HomeMy WebLinkAbout20091497.tiffRESOLUTION
RE: APPROVE CONTRACT AMENDMENT#1 FOR CANCER, CARDIOVASCULAR DISEASE,
AND CHRONIC PULMONARY DISEASE PREVENTION AND TREATMENT GRANT
PROGRAM FOR THE HEART OF WELD PROJECT 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 Contract Amendment #1 for the Cancer,
Cardiovascular Disease, and Chronic Pulmonary Disease Prevention and Treatment Grant
Program for the Heart of Weld Project 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, 2009, and ending June 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 Contract Amendment #1 for the Cancer, Cardiovascular Disease, and
Chronic Pulmonary Disease Prevention and Treatment Grant Program for the Heart of Weld
Project 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.
2009-1497
HL0036
CONTRACT AMENDMENT #1 FOR CANCER, CARDIOVASCULAR DISEASE, AND CHRONIC
PULMONARY DISEASE PREVENTION AND TREATMENT GRANT PROGRAM FOR THE HEART
OF WELD PROJECT
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 29th day of JA.D., 2009.
ATTEST:,�7Nh
Weld County Clerk to the Boar
BY:
AP
BarbKirkmeyer
'ut L)an7? dZ
ty Cle to the Board
ARD OF NTY COMMISSIONERS
rG9�ORADO
/
CiAls2VNJr
ougla• Rademac'er, Pro-Tem
Sea P. P. Conway
c
ORM: — /ll�'✓�
y Attorney
David E. Long
Date of signature I310e1
2009-1497
HL0036
Otcft
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 X11 Q
1/V04\5'`a te`\J\
DATE: June 1, 2009
SUBJECT: Heart of Weld Project - Cancer,
Cardiovascular Disease and Chronic
Pulmonary Disease Prevention and
Treatment Program (CCPD) Contract
Enclosed for Board review and approval is Contract Amendment #1 between the Colorado
Department of Public Health and Environment, Cancer, Cardiovascular Disease and Pulmonary
Disease Competitive Grants Program and Weld County for the Weld County Department of
Public Health and Environment for the Heart of Weld Project. The grant period is July 1, 2009
through June 30, 2010 for an amount not to exceed $255,629.00. Funding is entirely from the
State of Colorado attributable to Amendment 35, the tobacco tax.
During year one, the Heart of Weld Project expanded Women's Wellness Connection
programming to include cardiovascular disease prevention screening and education services.
The purpose of the project is to reduce modifiable risk factors for cardiovascular disease among
women aged 40 to 64 who are uninsured or underinsured, with an emphasis on low income or
Latino residents.
The increase in funding for year two covers salary and fringe benefits for existing FTE and
increased screening supplies to provide services for 750 women. Staff includes a 1.75 FTE
Health Educator II, .5 FTE bilingual medical assistant and a .1 FTE Data
Specialist/Epidemiologist. I recommend your approval of this contract.
Enclosure
2009-1497
STATE OF COLORADO
Bill Ritter, Jr., Governor
James B. Martin, 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
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 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 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
JUN 2 9 2009
Date Signed
RETURN THIS FORM WITH YOUR CONTRACT
Page 5 of 5
O7oe9 - / -
COLORADO
Granting Agency:
Applicant's Name:
Applicant's Address:
Applicant's Phone:
Applicant's Fax:
Project Title:
Contact Person:
Date:
Amount:
DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
1555 N. 17`" Avenue
Greeley, CO 80631
WEBSITE: www.co.weld.co.us
ADMINISTRATION: (970) 304-6410
FAX: (970) 304-6412
PUBLIC HEALTH EDUCATION & NURSING: (970) 304-6420
FAX: (970) 304-6416
ENVIRONMENTAL HEALTH SERVICES: (970) 304-6415
FAX: (970) 304-6411
Colorado Department of Public Health and Environment
Weld County Department of Public Health and Environment
1555 N. 17th Avenue
Greeley, CO 80631
(970) 304-6420, ext. 2380
(970) 304-6452
Heart of Weld Project (Cardiovascular Disease Prevention)
Gaye Morrison, Health Communication Director
July 1, 2009 — June 30, 2010
$255,629.00
Weld County Department of Public
Ith and Environment
5
Mark E. Wallace, MD, MPH,
to
Weld County
vWilliamamm F.Garcia, Chair
Weld County Clerk to t
' 1
By:
Deputy Clerk to t
B d of Commissioners
JUN 2 9 2009
DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
PSD-CCPD
DEPARTMENT OR AGENCY NUMBER
FLA
CONTRACT ROUTING NUMBER
10-00084
CONTRACT AMENDMENT #1
THIS AMENDMENT, made this 7th day of May, 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 for use and benefit of 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 176 Ave., 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 contract dated April 18, 2008 with contract encumbrance number PO FLA
PPG0900318 and contract routing number 09 FLA 00318, whereby the Contractor was to provide to the State the
following:
Perform work for the project Heart of Weld Project
The purpose for this amendment is described below.
The State promises to increase the amount of funds to be paid to the Contractor by Two Hundred Fifty-
five Thousand, Six Hundred Twenty -Nine Dollars ($255,629.00) for the renewal term of 12 months,
ending on 6/30/2010, in exchange for the promise of the Contractor to perform the increased work
described herein. The State promises to incorporate a new provision to the General Provisions of the
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
1. Consideration for this amendment to the original contract, 09 FLA 00318 PO FLA PPG0900318 dated
April 18, 2008 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. It is expressly agreed to by the parties that this Amendment is supplemental to the original contract,
contract routing number 09 FLA 00318 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 agreed the original contract is and shall be modified, altered, and changed in the following respects
only:
A. This Amendment is issued pursuant to paragraph 16.b. of the Original Contract identified by contract
routing number 09 FLA 00318. This Amendment is for the renewal term of July 1, 2009, through
and including June 30, 2010. The maximum amount payable by the State for the work to be
performed by the Contractor during this renewal term is Two Hundred Fifty-five Thousand, Six
Hundred Twenty -Nine Dollars, ($255,629.00) for an amended total financial obligation of the State
of FOUR HUNDRED SEVENTY-SEVEN THOUSAND, FIVE HUNDRED SEVENTY
DOLLARS and EIGHTY CENTS, , ($477,570.80). This is an increase of Two Hundred Fifty-five
Thousand, Six Hundred Twenty -Nine Dollars. f$255,629.00) of the amount payable from the
previous term. The revised specifications to the original Scope of Work and revised Budget, if any,
for this renewal term are incorporated herein by this reference and identified as "Exhibit E" and
"Exhibit F."
B. The General Provisions of the Contract are hereby modified to incorporate the following language:
By entering into this 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
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 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 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
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 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 Contract is modified accordingly. All other terms and conditions of the Original Contract are
reaffirmed.
Page 2 of 4 Rev 4/3/09
4. The effective date of this amendment is upon approval of the State Controller or July I, 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 he 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:
BOARD OF COUNTY COMMISSIONERS
OF WELD COUNTY for the use and benefit of
WELD COUNTY DEPARTMENT OF PUBLIC
IIEALTH AND ENVIRONMENT
(a political subdivisiog,gf the State of Colorado)
Signature of Authorized Officer
William F. Garcia
Print Name of Authorized Officer
Chair
Print Title of Authorized Officer
STATE:
STATE OF COLORADO
Bill Ritter, Jr. Governor
By:
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
ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER
CRS §24-30-202 requires the State Controller to approve all State Contracts. This Amendment 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.
ICONTROLLER
d J. McDermot
By:
(Kevin Edwards Yvonne Anfyersbn
Dale:
Page 4 of 4
BY:
Robert JarosT>4Donald Rieck
WELD COUNTY DEPARTMENT OF
LI
A ENVIRONME
t71.b
Rev 4/3/09
Mark E. Wallace, MD, MPH -Directo
?cn9 -i5`9'
Exhibit E
SCOPE OF WORK
Commonly Used Acronyms And Abbreviations In The Cardiovascular, Cancer and Pulmonary Disease (CCPD)
Grants Program That May Be Referenced In The Scope of Work:
AACVPR
AAFP
ACC
ACS
ADA
AHA
AHEC
AMC
ANOVA
ARB
BDC
BDM
BG
BMI
BP
BRFSS
CAAH
CAC
CACTI
CAD
CAHP
CBGH
CCGC
CCH
CCHN
CCPD
CCSP
CDC
CDE
CDPHE
CHC
CHES
CHHS
CHS
CICP
CHW
CLIA
COAW
COPAN
COPD
COPIC
CPC
CPD
CPHA
CRC
CRHC
CSU
CV
CVD
CWCCI
CCI
DCHS
DFM
DH
DHHA
DHHS
DM
American Association of Cardiovascular and Pulmonary Rehabilitation
American Academy of Family Physicians
The American College of Cardiology
American Cancer Society
American Diabetes Association
American Heart Association
Area Health Education Center
The AMC Cancer Research Center
Analysis of Variance
Angiotensin Receptor Blockers
Barbara Davis Center
Biostatistics and Data Management
Blood Glucose
Body Mass Index
Blood Pressure
Behavioral Risk Factor Surveillance System
Center for African American Health
Community Advisory Council
Coronary Artery Calcification in Type 1 Diabetes
Coronary Artery Disease
Colorado Association of Health Plans
Colorado Business Group on Health
Colorado Clinical Guidelines Collaborative
Colorado Coalition for the Homeless
Colorado Community Health Network
Cardiovascular, Cancer, Pulmonary Disease
Colorado Colorectal Screening Program
Centers for Disease Control and Prevention
Certified Diabetes Educator
Colorado Department of Public Health & Environment
Community Health Center
Certified Health Education Specialist
Colorado Healthy Heart Solutions
Child Health Survey
Colorado Indigent Care Program
Community Health Worker and Lay Community Health Worker
Clinical Laboratory Improvement Amendment
Consortium for Older Adult Wellness
Colorado Physical Activity & Nutrition Unit
Chronic Obstructive Pulmonary Disease
COPIC Insurance Company
Colorado Prevention Center
Coronary Pulmonary Disease
Colorado Public Health Association
Colorectal Cancer
Colorado Rural Health Center
Colorado State University
Cardiovascular
Cardiovascular disease
Colorado Women's Cancer Control Initiative
Denver Community Health Services
Department of Family Medicine
Denver Health
Denver Health and Hospital Authority
United States Department of Health and Human Services
Diabetes Mellitus
Page I of 22
Exhibit E
DPS
ED
HER
EMR
EPSDT
F&A
FORT
FPG
FQHC
FRS
FT
FTE
GOLD
HBPM
HDL
HEDIS
HHP
HIPPA
HIV/STD
HL
HPRN
HPV
HR
hr
HRSA
HSNP
HTN
ICR
ICS
IMPACT
IPIP
IRB
IT
IVR
JNC VI
LCSW
LDL
LUCHAR Project
MBA
MCPN
MD
mg/dL
mm Hg
mo
MPA
MPH
MRMC
MS
MSI/IHC
MOU
NA
NAEPP
NCCN
NCEP/ATP III
NCI
NCIPA
NHLBI
NIH
NIAID
Denver Public Schools
Emergency Department
Electronic Health Record
Electronic Medical Record
Early, Periodic Screening, Diagnosis and Treatment
Financial and Accounting
Fecal Occult Blood Test
Fasting Plasma Glucose
Federally Qualified Health Center
Framington Risk Score
Full-time Equivalent
Full-time Equivalent
Global Initiative for Chronic Obstructive Lung Disease
Home Blood Pressure Monitoring
High —density Lipoprotein
Healthcare Effectiveness Data and Information Set
Home Health Parties
Health Insurance Portability and Accountability Act
Human Immunodeficiency Virus/Sexually Transmitted Disease
Healthier Living
High Plains Research Network
Human Papillomavirus
Human Resources
Hour
Health Resources and Services Administration
Heart Smart Navigation Program
Hypertension
Indirect Cost Reimbursement
Inhaled Corticosteroids
Improving Pediatric Asthma Care Training
Improving Performance In Practice
Institutional Review Board
Information Technology
Interactive Voice Recognition
The Sixth Report of the Joint National Committee on Prevention, Detection,
Evaluation, and Treatment of High Blood Pressure
Licensed Clinical Social Worker
Low -density Lipoprotein
Latinos Using Cardio Health Actions to Reduce Risk
Master of Business Administration
Metro Community Provider Network
Medical Doctor
Milligrams Per Deciliter — Common Medicinal Unit
Millimeter of Mercury — Unit of Pressure
Month
Master of Public Administration in Health and Human Services
Master of Public Health
Mercy Regional Medical Center
Master of Science
Microsatellite Instability with Immunohistochemical Detection
Memorandum of Understanding
Not Applicable
National Asthma Education and Prevention Program
National Comprehensive Cancer Network
National Cholesterol Education Program/Adult Treatment Panel III
National Cancer Institute
Northern Colorado Individual Practice Association
National Heart, Lung and Blood Institute
National Institutes of Health
National Institute of Allergy and Infectious Diseases
Page 2 of22
Exhibit E
NLHEP National Lung Health Education Program
NP Nurse Practitioner
NWCOVNA Northwest Colorado Visiting Nurse Association
PA Physician's Assistant
PAP Pap Smear
PCP Primary Care Provider
PDSA Plan -do -study -act
PECS database Patient Electronic Care System
PhD Doctor of Philosophy
PHN Public Health Nurse
PI Principal Investigator
PN Patent Navigator
PNRP Patient Navigation Research Program
POC Point of Care
PSA Public Service Announcement
QI Quarter One
Q2 Quarter Two
Q3 Quarter Three
Q4 Quarter Four
QI Quality Improvement
RD Registered Dietitian
RFA Request for Application
RGCPH Rio Grande County Public Health
RGPH Rio Grande Public Health
RMD Reach my Doctor
RMGA Rocky Mountain Gastroenterology Association
RMPRC Rocky Mountain Prevention Research Center
RN Registered Nurse
RT Respiratory Therapist
RTIP Research -tested Intervention Programs
SCPH Saguache County Public Health
SBDOT School -based Daily Observed Treatment
SCEP Senior Connections on the Eastern Plains
SMART Specific, Measurable, Achievable, Realistic, Time -bound
SMC Swedish Medical Center
SMC/CNI Swedish Medical Center/Colorado Neurological Institute
SNAP ED Supplemental Nutritional Assistance Programs Education
SNOCAP State Networks of Colorado Ambulatory Practices and Patients
SSC Stout Street Clinic
STEPP State Tobacco Education and Prevention Partnership
SUA Southern Ute Agency
T1D Type 1 Diabetes
TBD To Be Determined
TCH The Children's Hopital
TCPH Teller County Public Health
TLC Therapeutic Lifestyle Changes
UCCC University of Colorado Cancer Center
UCD University of Colorado Denver
UCD-AMC University of Colorado Denver Anschutz Medical Campus
UCHSC PN University of Colorado Health Science Center Patient Navigation
US United States
USDA United States Department of Agriculture
USPSTF United States Preventive Services Task Force
WIC Women, Infants, and Children
WISEWOMAN Well -Integrated Screening and Evaluation for Women Across the Nation
WHO World Health Organization
WRC Women's Resource Center
WWC Women's Wellness Connection
yr Year
Page 3 of 22
Exhibit E
Scope of Work
The Heart of Weld Project is modeled after the Center for Disease Control and Prevention's
(CDC) Well -Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN)
program. The cardiovascular risk factor screening assessment uses the Cardiovascular
Disease and Stroke Prevention Guideline developed by the Colorado Clinical Guidelines
Collaborative (CCGC). The lifestyle intervention component uses the A New Leaf ... Choices
for Healthy Living curriculum.
Each enrolled participant receives a baseline screening with the results of this screening then
determining the intervention. Participants with low risk for CVD are eligible for a 12 -month
follow-up screening. Participants with elevated CVD risk (i.e., moderate or high risk) receive the
usual standard of care services including a medical referral and clinical follow-up as well as the
lifestyle and maintenance interventions. Participants with elevated CVD risk are eligible for a 6 -
month and 12 -month follow-up CVD screening to monitor their status and to determine if re -
enrollment into the 8 week lifestyle intervention should be offered.
During the initial year of the project, most of the women who qualified for Heart of Weld
CVD screenings had a medical home established at Sunrise Community Health, Inc.
During years two and three of the project, we will expand the screening to include more
uninsured and underinsured women in the community. Women without a medical home
who are found to be at elevated risk for CVD will become eligible for a one-time medical
voucher. These vouchers will go to clinicians accepting medical referrals for patients.
The Heart of Weld project also strives to connect all community members with community -
based lifestyle intervention support services by connecting them with healthy cooking
classes and group exercise classes taught in both English and Spanish. The Year 2
detailed work plan follows.
Page 4 of 22
W
X
w
Year 2 Work Plan
2009-2010
To reduce modifiable risk factors for cardiovascular disease among women aged 40 to 64 years who are uninsured or underinsured, with an
emphasis on low income or Latina residents and women enrolled in the Women's Wellness Connection,
By 06/30/10, 750 women from the target population, residing in Weld County, will complete CVD risk factor screening.
Measures or data that will show your Reach,
Effectiveness, or Implementation
Reach: program database; number of participants
screened
Effectiveness: N/A
Implementation: program database; participant
characteristics and risk levels
z
s
a
co
Cu
Ce
Effectiveness: N/A
Implementation: review/audits of program
database and program records for compliance
with program procedure
Reach: N/A
Effectiveness. N/A
Implementation: program database; referral
counts
Reach: program records; number of vouchers
distributed
Effectiveness: N/A
Implementation: program records; cost per
eligible woman: actual vs. budgeted cost
Anticipated Outcomes
Detect level of disease
for further follow-up and
to prevent
onset/progression of
disease
Detect level of disease
for further follow-up and
to prevent
onset/progression of
disease
Increase awareness and
connect target
population with low/no
cost prevention and
intervention services
Reduce financial
bamers to obtaining
needed medical follow-
up for disease
knplementation
Timeframe
9
O
d
5
d
5
d
Ci
Target Population
Women, age 40-
64, who are under -
or uninsured,
residing in Weld
County
Women. age 40-
64, who are under -
or uninsured.
residing in Weld
County
N O CD
O 7D C
V 3 d
co d ry a> y
0 @ = a on
E. o d =
E £5.g .>
= O O O N N
Women identified
with alert values at
baseline screening
without a medical
home
Services/Activities Details
What: baseline screenings to
determine CVD risk based on CCGC
guidelines
Where: Sunrise and at least 2 new
clinical sites
How Often: at least once per quarter
per site
What: results letters
Where: Sunrise and at least 2 new
clinical sites
How Often: within one week after
baseline screening
What: referral appointments/screenings
for community services including Heart
of Weld Lifestyle Intervention, smoking
cessation, cancer and behavioral health
screenings
Where: Sunrise and at least 2 new
clinical sites
How Often: at baseline screenings
What: offer medical vouchers for first
time office visits
Where: n/a
How Often: one time per eligible
woman
J
¢
O
S.M.A.R.T.
Outcome Objective
#1:
Strategies to meet
your objective
Screening
(baseline)
Screening
(baseline)
an
an
CD
C
CO
Access to Care
Reach: N/A
Effectiveness: N/A
Implementation: program records documenting
referral relationships
Reach: N/A
Effectiveness: N/A
Implementation: data about referrals;
presentation logs
Reach: N/A
Effectiveness: N/A
Implementation: program records; analysis of
actual vs. budgeted costs
By 06/30/10, at least 50% of all baseline screened women will complete their 12 mo. screening visit.
Measures or data that will show your Reach,
Effectiveness, or Implementation
Reach: program database; number of baseline
screened participants re -screened compared to
target of 50%
Effectiveness: program database; changes in
biometric measurements and risk levels
Implementation: review/audit of program
database and program records for compliance
with program procedure
Reach: N/A
Effectiveness: N/A
Implementation call logs, program database;
number reached vs. lost to follow-up
Improve coordination
between program and
health care providers
Expand reach in
community
Build infrastructure and
expand reach
Anticipated Outcomes
Detect level of disease
for further follow-up and
to prevent
onset/progression of
disease
Excellent re -screening
rates
0
a
a
Implementation
Timeframe
0
a
0
a
Clinic staff
Social -service and
faith -based
organizations
Clinical screening
sites
Target Population
d o o
-o -
c
o
00) N N
CO A
0 N O
o N = C =
E 0 3 = N2 ,a o
Women, age 40-
64, who are under -
or uninsured,
residing in Weld
County
What: get clinics to accept medical
referrals (and vouchers) for enrolled
women without a medical home.
Where: at least one new clinic
How Often: as often as needed
What: publicize the CVD project to
obtain referrals
Where: to at least five different
community -based social service & five
faith -based organizations
How Often quarterly
What: acquire equipment, supplies,
and resources for expansion sites
Where: n/a
How Often: as planned
Services/Activities Details
What: annual follow-up screenings
Where: Sunrise and at least 2 new
clinical sites
How Often 12 month intervals from
baseline screening (at least once
quartedy)
What: reminder calls and/or mailings
for screening appointments
Where: n/a
How Often: at least two contacts
Collaboration/
Partnership
Infrastructure
Infrastructure
S.MAR.T.
Outcome Objective
N2:
Strategies to meet
your obiective
Screening
(12 month follow-
up)
Screening (12
month follow-up)
N
N
0
CO
N
m
m
2
W
a
L
x
W
By 06/30/10, at least 75% of women* enrolled in the Heart of Weld Lifestyle Intervention Program will complete their 6mo. &
12 mo. screenings. rWISEWOMAN program target)
Measures or data that will show your Reach,
Effectiveness, or Implementation
Reach: program database; number of Heart of
Weld participants re -screened compared to target
of 75%
Effectiveness: program database; changes in
biometric measurements and risk levels
Implementation. review/audit of program
database and program records for compliance
with program procedure
Reach: program database; number of Heart of
Weld participants re -screened compared to target
of 75%
Effectiveness: program database; changes in
biometric measurements and risk levels
Implementation: review/audit of program
database and program records for compliance
with program procedure
Reach: N/A
Effectiveness: N/A
Implementation: call logs, program database;
number of contacts per baseline screened woman
By 06/30/10, at least 60% of women' enrolled in the Heart of Weld Lifestyle Intervention Program will complete all
intervention sessions. ('WISEWOMAN program target)
Measures or data that will show your Reach,
Effectiveness, or Implementation
Reach: Class sign in sheets; program database;
data about class participation for one, four and all
eight sessions
Anticipated Outcomes
Detect level of disease
for further follow-up and
to prevent
onset/progression of
disease
Detect level of disease
for further follow-up and
to prevent
onset/progression of
disease
Excellent re -screening
rates
Anticipated Outcomes
Improve nutrition,
physical activity, stress
Implementation
Timeframe
d
5
d
5
d
O
Implementation
Timeframe
O
5
Target Population
N
d L L 7
i s
O> N O> N d
O d U OJ ≤,
c O 0 t0 ≤ N .-
0 3 0Ip y@ L 2
o f •c t- m `h
. N
d L L a
= • -
E
0) ow N O Q @ d
@ m 6 .... U m =,„,
O)
N s C co O, c
0 3 0 763 R L a)
`o E•2 m y
N
dco ap = C =
-L Q j L
m E
0) d N 0 9 N O
@ t0 J« U C.E m
N O = 0 C d c
O_ = O- E L N
`o E•2 Tv w
Target Population
Women at risk for
CVD
Services/Activities Details
What 6 month follow-up screenings
Where: Sunrise and at least 2 new
clinical sites
How Often: 6 month intervals from
baseline screening (at least once
quarterly)
What: annual follow-up screenings
Where: Sunrise and at least 2 new
clinical sites
How Often: 12 month intervals from
baseline screening (at least once
quarterly)
What: reminder calls and/or mailings
for screening appointments
Where: n/a
How Often: at least two contacts
ServiceslActivities Details
What: New Leaf / Wisewoman lifestyle
intervention classes in English and
Spanish
S.M.A.R.T.
Outcome Objective
#3:
Strategies to meet
your objective
Screening
(6 month follow-
up)
Screening
(12 month follow-
up)
Screening (6 and 12
month follow-up)
S.M.A.R.T.
Outcome Objective
#4 :
Strategies to meet
your objective
Risk Factor
Reduction
N
N
0
N
N
m
m
d
w
0
x
w
Effectiveness: Self -reported behavior change
upon completion of lifestyle intervention program
and changes in biometric measurements at six
and/or twelve months
Implementation: Instructor class notes;
participant survey
Reachprogram database
Effectiveness: Self -reported behavior change
upon completion of lifestyle intervention program
and changes in biometric measurements at six
and/or twelve months
Implementation: Counseling notes; participant
survey
Reach: N/A
Effectiveness: N/A
Implementation: training evaluation forms
By 06/30/10, 50% of women completing* the Heart of Weld Lifestyle Intervention Program will improve one or more
dietary, physical activity, stress reduction, and/or smoking practices. ('Completion means at least 10 months from
baseline screening and upon completion of the 8 -week lifestyle intervention and maintenance programs.)
Measures or data that will show your Reach,
Effectiveness, or Implementation
Reach: program database
Effectiveness: Self -reported behavior change
upon completion of lifestyle intervention program
and changes in biometric measurements at six
and/or twelve months
Implementation: program records; participant
survey
Reach: program database
Effectiveness: Self -reported behavior change
upon completion of lifestyle intervention program
and changes in biometric measurements at six
and/or twelve months
reduction, and smoking
practices.
Improve nutrition,
physical activity, stress
reduction, and smoking
practices.
Increase knowledge and
skills in implementing
program
Anticipated Outcomes
Improve nutrition,
physical activity, stress
reduction, and smoking
practices.
Improve nutrition,
physical activity. stress
reduction, and smoking
practices.
p
O
$99
_
Ii
(J
O
O
0
Y
`
N
=
E Q
co >U
Program and clinic
staff
Target Population
o
Y
N
•C
N
=
E c
U
Women at risk for
CVD
Where: community
How Often: 4 series of eight sessions
during grant year 2
What: individual healthy lifestyle
counseling
Where: clinic or by phone
How Often: at least once during
lifestyle intervention classes
What: lifestyle intervention training
(New Leaf Curriculum)
Where: screening sites
How Often: once
Services/Activities Details
What: maintenance program
educational mailings
Where: n/a
How Often: at least four times (3
months after completion of lifestyle
intervention classes)
What: maintenance program brief
phone counseling
Where: n/a
Risk Factor
Reduction
EducationfTraining
S.MA.R.T.
Outcome Objective
/5 :
Strategies to meet
your objective
O C
u O
A'-
LL CJ
Y Q
N y
Risk Factor
Reduction
0
CO
O
to
a
W
w
Implementation Counseling notes, participant
survey
By 06/30/10, at least 50% of women completing the Heart of Weld Lifestyle Intervention Program will participate in
community -based nutrition education or physical activity programs.
Measures or data that will show your Reach,
Effectiveness, or Implementation
Reach class sign -ins data about participation
compared to 30% target
Effectiveness N/A
Implementation data about class participation
and completion
Reach class sign -ins data about participation
compared to 30% target
Effectiveness N/A
Implementation data about class participation
and completion
Reach group sign -ins, data about participation
compared to 30% target
Effectiveness N/A
Implementation data about participation and
completion
z
=
U
A
d
ce
Effectiveness N/A I
Implementation evidence of certification
Reach media exposure counts
Effectiveness N/A
Implementation program records
Anticipated Outcomes
Improved dietary
practices
Increased physical
activity
Increased physical
activity
Zumba instructor
certification
Increase awareness
about CVD, prevention,
and available services
E
O
O
O
Q2
SI
Target Population
Women at nsk for
CVD
Women at nsk for
CVD
Women at nsk for
CVD
2 Community
members
Women at nsk for
CVD
How Often at least twice (3 months
after completion of lifestyle intervention
classes)
Services/Activities Details
What healthy cooking & nutntion
classes
Where community
How Often twice monthly
What Multiple senes of Zumba classes
Where community
How Often minimum of once / week
for 8 weeks
What multiple senes of walking groups
I Where community
How Often minimum of twice weekly
I What Zumba instructor training
I Where community
How Often one time
What media campaign and advertising
program
I Where community
How Often quartedy campaigns
S.M.A.R.T.
Outcome Objective
#6:
Strategies to meet
your objective
Risk Factor
Reduction
Risk Factor
Reduction
Risk Factor
Reduction
Education/Training
Awareness
N
N
O
a,
N
m
c
a
Exhibit E
Background
Based on data from the 2005 Weld County Beh avior Risk Factor Surveillance Survey,
we estimate there are approximately 32,500 women between the ages of 40 and 64 years in
Weld County. Women in this age group comprise about 40 percent of all adult women in Weld
County and about 20 percent of all Weld County adults. We estimate the target population for
this project to be about 10,900 women between the ages of 40 to 64 years or about 33 percent
of women in this age group.
Table 1 outlines several demographic characteristics of Weld County women in this age
group compared to the program's initial cohort of participants in which data are available. Most
Weld County women in this age group are White (75%), have attended some college (57%),
and employed (59%). On the other hand, most Heart of Weld program participants are of
Hispanic or Latino origin (65%), not high school graduates (42%), and homemakers (33%).
Approximately 16 percent of Weld County women aged 40 to 64 years describe their overall
health status as fair or poor compared to 50% of program participants so far. Seventeen
percent of Weld County women in this age group report they do not have health insurance
compared to 98% of program participants.
Table 1. Weld County women aged 40 to 64 years compared to Heart of Weld cohort 1
participants
Characteristic
Race/Ethnicity Category
White, not Hispanic
Hispanic origin
Other race/ethnicity
Education Level
No high school diploma
High school graduate or equivalent
Some college
College graduate
Employment Status
Employed
Self-employed
Out of work
Homemaker
Weld County Screened Women
Women* Cohort 1 (n=64)
75%
22%
2%
14%
28%
31%
26%
59%
10%
4%
14%
32%
65%
3%
42%
20%
28%
8%
19%
5%
14%
33%
Page 10 of 22
Exhibit E
Student
Retired
Not able to work
Self -reported health fair or poor
No health insurance
<1%
7%
2%
6%
22%
50%
98%
*2005 Weld County Behavior Risk Factor Surveillance Survey
Preliminary data are available on a small group of program participants (n=64) regarding
their risk for cardiovascular disease and their current medical history. Over 60% of participants
were at moderate or high risk for cardiovascular disease based on the Adult Cardiovascular
Disease and Stroke Prevention Guidelines developed by the Colorado Clinical Guidelines
Collaborative. A majority of the women were overweight or obese, 20% were smokers, and
50% had Type II diabetes. Additional risk factors are highlighted in Table 2.
Table 2. Heart of Weld cohort one participant risk factors
Framingham Risk Level
Low
Moderate
High (includes modified based on personal health
factors)
Total cholesterol high
HDL high
LDL high/very high
Triglycerides high/very high
At risk blood pressure
BMI risk (overweight/obese)
Current tobacco user
Currently taking HBP meds
Currently taking cholesterol meds
History of stroke/TIA
History of heart disease
Type II diabetes
Cohort 1
(n=64)
39%
2%
59%
25%
50%
11%
58%
77%
92%
20%
57%
23%
5%
9%
50%
Page 11 of 22
w
x
w
Updated Program Evaluation Plan & Logic Model
The Heart of Weld updated evaluation plan is outlined in Tables 3 through 8 by each SMART Objective. Each table contains
information about the extent which objectives will be evaluated including methods, data sources, analysis, timelines, reporting, and use of
yes have not changed from year 1. The current detailed evaluation plan was expanded from the year
on page 27. The goals and obje
one evaluation plan and includes more specific evaluation questions that correspond with the measures and data we plan to use to
evaluation the program's reach, effectiveness, and implementation with the target population.
Table 3. Detailed evaluation plan.
Objective 1: By 06/30/10, 750 women from the target population residing in Weld County will complete CVD risk factor screening.
Reporting
and Use
a) Go
0 O c tr
-
N O MS N a3
N c aL
2 0 -OQ acr) r l6 Y
0
0
as Tam
' m
o Q
o
LO 0 0
rn a)
0 o +- ) C '0 c6
m o.o�c
a3 a) -.-'n, a)r nc.-
a C-) a) a °E - a)
O= c a) O O a
U c m d m a 2 o r- 12
Time
Frame
a
a)
t
as
3
O
Data Collection
Methods
co
0
a)
z
o- vs
o to
N a
m a
sa I-
m
m�
0 m
Data
Source(s)
w E
n1 aJ
��
o co
m
0_ -o
Indicators
T
,r- 0 a
0 0) c
c_ c a5
a)•c—
a m
a) a)a)
)
Z wow
Evaluation Questions
How many eligible women
were screened at each site
and what percentage of
the target population
(n=10,900) did the
program come in contact
with?
Page 12 of 22
Objective 1: By 06/30/10, 750 women from the target population residing in Weld County will complete CVD risk factor screening.
Reporting
and Use
Progress
report for
funder &
written report
for all partners/
stakeholders
Written report
for all
partners/
stakeholders
Written report
for all
partners/
stakeholders
Report to
program staff/
advisory
committee
Report to
program staff/
advisory
committee
Report to
program staff/
advisory
committee
N
0
T _
V R
co C
O4
Comparison of
descriptive
statistics of
participants to
target
population
Calculate
percentages
Calculate
percentages
Program
records audit
Program
records audit
Calculate
percentages
N
N E
F-LL8
A
C
>
Quarterly
>.
t
>
a
Annually
Annually
T
C
CO
S
a
Data Collection
Methods
Database queries
and reports
Database queries
and reports
Database queries
and reports
Staff interview and
review of program
records
Staff interview and
review of program
records
Database queries
and reports
Data
Source(s)
Program
database
Program
database
Program
database
Program
records
Program
records
Program
database & E -
Cast
database
Indicators
Demographic
and other
characteristics
of women
screened
Count of
screened
women in each
risk category
Count of
screened
women in each
BMI, BP, and
cholesterol risk
category
Number of
results letter
mailed
Evidence that
procedures
followed
Count of
women
screened who
are enrolled in
WWC
Evaluation Questions
Do participant
characteristics reflect the
target population?
What percentage of
screened women are low,
moderate, and high risk
based on Framingham
tool?
What percentage of
women were at risk for
CVD based on BMI,
elevated BP or
cholesterol?
Were the necessary and
appropriate results letters
prepared and mailed in a
timely fashion?
To what extent were
CCGC guidelines followed
for determination of risk
and subsequent referral?
Of the women screened,
how many were also
enrolled in Women's
Wellness Connection and
how many were referred to
WWC?
Page 13 of 22
W
n
w
Objective 1: By 06/30/10, 750 women from the target population residing in Weld County will complete CVD risk factor screening.
Reporting
and Use
f6
N U)
O co N E
U) °) > E
cc `o_m o
Progress
report for
funder
Progress
report for
funder
N
N
U7 T
CO C
Q
m
U) >,
0) O)Q N
N
N ' N w
= N O
V O U) U)
a
U a 2
Voucher
counts and
dollar spent
compared to
annual
allocation
Comparison of
planned vs.
actual number
of
presentations
and contacts
Time
Frame
T
la
t
co =
0
T
L
C O
2
T
To
=
c
a
Data Collection
Methods
Co
U)
•U)
_
Cr Co
)r
N O
6 O
N
f6
0a
D m
Voucher log
Staff interview and
review of program
records
co
i
(1)
N 9
Ca
Program
records
Presentation
logs and
program
records
Indicators
-0 c
U O
0
w c p
O N «.- c 06 N Cl
C MO O
1] N d Z Y N O N c0 «. U)
E E d p go) c 2.c 0 2
= O E U) (6 O U) N O
Z �i O= Co o U CO L N
Counts and
total dollars
spent on
vouchers
Counts of
presentations/
contacts and
agencies
reached
Evaluation Questions
How many baseline
screened women were
referred to the lifestyle
intervention, smoking
cessation, colon cancer
screening, and/or
behavioral health
screening?
How many women
received vouchers?
Was the project publicized
to social service and faith -
based organizations as
planned? How many
organizations were
reached?
Page 14 of 22
W
W
Objective 2: By 06/30/10, at least 50% of all baseline screened women will complete their 12 mo. screening visit.
Reporting
and Use
Progress
report for
funder
Written report
for all partners/
stakeholders
Report to
program staff/
advisory
committee
N
N
_T
V C
co C
O <
Calculate and
compare
percentage to
target of 50%
Statistical
comparison of
baseline and
12 month
screening
results
Calculate
percentage
reached to
target of >
80%
N="'
d
E `
F LL
(6
c
Q
T
N
C
Q
Annually
Data Collection
Methods
Database queries
and reports
Database queries
and reports
Staff interview and
review of program
records
Data
Source(s)
Program
database
Program
database
Program
records
Indicators
Number of
baseline
women
screened at
one-year re-
screening visit
Change in
biometric
measurements
and risk levels
after one year
Percentage of
screened
women reached
to schedule
follow-up
Evaluation Questions
How many baseline
screened women,
regardless of risk level,
completed their one-year
screening visit?
To what extent did their
risk levels change?
How many baseline
screened women were
reached by phone or mail
to schedule their follow-up
appointments?
Page 15 of 22
W
L
X
W
Objective 3: By 06/30/10, at least 75% of women* enrolled in the Heart of Weld Lifestyle Intervention Program will complete their
6mo. & 12 mo. screenings. (*WISEW0MAN program target)
Reporting
and Use
a3
7) a)
t O N N E
a °'.5 E
ft acu o0
Report to
program staff/
advisory
committee
Report to
program staff/
advisory
committee
u)
7)
R C
OQ
w
m
a) a)
co -
@
C
O co
N =
a a)IL)
Calculate
percentage
reached to
target of >
80%
Content
analysis
a)
0 Er
E go
H LL
T
N
=
O
>.
>
C
Q
T
>
C
Q
Data Collection
Methods
Database queries
and reports
Staff interview and
review of program
records
Staff interview and
review of program
records
h
y
V
:° 3
0 y
E N
9 a7
I'm
o r
d aa
Program
records /
database
Program
records /
database
Indicators
L
O -
N .'c o y
w o
O — C a5 E O>
a)CE cti a) O -5 a) a5 .O- ON C
a' r c a a)
zSJ co_ a2' m ai
Percentage of
lifestyle
intervention
program
women reached
to schedule
follow-up
Description of
reasons and
counts of
reasons for not
bein screened
Evaluation Questions
How many Heart of Weld
Lifestyle Intervention
Program participants
completed their six-month
and twelve month
screening visit?
How many were reached
by phone or mail to
schedule their follow-up
appointments?
For what reasons were
women not re -screened at
6 months and 12 months?
Page 16 of 22
W
X
w
Objective 4: By 06/30/10, at least 60 percent of women* enrolled in the Heart of Weld Lifestyle Intervention Program complete all
intervention sessions. (*WISEWOMAN program target)
Reporting
and Use
Progress
report for
funder &
written report
for all partners/
stakeholders
Progress
report for
funder &
written report
for all partners/
stakeholders
Progress
report for
funder &
written report
for all partners/
stakeholders
7.5
O a) y
ac a)
ma o
a) L
= m
a) a)
2 N
co
W C
¢
Calculation of
participation
rates
compared to
target rate of
60%
Calculation
and
comparison of
individual
sessions
participation
rates
;Percentage of
lifestyle
intervention
who received
counseling
`o
N Q o
° C O y 0
@ a to
a) a) can a) ...
a a '> a7
Time
Frame
>.
r
a)
=
(J
T
r
a'
M
Ci
>,
r
to
Z
C
C 2"
w o m
o
-o N 3
c w c
y w m
Data Collection
Methods
Review of program
data, database
reports
Review of program
data, database
reports
Review of program
data, database
reports
Self-administered
questionnaires;
program survey
ar
a
Oc
Class sign -in
sheets;
program
database
Class sign -in
sheets;
program
database
Counseling
logs; program
database
c
as
a w
U
a u)
Indicators
Number of
participants
attending
lifestyle
intervention
sessions
Number of
participants
attending
lifestyle
intervention
sessions
Number of
lifestyle
intervention
participants
who received
one-on-one
counseling
L_
3 0
c
c o c a
o (13 a U � E c a) E
c w6 -6 N a O N
> r > a' Ea -o °'
p O O
a
a N .E a s N a
Evaluation Questions
How many lifestyle
intervention program
participants attend at least
one session? At least 4
sessions? All sessions?
Which sessions did
participants attend most?
Did participants receive at
least one healthy lifestyle
individual counseling
sessions during the 8 -
week intervention
program?
To what extent were
lifestyle intervention
participants satisfied with
the program overall? With
particular sessions? Other
aspects of the program?
W
a
W
Objective 4: By 06/30/10, at least 60 percent of women* enrolled in the Heart of Weld Lifestyle Intervention Program complete all
intervention sessions. ("WISEWOMAN program target"
Reporting
and Use
Report to
program staff/
advisory
committee
Report to
program
staff/advisory
committee
0
0
Content
analysis
Content
analysis
T
r
co
_
R
i
0
4
d
Annually
Annually
E R
F LL
Data Collection
Methods
Staff interview and
review of program
records
,Staff interviews and
review of program
records
N
Participant
surveys
Program
records
07
O
2,
0
Indicators
Description of
barriers for not
being screened
Multiple
indicators of
evidence of
curriculum
fidelity
Evaluation Questions
What barriers prevented
participants from
completing all sessions?
To what extent was the
curriculum for each
lifestyle intervention
session followed?
0
0O
N
O)
Cu
a
W
L
x
w
Objective 5: By 06/30/10, 50% of women completing the Heart of Weld Lifestyle Intervention Program will improve one or more
dietary, physical activity, stress reduction, and/or smoking practices.
Reporting
and Use
Progress
report for
funder &
written report
for all partners/
stakeholders
Progress
report for
funder & report
to program
staff/ advisory
committee
Progress
report for
funder & report
to program
staff/ advisory
committee
Report to
program staff/
advisory
committee
N
N
T RI 75
R C
O <
Statistical
analysis of 6
month and 12
month findings
to baseline
Percentage of
lifestyle
intervention
who received
,mailings
Percentage of
lifestyle
intervention
who received
phone
counseling
Descriptive
and analytic
analysis of
behavior
outcomes
Time
Frame
CO N
N r
C ui N
--•
N c c
co coEE
T
N
(6
0
T
N
(0
0
T
N
c
Q
Data Collection
Methods
Self-administered
survey
Review of program
data, database
reports
Review of program
data, database
reports
Database queries
and reports
N
d
U
(0 6-
r 7
N O
Participant
survey
Program
database
Counseling
logs; program
database
Program
database
Indicators
Changes in
diet, exercise,
stress
reduction, or
smoking
behavior
Number of
lifestyle
intervention
participants
who received
educational
mailings
Number of
lifestyle
intervention
participants
who received
brief phone
counselin
Number of
participants
exhibiting
behavior
change by level
of program
participation
Evaluation Questions
To what extent did women
completing the lifestyle
intervention program
positively change their diet,
exercise, stress reduction,
and smoking behaviors?
Did lifestyle intervention
program participants
receive educational
mailings?
Did lifestyle intervention
participants receive
maintenance program brief
phone counseling?
Was there a positive
association between
behavior changes and
level of participation in the
lifestyle intervention
program and maintenance
pro ram?
w
a
x
w
Objective 6: By 06/30/10, at least 50% of women completing the Heart of Weld Lifestyle Intervention Program will participate in
community -based nutrition education, physical activity, or stress reduction programs.
Reporting
and Use
Report to
program staff/
advisory
committee
Report to
program staff/
advisory
committee
Report to
program staff/
advisory
committee
Report to
program staff/
advisory
committee
Report to
program staff/
advisory
committee
N
0
_T
M(71
R C
0Q
Calculation of
participation
rates
compared to
target rate of
50%
Calculation of
participation
'rates
compared to
target rate of
50%
Calculation of
participation
rates
compared to
target rate of
50%
Calculation of
participation
rates
compared to
target rate of
50%
Content
analysis of
program
records
Time
Frame
T
@
C
C
Q
T
N
C
C
Q
T
(7
C
C
Q
T
6
C
C
Q
Annually
Data Collection
Methods
Self-administered
survey
Self-administered
survey
Self-administered
survey
Self-administered
survey
Review of program
records
Data
Source(s)
Participant
survey
Participant
survey
Participant
survey
Participant
survey
Program
records
Indicators
Number of
lifestyle
intervention
women
participating in
nutrition classes
Number of
lifestyle
intervention
women
participating in
exercise
classes
Number of
lifestyle
intervention
women
participating in
other classes
Number of
lifestyle
intervention
women
participating in
stress reduction
classes
Evidence of
certification
Evaluation Questions
How many women from
the lifestyle intervention
program also participated
in community -based
nutrition classes?
How many women from
the lifestyle intervention
program also participated
in Zumba classes and/or
walking groups?
How many women from
the lifestyle intervention
program also participated
in other nutrition education
or physical activity
programs?
How many participated in
community -based stress
reduction programs?
How many new Zumba
instructors were trained in
Year 2?
N
0
0
N
d
m
m
a
w
a
L
w
Objective 6: By 06/30/10, at least 50% of women completing the Heart of Weld Lifestyle Intervention Program will participate in
community -based nutrition education, physical activity, or stress reduction programs.
Reporting
and Use
Progress
report for
funder & report
for all partners/
stakeholders
Progress
report for
funder &
written report
for all partners/
stakeholders
N
y
_T
Y
N C
OQ
Content
analysis
Percentage of
participants
Time
Frame
Quarterly
T
C
C
C
a
Data Collection
Methods
Media exposure
logs
Self-administered
survey
N
N
U
ate+ J
CO O
Program
records
Participant
survey
N
O
V
CO
U_
V
C
Paid and
earned media
exposure
counts
Number of
participants
recalling seeing
or hearing CVD
media
messages
Evaluation Questions
How many media
exposures occurred in
Year 2?
How many participants
report seeing or hearing
messages about CVD?
N
N
0
N
N
m
N
a
Exhibit E
Heart of Weld Theory of Action Logic Model (revised January 2009)
Project Goal: To reduce modifiable risk factors for cardiovascular disease among women aged 40 to 64 years who
are uninsured or underinsured, with an emphasis on low income or Latino residents and women enrolled in the
Women's Wellness Connection.
Project Components
(Inputs)
o Screening for major modifiable
CVD risk factors using CCGC
Screening and Referral
Guidelines
Integration of screening &
intervention activities with
Northern Colorado Women's
Wellness Connection clients
Community -based lifestyle
intervention classes that target
people at all levels of risk for
CVD
• Research -based curriculum
(New LeafNida Saludable,
Corazon Contento)
Partners: Sunrise Community
Health, Inc. ; Salud Community
Health Center, and other North
Colorado Health Alliance
providers
c Active collaboration with other
health department partners:
WC Diabetes Coalition; Steps
to a Healthier Weld; CSU
Extension Food and Nutrition
Program; Weld County Faith -
based Initiative; Greeley/Evans
School District 6
▪ Regular communication with
advisory committees: North
Colorado Health Alliance; Weld
County Health Media Advisory
Committee; Project Advisory
Committee
a Active target population
involvement in planning and
implementing program
• Trainings for staff, health care
providers and administrators
Medical vouchers for clinical
services
• Participant incentives (e.g., gift
cards, cookbooks. etc.)
Comprehensive evaluation plan
0
O
Activities
What happens:
Screening & risk
assessment by
qualified clinical staff
Appropriate clinical
referrals (including
smoking cessation) and
follow-up
Individual and group
counseling (2 one-on-
one sessions; 8 week
group counseling using
modified New Leaf
Curriculum and
Spanish counterpart)
Maintenance
intervention at three
months of 4 nutrition
and physical activity
educational mailings
and 2 brief phone
counseling calls from
health staff
Re -screening at sir
months and one year
Ongoing weekly
community -based
physical activity and
nutrition classes
Community awareness
campaign for target
population
Short-term
Objectives
Objective 1:
Women will
complete CVD risk
factor screening
Intermediate
Objectives
Objective 2 & 3:
Women will
complete their six-
month and 12 -
month screening
visit
Objective 4:
Women will
complete lifestyle
intervention &
maintenance
program
Objective 5:
Women will
improve their
dietary, physical
activity, stress
reduction or
smoking practices
Objective 6:
Women will
participate in
community -based
clinical and
physical activity
and nutrition
activities
Long-term
Objectives
Reduce the
percentage of
eligible women
with elevated
CVD risk scores
Decrease the
incidence of
eligible women
with risk factors
for nutrition.
physical
activity, obesity,
stress, and/or
smoking
Page 22 of 22
Exhibit F
APPLICATION BUDGET FORM
Cantor Cardiovascular Disease and Pulmonary DL ease Competitive Grants Program
APPLICANT:
PROJECT TITLE:
6'he
.k only one:
7 veer 2 (24), I, 2069- rune 30. 2010)
Weld County Department of Public Health 8
Environment
Heart of Weld
SOURCE OF FUNDS
Requested
Other Source'
Other Source'
CDPHE
Since
$0066.2
PERSONAL SERVICES
FTE
%Etfon
Monthly
Salary
Monthly
Benefits
leof
Months
If applicable,
funding
source name
If applicable,
funding
source name
Name
Position
Gabrielle Vergaa
Project Coordinator
050
$533090
$189744
120
$43,418.04
$0.00
5000
GTiselda Still
Health Educator II
065
$4.96.41
$1,519 83
120
$45.21067
$0.00
$0.00
Of elm Orozco
Heats Educator II
0.75
$4.32507
$1,537.13
12.0
$52759.80
$000
$0.00
Elena Vasquez
Medical Assistant
0.50
$2,882.88
$11532
120
$17.98920
$0.00
$000
Cindy Kronauge
Data Specialist
0.10
$6,192.80
52,200.92
12.0
510072.46
$0.00
$0.00
0.00
50.00
5000
00
$000
$o.00
$0.00
Subtotal Personal Services
2.50
$169,450.18
SO.00
$0.00
DIRECT OPERATING COSTS
Unit
Quantity
Rate
Printing/Copying
each
500000
$ 020
$1,000.00
$000
$0.00
Postage/Shipping
each
1200.00
$ 1.00
$1,200.00
$0.00
$0.00
Computer Equipment
each
100
$ 2.500.00
$2500.00
$0 e0
$0.00
Supplies (Cnmeoct unit unuppliel
each
200
$ 2,30000
$4,600.00
$0.00
$0.00
Supplies( fa s-eenmgl
per screening
1200.00
$ 200
52,40000
$0.00
$0.00
Supplies lguneal°ourrouter,
per FTE
250
$ 45.00
$11250
$000
$000
Staff Development
staff member
4.00
$ 350.00
51400.DO
$0.00
$0.00
Meeting Expenses peeumsessi
per meeting
1500
$ 75.00
$1.12500
$000
$0.00
Other Program Cost s fp,oga,n inamivesl
per participant
30000
5 25.00
67500.00
$000
$0.00
Subtotal Operating Costs
$21,837.50
$0.00
5000
TRAVEL
Unit
Quantity
Rate
Mileage
mid
8000.00
$ 050
$ 4000.00
$0.00
$000
Lodging
day
200
$ 150.00
$ 30000
$000
$0.00
Meals
stun/day
000
$ 4000
$ 320.90
$000
$0.00
Other Travel
$ -
1000
$0.00
Subtotal Travel Costs
54,620.00
$000
$0.00
CONTRACTUAL
Unit
Quantity
Rate
Contract Trainer l New leaf Training orequiva.eml
per training
100
$ 4,000.00
$ 4,00000
$000
50.00
Contract Trainer iZ.rrba lhsauoNr Training)
per person
2.00
$ 27500
$ 550 OD
$0.00
$000
Subcontract idalabase development/management)
hour
8000
5 7500
$ 6,000.00
S000
$0.00
Subcontract iZumba Insirumorl
hour
10000
S 2000
1 2,000.00
$0.00
$000
Subtotal Contractual Costs
$12,550.00
$0.00
$0.00
OTHER COSTS
Unit
Quantity
Rate
Marketing/Media
per campaign
4
1 1500.00
$ 6.00000
$000
$0.00
Outreach/Educational Materials
per class
6900
$ 5000
$ 345000
$0.00
$000
Screening
per screening
120000
$ 10.00
$ 12000.00
$000
$000
Treatment lmodme,, rouc'e's)
vouchers
2500
$ 100.00
$ 250000
$900
50.00
Other Intervention Costs ,:smoking cessation classes)
vouchers
2500
5 11.00
$ 27500
$0.00
$000
Subtotal Other Costs
$24,225.00
$0.0
$0.00
CDPHE
ton 1
Saxe 2
TOTAL DIRECT COST:
$232,68268
$0.00
$0.00
INDIRECT COSTS'. 2% 01 Contractual
$12,550.00
$25100
INDIRECT COSTS' 10% Of All Other
$220,13268
$22,69568
Total Indirect Cost (Calculated on Amount Requested from CDPHE Only)
$22,946.68
TOTAL AMOUNT REQUESTED FROM CDPHE
$ 255,629
'Other Please indicate additional funding sources if applicable.
Page 1 of 5
Exhibit F
BUDGET NARRATIVE
Year 2 (only): July 1, 2009 through June 30, 2010
PERSONAL SERVICES: $169,450.18
Note: There has been a slight change in FTE from the original Year 2 budget. Originally,
our project coordinator position was 1 FTE and was split between two staff We have now
dropped that position to .50 F TE and it will be held by one staff person. The other .50 FTE,
which has actually been increased to .65 FTE, will strictly be a health educator position. We
made this change for better delineation of job duties. We increased the FTE of this position
because we were finding that we needed more hours for the lifestyle intervention and
community classes.
Project Coordinator (.50 FTE)
The Project Coordinator, Gabrielle (Gabri) Vergara, MPH, will manage the grant, provide
general project oversight and supervision of grant personnel, arrange contracts with clinics
to provide CVD screening services and contacts with Zumba instructors and trainers, and
act as spokesperson for cardiovascular awareness campaigns. Gabri will perform
recruitment activities in the community and work with community partners to identify women
who are eligible for CVD screening. She will also recruit community members and clinical
service providers to participate on the project's advisory council and arrange monthly
meetings; and will train all personnel involved with the clinical screenings and lifestyle
intervention, as needed. Gabri, with the data specialist, will track project related data,
complete grant required reporting, and assist with project evaluation.
Salary calculation is $43,418.04 per year (at .50 FTE), which is $3,618.17 per month for
twelve months.
Health Educators (Griselda Still .65 FTE / Ofelia Orozco .75 FTE)
Griselda Still and Ofelia Orozco, will be the bi-lingual/bicultural health educators. They will
provide individual and group lifestyle intervention counseling, as well as maintenance
intervention phone counseling, and ar range follow-up screening. Griselda and Ofelia will
conduct outreach and recruitment activities for the project and assist with CVD screenings.
Griselda and Ofelia will also conduct a walking program, the lifestyle intervention classes,
and the community healthy nutrition/cooking classes. They will also assist the Project
Coordinator with data collection, and input client and program information into the database.
The salary calculation for Griselda is $45,210.67 per year (at .65 FTE), which is $3,767.55
per month for twelve months.
The salary calculation for Ofelia is $52,759.80 per year (at .75 FTE), which is $4,396.65 per
month for twelve months.
Page 2 of 5
Exhibit F
Medial Assistant (.50 FTE)
Elena Vasquez, the bi-lingual/bicultural medical assistant, will provide screening services at
contracted CVD screening sites. She will collect medical histories, an assessment of dietary
risk, physical activity habits, and smoking status along with all applicable clinical testing.
Elena will assist with conducting appointment reminder calls, scheduling follow up
screenings, assisting with group lifestyle intervention sessions, intervention classes,
entering data into the database, and in recruiting efforts for project participation.
The salary calculation for this position is $17,989.20 per year (at .50 FTE), which is
$1,499.10 per month for twelve months.
Data Specialist (.10 FTE)
Cindy Kronague, MPH, will gather, communicate, and manage all Heart of Weld data for
reporting and evaluation purposes, and provide supervision and guidance to the sub-
contracted database management team.
The salary calculation for this position is $10,072.46 per year (at .10 FTE), which is $893.37
per month for twelve months.
OPERATING COSTS: $21,837.50
Printing/Copying
5,000 copies for promotional and educational printing, patient history forms, and misc.
projects @ .20/copy for $1,000
Postage/Shipping
4 maintenance intervention mailings per enrolled lifestyle intervention participant: 300
participants x $1.00 per mailing x 4 mailings for $1,200
Computer Equipment
One laptop computer with docking station and software for $2,500
Supplies (Cholestech unit & related supplies)
Two Cholestech units (includes printer) @ $2,200/each for $4,400
Thermal printer labels @ $20/roll x 10 for $200
Total: $4,600
Supplies (for screening)
Blood Pressure Cuffs: 2 extra large @ $150 for $300
Stethoscopes: 2 @ $100 for $200
Digital Medical Scale (with a height arm): 2 scales @ $350.00 for $700
Miscellaneous screening supplies (pipettes, lancets, sharps containers etc): $1200
Total: $2,400
Supplies (general office supplies)
Miscellaneous general office supplies @ $45/FTE for $112.50
Page 3 of 5
Exhibit F
Staff Development
$350 per staff member (does not include data specialist) attend various staff development
trainings offered throughout the year for $1,400
Meeting Expenses
10 advisory committee meetings and 5 project clinical and intervention staff
meetings/trainings @ $75 each for $1,125
Other Program Costs (program incentives)
Includes small incentives for each of the 8 classes, related to that particular class (i.e.,
pedometer for physical activity class); also includes drawing for larger prize for those women
completing all 8 classes: 300 participants x $25 for $7,500
TRAVEL: $4,620
Mileage (in -state only)
Total of 8,000 miles for all staff @ $ 0.50/mile for $4000
Lodging
2 nights lodging for out-of-town meetings/conferences @ $150/night for $300
Meals
Meals for staff while attending out-of-town meetings/conferences: 2 days x 4 staff x $40/day
for $320
CONTRACTUAL: $12,550
Contract Trainer (New Leaf Training or equivalent)
$4,000 for project staff to be trained on the New Leaf curriculum; if not available, staff will
receive an equivalent training
Contract Trainer (Zumba instructor training)*
2 individuals to be trained as Zumba instructors @ $275/each for $550
* These individuals, once trained, will provide Zumba classes in their communities
Subcontract (database development/management)
80 hrs. (20 per quarter) @ $75/hour for $6,000 for the development and management of
project database
Subcontract (Zumba Instructor)
2 classes per week for 50 weeks @ $20/hour for $2,000
OTHER COSTS: $24,225
Marketing and Media
4 (quarterly) media/marketing campaigns during the year @ $1,500 per campaign for $6,000
Page 4 of 5
Exhibit F
Outreach/Education materials
Teaching supplies, educational materials, cooking supplies (for health cooking classes), etc.
for lifestyle intervention classes: 69 classes @ $50 per class for $3,450
Screening
Cholestech cartridges (test for Total Cholesterol, HDL, LDL, Triglycerides, and Glucose) @
$10/cartridge x 1,200 screenings for $12,000
Treatment
Medical vouchers for uninsured patients with "alert" screening results for one time medical
provider consultation: 1 voucher @ $100 x 25 patients for $2,500
Other Intervention Costs
Vouchers for smoking cessation classes: 25 vouchers @ $11/each for $275
INDIRECT COSTS: $22,946.68
Funding to cover grant management, administrative support and other indirect expenses is
calculated @ 10.31% (Weld County rate) of total direct costs. Contractual flow through is
calculated @ 2% of total contractual costs.
Page 5 of 5
STATE OF COLORADO
Bill Ritter, Jr., Governor
James B. Martin, 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
July 6, 2009
Judy Nero
1555 North l7`h Ave.
Greeley, CO 80631
Dear Ms. Nero:
Laboratory Services Division
8100 Lowry Blvd.
Denver, Colorado 80230-6928
(303) 692-3090
Colorado Department
of Public Health
and Environment
Enclosed is a fully executed contract amendment, routing no. 10 FLA 00084 for the Cardiovascular, Cancer, Pulmonary
Disease (CCPD) Program. Work can begin under this contract.
Corrections required by Colorado Department of Public Health and Environment's Purchasing & Contracts Office may have
been applied to this contract amendment. These corrections may include:
1) The addition of an extra zero in the middle of the contract routing number if the number was originally a six -
digit number (e.g. 10-0040 is now 10-00040);
2) The change of the header before the acronym list of the scope of work to "Scope of Work, Commonly Used
Acronyms and Abbreviations In The Cardiovascular, Cancer and Pulmonary Disease (CCPD) Grants Program
That May be Referenced In The Scope of Work:";
3) The correction of the title of all Interagency Agreement Amendments to "Contract Amendment."
These non -substantial corrections were made as "running changes." Pages of the original contract highlighting the corrected
language may be included for your reference.
Please contact me at (303) 692-2505 or chandra.hardwick(alstate.co.us with any questions.
Respectfully,
eittivitz
Chandra Hardwick
Colorado Department of Public Health and Environment
PSD Contracts & Purchasing Fiscal Officer
Enc.
Hello