HomeMy WebLinkAbout20081446.tiff RESOLUTION
RE: APPROVE CANCER, CARDIOVASCULAR DISEASE, AND CHRONIC PULMONARY
DISEASE PREVENTION AND TREATMENT PROGRAM CONTRACT 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 a Cancer, Cardiovascular Disease, and
Chronic Pulmonary Disease Prevention and Treatment Program Contract 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, 2008, and ending June 30, 2009, with further terms and conditions being as stated in said
contract, and
WHEREAS, after review, the Board deems it advisable to approve said contract, a copy of
which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Cancer, Cardiovascular Disease, and Chronic Pulmonary Disease
Prevention and Treatment Program Contract 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 restrictions on lobbying by anyone
using funds pursuant to this grant shall apply to any lobbying, as defined in Section 24-6-301 (3.5)
(a), C.R.S., and shall apply to all local government bodies, as well as their members.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said contract.
2008-1446
HL003,5
CANCER, CARDIOVASCULAR DISEASE, AND CHRONIC PULMONARY DISEASE
PREVENTION AND TREATMENT PROGRAM CONTRACT 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 14th day of May, A.D., 2008.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: ,�� , C C,r
o,. William H. Jerke, Chair
Weld County Clerk to t � .z
sITLP
4''�� •' EXCUSED
( 1 _y , Robert D. Masden, Pro-Tem
BY:
Deputy Cle to the Boar.
Willman F. Garcia
APPROVED A U+\
David E. Long
ounty ttorney c&>#6 "'ai "ielseN
Douglas Rademacher
Date of signature: WIE
2008-1446
HL0035
Memorandum
Keetisz, TO: William H.Jerke, Chair
Board of County Commissioners
FROM: Mark E. Wallace,MD, MPH,Director
111 DC Department of Public Health and Zt
Environment
COLORADO DATE: May 5,2008 G �\
SUBJECT: Cancer, Cardiovascular Disease and
Chronic Pulmonary Disease Prevention
and Treatment Program (CCPD)
Contract
Enclosed for Board review and approval is a contract between the Colorado Department of
Public Health and Environment(CDPHE) Cancer, Cardiovascular Disease and Pulmonary
Disease Competitive Grants Program and Weld County for the Weld County Department of
Public Health and Environment (WCDPHE). The grant period is July 1, 2008 through June 30,
2009 for an amount not to exceed $221,941.80. The funding is entirely from the State of
Colorado attributable to the tobacco tax.
The grant will expand the Women's Wellness Connection's screening services in Weld County
with new cardiovascular disease prevention services based on the nationally recognized
Wisewoman Program. 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 and women enrolled in the Women's Wellness
Connection Program. The key objective is to improve access and reduce health disparities by
providing culturally competent screening and education at the community level.
Staffing for this grant will include a 1.0 FTE Public Health Nurse II who coordinates the
program, a .75 FTE bilingual health educator to work with the Hispanic community, a .5 FTE
bilingual medical assistant to conduct screenings and a .1 Data Specialist/Epidemiologist to
conduct program evaluation. I recommend your approval of this contract.
Enclosure
2008-1446
DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT
ROUTING NO. 09 FLA 0 0 3 1 8
WAIVED CONTRACT #197
STATE: CONTRACTOR:
State of Colorado for the use&benefit of the Board of County Commissioners of Weld County
Department of Public Health and Environment For the use and benefit of
Weld County Department of Public Health and
Environment
Cancer,Cardiovascular Disease and Chronic 1555 North 17`h Avenue
Pulmonary Disease Prevention and Treatment Greeley,CO 80631
Program
4300 Cherry Creek Drive South
Denver,CO. 80246
CONTRACT MADE DATE: CONTRACTOR ENTITY TYPE:
04/18/2008 Political Subdivision
CONTRACTOR FEIN OR SOCIAL SECURITY NUMBER
PO/SC ENCUMBRANCE NUMBER:
PO FLA PPG 0900318 BILLING STATEMENTS RECEIVED:
TERM: Monthly
This contract shall be effective upon approval STATUTORY AUTHORITY:
by the State Controller,or designee,or on Not Applicable
07/01/2008,whichever is later. The contract CONTRACT PRICE NOT TO EXCEED:
shall end on 06/30/2009. $221,941.80
FEDERAL FUNDING DOLLARS: $0.00
STATE FUNDING DOLLARS: $221,941.80
MAXIMUM AMOUNT AVAILABLE PER FISCAL YEAR:
PROCUREMENT IOD: FY 09: $221,941.80
Competative Negotiaition
BID/REP/LIST PRIM.AGRREMENT NUMBER:
Not Applicable
JAW SPECIFIED VENDOR STATUTE PRICE STRUCTURE
Not Applicable Cost Reimbursement
STATE REPRESENTATIVE CONTRACTOR REPRESENTAI1VE
Gloria Latimer Mark Wallace, MD, MPH Director
Prevention Services Division 1555 N. 17th Avenue
4300 Cherry Creek Drive South Greeley, CO 80631
Denver, CO 80246
SCOPE OF WORK:
Heart Of Weld Project
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&eel -/994
EXHIBITS:
The following exhibits are hereby incorporated:
Exhibit A - Additional Provisions (and any of its Attachments; e.g., A-1,A-2, etc.)
Exhibit B - Statement of Work (and any of its Attachments; e.g.,B-1,B-2, etc.)
Exhibit C - Limited Amendment Template
Exhibit D Budget and Budget Narrative
COORDINATION:
The State warrants that required approval, clearance and coordination has been accomplished from and
with appropriate agencies.
APPROVAL
In no event shall this contract be deemed valid until it shall have been approved by the State Controller or
his/her designee.
PROCUREMENT:
This contractor has been selected in accordance with the requirements of the Colorado
Procurement Code.
PRICE PROVISIONS:
Payments pursuant to this contract shall be made as earned, in whole or in part, from available funds,
encumbered for the purchase of the described services and/or deliverables. The liability of the State
at any time for such payments shall be limited to the encumbered amount remaining of such funds.
Authority exists in the laws and funds have been budgeted, appropriated and otherwise made
available, and a sufficient unencumbered balance thereof remains available for payment.
Financial obligations of the State of Colorado payable after the current fiscal year are contingent
upon funds for that purpose being appropriated, budgeted and otherwise made available.
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GENERAL PROVISIONS
The following clauses apply to this contract. In some instances,these general clauses have been expanded upon in
other sections/exhibits of/to this contract. To the extent that other provisions of the contract provide more
specificity than these general clauses,the more specific provision shall control.
1. Governmental Immunity. Notwithstanding any other provision to the contrary,no term or condition of this
contract shall be construed or interpreted as a waiver,express or implied,of any of the immunities,rights,
benefits,protection or other provisions of the Colorado Governmental Immunity Act,Section 24-10-101
et.seq.,CRS,as now or hereafter amended. The parties understand and agree that liability for claims for
injuries to persons or property arising out of negligence of the State of Colorado,its departments,institutions,
agencies,boards,officials and employees is controlled and limited by the provisions of Section 24-10-101
et.seq.,CRS and the risk management statutes,Section 24-30-1501,et.seq.,CRS as now or hereafter amended.
2. Federal Funds Contingency. Payment pursuant to this contract,if in federal funds,whether in whole or in
part, is subject to and contingent upon the continuing availability of federal funds for the purposes hereof.
In the event that said funds, or any part thereof become unavailable,as determined by the State,the State
may immediately terminate this contract or amend it accordingly without liability including liability for
termination costs.
3. Billing Procedures. The State shall establish billing procedures and requirements for payment due the
Contractor in providing performance pursuant to this contract.The Contractor shall comply with the established
billing procedures and requirements for submission of billing statements. The State shall comply with CRS 24-
30-202(24)when paying vendors upon receipt of a correct notice of the amount due for goods or services
provided hereunder.
4. Exhibits-Interpretation. Unless otherwise stated,all referenced exhibits are incorporated herein and made a
part of this contract.Unless otherwise stated,the terms of this contract shall control over any conflicting terms
in any of its exhibits.In the event of conflicts or inconsistencies between this contract and its exhibits or
attachments,such conflicts or inconsistencies shall be resolved by reference to the documents in the following
order of priority: 1)the Special Provisions of this Contract;2)the Additional Provisions Exhibit A and its
attachments if included;3)the Contract(other than the Special Provisions);4)the RFP if applicable and
attached;5)the Scope/Statement of Work Exhibit B and its attachments if included;6)the Contractor's
proposal if applicable and attached;7)other exhibits/attachments in their order of appearance.
The conditions,provisions, and terms of any RFP attached hereto, if applicable, establish the minimum
standards of performance that the Contractor must meet under this Contract. If the Contractor's Proposal, if
attached hereto, or any attachments or exhibits thereto, or the Scope/Statement of Work Exhibit B,establish
or create standards of performance greater than those set forth in the RFP,then the Contractor shall also
meet those standards of performance under this Contract.
5. Notice and Representatives. For the purposes of this contract,the representative for each party is as designated
herein.Any notice required or permitted may be delivered in person or sent by registered or certified mail,
return receipt requested,to the party at the address provided,and if sent by mail it is effective when posted in a
U.S.Mail Depository with sufficient postage attached thereto.Notice of change of address or change or
representative shall be treated as any other notice.
6. Contractor Representations-Qualifications/Licenses/Approvals/Insurance. The Contractor certifies that,at
the time of entering into this contract, it and its agents have currently in effect all necessary licenses,
certifications,approvals, insurance, etc.required to properly provide the services and/or supplies covered
by this contract in the state of Colorado.Proof of such licenses, certifications,approvals,insurance,etc.
shall be provided upon the State's request.Any revocation,withdrawal or non-renewal of necessary license,
CDPI-IE Version 1.0(4/04) Page 3 of 17 Revised:8/04/06
certification,approval,insurance, etc.required for the Contractor to properly perform this contract, shall be
grounds for termination of this contract by the State.
Contractor certifies that it is qualified to perform such services or provide such deliverables as delineated in this
contract.
7. Legal Authority. The Contractor warrants that it possesses the legal authority to enter into this contract and that
it has taken all actions required by its procedures,by-laws,and/or applicable law to exercise that authority,and
to lawfully authorize its undersigned signatory to execute this contract and bind the Contractor to its teens.The
person(s)executing this contract on behalf of the Contractor warrant(s)that such person(s)have full
authorization to execute this contract.
8. Insurance—Contractor. During the term of this contract,and any renewals or extensions thereof,
Contractor shall,and hereby agrees to,obtain,maintain,and keep in force at all times during the term of
this contract an insurance policy or policies, issued by a company authorized to do business in Colorado,in
the kinds and minimum amounts,and under the conditions specified below.
a. Worker's Compensation Insurance as required by state statute,and Employer's Liability Insurance
covering all ofContractor's employees acting within the course and scope of their employment.
b. Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or
equivalent,covering premises operations,fire damage,independent contractors,products and
completed operations,blanket contractual liability,personal injury,and advertising liability with
minimum limits as follows:
I. $1,000,000 each occurrence;
II. $1,000,000 general aggregate;
III. $1,000,000 products and completed operations aggregate;and
IV. $50,000 any one fire.
If any aggregate limit is reduced below$1,000,000 because of claims made or paid,the Contractor
shall immediately obtain additional insurance to restore the full aggregate limit and furnish to the
State a certificate or other document satisfactory to the State showing compliance with this
provision.
c. Automobile Liability Insurance covering any auto(including owned,hired and non-owned autos)
with a minimum limit as follows: $1,000,000 each accident combined single limit.
d. The State of Colorado shall be named as an additional insured on the Commercial General
Liability and Automobile Liability Insurance policies. Coverage required of the contract will be
primary outer any insurance or self-insurance program carried by the State of Colorado.
e. The insurance shall include provisions preventing cancellation or non-renewal without at least
forty-five(45)calendar days prior written notice to the State by certified mail.
f. The Contractor will require all insurance policies in any way related to the contract and secured
and maintained by the Contractor to include clauses stating that each carrier will waive all rights
of recovery,under subrogation or otherwise,against the State of Colorado,its agencies,
institutions,organizations,officers, agents,employees and volunteers.
g. All policies evidencing the insurance coverages required hereunder shall be issued by insurance
companies satisfactory to the State.
h. The Contractor shall provide certificates showing insurance coverage required by this contract to
the State by the effective date of the contract. No later than fifteen (15)calendar days prior to the
expiration date of any such coverage,the Contractor shall deliver to the State certificates of
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insurance evidencing renewals thereof. At any time during the term of this contract,the State may
request in writing, and the Contractor shall thereupon within ten(10)calendar days supply to the
State,evidence satisfactory to the State of compliance with the provisions of this section.
i. The Contractor shall provide such other insurance as may be required by law,or in a specific
solicitation.
9. Rights in Data, Documents and Computer Software or Other Intellectual Property. All intellectual property
including without limitation,databases, software,documents,research,programs and codes,as well as all,
reports, studies,data,photographs,negatives or other documents,drawings or materials prepared by the
Contractor in the performance of its obligations under this contract shall be the exclusive property of the
State. Unless otherwise stated,all such material shall be delivered to the State by the Contractor upon
completion,termination,or cancellation of this contract.Contractor shall not use,willingly allow, or cause
to have such materials used for any purpose other than the performance of the Contractor's obligations
under this contract without the prior written consent of the State. All documentation,accompanying the
intellectual property or otherwise, shall comply with the State requirements which include but is not limited
to all documentation being in a paper,human readable format which is useable by one who is reasonably
proficient in the given subject area. Software documentation shall be delivered by Contractor to the State
that clearly identifies the programming language and version used,and when different programming
languages are incorporated, identifies the interfaces between code programmed in different programming
languages. The documentation shall contain source code which describes the program logic,relationship
between any internal functions,and identifies the disk files which contain the various parts of the code.
Files containing the source code shall be delivered and their significance to the program described in the
documentation. The documentation shall describe error messages and the location in the source code,by
page,line number,or other suitable identifier,where the error message is generated. The Contractor
warrants that the delivered software will be sufficiently descriptive to enable maintenance and modification
of the software. The State's ownership rights described herein shall include,but not be limited to,the right
to copy,publish,display,transfer,prepare derivative works,or otherwise use the works.
If any material is produced under this Contract and the parties hereto mutually agreed that said material
could be copyrighted by Contractor or a third party,then the State,and any applicable federal funding
entity, shall,without additional cost,have a paid in full,irrevocable,royalty free,and non-exclusive license
to reproduce,publish, or otherwise use,and authorize others to use,the copyrightable material for any
purpose authorized by the Copyright Law of the United States as now or hereafter enacted. Upon the
written request of the State,the Contractor shall provide the State with three(3)copies of all such
copyrightable material.
10. Confidential or Proprietary Information. Subject to the Public(Open)Records Act,section 24-72-101,et
seq.,C.RS.,as amended,if the Contractor obtains access to any records, files,or other information of the
State in connection with,or during the performance of;this Contract,then the Contractor shall keep all
such records, files,or other information confidential and shall comply with all laws and regulations
concerning the confidentiality of all such records, files,or information to the same extent as such laws and
regulations apply to the State. Any breach of confidentiality by the Contractor,or third party agents of the
Contractor,shall constitute good cause for the State to cancel this Contract,without liability to the State.
Any State waiver of an alleged breach of confidentiality by the Contractor,or third party agents of the
Contractor,does not constitute a waiver of any subsequent breach by the Contractor,or third party agents
of the Contractor. Contractor shall protect the confidentiality of all information used,held,created or
received in connection with this Contract and shall insure that any subcontractors or agents of Contractor
protect the confidentiality of all information under this Contract. Contractor shall use and disclose
confidential information only for purposes of this Contract and for the operation and administration of the
Contractor. Contractor shall implement appropriate safeguards as are necessary to prevent the use of
disclosure of confidential information and shall maintain a comprehensive written information privacy and
security program that includes administrative,technical and physical safeguards for the electronic
transmission of confidential information which are appropriate to the size and complexity of the
Contractor's operations and the nature and scope of its activities. Contractor shall promptly notify the State
if Contractor breaches the confidentiality of any information covered by this Contract.
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The Contractor must identify to the State the information that it considers confidential or proprietary. This is a
continuing obligation. Confidential or proprietary information for the purpose of this paragraph is information
relating to Contractor's research,development,trade secrets,business affairs,internal operations and
management procedures and those of its customers,clients or affiliates,but does not include information
lawfully obtained by third parties,information which is in the public domain,or information which is or could
have been acquired/developed independently by the State or a third party. Notwithstanding the foregoing,the
State shall not be in violation of its obligations under this section should it disclose confidential information if
such disclosure is,in the sole opinion of the State's legal counsel,required by applicable law and/or legal
process(including,but not limited to,disclosures required pursuant to the Colorado(Open)Public Records Act,
sections 24-72-201,et.seq,C.R S.,as now or hereafter amended). The State shall endeavor to provide notice to
the Contractor,as promptly as practicable under the circumstances,of any demand,request,subpoena,court
order or other action requiring such disclosure,in order to afford Contractor the opportunity to take such lawful
action as it deems appropriate to oppose,prevent or limit the disclosure,solely at its own instance and expense;
but nothing herein shall be construed to require the State to refuse or delay compliance with any such law,order
or demand.
11. Records Maintenance,Performance Monitoring&Audits. The Contractor shall maintain a complete file of
all records,documents,communications,and other materials that pertain to the operation of the
program/project or the delivery of services under this contract. Such files shall be sufficient to properly
reflect all direct and indirect costs of labor,materials,equipment,supplies and services,and other costs of
whatever nature for which a contract payment was made.These records shall be maintained according to
generally accepted accounting principles and shall be easily separable from other Contractor records.
The Contractor shall protect the confidentiality of all records and other materials containing personally
identifying information that are maintained in accordance with this contract. Except as provided by law,no
information in possession of the Contractor about any individual constituent shall be disclosed in a form
including identifying information without the prior written consent of the person in interest,a minor's
parent,guardian,or the State.The Contractor shall have written policies governing access to,duplication
and dissemination of all such information and advise its agents,if any,that they are subject to these
confidentiality requirements.The Contractor shall provide its agents,if any, with a copy or written
explanation of these confidentiality requirements before access to confidential data is permitted.
The Contractor authorizes the State,the federal government or their designee,to perform audits and/or
inspections of its records,at any reasonable time during the term of this contract and for a period of six(6)
years following the termination of this contract, to assure compliance with the state or federal government's
terms and/or to evaluate the Contractor's performance. Any amounts the State paid improperly shall be
immediately returned to the State or may be recovered in accordance with other remedies.
All such records, documents,communications,and other materials shall be the property of the State unless
otherwise specified herein and shall be maintained by the Contractor in a central location as custodian for
the State on behalf of the State,for a period of six (6)years from the date of final payment or submission of
the final federal expenditure report under this contract,unless the State requests that the records be retained
for a longer period,or until an audit has been completed with the following qualification.If an audit by or
on behalf of the federal and/or state government has begun but is not completed at the end of the six(6)
year period,or if audit findings have not been resolved after a six (6)year period,the materials shall be
retained until the resolution of the audit findings.
The Contractor shall permit the State,any other governmental agency authorized by law,or an authorized
designee thereof, in its sole discretion,to monitor all activities conducted by the Contractor pursuant to the
terms of this contract. Monitoring may consist of internal evaluation procedures,reexamination of program
data, special analyses,on-site verification, formal audit examinations,or any other procedures as deemed
reasonable and relevant. All such monitoring shall be performed in a manner that will not unduly interfere
with contract work.
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12. Taxes. The State,as purchaser,is exempt from all federal excise taxes under Chapter 32 of the Internal
Revenue Code [No. 84-730123K] and from all state and local government use taxes[C.RS.39-26-114(a)
and 203,as amended].The Contractor is hereby notified that when materials are purchased for the benefit
of the State, such exemptions apply except that in certain political subdivisions the vendor may be required
to pay sales or use taxes even though the ultimate product or service is provided to the State.These sales or
use taxes will not be reimbursed by the State.
13. Conflict of Interest. During the term of this contract,the Contractor shall not engage in any business or
personal activities or practices or maintain any relationships which conflict in any way with the Contractor
fully performing his/her obligations under this contract.
Additionally,the Contractor acknowledges that,in governmental contracting,even the appearance of a
conflict of interest is harmful to the interests of the State. Thus,the Contractor agrees to refrain from any
practices,activities or relationships which could reasonably be considered to be in conflict with the
Contractor's fully performing his/her obligations to the State under the terms of this contract,without the
prior written approval of the State.
In the event that the Contractor is uncertain whether the appearance of a conflict of interest may reasonably
exist,the Contractor shall submit to the State a full disclosure statement setting forth the relevant details for
the State's consideration and direction. Failure to promptly submit a disclosure statement or to follow the
State's direction in regard to the apparent conflict shall be grounds for termination of the contract.
Further,the Contractor,and its subcontractors or subgrantees,shall maintain a written code of standards
governing the performance of its employees engaged in the award and administration of contracts. No
employee, officer,or agent of the Contractor, subcontractor,or subgrantee shall participate in the selection,
or in the award or administration of a contract or subcontract supported by Federal funds if a conflict of
interest,real or apparent,would be involved. Such a conflict would arise when:
a. The employee,officer or agent;
b. Any member of the employee's immediate family;
c. The employee's partner; or
d. An organization which employees,or is about to employ,any of the above,
has a financial or other interest in the firm selected for award. The Contractor's,subcontractor's,or
subgrantee's officers,employees,or agents will neither solicit nor accept gratuities, favors, or anything of
monetary value from Contractor's potential contractors, or parties to subagreements.
14. Inspection and Acceptance(Services)and Contractor Warranty. The State reserves the right to inspect
services provided under this contract at all reasonable times and places during the term of the contract.
"Services"as used in this clause includes services performed or tangible material produced or delivered in
the performance of services. If any of the services do not conform with contract requirements,the State
may require the contractor to perform the services again in conformity with contract requirements,with no
additional payment. When defects in the quality or quantity of service cannot be corrected by re-
performance,the State may(1)require the contractor to take necessary action to ensure that the future
performance conforms to contract requirements and(2)equitably reduce the payment due the contractor to
reflect the reduced value of the services performed. These remedies in no way limit the remedies available
to the State in the termination provisions of this contract,or remedies otherwise available at law.
Contractor warrants that all supplies furnished under this contract shall be free from defects in materials or
workmanship,are installed properly and in accordance with manufacturer recommendations or other
industry standards,and will function in a failure-free manner for a period of one(1)year from the date of
delivery or installation. Contractor shall,at its option,repair or replace any supplies that fail to satisfy this
warranty during the warranty period. Additionally, Contractor agrees to assign to the State all written
manufacturer warranties relating to the supplies and to deliver such written warranties to the State.
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15. Adiustments in Price. Adjustments to contract prices are allowable only so long as they are mutually agreeable
by the parties and so long as they are included within a contract amendment made prior to the effective date of
the price adjustments and made pursuant to the State of Colorado Fiscal Rules,signed by the parties,and
approved by the State Controller or designee. The Contractor shall provide cost or pricing data for any price
adjustment subject to the provisions of the Cost or Pricing Data Section of the Colorado State Procurement
Rules. Any adjustment in contract price pursuant to the application of a clause in this contract shall be made in
one or more of the following ways:
a. By agreement on a fixed-price adjustment;
b. By unit prices specified in the contract;
c. In such other manner as the parties may mutually agree;or
d. In the absence of agreement between the parties,by a unilateral determination by the procurement
officer of the costs attributable to the event or situation covered by the clause,plus appropriate profit
or fee.
16. Contract Renewal,Extension,and Modification.
a. Limited Amendment. The State,with the concurrence of the Contractor,may prospectively renew
or extend the term of this Contract,or increase or decrease the amount payable under this Contract
through a"Limited Amendment"that is substantially similar to the sample form Limited
Amendment that is incorporated herein by this reference and identified as Exhibit C. To be
effective,this Limited Amendment must be signed by the State and the Contractor,and be
approved by the State Controller or an authorized delegate thereof. The parties understand that
this Limited Amendment shall be used only for the following:
I. To increase or decrease the level of funding during the current term of the Original
Contract due to an increase or decrease in the amount of goods and/or level of services
being provided based upon the existing Scope of Work and/or established pricing and/or
established Budget/pricing;
II. To revise specifications within the current Scope of Work and/or Budget that
increase/decrease the level of finding during the current term of the Original Contract;
III. To renew or extend the term of the contract with appropriate changes in the amount of
funding that results in a new total financial obligation of the State based upon:
(A) the same Scope of Work and pricing,or
(B) revised specifications to the previously defined Scope of Work.
IV. To make changes to the specifications to the original Scope of Work,project
management/manager identification,notice address or notification personnel,or the
period of performance,that result in"no cost"changes to the Budget.
Upon proper execution and approval,this Limited Amendment shall become a formal amendment
to this Contract.
b. Other Contract Modifications. This contract is subject to such modifications as may be required
by changes in Federal or State law, or their implementing regulations. Any such required
modification shall automatically be incorporated into and be part of this contract on the effective
date of such change as if fully set forth herein. If either the State or the Contractor desires to
modify the terms and conditions of this Contract other than as provided for in paragraph 16.a
above, then the parties shall execute a standard written amendment to this Contract initiated by the
State. The standard written amendment must be executed and approved in accordance with all
applicable laws and rules by all necessary parties including the State Controller or delegate.
17. Litigation. The Contractor shall within five(5)calendar days after being served with a summons,
complaint,or other pleading which has been filed in any federal or state court or administrative agency
notify the State that it is a party defendant in a case which involves services provided under this contract.
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The Contractor shall deliver copies of such document(s)to the State's Executive Director.The term
"litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy,reorganization
and/or foreclosure.
18. Notice of Breach and Dispute Resolution: If the State or the Contractor believes in good faith that the other
party has failed to timely complete a deliverable, or has otherwise committed a material breach of this
Contract,then the non-breaching party shall notify the breaching party in writing of the alleged breach
within ten(10)business days of: 1)the date of the alleged breach if the non-breaching party is aware of the
breach at the time it occurs; or 2)the date that the non-breaching party becomes aware of the breach.
Upon receipt of written notice of an alleged breach of the Contract,the breaching party shall have ten(10)
business days, or such additional time as may be agreed to in writing between the parties,within which to
cure the alleged breach or to notify the non-breaching party in writing of the breaching party's belief that a
material breach of this Contract has not occurred. Failure of the breaching party to cure or respond in
writing within the above time period shall result in the non-breaching party being entitled to pursue any and
all remedies available at law or in equity.
Except as herein specifically provided otherwise,disputes concerning the performance of this contract
which cannot be resolved by the designated contract representatives shall be referred in writing to a senior
departmental management staff designated by the department and a senior manager designated by the
Contractor. Failing resolution at that level, disputes shall be presented in writing to the Executive Director
and the Contractor's chief executive officer for resolution. This process is not intended to supersede any
other process for the resolution of controversies provided by law.
The Contractor and its sureties shall be liable for any damage to the State resulting from the Contractor's
breach,whether or not the Contractor's right to proceed with the work is terminated. The State reserves the
right,in its sole discretion,to determine whether or not to accept substituted performance tendered by the
Contractor or the Contractor's sureties and acceptance is dependent upon completion of all applicable
inspection procedures.
19. Remedies: In addition to any other remedies provided for in this contract,and without limiting its remedies
otherwise available at law,the State may exercise the following remedial actions if the Contractor
substantially fails to satisfy or perform the duties and obligations in this contract. Substantial failure to
satisfy the duties and obligations shall be defined to mean significant insufficient,incorrect or improper
performance,activities,or inaction by the Contractor. Without limitation,these remedial actions include:
a. withhold payment to Contractor until the necessary services or corrections in performance are
satisfactorily completed; and/or
b. require the vendor to take necessary action to ensure that the future performance conforms to
contract requirements;and/or
c. request the removal from work on the contract of employees or agents of Contractor whom the
State justifies as being incompetent,careless,insubordinate,unsuitable,or otherwise unacceptable,
or whose continued employment on the contract the State deems to be contrary to the public
interest or not in the best interest of the State;and/or
d. deny payment for those services or obligations which have not been performed and which due to
circumstances caused by Contractor cannot be performed,or if performed would be of no value to
the State;denial of the amount of payment must be reasonably related to the value of work or
performance lost to the State;and/or
e. suspend Contractor's performance pending necessary corrective action as specified by the State
without Contractor's entitlement to adjustment in price/cost or schedule;and/or
f. modify or recover payments(from payments under this contract or other contracts between the
State and the vendor as a debt due to the State)to correct an error due to omission,error, fraud
and/or defalcation;and/or
g. terminate the contract.
CDPHE Version 1.0(4/04) Page 9 of 17 Revised: 8/04/06
•
These remedies in no way limit the remedies available to the State in the termination provisions of this
contract,or remedies otherwise available at law.
20. Termination.
a. Termination for Default. The State may terminate the contract for cause. In the event this
contract is terminated for cause,the State will only reimburse the Contractor for accepted work or
deliverables received up to the date of termination.In the event this contract is terminated for
cause, final payment to the Contractor may be withheld at the discretion of the State until
completion of final audit. Notwithstanding the above,the Contractor shall not be relieved of
liability to the State for any damages sustained by the State by virtue of any breach of the contract
by the Contractor, and the State may withhold any payment to the Contractor for the purposes of
mitigating its damages until such time as the exact amount of damages due to the State from the
Contractor is determined. If it is determined that the Contractor was not in default then such
termination shall be treated as a termination for convenience as described herein. In the event of
termination,all finished or unfinished documents,data,studies, surveys,drawings,maps,models,
photographs,and reports or other material prepared by the contractor under this contract shall,at
the option of the State,become its property,and the Contractor shall be entitled to receive just and
equitable compensation for any services and supplies delivered and accepted. The Contractor
shall be obligated to return any payment advanced under the provisions of this contract.
b. Termination for Convenience. The State shall have the right to terminate this contract at any time
the State determines necessary by giving the Contractor at least twenty(20)calendar days prior
written notice. If notice is so given,this contract shall terminate on the expiration of the specified
time period,and the liability of the parties hereunder for further performance of the terms of this
contract shall thereupon cease,but the parties shall not be released from the duty to perform their
obligations up to the date of termination. In the event of termination,all finished or unfinished
documents,data, studies,surveys,drawings,maps,models,photographs,and reports or other
material prepared by the contractor under this contract shall,at the option of the State,become its
property,and the Contractor shall be entitled to receive just and equitable compensation for any
satisfactory services and supplies delivered.
In the event that the State terminates this contract under the Termination for Convenience
provisions,the Contractor is entitled to submit a termination claim within ten(10)days of the
effective date of termination. The termination claim shall address and the State shall consider
paying the following costs:
I. the contract price for performance of work,which is accepted by the State,up to the
effective date of the termination;
II. reasonable and necessary costs incurred in preparing to perform the terminated portion of
the contract;
III. reasonable profit on the completed but undelivered work up to the date of termination;
IV. the costs of settling claims arising out of the termination of subcontracts or orders,not to
exceed 30 days pay for each subcontractor;
V. reasonable accounting,legal,clerical,and other costs arising out of the termination
settlement.
In no event shall reimbursement under this clause exceed the contract amount reduced by amounts
previously paid by the State to the Contractor.
c. Immediate Termination. This contract is subject to immediate termination by the State in the
event that the State determines that the health, safety, or welfare of persons receiving services may
be in jeopardy. Additionally, the State may immediately terminate this contract upon verifying
that the Contractor has engaged in or is about to participate in fraudulent or other illegal acts.
CDPHE Version 1.0(4/04) Page 10 of 17 Revised: 8/04/06
21. Stop Work Order. Upon written approval by the State Procurement Officer or delegee,the State may,by
written order to the Contractor,at any time,and without notice to any surety,require the Contractor to stop
all or any part of the work called for by this contract. This order shall be for a specified period after the
order is delivered to the Contractor. Any such order shall be identified specifically as a stop work order
issued pursuant to this clause. Upon receipt of such an order,the Contractor shall forthwith comply with its
terms and take all reasonable steps to minimize the incurring of costs allocable to the work covered by the
order during the period of work stoppage. Before the stop work order expires,as legally extended,the
State Procurement Officer or delegee shall either:
a. Cancel the stop work order;or
b. Terminate the work covered by such order;or
c. Terminate the contract.
If a stop work order issued under this clause is properly canceled, the Contractor shall have the right to
resume work. An appropriate adjustment shall be made in the delivery schedule or contract price,or both,
and the contract shall be modified accordingly in writing pursuant to the terms of this contract dealing with
contract modifications,if
a. The stop work order results in increased time required for,or in the Contractor's cost properly
allocable to, the performance of any part of this contract;and
b. The Contractor asserts claim for such an adjustment within thirty(30)days after the end of the
period of work stoppage.
If the work covered by such order is terminated for default or convenience,the reasonable costs resulting
from the stop work order shall be allowed by adjustment or otherwise and such adjustment shall be in
accordance with the Price Adjustment Clause of this contract.
22. Venue. The parties agree that exclusive venue for any action related to performance of this contract shall be in
the City and County of Denver,Colorado.
23. Understanding of the Parties.
a. Complete Integration. This contract is intended as the complete integration of all understandings
between the parties.No prior or contemporaneous addition, deletion,or other amendment hereto
shall have any force or effect whatsoever,unless embodied herein in writing.No subsequent
novation,renewal,addition,deletion,or other amendment hereto shall have any force or effect
unless embodied in a written contract executed and approved pursuant to the State Fiscal Rules.
b. Severability. To the extent that this contract may be executed and performance of the obligations
of the parties may be accomplished within the intent of the contract,the terms of this contract are
severable, and should any term or provision hereof be declared invalid or become inoperative for
any reason,such invalidity or failure shall not affect the validity of any other term or provision
hereof.
c. Binding Agreement. Except as herein specifically provided otherwise,it is expressly understood
and agreed that this contract shall inure to the benefit of and be binding upon the parties hereto and
their respective successors and assigns.All rights of action relating to enforcement of the terms
and conditions shall be strictly reserved to the State and the named Contractor.Nothing contained
in this agreement shall give or allow any claim or right of action whatsoever by any other third
person. It is the express intention of the State and the Contractor that any such person or entity,
other than the State or the Contractor,receiving services or benefits under this agreement shall be
deemed an incidental beneficiary only.
d. Waiver. The waiver of any breach of a term hereof shall not be construed as a waiver of any other
term,or the same term upon subsequent breach.
CDPHE Version 1.0(4/04) Page 11 of 17 Revised:8/04/06
e. Continuing Obligations. The State and the Contractor's obligations under this contract shall survive
following termination or expiration to the extent necessary to give effect to the intent and
understanding of the parties.
f. Assignment and Change In Ownership,Address,Financial Status. Except as herein specifically
provided otherwise,the rights,duties and obligations of the Contractor arising hereunder cannot
be assigned,delegated,subgranted or subcontracted except with the express prior written consent
of the State,which consent shall not be unreasonably withheld. In the case of assignment or
delegation,Contractor and the State shall execute the standard State novation agreement prior to
the assignment or delegation being effective against the State. The subgrants and subcontracts
permitted by the State shall be subject to the requirements of this contract.The Contractor is
responsible for all subcontracting arrangements,delivery of services, and performance of any
subgrantor or subcontractor. The Contractor warrants and agrees that any subgrant or subcontract,
resulting from its performance under the terms and conditions of this contract, shall include a
provision that the said subgrantor or subcontractor shall abide by the terms and conditions hereof.
Also, the Contractor warrants and agrees that all subgrants or subcontracts shall include a
provision that the subgrantor or subcontractor shall indemnify and hold harmless the State.The
subgrantors or subcontractors must be certified to work on any equipment for which their services
are obtained.
This provision shall not be construed to prohibit assignments of the right to payment to the extent
permitted by section 4-9-318,CRS,provided that written notice of assignment adequate to identify
the rights assigned is received by the controller for the agency,department, or institution executing
this contract. Such assignment shall not be deemed valid until receipt by such controller—as
distinguished from the State Controller—and the Contractor assumes the risk that such written
notice of assignment is received by the controller for the agency,department,or institution
involved.
The Contractor is required to formally notify the State prior to,or if circumstances do no allow
prior notification then immediately following,any of the following:
I. change in ownership;
II. change of address;
III. the filing of bankruptcy.
g. Force Majeure. Neither the Contractor nor the State shall be liable to the other for any delay in,or
failure of performance of; any covenant or promise contained in this contract,nor shall any delay
or failure constitute default or give rise to any liability for damages if,and only to the extent that,
such delay or failure is caused by"force majeure." As used in this contract"force majeure"means
acts of God;acts of the public enemy; acts of the State and any governmental entity in its
sovereign or contractual capacity; fires; floods,epidemics;quarantine restrictions, strikes or other
labor disputes; freight embargoes; or unusually severe weather.
h. Changes In Law. This contract is subject to such modifications as may be required by changes in
applicable federal or State law,or their implementing rules,regulations,or procedures. Any such
required modification shall automatically be incorporated into and be part of this contract on the
effective date of such change as if fully set forth herein. Except as provided above,no
modification of this contract shall be effective unless agreed to in writing by both parties in the
form of a written amendment to this Contract that has been previously executed and approved in
accordance with applicable law.
Media or Public Announcements. Unless otherwise provided for in this Contract,the Contractor
shall not make any news release,publicity statement,or other public announcement, either in
written or oral form,that concerns the work provided under this Contract,without the prior written
approval of the State. The Contractor shall submit a written request for approval to the State no
less than ten(10)business days before the proposed date of publication. The State shall not
CDPHE Version 1.0(4/04) Page 12 of 17 Revised: 8/04/06
unreasonably withhold approval of the Contractor's written request to publish. Approval or denial
of the Contractor's request by the State,shall be delivered to the Contractor in writing within six
(6)business days from the date of the State's receipt of Contractor's request for approval.
If required by the terms and conditions of a federal or state grant,the Contractor shall obtain the
prior approval of the State and all necessary third parties prior to publishing any materials
produced under this Contract. If required by the terms and conditions of a federal or state grant,
the Contractor shall also credit the State and all necessary third parties with assisting in the
publication of any materials produced under this Contract. It shall be the obligation of the
Contractor to inquire of the State as to whether these requirements exist and obtain written
notification from the State,as Contractor deems appropriate.
24. Intellectual Indemnity. Contractor shall defend,at its sole expense,any claim(s)or suit(s)brought against
the State alleging that the use by the State of any product(s),or any part thereof, supplied by Contractor
under this agreement constitutes infringement of any patent,copyright,trademark,or other proprietary
rights,provided that the State gives Contractor written notice within twenty(20)days of receipt by the
State of such notice of such claim or suit,provides assistance and cooperation to Contractor in connection
with such action,and Contractor has sole authority to defend or settle the claim. Contractor shall consult
the State regarding such defense and the State may,at its discretion and expense,participate in any defense.
Should the State not choose to participate,Contractor shall keep the State advised of any settlement or
defense.
Contractor shall have liability for all such claims or suits,except as expressly provided herein,and shall
indemnify the State for all liability incurred by the State as a result of such infringement.Contractor shall
pay all reasonable out-of-pocket costs and expenses,and damages finally awarded by a court of competent
jurisdiction,awarded or agreed to by Contractor regarding such claims or suits.
If the product(s),or any part thereof,become the subject of any claim, suit or proceeding for infringement
of any patent,trademark or copyright,or in the event of any adjudication that the product(s), or any part
thereof,infringes any patent,trademark or copyright,or if the sub-license or use of the product(s),or any
part thereof,is enjoined,Contractor,after consultation with the State, shall do one of the following at
Contractor's expense:
a. produce for the State the right under such patent,trademark or copyright to use or sub-license,as
appropriate,the product or such part thereof;or
b. replace the product(s),or part thereof,with other suitable products or parts conforming to the
original license and State specifications;or
c. suitably modify the products,or part thereof.
Except as otherwise expressly provided herein, Contractor shall not be liable for any costs or expenses
incurred without its prior written authorization.
Contractor shall have no obligation to defend against or to pay any costs, damages or attorney's fees with
respect to any claim based upon:
a. the use of an altered release if Contractor had not consented to the alteration;or
b. the combination,operation or use of the product(s)with programs or data which were not
furnished by Contractor,if such infringement would have been avoided if the programs or data
furnished by persons or entities other than Contractor had not been combined,operated or used
with the product(s);or
c. the use of product(s)on or in connection with equipment or software not permitted under this
contract if such infringement would have been avoided by not using the product(s)on or in
connection with such other equipment or software.
25. Conformance with Law. If this Contract involves federal funds or compliance is otherwise federally
mandated,the Contractor and its agent(s)shall at all times during the term of this contract strictly adhere to
CDPI E Version 1.0(4/04) Page 13 of 17 Revised: 8/04/06
all applicable federal laws, state laws, Executive Orders and implementing regulations as they currently
exist and may hereafter be amended.Without limitation,these federal laws and regulations include:
a. Office of Management and Budget Circulars A-21,A-87,A-102,A-110,A-122,A-133,and The
Common Rule for Uniform Administrative Requirements for Grants and Cooperative Agreements
to State and Local Governments,as applicable;
b. the"Hatch Act" (5 U.S.C. 1501-1508)and Public Law 95-454, Section 4728. These federal
statutes declare that federal funds cannot be used for partisan political purposes of any kind by any
person or organization involved in the administration of federally assisted programs;
c. the"Davis-Bacon Act"(40 U.S.C. 276A-276A-5). This federal Act requires that all laborers and
mechanics employed by contractors or subcontractors to work on construction projects financed
by federal assistance must be paid wages not less than those established for the locality of the
project by the Secretary of Labor;
d. 42 U.S.C. 6101 et seg.,42 U.S.C. 2000d,29 U.S.C.794. These federal Acts mandate that no
person shall,on the grounds of race,color,national origin,age, or disability,be excluded from
participation in or be subjected to discrimination in any program or activity funded,in whole or in
part,by federal funds;
e. the"Americans with Disabilities Act"(Public Law 101-336;42 U.S.C. 12101, 12102, 12111 -
12117, 12131 - 12134, 12141 - 12150, 12161 - 12165, 12181 - 12189, 12201 - 12213 and 47
U.S.C. 225 and47 U.S.C. 611);
f. if the Contractor is acquiring an interest in real property and displacing households or businesses
in the performance of this Contract,then the Contractor is in compliance with the"Uniform
Relocation Assistance and Real Property Acquisition Policies Act",as amended, (Public Law 91-
646,as amended,and Public Law 100-17, 101 Stat. 246-256);
g. when applicable,the Contractor shall comply with the provisions of the"Uniform Administrative
Requirements for Grants and Cooperative Agreements to State and Local Governments"
(Common Rule);
h. Section 2101 of the Federal Acquisition Streamlining Act of 1994,Public Law 103-355,which
prohibits the use of federal money to lobby the legislative body of a political subdivision of a
State;and
i. If the Contractor is a covered entity under the Health Insurance Portability and Accountability Act
of 1996,42 U.S.C. 1320d- 1320d-8,the Contractor shall comply with applicable HIPAA
requirements. If Contractor is a business associate under HIPAA,Contractor hereby agrees
to,and has an affirmative duty to,execute the State's current HIPAA Business Associate
Agreement. In this case,Contractor must contact the State's representative and request a
copy of the Business Associate Agreement,complete the agreement,have it signed by an
authorized representative of the Contractor,and deliver it to the State.
26. Contractor Affirmation. If this Contract involves federal funds or compliance is otherwise federally mandated,
then by signing and submitting this Contract the Contractor affirmatively avers that:
a. the Contractor is in compliance with the requirements of the"Drug-Free Workplace Act"(Public
Law 100-690 Title V, Subtitle D,41 U.S.C.701 et seq.);
b. the Contractor is not presently debarred,suspended,proposed for debarment,declared ineligible,
or voluntarily excluded from covered transactions by any federal department or agency;the
Contractor shall comply with all applicable regulations pursuant to Executive Order 12549,
including,Debarment and Suspension and Participants'Responsibilities,29 C.F.R.98.510(1990);
and,
c. the Contractor shall comply with all applicable regulations pursuant to Section 319 of Public Law
101-121,Guidance for New Restrictions on Lobbying,including,Certification and Disclosure,29
C.F.I.93.110(1990).
27. Annual Audits. If the Contractor expends federal funds from all sources(direct or from pass-through
entities)in an amount of$500,000 or more during its fiscal year,then the Contractor shall have an audit of
that fiscal year in accordance with Office of Management and Budget(OMB)Circular A-133 (Audits of
States,Local Governments,and Non-Profit Organizations). If the Contractor expends federal funds
CDPITE Version 1.0(4/04) Page 14 of 17 Revised:8/04/06
received from the State in an amount of$500,000 or more during its fiscal year,then the Contractor shall
furnish one(1)copy of the audit report(s)to the State's Internal Audit Office within thirty(30)calendar
days after the Contractor's receipt of its auditor's report or nine(9)months after the end of the Contractor's
audit period,whichever is earlier. If(an)instance(s)of noncompliance with federal laws and regulations
occurs,then the Contractor shall take all appropriate corrective action(s)within six(6)months of the
issuance of(a)report(s).
If the Contractor submits an annual indirect cost proposal to the State for review and approval,then the
Contactor's auditor shall audit the proposal in accordance with the requirements of OMB Circulars A-21
(Cost Principles for Educational Institutions),A-87(Cost Principles for State, Local, and Tribal
Governments),or A-122(Cost Principles for Non-Profit Organizations),whichever is applicable.
28. Holdover. In the event that the State desires to continue the services provided for in this Contract and a
replacement contract has not been fully executed by the expiration date of the Contract,this Contract may
be extended unilaterally by the State for a period of up to two(2)months upon written notice to the
Contractor under the same terms and conditions of the original Contract including,but not limited to,
prices,rates,and service delivery requirements. However,this extension terminates when the replacement
contract becomes effective when signed by the State Controller or an authorized delegate.
29. Survival of Certain Contract Terms. Notwithstanding anything in this contract to the contrary,the parties
understand and agree that all terms and conditions of this contract which may require continued
performance,compliance,or effect beyond the termination date of the contract and shall survive such
termination date and shall be enforceable by the State as provided herein in the event of failure to perform
or comply by the Contractor.
CDPI-IE Version 1.0(4/04) Page 15 of 17 Revised: 8/04/06
SPECIAL PROVISIONS
The Special Provisions apply to all contracts except where noted in italics.
I. CONTROLLER'S APPROVAL. CRS 2430-202(1). This contract shall not be deemed valid until it has been approved by the Colorado State
Controller or designee.
2. FUND AVAILABILITY. CRS 24-30-202(53). 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.
3. INDEMNIFICATION. Contractor shall indemnify, save, and hold harmless the State, its employees and agents, against any and all claims,
damages, liability and court awards including costs, expenses, and attorney fees and related costs, inured as a result of any act or omission by
Contractor,or its employees,agents,subcontractors,or assignees pursuant to the terms of this contract.
/Applicable Only to Intergovernmental Contracts!No term or condition of this contract shall be construed or interpreted as a waiver, express or
implied,of any of the immunities,rights,benefits,protection,or other provisions,of the Colorado Governmental Immunity Act,CRS 24-10-101 et seq.,
or the Federal Tort Claims Act,28 U.S.C.2671 et seq.,as applicable,as now or hereafter amended.
4. INDEPENDENT CONTRACTOR. 4 CCR 801-2. Contractor shall perform its duties hereunder as an independent contractor and not as an
employee. Neither contractor nor any agent or employee of contractor shall be or shall be deemed to be an agent or employee of the state. Contractor
shall pay when due all required employment taxes and income taxes and local head taxes on any monies paid by the state pursuant to this contact.
Contractor acknowledges that contractor and its employees are not entitled to unemployment insurance benefits unless contractor or a third party
provides such coverage and that the state does not pay for or otherwise provide such coverage. Contractor shall have no authorization,express or
implied,to bind the state to any agreement,liability or understanding,except as expressly set forth herein Contractor shall provide and keep in force
workers compensation(and provide proof of such insurance when requested by the state)and unemployment compensation insurance in the amounts
required by law and shall be solely responsible for its acts and those of its employees and agents.
5. NON-DISCRIMINATION. Contractor agrees to comply with the letter and the spirit of all applicable State and federal laws respecting
discrimination and unfair employment practices.
6. CHOICE OF LAW. The laws of the State of Colorado,and rules and regulations issued pursuant thereto,shall be applied in the interpretation,
execution,and enforcement of this contract. Any provision of this contract, whether or not incorporated herein by reference, which provides for
arbitration by any extra-judicial body or person or which is otherwise in conflict with said laws,rules,and regulations shall be considered null and void.
Nothing contained in any provision incorporated herein by reference which purports to negate this or any other special provision in whole or in part shall
be valid or enforceable or available in any action at law,whether by way of complaint,defense,or otherwise. Any provision rendered null and void by
the operation of this provision will not invalidate the remainder of this contract,to the extent that this contract is capable of execution. At all times
during the performance of this contract,Contractor shall strictly adhere to all applicable federal and State laws,rules,and regulations that have been or
may hereafter be established.
7. [Not Applicable to Intergovernmental Contracts] VENDOR OFFSET. CRS 24-30-202(1)and 24-30-202.4. The State Controller may withhold
payment of certain debts owed to State agencies under the vendor offset intercept system for:(a)unpaid child support debt or child support areamges;
(b)unpaid balances of tax,accrued interest,or other charges specified in Article 21,Title 39,CRS; (c)unpaid loans due to the Student Loan Division of
the Department of Higher Eucation; (d)amounts required to be paid to the Unemployment Compensation Fund;and(e)other unpaid debts owing to
the State or its agencies,as a result of final agency determination or reduced to judgment,as certified by the State Controller.
8. SOFTWARE PIRACY PROHIBITION. Governor's Executive Order D 002 00. No State or other public funds payable under this contract
shall be used for the acquisition, operation, or maintenance of computer software in violation of federal copyright laws or applicable licensing
restrictions. Contractor hereby certifies that,for the term of this contract and any extensions,Contractor has in place appropriate systems and controls to
prevent such improper use of public funds. If the State determines that Contractor is in violation of this paragraph,the State may exercise any remedy
available at law or equity or under this contract,including,without limitation,immediate termination of this contract and any remedy consistent with
federal copyright laws or applicable licensing restrictions.
9. EMPLOYEE FINANCIAL INTEREST. CRS 24-18-201 and 24-50-507. The signatories aver that to their knowledge,no employee of the State
has any personal or beneficial interest whatsoever in the service or property described in this contract.
10. [Not Applicable to Intergovernmental Contracts]. ILLEGAL ALIENS - PUBLIC CONTRACTS FOR
SERVICES AND RESTRICTIONS ON PUBLIC BENEFITS. CRS 8-17.5-101 and 24-76.5-101. Contractor
certifies that it shall comply with the provisions of CRS 8-17.5-101 et seq. Contractor shall not knowingly employ
or contract with an illegal alien to perform work under this contract or enter into a contract with a subcontractor
that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien
to perform work under this contract. Contractor represents, warrants, and agrees that it (i) has verified that it
does not employ any illegal aliens, through participation in the Basic Pilot Employment Verification Program
administered by the Social Security Administration and Department of Homeland Security, and (ii) otherwise shall
comply with the requirements of CRS 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under CRS 8-17.5-102 by the Colorado Department of Labor and
Employment. Failure to comply with any requirement of this provision or CRS 8-17.5-101 et seq., shall be cause
for termination for breach and Contractor shall be liable for actual and consequential damages.
Contractor,if a natural person eighteen (18)years of age or older,hereby swears or affirms under penalty of perjury
that he or she (i) is a citizen or otherwise lawfully present in the United States pursuant to federal law, (ii) shall
comply with the provisions of CRS 24-76.5-101 et seq.,and(iii)shall produce one form of identification required by
CRS 24-76.5-103 prior to the effective date of this contract.
Revised October 25, 2006 Effective Date of Special Provisions:August 7, 2006
CDPHE Version 1.0(4/04) Page 16 of 17 Revised:3/21/05
THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT
*Persons signing for Contractor hereby swear and affirm that they are authorized to act on
Contractor's behalf and acknowledge that the State is relying on their representations to that effect and
accept personal responsibility for any and all damages the State may incur for any errors in such
representation.
CONTRACTOR: STATE OF COLORADO:
Board of County Commissioners of Weld County BILL RITTER,JR.GOVERNOR
For the use and benefit of
Weld county Department of Public Health and
Environment '//r �� ,q� )
Legal Name of Contracting Entity / " 2e""
B
For Executive Director
Department of Public Health and Environment
Social Security Number or FEIN
Department Program Approval:
Signature of Authorized Officer
05/14/2008
William H. Jerke, Chair By
�/
Print Name&Title of Authorized Officer
WELD COUNTY DEPARTMENT OF LEGAL REVIEW:
PUB IC HEALT I Pi*q EN�VI 4EENT COLORADO DEPARTMENT OF LAW
BY. .. C AL G(, C �t �1 OFFICE OF THE ATTORNEY GENERAL
Mark E. Wallace, MD, MPH•Director"
By / t Ik
ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER
CRS 24-30-202 requires that the State Controller approve all state contracts. This contract 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 the goods and/or services provided.
STATE CONTROLLER
David J.McDermott,CPA
❑Kevin Edwards ❑YvonneAnderson ❑Robert Jarosonald Rieck
//Date C9la�a JO
CDPHE Version 1.0(4/04) Page 17 of 17 Revised:3/21/05 /
EXHIBIT A
ADDITIONAL PROVISIONS
To Contract Dated 04/18/2008-Contract Routing Number 09 FLA 00318
These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above.
1. This contract contains 100%state funds.
2. To receive compensation under this Contract, the Contractor shall submit a signed monthly Invoice/Cost
Reimbursement Form. A sample of the required Invoice/Cost Reimbursement Statement is attached hereto
as Attachment A-1 and incorporated herein by this reference. An Invoice/Cost Reimbursement Statement
must be submitted within forty-five(45)calendar days of the end of the billing period for which services
were rendered. Expenditures shall be in accordance with the RFA Response Statement of Work attached
hereto as Attachment B-1,and incorporated herein. These items may include,but are not limited to, the
Contractor's salaries, fringe benefits, supplies,travel,operating,indirect costs which are allowable,and
other allocable expenses related to its performance under this Contract.
Reimbursement under this Contract shall be made only for work completed and/or purchases made,and
goods and/or services received on this project prior to the expiration date of this Contract.Invoice/Cost
Reimbursement Statements shall: 1)reference this Contract by its contract routing number,which number
is located on page one of this Contract; 2) state the applicable performance dates;3)state the names of
payees;4)include a brief description of the services performed during the relevant performance dates;5)
describe the incurred expenditures if reimbursement is allowed and requested;and, 6)show the total
requested payment. Payment during the initial,and any renewal or extension,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. Invoice/Cost Reimbursement Statements shall be sent to:
Prevention Services Division
CCPD
Colorado Department of Public Health and Environment
PSD/CCPD/A-5
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 forty-five
(45)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 forty-five(45)calendar days from the effective expiration or termination date of this
Contract.
The Budget and Budget Narrative,which is attached hereto as Exhibit D, shall govern the expenditure of
funds by the Contractor under this Contract as well as subsequent reimbursement by the State.
3. Time Limit For Acceptance Of Deliverables.
a. Evaluation Period. The State shall have ten(10)calendar days from the date a deliverable is
delivered to the State by the Contractor to evaluate that deliverable,except for those deliverables
that have a different time negotiated by the State and the Contractor.
b. Notice of Defect. If the State believes in good faith that a deliverable fails to meet the design
specifications for that particular deliverable,or is otherwise deficient,then the State shall notify
the Contractor of the failure or deficiencies, in writing,within ten(10)calendar days of: 1)the
date the deliverable is delivered to the State by the Contractor if the State is aware of the failure or
deficiency at the time of delivery; or 2)the date the State becomes aware of the failure or
To be attached to CDPHE Page 1 of 3 Revised:4/1/04
Version 1.0(4/04)contract template
EXHIBIT A
deficiency. The above time frame shall apply to all deliverables except for those deliverables that
have a different time negotiated by the State and the Contractor in writing pursuant to the State's
fiscal rules.
c. Time to Correct Defect. Upon receipt of timely written notice of an objection to a completed
deliverable,the Contractor shall have a reasonable period of time,not to exceed ten(10)calendar
days, to correct the noted deficiencies.
4. The following options should only be used in unforeseen circumstances. Funding levels within the
Budget, attached to this Contract,may be modified as follows:
a. Up to ten percent(10%)of the funds originally set forth in each major budget category(e.g.,
Personal Services, Operating,Travel,Contractual,and Other Costs)may be transferred to other
major budget categories by notifying the state and providing a justification. The Contractor shall
notify the state and provide written justification within two(2)weeks of the date of the transfer.
b. Up to ten percent(10%)of the funds originally set forth in each line item within a major budget
category may be transferred to other line items within that major budget category by notifying the
state and providing a justification.
5. 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.
6. Notwithstanding the terms contained in Paragraph 11,Page 6, General Provisions,of this Contract,the
parties agree to add the following language as new paragraph two:
a) "The financial management systems of the Contractor must meet the following standards:
b) Contractor shall expend and account for contract funds in accordance with generally accepted
accounting principles
c) Contractor shall maintain records that adequately identify the source/revenue and
application/expenditure of funds.These records must contain information pertaining to contract
awards,assets, liabilities,expenditures and income.
d) Accounting records shall be supported by source documentation,including but not limited to
cancelled checks,paid bills,payroll,time and attendance records,contract and subcontract
documents.
e) Contract funds shall be separately accounted for in Contractor's accounting records and shall not
be commingled with Contractor's other funds.
t) Actual expenditures shall be compared with budgeted amounts
g) Costs allocated to this Contract shall be based upon relative benefits received
h) Applicable laws,regulations,and terms of the Contract will be followed in determining the
reasonableness,allowability, and allocability of costs.
i) Fiscal controls and accounting procedures of the Contractor must be sufficient to:
1) permit the preparation of financial reports required by this Contract and preparation of
financial statements
2) allow Contractor's staff, in the normal course of performing their assigned functions,to
prevent or detect misstatements in financial reporting or the loss of assets in a timely
basis
3) allow for accurate, current,and complete disclosure of the financial activities made in
accordance with the financial reporting requirements of the Contract"
To be attached to CDPHE Page 2 of 3 Revised:4/1/04
Version 1.0(4/04)contract template
EXHIBIT A
7. Notwithstanding the terms contained in Paragraph 27,Pages 14 and 15,General Provisions,of this
Contract,the parties agree to add the following language as new paragraph two:
"Financial Statement Audit. If the Contractor is not subject to provision 27a,above, because it expends
federal funds from all sources in an amount less than$500,000 during its fiscal year,the Contractor shall
have a financial statement audit performed in accordance with generally accepted auditing standards. Costs
for the audit report shall be allocated as an indirect cost or to the various funding sources based upon
relative benefits received(e.g.,expenditures). The Contractor shall furnish (1)copy of its financial
statement audit report and management letter to the State's Internal Audit Office within thirty(30)calendar
days after the Contractor's receipt of its auditor's report or nine(9)months after the end of the Contractor's
audit period,whichever is earlier."
To be attached to CDPHE Page 3 of 3 Revised:4/1/04
Version 1.0(4/04)contract template
CANCER, CARDIOVASCULAR DISEASE,AND PULMONARY DISEASE GRANTS PROGRAM
COST REIMBURSEMENT FORM
Attachment A-1
TO: Colorado Departrnent of Public Health and Environment FROM.AGENCY/INSTITUTION'.
Awn:Grants Accounting Unit CONTRACT OR PO NO.:
4300 Cherry Creek Drive South,PSD/CCPD/A-5 FEIN'.
Denver,CO 80246-1530 INVOICE PERIOD'.
Fiscal Contact
Phone: E-mail.
Reimbursement is made for work completed and/or purchases made and goods and/or services received on the above project prior to the expiration date of this contract.
Invoices must be submitted on a monthly basis.
Expensed Amount
PERSONAL SERVICES ORIGINAL CONTRACT/PO SUM $
Salry $ - (Your original award amount)
Fringe Benefit $ - PREVIOUS INVOICES $
Total Personal Services $ (Total amount previously invoiced)
g
u.4
. .-
_- . lt PRESENT CONTRACTUAL TOTAL $PROGRAM OPERATING (Original award amount,minus total previous invoices)
Printing/Copying $ - Provide a brief description of work completed for this period
Postage/Shipping $
RenUUtilities $
Phone/Faxllntemet
Computer Equipment $Medical Equipment $
Education Materials I
Other Expenses(itemizelattach detail) $ -
TOTAL OPERATING $
tae ."tdd t.
TRAVEL
In.Slate Only $ -
Total o Travel Costs
rat a P �(54 :VE? alr
CONTRACTUAL
Trainer/Speakers $Family Medicine $ -
DenverHealthBHospitals $ -
Salud $ -
St Mary Corwin Hospital $ -
ColoradoCommunityHealth $ -
TOTAL CONTRACTUAL $ -
OTHER COSTS $ -
Media(prior approval needed)
Outreach/Educational Materials $ -
(Prioryrprovalneeded) $ -
Equipment(Attach copies of receipts) $ -
Incentives(Attach copies of receipts) $ -
Evaluadon $ -
Saeening $ -
Treatment $ -
TotalOtherCosts $ -
sax,:. -h a " .w r,. .
SUBTOTALS $ -
e:-, ..
`' I/We certify that all work and materials included in this cost reimbursement statement were
IPOtREcf COSTS:zx Caaaaeu.t Ftownhrtugh $ - incurred per Contract and/or PO during the time staled above.
lNpRECT cosrs:(251%a Wt veer ouch+tale of u.
raaowmas co.a) $ - PaNal PaymentRequest Final Payment Request
Total Indirect Cost $ -
"u
a Authorized Signature Date
Revised 04/25/08 ceniry that all COntractiPO requirements have been met and the amounts billed are correct.
CDPHE Program Director/Fiscal Othcer Dale
EXHIBIT B
STATEMENT OF WORK
To Contract Dated 04/18/2008 Contract Routing Number 09 FLA 00318
These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above.
1. The Contractor, in accordance with the terms and conditions of this Contract,shall perform all activities
described in the RFA Response Statement of Work,and attached hereto as Attachment B-1.
2. The Contractor shall participate in contractors meetings and/or training deemed to be essential to the
overall Cancer, Cardiovascular Disease,and Pulmonary Disease Grants Program,hereinafter referred to as
"CCPD."
3. The Contractor shall participate in evaluation activities deemed to be essential to determining the overall
effectiveness of the CCPD program at the request of the state.
4. The Contractor shall submit a quarterly progress report on or before October 17, 2008,January 16,2009,
April 17,2009 and a final report on or before July 17,2009,on forms provided by the state. At a
minimum,the final report shall describe results for each objective,describe key accomplishments,and
summarize the overall implementation of the work plan.
5. A continuation application with a detailed scope of work and budget will be required for each year of
additional funding up to a total of three(3)years. Approval of continuation applications will be dependent
upon successful completion of the project's scope of work at the time of renewal and the availability of
funds.All future grant funding is directly tied to past performance.
6. The Contractor shall submit all media plans,media purchases and earned media,and public education
programs to the CCPD Program for prior review and approval by the Colorado Department of Public
Health.
7. The following sponsorship information under this contract shall be included on all printed materials,
educational materials,and paid media: "This project is sponsored by the Cancer,Cardiovascular
Disease,and Pulmonary Disease Grants Program, at the Colorado Department of Public Health and
Environment".
8. 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.
To be attached to CDPHE Page 1 of 1 Revised:4/1/04
Version 1.0(4/04)contract template
Attachment B-I
Statement of Work
Work Plan
Work Plan: FY08f09
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 women and women
enrolled in the Women's Wellness Connection.
Long-term By December 30, 2013, decrease by 10%from 2009 baseline measures the incidence of eligible
Objective: women with risk factors for nutrition, physical aq.ivity,obesity, and smoking as measured by Weld
County's oversample BRFSS (Behavioral Risk Factor Surveillance System)and Community Health
Survey.
Intermediate By June 30, 2011, reduce by 10%from 2009 b;eline the percentage of eligible women with high
Obj. 1: CVD(Cardiovascular Disease) risk scores.
Short-term By June 30, 2009, at least 250 eligible women s all complete CVD risk factor screening.
Obj. 1:
Time Frame
Process Objectives (activities) Q1 Q2 Q3 Q4
Jul.— Oct.— Jan.— Apr.—
Sept., .Dec., Mar., Jun.,
2008 2008 2009 2009
1) By July 31, 2008, hire a fulltime Project Coordinator and : part- X
time health educator. Priority shall be given to bi-ling al, bi-
cultural candidates.
2) By August 30, 2008,establish and convene an advisory X
committee for the program consisting of at least 3 community
health center key personnel, 3 members of the program's target
population, 1 Women's Wellness Connection Project Coordinator,
1 Tobacco Free Weld County personnel and 2 public health
personnel.
3) By September 30, 2008, establish program procedu s in X
collaboration with the advisory committee, modeled afte CDC
(Center for Disease Control) Wisewoman guidelines.
4) By November 1, 2008, hire a .5 FTE medical assistant, X
5) By December 30, 2008,train all project clinical staff on how ito use X
clinical screening equipment and the eCaST system.
6) By December 30, 2008, publicize to at least five health care X
providers external to Sunrise Community Health, Inc. and five
community-based social service organizations about the project to
obtain referrals.
7) By January 30, 2009, recruit at least 50 eligible women in the X
community via Sunrise Community Health, Inc. and the Women's
Wellness Connection.
1 of27
Attachment B-I
Work Plan: FYO81O9
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 women and women
enrolled in the Women's Wellness Connection.
Long-term By December 30, 2013,decrease by 10%from 2009 baseline measures the incidence of eligible
Objective: women with risk factors for nutrition, physical activity, obesity, and smoking as measured by Weld
County's oversample BRFSS and Community Health Survey.
Intermediate By June 30, 2011, at least 75%of women completing the lifestyle intervention shall improve their
Obj.2: dietary, physical activity, and smoking practices.
Short-term By June 30, 2009, at least 50%of the newly screened women with moderate or high risk for CVD
Obj. 2: shall complete at least 4 or more lifest le intervention sessions.
Time Frame
Process Objectives (activities) Q1 Q2 Q3 Q4
Jul.— Oct.— Jan.— Apr.—
Sept., Dec., Mar., Jun.,
2008 2008 2009 2009
8) By November 30, 2008, create project materials in collaboration X
with the advisory committee based on the New Leaf and Vida
Saludable, CorazOn Contendo curricula.
9) By December 30, 2008, 90%of all staff involved directly or X
indirectly with the lifestyle intervention shall successfully complete
project training which shall include(a) New Leaf curricula, (b)
WISEWOMAN program guidelines, and (c)cultural competency
training.
10) By January 30, 2009, at least 50 women (25 in English classes X
and 25 in Spanish classes) with elevated risk for CVD shall be
enrolled in an 8-week lifestyle intervention program.
11) By February 1, 2009, develop and initiate a system to do phone X X
follow-up reminders for all participants who miss a lifestyle
intervention class.
12) By February 28, 2009, at least 50 women shall receive individual X
one-on-one lifestyle counseling (face-to-face or phone)with a
registered dietitian or registered nurse.
13) By April 30, 2009, at least 50 women (25 in English classes and X
25 in Spanish classes) with elevated risk for CVD shall be
enrolled in an 8-week lifestyle intervention program.
14) By May 30, 2009, at least 50 women shall receive individual one- X
on-one lifestyle counseling (face-to-face or phone) with a
registered dietitian or registered nurse.
2 of 27
Attachment B-I
Work Plan: P/08/09
Goal 1: 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 women and women
enrolled in the Women's Wellness Connection.
Long-term By December 30, 2013, decrease by 10%from 2009 baseline measures the incidence of eligible
Objective: women with risk factors for nutrition, physical activity, obesity, and smoking as measured by Weld
Count 's oversam.le BRFSS and Communi Health Surve .
Intermediate By June 30, 2011, at least 40%of eligible women shall complete their annual screening evaluation
Obj.3: visit.
Short-term By June 30, 2009, at least 30%of high risk eligible women shall complete their six-month
Obj.3: evaluation screening visit.
Time Frame
Process Objectives(activities) Q1 Q2 Q3 Q4
Jul.— Oct.— Jan.— Apr.—
Sept., Dec., Mar., Jun.,
2008 2008 2009 2009
15) By March 1, 2009, in collaboration with the Advisory Committee, X
create a project maintenance program based on the New Leaf
maintenance program to assist women in establishing adherence
to their new behavior .atterns.
16) By April 1, 2009,every woman who completes the 8-week lifestyle X
intervention group counseling shall receive at least four nutrition
and physical activity mailings and two brief phone counseling calls
over the next 10 months from when they completed the 8-week
intervention.
17) By May 1, 2009, ut a reminder led x mail system-to ■■■ X
remind women about their scheduled six-month follow-up
screenin•.
3 of 27
Attachment B-1
Work Plan: FYO8/09
Goal 1: 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 women and women
enrolled in the Women's Wellness Connection.
Long-term By December 30, 2013,decrease by 10%from 2009 baseline measures the incidence of eligible
Objective: women with risk factors for nutrition, physical activity, obesity, and smoking as measured by Weld
County's oversample BRFSS and Community Health Survey.
Intermediate By June 30, 2011, at least 50%of women participating in community-based resources and activities
Obj.4: shall report ongoing participation in those resources and activities.
Short-term By June 30, 2009, at least 50%of screened women shall participate in community-based clinical or
Obj.4: physical activity and nutrition resources or activities.
Time Frame
Process Objectives (activities) Q1 Q2 Q3 Q4
Jul.- Oct.- Jan.- Apr.-
Sept., Dec., Mar., Jun.,
2008 2008 2009 2009
18) By September 30, 2008, (and on-going), provide 2 healthy X X X X
cooking classes and 2 nutrition education programs per month in
the community. Cooking and nutrition classes shall include
hands-on participation and shall be taught in English and Spanish.
19) By September 30, 2008, collaborate with other chronic disease X X X X
grants currently being funded and administered in the community
to leverage resources to cover a county-wide effort on chronic
disease prevention. The Project Coordinator shall become a
member of the established Weld County Health Media Advisory
Committee.
20) By September 30, 2008,establish a contract with the City of X X X X
Greeley's Recreation Department to offer Zumba group exercise
classes at least one time a week. Work with the City to promote
class participation among other community members.
21) By September 30, 2008, publicize the Zumba classes in the City X X X X
of Greeley Recreation Departments Leisure Connection, the
Greeley Tribune, and La Tribuna.
22) By October 31,2008, offer weekly Zumba group exercise classes X X X
with a minimum of 25 regular participants at the Rodarte Center.
23) By September 30, 2008, organize and coordinate one or more X X X X
walking groups with at least 20 regular participants.
24) By January 10, 2009,develop and coordinate a comprehensive X X
media plan with the Health Media Advisory Council (HMAC)to
support Heart Month. Distribute media messages to print news,
internet, radio PSAs, TV spots on cable and Telemundo,
billboards, bus ads, posters, flyers, and brochures.
25) By April 1, 2009, develop and coordinate a comprehensive media X X
campaign with HMAC to support Stroke Alert Day in May 2009
using all media venues listed above.
26) By April 30, 2009, participate in all nine Weld County 9News X
Health Fairs by offering interactive education booths on
cardiovascular disease.
27) By June 30, 2009, provide cardiopulmonary resuscitation (CPR) X
training to at least 20 lifestyle intervention participants.
4 of 27
Attachment B-1
Fiscal Year 2009-2010 and Fiscal Year 2010-2011
Work Plan: FY09/10 & FY10/11
Goal 1: 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 women and women
enrolled in the Women's Wellness Connection.
Long-term By December 30, 2013, decrease by 10%from 2009 baseline measures the incidence of eligible
Objective: women with risk factors for nutrition, physical activity, obesity, and smoking as measured by Weld
County's oversample BRFSS and Community Health Survey.
Intermediate. ` By June 30, 2011, reduce by 10%from 2009 baseline the percentage of eligible women with high
Obj. 1: CVD risk scores.
Short-term At least 750 eligible women shall complete CVD risk factor screening in grant years two and three.
Obj. 1:
Time Frame
Process Objectives (activities) Q1 Q2 Q3 Q4
Jul.- Oct.- Jan.- Apr.
Sept., Dec., Mar., Jun.,
2009/2010 2009/2010 2010/2011 2010/2011
28) Expand screenings to at least 2 new clinical sites in grant X X X X
year two and in grant year three.
29) Publicize to at least five new community-based social X X X X
service organizations about the project to obtain referrals in
grant year two and grant year three.
30) Publicize to at least five community-based faith X X X X
organizations about the project to obtain referrals in grant
year two and grant year three.
31) Recruit at least one new clinic to accept medical referrals X X X X
for project eligible women who are found to be at elevated
risk for CVD disease but do not have a medical home.
Offer$100 medical vouchers for first time office visits to the
clinics that accept referrals from un/underinsured elevated
risk program participants.
5 of 27
Attachment B-1
Work Plan: FYO9/1O&FY10/11
Goal 1: 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 women and
women enrolled in the Women's Wellness Connection.
Long-term By December 30, 2013, decrease by 10%from 2009 baseline measures the incidence of eligible
Objective: women with risk factors for nutrition, physical activity, obesity, and smoking as measured by Weld
Count 's oversam.le BRFSS and Communi Health Surve .
Intermediate By June 30, 2011, at least 75%of women completing the lifestyle intervention shall improve their
Obj.2: dieta , .h sical activit , and smokin. .ractices.
Short-term Obj. At least 40%of the newly screened women shall complete at least 4 or more lifestyle intervention
2: sessions in .rant ears two and three.
Time Frame
Process Objectives (activities) O1 Q2 Q3 Q4
Jul.— Oct.— Jan.— Apr.—
Sept, Dec., Mar., Jun.,
2009/2010 2009/2010 2010/2011 2010/2011
32) At least 300 women with elevated risk for CVD shall be X X X X
enrolled in an 8-week intervention aro.ram.
33) Conduct phone follow-up reminders for all participants who X X X X
miss a lifes le intervention class.
34) At least 300 women shall receive individual one-on-one X X X X
lifestyle counseling (face-to-face or phone)with a registered
dietitian or re.istered nurse.
Work Plan: FYO9/1O &FY1O/11
Goal 1: 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 women and women
enrolled in the Women's Wellness Connection.
Long-term By December 30, 2013, decrease by 10%from 2009 baseline measures the incidence of eligible
Objective: - women with risk factors for nutrition, physical activity, obesity, and smoking as measured by Weld
Count 's oversamIle BRFSS and Communi Health Surve .
Intermediate By June 30, 2011, at least 40%of eligible women shall complete their annual screening evaluation
Obj.3: visit.
Short-term At least 30%of high risk eligible women shall complete their six-month evaluation screening visit in
Obj.3: grant years two and three.
Time Frame
Process Objectives (activities) Q1 Q2 Q3 04
Jul.- Oct.- Jan.- Apr.-
Sept:, Dec., Mar, Jun.,
2009/2010 2009/2010 2010/2011 2010/2011
34) Every woman who completes the 8-week lifestyle X X X
intervention group counseling shall receive at least four
nutrition and physical activity mailings and two brief phone
counseling calls over the next 10 months from when they
com.leted the 8-week intervention.
35) Every program participant that was found to be at elevated X X X
risk for CVD shall receive a reminder phone call and/or
mailing to remind them of their scheduled six-month follow-
u. screenin..
6 of 27
Attachment B-I
Work Plan: FYO9/1O & FY10/11
Goal 1: 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 women and women
enrolled in the Women's Wellness Connection WWC .
Long-term By December 30, 2013,decrease by 10%from 2009 baseline measures the incidence of eligible
Objective: ; women with risk factors for nutrition, physical activity,obesity, and smoking as measured by Weld
Count 's oversam•le BRFSS and Communi Health Surve .
Intermediate By June 30, 2011, at least 50%of women participating in community-based resources and activities
Obj.4: shall resort on•oin• •artici•ation in those resources and activities.
Short-term At least 30%of screened women shall participate in community-based clinical or physical activity
Obj.4: and nutrition resources or activities in grant years two and three.
Time Frame
Process Objectives (activities) Q1 Q2 Q3 44
Jul.— Oct. Jan.— Apr.—
Sept., Dec., Mar., Jun.,
2009/2010 2009/2010 2010/2011 2010/2011
36) Provide 2 healthy cooking classes and 2 nutrition education X X X X
•ro•rams •er month in the communit .
37) Offer Zumba group exercise classes a minimum of one time X X X X
ter week.
38) Expand the walking program to include 30 regular participants X X X X
in •rant ear two and 40 regular •artici•ants in •rant ear 3.
39) Provide a half day seminar on cultural competency. X X
40) Provide cardiopulmonary renton resuscitation (CPR)wotrai and togrant
nt0 . X . X
lifestyle intervention participants in grant year two and grant
ear three.
a. Evidence-based justification for the proposal.
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 CDC
funds over 15 programs across the country. These programs are designed to promote lasting healthy
lifestyle changes. WISEWOMEN programs provide standard preventive services including blood pressure
and cholesterol testing. In addition to testing and referral, WISEWOMAN programs also offer a variety of
lifestyle intervention programs such as cooking classes, exercise classes, fitness challenges, and smoking
cessation classes[.
WISEWOMAN programs have been well researched and evaluated2 The WISEWOMEN programs
have been shown to reduce the prevalence of hypertension and high blood pressure3. They have also been
shown to increase physical activity and short-term consumption of fruits and vegetables.
The cardiovascular risk factor screening assessment shall use the Cardiovascular Disease and Stroke
Prevention Guideline developed by the Colorado Clinical Guidelines Collaborative (CCGC) in February
20074. Many factors are known to increase the risk for coronary heart disease. More than 40 years ago,
investigators with the Framingham Heart Study identified several key risk factors and about 10 years ago
used this knowledge to develop a tool to predict heart disease risks. Variations exist, but they rely on six
pieces of information—age, gender, total cholesterol, HDL cholesterol, smoking status, and systolic blood
pressure—to estimate one's chance (risk) of having a first heart attack or being diagnosed with heart
disease in the next 10 years. An accurate assessment of cardiovascular risk is critical in helping health
care providers determine which prevention strategies to recommend for any particular patients.
7 of 27
Attachment B-I
The lifestyle intervention component shall use the A New Leaf... Choices for Healthy Living curriculum.
This curriculum is a research-based nutrition, physical activity, and smoking cessation assessment and
intervention program for cardiovascular disease risk reduction especially for low income individualss. The
diet and activity assessments are quickly and easily administered, scored, and interpreted by non-
specialists. They identify major problem areas as well as strengths in terms of diet and activity, and assess
attitudes and misconceptions that may serve as barriers to dietary change or increased physical activity
using standardized validated instruments. The New Leaf curriculum has been tested in numerous
randomized clinical trials since 1991. Results from two randomized controlled trials found significant
improvements in self-reported diet and physical activity behaviors at six and twelve month follow-up7.
Programs delivered at clinical sites that used the New Leaf curriculum have demonstrated effectiveness in
reducing risk factors for heart disease and stroke including diet and cholesterols.
A recent review of the literature on physical activity and health in women found 17 studies which
showed significant cardiovascular risk reductions for women who improve their cardiorespiratory fitness
levels. Three large cohort studies (the Women's Health Study, Women's Health Initiative, and Nurse's
Health Study) found that participation in as little as 1 to 3 hours of moderate physical activity weekly can
reduce cardiovascular risk 20% -30% . Increasing either intensity or duration of physical activity resulted in
even further reductions in risk. Benefits were identified between simply brisk walking and CVD risk
reduction. In one study, as little as one hour of walking per week resulted in a risk reduction between 18%
and 50% for several cardiovascular disease outcomes including stroke.
Strategies for increasing adherence with prevention and treatment recommendations have been
studied over the past twenty-five yearst0. Recent research has shown that effective interventions use a
variety of behavioral, cognitive, and education strategies. On the patient level, skills such as problem-
solving, self-monitoring, developing prompts or reminder systems, identifying a risk for relapse to a former
behavior, enlisting social support, setting appropriate and realistic goals, and rewarding achievement of
new behaviors are useful in achieving long term adherence to behavior change. Heart of Weld shall
implement the New Leaf curriculum's maintenance intervention which has a successful history of promoting
long-term adherence to new behavior patterns promoted in lifestyle intervention classes. Heart of Weld
shall provide the participants with ongoing contact with health facility staff and relapse prevention
counseling to reinforce lifestyle intervention changes for up to one year after each participant enters the
program. Additionally, all high risk women shall be tracked and encouraged to complete their six month re-
screening and all eligible women shall be encouraged to complete their twelve month annual screening.
b. Describe how diagnosis and treatment services shall be integrated and coordinated and
estimate the number of people who shall need treatment.
During the initial year of the project, most of the women who qualify for Heart of Weld CVD screenings
shall have a medical home already established at Sunrise Community Health, Inc. We shall integrate the
Framingham 10-year Cardiovascular Disease Risk Assessment into clinical practice for these screenings
and follow its protocols to determine CVD risk. Each enrolled participant shall receive a baseline screening
with the results of this screening then determining the intervention. Participants with low risk for CVD shall
be eligible for a 12-month follow-up screening. Participants with elevated CVD risk (i.e., moderate or high
risk) shall receive the usual standard of care services including a medical referral and clinical follow-up as
well as the lifestyle intervention, which shall include the New Leaf dietary and physical activity counseling
sessions. Participant with elevated CVD risk shall be eligible for a 6-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 year two and three of the project, we shall 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
8 of 27
Attachment B-I
risk for CVD shall become eligible for a one-time $100 voucher. These vouchers shall go to clinicians
accepting medical referrals for patients.
We estimate that 25 patients in the first year of the project shall not have a medical home and shall
become eligible for the $100 medical voucher. In years two and three of the project we estimate that 100
women in the community shall be screened and determined to be at high risk for CVD and shall not have a
medical home. These 100 women each year shall then be eligible for the $100 medical voucher.
c. Describe how your program actively collaborates with other agencies to share resources,
coordinate efforts, and avoid duplication of services, including state or local chronic disease
programs in your community and local public health departments or county nursing services.
The Weld County Department of Public Health and Environment has taken the lead in establishing
community coalitions to share resources, coordinate efforts and avoid duplication of services related to
chronic diseases. The North Colorado Health Alliance is an organization composed of 12 agencies in Weld
County that work together to address the health needs of the uninsured and underinsured residents of
Weld County. Shared clinic space,joint projects for school health clinics, electronic medical records
system that links the health department and community health clinic records, and diabetes prevention
classes in Spanish are examples of projects where the Health Department has taken the lead in
collaborating with these agencies.
d. Provide evidence of past,successful collaborative projects with other groups and agencies or
other chronic disease programs in the community.
The Health Department has collaborated with many agencies and businesses on chronic disease
issues. For more than 10 years the Health Department has been the lead agency for the Weld County
Diabetes Coalition, coordinating a variety of community outreach activities and educational programs for
professionals. The health department's Diabetes Disparities Project has partnered with the City of
Greeley's Recreation Departments, Greely/Evans School District 6 and Sunrise Community Health, Inc. to
offer no cost Zumba group exercise classes targeting Latino women at-risk for developing diabetes. These
classes have been offered up to three times a week with an average attendance of 40 participants per
class. The Health Department has also collaborated with CSU Extension Service's Food and Nutrition
Program to provide Dining with Diabetes classes and an adolescent support group for overweight children
and their parents. Both programs were facilitated in English and Spanish. The Health Department has also
coordinated two very successful physical activity events in partnership with the Greeley Tribune to motivate
community members to collectively"Walk Around the World in 92 Days" and an individual challenge for
community members to "Leave their Behinds, Behind". The response was so great(700+ participants) that
two trips around the world were achieved with the Weld Walks program. Additionally, the health
department also houses a very successful Women's Wellness Connection (WWC) program that has
established partnerships throughout the community with clinical providers to offer breast and cervical
cancer screenings to low-income underinsured women between the ages of 40-64, In 2006 WWC
screened 940 eligible women.
e. Provide a list of partners or supporters of the application and a description of their roles.
1. Sunrise Community Health, Inc. shall provide qualifying patients for screening and provide space for
the screenings and group lifestyle intervention classes. They shall provide office space for the Project
Coordinator and Health Educator, a large room to offer Zumba classes, and access to the E-CaST and
EMR (Electronic Medical Records) system to record data.
2. The Health Communication, Education, and Planning Division of WCDPHE (Weld County Department
of Public Health & Environment) where many population-based education and prevention grants are
administered. Steps to a Healthier Weld County, the Weld County Tobacco Program, the Diabetes
Disparities Project, and The Women's Wellness Connection shall collaborate to leverage resources
and prevent duplication of services.
9 of 27
Attachment B-1
3. The Weld County Tobacco Program shall provide group smoking cessation classes.
4. The Weld County Women's Wellness Connection shall collaborate with the Heart of Weld by
integrating recruitment efforts for both projects and organizing joint marketing efforts for both programs.
5. The City of Greeley's Recreation Department shall host group exercise classes for lifestyle intervention
participants. They shall provide a large aerobics room and/or gym for Zumba classes and classroom
space for group lifestyle intervention classes if needed.
f. Describe how those affected by your project have been and/or shall be involved in the design
and implementation.
On December 3, 2007 the Weld County Health Department conducted a focus group of 8 bi-lingual/bi-
cultural members of the target population who use Sunrise Community Health Center as their medical
home. We asked for their input regarding the structure of the lifestyle intervention classes, desired location,
length of sessions, what the barriers would be to attend all classes (i.e. childcare, transportation), what
additional support they would need to be successful with the intervention (i.e., CPR training, additional
opportunities for group exercise, on-going support and follow-up screenings). Additionally, we have
community health survey data from a random sample of community members (completed December 15,
2007) that shall be used to help further refine the project design.
Also, a minimum of three project participants shall be invited to participate in monthly program advisory
committee meetings. We shall encourage successful program participants to share their stories with local
media including local Spanish Radio and local Spanish language newspaper. Furthermore, we shall
provide opportunities for successful program participants to be trained as Promotoras to assist with group
lifestyle intervention classes.
g. Describe how the project is appropriate culturally, linguistically, and for literacy level for the
target population.
The lifestyle intervention classes shall use both the New Leaf Curriculum and the Spanish version, Vida
Saludable, Corazon Contento, so that classes may be taught in English and Spanish. The educational
materials in these two curriculums were developed and refined for the target population by the original
curriculum developers. The curriculum is written at about a sixth-grade level and uses numerous graphics
and visuals. The physical activity portion of the curriculum is tailored to middle-aged and older women. We
have stipulated in the work plan that all clinical staff and health educators involved in the Heart of Weld
project shall receive a minimum of one cultural competency training within the first 6 months of contract
initiation as well as follow-up trainings each succeeding year of the project.
10 of 27
Attachment B-1
Evaluation Plan
a. Evaluating Reach of the Heart of Weld Project.
Based on data from the 2005 Weld County Behavior Risk Factor Surveillance Survey, we estimate there
are approximately 32,500 women between the ages of 40 and 64 years of age 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. Table 1 outlines several demographic characteristics of women in this age group. Most
women in this age group are White (75%), not college graduates (74%), employed (59%), and live in
households with an annual income less than $50,000 (51%). Approximately 16 percent of Weld County
women aged 40 to 64 years describe their overall health status as fair or poor. Seventeen percent of
women in this age group report they do not have health insurance. 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. Demographic Characteristics of Women Aged 40 to 64 Years in Weld County(BRFSS, 2005)
Percentage
Race/Ethnicity Category
White, not Hispanic 75.2%
Hispanic origin 22.2%
Other race/ethnicity 2.2%
Education Level
No high school diploma 13.7%
High school graduate or equivalent 28.4%
Some college 31.4%
College graduate 26.4%
Employment Status
Employed 58.9%
Self-employed 9.6%
Out of work 3.6%
Homemaker 13.5%
Student <1%
Retired 7.3%
Not able to work 6.5%
Annual Household Income
<$25,000 21.6%
$25,000-$35,000 11.5%
$35,000-$50,000 18.1%
$50,000-$75,000 22.0%
>$75,000 26.8%
Self-reported health fair or poor 15.5%
No health insurance 17.1%
We shall use several data indicators to evaluate reach of the project into the target population. We
shall track the total number of screenings, total number of first time screenings, percentage of
Women's Wellness Connection women screened, percent of Latino women screened, and percent of
women who attended at least one lifestyle intervention session.
During the first year of the project, we shall recruit women from Sunrise Community Health, Inc.
(CHC) which has a site in Greeley and in Evans, Colorado and Weld County Department of Public
11 of 27
Attachment B-I
Health and Environment(WCDPHE) in Greeley, Colorado. Sunrise Community Health, Inc. primarily
serves uninsured residents. WCDPHE serves uninsured and underinsured residents. Over the past
three years, Sunrise Community Health, Inc. saw 2,480 women between the ages of 40 and 64 years
and WCDPHE saw 71 women between the ages of 40 to 64 years. In years two and three the project
plans to recruit women from other clinical sites in Weld County.
Over the next three years, we estimate the number of eligible women exposed to the program
annually shall be 1,000 for a total of 3,000 eligible women over the grant period. The actual number we
desire to respond to recruitment annually is 250 in year 1, and 750 in years 2 and 3 for a total of 1,750.
Therefore, our estimated reach into the target population over the grant period is 16 percent(1,750 out
of 10,900).
b. Evaluation of Short-term and Intermediate Outcomes,
Weld County Department of Public Health and Environment personnel use logic models to develop,
manage, and evaluate programs. A logic model depicting the program's inputs, activities, and short,
intermediate, and long-term outcomes for this program was developed and can be found in the appendix.
The Project Evaluation Matrix outlines the methods the Heart of Weld project shall use to evaluate short-
term and intermediate objectives and includes details about the measurement tools, data sources, analytic
methods, timelines, and responsible personnel. Once the project is funded, a more detailed evaluation plan
shall be developed.
12 of 27
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Attachment B-I
c. Linkage to State Strategic Plans
The Heart of Weld Project shall assist the state of Colorado in achieving the following strategic plan
objectives:
• Increase to 80 percent the proportion of adults who have had their blood cholesterol checked
within the preceding five years.
• Reduce cardiovascular disease deaths to a rate of 108.9 per 100,000
d. Tracking and Reporting of Process Objectives
Implementation evaluation shall monitor the project's activities to provide information to the
project's stakeholders. This shall include assessing progress, strengths, weaknesses, and lessons
learned on a continuous basis. At regular intervals over the grant period the project coordinator
and lead evaluator(the Health Data Specialist/Analyst) shall meet to discuss how the project is
doing. The project coordinator shall maintain detailed project management records in an
appropriate format (e.g., binders and/or electronic files) and summarized in a project management
plan developed in collaboration with the evaluator and state of Colorado. Methods for assessing
the extent which process objectives have been met shall include document reviews, interviews,
and observation. For example, evidence of organized materials, meeting minutes and agenda,
attendance rosters, evaluation forms, training materials, and program policies shall be reviewed to
compare the extent which what was planned to what occurred. Where appropriate, activities shall
be judged on their level of(a) completeness and (b) overall quality. The Health Data Specialist/
Analyst and Evaluation Assistant shall conduct the process evaluation. Data shall be managed and
analyzed using NVivo 7, SPSS Version 15, and Microsoft Excel.
16 of27
Attachment B-1
Needs Statement
a) Describe how your proposal satisfies an unmet need.
This project, the Heart of Weld Project, shall provide heart health risk assessments for Weld
County women aged 40 to 64 years who are uninsured or underinsured, combined with one-on-
one counseling and lifestyle intervention classes to help reduce their risks of developing heart
disease (see Heart of Weld Program Flow Diagram in appendix for more description). It shall also
provide community-level interventions for cardiovascular disease risk reduction. This project was
conceptualized by Weld County Department of Public Health and Environment as a result of
several areas of growing concern nationally and locally regarding the growing burden of
cardiovascular disease and our commitment to education and prevention.
During the last century, the pattern of chronic diseases leading to death, illness, and disability
among Americans has changed dramatically. Chronic diseases such as heart disease, cancer, and
diabetes are now among the most prevalent, costly, and, at the same time, preventable of all
health conditions. Seven of every 10 Americans who die each year, or more than 1.7 million
people, die of a chronic disease1. Over 90 million Americans live with chronic illnesses. The
medical care costs of people with chronic illnesses exceed 75 percent of the nations' total medical
care costs.
Cardiovascular disease, which includes coronary heart disease (CHD), stroke, and other
cardiovascular diseases, is a major health problem for women. According to the American Heart
Association2, nearly two out of five female deaths (39%) in America are due to cardiovascular
disease. Coronary heart disease is the leading cause of death for American women. One out of
four women dies of heart disease and more than half of the persons who die each year of heart
disease are women.
Most diseases and injuries have multiple causes and conditions that can contribute to a single
death; however, a recent study analyzing the major modifiable behavioral risk factors associated
with mortality found the two leading actual causes of death to be tobacco (18%) and poor diet and
physical inactivity (15%) (see Figurel)3. The authors estimated that roughly 400,000 deaths occur
annually due to poor diet and physical inactivity (measured as deaths due to overweight) compared
to 435,000 deaths attributable to tobacco. They also compared mortality trends between 1990 and
2000 and found that deaths due to poor diet and physical inactivity4 increased more rapidly than
any other cause or condition.
Actual Causes of Death in the United States,2000
Tobacco .k*_'`. ,rr.'c`.:'W "¢.'��` , e. - 15%
Poor diet/lack of exercise = 'T - li e .rv. 15%
Alcohol use M „ ''4%
Infectious agents -VT,-VTI,3%
Pollutants/toxins 672%
Motor vehicle crashes ~."2%
Firearms 2 1wo
Risky sexual behavior j 1%
Illicit drug use 1%
0% 5% 10% 15% 20% 25%
Source:JAMA,Vo1.291,No. 10 pp123H-1245 Percent of All Deaths
17 of27
Attachment B-1
Figure 1.
The need for a cardiovascular disease prevention program targeting underserved women aged
40 to 64 years in Weld County is bolstered by the fact that the demographic profile of the county is
changing. These changes, mainly driven by population growth, are having effects on the county's
overall health status.
Geographically Weld County is a large, mainly rural area located in northeastern Colorado;
however, the majority of its population resides in several cities and towns in the eastern portion of
the county. Weld County's population has increased dramatically over the past decade with an
estimated 2006 population of about 237,0005, It is currently ranked the ninth largest county in
Colorado and is in the top 100 fastest growing counties in the United States. Similar to the nation
as a whole, the age structure of Weld County's population has shifted with older age groups
making up more of the population total. Lastly, over the past three decades, the Latino population
has increased. Currently, about one-third of Weld County residents are Hispanic.
Keeping in mind what we know about the relationship between income and health, Weld
County's economic profile also signals a need for this program. Weld County has a lower average
income than the rest of the Colorado and over one-fourth (27%) of Weld County households live on
incomes that are below the 200% federal poverty level. In 2005, about one out of ten people living
in Weld County were in poverty. This rate is lower than the U.S. rate but slightly higher than
Colorado's rate. And, among Weld County families with a female householder and no husband
present, three out of ten of these households live in poverty6. These indicators, as well as
anecdotal data gathered by Weld County Department of Public Health & Environment (WCDPHE)
during regular program and community assessments, point to a growing population of households
struggling to carry on in day-to-day life.
In terms of health care access and coverage, we know that that people who lack insurance or
have less than optimal access to health care are more likely to delay getting health care and are at
risk for experiencing adverse health outcomes.
Percentage of Weld County Residents 18 Years and Older with
Health Insurance Coverage
100%
HP2010
Objective
80%
r
60% ' -c
•
1',‘411,
. •
ri
40% x f
11Gf
x
0% _ Yqe,
1998-1999 2002-2003 2004 2005
Data Source:Weld Behavioral Risk Factor Surveillance Survey
Figure 2.
18 of 27
Attachment B-1
Based on Weld County Behavioral Risk Factor Surveillance Survey data, it appears that more
Weld County residents do not have health insurance compared to ten years ago7. In Weld County
the percentage of adults with private or public health insurance decreased from 86 percent in 1998-
1999 to 78 percent in 2005. This rate is much lower than Colorado's (84%) and the national rate
(86%). The actual number of underinsured residents is not known but state and national estimates
say that another 20 percent of people do not have adequate health insurances. For those without
health insurance or those with inadequate health insurance, preventive health services are out of
reach.
Looking at the leading causes of death among Weld County women, we found that women of all
ages in Weld County are similar to women in Colorado and across the nation in terms of mortality
due to cardiovascular disease. In Weld County we know that from 2004-2006, there were 3,775
deaths among all Weld County residents, 1,880 of which were female residents. During this time
period, 595 Weld County women, or nearly one-third, died from cardiovascular disease. Heart
disease alone accounted for 23 percent(432 out of 1880) of deaths among Weld County women
and nearly half(432/882) of the persons who die each year of heart disease are women9.
Leading Causes of Death Among Weld County and Colorado Females,2004-2006
Cancers I _._ —. =<- 22%
Heart Disease 21%
Stroke w- - •1 7%
E N Chronic Lower Resp Dis *x-�� '- =1 7%
LL. Alzheimer's Yn== -1 5%
o
v Unintentional Injuries =1 5%
o z Diabetes •=j 2%
o Influenza& Pneumonia F77.- 2%
U Kidney Diseases alJ 2%
Suicide J 1%
Heart Disease -. -.^ x. c 23%
y
Cancers -.. -. W,- »:-: * ,'::e- 23%
E Chronic Lower Resp Dis - „_. .. 6%
• o
Alzheimer's 6%
co
,y.m Stroke _- zaP„mjl 6%
• V Unintentional Injuries ars•==.≥rl1 4%
3 Diabetes -1 4%
-o Influenza& Pneumonia = - 2%
Kidney Diseases 2%
Suicide M 1%
0% 10% 20% 30%
Data Source: CDPHE, CoHID Percent of Deaths
Figure 3.
An in-depth analysis of women aged 40 to 64 years, which this project's target population shall
be drawn from, found that there are more than 32,500 women between the ages of 40 to 64 years
in Weld County10. Of women in this age group, only 59 percent report they are employed and 83
percent report they have health insurance. Focusing attention on modifiable risk factors for
cardiovascular disease, we found that 19 percent of women in this age group report that they have
either not had their cholesterol levels checked or have not had it checked within the last five years
(see Table 1). Among women in this age group who had their cholesterol checked, 35 percent
report had high cholesterol. Among women in this age group who had their blood pressure
checked, 19 percent had high blood pressure. Over half the women in this age group (54%) have
I9 of 27
Attachment B-1
excess body weight (i.e., BMI of more than 25) and 20 percent are current smokers. More than
half of the women in this age group have inadequate levels of physical activity with 25 percent
reporting they have not engaged in any recent physical activity or exercise11. Clearly, there are
many women at risk for cardiovascular disease in Weld County; many of whom may be at
considerable risk for developing coronary heart disease or stroke.
Table 1. Modifiable Risk Factors for Cardiovascular Disease (Weld County 2005 BRFSS Data)
Women Aged 40 to 64 Years
Total women in target age group 32,503
Cholesterol checked risk factor(more than five years or 19.0%
never)
High cholesterol risk factor 34.9%
High blood pressure risk factor 18.9%
BMI >25.00 53.6%
Current smoker risk factor 20.1%
No physical activity or exercise in past 30 days 24.6%
Does not meet recommended physical activity guidelines 50.1%
Data from Sunrise Community Health, Inc., a federally-designated community health center
where the majority of the target population for the program shall be recruited, indicate that 61
percent of the patients receiving care there are below 100%of the federal poverty level and 93
percent are below 200% of the federal poverty level. In addition, Sunrise has seen the number of
uninsured patients increase over time. Between 2000 and 2004, the number of uninsured patients
increased by 28 percent12.
In 2007, in response to an increasing uninsured patient population, Sunrise Community Health
Center, Inc. expanded its Greeley facility in order to better serve its patients and to serve more
patients. While Sunrise currently does some CVD screening, they do not have a comprehensive
program like the proposed Heart of Weld Project. Now that Sunrise has more space, the time is
right for initiating a project like the Heart of Weld. The addition of a medical assistant and health
educator(which this grant shall provide) at Sunrise is needed to make this program work. Sunrise
is enthusiastically looking forward to being able to offer this service to their patients.
Chronic disease and especially cardiovascular disease is a national health problem. For
women, cardiovascular disease is the leading cause of death. In Weld County, it appears a
significant number of women are at risk for being affected by cardiovascular disease. Given Weld
County's changing demographic makeup, it is time for a program such as the Heart of Weld
Project. We know the need is there and that many Weld County women in the target population are
not getting the preventive health screening and treatment for cardiovascular disease. WCPHE and
its partners have the knowledge and ability to help these women decrease their risks for
cardiovascular disease.
20 of 27
Attachment B-t
Project Narrative
a) Describe your organization's ability to complete this project, and knowledge and
experience providing the services proposed, including working with the target population.
Weld County Department of Public Health and Environment (WCDPHE) is celebrating its 70th
Anniversary in 2008. WCDPHE is overseen by an executive director. The five-member Board of
County Commissioners appoints the department's director, who subsequently is responsible for the
staff. The Board of County Commissioners appoints citizens to the nine-member Board of Health
which serves in an advisory capacity. The department receives about one-third of its funds from
Weld County, one-third from State and Federal grant funds, and one-third in fees for services. In
2007, the Health Department was re-organized into five service divisions: Administrative (FY08-
$220,000); Public Health Preparedness (FY08-$459,000); Environmental Health (FY08-$2.2
million); Health Communication, Education and Planning (FY08-$1.5 million); and Public Health
Services (FY08-$3.6 million). The department employs over 100 staff(92 FTE) and has a total
budget of$8.1 million.
The Health Communication, Education, and Planning (HCEP) Division, which shall monitor this
grant, and its leadership has a long history of successfully competing for and managing numerous
grants. In addition to county funding for several health education programs, this division currently
oversees six grant projects totaling over$1 million —Steps to a Healthier Weld ($491,000), Weld
County Diabetes Disparities Project($147,000), Weld County Tobacco Program ($248,000),
Women's Wellness Connection ($123,000), Susan G. Koman Foundation Grant($10,000),
Medicaid Teen Pregnancy Prevention Funding ($17,000). Many of these grant programs have
been in existence for several years, have received increased funding, or have been recognized at
the state and national level. For example, the Steps to a Healthier Weld County program has been
recognized by the Centers for Disease Control for its VERB campaign. In addition, Weld County's
VERB campaign successes shall soon be published in the Journal of Preventive Medicine. The
Steps DO-NUTrition Box Program has been recognized by Better Homes & Gardens Magazine
and the 2006 Weld County Health Status Report (which sponsored by Steps and the HCEP
Division) has been recognized by the State of Colorado and others leaders around the state. The
Tobacco Program has been recognized for its strong community coalition which has been in
existence for nearly 20 years. Finally, the Diabetes Disparities Project has been recognized locally
for implementing the county's only Spanish exercise classes. Very recently, one of its staff was
recognized by the Hispanic Women of Weld County for positively influencing health behaviors
among Hispanic women in the community.
It's important to note that the division has the capacity to analyze data and evaluate programs
such as the proposed project. In 2004, as part of the Steps to a Healthier Weld County Grant, the
department began collecting the Weld County Behavior Risk Factor Surveillance Survey. This five-
year oversample survey is collecting important health data from over 4,000 adult residents in Weld
County. Data is being collected on risk factors for cardiovascular disease such as cholesterol,
blood pressure, smoking, and physical activity and nutrition habits. The department plans to
sustain funding for oversampling every other year beginning in 2010. Also, the department is
supplementing BRFSS data with its own Community Health Survey. Data on health status and
health behaviors related to cardiovascular disease were included in this random sample survey as
well. The Weld County Community Health Survey was conducted in fall 2007 and shall be
conducted again in 2009. Finally in 2007, the department hired a Health Data Analyst(housed in
21 of 27
Attachment B-1
the Health Communication, Education, and Planning Division). The Health Data Analyst has a
strong background in statistical analysis and evaluation methods and shall be overseeing the
evaluation of this grant, Because we have local-level BRFSS data and we have capable staff, we
shall be able to asses the impacts of the proposed program.
Even though WCDPHE does not currently have a cardiovascular disease prevention, detection,
and treatment program, we have considerable knowledge and experience conducting similar
programs. One current example is the Weld County Diabetes Disparities Project. During the last
two years, funding from the State of Colorado Office of Disparities has enabled WCDPHE to do
community-based prevention, intervention, and education related to diabetes. In the first year of
the grant, nearly 1,400 diabetes risk assessment screenings were done; over 800 community
residents participated in exercise classes (Zumba and others); 315 people participated in home-
based Platicas diabetes and cancer prevention education classes; and over 150 diabetics learned
how to manage their diabetes better through one-on-one counseling or self-management classes.
All in all, this program has served nearly 4,000 Weld County residents so far. Preliminary
evaluation data from this program shows that the program is positively impacting its participants.
Pre and posttest data showed that participants in the Dining with Diabetes classes significantly
increased their knowledge about diabetes and gained self-efficacy about managing their diabetes.
One of the participants, who participated in the Platicas and Zumba classes said, "I changed what I
eat because of the classes. My family has a history of diabetes. The classes helped me learn what
I could do to keep my blood sugars normal. I love the Zumba classes. They changed my health."
:^
Dining with Diabetes Class — Zumba class
...Ili, 61;*.n.cii• :,,. .00:::::..mi.., I;id"), :
,
22 of 27
Attachment B-1
WCDPHE has extensive knowledge and experience working with the target population for this
proposal. Nearly all of our programs work with low income, uninsured or underinsured residents. A
large proportion of this target group is also Latino and we have extensive experience working the
variety of Hispanic populations living in Weld County. In addition, we use people from the target
population to deliver our programs. For example, we have been are offering physical activity
classes taught by bi-lingual certified instructors, called Zumba (see photo above), to women in the
target population age group with an average of 40 participants per class for the past 18 months. To
our knowledge, this is the only physical activity class taught in Spanish in Weld County. Through
the Steps to a Healthier Weld grant, we are also offering a weight management/nutrition class at
AIMS Community College in Greeley. These classes are primarily attended by women, always
filled to capacity, and frequently have a waiting list. WCDPHE staff also has experience conducting
support groups in Spanish. Lastly, we want to point out that our partner for this project, Sunrise
Community Health, Inc. has very extensive experience working with women aged 40 to 64 years
who are low income, uninsured or underinsured, or Hispanic.
Because of our successes, WCDPHE shall be able to complete the work plan for this grant,
reach the target audience, and reduce the risk of heart disease for a significant number of Weld
County women.
b) Describe the background of your organization in designing, managing and implementing
prevention, early detection, and treatment programs in cancer, cardiovascular disease or
pulmonary disease.
WCDPHE has designed, managed, and implemented a variety of prevention, early detection,
and treatment programs in cancer, cardiovascular disease or pulmonary disease. From 2001-2003,
we administered community-based programs with preventive health block grant dollars. Starting in
1991, WCDPHE became the coordinating organization for the Weld County's Colorado Women's
Cancer Control Initiative (CWCCI) grant, now called the Women's Wellness Connection (WWC).
During 2006, the providers and coordinator worked together to reach more rarely or never
screened women. To date, this program has screened about 950 women and the outreach
coordinators have always exceeded their goals for contacts and screenings. This program now
operates in an eleven county northeastern Colorado area. The proposed project shall be working
closely with the WWC to recruit women in the target group for this project.
In addition to the Weld County's Women's Wellness Connection program, WCDPHE has taken
the lead with several prevention programs related to cardiovascular disease. One of our earliest
grants (1989) worked with Hispanic churches to provide screening and heart disease risk reduction
education, Especially in rural areas, working with the churches provided important contacts and
gave credibility to the program. WCDPHE has also had grants that successfully addressed
nutrition and physical activity for adults and seniors. Screening programs for diabetes have been
done at congregate meal sites for seniors and in cooperation with the 9Health Fairs in the county.
Because of the success of these collaborative efforts, WCDPHE is considered a key player, even
the lead agency, in most prevention activities in the county.
Recently, the leadership of WCDPHE in prevention activities has been reinforced by the Steps
to a Healthier Weld grant, a federally funded initiative to address obesity, nutrition, physical activity
and asthma. Weld County is one of only four counties receiving funding in Colorado for this
initiative. The annual operating budget for Steps is nearly $500,000. The extensive work plan for
this program implements activities in schools, worksites, the community, and healthcare systems
and has been very successful. As mentioned previously, the Steps to a Healthier Weld has been
recognized locally, regionally, and nationally for its innovations. For the past four years a variety of
23 of 27
Attachment B-1
activities have been implemented to encourage all Weld County residents to move more and eat
better. A listing of the Steps to a Healthier Weld County successes can be found in the appendix;
however, a few key points shall be mentioned here. First and foremost, Steps to a Healthier Weld
County activities have begun to"take root" and build an infrastructure for physical activity and
nutrition prevention programming in the community. For example, Steps and its partners are
working on getting the city of Greeley designated as a well city by the year 2010. The program's
strong worksite wellness component reaches people who work at several larger employers (e.g.,
Weld County government, City of Greeley, and NCMC) in the county. Another standout quality of
the Steps program that demonstrates our organizations background in administering programs
concerns our ability to link partners in the community. Several successful linkages include
promoting nutrition education through healthy cooking classes with Colorado State University
Extension service and the city of Greeley and continuing education classes at AIMS Community
College. Steps to a Healthier Weld has also sponsored six community garden projects, summer
Farmer's Markets, and distributed over 2,000 pedometers to citizens in the community.
Because WCDPHE does not provide primary care, except for family planning and
immunizations, the treatment of cardiovascular disease has not been done by Health Department
staff, other than monitoring blood pressures. This is why we are partnering with the Sunrise
Community Health, Inc. in Greeley/Evans. Sunrise Community Health, Inc. has a new large facility
which is ideally suited for providing additional screening and lifestyle programs that shall benefit
their patients and the community.
c. Describe the strengths of your organization, including historical accomplishments,
experience with public health entities,public health and health care services in chronic
disease, and experience with outreach to the target group.
Weld County Department of Public Health and Environment (WCDPHE) has been doing public
health since 1938. Our mission is "In partnership with the communities we serve, to preserve,
promote, and protect the health and environment of the residents of Weld County". Prevention,
people, and partnerships sum up the work of WCDPHE. We strive to make sure all residents have
the opportunity to be healthy in mind, body, and spirit. In 2007, the WCDPHE Strategic Plan was
updated to reflect the current emphasis on prevention of chronic diseases:
"We want all residents to know that prevention is of the utmost importance in chronic and
communicable disease. In the areas of chronic and communicable disease, we want to
strengthen our partnerships with health care providers. We shall have a culturally
competent workforce. We shall be able to effectively communicate with and educate all
residents about chronic and communicable diseases." (WCDPHE 2007-2010 Strategic
Plan, p.8)
Besides our mission, Weld County Department of Public Health and Environment(WCDPHE)
has a close connection with many public health and health care services locally through the
department director, Mark Wallace, who has served in that capacity since 2000. Dr. Wallace is a
family physician and president of the North Colorado Health Alliance, a non-profit organization
whose mission is to expand access to health care for the uninsured and underinsured. In addition,
Dr. Mark Wallace sits on the board of directors of the Weld County Medical Society, the Colorado
Academy of Family Physicians, and Sunrise Community Health, Inc. Dr. Wallace is a public health
champion in Weld County and the state. He has been recognized by the Colorado Community
Health Network, the Colorado Association of School Boards, and the Colorado Medical Society. Dr.
Wallace continues to see patients here at the health department and elsewhere in the community.
WCDPHE takes the lead in many community collaborations. One group that has addressed a
24 of 27
Attachment B-1
chronic disease is the Weld County Diabetes Coalition, in existence since 1997. Made up of
individuals and agencies that work with people who have been diagnosed with diabetes, or with
those at risk for developing diabetes, the Diabetes Coalition members have worked together to
provide screening, referrals, education for health care providers, educational materials for the
library district, and a myriad of other programs which benefit the community. One noteworthy
achievement was using the diabetes coalition members as a focus group to determine the needs of
the community related to diabetes. Based on their input, a grant was written and funded to provide
the diabetes prevention and interventions that had been identified by coalition members as gaps in
care and service.
The work of the Weld County Diabetes Disparities Project has been described as a"Shining
Star' by the Colorado Diabetes Prevention and Control program at the Colorado Department of
Public Health and Environment, because of the successful outreach to low income, un- and
underinsured residents, primarily women. The Zumba classes (a fusion of Latin dance and
exercise) are crowded with parents and kids moving to the music. Cooking (Dining with Diabetes)
classes are filled and attendees show an increase in knowledge about healthy eating, as well as a
commitment to make changes in their shopping and eating. The small discussion groups in the
home, Platicas, are successful in helping families make changes because the information is
delivered in a culturally appropriate manner.
At one of the meetings of the Weld County Diabetes Coalition, it was suggested that radio is a
great method to get health information to Spanish speaking listeners. Greeley has a Spanish
language radio-station with a half-million people in their audio range. According to research
reported in 2003 by the Roslow Research Group, 50%of U.S. Hispanics speak Spanish all or most
of the time; 88% speak Spanish at least some of the time. The report also stated that information
provided on the radio in Spanish is 61% more effective at increasing awareness than information in
English. And 69%of U.S. Hispanics believe they get more information when it is presented in
Spanish than in English.5
For the past three years WCDPHE has sponsored the Health Talk program on KGRE, the
Spanish language radio station in Greeley. It has been a very effective method of providing
information about diseases, such as diabetes, tuberculosis, arthritis, and heart disease in Spanish,
as well as promoting upcoming events and classes. Because of this successful outreach, KGRE
received a grant from Sound Partners for community education and activities.
WCDPHE is really the lead agency for taking prevention programs and health information to
community members, especially those who are low income. This grant shall provide an opportunity
to continue to work with this target population and shall continue to make a difference in the lives
and health of participants.
d. Describe how your proposed strategy or method enhances or expands existing
programs but does not duplicate or supplant funding for existing programs and your
organization's plan to sustain the proposed project beyond CCPD funding.
The services and strategy we propose for this grant shall compliment the other county funded
and grant funded programs in the division. We have programming to address a number of
important health issues in Weld County but none that provides screening and education specifically
for cardiovascular disease prevention. We strive to integrate activities among the programs to best
utilize staff, funding, and time spent working with our many community partners. We spend
considerable time as a division coordinating objectives, meetings with coalition partners, and
contacts with community agencies and schools to ensure we are not duplicating each other's work
but enhancing each other's programs.
25 of 27
Attachment B-1
The relationships we have built in the community with Sunrise, NCMC, and other health care
providers helped us understand the gap in services for cardiovascular screening and lifestyle
intervention classes for the underserved population in Weld County. These same relationships
shall help us as we move forward to identify possible barriers, avoid duplication of programming
and find options for sustaining the program long term.
Many of the programs we have developed in our division are now supported by other agencies
and organizations because we know that a community based effort is the best long term solution to
many of our health issues, One example is the Drive Smart Coalition that has been in place since
1991. Membership includes insurance companies, state patrol, sheriff's department, fire and
rescue, health department, etc. They work on many different levels in the community, on different
issues around traffic safety and together have helped bring down the number of traffic crashes in
Weld County.
This grant funding shall greatly enhance and expand the work of the Women's Wellness
Connection (WWC) to include women's risk for heart disease, using the evidence-based
WISEWOMAN program with the New Leaf curriculum. For the past three years, the WWC has
held a half-day workshop with educational presentations about cancer prevention and cancer
treatment. In 2007, more than 60 women attended. On the evaluations for the event, several
participants suggested broadening the health information presented. "Next year! would like to
hear more survivors and more about heart disease; it is the#1 killer of women in this country.!"
This grant would provide the resources to expand the workshop to include heart disease, as
requested.
Currently, WCDPHE partners with Sunrise Community Health, Inc. on several projects. The
Sunrise Community Health, Inc. recently moved into a new, much larger facility. Zumba classes
taught in Spanish and Dining with Diabetes classes (both English and Spanish classes) have been
held in their clinic and been very well attended. The Women, Infants and Children (WIC) offices
are in the clinic. This would be a good connection for the community intervention goal of the grant.
With increased space, Sunrise Community Health, Inc. added more providers. This shall be a
valuable resource as women are identified with elevated risk factors for heart disease and need to
be connected with a medical home.
Denver Health has had a CCPD cardiovascular disease risk assessment grant working
statewide to screen women for heart disease. There has been some outreach in Weld County, but
their program has not been available to patients of Sunrise Community Health, Inc. Also, we are
not aware of one-on-one counseling or any other intervention being offered to those that are
screened and who are considered elevated risk. This project shall provide the risk assessment for
Sunrise patients, and shall also provide the lifestyle interventions. In fact, women from the target
population who are identified by a health care provider as having high or moderate risk for heart
disease shall be referred to the lifestyle interventions.
The WISEWOMAN program has been in place in North Carolina for several years. Follow-up
surveys done with the participants found that having three one-on-one counseling sessions over a
six-month period with a health care professional (R.N. or R.D.) created only short-term changes in
diet and physical activity. Based on this information, as well as focus group discussions and
experience with the Diabetes Disparities grant in Weld County, the work plan for this grant includes
weekly group counseling/classes and reminder phone calls for eight weeks, followed by four
mailings and two phone calls a month to keep in touch with the participants for another four
months. In addition, women with moderate and high risks for heart disease shall be encouraged to
participate in the community-level interventions such as Zumba and healthy cooking classes.
26 of 27
Attachment B-1
There are several possibilities for continuing this project after the grant funding ends. As
Sunrise Community Health, Inc. is able to expand its services with the increased space and
additional staffing, the screening for heart disease risk can be incorporated into their on-going
programs. Also, collaborating with the Jesus Rodarte Recreational Center(as well as Sunrise
Community Health, Inc.) for the location of Zumba classes and healthy cooking classes shall help
strengthen the relationship and provide a base for continuing these two important lifestyle
programs. Participants can either pay a small fee, or else they could apply for financial waivers, to
continue the successful programs.
27 of 27
EXHIBIT C
DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLIC HEALTH AM)ENVIRONMENT
(ADD PROGRAM NAME HERE)
DEPARTMENT OR AGENCY NUMBER
***
CONTRACT ROUTING NUMBER
LIMITED AMENDMENT#*
This Limited Amendment is made this****day of*********.200*,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,LEGAL NAME OF ENTITY,(legal type of entity),whose address or principal place of business is
Street Address,City,State&Zip Code hereinafter referred to as the"Contractor".
FACTUAL RECITALS
The parties entered into a contract dated******** ** **** with contract encumbrance number PO***
********** and contract routing number** ******** whereby the Contractor was to provide to the State the
following:
]briefly describe what the Contractor was to do under the original contract—indent this paragraph!
]Please choose one of the following four options and then delete this heading and the other three options not
selected:]
The State promises to ]choose one and delete the otherlincrease/decrease the amount of funds to be paid to the
Contractor by ********** Dollars ($*.**)during the current term of the Original Contract in exchange for the
promise of the Contractor to perform the ]choose one and delete the other]increased/decreased work under the
Original Contract.
The State promises to pay the Contractor the sum of**********Dollars ($*.**)in exchange for the promise of
the Contractor to continue to perform the work identified in the Original Contract for the renewal term of****
years/months,ending on******** ** ****.
The State promises to ]choose one and delete the other]increase/decrease the amount of funds to be paid to the
Contractor by********** Dollars,($*.**)for the renewal term of**** (choose one and delete the
other]years/months,ending on******** **,****,in exchange for the promise of the Contractor to perform the
]choose one and delete the other]increased/decreased specifications to the Scope of Work described herein.
The State hereby exercises a"no cost"change to the ]insert those that apply and delete those that don't]budget,
specifications within the Scope of Work,project management/manager identification,notice address or
notification personnel,or performance period within the]choose one and delete the other]current term of the
Original Contract or renewal term of the Original Contract.
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 Contract consists of the payments and services
that shall be made pursuant to this Limited Amendment,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
Page 1 of 4
contract,contract routing number** *** *****, [insert the following language here if previous
amendment(s),change order(s), renewal(s) have been processed]as amended by]include all previous
amendment(s),change order(s),renewal(s)and their routing numbers], (insert the following word
here if previous amendment(s),change order(s),renewal(s)have been processed]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 Limited Amendment as
though they were expressly rewritten,incorporated,and included herein.
3. It is expressly agreed to by the parties that the Original Contract is and shall be modified,altered,and
changed in the following respects only:
A. ]Use this paragraph when changes to the funding level of the Original Contract occur
during the current term of the Original Contract]This Limited Amendment is issued pursuant
to paragraph*_*.of the Original Contract identified by contract routing number** *** *****.
This Limited Amendment is for the current term of********* ** **** through and including
********* ** **** The maximum amount payable by the State for the work to be performed by
the Contractor during this current term is ]choose one and delete the
otherlincreased/decreased by **********Dollars ($*.**)for an amended total financial
obligation of the State of**********DOLLARS,($*.**). ]delete any portion of this sentence
that is not applicable]The revised specifications to the original Scope of Work and the revised
Budget,if any,are incorporated herein by this reference and identified as"Attachment*"and
"Attachment*". The first sentence in paragraph_*.of the Original Contract is modified
accordingly. All other terms and conditions of the Original Contract are reaffirmed.
A. [Use this paragraph when the Original Contract will be renewed for another term]This
Limited Amendment is issued pursuant to paragraph*_*.of the Original Contract identified by
contract routing number** ********. This Limited Amendment is for the renewal term of
*********** **** through and including********* ** ****. The maximum amount payable
by the State for the work to be performed by the Contractor during this renewal term is
**********Dollars,($*.**)for an amended total financial obligation of the State of**********
DOLLARS,($*,**). This is an(choose one and delete the other]increase/decrease of
**********Dollars,($*.**)of the amount payable from the previous term. ]delete any portion
of this sentence that is not applicable]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"Attachment*"and"Attachment*". The first sentence in paragraph*_*.of the
Original Contract is modified accordingly. All other terms and conditions of the Original Contract
are reaffirmed.
A. [Use this paragraph when there are"no cost changes"to the Budget,the specifications
within the original Scope of Work,allowable contract provisions as noted,or performance
period.]This Limited Amendment is issued pursuant to paragraph*_*.of the Original Contract
identified by contract routing number** *** *****. This Limited Amendment[choose those
that apply and delete those that don't]modifies the Budget in [identify location in contract],
modifies the specifications to the Scope of Work in [identify location in contract],modifies
the project management/manager identification in [identify location in contract],modifies
the notice address or notification personnel in [identify location in contract],modifies the
period of performance in [identify location in contract] of the Original Contract. The revised
[choose those that apply and delete those that don't]Budget,specifications to the original
Scope of Work,project management/manager identification,notice address or notification
personnel,or period of performance is incorporated herein by this reference and identified as
"Attachment*". All other terms and conditions of the Original Contract are reaffirmed.
4. The effective date of this Amendment is date or upon approval of the State Controller,or an authorized
delegate thereof,whichever is later.
5. Except for the General Provisions and Special Provisions of the Original Contract,in the event of any
Page 2 of 4
EXHIBIT C
conflict,inconsistency,variance,or contradiction between the terms and provisions of this Amendment and
any of the terms and provisions of the Original Contract,the terms and provisions of this Amendment shall
in all respects supersede,govern,and control. The Special Provisions shall always control over other
provisions of the Original Contract or any subsequent amendments thereto. The representations in the
Special Provisions to the Original Contract concerning the absence of personal interest of state of Colorado
employees is 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
IN WITNESS WHEREOF,the parties hereto have executed this Form 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:
[LEGAL NAME OF CONTRACTOR[ STATE OF COLORADO
(legal type of entity) Bill Ritter,Jr.Governor
By: By:
Name: For the Executive Director
Title: DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT
PROGRAM APPROVAL:
By:
ALL CONTRACTS MUST BE APPROVED 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.
STATE CONTROLLER
David J.McDermott,CPA
By:
Date:
Page 4 of 4
Exhibit D
Budget & Budget Narrative
BUDGET NARRATIVE Year 1: July 1, 2008 through June 30, 2009
PERSONAL SERVICES:
RN Project Coordinator
1.0 FTE
The BSN (Bachelor of Science in Nursing) Project Coordinator shall manage the grant,
provide general project oversight and supervision of grant personnel, arrangecontracts
with clinics to provide CVD (Cardiovascular disease) screening services, contracts with
Zumba instructors, cultural competency trainers, and spokespeople for cardiovascular
awareness campaigns. The Project Coordinator shall perform recruitment activities in the
community, as well as, use the electronic medical records system to identify women who
are eligible for CVD screening. This position shall recruit community members and
clinical service providers to participate on the project's advisory council and arrange
monthly meetings. The Project Coordinator shall train all personnel involved with the
clinical screenings and lifestyle intervention as needed, facilitate the lifestyle intervention
group counseling sessions, conduct individual counseling sessions and maintenance
intervention phone counseling, arrange follow-up screening, track project related data,
complete grant required reporting, and participate with project evaluation. Salary
calculation is $48,758.56 per year, which is $4063.21 per month for twelve months.
Health Educator
.75 FTE
Ofelia Orozco, CAN (Certified Nursing Assistant) shall be the bi-lingual/bicultural health
educator. She shall provide individual and group lifestyle intervention counseling in
Spanish, coordinate a walking program, conduct outreach and recruitment activities for
the project, and assist with CVD screenings as needed. In addition, the Health Educator
shall conduct healthy Latin cooking classes in Spanish throughout the community, assist
the Project Coordinator with data collection, and use the e-cast system to enter program
information. The salary calculation for this position is $34,539.05 per year, which is
$2878.25 per month for twelve months.
1 of 5
Exhibit D
Medial Assistant
.5 FTE
The bi-lingual/bicultural medical assistants shall provide screening services at contracted
CVD screening sites. They shall collect medical histories, an assessment of dietary risk,
physical activity habits, and smoking status along with all applicable clinical testing. The
MA's (medical assistants) shall assist with conducting appointment reminder calls,
scheduling follow up screenings, assisting with group lifestyle intervention sessions,
community intervention classes, entering data into the e-cast system and in recruiting
efforts for project participation. The salary calculation for this position is $14,127.92 per
year, which is $1302.92 per month. This position shall be for 8 months of the first year
of funding and then 12 months for grant years 2 and 3.
Data Specialist
.1 FTE
Cindy Kronague, MPH shall gather, communicate and manage all Heart of Weld data for
reporting and evaluation purposes and provide supervision and guidance to the sub-
contracted Data Specialist. The salary calculation for this position is $9356.74 per year,
which is $575.28 per month.
OPERATING COSTS:
Printing/Copying
15,000 copies for promotional and educational printing, patient history forms, and misc.
projects @ .10/copy for $1500.00.
Color printer cartridges: 3 @ $375 ea. for$1125.00
Total Printing/Copying: $2625.00
Postage/Shipping
4 maintenance intervention mailings per enrolled lifestyle intervention participant: 100
participants x $1.00 per mailing for $400
Computer Equipment
One laptop computer with docking station and software for $2,500
Staff Development
$425 per FTE to attend various staff development trainings offered throughout the year
Office Supplies
Miscellaneous general office supplies @ $100/FTE for $235
Meeting Expenses
10 Advisory Committee meetings @ $75 per meeting and 6 project clinical and
intervention staff meetings/trainings @ $100 each for $1,350
2 of 5
Exhibit D
Other Program Costs
Incentives for lifestyle intervention participation: 1 gift card for $10 per participant who
successfully completes four weeks of intervention classes for 100 participants and 1 gift
card for$10 per participant who successfully completes eight weeks of intervention
classes for 80 participant for $3,600. 32 gift cards for childcare providers during
intervention classes @ $20 each for$480. Total: $2440
TRAVEL
In-State only
1.75 FTE @ 600miles/mo x 12 months x .39/mile for outreach, trips to contracted clinics
for screening administration, and trips to various intervention sites throughout the county
for $4,914
.5 FTE @ 200miles/mo x 8 months x .39/mile for travel to clinical sites for screenings,
outreach, and to travel to various intervention sites throughout the community for $312.
Total for travel: $5,226
CONTRACTUAL
2 half day (4 hour) Cultural Competency in Health Care Delivery trainings for contracted
clinic personnel, lifestyle intervention personnel and public health staff @ $2000 per
training for $4000.00
SUBCONTRACTORS
Zumba Instructor 1 hour/week @ $20/hour for 50 weeks for $1000.
Evaluation Specialist for 10hours/week @ $20/hour for 24 weeks for $4,800
Total Subcontract charges: $5,800
OTHER COSTS
Marketing and Media
Air time on KGRE Spanish Language radio in February for Heart Awareness Month and
in March for Stroke Awareness Day: $350/30minutes of air time x 2 for$700
Public Service Announcements (PSAs) on KGRE Spanish Language radio: 100 PSAs @
$10 for $1000
Ads for community classes and public awareness campaigns in local publications
including La Tribuna Spanish Newspaper: $120/4" x 4" ad for 10 ads for $1,200
Ads to promote community events and to raise awareness on Telemundo Spanish
language television: 144 public service announcements over a 9 week period of time for
$4000.00
Ads to promote community events and to raise awareness on KUAD radio: 105 radio
spots for$3100
Total for marketing/media: $10,000
3 of 5
Exhibit D
Outreach/education materials
Notebook binders: 100 binders @ $2.00 for $200
Nutrition reinforcement-cookbooks: 50 in English and 50 in Spanish @ $5.00 for $500
Physical activity reinforcement-therabands: 100 @ $3.00 for $300
Physical activity reinforcement-pedometers: 100 @ $6.00 for $600
Food for community healthy Latin cooking classes: 20classes @ $75.00/class for $1,500
Healthy Snacks for lifestyle intervention classes: 32classes @ $40.00/class for $1,280
Heart disease and Stroke educational pamphlets/brochures for distribution at health fairs
and other community events: $200
Total for Outreach/education materials: $4580.00
Screening
CardioChek PA Professional (test for Total Cholesterol, HDL, LDL, Triglycerides,
Ketone and Glucose): 3 units @ $460 for $1,380
Thermal Printer(allows individual test results to be printed out when performing tests on
CardioChek PA): 3 units @ $415 for $1,245
Cholesterol, HDL & Glucose Combo Strips: 15ct @ $105 x 20 for $2,100
Thermal printer labels (500 ct) @ $19.95 x 3 for $59.85
Thermal printer paper 1 roll @ $29.95 x 3 for $89.85
Blood Pressure Cuffs: 3 extra large @ $129.95 for $519.80
Stethoscopes: 3 @ $81.00 for $324.00
500KL Digital Medical Scale (with a height arm and BMI function): 3 scales @ $324.00
for $962
Miscellaneous screening supplies (pipettes, lancets, sharps containers etc): $150
Total screening supplies: $6830.50
Treatment
Medical vouchers for uninsured patients with high risk screening results for 1 time
medical provider consultation: 1 voucher @ $100 for 25 patients for $2500
Other Intervention Costs
Vouchers for smoking cessation classes: 50 vouchers @ $11/ea for$550
Indirect Costs
Funding to cover grant management, administrative support and other indirect expenses
is calculated @ 20% of total direct costs. Contractual flow through is calculated @ 2%
of total contractual costs. Total Indirect Costs: $35,324.30
4 of 5
Exhibit D
Cep; Cadiovasaia-Disaaee aid PnlmmayCiseaseCanpetititv Grants Roga�,n.n�FY2008-09
Cheri(col)/one. E Year 1(AS 1,2008-Are 30.2009)
APPLICANT', V11d Carty Department of Public Health 8 Environr ❑Year 2(My 1,209-Are 30.2010)
❑Year 3(My 1,2010-Sue 30.2011)
PROJECT TITLE Heart of Nell SOURCE CF FUNDS
Requested Cher Scree" Other Source*
-` ;-Q3tE i5oiXibt r93n2-:r
PERSONAL SEZv10ES FIE Molly fvbrtliy ad Etter name here Enter pane here
Nave Positron Say Benefits Mats if applicable if applicable
To be deterrrired Rgel Cardnaa RN 1W 54,06321 $1,444.07 120 $fi6,867.00 $O OD $000
Ofdia Orozm Heath Educator 075 $2,87&25 $1,02293 120 $46,814.23 $0W $000
To be delarrined Medica Assisted 050 $1,30293 546706 SO $14,127,92 saw $000
On*Knalauge Data Spedalist 010 $57528 $204.45 120 $9,34&74 $000 $060
Subtotals. 235 $136,38625 $0W $000
Total Personal Services 5136,38625 $0.00 WOO
DIRECT OPERATING 036T5 - DESORPTION,..
Pmdirg/Copirg parting,cda printer off,paper $2625.00 $0 W $060
PcstagdSNPpirg postage for rreinteaance irtexentlm railings $460.60 $0W $060
Telephone,Fah IrtemdPttass $000 6060 SOW
031113407 EAdpliell 1 latapcopAa sit decking stair&sates° $250000 SOW SO.W
Staff Development attedirarags $99875 $0.00 SOW
Office Supplies expendable genera office applies @$100/FTE x 235 FE $2'b.W $0.W $OW
Meeting Expenses nMlyAdvlsay Cbwifleetreags ad 6 persona trawl:a/mange $1,350.60 $060 saw
Other Prcgran Cost irmeles faints-anion doss pellidpatat gift cads for rtildae ponders $2440.80 $060 woo
Total Operating Costs 510,54675 $0.00 $0.00
TRAVEL DESCRPnat . .
Instate Only Rgal Ccordrabr,Hnz fli Edda,Mika Amdart Mb @.34'nile $5,226.60 00.00 $0.W
Total Travel Cats $5,718.00 WOO WOO
CCNTRACTIYLL CESCfOPTIat ..
Conchal 6000 saw sow
Contract Trainers/Speaffirs Cana Carpeteay Trance $4,010.00 saw so CO
Stbcentradas Zurhe lraVWa laM @$20per bar,Eva'uabm Assislan 10trawk@$20/hr $5,860.60 $060 $0.00
Total Conches Costs $9,80600 $600 WOO
OTFER COSTS DESCPoPPCN _ ..
Marketing/Media real&nake0rg neotias for Haat 60th 8 SidaAwaeess carpags $10,00000 $0.60 $060
abeadtEdurbord Maeda Sates,cookbooks,food for cooling dassspaspflels,tax Lee Mtls,tinders $4,56.00 SOW $0.60
Screening testing&priis,,bloat pressure arts,CardoOek PA Praeaskrds,sals 5&83).W $0.00 $060
Treetnat nasal vouchers $250960 $060 $0.00
001er Costs sndtlng cesason w.dtas $560.60
Total Other Costs $24,48650 $100 W.00
SUBTOTALS $186,421.50 WIC $600
a
INDIRECT a,COSTS', 2% Conlrua $19660
INDIRECT COSTS: 20% Personal Vices,Operating,Trate ad Other $35,3243)
Total Irr3rect Cost(falnlated on knout Requested from CDPFE ply) 535,2130
TOTAL AMOUNT REQUESTED FROM CDPHE $221,941.80
'Ober Pease iascateadAkna mare 4ankahle.
9'grafre ofArtlmzed f4yresetatie Date Rrv.121107
5 of 5
STATE OF COLORADO
Bill Ritter,Jr.,Governor
James B. Martin, Executive Director OF,•coco
Dedicated to protecting and improving the health and environment of the people of Colorado �� ,.s90
0
4300 Cherry Creek Dr. S. Laboratory Services Division . .
Denver,Colorado 80246-1530 8100 Lowry Blvd. +
Phone(303)692-2000 Denver,Colorado 80230-6928 "r876
TDD Line(303)691-7700 (303)692-3090 Colorado Department
Located in Glendale,Colorado
http://www.cdphe.slateoo.us of Public Health
and Environment
July 7, 2008
Attn: Contract's Administrator:
Please find enclosed for your records one(1) fully executed signed original contract or an amendment to
your existing contract. Awarded funds for FY 08/09 must be expensed and associated invoices to your
organization dated by June 30, 2009. The period covered under this agreement is July 1, 2008 through
June 30, 2009.
In addition, the required Cost Reimbursement Form must be used when submitting and processing
invoices for reimbursement purposes. This form can be found under"Forms" on our Website:
www.cdphe.state.co.us/pp/ccpd.
Should you have any questions regarding this agreement, please call me at(303)
692-2433.
Sincerely,
i"
Marti Wood
Grants Accounting Coordinator
Enclosure as stated
cc: File
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