HomeMy WebLinkAbout20081449.tiff RESOLUTION
RE: APPROVE LIMITED AMENDMENT FOR TASK ORDER#1 FOR NURSE HOME VISITOR
PROGRAM AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Limited Amendment for Task Order#1
for the Nurse Home Visitor Program between the County of Weld, State of Colorado, by and
through the Board of County Commissioners of Weld County, on behalf of the Weld County
Department of Public Health and Environment, and the Colorado Department of Public Health and
Environment, commencing July 1, 2008, and ending June 30, 2009, 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 the Limited Amendment for Task Order #1 for the Nurse Home Visitor
Program between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Weld County Department of Public Health and
Environment, and the Colorado Department of Public Health and Environment be, and hereby is,
approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said amendment.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 14th day of May, A.D., 2008.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ilaa
ATTEST: Ageki
��� ';''t7�=? •' L l ,
William H. Jerke, Chair
' 1861 F
Weld County Clerk to th Bo
EXCUSED
6I �� Robert D. Masden, Pro-Tem
BY: I /t-- i s�i!a► � 4a/�_�
Deputy Clerk o the Board
Willi F. Garcia
�
APP � il
7i David E. Lang I/
ounty orney ce �ZZ�/+winat.-N
Douglas Rademacher )))
Date of signature: 4/414512
2008-1449
/1 HL0035
/ /y
Memorandum
TO: William H. Jerke, Chair
Board of County Commissioners
IlD
Mark E. Wallace, MD, MPH
cFROM:
Director, Department of Public Health
and Environ ent
COLORADO DATE: April 30, 2008
SUBJECT: Limited Amendment for Task Order #1
for the Nurse Home Visitor Program
Enclosed for Board review and approval is a limited amendment to Task Order#1 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 for the Nurse Home Visitor Program.
Under the provisions of this contract, WCDPHE will provide countywide nurse home visitor
services to low-income, first-time mothers. The funding from this task order will be used to
support health, education, and other resources for new young mothers during pregnancy and the
first years of their infants' lives.
For providing the services described above during the time period of Julyl, 2008 through
June 30, 2009, the State will pay Weld County an amount not to exceed $530,549, and it is
anticipated Medicaid will pay approximately$159,188. I recommend your approval of this task
order.
Enclosure
;cri — Ilu�l40
2008-1449
DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
NHVP
DEPARTMENT OR AGENCY NUMBER
FLA
CONTRACT ROUTING NUMBER
09-00019
LIMITED AMENDMENT FOR TASK ORDER#1
This Limited Amendment is made this 21st day of April, 2008, by and between the State of
Colorado, acting by and through the DEPARTMENT OF PUBLIC HEALTH AND
ENVIRONMENT, whose address or principal place of business is 4300 Cherry Creek Drive
South, Denver, Colorado 80246, hereinafter referred to as the "State"; and, Board of County
Commissioners of Weld County, for the use and benefit of the WELD COUNTY
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT, (a political subdivision of
the state of Colorado), whose address or principal place of business is 1555 North 17`h
Avenue, Greeley, Colorado 80631, hereinafter referred to as the "Contractor".
FACTUAL RECITALS
The parties entered into a Master Contract, dated January 23, 2007. with contract routing
number 08 FAA 00052 "the Master Contract".
Pursuant to the terms and conditions of the Master Contract, the parties entered into a Task Order
Contract, dated July 4,2007,with contract encumbrance number PO FLA FHS0800184, and
contract routing number 08 FLA 00184, collectively referred to herein as the "Original Task
Order Contract, whereby the Contractor was to provide to the State the following:
Contractor is to provide nurse home visitor services to low-income, first-time mothers in
the state of Colorado.
The State promises to pay the Contractor the sum of Five Hundred Thirty Thousand, Five
Hundred Forty-Nine Dollars, ($530,549.00) in exchange for the promise of the Contractor to
continue to perform the work identified in the Original Task Order Contract for the renewal term
of one year. ending on June 30, 2009.
NOW THEREFORE, in consideration of their mutual promises to each other, stated below. the
parties hereto agree as follows:
I. Consideration for this Limited Amendment to the Original Task Order Contract consists
of the payments and services that shall be made pursuant to this Limited Amendment,
Page 1of3
and promises and agreements herein set forth.
2. It is expressly agreed to by the parties that this Limited Amendment is supplemental to
the Original Task Order Contract, contract routing number 08 FLA 00184,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 Limited Amendment as though they were expressly rewritten, incorporated, and
included herein.
3. It is expressly agreed to by the parties that the Original Task Order Contract is and shall
be modified, altered, and changed in the following respects only:
A. This Limited Amendment is issued pursuant to paragraph 5 of the Original Task
Order Contract identified by contract routing number 08 FLA 00184. This
Limited Amendment is for the renewal term of July 1, 2008, through and
including June 30, 2009. The maximum amount payable by the State for the
work to be performed by the Contractor during this renewal term is Five
Hundred Thirty Thousand, Five Hundred Forty-Nine Dollars, ($530,549.00)
for an amended total financial obligation of the State of ONE MILLION,
FIFTY-THREE THOUSAND, THREE HUNDRED SEVENTY-NINE
DOLLARS, ($1,053,379.00). The revised Budget is incorporated herein by this
reference and identified as "Exhibit F". The revised Medicaid Reimbursement
Guidelines are incorporated herein by this reference and identified as "Exhibit
G". 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 Limited Amendment is July 1, 2008, or upon approval of the
State Controller, or an authorized delegate thereof, whichever is later.
5. Except for the Special Provisions and other terms and conditions of the Master Contract
and the General Provisions of the Original Task Order Contract, in the event of any
conflict, inconsistency, variance, or contradiction between the terms and provisions of
this Limited Amendment and any of the terms and provisions of the Original Task Order
Contract, the terms and provisions of this Limited Amendment shall in all respects
supersede, govern, and control. The Special Provisions and other terms and conditions of
the Master Contract shall always control over other provisions of the Original Task Order
Contract or any subsequent amendments thereto. The representations in the Special
Provisions to the Master Contract concerning the absence of personal interest of state of
Colorado employees and the certifications in the Special Provisions relating to illegal
aliens are presently reaffirmed.
6. FINANCIAL OBLIGATIONS OF THE STATE PAYABLE AFTER THE CURRENT
FISCAL YEAR ARE CONTINGENT UPON FUNDS FOR THAT PURPOSE BEING
APPROPRIATED, BUDGETED. AND OTHERWISE MADE AVAILABLE.
Page 2 of 3
IN WITNESS WHEREOF, the parties hereto have executed this Limited 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 and
accept personal responsibility for any and all damages the State may incur for any errors in such
representation.
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 ORADO
(a political subdivision of the state of Colorado) ill Ritter,. . Governor
By: /( By:
Name: William H. Jerke For the Executive Director
Title: Chair 05/14/2008 DEPARTMENT OF PUBLIC
HEALTH
AITEST: E AND ENVIRONMENT
V C!D COUNTY CLE^a TO TH A. % L` PROGRAM APPROVAL:
.�.. r \
By:
ATTESTING TO BOARD OF COON 7 '
COMMISSIONER SIGNATURES ONL tY
ALL CONTRACTS MUST BE APPROVE?) BY THE STATE CONTROLLER
CRS 24-30-202 requires that the State Controller approve all state contracts. This limited
amendment is not valid until the State Controller,or such assistant as he may delegate, has
signed it. The contractor is not authorized to begin performance until the contract is
signed and dated below. If performance begins prior to the date below, the State of
Colorado may not be obligated to pay for goods and/or services provided.
ST TE CONTROLLER
Da i J. McDer o , PA
By: L �
Date: "' D y 'OS--
v
WELD COUNTY DEPARTMENT OF
PUB_IICHEAL H ENV 'i' �EN J,
Page 3 of 3 BY: ,'�/�� . L& L
Mark E. Wallace, MD, MPH-Director
,2DDc9-79 9
COLORADO NURSE HOME VISITOR PROGRAM Exhibit F
200E-09 Final Budget
GRANTEE'.WELD County Health FOR THE PERIOD'. July 1.2008-June 30,2009
PROJECT'.
SOURCE OF FUNDS
Annual Na.of
Salary tenth TOTAL TOTAL REQUESTED
yA,
AMOUNT OTHER SOURCES :jyr`7E 4 i
Rat j Budget FTE REQUIRED Non-Medicaid) b v_GOPHE
PERSONAL SERVICES
nal Services I
drone Rowe Denning RN,B5N,NHO PHN II 561930 12 56930 13,139.17 43,]91
Eve Rodriguez RN,BON,NHV PHN II 56 930 12 58930 13,13917 43,791
Gera Hellos RN,BON,HON PHN II 56,506 12 66506 13,04131 43,465
Vesta Unruh RN BON NHV PHNII 52 415 12 52414 12,09690 4031]
Haley Harare RN SON,NHV PHN II 50.832 12 50831 11 731 55 39,099
Barbara Silverman,RN„BSN,NHV PHN II 50,032 12 50,831 11731 55 39 099
yore,Paslllas,Dale Entry Tappan OT III li 31.911 12 31011 7,36460 24,545
Barbara Francisco,RN.001.Supervisor PHN III 41609 12 0 41609 9,60316 32,006
centractaaleee Mr Service 0
supe:v:sag Pmaonnel 0
Serge Burette Rate=3554% 141436 32,642]5 108793
1,TOTAL PERSONAL SERVICES $539,397 OD SOW 5124,490.25 1414,906.]5
OPERATING Detail Expenusl _____
qr[e Tucsn '1'�..ss�.xmm 3000 59249 2306
Client Tucson oOprRMatetalt }ta�'ai.NCFv6`d.3900 1 90010 5,000
Copies or brerrsManlbator5 1000 230.10 3700
Postage 1000 460 80 ]39
Comla, ag Fes 2000 46134 31530
medical&Usage program
1200 36919 1,134
medical BPID Development
es 550 346.49 2.154
Pronoard erorost salt iren tE000 23040 2705
2.TOTryBOPE ATINGs -d *lu+ 000 28010 ]fig
2.TOTAL OPERATING $2125000 00 $62891] $2096003
EQUIPMENT Detail Expenses)
Computers w/Sofware 2500 576 99 1 923
Cellular Phones 75 1731 58
3.TOTAL EQUIPMENT $2 575 00 $000 $59030 5108070
TRAVEL(Detail Expenses)
Visit Outreach Mileage IS 4851 -mgµ $5$D 130545 24,615
NCCFC/UCHSC 1Inning Travel 175 4039 135
NCAST Travel 000 D
PIPE Travel BO 20 77 69
Nurse Meetings suwlotbet 1508 34804 1,160
4.TOTAL TRAVEL 50 00$33 77300S0W 57]9065 3259]8.35
NFP TRAINING B TECH ASSISTANCE(Detail Expenses)
Technical Assistance 1 d!!. aT.ii00ee 185206 6 200
Oo gong Nurse 0 doaton v(5 t{(OBI 32242 1870
India.Nurse Education
India,Supervisor Education
Odumlien Materials
S.TOTAL TRAINING&TECH ASSISTANCE 5940500 00 D0 $218448 57 280521
NCAST COSTS(Detail NCAST Training E Materials(
NCAST Regrswton 150 3462 115
NCAST MaLLnels 000 0
PIPE Training Materials 140 3231 108
0 00
TOTAL NCAST COSTS $29000 S000I 96693 522307
OTHER COSTS(Detail Other Program Costs)
7 TOTAL OTHER COSTS 9000 $000 5000 5000
TOTAL DIRECT PROGRAM COSTS(Add Lines 1-7I $612,750.00 $8,00 $141419 77I 9471,330.23
ADMINSTRATIVE COSTS Detail AEminstrative Costs)
Administrative stag,Human Resources Dept
sling E0L Finance Dept..Purchasing Dept,Treasurer 76007 17 768 23 59,219
DeplAccou 1nsurance,Building Maintenance and Pudding Use
Costs not prenousluy allocated as direct progem costs
TOTAL ADMINISTRATIVE COSTS 07698700 E000I 0!776023 $59,216%7
TOTAL PROJECT COST 'Direct Pronram E ADminlstrahve C0515) $689,737.00 $0.001 1159,188.00 $530,549.00
LIST OTHER SOURCES 0l FUNDING lea.,m in
MEDICAID 5159 188 00
$
$
$
TOTAL OTHER SOURCES 8159,188.00
Signalore of Authorized Representative Dale
Exhibit G
Colorado Department of Public Health and Environment
State Fiscal Year 2008-2009
Colorado Nurse Home Visitor Program
MEDICAID REIMBURSEMENT GUIDELINES
Agencies receiving funding through the Colorado Nurse Home Visitor Program (NHVP) are required to bill the Colorado
Department of Health Care Policy and Financing (HCPF) for Targeted Case Management (TCM) services provided to
Medicaid eligible mothers and children receiving services through the NI-IVP. Below is the information pertaining to the
NHVP Medicaid reimbursement process.
Contractor Name: Weld County Department of Public Health and Environment
Reimbursement Period: July 1,2008 To June 30,2009
Definition of Reimbursable Services: Colorado Nurse Home Visitors will provide Targeted Case Management (TCM)
services to first-time(defined as no previous live births), pregnant women or whose first child is less than one month old and
who are at or below 200% of the Federal Poverty Level. Program enrollment occurs during pregnancy, or within one month
postpartum. and services are designed to continue through the child's second birthday. TCM services include: Assessment of
the needs for health, mental health, social services, education, housing, child care, and related services for the women and
children; Development of care plans to obtain the needed services; Referral to resources to obtain the needed services,
including to medical providers who provide care to Medicaid-eligible pregnant women and children; Routine monitoring and
follow-up visits with the women in which the progress in obtaining the needed services is monitored, problem-solving
assistance is provided,and the care plans are revised to reflect the women and children's current needs.
Medicaid Billing Information:
NHVP providers will submit bills through the Medicaid Management
Billing Cycle Information System(MMIS)at the end of the month for each mother/child
receiving a visit.
Claim Form CO-1500
Claim Type E(practitioner/physician)
I1 (clinic), 12(Home),50(Family Qualified Health Center).and 72(Rural
Place of Service Health Center)
G9006,HD(For services rendered to the mother)
Procedure Code Modifiers
•
"f1017, HD(For services rendered to the child)
Affiliated Computer Services(ACS),the Medicaid fiscal agent, has a 120-day
"timely filing"policy(invoices must be submitted to ACS within 120 days
Billing Requirements from the date of service). Claims are usually paid/denied/adjusted within two
weeks of receipt—the maximum ACS response time is set at 30 days.
For information related to Medicaid billing and training,please contact
Affiliated Computer Services(ACS)at http:/coloradotmedicaid.acs-inc.com or
Provider Services Unit at 1-800-237-0757 or(303)534-0146 Monday through
Medicaid Contractor
Friday, 8:00 a.m.to 5:00 p.m.
Page 1 of 2
Exhibit G
You may also contact Ginger Burton,Colorado Department of Health Care
Policy and Financing,at 303-866-2693 or Givaer.Bunonostate.co.us if you
have questions on the Medicaid enrollment or billing process.
Medicaid Reimbursement Rate $190.04
For the Mother-Services to the mother shall be limited to 3 units per month
with a lifetime maximum of 30 units,or 3 units per month for 10 months. One
(I)unit equals 15 minutes of service. Each unit will equal $63.35 ($190.04
divided by 3). Full Medicaid reimbursement will be earned with a minimum of
45 minutes of service per month.
Service Limits
For the Child- Services to the child shall be limited to 3 units per month with
a lifetime maximum of 75 units,or 3 units per month for 25 months. One(I)
unit equals 15 minutes of service. Each unit will equal$63.35 ($190.04 divided
by 3). Full Medicaid reimbursement will be earned with a minimum of 45
minutes of service per month.
FY2008-09 Estimated $159,188
Medicaid Revenue
Page 2 of 2
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