HomeMy WebLinkAbout20072778.tiff RESOLUTION
RE: APPROVE TASK ORDER CONTRACT FOR MATERNAL AND CHILD HEALTH
PROGRAM AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS,the Board has been presented with a Task Order Contract for the Maternal and
Child Health Program between the County of Weld, State of Colorado, by and through the Board
of County Commissioners of Weld County, on behalf of the Weld County Department of Public
Health and Environment, and the Colorado Department of Public Health and Environment,
commencing October 1, 2007, and ending September 30, 2008, with further terms and conditions
being as stated in said Task Order Contract, and
WHEREAS, after review, the Board deems it advisable to approve said Task Order
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 Task Order Contract for the Maternal and Child Health Program
between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Weld County Department of Public Health and
Environment, and the Colorado Department of Public Health and Environment be, and hereby is,
approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said task order contract.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 29th day of August, A.D., 2007.
0 IS za BOARD OF COUNTY COMMISSIONERS
A v✓�WELD COUNTY, COLORADO
ATTEST: �t� i 71 »t'`; �``�� XCUSED
David E. Long, Chair
Weld County Clerk to the j!,• \ /
Wil �rke, Pro
BY: �,y 6Y l2 t T /,
ut erk to the Bp rd
William F. G cia
AP V D AS T M: EXCUSED
Robert D. Masden
ounty Attorney 2 ?,b'7
Dbugla$ ademac er
Date of signature: gl i0(o7
2007-2778
HL0034
(P t/L/a C1 oq-ic.-f'7
Memorandum
TO: David E. Long, Chair
Board of County Commissioners
WI I FROM: Mark E. Wallace, MD, MPH
ODirector, Departmen 1offPubl'i_c cHealth
• and Environment t /1tAteea4,1
COLORADO DATE: August 23, 2007
SUBJECT: MCH Program Task Order Contract
Enclosed for Board review and approval is a task order contract between the Weld County Board
of Commissioners on behalf of the Department of Public Health and Environment (WCDPHE)
and the State of Colorado through the Colorado Department of Public Health and Environment
for the Maternal and Child Health (MCH) Program.
Funding provided by this contract will be used to facilitate the development and enhancement of
community-based systems of care for the maternal and child populations. It will be used to
address the MCH performance measures for Weld County and the State of Colorado and to help
ensure all families have access to direct care services.
For these services, Weld County will be reimbursed an amount not to exceed $141,252 for the
time period October 1, 2007 through September 30, 2008. This funding is all pass through
funding from the federal government. I recommend your approval of this contract.
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2007-2778
DEPARTMENT OF PUBLIC FIEALTI I AND ENVIRONMENT
ROUTING NO.08 FLA 00473
APPROVED TASK ORDER CONTRACT-WAIVER#154
This Task Order Contract is issued pursuant to Master Contract made on 12/18/2006,with routing number 08 FAA 00052
STATII CONTRACTOR
State of Colorado for the use&benefit of the Board of County Commissioners of Weld County
Department of Public Health and 915 10'h Street
Environment Greeley, Colorado 80632-0758
Prevention Services Division, MCH for the use and benefit of the
4300 Cherry Creek Drive South Weld County Department of Public Health and
Denver,Colorado 80246 Environment, 1555 North 17'h Avenue
Greeley, Colorado 80631
TASK ORDER MADE DATE: CONTRACTOR ENTITY TYPI
08/01/2007 Colorado Political Subdivision
PO/SC ENCUMBRANCE NUMBER: CONTRACTOR FEIN OR SOCIAL SIECURTIY NUMBER:
PO FLA PSD0800473 846000813
TERM: BILLING S"TATL'MENTS RI ICIEIVI:D:
This Task Order shall be effective upon Monthly or Quarterly
approval by the State Controller, or designee,
or on 10/01/2007 whichever is later. The STATUTORY AUTHORITY:
Task Order shall end on 09/30/2008. C.S.R. 25-1.5-101,25-1-709
PRICE STRUCTURE: CONTRACT PRICE NO1"1O EXCEED:
Fixed Price $141,252.00
PROCUREMENT NUM IOD: MIDIiRAI.FUNDING DOLLARS: $141,252.00
Exempt STAVE FUNDING DOLLARS: $0.00
BID/RFP/LIST PRICE AGREEMENT NUMBER: MAXIMUM AMOUNT AVAILABI.I I PI❑t FISCAL YEAR.
Not Applicable FY 08: $105,939.00
FY 09: $35,313.00
LAW SPECIFIED VENDOR STATUTE:
Not Applicable
STATE RUPRESIINTATIVE: CONTRACTOR RI BIM ISP:NTAIIVE.
Karen B Trierweiler Judy Nero
Department of Public Health and Weld County Department of Public Health and
Environment Environment
Prevention Services Division,MCH 1555 North 17th Avenue
4300 Cherry Creek Drive South Greeley, Colorado 80631
Denver,CO 80246
SCOPE OF WORK
In partnership with other community organizations, shall facilitate the development and enhancement of
community-based systems of care for the maternal and child populations.And to ensure that all families
have access to direct care services,as well as enabling and population-based services that address the issues
and health problems delineated in the MCH performance measures.
Page 1 of 4
1 c-m-)1 — _l ti v
Ex!min III'S:
The following exhibits are hereby incorporated:
Exhibit A- Additional Provisions (and its attachments if any—e.g.,A-1,A-2,etc.)
Exhibit B- Statement of Work and Budget(and its attachments if any—e.g.,B-1,B-2,etc.)
Exhibit C - Limited Amendment Template for Task Orders
GENERAL PROVISIONS
The following clauses apply to this Task Order Contract. These general clauses may have been expanded upon or made
more specific in some instances in exhibits to this Task Order Contract. To the extent that other provisions of this Task
Order Contract provide more specificity than these general clauses,the more specific provision shall control.
1. This Task Order Contract is being entered into pursuant to the terms and conditions of the Master Contract
including,but not limited to,Exhibit One thereto. The total term of this Task Order Contract,including
any renewals or extensions,may not exceed five(5)years. The parties intend and agree that all work shall
be performed according to the standards,terms and conditions set forth in the Master Contract.
2. In accordance with section 24-30-202(1),C.R.S.,as amended,this Task Order Contract is not valid until it
has been approved by the State Controller,or an authorized delegee thereof. The Contractor is not
authorized to,and shall not;commence performance under this Task Order Contract until this Task Order
Contract has been approved by the State Controller or delegee. The State shall have no financial obligation
to the Contractor whatsoever for any work or services or,any costs or expenses,incurred by the Contractor
prior to the effective date of this Task Order Contract. If the State Controller approves this Task Order
Contract on or before its proposed effective date,then the Contractor shall commence performance under
this Task Order Contract on the proposed effective date. If the State Controller approves this Task Order
Contract after its proposed effective date,then the Contractor shall only commence performance under this
Task Order Contract on that later date. The initial term of this Task Order Contract shall continue through
and including the date specified on page one of this Task Order Contract,unless sooner terminated by the
parties pursuant to the terms and conditions of this Task Order Contract and/or the Master Contract.
Contractor's commencement of performance under this Task Order Contract shall be deemed acceptance of
the terms and conditions of this Task Order Contract.
3. The Master Contract and its exhibits and/or attachments are incorporated herein by this reference and made
a part hereof as if fully set forth herein. Unless otherwise stated,all exhibits and/or attachments to this Task
Order Contract are incorporated herein and made a part of this Task Order Contract. Unless otherwise stated,
the terms of this Task Order Contract shall control over any conflicting terms in any of its exhibits. In the event
of conflicts or inconsistencies between the Master Contract and this Task Order Contract(including its exhibits
and/or attachments),or between this Task Order Contract and its exhibits and/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 the Master Contract;2)the Master Contract(other than the Special Provisions)and its
exhibits and attachments in the order specified in the Master Contract;3)this Task Order Contract;5)the
Page 2 of 4
Additional Provisions- Exhibit A,and its attachments if included,to this Task Order Contract;4) the
Scope/Statement of Work-Exhibit B,and its attachments if included,to this Task Order Contract;6)other
exhibits/attachments to this Task Order Contract in their order of appearance.
4. The Contractor,in accordance with the terms and conditions of the Master Contract and this Task Order
Contract,shall perform and complete,in a timely and satisfactory manner,all work items described in the
Statement of Work and Budget,which are incorporated herein by this reference,made a part hereof and
attached hereto as"Exhibit B".
5. The State,with the concurrence of the Contractor,may,among other things,prospectively renew or extend
the term of this Task Order Contract, subject to the limitations set forth in the Master Contract,increase or
decrease the amount payable under this Task Order Contract,or add to,delete from,and/or modify this
Task Order Contract's Statement of Work through a"Limited Amendment for Task Orders"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. Upon proper
execution and approval,this Limited Amendment shall become a formal amendment to this Task Order
Contract. 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 Task Order Contract on the effective date of such change as if fully set forth herein.
6. 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 Task Order Contract. If the Contractor's
Proposal,if attached hereto,or any attachments or exhibits thereto,or the Scope/Statement of Work-
Exhibit B,establishes or creates standards of performance greater than those set forth in the RFP,then the
Contractor shall also meet those standards of performance under this Task Order Contract.
Page 3 of 4
IN WITNESS WHEREOF, the State has executed this Task Order Contract as of the day first above
written.
CONTRACTOR: STATE OF COLORADO:
Board of County Commissioners of Weld BILL RITTER,JR.GOVERNOR
County
for the use and benefit of the
Weld County Department of Public Health and
Environment
Legal Name of Contracting Entity
By
?)-)46-
For Executive Director
846000813 Department of Public Health and Environment
Social Security Number or FEIN
Department Program Approval:
Signature of Authorized Officer
William H. Jerke, Chair Pro—Tern By
Print Name&Title of Authorized Officer
08/29/2007
GOVERNMENTAL ENTITIES: ,t\ic 1E 44
,
(An attestation a 1 a r
* •
186 i III
Attest(Seal)By el 186 '�
(Town/City/County Cler Equivalent) 14k. � ., ,�'^lm vernment seal here)
A‘ `/ Si
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:
Leslie M.Shenefelt
By AJrte l f o
1yELp COUNTY DEPARTVIROT OF
PU �ClnVN,E,\AnC�fF A C�1V
Page 4 of 4 BY:
vY�
Mark E. Wallace, MPH•Director
&CO7- a77f
EXHIBIT A
ADDITIONAL PROVISIONS
To Task Order Contract Dated 08/01/2007-Contract Routing Number 08 FLA 00473
These provisions are to be read and interpreted in conjunction with the provisions of the
Task Order Contract specified above.
The United State Department of Health and Human Services("HHS"),through the Maternal and Child
Health Services Block Grant(MCH)has awarded the State Title V federal funds under Notice of Grant
Award("NGA)number B04MC04248(See,Catalog of Federal Domestic Assistance("CFDA")number
93.994). The State's Prevention Services Division(PSD)is charged with the administration of funds from
the Title V MCH Block Grant to improve the health and well being of the maternal and child/adolescent
populations through assessing population needs,influencing health policy,engaging in strategic planning
and coordinating/implementing best practices and evidenced-based programs.
The authority for the administration of the Title V MCH Block Grant,including the maternal,child and
children with special health care needs resides in Title V of the Social Security Act,§§ 501-509.
Each state that receives MCH funds from the HHS must demonstrate to the HHS that it has served three(3)
distinct population groups with the MCH funds. These three(3)distinct population groups are:"the
perinatal population",which is defined to include women of childbearing age,pregnant women,and
mothers;the"child and youth population",which is defined to include infants,children,and adolescents
from birth through age twenty(20);and,the"children with special health care needs population"
(CSHCN),which is defined as those children who have,or are at increased risk for a chronic physical,
developmental,behavioral,or emotional condition and who also require health and related services of a
type or amount beyond that required by children generally.
The State has formulated a comprehensive statewide plan to carry out a Maternal and Child Health
Program,funded by Title V MCH dollars. As part of the comprehensive plan,it is the express intent of the
state to support local public health agencies in contributing to a coordinated,efficient statewide program
which focuses on specific MCH performance measures set by the MCH state and Federal agencies. Local
public health agencies,working in partnership with other community organizations,facilitate the
development and enhancement of community-based systems of care for the maternal,and child population.
The goal of these systems is to ensure that all families have access to direct care services,as well as,
enabling and population-based services that address the issues and health problems delineated in the MCH
performance measures.
If the underlying Award authorizes the State to pay all allowable and allocable expenses of a contractor as
of the effective date of that Award,then the State shall reimburse the Contractor for any allowable and
allocable expenses of the Contractor that have been incurred by the Contractor since the proposed effective
date of this Task Order Contract. If the underlying Award does not authorize the State to pay all allowable
and allocable expenses of a contractor as of the effective date of that Award,then the State shall only
reimburse the Contractor for those allowable and allocable expenses of the Contractor that are incurred by
the Contractor on or after the effective date of this Task Order Contract,with such effective date being the
later of the date specified in this Task Order Contract or the date the Task Order Contract is signed by the
State Controller or delegee.
2. In consideration of those Prenatal and Child/Adolescent services,set forth in Exhibit A satisfactorily and
timely performed by the Contractor under this Task Order,the State shall cause to be paid to the Contractor
a sum not to exceed ONE HUNDRED FORTY-ONE THOUSAND TWO HUNDRED FIFTY-TWO
DOLLARS($141.252.001. Of the financial obligation for the Prenatal and Child/Adolescent services,
ONE HUNDRED FORTY-ONE THOUSAND TWO HUNDRED FIFTY-TWO DOLLARS
To be attached to CDPHE Page 1 of 4 Revised: 12/19/06
Task Order v1.0(11/05)contract template
EXHIBIT A
1$141.252.001 are identified as attributable to a funding source of the federal government and,ZERO
DOLLARS,($0.00)are identified as attributable to a funding source of the state of Colorado.
3. Reimbursement for the Prenatal and Child/Adolescent services under this Task Order,and any renewal or
extension hereof,shall be made to the Contractor monthly. Accordingly,the Contractor shall be paid one
twelfth(1/12)of the State's financial obligation for the Prenatal and Child/Adolescent services under this
Task Order each month for the first eleven(11)months.
The final payment for the twelfth(12'")month or fourth(4'")quarter,for the initial term of this Task Order,
and any renewal or extension hereof,is contingent upon the State's timely receipt of a Final Expenditure
Report from the Contractor by utilizing the"Application Budget and Final Expenditure Report"form
incorporated herein by this reference located on the MCH website
http:/iwww.cdphe.state.co.us/ps/nich/plan/forms.html
The State shall reimburse the Contractor for actual indirect costs up to the Prevention Services Division's
maximum of twenty-five percent(25%)when the Contractor's indirect rate is based on Direct Costs,
twenty-seven percent(27%)when the Contractor's indirect rate is based on Salary Only,or thirty percent
(30%)when the Contractor's indirect rate is based on Salary and Fringe where no other direct costs are
charged.
Unless otherwise provided for in this Task Order Contract,"Local Match", if any,shall be included on all
billing statements as required by the funding source.
The Contractor shall not use federal funds to satisfy federal cost sharing and matching requirements unless
approved in writing by the appropriate federal agency.
4. Contractor shall retain and use all revenues generated by the individual MCH Programs for services in
those programs.
5. Title V,Section 504(b)(6).Title V funds may not be used to pay for any item or service(other than an
emergency item or service)furnished by an individual or entity convicted of a criminal offense under the
Medicare or any State health care program(i.e.,Medicaid,Maternal and Child Health,or Social Services
Block Grant Programs).
6. The Contractor agrees to provide services to all Program participants and employees in a smoke-free
environment in accordance with Public Law 103-227,also known as"the Pro-Children Act of 1994",(Act).
Public Law 103-227 requires that smoking not be permitted in any portion of any indoor facility owned or
leased or contracted for by an entity and used routinely or regularly for the provision of health,day care,
early childhood development services,education or library services to children under the age of 18, if the
services are funded by Federal programs either directly or through State or local governments,by Federal
grant,contract,loan,or loan guarantee. The law also applies to children's services that are provided in
indoor facilities that are constructed,operated,or maintained with such Federal funds. The law does not
apply to children's services provided in private residences;portions of facilities used for inpatient drug or
alcohol treatment;service providers whose sole source of applicable Federal funds is Medicare or
Medicaid;or facilities where WIC coupons are redeemed. Failure to comply with the provision of Public
Law 103-227 may result in the imposition of a civil monetary penalty of up to$1,000 for each violation
and/or the imposition of an administrative compliance order on the responsible entity. By signing this Task
Order,the Contractor certifies that the Contractor will comply with the requirements of the Act and will not
allow smoking within any portion of any indoor facility used for the provision of services for children as
defined by the Act. The Contractor agrees that it will require that the language of the Act be included in
any subcontracts which contain provisions for children's services and that all contractors shall sign and
agree accordingly.
7. The Contractor certifies,to the best of its knowledge and belief,that no federally appropriated funds have
been paid or will be paid by or on behalf of the Contractor,to any person for influencing or attempting to
influence an officer or employee of any agency,a Member of Congress,an officer or employee of
To be attached to CDPHE Page 2 of 4 Revised: 12/19/06
Task Order v1.0(11/05)contract template
EXHIBIT A
Congress,or an employee of a Member of Congress in connection with the awarding of this Task Order,
and the extension,continuation,renewal,amendment,or modification of this Task Order,or any grant,
loan,or other cooperative agreement that utilizes Federal funds. If any funds other than federally
appropriated funds have been paid or will be paid to any person for influencing or attempting to influence
an officer or employee of any agency,Member of Congress,an officer or employee of Congress in
connection with this Task Order,or any other grant,loan,or other cooperative agreement,then the
Contractor shall complete and submit Standard Form-LLL,"Disclosure Form to Report Lobbying" in
accordance with its instructions. The Contractor shall require that the language of this certification be
included in the award documents for subawards at all tiers(including subcontracts,subgrants,and contracts
under grants,loans,and cooperative agreements)and that all subrecipients shall certify and disclose
accordingly. This certification is a material representation of fact upon which reliance was placed when
this transaction was made or entered into. This certification is a prerequisite for making or entering into
this transaction imposed by section 1352,title 31,U.S.Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each
such failure.
8. The Contractor shall not charge for services those individuals of families at or below the official poverty
guidelines,updated periodically in the Federal Register by the U.S.Department of Health and Human
Services under the authority of 42 U.S.C.9902(2),in accordance with Title V,Section 501 (1)(B)and
Section 505(5)(D). The most current version of this document is available on the HCP website:
www.hcpcolorado.org If the State receives new poverty guidelines from the DHHS during the term of this
Contract,then the State shall immediately update the guideline on the MCH&HCP websites. The
Contractor shall use these new poverty guidelines,if any,upon receipt thereof from the State.
9. If any charges are imposed for services to clients who are above the one hundred percent(100%)of poverty
level,such charges must be on a sliding scale which takes into account the client's family size,income and
resources. These charges and the sliding fee scale must be made available to the general public and to all
clients and must be based on the agency's usual and customary cost for the service. Clients must
understand they shall not be denied services for inability to pay any of the sliding fee charges.
10. The Contractor shall protect the confidentiality of all applicant or recipient records and other materials that
are maintained in accordance with this Task Order. Except for purposes directly connected with the
administration of this Task Order,no information about or obtained from,any applicant or recipient shall
be disclosed in a form identifiable with the applicant or recipient without the prior written consent of the
applicant or recipient,or the parent or legal guardian of a minor applicant or recipient with the exception of
information protected by Colorado statute as it applies to confidentiality for adolescent services in which
case the adolescent minor and not the parent or legal guardian must provide consent or,as otherwise
properly ordered by a court of competent jurisdiction. The Contractor shall have written policies governing
the access to,and duplication and dissemination of,all such information. The Contractor shall advise its
employees,agents,servants,and subcontractors,if any,that they are subject to these confidentiality
requirements.
11. Contractor shall ensure that the provisions of Section 601 of Title VI of the Civil Rights Act of 1964 are
carried out. That Act states that"no person in the United States shall on the ground of race,color,or
national origin,be excluded from participation in,be denied the benefits of,or be subjected to
discrimination under any program or activity receiving Federal financial assistance." The Office of Civil
Rights has concluded that it is the responsibility of any program which is a recipient of funds from the
Department of Health and Human Services to ensure that clients who do not speak or understand English
well,be provided interpretation services to ensure that the service provider and the client can communicate
effectively. The Contractor shall have policies and procedures to ensure that interpretation services are
available for clients with Limited English Proficiency and will advise such clients that an interpreter will be
provided for them. If a client has their own interpreter,they shall be advised that the Contractor will
provide an interpreter if the client so chooses.
12. The services or activities under this Task Order may be carried out by the Contractor itself,or through
subcontracts with other providers or,through collaborative partnerships with other community partners.
To be attached to CDPHE Page 3 of 4 Revised: 12/19/06
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EXHIBIT A
The State authorizes the Contractor to subcontract some, or all,of the services that are to be performed
under this Task Order. However, a subcontractor is subject to all of the terms and conditions of this Task
Order. Additionally,the Contractor remains ultimately responsible for the timely and satisfactory
completion of all work performed by any subcontractor(s) under this Task Order. If the Contractor desires
to subcontract some, or all, of the services that are to be performed under this Task Order,the Contractor
shall obtain the prior, express,written consent of the State before entering into any subcontract.
13. 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.
14. The State has determined that this contract does not constitute a Business Associate relationship under HIPAA.
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EXHIBIT B
STATEMENT OF WORK
To Task Order Contract Dated 08/01/2007-Contract Routing Number 08 FLA 00473
These provisions are to be read and interpreted in conjunction with the provisions of the Task Order Contract specified above.
This Statement of Work is for two of the three maternal and child health(MCH)populations: prenatal and child and
adolescent.
1. Under this Task Order,the Contractor shall provide the core public health services of assessment,policy
development,and assurance on behalf of the prenatal and child and adolescent populations as described and
defined in the"Core Public Health Services Delivered by MCH Agencies"component of the MCH
Guidelines at http://vww.cdphe.state.co.us/ps/mch/plan/fonns.html.
2. The Contractor shall provide leadership,in coordination with public and private community partners, in the
development and implementation of the Contractor's Prenatal and Child/Adolescent Operational Plans.
3. The State shall provide guidance and technical assistance to the Contractor to support the implementation
of the Contractor's Prenatal and Child/Adolescent Operational Plans for federal fiscal year 2007-2008 and
for the development of the Contractor's Local Prenatal and Child/Adolescent Operational Plans for the
federal fiscal year 2008-2009.
4. The Prenatal and Child/Adolescent Operational Plans are to be based on a community planning process that
includes a review of the health status needs of the prenatal and child and adolescent populations and of the
health system resources of a community. These plans are further designed to:
a. Contribute to the accomplishment of the National and State's priorities,performance measures,
and outcome measures,as identified in the MCH Guidelines;
b. Provide for the continuation of the core public health services of assessment,policy development,
and assurance on behalf of the maternal and child health populations and in implementing the 10
essential services for this population in partnership with the State,as identified in the MCH
Guidelines;
c. Work with public and private community partners to plan for the development and maintenance of
resources that assure access to direct care and services for vulnerable women,children,and
adolescents,such as those who are low-income,uninsured,underinsured,or who live in rural or
underserved areas or who are from ethnic or cultural minority communities and may experience
language or cultural barriers to services;
d. Facilitate outreach and enrollment efforts, including having information and applications on site,
to increase enrollment of eligible children and adolescents,including those with special health care
needs,in Medicaid(Colorado Baby Care/Kid's Care Program)or Child Health Plan Plus(CHP+)
and Supplemental Security Income(SSI);
e. Refer families participating in any and all programs in its agency such as Women,Infants and
Children(WIC);Early and Periodic Screening,Diagnosis and Treatment(EPSDT);Immunization
Clinics; Family Planning;HCP;etc.to appropriate enabling and direct care service programs in
the community. All pregnant women in need of resources for prenatal medical care shall be
provided with information about programs such as Prenatal Plus,Nurse Family Partnership,WIC,
etc.,as needed. The Contractor shall provide all individuals seeking reproductive health services:
with information about pregnancy planning,the consequences of unintended pregnancies,and,
referrals to comprehensive family planning services;and
To be attached to CDPHE Page 1 of 2 Revised: 12/19/06
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EXHIBIT B
f. Work with public and private community partners to plan for the development and implementation
of population-based approaches for addressing MCH performance measures and priority issues for
women,children and adolescents.
5. The Contractor shall perform in accordance with the MCH Contractor Responsibilities as listed in the MCH
Guidelines and shall follow the policies and procedures in the MCH Guidelines. The Guidelines are
available on the MCH web site: http:%'www.cdphe.state.co.us/pshuch;uhm/forms.html.
6. The Guidelines are periodically updated and the contractor will be notified by email when
updates/revisions are made. The contractor is responsible for complying with any updates/revisions.
7. The Contractor shall submit,but not limited to,the following reports,incorporated by reference. These
documents,including instructions for completion and submission are available in the MCH Guidelines
located on the MCH website:hnp://www.cdphestate.co.us/ps/mch/plareforms.html.
a. Final Expenditure Report for the Prenatal Population for FFY 2006-2007 using the Application
Budget&Final Expenditure Report Form
b. Final Expenditure Report for the Child/Adolescent Population for FFY 2006-2007 using the
Application Budget&Final Expenditure Report Form
c. Actual Budget Allocations for FFY 2006-2007 using the Core Public Health Services Budget
Application&Expenditure Report
d. Numbers Served Report for FFY 2006-2007—Tables I&II
e. Prenatal and Child/Adolescent Operational Plan Annual Report for FFY2006-2007
f. Estimated Funding Allocations for the Prenatal Population for FFY 2008-2009 using the
Application Budget&Final Expenditure Report Form
g. Estimated Funding Allocations for the Child/Adolescent Population for FFY 2008-2009 using the
Application Budget&Final Expenditure Report Form
h. Line Item Application Budget for FFY 2008-2009 using the Core Public Health Services Budget
Application&Expenditure Report
i. Local Prenatal and Child/Adolescent Operational Plan for FFY 2008-2009
7. The Contractor shall implement the Prenatal and Child/Adolescent Operational Plan for FFY2007-2008
during the course of this contract.
8. The Contractor shall participate in activities in conjunction with the State to ensure that the program
planning,evaluation and monitoring requirements as described in this Task Order,Exhibits and
Attachments are met. Activities include,but are not limited to,participation in site visits and meetings as
requested by the State at the Contractor's location.
9. The Contractor shall cooperate with the State and provide all requested records regarding recipients for
whom services were provided under this Task Order.
To be attached to CDPHE Page 2 of 2 Revised: 12/19/06
Task Order v1.0(11/05)contract template
EXHIBIT C
DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
(ADD PROGRAM NAME HERE)
DEPARTMENT OR AGENCY NUMBER
***
CONTRACT ROUTING NUMBER
ELIMINATE ALL INFORMATION APPEARING IN RED
LIMITED AMENDMENT FOR TASK ORDERS #*
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 Master Contract, dated******** **, ****, with contract routing
number ** *** ***** "the Master Contract").
Pursuant to the terms and conditions of the Master Contract,the parties entered into a Task Order
Contract, dated******** ** ****, with contract encumbrance number PO *** **********
and contract routing number** *** *****, )insert the following if previous amendment($),
change order(s), renewal(s) have been processed: as amended by] )include all previous
amendment(s), change order(s), renewals) and their routing numbers), )insert the
following if previous amendment(s), change order(s), renewal(s) have been processed:
collectively) referred to herein as the"Original Task Order Contract,whereby the Contractor was
to provide to the State the following:
)Briefly describe what the Contractor was to do under the Original Task Order
Contract— indent this paragraph)
)Please choose one of the following four options and delete the other three options not
selected)
The State promises to )choose one and delete the other] increase/decrease the amount of funds
to be paid to the Contractor by **********Dollars, ($*.**) during the current term of the
Original Task Order Contract in exchange for the promise of the Contractor to perform the
)choose one and delete the other) increased/decreased work under the Original Task Order
Contract.
Page 1 of 5
The State promises to pay the Contractor the sum of********** Dollars, ($*.**) in exchange
for the promise of the Contractor to continue to perform the work identified in the Original Task
Order 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 work described herein.
The State hereby exercises a"no cost"change to the [choose those that apply and delete those
that don't apply] budget,specifications within the Statement 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 Task Order Contract or renewal term of the Original Task Order Contract.
NOW THEREFORE, in consideration of their mutual promises to each other, stated below, the
parties hereto agree as follows:
1. Consideration for this Limited Amendment to the Original Task Order Contract consists
of the payments and services that shall be made pursuant to this Limited Amendment,
and promises and agreements herein set forth.
2. It is expressly agreed to by the parties that this Limited Amendment is supplemental to
the Original Task Order Contract, contract routing number** *** *****, 'insert the
following language here if precious 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 if
previous amendment(s), change order(s), renewal(s) have been processed,otherwise
delete "collectively")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 Task Order Contract is and shall
be modified, altered, and changed in the following respects only:
I Please choose one of the following three options and delete the two options not
selected)
A. 'Use this paragraph when changes to the funding level of the Original Task
Order Contract occur during the current term of the Original Task Order
Contract) This Limited Amendment is issued pursuant to paragraph 5 of the
Original Task Order Contract identified by contract routing number** ***
*****. This Limited Amendment is for the current term of********* **
Page 2 of 5
EXHIBIT C
****, 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 other[ increased/decreased by
**********Dollars, ($*.**) for an amended total financial obligation of the
State of********** DOLLARS, ($*.**). [Delete the following sentence if not
applicable in your situation[ The revised Statement of Work is incorporated
herein by this reference and identified as "Attachment *". [Delete the following
sentence if not applicable in your situation] The revised Budget is incorporated
herein by this reference and identified as "Attachment *". The Original Task
Order Contract is modified accordingly. All other terms and conditions of the
Original Task Order Contract are reaffirmed.
A. [Use this paragraph when the Original Task Order Contract will he renewed
for another term[ This Limited Amendment is issued pursuant to paragraph 5 of
the Original Task Order Contract identified by contract routing number** ***
*****. This Limited Amendment is for the renewal term of********* **
****, through and including ********* **, ****. The maximum amount
payable by the State for the work to be performed by the Contractor during this
renewal term is********** Dollars, ($*.**) for an amended total financial
obligation of the State of**********DOLLARS, ($*.**). [Delete the
following sentence if not applicable in your situation] The revised Statement of
Work is incorporated herein by this reference and identified as"Attachment*".
[Delete the following sentence if not applicable in your situation[ The revised
Budget is incorporated herein by this reference and identified as "Attachment *".
The Original Task Order Contract is modified accordingly. All other terms and
conditions of the Original Task Order Contract are reaffirmed.
A. [Use this paragraph when there are "no cost changes" to the Budget, the
specifications within the original Statement of Work, allowable contract
provisions as noted, or performance period.) This Limited Amendment is
issued pursuant to paragraph 5 of the Original Task Order 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 Statement of Work in [identify location in
contract j, modifies the project management/manager identification in
[identity 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 Task Order
Contract. The revised [choose those that apply and delete those that don't)
Budget, Statement of Work,project management/manager identification,
notice address or notification personnel, or period of performance is
incorporated by this reference and identified as. All other terms and conditions of
the Original Task Order Contract are reaffirmed.
4. The effective date of this Limited Amendment is **/**/****, or upon approval of the
State Controller, or an authorized delegate thereof, whichever is later.
Page 3 of 5
•I r
5. Except for the Special Provisions and other terms and conditions of the Master Contract
and the General Provisions of the Original Task Order Contract, in the event of any
conflict, inconsistency, variance, or contradiction between the terms and provisions of
this Limited Amendment and any of the terms and provisions of the Original Task Order
Contract, the terms and provisions of this Limited Amendment shall in all respects
supersede, govern, and control. The Special Provisions and other terms and conditions of
the Master Contract shall always control over other provisions of the Original Task Order
Contract or any subsequent amendments thereto. The representations in the Special
Provisions to the Master Contract concerning the absence of personal interest of state of
Colorado employees and the certifications in the Special Provisions relating to illegal
aliens are presently reaffirmed.
6. FINANCIAL OBLIGATIONS OF THE STATE PAYABLE AFTER THE CURRENT
FISCAL YEAR ARE CONTINGENT UPON FUNDS FOR THAT PURPOSE BEING
APPROPRIATED, BUDGETED, AND OTHERWISE MADE AVAILABLE.
Page 4 of 5
EXHIBIT C
IN WITNESS WHEREOF, the parties hereto have executed this Limited Amendment on the
day first above written.
CONTRACTOR: STATE:
[LEGAL NAME OF CONTRACTOR] O
(a political subdivision of the State of Colorado o ernor
By:
Name: o For the Executive Director
Title: DEPA OF PUBLIC
H ENVIRONMENT
131,
• M APPROVAL:
Because the Con ov
entity, an attestat Di e By:
(Seal, required)
By:
City, City and County,County,
Special District,or Town Clerk or Equivalent
)Delete inapplicable language.)
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
Leslie M. Shenefelt
By:
Date:
Page 5 of 5
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