HomeMy WebLinkAbout20062270 RESOLUTION
RE: APPROVE TASK ORDER FOR HEALTH DISPARITIES 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 for Health Disparities
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
September 1, 2006, and ending June 30, 2007, with further terms and conditions being as stated
in said task order, and
WHEREAS, after review, the Board deems it advisable to approve said task order, 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 for Health Disparities 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.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 21st day of August, A.D., 2006.
BOARD OF COUNTY COMMISSIONERS
res
„ a WELD CO Y, COLORADO
ATTEST: � � (iv
M. J. ile, Chair
Weld County Clerk to the ,2
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Het David E. Long, Pro-Tem
BY: 1 L4 q CL
Dep Clerk t the Board vt FL/
Wil arks
APP V AS TO F
Robert D. Masden
unty A rney EXCUSED
Glenn Vaad
Date of signature: q I i 1ble
2006-2270
HL0033
de : SSC3O..t: {.) O(,
Memorandum
TO: MJ Geile, Chair
Board of County Commissioners
I C FROM: Mark E. Wallace, MD, MPH, Director Department of Public Health and
Environment -- aA lkiaF�n
COLORADO DATE: August 17, 2006 e
SUBJECT: Health Disparities Grant Task Order
Enclosed for Board review and approval is a task order between the Colorado Department of
Public Health and Environment and Weld County for the Health Disparities Grant, Decreasing
Diabetes in Weld County. This grant will provide funding for diabetes awareness, education,
screening, and case management services for the underserved, uninsured and underinsured
residents of Weld County.
For providing the above services, Weld County will be compensated an amount not to exceed
$160,313 for the time period September 1, 2006 through June 30, 2007. The funding, all
attributable to the State of Colorado, will provide for hiring two employees to implement the
work plan, a 1.0 FTE community diabetes specialist and a .75 FTE diabetes health educator.
I recommend your approval of this task order.
Enclosure
2006-2270
DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
DEPARTMENT OR AGENCY NUMBER
FAA
CONTRACT ROUTING NUMBER
07-00090
TASK ORDER
Health Disparities Program
This Task Order is made this 19th day of May,2006,by and between: the state of Colorado,acting by and through
the COLORADO 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,the BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY(a
political subdivision of the state of Colorado),whose address or principal place of business is 1555 NORTH 17Th
AVENUE,GREELEY,CO 80631, for the use and benefit of the Weld County Department of Public Health and
Environment, whose address or principal place of business is 1555 North 17th Avenue,Greeley,CO 80631,
hereinafter referred to as"the Contractor".
FACTUAL RECITALS
Pursuant to section 25-4-2201 C.R.S., as amended,the General Assembly of the state of Colorado"hereby declares
that it is in the best interests of the State to establish a Health Disparities Grant Program to provide prevention, early
detection,and treatment of cancer and cardiovascular and pulmonary diseases to minority populations". Section
25-4-2203 C.R.S., as amended, further states that the department shall administer the grant program. The State
Board shall award grants to selected entities from moneys appropriated to the prevention, early detection, and
treatment fund created in section 24-22-117,C.R.S.
Section 29-1-201, C.R.S. as amended, encourages governments to make the most efficient and effective use of their
powers and responsibilities by cooperating and contracting with each other to the fullest extent possible to provide
any function,service, or facility lawfully authorized to each of the cooperating or contracting entities. Section 29-1-
201,C.R.S., as amended, further states that all state of Colorado contracts with its political subdivisions are exempt
from the state of Colorado's personnel rules and procurement code.
The Contractor is a political subdivision of the state of Colorado. The State and the Contractor mutually agree that
the most efficient and effective way to provide the above-described services is at the local level. The State and the
Contractor previously entered into a Master Contract with contract routing number 05 FAA 00054.This Task Order
is issued pursuant to the terms and conditions of that Master Contract.
As to the State, authority exists in the Law and Funds have been budgeted, appropriated,and otherwise made
available, and a sufficient uncommitted balance thereof remains available for subsequent encumbering and payment
in Fund Code(s) 19F, Organizational Unit Code(s)0270 Appropriation Code(s)739,Program Code(s)9010,
Function Code(s)XMPT, Object Code(s)5120,and Grant Budget Line Code(s)0M7C under Contract
encumbrance number PO FAA ADM07000090. All required approvals, clearances,and coordination have been
accomplished from and with all appropriate agencies.
NOW,THEREFORE, in consideration of their mutual promises to each other, stated below,the parties hereto
agree as follows:
A. PERIOD OF PERFORMANCE AND TERMINATION. The proposed effective date of this Task
Order is September 1,2006. However, in accordance with section 24-30-202(1),C.R.S.,as amended,this
Task Order is not valid until it has been approved by the State Controller, or an authorized designee
Page 1 of 5
thereof The Contractor is not authorized to,and shall not;commence performance under this Task Order
until this Task Order has been approved by the State Controller. 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. If the State Controller approves this Task Order
on or before its proposed effective date,then the Contractor shall commence performance under this Task
Order on the proposed effective date. If the State Controller approves this Task Order after its proposed
effective date,then the Contractor shall only commence performance under this Task Order on that later
date. The initial term of this Task Order shall commence on the effective date of this Task Order and
continue through and including June 30,2007,unless sooner terminated by the parties pursuant to the
terms and conditions of this Task Order. In accordance with section 24-103-503,C.R.S., as amended, and
Colorado Procurement Rule R-24-103-503,the total term of this Contract, including any renewals or
extensions hereof,may not exceed five(5)years.
B. DUTIES AND OBLIGATIONS OF THE CONTRACTOR. The Contractor, in accordance with the
terms and conditions of the Master Contract and this Task Order,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"Attachment A".
C. DUTIES AND OBLIGATIONS OF THE STATE.
1. The Contractor shall be compensated in accordance with the rates set forth in Attachment A
hereto. In consideration of those services 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 SIXTY THOUSAND THREE HUNDRED AND THIRTEEN DOLLARS,
(5160,313.001 for the initial term of this Task Order. Of the total financial obligation of the State
referenced above,$0.00 are identified as attributable to a funding source of the United States
government and,$160,313.00 are identified as attributable to a funding source of the state of
Colorado.
2. Payments under this Task Order shall be made either through the State's Electronic Fund Transfer
system or,upon the Contractor's periodic submission of a duplicate"Task Order Reimbursement
Statement".
3. If this Task Order requires the Contractor submit a"Task Order Reimbursement Statement",then
the Contractor shall submit a signed,duplicate monthly Task Order Reimbursement Statement
within sixty(60)calendar days of the end of the billing period for which services were rendered.
Expenditures shall be in accordance with those items identified in Attachment A. These items
may include,but are not limited to: the Contractor's salaries, fringe benefits,supplies,travel,
operating,and indirect costs which are allowable and allocable expenses related to its performance
under this Task Order.
Each Task Order Reimbursement Statement shall reference the related Master Contract by its
contract routing number and this Task Order by their respective contract routing numbers. The
contract routing numbers are located on page one of these documents. Each Task Order
Reimbursement Statement shall also indicate the applicable performance dates,the names of
payees;a brief description of the services performed during the relevant performance dates; all
expenditures incurred;and,the total reimbursement requested. Reimbursement during the initial,
or any renewal,term of this Task Order shall be conditioned upon affirmation by the State that all
services were rendered by the Contractor in accordance with the terms of this Task Order. Each
Task Order Reimbursement Statement shall be sent to:
Mauricio Palacio
Health Disparities Grant Program
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South
Denver,CO 80246
Page 2 of 5
4. The State may prospectively increase or decrease the amount payable under this Task Order
through a"Task Order Change Order Letter"that is substantially similar to the sample Task Order
Change Order Letter that is incorporated herein by this reference,made a part hereof, and attached
hereto as"Attachment B". To be effective,a Task Order Change Order Letter must be: signed by
the State and the Contractor;and,approved by the State Controller or an authorized designee
thereof. Additionally, a Task Order Change Order Letter shall include the following information:
A. Identification of the related Master Contract and this Task Order by their respective
contract routing numbers and affected paragraph number(s);
B. The type(s)of service(s)or program(s)increased or decreased and the new level of each
service or program;
C. The amount of the increase or decrease in the level of funding for each service or
program and the new total financial obligation;
D. A provision stating that the Task Order Change Order Letter is effective upon approval
by the State Controller, or designee, or its proposed effective date,whichever is later.
Upon proper execution and approval,a Task Order Change Order Letter shall become an
amendment to this Task Order. Except for the General and Special Provisions of the Master
Contract,and the Additional Provisions of the Task Order, if any,the Task Order Change Order
Letter shall supersede this Task Order in the event of a conflict between the two. It is expressly
understood and agreed to by the parties that the task order change order letter process may be used
only for increased or decreased levels of funding,corresponding adjustments to service or program
levels, and any related budget line items. Any other changes to this Task Order, other than those
authorized by the task order option to renew letter process described below, shall be made by a
formal amendment to this Task Order executed in accordance with the Fiscal Rules of the state of
Colorado.
If the Contractor agrees to and accepts a proposed Task Order Change Order Letter,then the
Contractor shall execute and return that Task Order Change Order Letter to the State by the date
indicated in that Task Order Change Order Letter. If the Contractor does not agree to and accept a
proposed Task Order Change Order Letter,or fails to timely return a partially executed Task Order
Change Order Letter by the date indicated in that Task Order Change Order Letter,then the State
may,upon written notice to the Contractor,terminate this Task Order no sooner than thirty(30)
calendar days after the return date indicated in the Task Order Change Order Letter has passed.
This written notice shall specify the effective date of termination of that Task Order. If a Task
Order is terminated under this clause,then the parties shall not be relieved of their respective
duties and obligations under that Task Order until the effective date of termination has passed.
Increases or decreases in the level of contractual funding made through the task order change
order letter process during the initial, or renewal,term of a Task Order may only be made under
the following circumstances:
E. If necessary to fully utilize appropriations of the state of Colorado and/or non-
appropriated federal grant awards;
F. Adjustments to reflect current year expenditures;
G. Supplemental appropriations, or non-appropriated federal funding changes resulting in an
increase or decrease in the amounts originally budgeted and available for the purposes of
a Task Order;
H. Closure of programs and/or termination of related contracts or task orders;
Page 3 of 5
I. Delay or difficulty in implementing new programs or services;and,
J. Other special circumstances as deemed appropriate by the State.
5. The State may renew a Task Order through a"Task Order Option to Renew Letter"substantially
similar to the sample Task Order Option to Renew Letter that is incorporated herein by this
reference,made a part hereof,and attached hereto as"Attachment C". To be effective, a Task
Order Option to Renew Letter must be: signed by the State and the Contractor; and,approved by
the State Controller or an authorized designee thereof. Additionally, a Task Order Option to
Renew Letter shall include the following information:
A. Identification of the related Master Contract and that Task Order by their respective
contract routing numbers and affected paragraph number(s);
B. The type(s)of service(s)or program(s), if any,increased or decreased and the new level
of each service or program for the renewal term;
C. The amount of the increase or decrease, if any, in the level of funding for each service or
program and the new total financial obligation;
D. A provision stating that the Task Order Option to Renew Letter is effective upon
approval by the State Controller,or designee, or its proposed effective date,whichever is
later.
Upon proper execution and approval,a Task Order Option to Renew Letter shall become an
amendment to this Task Order. Except for the General and Special Provisions of the Master
Contract,and the Additional Provisions, if any of that Task Order, a Task Order Option to Renew
Letter shall supersede that Task Order in the event of a conflict between the two. It is expressly
understood and agreed to by the parties that the task order option to renew letter process may be
used only to: renew a Task Order; increase or decrease levels of funding related to that renewal;
make corresponding adjustments to service or program levels,and, adjust any related budget line
items. Any other changes to a Task Order,other than those authorized by the task order change
order letter process described above, shall be made by a formal amendment to a Task Order
executed in accordance with the Fiscal Rules of the state of Colorado.
If the Contractor agrees to and accepts a proposed Task Order Option to Renew Letter,then the
Contractor shall execute and return that Task Order Option to Renew Letter to the State by the
date indicated in that Task Order Option to Renew Letter. If the Contractor does not agree to and
accept the proposed renewal term, or fails to timely return a partially executed Task Order Option
to Renew Letter by the date indicated in that Task Order Option to Renew Letter,then the State
may,upon written notice to the Contractor,terminate this Task Order no sooner than thirty(30)
calendar days after the return date indicated in the Task Order Option to Renew Letter has passed.
This written notice shall specify the effective date of termination of that Task Order. If a Task
Order is terminated under this clause,then the parties shall not be relieved of their respective
duties and obligations under that Task Order until the effective date of termination has passed.
6. All attachments or exhibits to this Task Order are incorporated herein by this reference and made a
part hereof as if fully set forth herein. If a conflict or inconsistency is found to exist between the
terms and conditions of this Task Order and those of any attachment or exhibit hereto,then the
terms and conditions of this Task Order shall control.
Page 4 of 5
IN WITNESS WHEREOF,the parties hereto have executed this Task Order as of the day first above written.
CONTRACTOR: STATE:
BOARD OF COUNTY COMMISSIONERS OF
WELD COUNTY STATE OF COLORADO
(a political subdivision of the state of Colorado) Bill Owens. Governor
for the use and benefit of the WELD COUNTY
DEPARTMENT OF PUB IC HEALTH AND
ENVIRONMENT
By: By:
Name: M. . Celle For the Executive Director
Title: Chair. Board of Cn„nry Commissioners DEPARTMENT OF PUBLIC HEALTH
FEIN: 84908731 2006 AND ENVIRONMENT
Date: RUU L Date:
ELA\
TT ./ Q PROGRAM APPROVAL:cued ount Clerk to the Board
,
A � la �A_ By:
tyit l"aL7
y Clerk to the Board
APPROVALS:
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:
Date: 7 (kb Jai
Revised:11/5/04
WELD COUNTY DEPARTMENT OF
PUBLIC HEALTH D E I M#�
BY: 1� ° T
Page 5 of 5 Mark E. Wallace, MD, MPH-Director
Attachment A
PROJECT NARRATIVE FORMAT
Project Title:
Decreasing Diabetes Disparities in Weld County
Health disparity issue or need to be addressed:
Health disparities among Hispanics are seen at all levels of health care, at national, state and
county levels; minority populations have higher rates of disease, disability and death compared to
Caucasians. These disparities are largely attributed to social and economic reasons, rather than
biological.As the minority population continues to grow at a dramatic rate, and if the health
disparities continue,the economic burden caused by these health disparities will also increase.
Diabetes is the ninth leading cause of death in Colorado and people with diabetes are at higher
risk for other health problems such as heart disease, stroke, high blood pressure,blindness, kidney
disease and amputations. As the disparities increase, so do the costs to care for people with
diabetes whose care also includes chronic complications associated with their diabetes and
increased need for general care.
According to the Colorado Behavioral Risk Factor Surveillance System (BRFSS),the prevalence
rate of diabetes is highest among African Americans and Latinos. When calculated, if we were to
eliminate the rate of the diabetes health disparity between Caucasians and Hispanics, it would
result in 6,056 fewer cases among minority adults per year. And at an average of$13,243 per
person,the 6,056 fewer cases would result in an $80 million dollar savings every year for
Coloradoans.
Weld County trends mirror the national and state trends. Increasing obesity rates and more people
being diagnosed with diabetes are affecting a community health care system that is already
overwhelmed. Based on a survey conducted between 1997 and 2002,Weld County has more than
25,000 individuals who do not have health insurance. This number represents 16.5% of the
county's residents. That is higher than the state average percentage of uninsured that is at 15.6%.
When compared to the state, Weld County also demonstrates higher disparities with higher
poverty levels, higher percentage of minorities, and fewer physicians per 100,000 people. And
while there is no single measure to establish the level of access to quality health care, it is well
known that factors such as insurance status, income, age, education,citizenship, race and
employment can affect the access to quality health care.
Target population:
A July 2003 estimate lists the Weld County population at about 209,909. There is a large
Hispanic population estimated to at 34.32%of the total population in 2004. With the median age
at 28.95,the county is growing very quickly with a lot of the growth being seen in the young
Hispanic population. Uninsured rates among Hispanics are 1.5 to 3 times higher than Caucasians
in the service area.
The target population that will benefit from this project include:
1. Older Hispanic/Latino adults, who have been diagnosed and are attempting to manage
their diabetes
2. Younger Hispanic/Latino adults,who are at risk of developing diabetes
3. Hispanic/Latinos who have limited access to traditional health care due to availability,
affordability and acceptability. The addition of a Cholestech Hemoglobin A1C Analyzer
will allow us to better serve our rural/migrant clients.
4. Hispanic/Latino families, ranging from older adults to children,through the involvement
of a bilingual/bicultural diabetes health education/promotora who will host platicas in
homes.
Goal(s) and Objective(s):
The goals of the Decreasing Diabetes Disparities in Weld County Project are to improve the
health status of the Hispanic/Latino population in Weld County by guiding our clients through a
diabetes referral and monitoring system, providing resources to those who have been diagnosed
and those that are at risk, offering health promotion activities to the Hispanic/Latino community
and health care providers, and assisting in early detection and management of health problems.
The first goal of this program is improve the health status of Hispanic/Latinos of Weld County to
reduce their risk of cardiovascular disease, including diabetes, through the establishment of a
Diabetes Disparities Program. The objectives that support this goal include:
Process Objectives:
• To hire full-time Community Diabetes Specialist and a part-time Diabetes Health
Educator.
• These staff member will complete orientation and training by August 15, 2006.
• The Community Diabetes Specialist will create a system to do chart reviews of people
with cardiovascular disease, including diabetes, in the Electronic Medical Records
(EMR)
• The Community Diabetes Specialist will coordinate at least three trainings for health care
professionals including one Cultural Competency Train-the-Trainer Course, which will
allow community members to:teach Cultural Competency courses throughout Weld
County.
Impact Objectives:
• By June 30, 2007, Sunrise Community Health Center and the Diabetes Clinic at the Weld
County Department of Public Health and Environment will see an increase in patient
follow-ups due to the new Electronic Medical Records' flagging system implemented by
the Project Coordinator.
• Following each"Health Care Professional"Training, participants will demonstrate
increased knowledge regarding diabetes care issues and cultural competence.
• Participants of the Cultural Competency Training will be asked to teach 4 classes/year to
their organizations or within the community after completing the course.
Outcome Objectives:
• By 2008, the rate of diabetes that is clinically diagnosed in Weld County will be reduced
by 5%
• By 2008,the rate of follow-up visits of patients with diabetes will increase by 15%.
The second goal is to establish and support community education programs for people who have
risk factors for developing cardiovascular disease, including diabetes, or the medically
underserved who have been diagnosed with diabetes.
Process Objectives:
• To provide regular Dining with Diabetes classes in the community, at least four times in
English,and four times in Spanish, each year.
• Provide at least four platicas(small group discussions)a month using the Small Changes
Make a Big Difference curriculum in homes or other locations.
• Organize and coordinate a walking program for people who have attended a platica or
Dining with Diabetes class.
• Provide a quarterly self-management class in Spanish for the community, which will be
taught by a Bilingual Diabetes Educator,Nurse or Nurse Practitioner.
• To offer regular risk assessments and screenings in geographically convenient locations
for the target population to identify people with elevated blood glucose and therefore
help the target population understand the risk of developing diabetes, as well as
providing education about how diabetes can be prevented or delayed.
Impact Objectives:
• By 2008, meet the community's need for comprehensive diabetes education by
providing regular Dining with Diabetes,platicas sessions and diabetes self-management
classes.
• By 2008, increase the number of Spanish-speaking diabetics who have received formal
diabetes self-management classes
• By 2008, diagnose participants earlier by providing screening at geographically
convenient locations
Outcome Objectives:
• By 2008, create a community group to provide ongoing feedback on programs provided
through the Decreasing Diabetes Disparities in Weld County Project and to work on a
plan of sustainability for the program
How project will be accomplished:
This project will be made possible through the collaboration of several agencies: the Weld
County Department of Public Health and Environment(WCDPHE),the North Colorado Health
Alliance, Sunrise Community Health Center, Salud Family Health Clinic,North Colorado
Medical Center, Greeley School District 6-Nutrition Services, and the Colorado State University
Cooperative Extension Office. These organizations have already been working together for
several years through the Weld County Diabetes Coalition. This group meets regularly and has
provided educational events and done other projects in an attempt to meet the needs of the
community that has limited resources for people with diabetes and an overwhelmed community
health care system. The project being proposed incorporates two goals that are reflective of the
needs that are being demanded from us by our community. The two components will be
spearheaded by the WCDPHE
The first goal is to improve the health status of Hispanics/Latinos of Weld County,to reduce
their risk of cardiovascular disease, including diabetes,through the establishment of a Diabetes
Disparities Program. The first objective the goal will be hire bilingual/bicultural staff to
implement the goals. The Diabetes Health Educator will work as a lay community health
workers or promotora. Promotoras typically live in the communities they serve and their
expertise is often based on their experience in the community, enhanced by special training.
They are useful in reaching those"hard-to-reach"communities,in our case Hispanic/Latino,
because they are well established in the neighborhood and are culturally sensitive.
A Community Diabetes Specialist will be hired and one of his/her responsibilities will be to
create a system to do chart reviews (second objective)with the Electronic Medical Records,to
assist with teaching diabetes education classes and to coordinate the programs and classes for the
program. The Electronic Medical Records (EMR) is a tool that can be used to better provide
service to our clients. The system is a shared database with access in six sites in Weld and
Larimer counties. Currently, 200 individuals have been trained to access information. The new
system is 95%paperless, allows medical staff to place orders electronically, makes information
accessible to medical staff from anywhere and allows for lab interface-electronic results.This
new system will make reporting easier while increasing the quality of customer service and
patient care for our clients. We will make the process easier by creating a system that will"flag"
patients with cardiovascular disease, including diabetes. This will allow health care professionals
in the health centers to perform appropriate tests, remind patients about follow-up appointments
and to make them aware of any available educational opportunities.
The Community Diabetes Specialist will also be responsible for coordinating the educational
opportunities (third objective) for both the medical community dealing with diabetics and the
target population. For medical staff, we will be working with North Colorado Medical Center
(NCMC)to provide Continuing Medical Education(CME)and Continuing Education Units
(CEU) for attending diabetes-related medical trainings. We will also be working with Cross
Cultural Health Care Program at NCMC to provide medical staff and community members a
train-the-trainer course in Cultural Competency. We hope that by providing this training at a
community level, different organizations and community members will incorporate cultural
competency programs into their organizations. The course covers elements in an interactive
method and focuses on building culturally competent community partnerships and building
culturally competent systems of care.
The second goal of the proposed grant is to establish and support community education programs
for people who have risk factors for developing cardiovascular disease, including diabetes, or the
medically underserved who have been diagnosed with diabetes. The first objective is to provide
regular Dining with Diabetes classes in the community. We would like to offer the course at least
eight times each year, with four of the series of four(4)classes being taught in Spanish and the
other four being taught in English. Dining with Diabetes is a practical hands-on meal-planning
course that is appropriate for people who are diagnosed with diabetes,those at risk for
developing diabetes and caretakers of diabetics.This program has repeatedly demonstrated
significant increases in participants' knowledge, behavior and self-efficacy by the end of the
series. Dining with Diabetes courses have been taught in Weld County before through the CSU
Cooperative Extension and through volunteers, and it has always been well received by those
who attended. A CSU staff member will be contracted to teach one series of classes, while
training the Community Diabetes Specialist and the Diabetes Health Educator to conduct the
other series of classes.
The second objective is for the Diabetes Health Educator to host four platicas each month. The
platicas program brings diabetes prevention education to the home. The Diabetes Health
Educator will recruit women from the community to host a platica, a small group discussion in
their home or church. The Diabetes Health Educator will facilitate a discussion with friends and
family members about diabetes prevention in the comfort of a woman's home.They will use the
Small Changes Make a Big Difference Presentation that was developed by the Colorado State
University Cooperative Extension and the Colorado Department of Public Health and
Environment. Hostesses will be identified from target population members, as well as recruited
through Health Talk programs on a local Spanish language radio station.
The third objective will involve the Community Diabetes Specialist and the Diabetes Health
Educator organizing and coordinating a walking program for people from the plkticas or Dining
with Diabetes classes that are interested in increasing their physical activity. It would be held in a
location that is convenient for the participants. A walking log will be encouraged and
pedometers will be given to those who have attended five walking sessions.
The fourth objective is to provide a quarterly Diabetes Self-Management class in Spanish.
Unfortunately,there have been difficulties in providing Diabetes Self-Management classes for
our community since the hospital no longer offers outpatient classes to the community. Some
private clinics have been providing classes for their English-speaking clients. Unfortunately,the
need for Spanish Diabetes Self-Management classes is not being met and offering these classes
will help fill that need.
The fifth objective is to offer regular risk assessments and screening in geographically
convenient locations. This will help better serve the target population since we will be able to
identify people with elevated blood glucose levels and help the target population understand their
risks of developing diabetes, as well as providing education on how diabetes can be delayed or
prevented. We will accomplish this by collaborating with local health fairs, including the 9News
Health Fair held in April in several locations in the county, and the Weld County Senior Health
Fair held in October. We will also join with the American Diabetes Association to coordinate
Diabetes Sunday activities at local churches.
An important equipment purchase would be buying the Hemoglobin AlC Analyzer for our
mobile health van. The Analyzer will allow us to better and faster diagnose our clients. The van
travels all over the county, providing services at school-based health centers and migrant farm
worker camps.
The sixth objective is to create a group of community members to serve as a steering committee
for the Diabetes Disparities Project. It would be composed of key community members from the
target population and public health staff to provide on-going feedback about the project and to
create a plan for sustainability. This steering committee will bring interested citizens and public
health staff together to discuss current projects, provide ongoing community feedback, and create
a plan for sustainability. They will meet with the Weld County Diabetes Coalition to facilitate
communication between health professionals and the Hispanic community.
Describe the interventions or approach selected and the desired outcomes
Hiring Bilingual/Bicultural Staff: It is important that staff be able to communicate effectively
with the clients in a language that they understand. It is key to have staff that can deliver the
correct message in a manner that is both culturally and linguistically competent. The clients will
be more open to change if they feel comfortable communicating with the bicultural/bilingual
staff.
Using Evidence-based programs: The curriculum for Dining with Diabetes and Small Changes
make a Big Difference will be used. Both programs have evaluation components and have been
tested extensively. Since these programs have been taught on a limited basis in our community
previously, individuals who have attended will encourage others to participate. Research done in
2003 by the Roslow Research Group found that 69% of U.S. Hispanics believe they get more
information when it is provided in Spanish than in English.
Involving the Community: Forming a steering committee will be an important step in
accomplishing the project objectives and will provide important community feedback and
perspectives. Involving the community is key in making the program successful. Asking for
opinions and getting involvement in the process makes participants realize how integral they are
to the success of the program, and therefore more invested in seeing it succeed.
Why this approach was chosen:
All the approaches were chosen because they have been proven to work. The Community Health
worker/promotora has been successfully used in many health promotion programs. We have also
had experience using some of the programs proposed for this grant, including the Dining with
Diabetes classes,the platicas incorporating the"Small Changes make a Big Difference"
presentation. It is also well established that screening in an essential component of early
detection and early intervention. Screening can be used as a foundation for an educational
component and follow-up referrals, which will be made easier through the"flagging" system
established through the electronic medical records.
Cultural Competency:
The Weld County Department of Public Health and Environment(WCDPHE)strives to serve all
of our patients in a culturally competent manner. We understand that by being culturally
competent we are: I) proactively addressing the changing demographic of our community, 2)
working towards eliminating long-standing disparities in the health status of people of diverse
racial, ethnic and cultural backgrounds, and 3) improving the quality and health services we offer
all our clients regardless of race, class, income level, etc. Our commitment to cultural competency
is seen in the staff we hire. Currently about one-third of the employees at WCDPHE are bi-
lingual. Some staff members have completed Cultural Competency trainings for their projects.
Other employees have completed the Cross Cultural Health Care Program's Bridging the Gap
course(a 40-hour intensive medical interpretation course which teaches the participants how to
properly interpret for clients while being cultural-sensitive). Also, Spanish classes are provided
for employees who are interested in learning or improving their Spanish.
Our commitment to meeting the needs of our Hispanic community can also be seen in our efforts
to reach the Hispanic community through Spanish-language radio and newspapers. According to
a large-scale study put on by the Roslow Research Group, commercials in Spanish are 61% more
effective at increasing awareness than those in English.Understanding how powerful radio
communication is to our Hispanic community, we sponsor a Health Talk program that features
different health agencies in the community discussing a variety of topics ranging from leading
health issues affecting the Hispanic/Latino community in Weld County to accessing free/reduced
cost services. Radio has proven to be a cost-effective, and culturally and linguistically-appropriate
method of reaching our target population.
Total amount of funds requested:
Year 1 = $160,313.00; Year 2=$147,570.88; Total=$307,883.88
What are plans for sustainability after the grant period ends?
We hope that the success of this program can be institutionalized within the existing programs at
the WCDPHE. Rallying community support through forming a steering committee and
collaborating with other agencies will be important in securing more funding. Future funding may
come in the form of federal, state, local or private grants, and cash donations from local
businesses and in-kind contributions.
Health Disparities Grant Program
2007-2008
WORK PLAN FORMAT
Project Title: Decreasing Diabetes Disparities in Weld County Project
GOAL 1: To improve the health status of Hispanics/Latinos of Weld County to reduce their risk
of cardiovascular disease,including diabetes,through the establishment of a Diabetes Disparities
Program.
Objective Activity Responsible Duration Date
Party Completed
1. To Hire a fulltime la Develop job Gaye Morrison 6 weeks September
Community Diabetes descriptions, advertise, 2006
Specialist and a part- interview,
time Diabetes Health lb Hire staff: Gaye Morrison
Educator Community Diabetes
Specialist and Diabetes
Health Educator
lc Provide orientation Gaye Morrison
and training as needed
2.To create a system 2a Train staff on EMR Community Beginning On-going
to do chart reviews of System Diabetes September
people with 2b Create"real time" Specialist 2006 and
cardiovascular disease, prompts for physicians to continuing
including diabetes in use
the Electronic Medical 2c Create reports to Community
Records(EMR) identify clients that need Diabetes
appointments Specialist
3. To coordinate 3 3a. Identify specific Community Starting Completed by
Trainings for health issues related to diabetes Diabetes September, June 30,2008
care professionals, that health care Specialist 2006
including one cultural professionals are
competency train-the- interested in learning
trainer course about
3b. Work with NCMC to Community Starting
offer CME trainings Diabetes September,
3c. Offer Cultural Specialist 2006
Competency Train-the-
Trainer courses for
community partners Community Starting
3d. Identify specialist to Diabetes October,
do trainings, including Specialist 2006
Cultural Competency
Trainings. Set-up dates, Community
location, etc. Diabetes
3e. Invite and encourage Specialist and Starting
health care professionals Community November,
to attend partners 2006
GOAL 2: To establish and support community education programs for people who have risk
factors for developing cardiovascular disease,including diabetes,or the medically underserved who
have been diagnosed with diabetes.
Objective Activity Responsible Party Duration Date
Completed
1.Provide regular la Contract with the Community September May 2008
Dining with Diabetes Weld County CSU Diabetes Specialist 2006
classes in the Cooperative Extension
community, at least 4 Office to provide a
times in English and 4 Dining with Diabetes
times in Spanish, each class for training
year lb Provide Dining Community
with Diabetes classes in Diabetes Specialist
Spanish to parents in and Diabetes
four elementary schools Health Educator
in Greeley, working
with Parent/school
liaison
2. Provide at least four 2a Identify potential Community Starting Completed
platicas (small group hostesses for platicas Diabetes Specialist September June 2008
discussions)a month 2b Arrange classes; and Diabetes 2006
using the Small provide hostess with Health Educator
Changes Make a Big $40 gift certificate
Difference in homes 2c Invite participants Diabetes Health
or other locations to join walking groups Educator
or other physical
activities
3. Organize and 3a Establish location Community Starting Completed
coordinate a walking and time for walking Diabetes Specialist September June 2008
program for people program and Diabetes 2006
who have attended a 3b Develop walking Health Educator
platica or a Dining log and provide
with Diabetes class, pedometers for those
with at least 20 regular who have attended 5
participants walks
4. Provide quarterly 4a Contract with a bi- Community September June 2008
Diabetes Self- lingual Diabetes Diabetes Specialist 2006
Management Classes Educator or Nurse
in Spanish Practitioner to provide
classes
3b Identify location for Community
classes Diabetes Specialist
3c. Develop brochures Community
about classes and Diabetes Specialist
distribute to clinics
5 To offer regular risk 5a. Collaborate with 9 Community September June 2007
assessments and News Health Fair to do Diabetes Specialist 2006
screenings in blood glucose
geographically screenings at all events
convenient locations in Weld County
for the target 5b. Purchase Community
population to identify hemoglobin A1C Diabetes Specialist
people with elevated analyzer for use with
blood glucose, and mobile medical van
therefore help the 5c. Help with the Community
target population Diabetes Sunday Partners
understand the risk of activities at local
developing diabetes, churches with the
as well as providing American Diabetes
education about how Association
diabetes can be
delayed or prevented
7. To create a 7a. Invite interested Community October 2006 June 2008
community steering citizens, participants of Diabetes Specialist
committee,composed Diabetes Programs to
of key community and public health staff
members and public to form steering
health staff to provide committee
on-going feedback and 7b. Schedule meetings
create a plan for every other month to
sustainability for the discuss current projects
Diabetes Disparities and plan for
Project sustainability
7c. Work with the Weld
County Diabetes
Coalition to facilitate
communication
between health
professionals and the
Hispanic community
Health Disparities Grant Program funds
2007 -2008
LINE ITEM BUDGET FORMAT
Applicant: Weld County Department of Public Health and Environment
Project Title: Decreasing Diabetes Disparities in Weld County $307,883.88
(Round to the nearest dollar)
Fiscal Year 2007 Fiscal Year 2008 Total
(Yr. 1) (Yr.2) (Yr.1 and Yr. 2)
Personnel Expenses:
Community Diabetes Specialist: 1 @ 1.0 FTE $ 57,226.98 $ 65,476.36 $ 122,703.34
Diabetes Health Educator: 1 @ .75 FTE each 37,924.35 43,662.67 81,587.02
Administrative Assistant for budget: 2 hrs/week 2,227.95 2,314.12 4,542.07
Itemized Travel Expenses:
In area travel:(700 mi/month at$.425/mile $3272.50 3570 6842.50
For 11 months the first year
Itemized Contractual\Subcontracts:
Contract with CSU Extension for one Dining $2000 2000
with Diabetes(DWD)class for training
Contract with CDE/NP for diabetes self- 2000 2000 4000
management classes in Spanish 4/yr
KGRE Spanish Language radio 8000 8000 16000
Cross Cultural Train-the-Trainer Course 18000 18000
Itemized Supplies:
Gift cards for platica hostesses 1920 1920 3840
Pedometers 1000 1000
Notebooks for DWD classes 200 200 400
Provider Training Expenses 1000 1000 2000
Printing 1000 1000 2000
Materials/food for DWD classes 3000 3000 6000
Office Supplies(toner,paper,etc) 1000 1000 2000
Meeting Expenses 1000 1000 2000
Indirect: (Not to exceed 15%of Personnel,
Travel, Contractual\Subcontracts and Operating) 14,091.22 13,427.73 27,518.95
10.01%
Subtotal: $154,863.00 $147,570.88 $302.433.88
Itemized Equipment Expenses: (including
purchase/lease of vehicles) 1 PC+software 1350 1350
1 laptop+docking station+software 2400 2400
Cholestech Hemoglobin Ale Analyzer
Analayzer Test Cartridges(192) 1700 1700
Limited Facility Renovation Expenses:
Total Project Cost $160,313.00 $147,570.88 $307,883.88
Signature of Authorized Representative and Date
*For this grant purpose, State Fiscal Year 2007 includes July 1,2006 through June 2007. State Fiscal
Year 2008 included July 1,2007 through June 30,2008.
Attachment B
TASK ORDER CHANGE ORDER LETTER
[Date]
Task Order Change Order Letter Number**, Contract Routing Number** s** *****
State Fiscal Year 20**-20** *************** Proaram
,
This Task Order Change Order Letter is issued pursuant to paragraph*_*.of the Master Contract identified as
contract routing number** *** ***** and paragraph*. *. of the Task Order identified as contract routing number
** *** ***** and contract encumbrance number** *** **********. This Task Order Change Order Letter is
between the COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT and!LEGAL
NAME OF CONTRACTOR!. The Task Order has been amended by Task Order Option to Renew Letter**
contract routing number** *** *****, and/or Task Order Change Order Letter** contract routing number** ***
*****, if any. The Task Order,as amended,if applicable,is referred to as the"Original Task Order". This Task
Order Change Order Letter is for the current term of********* ** **** through********* **.****. The
maximum amount payable by the State for the work to be performed by the Contractor during this current term is
increased/decreased by********** Dollars,($*.**)for an amended total financial obligation of the State of
********** DOLLARS,($*.**). The revised specifications to the original Scope of Work and the revised Budget
are incorporated herein by this reference,made a part hereof,and attached hereto as"Attachment*" and
"Attachment*". The first sentence in paragraph_*.of the Original Task Order is modified accordingly. All
other terms and conditions of the Original Task Order are reaffirmed. This change to the Task Order shall be
effective upon approval by the State controller,or designee, or on ********* **, **** whichever is later.
Please sign,date, and return all** originals of this Task Order Change Order Letter by********* **,**** to the
attention of: ************ ************ Colorado Department of Public Health and Environment,4300
Cherry Creek Drive South, Mail Code***-***-**,Denver,Colorado 80246. One original of this Task Order
Change Order Letter will be returned to you when fully approved.
[LEGAL NAME OF CONTRACTOR] STATE OF COLORADO
(a political subdivision of the state of Colorado) Bill Owens,Governor
By: By:
Name: For the Executive Director
Title: DEPARTMENT OF PUBLIC HEALTH
FEIN: AND ENVIRONMENT
PROGRAM APPROVAL:
(Seal-Required)
By:
ATTEST(required):
By:
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:
Date:
Revised:11/5/04
Attachment C
TASK ORDER OPTION TO RENEW LETTER
[Date]
Task Order Option to Renew Letter Number**, Contract Routing Number** ***
State Fiscal Year 20**-20** Program
This Task Order Option to Renew Letter is issued pursuant to paragraph*_**.of the Master Contract identified by
contract routing number***** and paragraph*. ". of the Task Order identified by contract routing nwnber
** *** and contract encumbrance number" . This Task Order Option to Renew Letter is
between the COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT and JLEGAL
NAME OF CONTRACTOR). The Task Order has been amended by Task Order Change Order Letter**,contract
routing number** ******** and/or Task Order Option to Renew Letter**,contract routing number** ***
,if any. The Task Order,as amended,if applicable,is referred to as the"Original Task Order". This Task
Order Option to Renew Letter is for the renewal term of*********** **** through********* ",****. 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 increase/decrease of($*.**)of the amount payable from the previous term. The Budget for this renewal term
is incorporated herein by this reference,made a part hereof,and attached hereto as"Attachment*". The first
sentence in paragraph'_*.of the Original Task Order is modified accordingly. All other terms and conditions of
the Original Task Order are reaf fiimred. This Task Order Option to Renew Letter is effective upon approval by the
State Controller,or designee,or on **,***' whichever is later.
Please sign,date,and return all**originals of this Task Onkr Option to Renew Letter by *',"" to
the attention of: ,Colorado Department of Public Health and Environment,Mail
Code***-***-**,4300 Cherry Creek Drive South,Denver,Colorado 80246. One original of this Task Order
Option to Renew Letter will be returned to you when fully approved.
[LEGAL NAME OF CONTRACTOR] STATE OF COLORADO
(a political subdivision of the state of Colorado) Bill Owens,Governor
By: By:
Name: For the Executive Director
Title: DEPARTMENT OF PUBLIC HEALTH
FEIN: AND ENVIRONMENT
PROGRAM APPROVAL:
(Seal-required)
By:
ATTEST(required):
By:
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:
Date:
STATE OF COLORADO
Bill Owens,Governor
Dens E.Ellis,Executive Director
a4 ;
Dedicated to protecting and improving the health and environment of the people of Colorado r. �
4300 Cherry Creak Dr.S. Laboratory Services Division * i
Denver.Colorado 80246-1530 8100 Lowry Blvd. •re76•
Phone(303)892-2000 Denver,Colorado 80230-6928
TDD Line(303)691-7700 (303)692-3090 Colorado Department
Located in Glendale,Colorado of Public Health
http://www.cdphe.state.co.us and Environment
September 20, 2006
Weld County Department of Public Health&Environment
Attn: Gaye Morrison
1555 North 17a'Avenue
Greeley, CO 80631
Dear Ms. Morrison,
Enclosed is your copy of the Health Disparities Grant Program contract. The work may begin anytime
for this project. Some time in the next 1-2 weeks, a staff member from the Healtlf Disparities program
will be contacting you to provide you with the invoice to be used when seeking reimbursement.
Please contact me if you have any questionf relating to the finance aspect of this contract or you may
contact Carolyn Gissendanner-Borwick at(303) 692-2144 for any technical questions relating to your
project.
you,
Tracey Cl k
Grants& Contracts Manager
(303) 692-2154
tracey.clark(i4state.co.us
Hello