task Order Contract or any subsequent amendments thereto. The representations in the Special Provisions to the Master Contract concerning the absence of personal interest of state of Colorado employees and the certifications in the Special Provisions relating to illegal aliens are presently reaffirmed. 6. FINANCIAL OBLIGATIONS OF THE STATE PAYABLE AFTER THE CURRENT FISCAL YEAR ARE CONTINGENT UPON FUNDS FOR THAT PURPOSE BEING APPROPRIATED, BUDGETED, AND OTHERWISE MADE AVAILABLE. Page 2 of 3 Rev 3/16/2010 IN WITNESS WHEREOF,the parties hereto have executed this Amendment on the day first above written. *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: BOARD OF COUNTY COMMISSIONERS OF WELD STATE OF COLORADO COUNTY for the use and benefit of the Bill Ritter,Jr.Governor WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT (a political subdivision of the State of Colorado) /T /�f M ma By: Signature Authorized Officer For the Executive Director MAY 2 4 2010 DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT Douglas Rademacher Print Name of Authorized Officer Chair Print Title of Authorized Officer PROGRAM APPROVAL: By: - 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 avid J.McDermott, By: WELD COUNTY D PANTMtN1 @r PUBLIC HEALiN AND ENVIRONMENT Date: ft) Date: BY: Mark E. Wallace, MD, MPH-Director Page 3 of 3 Rev 3/16/2010 EXIIIBIT.1 ADDITIONAL PROVISIONS To Contract Dated 03/01/2010-Contract Routing Number 11 FLA 15919 These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above. The revised Additional Provisions are effective July 1,2010. I. 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. To receive compensation under this Task Order Contract,the Contractor shall submit a signed Monthly Colorado Family Planning Initiative(CFPI)Cost Reimbursement Statement in a format acceptable to the State. A CFPI Cost Reimbursement Statement is incorporated and made part hereof by reference.This document is located at: him: Wll W.00SMC.StilIC.00MS pp nomcnNll 'vuraine( ow,insForrirdifmrcol2 tulen.ACost Reimbursement Statement must be submitted within sixty(60)calendar days of the end of the billing period for which services were rendered.CFPI Cost Reimbursement Statements must be accompanied by detailed cost ledger to reflect all purchases being invoiced under that contract and should include date of payment,payee name and amount,and check or voucher number,when available.Expenditures shall be in accordance with the Statement of Work attached hereto as Exhibit K and in accordance with allocable expenses outlined in Cost Reimbursement Guidelines attached hereto as Attachment J-1. These items may include,but are not limited to,the Contractor's salaries,fringe benefits,supplies,travel,operating, administrative costs which arc allowable,and other allocable expenses related to its performance under this Task Order Contract. CFPI Cost Reimbursement Statements shall: I)reference this Task Order Contract by its contract routing number,which is located on page one of this Task Order Contract;2)state the applicable performance dates;3)state the names of payees;4)include a brief description of the services performed during the relevant performance dates;and,5)show the total requested payment. Payment during the initial,and any renewal or extension,term of this Task Order Contract shall be conditioned upon affirmation by the State that all services were rendered by the Contractor in accordance with the terns of this Task Order Contract. CFPI Cost Reimbursement Statements shall be sent to: Fiscal Officer Family Planning Program Prevention Services Division Colorado Department of Public Health and Environment PSD-A4 4300 Cherry Creek Drive South Denver,CO 80246 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 no event no later than sixty(60)calendar days from the effective expiration or termination date of this Task Order Contract. 4. The Contractor is authorized to make limited transfers of funds from one line item in its Budget to another line item in its Budget but must notify the Program Director by email prior to the transfer. A transfer from one line item to another line item may not exceed ten percent(10%)or One Thousand Dollars($1000), which ever amount is more,of the total amount of the line item from which the transfer is nude unless prior written approval is received from the Program Director. If the Contractor desires to transfer more than ten percent(10%)or One Thousand Dollars($1000),which ever amount is more,from one line item in its budget to another line item in its budget then the Contractor shall request and receive prior written approval from the Program Director by completing and submitting a Budget Revision Request Form, To be attached to CDPFIE Page I of 3 Revised:4/1/04 Version 1.0(4/04)contract template EXHIBIT.1 incorporated and made part hereof by reference.This document is located at: Imp \V%v .cdpl:esiate.ca us 1p 1%0111C11, I PA'ur ine( on<ntsform..html?cult-open. 5. The services or activities under this Contract may be carried out by the Contractor,or through subcontracts with other providers or,through collaborative partnerships with other community partners. The State authorizes the Contractor to subcontract some,or all,or the services that are to be performed under this Contract. However,a subcontractor is subject to all of the terms and conditions of this Contract. Additionally,the contractor remains ultimately responsible for the timely and satisfactory completion of all work performed by any subcontractor(s)under this Contract. If the Contractor desires to subcontract some, or all,of the services that are to be performed under this Contract,the Contractor shall obtain the prior, express,written consent of the State before entering into any subcontract.The Contractor shall maintain,at a minimum a Memorandum of Understanding or other binding contractual agreement,and provide a copy to the Family Planning Program Director fifteen(15)calendar days from the date the agreement is executed.The Contractor shall maintain records of any subcontractors for a minimum of three years. 6. Contractor agrees to provide services to all Program participants and employees in a smoke-free environment in accordance with Public Law 103-227,also known as"the Pro-Children Act of 1994",(Act). Public Law 103-227 requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health,day care, early childhood development services,education or library services to children under the age of 18,if the services are funded by Federal programs either directly or through State or local governments,by Federal grant,contract, loan,or loan guarantee. The law also applies to children's services that are provided in indoor facilities that are constructed,operated,or maintained with such Federal funds. The law does not apply to children's services provided in private residences;portions of facilities used for inpatient drug or alcohol treatment;service providers whose sole source of applicable Federal funds is Medicare or Medicaid;or facilities where Women Infant and Children(WIC)coupons are redeemed. Failure to comply with the provision of Public Law 103-227 may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. By signing this Contract,the Contractor certifies that the Contractor will comply with the requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act. The Contractor agrees that it will require that the language of the Act be included in any subcontracts which contain provisions for children's services and that all contractors shall sign and agree accordingly. 7. Contractor shall ensure that the provisions of Section 601 of Title VI of the Civil Rights Act of 1964 are carried out. That Act states that"no person in the United States shall on the ground of race,color,or national origin,be excluded from participation in,be denied the benefits of,or be subjected to discrimination under any program or activity receiving Federal financial assistance." The Office of Civil Rights has concluded that it is the responsibility of any program which is a recipient of funds from the Department of Health and Human Services to ensure that clients who do not speak or understand English well,be provided interpretation services to ensure that the service provider and the client can communicate effectively. The Contractor shall have policies and procedures to ensure that interpretation services are available for clients with Limited English Proficiency and will advise such clients that an interpreter will be provided for them. If a client has their own interpreter,they shall be advised that the Contractor will provide an interpreter if the client so chooses. 8. The State may require forms attached to this contract and incorporated herein by reference by updated during the term of this contract.The Contractor will be informed of the new forms as they are developed. Forms may be sent to contractors or will be available on the Family Planning Administrative Manual website: hupl www.cdphc,a,uc co u_ womcns hunl_ 9. Notwithstanding anything herein to the contrary,the parties understand and agree that all terms and conditions of this Task Order Contract and the exhibits and attachments hereto which may require continued performance,compliance or effect beyond the termination date of this Task Order Contract shall survive such termination date and shall be enforceable by the State as provided herein in the event of such failure to perform or comply by the Contractor. To be attached to CDPHE Page 2 of 3 Revised:4/1/04 Version 1.0(4/04)contract template • END BIT Funding adjustments may be made during the term of this contract.The State makes funding adjustments on this contract using a Funding Letter substantially equivalent to Exhibit D of Original Contract and bearing the approval of the State Controller or his designee; the funding letter shall not be deemed valid until the State Controller or his designee has approved it. To be attached to CDPHE Page 3 of 3 Revised:4/1/04 Version 1.0(4/04)contract template • N ° E 41 E a el) cn o czt w o p oPq e . ,`oe 'b ° c, y Q C O ≥ J j ea 04 04 04 N b s RI N N E E E 7 U N 0.'D a' P.w L U IE U Y N p I.) 4. C \ L L L N in t 'P+ o U U U U U 4 N V3 U d O C d d 't d u P -p eC O cd W U 44 44 u U U 04 ea U� U N 0 0 04 O C O..= .a) .0 w of C y O p N ,fl w 'O w -0 M L w .. 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E 7 o Y O •N c� u en w - z H e To x • 1.4 E \\ to i i t \ e j . O § 2 \ �\ Cd - to; - q \ \ } )3 / ({ $ z a © ct L.1O k\ « ( .0 /\ § ) CY GO O CI [ ] ) •E. 0 C. C. I. P. & I. 2 � & I. \ { � "Cl \ \ O.© \ & ; § \ / j2ai 23 ! 7 \ 7 ? \ « e { • S � � ! % � { 3 § { ° 4 \ � « f „ # 2f � # � � 32a _ � j ) O o ...\ \ / '2 Z t 7 . "O VCIJ 44 / •�\ .! .§ ) tn o. \ 0 / ( N Cl ,' ! \ 2 eJ 4 i � ( � fj { { .0 .0 • \ ] \ 2 ) \ ; ? .O .O § og § g § / 2 O (7 (\ 2 ») jf ) ) k } ) \ \ O-O3 \ \ \ \ \ f cd E * o » » ) -J % a c.to % ) « 'm /GI CO ) S.O 00 ' \ \\ \ { ) q ,2 ( E } \ \ \ E ) \\ - {- in / \ % y - § § } < c. \ / 4 ) \ �� \ \ \ «el ) ; vp T | ) � ( O jEt e \ 22a % - ) 4.4 [ c \ / / u , \ ) ±' §n ® _ \ ; { / Hi %/ g . ! 2 \ / / d \ § 7.) j \ . , a u = \ EXHIBIT K STATEMENT OF WORK To Contract Dated 03/01/2010-Contract Routing Number 11 FLA 15919 1) The Contractor, in accordance with the terms and conditions of this contract,shall perform and complete, in a timely and satisfactory manner,all activities described in this approved Statement of Work and incorporated in accordance with the associated COLORADO FAMILY PLANNING INIATIVE BUDGET and COLORADO FAMILY PLANNING INIATIVE BUDGET NARRATIVE,which is attached hereto as Attachment K-1 and Attachment K-2. 2) The Contractor shall continue to conduct a comprehensive family planning program("the program"). This program shall comply with section 1001 of the federal Act and all applicable federal regulations,as amended, contained in Title X,42 C.F.R., Subpart A,Part 59, as well as all applicable state regulations.(Federal funding from HHS,CFDA#93.217 FP Services). The program shall offer the following under the Title X family planning program: A. Outreach services and/or other program efforts designed to improve client recruitment. B. Nursing and medical services, which shall include a comprehensive health and social history and physical examination administered in accordance with all applicable Title X regulations and,all applicable nursing-medical policies or procedures which have been,or may be,established by the State's Women's Health Unit(WHU). C. Contraceptive information, education,and supplies regarding all family planning methods. D. Education and counseling services regarding family planning,family planning methods,child spacing, infertility,sterilization, nutrition, sexually transmitted diseases,Human immunodeficiency virus(HIV)/Acquired immunodeficieny syndrome(AIDS), adolescent counseling and other related health issues, as outlined in the Nursing and Administrative Manual. E. Follow-up and/or referral services, as appropriate. 3) All money received by the Contractor from the State under the Colorado Family Planning Initiative(CFPI)shall be used by the Contractor to provide contraceptive services.The Contractor shall make its program available to men and women in their reproductive years and shall offer the following services under the CFPI: A. Utilize CFPI funding to purchase long acting reversible methods of contraception and contraceptive rings. These are limited to Intrauterine Devices (IUD)Mirena and Paraguard, contraceptive implants and contraceptive rings. B. Utilize CFPI funding to provide the referral process and cover the actual costs of tubal ligation and vasectomy procedures. C. Utilize CFPI funding for Family Planning staff to attend reproductive health related training with preference to those related to long acting reversible methods of contraception. D. Provide comprehensive family planning services to sustain the total number of family planning clients receiving services (fertile clients receiving contraceptive services) in FY10; and expand family planning services to "71" unduplicated qualified clients over the number of unduplicated qualified clients served in FY10. Pre-approved activities to include 1) Expanding capacity; 2) Outreach; 3) Media and Marketing; 4) Training and Education; 5) Information Technology and Data Management; and 6) Other approved activities. Services are in accordance with the Work Plan attached hereto as Attachment K-3. To be attached to CDPHE Page 1 of 3 Revised:4/1/04 Version 1.0(4/04)contract template EXHIBIT K 4) The services provided by the Contractor to the clients it serves shall be performed pursuant to law in accordance with prevailing medical standard of care for the same or similar medical,nursing and professional services. The services provided shall also comply with applicable Title X regulations, WHU nursing-medical policies and procedures, and any applicable fiscal or administrative policies of the State or Federal government which can be located at http://www.cdnhe.state.co.us/pp/womens/famplan.html?col2=open. Contractor acknowledges that it has reviewed these policies and procedures. 5) The Contractor shall provide the State's family planning program consultants and administrators with reasonable access to its operations to perform: periodic site reviews,data reviews, fiscal reviews or other evaluations of the Contractor's family planning program. Evaluations of the Contractor's program shall be based on established standards and policies of the State or the Federal government. The Contractor shall cooperate during all periodic site visits,data reviews, fiscal reviews or other evaluations conducted by the State. The established standards and policies for the Family Planning Program can be located in the Family Planning Administrative Manual and the Family Planning Nursing Manual located on the Family Planning website at httn://www.cdphe.state.co.us/pp/womens/famplan.html. 6) If necessary,the Contractor shall comply with all recommendations,including development and implementation of a Performance Improvement Plan,made by the State's family planning program consultants and/or administrators after a periodic site visit,data review, fiscal review or other evaluations that are necessary to bring its program into compliance with all program requirements and applicable federal and state laws,policies and regulations. The Contractor shall be in full compliance with a recommendation, if any,within three(3) months of the date a recommendation is made by the State. If the Contractor cannot obtain full compliance within this three(3)month period,then on or before the expiration date of that three(3)month period the Contractor shall present sufficient written evidence to the State: to show that continuing progress is being made towards full compliance;and,the date when full compliance shall occur. In no event,however, shall full compliance with a recommendation occur any later than six(6)months after the date that a recommendation was initially made by the State. Notwithstanding the foregoing provisions,the State may disregard these cure periods and immediately terminate the contract without liability if it has solely determined that Contractor's noncompliance places the health,safety or welfare of persons receiving services in jeopardy. 7) On a monthly basis,the Contractor shall collect and provide to the State,by the fifteenth calendar day of the following month unless otherwise specified by CDPHE, all pertinent data as defined by CDPHE regarding all services offered,and all family planning clients served,by its program during the preceding month,submitted through the IRIS data system. This data shall be verified on a quarterly basis to help assure accuracy. The Contractor must adhere to the Data Security, Use and Confidentiality Agreement, incorporated and made part hereof by reference. This document is located at: http://www.cdphe.state.co.us/pp/womens/FPNursingConsntsForms.html?colt=open. Contractor also agrees to respond to other data requests required by the program. 8) During the term of this Contract,the Contractor agrees to provide the State with the semi-annual Family Planning Expenditure/Revenue Reports.The Expenditure/Revenue Report(ERR) is located on pages 19-21 in the Financial Management Section of the Family Planning Administrative Manual,this information can also be accessed online on the CDPHE Family Planning website at http://www.cdphe.state.co.us/pp/womens/famplan.html.The first report is for the months of October through December will be due in February.January through June and will be due in August. Final due dates will be specified by CDPHE. 9) The Contractor shall protect the confidentiality of all client records and other materials that are obtained, created, or maintained by the Contractor under this contract. Except for purposes directly related to the administration of this contract, no information about,or obtained from, any client shall be disclosed by the Contractor in any form that would identify that client without the prior written consent of that client. As of the acceptance date of this contract by the Contractor,the Contractor shall have written policies goveming the access to and,the duplication and dissemination of, all such information. The Contractor shall advise its To be attached to CDPHE Page 2 of 3 Revised:4/1/04 Version 1.0(4/04)contract template EXHIBIT K directors,officers, employees, agents, servants,and subcontractors, if any,that they are subject to these confidentiality requirements. 10) Maintenance of Effort(MOE) Colorado Family Planning Initiative funding is expected to provide new funding for providing services to additional family planning clients and increasing the total number of clients utilizing efficacious methods of contraception. This is a temporary funding source, and therefore shall not be used to supplant other traditional funding sources.Therefore,the contractor shall show Maintenance of Effort(MOE)for revenue provided by local government as documented on the required family planning program Expenditure Revenue Reports (ERR),for the three years previous to any year in which funding from the Colorado Family Planning Initiative is received. This revenue, provided by local government(county and city grants and contracts)shall be equal to, or in excess of, 90%of the average of the last 3 year's Expenditure Revenue Reports. Definition: Maintenance of Effort(MOE)—A measure intended to preserve funding for the base program. This ensures that fiscal resources are not supplanted and that new funding creates an expansion in the program. MOE shall be determined by averaging the revenue provided by local government in the last 3 years' Expenditure/Revenue Reports(ERR)for the entity's family planning program, and then multiplying by ninety percent(90%).The result is the minimum amount that the entity must spend in order to illustrate MOE. In an instance where there is not three years' data,MOE shall be 90%of previous two years' local government revenues from the ERR,or 95%of the last year's results,as applicable. In the case of an anomaly where local government revenue level from the previous three years' ERR varies more than 30%in any two of the three years,an explanation of the variance must be provided by the Contractor. The Family Planning Director shall use this information to decide if the anomaly should be eliminated from the calculation of the MOE level. In any year in which the Contractor will not attain MOE,according to the formula described in the definition the Contractor shall notify the Family Planning Director. Should MOE not be obtained, in special hardship cases, a Maintenance of Effort Waiver to this clause may be requested from the CDPHE Family Planning Director, in conjunction with the Women's Health Director, attached hereto as Attachment B-2 of Original Contract. Should a Maintenance of Effort Waiver not be granted,the Colorado Family Planning Initiative funding may be reduced. 11. The services provided by the Contractor must be deemed acceptable, in good faith,by WH. For a service to be "acceptable"it must comply with all applicable:Title X regulations,WH nursing-medical policies and procedures,and any applicable fiscal and administrative policies and procedures of the State and Federal government. All applicable Title X regulations, WH nursing-medical policies and procedures, and all applicable fiscal or administrative policies of the State have been provided to the Contractor by the State as of the effective date of this Contract. 12. During the term of this Contract,the Contractor agrees to provide the State with quarterly reports to the Family Planning Program Coordinator. 13. The Contractor shall require any new staff working on Family Planning program services to participate in Fiscal Orientation within forty-five(45)days of employment. To be attached to CDPHE Page 3 of 3 Revised:4/1/04 Version 1.0(4/04)contract template ' COLORADO FAMILY PLANNING INIATIVE BUDGET Attachment K-1 APPLICANT: Weld County Department of Public Health and Environment FOR THE BUDGET PERIOD: CFPI July 1,2010-June 30,2011 TOTALS Salary %Time CDPHE-WIIU CDPIIE-WHU CDPHE-W11U.NONiaile{f�+'`" SEE ABOVE 'x` g phnmn.. JUNE 30,2010 JUNE 30,2010 FOR BUDGET JULY 1,2010-,Prb8tm4Pa)6d . _JUNE 30, PLEASE ROUND ALL FIGURES JUNE 29,2011 PERIODS BY JUNE 30,2011 fJJ{L'Y 1 #Old. 2011 F'I E (RANT J$N64 2014. --— — TO THE NEAREST DOLLAR —__ .____ -- -- s FEDERAL FEDERAL& - - CDPIIF.PLUS TITLE X STATE TITLE X CFPI :=NDNtDP.LJE`'; NON-CDPHE EXPANSION &CIII.AMY DIA R t : PERSONNEL EXPENSES:(Include name w e { &titI f i ) 6 1 COIIIE 41 yE huffing You do not 'd list l a t and idle IF ';! ?i $0 for employee'charged only to Non-(DPI IP hndingl n$23,Q72 $23,8$0 77 Office Technician II $23,877 87.00% $50,964 Office Technician III $50,964 150 00% ,tic L 5 4 $70,442 Rac4a medical Assistant $70,442 200 00% 60 S,-S! 443 $27,443 - Medical Assistant Supervisor $27,443 70.00 it A i4 44 $21,544 __ — Office Manager $21,544 40.00% P$, $47,529 KIN II $47,529 90.00 6 64',$378, $87,752 Debbie Drew,Nurse Practitioner $87,752 100006 $71.025 . 1 '4,sy 7 $87,151 Annette O'Dell,Nurse Practitioner $66,191 80.00% $47.350 I (I 1 $64 196 $84,786 100.00% $33,043 4'x 3 Dunn,Nurse Practitioner vior $74,890 Nurse Practitioner Nurse Supervisor $74,890 25.00% ?fg, $16,386 $16386 35.00% Public Health Nurse Supervisor kk1 Y 'te4 0, $9,450 Public Health Nurse Director $9,450 10.00% S r xs,7; $0 San^ biltSR t Rate and Expenses 35 54 z;' niabistlix'LI,i'K 1 c"f` Sfl$E1$54 a s` `- $0 $160.445 , -144,786,11,31 t N ttr' $787,831 CONTRACTUAL (Independent contractor t tuba!ligation,Ess l y Pe,r.5`x ' nl:y Oldies' my ePreclit'oun,,.m.In CFPI portion 081A)add referral fee m this sethnn. $0 lap. Womens Clinic �7'�' `.y ' ore Greeley 'It 00,000 F'2+ !}'y1 ', $100,000 $25,000 t«..V i $25,000 _ WCDPHE '. 1a4*+e -' PF igTh WCDPHE 15,000,4P,, 4in-x- $5,000 Referral Fees PP�'f' $0 T E47'91tft$okl'31ii'""(4« ua + 'v'. 5 °' uti ,1 Stye' $0 $0 $130,000 '9° 0. $130.00$0 0 OPERATING: COlitraceplive Methods(Ior le PI portion ONLI,III%Aminlee east he r 59,443 included in this line.) I I g{ ��p��? $$8,5004 $ tJeO $$2,500 Training 1 on t the t r : 1 I JAW) Other ya (Ir' tl t _ @ t Ln Pk 4emreme6ne eyaE e n mom Mt.ean.aa.rl zsu E.imm.a raaelnp $6.090 471 ..'001 $9,090 .+a.nn rc clue a 1 s *11+ $31,000 Educational r n1 w $2,500 Pdn I materials(brochures.del ,, r :0 $32,480 Clinical supplies x at .x $4,000 Office operating mrrre'Narex dean. Plus.ma) - e;ufgRaq $0 Office p (rent.utilities,maintenance) $452 tml a $5,4$0 on,Electronic is f) reco ;,4?'" iiir i tl)j $75,000 EIM medicalrecords .o�P'le $10,000 No Colorado Alliance :,43A $Membership $0 $6.090 $30,3014,01,40M,:0 $231465 �'P2hi1. YGfCn��ttYklld#fie^r ' r Lx 3 !as a t 'r t ......31t‘ $2,000 EQUIPMENT:(Computers Office furnitures) ix. $0 a`st x,ar s $0 $0 $0t 0. $2,000 'A'dtaLE9>d� 01 - §,.2 qua: : ,t - moptry.' E s av p v wt y7n —*lb' $0 $166,535 5205,181 i .- - $1,151,296 :1-.:r aw y3 firfk"4 J'v',-TS a G, �ra ire �'�s}`1 `t EaiT t f V * TI ,k, )Vil n5,: so $20,(,67 I i iR: : $92.968 $ddfd�Y�e�I 4u fR �1a1Y left ;.��,}:�p7 I — k left °nF' y, S4fA!`t�1'`f' 4 .nr d ,+ 3 » f A+ tt':. $4,524 '�r 5Fieir,e:iii, $4.524 T ilk 4ou 't4 «. � '4��rk1 K f e 'T K .a i . `�, DttE-3`OfiN6TICRY3': %priYlehL#?1`iY1 d''t t+—}ctt v I, t,�4p '?: as Nxl.u,°I,-`a;ss' r `h y- 6 r .f:U, §-*" t n 88'1'> $1,248,788 7'CJJ'v>$x pRfeS;ii its.- �`D,. t.4 L:-+4 �,.°:j ' . r 'Yn,'834202 $209.705 ., z Page 1 of 1 COLORADO FAMILY PLANNING INIATIVE BUDGET NARRATIVE Attachment K-2 tinTIMIgitgBUDGET A11l%4 'JV B-n, ....'tP3'7,f Cmtf!.xteg;sroiinl, tYith. lansiokF'0rant#appUcable, r . APPLICANT: Weld County Department of Public Health and Environment FOR THE PERIOD: July 1,2010-June 30,2011 For Personnel category list title of position How is the total amount required Total Relationship to project calculated? For all other categories list the line item from the budget ,.,�Ly pit yip yy �F�v��y r r a t' s ri fn 4So i,N1Yb�11�P�irW �FtRa:T ..21:x:`;•'@ 1 e�:::#'a �`'. r..r .`.' ...,< is_.r F ., e.:. ..N� Trs' r ,5 x.. .. .3'.= V �.:.F Laurie Dunn Nurse Practitioner 1.0 NP provides direct care and outreach Annual Salary of$84,786.00.4 FTC CFPI $33,043.00 at 2 sites.4 FTE in CFPI grant Fringe Benefit Rate 35.54% .08%Workmans comp, 11.9%PERA .39%life ins,4.61%vacation, $11,743.00 4.23 Holiday 2.3%sick, 10.49 Health ins 1.45%medicare 09 Unemployment CORTMOtaltaf { �' erta Pty 4 , t s in - :+a# i e Smm :`g a rg 'fi,a;,a'dr''. .e,�9€ ` t3i,#;$0 a Womens clinic of Greeley O6/ lEssure insertions for our clients 150 insertions at$2000 00/insertion 1 $100,000.00 GYN physicians NCMC Radiology HSG's pose Ensure test 50 procedures at$500.00 each $25,000.00 10000 per referral x 50 $5,000.00 WCDPHEyr+eyferral fee v r o c a 2 yLga , Iki y: t d :le` _ � .`r�C'.�'- es.$` L2;; :r`. _�'sa, z s iI �.,,�"" ;`l. u' r , .b ., a,-� :�o...x r.:� ,.: Mileage NP travels 102 locations to provide FP services Est raie 1.004 miles ts245/mile $452.00 and local travel for CFPI outreach activities Nuvanngs$15.75 each;Mirena$373;Paragard LARC,Tubal ligation and Vasectomy Purchase of various LARC methods 195.25;Implanon$285 $28.443.00 Training NP and RN registration to relevant iraniings $300.00 for 4NP's and I RN total$1500.00 $1,500.00 F 1,SP-WOMMO !> „₹ =/ I ../.. 2 AI :iO a ang ° r l rMet ` i,"� ?"' '.t a t * + /s ' CFPI Calculated et l0p $4,524.,0(00 {�}�,/��'.y.,./x�{�'y� lµyry� �i.. S -` ' t'C{ '°Far t°r sc ' ' eta g. 71. 'a, n,T+o-..'n ¢s y ha a#"h`r4 ,l�x`$T". ',.e.' a6. hF a`r } -.�.�t 421. �W'i�o."RAhillt5 J��W.i t !' t....# - �t u. "N .N .� l�, :�"f', .. L,, r. Y =.-a r st` ty S tea K,;s�t k l xo- j t:r o r t a0 h is_ Tepiefir�yoiPS,.ii., r. ors �Ir,a.a c, ....f{ ',a'.„ d . ,i.- :,:6. �-.,,.,i ._ .ac.. ;s�_ �s>0. s5u, c�..dn ., a:o-. Page 1 of 1 O g Y •om, U st w 7 U 0 R i. w'" V U C51 C +tC t N 0> •.---- cd w 0 O n' 0 R y V O 2 U °, Q -2 o 0 o a O CU C)) u 'CS C - `" o pep o U' ,y' b U 0 V V] o• W .. .C '" a+ a, b0 L. w a) 0 •C' 0 e l o o ti •w w p ... O a 0 0 co O 0 b o 00 e. O U • .N, '� a-. o a, 4 .- a a .-a • k. W +- 0 a y m 0 a) a) H o z a - c '" c ^ t T.Y y Ty O T� O �ti CD � H d• •I y R i., CJ .p-, p0 0—,-, CO N G U 0 �_ A N M N M N M M C777 N C 0 DI) ° `� v, G p d , ro 0 . � Tb❑ h N y G 'C N O y _ C cC ° <e) O N w p t. rn h m Cl., .4 y O o l ~O i, a) U 4, ,n 0 U 0 O I. o a al o c • a) 3 -o 3 0 >; o '� o a - „, 0 o N 'o w, 0 0 rn o a) 0 t W c TO o N a o m o E fns O o ^ C - u o 0 0 C V o a 6) >, 0 0 y ea qU o oon ° ,.O 0 a) -0xHw t 4 xQo z 0 •-. aial ao O p Pt N 0 ^o .. ' ova o p. g N �°) ti Q N F N 0 �, -0 O 0 a) � LL -p a, ., oN � x o 5 to 0 9 0 " g e t a ° g bbc a 6 n c .a '' 3 o U b 0 0 c -0 0 0 'p 0 C CA i. O •N 0., 0 .� a) Q ° 0 o w a. CS •C c ! . W a 0 g c o c ° ti N o v I 'N o ' aCi •0 p 0 E 0 .� Y . ≥ 0 2 U -to°' o C Z b w ° W C a> v,ci m k b ° y Ca huh ! CZa, C° 0 w 'c ° c. C - p -0 h 0 0 a) O a) tO V +-' CC w U .. I I aunf-0I0Z XInf o © O W O ." £aea�{ \ / \ \ O \ u \ \ \ / / A \ \ — ~ § / % 6 a / \ cg m en \ o / e \ u / { 4 ] -C —C } ` .e % « / ( \ ° a t z u .+ g § ( ) / 3 \ = ee - } § vi ) ) § a / Ct 2 .A O e / ) 7t -a2 % { ( /\ . ) 2 L2 2 = ® 7 :( 45 ) \ &J± & � / ) ) \ 52 ) \22@ = = = = o « w ° ) •- \ / ) \ /-oAo0 _ 2 ] ) } \ ± } ( ;EEcn O a >.o a+ � IC 6 y >•-• 'C "^O , k. u 'd O O ❑❑ w L .w., y ti O Q4 C m N •P ¢' y y a •to cVa « v ^0 0 .— ti `�' v d cd 6 i u c p ct G o iz a"i °U on 'd o a) ≥ oo E a pp N ° wO °3 ^°'' u °: ° C N R •YN >� Qy LL aJR V) 'Y coo = C A � ,:pa V a R ro - W 3C . © o > cn a�i ." G • co co � W Nx o v °o V) W ° o co C ° .b o ° ° o a a iHh c o 4 i a) o. ° y am, w .-. y a. CIS ta p I u r. cd0 — a L. ° .-i C>bk,7 .C+ O o p C ctl ? >,O N °') O z O b 0.4 CL Q eet A O O O .C �+ U A ti 0 en Cip 4t 0 7 .p> R y } C w d ^+ ° - -irtii "0 ' vr�'.. .0 ° '— Cla 'HT N it .�. W O a R m d w 3 u M c b m c O iE u en o. © en • w x '> " W � �, C on .23a . . ) Cs • o°n 3L. -� a a o d ow li,Y a.) a R >, C -C ti (� •xa u.. tn M O .x O (-4 b N 0 - U NI w .d O •> L. .�fli p ,� -4 .° en vi 'd O 0 co ,. O O >. s°�.., c0 3 a -a O a O L .� f�., O N -;-.. d ai ' °3 o) b .0 8 C V — a a 7 a+ > N E C C O co w •d C cc u R1 N cd C 'it cc m ^dC C W C" u . oo P' Y 0 ^O R c0 X 4 ti > R y i3 N , r+ F, C d O 0 Q co.^ d p� R by d fl N H .7 C R a ly b � � o e5d — y OLI > C y cC h W N 7 ti as O ..u. C Z 1 'd O O F..• 1CCS aL s -d — o ^ u c� ^. y y .X O F, v, C �o p. ° w a � . Cr O °' y C VI U p .� o c ° a co L.• o E~ w E— ti F°- ° " Z d y N p N L. O '..• M C M w mo u u © Cl u 9 W o I i0Z aunf 0I0Z �Inf R aunf 0I0Z XInf g O W O i £ ►ea i O W O £aeaA F STATE OF COLORADO Bill Ritter,Jr.,Governor Martha E.Rudolph,Executive Director .oF•Coto Dedicated to protecting and improving the health and environment of the people of Colorado ye o, 4300 Cherry Creek Dr.S. Laboratory Services Division * *' Denver,Colorado 80246-1530 8100 Lowry Blvd. *. y" Phone(303)692-2000 Denver,Colorado 80230-6928 187s. TOD Line(303)691-7700 (303)692-3090 Colorado Department Located in Glendale,Colorado eparan of Public Health http://www.cdphe.state.co.us and Environment July 14,2010 Re: Colorado Family Planning Initiative(CFPI) FYI 1 Contract Amendment Enclosed please find a fully executed copy of the above referenced contract. The funding awarded through this contract amendment should be spent between the dates of 07/01/10 and 06/30/11. Please review your contract amendment carefully,as non-substantive changes may have been made. This may include minor edits in page numbers,document labels,or formatting. In the event larger revisions were required,your organization would be notified in detail of these changes. If there are any questions regarding this contract amendment,please contact Julie Becker,Fiscal Officer,at 303-692-2431 or iulie.becker(1i state.co.us,or Jacqueline O'Bryan,Contracts Manager,at 303-692-2485 or jacqueline.o'bryan@state.co.us. Sincerely, Fiscal Services Unit Enclosure ' MEMORANDUM eTo: Office of Clerk to the Board of Weld Counts, Commissioners Date: wl1 ai, a 01 �t (�� COLORADO From: 9 a ►(�a '✓L Allen S ,Health Department Subject: CO 'ami i1 planning Attached to this memo is the finalized contract, amendment to a contract, letter of renewal, change order letter or other document as listed below. Please sign and date below in the designated areas indicating you have received the finalized document and return this signed memo to me in the Administration Division of the Health Department. Thank you for your assistance with the processing of this document. Att. tia tU cij Col ado a i►N PIann�r9 nit�ativt (FPt) Document Name: Resolution Number: auto - i 09 `I Finalized Document Received By: LI15-YU Date Received: `1-30—l b O C. r Hello