HomeMy WebLinkAbout20092400.tiffRESOLUTION
RE: APPROVE AMENDMENT #2 TO TASK ORDER CONTRACT FOR HEALTH CARE
PROGRAM FOR CHILDREN WITH SPECIAL NEEDS 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 #2 to the Task Order Contract
for the Health Care Program for Children with Special Needs 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 October 1, 2009, and ending September 30, 2010,
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 #2 to the Task Order Contract for the Health Care Program
for Children with Special Needs 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 9th day of September, A.D., 2009.
BOARD OF COUNTY COMMISSIONERS
WELD COL l�Y, COLORADO
Weld County Clerk to the
Deputy Clerk to the Boar
Date of signature (O/1/61
David E. Long
2009-2400
1 H 0036
CC : f l � (3 ) a 944?
Wit
Wilk
COLORADO
Memorandum
TO: William F. Garcia, Chair
Board of County Commissioners
FROM: Mark E. Wallace, MD, MPH
Director, Department of Public Health
and Environment
DATE: August 18, 2008
SUBJECT: Amendment #2 to the HCP Program
Task Order Contract
Enclosed for Board review and approval is Amendment #2 to the task order contract between the
Weld County Board of Commissioners on behalf of the Department of Public Health and
Environment (WCDPHE) and the State of Colorado through the Colorado Department of Public
Health and Environment (CDPHE) for the Health Care Program for Children with Special Needs
(HCP).
This amendment will provide continuation funding in the amount of $185,903 for the time period
October 1, 2009 through September 30, 2010. Of this amount, $83,656 are attributable to a
funding source of the federal government, and $102,247 are attributable to a funding source of
the state of Colorado. These funds will be used to facilitate the development and enhancement
of community -based systems of care for children with special health care needs. Some of the
services provided will be case finding, community involvement, and interagency collaboration
for children and their families who are determined eligible for such services. Eligible children
are those who have or are at risk for a chronic physical, developmental, behavioral, or emotional
condition. I recommend your approval of this amendment.
Enclosure
2009-2400
STATE OF COLORADO
Bill Biller. Jr., Governor
James B. Marlin, Executive Director
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr. S.
Denver, Colorado 80245-1530
Phone (303) 692-2000
TDD Line (303) 891-770D
Located in Glendale, Colorado
http://www.Cdphe.state.co.us
Laboratory Services Division
8100 Lowry Blvd.
Denver, Colorado 80230-6928
(303) 692-3090
WORK STATUS CONFIRMATION LETTER
Colorado Department
of Public Health
and Environment
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 arc notified that ifs 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 under this contract until the contract is signed by the State Controller or on the effective
date, whichever is later.
Signature of Authorized Officer
William F. Garcia
Print Name of Authorized Officer
Chair, Board of Weld County Commissioners
Print Title of Authorized Officer
SEP 0 9 2009
Date Signed
RETURN THIS LETTER TO:
Natalie Ordoiez-Campbell, Contracts Manager
Colorado Department of Public Health & Environment
Center for Healthy Families & Communities, Fiscal
Services Unit
4300 Cherry Creek Drive South
PSD-CHFC-A4
Denver, CO 80246-1530
&ae9- O79°o
DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
PSD-HCP
DEPARTMENT OR AGENCY NUMBER
FLA
CONTRACT ROUTING NUMBER
10-2937
CONTRACT AMENDMENT #2
THIS AMENDMENT, made this 28th day of July, 2009, by and between the State of Colorado for the use and
benefit of 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 , (a political subdivision of the
state of Colorado), whose address or principal place of business is 915 —10'" Street. Greeley, CO 80632-0758
for the use and benefit of the WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND
ENVIRONMENT, whose address or principal place of business is 1555 North 17`" Avenue, Greeley, CO 80631
hereinafter referred to as "the Contractor".
FACTUAL RECITALS
Authority exists in the Law and Funds have been budgeted, appropriated, and otherwise made available and a
sufficient unencumbered balance thereof remains available for payment; and
Required approval, clearance, and coordination has been accomplished from and with all appropriate agencies; and
The parties entered into a Master Contract, dated January 23, 2007 with contract routing number 08 FAA 00052.
Pursuant to the terms and conditions of the Master Contract, the parties entered into a Task Order Contract, dated
August 1, 2007 with contract encumbrance number PO FLA HCP0800446, and contract routing number 08 FLA
00446, whereby the Contractor was to provide to the State the following:
In partnership with other community organizations, shall facilitate the development and
enhancement of community -based systems of care for children with special health care needs; and to
ensure that all families have access to direct care, enabling and population -based services that
address the issues and health problems delineated in the MCH performance measures.
The purpose for this amendment is described below.
To renew the contract for one year, to modify the Additional Provisions and the Statement of Work
and to incorporate a new provision to the General Provisions of the Task Order Contract,
concerning the monitoring of vendor performance on state contracts and inclusion of contract
performance information in a statewide contract management system.
NOW THEREFORE, it is hereby agreed that
I. Consideration for this amendment to the original task order contract, dated August 1, 2007 with contract
routing number 08 FLA 00446 and contract encumbrance PO FLA HCP0800446 consists of the
payments which shall be made pursuant to this amendment and the promises and agreements herein set
forth.
Page 1 of 4 rev 4/3/09
2(0 i —Si/37(3e /5!L%L
2. It is expressly agreed to by the parties that this Amendment is supplemental to the Original Task Order
Contract, Contract Routing Number 08 FLA 00446 as amended by Contract Amendment #1, Contract
Routing Number 09 FLA 00544 collectively referred to herein as the Original Task Order 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 agreed the original task order contract is and shall be modified, altered, and changed in the following
respects only:
A. This Amendment is issued pursuant to paragraph 5. of the Original Task Order Contract identified
by contract routing number 08 FLA 00446. This Amendment is for the renewal term of October
1� 2009, through and including September 30, 2010. Exhibit A, Additional Provisions, of the
Original Task Order Contract is hereby revised for the renewal term and incorporated herein by
this reference and identified as Exhibit F.
B. The maximum amount payable by the State for the work to be performed by the Contractor during
this renewal term is One Hundred Eighty -Five Thousand, Nine Hundred Three Dollars
f$185,903.00) for an amended total financial obligation of the State of FIVE HUNDRED
FORTY-NINE THOUSAND, NINE HUNDRED TWENTY-ONE DOLLARS, ($549,921.00).
This is an increase of One Hundred Eighty -Five Thousand, Nine Hundred Three Dollars,
($185,903.00) of the amount payable from the previous term. The revised specification to the
original Statement of Work for this renewal tenn is incorporated herein by this reference and
identified as Exhibit G.
C. General Provisions of the Contract are hereby modified to incorporate the following language:
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 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
Page 2 of 4 rev 4/3/09
202, which may result in the reversal of the debarment and reinstatement of Contractor, by the
Executive Director, upon showing of good cause.
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 upon approval of the State Controller or October 1, 2009.
whichever is later.
5. Except for the "Special Provisions", in the event of any conflict, inconsistency, variance, or contradiction
between the provisions of this amendment and any of the provisions of the original contract, the provisions
of this amendment shall in all respects supersede, govern, and control. The "Special Provisions" shall
always be controlling over other provisions in the contract or amendments. The representations in the
Special Provisions concerning the absence of bribery or corrupt influences and personal interest of State
employees 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 3 of 4 rev 4/3/09
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 COUNTY for the use and benefit of the
WELD COUNTY DEPARTMENT OF PUBLIC
HEALTH AND ENVIRONMENT STATE OF COLORADO
(a political subdilayinn of the state of Colorado) Bill er, J . Governor
Signature of Authorized Officer
William F. Garcia
By:
SEP 0 9 2009
Print Name of Authorized Officer
Chair, Board of County Commissioners
Print Title of Authorized Officer
For the Executive Director
DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT
Signatory avers to the State Controller or
that Contractor has not begun performance or
that a Statutory Violation waiver has been
requested under Fiscal Rules
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.
ATE CONTROLLER
id J. McDer
By:
❑Kevin Edwards ❑Yvonne And
C
Date:
Page 4 of 4
Robert Jaros
onald Rieck
WELD COUNTY DEPARTMENT O0
PUBLIC HEALHAND ENVIRONMENT \
rev 4/3/09
Mark E. Wallace, MD, MPH -Director
EXHIBIT F
ADDITIONAL PROVISIONS
To Contract Dated 07/28/2009- Contract Routing Number 10 FLA 2937
These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above.
The revised Statement of Work is effective October 1, 2009.
1. The United State Department of Health and Human Services ("HHS"), through the Maternal and Child Health
Services Block Grant (MCH) has awarded the State Title V federal funds under Notice of Grant Award ("NGA)
number B04MC04248 (See, Catalog of Federal Domestic Assistance ("CFDA") number 93.994). The State's
Prevention Services Division (PSD) is charged with the administration of funds from the Title V MCH Block Grant
to improve the health and well being of the maternal and child/children with special needs populations through
assessing population needs and coordinating/implementing best practices and evidenced -based programs.
The authority for the administration of the Title V MCH Block Grant, including the maternal, child and children
with special health care needs resides in Title V of the Social Security Act, §§ 501-509.
Each state that receives MCH funds from the HHS must demonstrate to the HHS that it has served the distinct
population group of children with special health care needs (CSHCN)which is defined to include infants, children,
and adolescents from birth through age twenty (20); and, which is defined as those children who have, or are at
increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health
and related services of a type or amount beyond that required by children generally.
The State has formulated a comprehensive statewide plan to carry out a CSHCN Program, funded by Title V MCH
dollars and state general funds. As part of the comprehensive plan, it is the express intent of the state to support
local public health agencies in contributing to a coordinated, efficient statewide program which focuses on specific
MCH performance measures set by the MCH state and Federal agencies. Local public health agencies, working in
partnership with other community organizations, facilitate the development and enhancement of community -based
systems of care for CSHCN. The goal of these systems is to ensure that families with CSHCN have access and ease
of use for direct care services, as well as, enabling and population -based services.
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 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 Contract, with
such effective date being the later of the date specified in this Contract or the date the Contract is signed by the State
Controller or delegee.
2. In consideration of those CSHCN services, set forth in Exhibit G satisfactorily and timely performed by the
Contractor under this contract, the State shall cause to be paid to the Contractor a sum not to exceed ONE
HUNDRED EIGHTY-FIVE THOUSAND, NINE HUNDRED AND THREE DOLLARS ($185,903). Of the
financial obligation for CSHCN services, EIGHTY-THREE THOUSAND, SIX HUNDRED AND FIFTY-SIX
DOLLARS ($83,656) are identified as attributable to a
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EXHIBIT F
funding source of the federal government and, ONE HUNDRED TWO THOUSAND, TWO HUNDRED AND
FORTY-SEVEN DOLLARS ($102,247) are identified as attributable to a funding source of the state of Colorado.
3. To receive compensation under this Contract, the Contractor shall submit a signed Quarterly or Monthly
Contract Reimbursement Statement in a format acceptable to the State. The Contractor shall declare the frequency
with which they plan to submit their Contract Reimbursement Statement in writing by the beginning of the contract
period. A Contract Reimbursement Statement is incorporated and made part if part herein. The Contract
Reimbursement Statement is available at www.hcpcolorado.orn,. A Contract Reimbursement Statement must be
submitted within sixty (60) calendar days of the end of the billing period for which services were rendered. Contract
Reimbursement Statements must be accompanied by a 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 G.
These items may include, but are not limited to, the Contractor's salaries, fringe benefits, supplies, travel, operating,
allowable indirect costs, and other allocable expenses related to its performance under this Contract.
Contract Reimbursement Statements shall: 1) reference this Contract by its contract routing number, which the
number is located on page one of this Contract; 2) state the applicable performance dates; 3) state the names of
payees; and, 4) show the total requested payment. Payment during the term of this Contract shall be conditioned
upon affirmation by the State that all services were rendered by the Contractor in accordance with the terms of this
Contract. Contract Reimbursement Statements shall be sent via email to:
Maternal and Child Health Generalist Consultant
Prevention Services Division
Colorado Department of Public Health and Environment
PSD - A4
4300 Cherry Creek Drive South
Denver, CO 80246
To be considered for payment, billings for payments pursuant to this 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 Contract must be received by the State
within a reasonable time after the expiration or termination of this Contract; but in no event no later than sixty (60)
calendar days from the effective expiration or termination date of this Contract. Contractors may not receive
payment for billings that exceed sixty (60) the calendar day period.
The Contractor shall not use federal funds to satisfy federal cost sharing and matching requirements unless approved
in writing by the appropriate federal agency.
4. Contractor shall retain and use all revenues generated by Health Care Program for Children with Special Needs
(HCP) for services in HCP. The revenue cannot be used for other programs or purposes.
5. Title V, Section 504 (b) (6). Title V funds may not be used to pay for any item or service (other than an
emergency item or service) furnished by an individual or entity convicted of a criminal offense under the Medicare
or any State health care program (i.e., Medicaid, Maternal and Child Health, or Social Services Block Grant
Programs).
6. The 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 WIC coupons are redeemed. Failure to comply with the provision
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EXHIBIT F
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. The Contractor certifies, to the best of its knowledge and belief, that no federally appropriated funds have been
paid or will be paid by or on behalf of the Contractor, to any person for influencing or attempting to influence an
officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of this contract, and the extension, continuation, renewal,
amendment, or modification of this contract, or any grant, loan, or other cooperative agreement that utilizes Federal
funds. If any funds other than federally appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, Member of Congress, an officer or
employee of Congress in connection with this contract, or any other grant, loan, or other cooperative agreement,
then the Contractor shall complete and submit Standard Form - LLL, "Disclosure Form to Report Lobbying" in
accordance with its instructions. The Contractor shall require that the language of this certification be included in the
award documents for subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a
material representation of fact upon which reliance was placed when this transaction was made or entered into. This
certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S.
Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
8. The Contractor shall not charge for services those individuals of families at or below the official poverty
guidelines, updated periodically in the Federal Register by the U.S. Department of Health and Human Services
under the authority of 42 U.S.C. 9902(2), in accordance with Title V, Section 501 (1) (B) and Section 505 (5) (D).
The most current version of this document is available on the HCP website: www.hcpcolorado.org. If the State
receives new poverty guidelines from the DHHS during the term of this Contract, then the State shall immediately
update the guideline on the HCP website. The Contractor shall use these new poverty guidelines, if any, upon receipt
thereof from the State.
9. If any charges are imposed for services to clients who are above the one hundred percent (100%) of poverty level,
such charges must be on a sliding scale which takes into account the client's family size, income and resources.
These charges and the sliding fee scale must be made available to the general public and to all clients and must be
based on the agency's usual and customary cost for the service. Clients must understand they shall not be denied
services for inability to pay any of the sliding fee charges.
10. The Contractor shall protect the confidentiality of all applicant or recipient records and other materials that are
maintained in accordance with this contract. Except for purposes directly connected with the administration of this
contract, no information about or obtained from, any applicant or recipient shall be disclosed in a form identifiable
with the applicant or recipient without the prior written consent of the applicant or recipient, or the parent or legal
guardian of a minor applicant or recipient with the exception of information protected by Colorado statute as it
applies to confidentiality for adolescent services in which case the adolescent minor and not the parent or legal
guardian must provide consent or, as otherwise properly ordered by a court of competent jurisdiction. The
Contractor shall have written policies governing the access to, and duplication and dissemination o1 all such
information. The Contractor shall advise its employees, agents, servants, and subcontractors, if any, that they are
subject to these confidentiality requirements.
11. 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
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EXHIBIT F
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.
12. 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 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.
13. Notwithstanding anything herein to the contrary, the parties understand and agree that all terms and conditions of
this contract and the exhibits and attachments hereto which may require continued performance, compliance or
effect beyond the termination date of this 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.
14. The State may require forms attached to this contract and incorporated herein by reference be 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 CDPHE Maternal and Child Health website: www.mchcolorado.org or the
HCP website: www.hcpcolorado.org.
15. 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.
16. The State may increase or decrease funds available under this Contract using a Grant Funding Letter
substantially equivalent to Exhibit H. The Grant Funding Letter is not valid until it has been approved by the State
Controller or designee.
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EXHIBIT G
STATEMENT OF WORK
To Contract Dated 07/28/2009 - Contract Routing Number 10 FLA 2937
These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above.
The revised Statement of Work is effective October 1, 2009.
This Statement of Work is for the maternal and child health (MCH) population: children with special health care
needs (CSHCN) birth to age 21.
1. The Contractor shall perform in accordance with the MCH Guidelines and shall follow the policies and
procedures detailed in the MCH Guidelines. The MCH Guidelines are incorporated and made part hereof
by reference, and are available on the MCH web site: v v. %. mchcalorado.oig
2. The Contractor shall perform in accordance with the HCP Policy and Procedures, HCP Guidance and HCP
CHIRP User Manual. These documents are available on the HCP web site: www.hepcolorado.org.
3. The MCH Guidelines, HCP Policy and Procedures, Guidance and CHIRP User Manual are periodically
updated and the contractor will be notified by email when updates/revisions are made. The contractor is
responsible for complying with any updates/revisions.
4. Under this contract, the Contractor shall provide the core public health services of assessment, policy
development, and assurance on behalf of children with special health care needs as described and defined
in the "Core Public Health Services Delivered by MCH Agencies" component of the MCH Guidelines at
,e�ti ye ..tnh_g(urad('.org.
5. The Contractor shall provide leadership, in coordination with public and private community partners, in the
development, implementation and evaluation of the Contractor's HCP Operational Plans.
6. The HCP Operational Plans are to be based on a community planning process that includes a review of the
health status needs of CSHCN population and of the health system resources of a community. These plans
are further designed to:
a) Contribute to the accomplishment of the MCH National and State priorities, performance measures,
and outcome measures, as identified in the MCH Guidelines;
b) Provide for the continuation of the core public health services of assessment, policy development, and
assurance on behalf of the maternal and child health populations and in implementing the 10 essential
services for this population in partnership with the State, as identified in the MCH Guidelines;
c) Work with public and private community partners to plan for the development and maintenance of
resources that assure access to direct care and services for all CSHCN including those who are low-
income, uninsured, underinsured, or who live in rural or underserved areas or who are from ethnic or
cultural minority communities and may experience language or cultural barriers and have increased
difficulty using services;
d) Refer families participating in any and all programs in its agency such as the Special Supplemental
Nutrition Program for Women, Infants and Children (WIC); Early and Periodic Screening, Diagnosis
and Treatment (EPSDT); Immunization Clinics; Family Planning; Nutrition Services, Public Health
Nursing; etc. to appropriate enabling and direct care service programs in the community, including
resources for accessing public insurance programs.
e) Work with public and private community partners to plan for the development and implementation of
population -based approaches within a community Medical Home approach for addressing MCH
performance measures and priority issues for CSHCN.
7. The Contractor shall implement the HCP Operational Plan for FFY 20010-2011 during the course of this
contract.
Page 1 of 2 Revised: 6/9/09 GF
EXHIBIT G
8. The Contractor shall submit, but not limited to, the reports, incorporated by reference. These documents,
including instructions for completion and submission are available in the MCH Guidelines located on the
MCH website: vn-mchcoiorido.or'.
9. The Contractor shall develop or revise, according to the MCH Guidelines, the Contractor's HCP
Operational Plans for the FFY 2011-2012, and an Operational Plan for each year after of renewal.
10. The State shall provide guidance and technical assistance to the Contractor to support the development or
revision, according to the MCH Guidelines, of the Contractor's HCP Plan for the FFY 2011-2012.
11. The Contractor shall work collaboratively with the State for consultation, technical assistance, oversight and
training on using the HCP Clinical Health Information Record of Patients (CHIRP) database for
documentation of HCP services.
12. The Contractor shall follow all HCP/CHIRP Security Policy and Procedures and have a Data Security Use
and Confidentiality Agreement signed by each user.
13. The Contractor shall provide orientation, technical assistance and ongoing training for HCP agency and
regional staff on HCP Guidance, Policy and Procedures, TBI and HCP Care Coordination, specialty care,
public health insurance, SSI, partner collaboration for easy to use services, health care transition, family
participation and a community Medical Home approach using the Medical Home Action Guide and HCP
Guidance located on HCP web site: www,.hcpcoloradu_org.
14. The Contractor shall attend monthly HCP Regional Office teleconferences, Bi-Annual HCP Team Leader's
Meetings and state training to promote learning and increase skills for HCP practitioners.
15. The Contractor shall utilize CSHCN and their families as the consumer voice when serving CSHCN
population by referencing the national outcome measures, Medical Home Action Guide and HCP Guidance
on the HCP web site: ww\v.hocololado .0 cu.
16. The Contractor shall cooperate with the State and provide all requested records regarding recipients for
whom services were provided under this contract.
17. The Contractor shall provide Maternal Child Health Generalist Consultants, state HCP staff and other State
administrators with reasonable access to its operations to perform: periodic site visits, data reviews, fiscal
reviews or other evaluations of the contractor's program. The contractor shall cooperate during all periodic
site visits, data reviews, fiscal reviews and other evaluations or audits conducted by the State.
18. The Contractor shall notify the State of programmatic changes that might affect the viability, effectiveness
or productivity of the programs, including but not limited to: changes in personnel; physical facilities in
which services are provided; scope of services that deviates from those proposed by the Contractor; sources
of funding and support as declared in the Contractor's submitted proposal for funding; and local
interagency or political circumstances that might impact the Maternal Child Health and HCP. Notification
shall be in writing within fifteen (15) business days of the said change.
19. If the State believes in good faith that an activity or service fails to meet the standard for that particular
activity or service, or is otherwise deficient, then the State shall notify the Contractor of the failure or
deficiencies in writing. Corrective action shall be addressed through a Performance Improvement Plan
(PIP) or sonic other method defined by the State. Due dates for completion of activities listed in a PIP will
be negotiated on a case -by -case basis. If the Contractor fails to correct such deficiencies, the Contractor
shall be in default of its obligations under this Contract and the State, at its option, may elect to withhold
payment or terminate this Contract.
Page 2 of 2 Revised: 6/9/09 GF
Exhibit H
SAMPLE GRANT FUNDING CHANGE LETTER
I Date:
I State Fiscal Year: I Grant Funding Change Letter #
CLIN Routing #
TO: Insert Grantee's name
In accordance with Section of the Original Contract routing number between the State of
Colorado, Department of Public Health and Environment and Contractor's Name beginning Insert start
date and ending on Insert ending date, the undersigned commits the following funds to the Grant:
The amount of grant funds available and specified in Section is ❑ increased or O decreased by
$amount of change to a new total funds available of $ 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
Bill Ritter, Jr. 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.
STATE CONTROLLER
David J. McDermott, CPA
By:
Donald Rieck
Date:
Page 1 of 1
Effective Date: 1/6/09
STATE OF COLORADO
Bill Ritter, Jr., Governor
James B. Marlin, 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
TDD Line (303) 691-7700
Located in Glendale, Colorado
http://www.cdphe.state.co.us
Laboratory Services Division
8100 Lowry Blvd.
Denver, Colorado 80230-6928
(303) 692-3090
Prevention Services Division
Center for Healthy Families and Communities
Telephone: (303) 692-2370; FAX: (303) 782-5576
October 1, 2009
Ms. Judy Nero
Weld County Department of Health and Environment
1555 North 17th Avenue
Greeley, CO 80631
Re: MCH Contract Amendment #1
Contract Routing Number 10-2514
HCP Contract Amendment #2
Contract Routing Number 10-2937
Dear Ms. Nero:
Colorado Department
of Public Health
and Environment
Enclosed please find fully executed copies of the above referenced Contract Amendments for your files.
The funding awarded through these contracts should be spent between the dates of October I, 2009 and
September 30, 2010.
Please review your contracts 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 the MCH Contract Amendment, please contact Gina Febbraro at 303-
692-2427 or rina.febbraro!wstate.co.us. If you have any questions regarding the HCP Contract Amendment,
please contact Shirley Babler at 303-692-2455 or shirley.bablerr )state.co.us.
Sincer
Nata • do ez-Campbell
Contrac(s anager
Center f. ealth Families & Communities
Enclosure (1)
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