HomeMy WebLinkAbout20040553 RESOLUTION
RE: APPROVE SEVEN PURCHASE OF SERVICE AGREEMENTS WITH VARIOUS
MIGRANT HEAD START PROVIDERS 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 seven Purchase of Service Agreements
with various Migrant Head Start Providers between the County of Weld, State of Colorado, by and
through the Board of County Commissioners of Weld County, on behalf of the Department of
Human Services, Family Educational Network of Weld County, and the following providers,with
further terms and conditions being as stated in said agreements:
1. Lyle Yost, DDS (dental services) -Term of March 1, 2004 through November 30,
2004
2. Walker Pharmacy (prescription services) - Term of February 2, 2004 through
November 30, 2004
3. Sodexho (food services) - Term of February 2, 2004 through November 30, 2004
4. Mike Ho, DDS (dental services)-Term of February 2,2004 through November 30,
2004
5. St. Mary's Family Practice Residency(health services)-Term of February 2, 2004
through November 30, 2004
6. Montrose Memorial Hospital (health services) - Term of March 1, 2004 through
November 30, 2004
7. Midwestern Mental Health Center(mental health services)-Term of February 29,
2004 through February 28, 2005
WHEREAS,after review,the Board deems it advisable to approve said agreements,copies
of which are attached hereto and incorporated herein by reference.
NOW,THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County,Colorado,that the seven Purchase of Service Agreements with various Migrant Head Start
Providers between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Human Services, Family
Educational Network of Weld County,and the above listed providers be,and hereby are,approved.
BE IT FURTHER RESOLVED by the Board that the Chair be,and hereby is,authorized to
sign said agreements.
2004-0553
HR0075
CO 11-pt
RE: SEVEN PURCHASE OF SERVICE AGREEMENTS WITH VARIOUS MIGRANT HEAD
START PROVIDERS
PAGE 2
The above and foregoing Resolution was,on motion duly made and seconded,adopted by
the following vote on the 23rd day of February, A.D., 2004, nunc pro tunc, February 2, 2004.
BOARD OF COUNTY COMMISSIONERS
LD COUNTY, COLORADO
Air
ATTEST: &4 / �I � ) . fL��� w)
Robert D. Maslen, Chair
Weld County Clerk to t B.• . tiVecp
,� =�
C� •� William H. rke, Pro-Tern
BY: 'L
Deputy Clerk to the 13oart l ,q
. eile
APP E S TO •
A4 C
id E. Long
o ty Attorney
Gle n Vaad
Date of signature:
2004-0553
HR0075
PURCHASE OF SERVICE AGREEMENT
THIS AGREEMENT, made and entered into this day of February, 2004, by and
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 Division of Human Services'
Family Educational Network of Weld County, Migrant/Seasonal Head Start Program,
hereinafter referred to as "FENWC" and Lyle Yost, D.D.S., hereinafter referred to as
"Dentist."
WITNESSETH
THAT FOR and in consideration of the covenants here in agreed to be kept and
performed, the Dentist hereby agrees to provide to FENWC the following described
services based upon the following terms and conditions:
1. FENWC agrees to arrange transportation for Head Start children to the dentist as
needed. This will enable parents to be transported with their children to attend their
child's scheduled appointment at the Dentist's office.
2. FENWC agrees to reimburse the Dentist $6.00 per child per screening not to
exceed $240.00 for up to forty (40) Head Start eligible children. All bills submitted
will be itemized according to child and service to:
Family Educational Network of Weld County
Migrant Head Start Program
attn: Julie Mallory
PO Box 1805
Greeley, CO 80632
4. FENWC will not be charged for those children covered by Medicaid or private
insurance. Medicaid numbers shall be provided at the time of the appointment and
billing will be sent to the appropriate agency by the Dentist. Head Start is a payer of
last resort.
5. For services not reimbursed by FENWC, the amount will be designated as In-Kind
Contribution to the FENWC Program on behalf of the Dentist and will be
documented on the bill.
6. The term of this Agreement is March 1, 2004 through November 30, 2004.
7. The Dentist assures that it carries adequate liability and malpractice insurance.
8. Assurances:
a. The Dentist agrees that he is an independent contractor and that his officers,
employees, and clients do not become employees of Weld County, and
therefore are not entitled to any employee benefits as Weld County
ahoy 6569
employees, as a result of the execution of this Agreement.
b. FENWC, the Weld County Board of Commissioners, its officers and
employees, shall not be held liable for injuries or damages caused by any
negligent acts or omissions of the Dentist, its employees, volunteers or
agents while performing this Agreement. The Dentist, its officers and
employees, shall not be held liable for injuries or damages caused by any
negligent acts or omissions of FENWC, the Weld County Board of
Commissioners, its officers and employees. The respective contracting
parties shall provide such liability insurance and worker's compensation
coverage as each deems appropriate, and as required by the Colorado
Worker's Compensation Act.
c. No portion of this Agreement shall be deemed to constitute a waiver of any
immunities the parties or their officers or employees may possess, nor shall
any portion of this Agreement be deemed to have created a duty of care with
respect to any persons not a party to this Agreement.
d. No portion of this Agreement shall be deemed to create an obligation on the
part of the County of Weld, State of Colorado, to expend funds not otherwise
appropriate in each succeeding year.
e. No officer, member, or employee of Weld County, and no member of their
governing bodies shall have any pecuniary interest, direct, or indirect in the
approved Agreement or the proceeds thereof.
f. The Dentist understands that monitoring and evaluation of the performance
of this Agreement shall be conducted by the Weld County Division of Human
Resources and the results provided to the Weld County Board of
Commissioners.
g. The Dentist and FENWC assure compliance with Title VI of the Civil Rights
Act of 1986, and that no person shall on the grounds of race, creed, color,
sex, handicap or national origin be excluded from participation in, be denied
the benefits of, or be otherwise subjected to discrimination under the
approved Agreement.
9. All modifications to this Agreement shall be in writing and signed by both parties.
10. This Agreement may be terminated by either party giving a thirty (30) days written
notice to the other party. If funding to FENWC should cease, this Agreement will
terminate immediately. If FENWC funding should be reduced, this Agreement will
be renegotiated immediately to reflect funding changes.
IN WITNESS WHEREOF, of the parties above hereunto placed their hands as of
the date first written above.
WELD COUNTY BOARD OF COMMISSIONERS DENTIST
Irt
)-{,14tv)s
Robert D. Masden, Chairperson i 3 2004 Lyle Yost, D.D.S.
ATTEST:Mid�S$ E La���
WELD COUNTY CLER
c't-1 r
By: %�►� / c)) . C 4
Deputy Clerk to the Bo. `. '11 N.
.►I
WELD COUNTY DIVISION OF HUMAN SERVICES
WaltitedS,
an, Executive Director
boa 5L-655.
PURCHASE OF SERVICES
THIS AGREEMENT, made and entered into this „22p) day of January, 2004, by and
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 Division of Human
Resources, Family Educational Network of Weld County's Summer Migrant Head Start
Program, hereinafter referred to as "FENWC" and the Walker Pharmacy hereinafter
referred to as " Pharmacy."
WITNESSETH
THAT for and in consideration of the covenants herein agreed to be kept and performed,
the pharmacy hereby agrees to provide to FENWC,the following described services based
upon the following terms.
1. The pharmacy will fill all prescriptions prescribed by a Medical provider licensed in
the State of Colorado brought to the said pharmacy for families/children enrolled in
a FENWC Migrant Head Start Center.
2. The pharmacy will use generic drugs whenever possible. Whether prescribed or
over the counter medications.
3. The pharmacy will write directions in both English and Spanish.
4. FENWC will supply prescription pads.
5. The pharmacy will submit a itemized bill, for children not covered by Medicaid or
private insurance, monthly for services to:
Family Educational Network of Weld County
Attention: Health Specialist
P.O. Box 1805
Greeley, CO 80632
FENWC will provide the Pharmacy with necessary insurance/Medicaid information.
6. No portion of this Agreement shall be deemed to constitute a waiver of any
immunities the parties or their officers or employees may possess, nor shall any
portion of this Agreement be deemed to have created a duty of care with respect to
any persons not a party to this Agreement.
7. No portion of this Agreement shall be deemed to create an obligation on the part of
the County of Weld, State of Colorado, or Pharmacy to expend funds not otherwise
appropriated in each succeeding year.
aOdy-/'S5S
8. The term of this Agreement shall be from February 2, 2004 through November 30,
2004.
9. This Agreement may be amended at any time with the written mutual consent of
both parties
10. Assurances:
1. The Pharmacy agrees that it is an independent contractor and that its
officers, employees, and clients do not become employees of Weld County,
and therefore are not entitled to any employee benefits as Weld County
employees, as a result of the execution of this Agreement.
2. FENWC, the Weld County Board of Commissioners, its officers and
employees, shall not be held liable for injuries or damages caused by any
negligent acts or omissions of the Pharmacy, its employees or agents while
performing this Agreement. The Pharmacy, employees, shall not be held
liable for injuries or damage caused by any negligent acts or omissions of
FENWC, the Weld County Board of Commissioners, its officers and
employees. The respecting contracting parties shall provide such liability
insurance and worker's compensation coverage as each deems appropriate,
and as required by the Colorado Worker's Compensation Act.
3. No officer, member, or employee of Weld County and no member of their
governing bodies shall have any pecuniary interest, direct or indirect, in the
approved Agreement or proceeds thereof.
4. The Pharmacy and FENWC assure compliance with Title VI of the Civil
Rights.
5. Act of 1986, and that no person shall, on the grounds of race, creed, color,
sex, handicap, or national origin be excluded from participation in, or denied
the benefits of, or be otherwise subjected to discrimination under the
approved Agreements.
IN WITNESS WHEREOF, the parties hereunto have caused this Agreement to be duly
expected as of the day, month, and year first herein above set forth.
WELD COUNTY BOARD OF WALKER PHARMACY
C 1:cl .,&
NTY COMMISSIONERS
A & UD------ ---e- _ Sviaikyrk
Robert D. Masden, Chairperson
FEB 2 3 2004
07 0047-06-63
LW/ E L
WELD COUNTY CLE T WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
M1
•
Deputy Clerk to the e:rte! LI Iter J. Speckman, Executive
Director
PURCHASE OF SERVICES
THIS AGREEMENT, made and entered into this day of February, 2004, by and
between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County Division of Human Resources, Family Educational
Network of Weld County's Migrant/Seasonal Head Start Program, hereinafter referred to
as "FENWC" and Sodexho hereinafter referred to as "Food Center."
WITNESSETH
THAT, for and in consideration of the covenants herein agreed to be kept and performed,
the Food Center hereby agrees to provide to FENWC, the following described services
based upon the following terms and conditions.
1. The Food Center will provide Breakfast for approximately seventy (70)
Migrant/Seasonal Head Start children and approximately twenty-one (21) adults at
a cost of one dollar and forty-three ($1.43) per meal. Price may be subject to
increase pursuant to board action.
2. The Food Center will provide lunch for approximately seventy (70)
Migrant/Seasonal Head Start children and approximately twenty-one(21)adults at
a cost of two dollars and sixth-six cents ($2.66) per meal. Price may be subject to
increase pursuant to board action.
3. The Food Center will provide two (2) snacks daily with 100% juice, or milk for
approximately seventy (70) Migrant/Seasonal Head Start children and
approximately twenty-one (21) adults at a cost of seventy-eight cents ($.78) per
snack. Price may be subject to increase pursuant to board action.
4. The Food Center will provide supper for approximately seventy (70)
Migrant/Seasonal Head Start children and twenty-one (21) adults at a cost of two
dollars and sixty-six cents ($2.66) per meal. Price may be subject to increase
pursuant to the board action.
5. FENWC will transport meals from the Food Center to the Head Start Center.
6. The Food Center will submit a bill for services by the 10th of the month for services
provided the preceding month. The Food Center agrees to provide information on
the cost of the quantity of meals served to enable FENWC to comply with USDA
reimbursement requirements. The bill should be submitted to:
The Family Educational Network of Weld County
Attn: Health Specialist
Post Office Box 1805
Greeley, Colorado 80632
7. FENWC will apply directly to USDA for reimbursement for each child's meal type
(full paid, free, or reduced) each month. The Food Center will not receive USDA
reimbursement for these meals.
8. FENWC agrees to pay the Food Center for all meals served and ala carte to the
Migrant/Seasonal Head Start children, Head Start children and staff. Such
reimbursement will be made within three (3) weeks of the receipt of a statement
of such changes from the Food Center. The rate will be as described in
paragraphs 1, 2, 3 and 4, above.
9. The Food Center agrees to provide meals in accordance with the regulations of
the United States Department of Agriculture's Child Care Food Program as
shown in attachment A hereto, which is hereby incorporated into this Agreement.
10. The Food Center will maintain the following records for FENWC:
a. Menu/Production Records, including number of meals prepared, menu,
portion sizes of menu items and amounts of food used to prepare menu
items. This is required at the preparation kitchen for all meals served.
b. The records will be made available upon request to FENWC for audit and
review purposes. The Food Center will maintain the records within the
record retention guidelines mandated by USDA.
11. FENWC will maintain a daily record of the number of meals served by type.
12. No portion of this Agreement shall be deemed to constitute a waiver of any
immunities the parties or their officers or employees may possess, nor shall any
portion of this Agreement be deemed to have created a duty of care with respect
to any persons not a party to this Agreement.
13. No portion of this Agreement shall be deemed to create an obligation on the party
of the County of Weld, State of Colorado, or Food Center to expend funds not
otherwise appropriated in each succeeding year.
14. If any section, subsection, paragraph, sentence, clause, or phrase of this
Agreement is for any reason held or decided to be unconstitutional, such
decision shall not affect the validity of the remaining options. The parties hereto
declare that they would have entered into this Agreement and each and every
section, subsections, paragraph, sentence, clause, and phrase thereof
irrespective of the fact that any one or more sections, subsections, paragraphs,
sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
15. The term of this Agreement shall be from February 2, 2004 through November
30,2004.
16. This Agreement may be amended at any time with the written mutual consent of
both parties.
17. The Food Center and FENWC mutually agree to accept that this agreement may
be terminated by either party upon a thirty (30) day written notice being provided
to the other party. However, this agreement will be terminated immediately if
Migrant Head Start funding is stopped.
18. Assurances:
a. The Food Center agrees that it is an independent contractor and that it's
officers, employees, and clients do not become employees of Weld
County, and therefore are not entitled to any employee benefits as Weld
County employees, as a result of the execution of this agreement.
b. FENWC the Weld County Board of Commissioners, its officers and
employees, shall not be held liable for injuries or damages caused by any
negligent acts or omissions of Food Center, the Board of action, its
employees, volunteers or agents while performing this Agreement. The
Food Center, its officers and employees, shall not be held liable for
injuries or damages caused by any negligent acts or omissions of
FENWC, the Weld County Board of Commissioners, its officers and
employees. The respective contracting parties shall provide such liability
insurance and worker's compensation coverage as each deems
appropriate, and as required by the Colorado Worker's Compensation
Act.
c. No officer, member, or employee of the Weld County and no member of
their governing bodies shall have any pecuniary interest, direct or
indirect, in the approved Agreement or proceeds thereof.
d. The Food Center understands that monitoring and evaluating of the
performance of this Agreement shall be conducted by the Weld County
Division of Human Resources and the results provided to the Weld
County Board of Commissioners.
e. The Food Center and FENWC assure compliance with the Title VI of the
Civil rights Act of 1986, and no person shall, on the grounds of race,
creed, color, sex, handicap, or national origin be excluded from
participation in, be denied the benefits of, or be otherwise subjected to
discrimination under the approved Agreements.
IN WITNESS WHEREOF, the parties hereunto have caused this Agreement to be duly
executed as of the day, month, and year first herein above set forth.
WELD COUNTY BOARD OF COMMISSIONERS
Robert D. Masden, C iairperson FEB 2 3 2004
SODEXHO
Mat D it ��E'�
By: ���// A , y. i--
Deputy Clerk to th19 at
WELD COUNTY DIVISION • U AN RESOURCES
W� c man, E� Director
aoa4L 0ss3
PURCHASE OF SERVICE AGREEMENT
THIS AGREEMENT, made and entered into this day of January, 2004, by and
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 Division of Human Services'
Family Educational Network of Weld County, Migrant Head Start Program, hereinafter
referred to as "FENWC"and Dr. Mike Ho, D.D.S., Skyline Dental hereinafter referred to as
"Dentist."
WITNESSETH
THAT FOR and in consideration of the covenants here in agreed to be kept and
performed, the Dentist hereby agrees to provide to FENWC the following described
services based upon the following terms and conditions:
1. FENWC agrees to arrange transportation for Head Start children to the dentist as
needed. This will enable parents to be transported with their children to attend their
child's scheduled appointment at the Dentist's office.
2. FENWC agrees to reimburse the Dentist $15.00 per child per
screening/examination not to exceed $1050.00 for up to seventy (70) Head Start
eligible children. Other dental services will be reimbursed according to the attached
fee schedule, not to exceed $5000.00. All bills submitted will be itemized according
to child and service to:
Family Educational Network of Weld County
Migrant Head Start Program
attn: Health Specialist
PO Box 1805
Greeley, CO 80632
4. FENWC will not be charged for those children covered by Medicaid or private
insurance. Medicaid numbers shall be provided at the time of the appointment and
billing will be sent to the appropriate agency by the Dentist. Head Start is a payer of
last resort.
5. For services not reimbursed by FENWC, the amount will be designated as In-Kind
Contribution to the FENWC Program on behalf of the Dentist and will be
documented on the bill.
6. The term of this Agreement is February 2, 2004 through November 30, 2004.
7. The Dentist assures that it carries adequate liability and malpractice insurance.
8. Assurances:
a. The Dentist agrees that he is an independent contractor and that his officers,
employees, and clients do not become employees of Weld County, and
therefore are not entitled to any employee benefits as Weld County
employees, as a result of the execution of this Agreement.
b. FENWC, the Weld County Board of Commissioners, its officers and
employees, shall not be held liable for injuries or damages caused by any
negligent acts or omissions of the Dentist, its employees, volunteers or
agents while performing this Agreement. The Dentist, its officers and
employees, shall not be held liable for injuries or damages caused by any
negligent acts or omissions of FENWC, the Weld County Board of
Commissioners, its officers and employees. The respective contracting
parties shall provide such liability insurance and worker's compensation
coverage as each deems appropriate, and as required by the Colorado
Worker's Compensation Act.
c. No portion of this Agreement shall be deemed to constitute a waiver of any
immunities the parties or their officers or employees may possess, nor shall
any portion of this Agreement be deemed to have created a duty of care with
respect to any persons not a party to this Agreement.
d. No portion of this Agreement shall be deemed to create an obligation on the
part of the County of Weld, State of Colorado, to expend funds not otherwise
appropriate in each succeeding year.
e. No officer, member, or employee of Weld County, and no member of their
governing bodies shall have any pecuniary interest, direct, or indirect in the
approved Agreement or the proceeds thereof.
f. The Dentist understands that monitoring and evaluation of the performance
of this Agreement shall be conducted by the Weld County Division of Human
Resources and the results provided to the Weld County Board of
Commissioners.
g. The Dentist and FENWC assure compliance with Title VI of the Civil Rights
Act of 1986, and that no person shall on the grounds of race, creed, color,
sex, handicap or national origin be excluded from participation in, be denied
the benefits of, or be otherwise subjected to discrimination under the
approved Agreement.
9. All modifications to this Agreement shall be in writing and signed by both parties.
10. This Agreement may be terminated by either party giving a thirty (30) days written
notice to the other party. If funding to FENWC should cease, this Agreement will
terminate immediately. If FENWC funding should be reduced, this Agreement will
be renegotiated immediately to reflect funding changes.
IN WITNESS WHEREOF, of the parties above hereunto placed their hands as of
the date first written above.
WELD COUNTY BOARD OF DENTIST
COUNTY COMMISSIONERS
Robert D. Masden, Chairperson FEB 2 3 7004 'Ek, Mike Ho D.D.S:,Skyline Dental
ATTEST: 4 #)/
WELD COUNTY CLE T!
By: a , _
Deputy Clerk to the ..rd i%1 m
WELD COUNTY DIVISION OF
HUMAN SERVICES
Walt eckman, Executive Director
aneS' 555
. FAMILY EDUCATIONAL NETWORK OF WELD COUNTY/MIGRANT HEAD START
DENTAL FEE SCHEDULE
�� iN i.,WINE) I�(�(r4..714L': :t i' I ' i{I,t10EN$ED DENTIST DENTAL GRADUATE STUDEItY ''PROCEDURE CODE P.RQ4� tU 'fiS � 1 i.
0120 PERIODIC ORAL EXAMINATION 14.00 7.00
0140 LIMITED ORAL EVALUATION/SCREENING 22.00 11.00
0210 FULL SERIES XR 36.00 18.00
0220 PERIAPICAL XR 10.00 5.00
0230 ADDITIONAL PERIAPICAL XR 6.00 3.00
0240 OCCLUSAL FILM 10.00 5.00
0272 TWO BITEWING XR 14.00 7.00
0274 FOUR BITEWING XR 18.00 9.00
0330 PANORAMIC FILM 38.00 19.00
1110 ADULT PROPHYLAXIS 31.00 15.50
1120 CHILD PROPHYLAXIS 22.00 11.00
1201 CHILD FLOURIDE W/PROPHY 30.00 15.00
1203 CHILD FLOURIDE W/O PROPHY 11.00 5.50
1204 ADULT FLOURIDE W/O PROPHY 12.00 6.00
1205 ADULT FLOURIDE W/PROPHY 30.00 15.00
1330 OHI 18.00 9.00
1351 SEALANT-PER TOOTH 18.00 9.00 !j{{j I (k(t
1510 UNILATERAL SPACE MAINTAINER-FIXED 81.00 All � li �II�H Fi(llinoilIl4 J II�,I3�{
6in,itNt 11111 illlI III IliiiNtlttIII slthl IIIIIldpi i,3
1515 BILATERAL SPACE MAITAINER-FIXED 137.00 III'iiiill IMil; 0I0 la Ili iti t t isI I u,tlt .
Hll!!�� +i
1520 SPACEMAINT-REMOVABLE-UNILATERAL 31.00 Ili l I ' 19 ll '1 1 ,,,,
ll
i 'el unllti ti lsi�pi it,r;�it t It, , ii i,s
1525 SPACE MAINT-BILATERAL REMOVABLE 87.00 k040009)tl3.itd40t}i14Clta10101N0040II,41 4i '
2110 ONE SURFACE AMALGAM,PRIM 31.00 15.50
2120 TWO SURFACE AMALGAM,PRIM 44.00 22.00
2130 THREE SURFACE AMALGAM,PRIM 56.00 28.00
2131 FOUR SURFACE AMALGAM,PRIM 69.00 34.50
2140 ONE SURF AMALGAM,PERMANENT 38.00 19.00
2150 TWO SURF AMALGAM,PERMANENT 50.00 25.00
2160 THREE SURF AMALGAM,PERMANENT 63.00 31.50
2161 FOUR SURF AMALGAM,PERMANENT 76.00 38.00
2330 ONE SURFACE RESIN 45.00 22.50
2331 TWO SURFACE RESIN 58.00 29.00
2332 THREE SURFACE RESIN 73.00 36.50
2335 FOUR SURFACE RESIN 80.00 40.00
2710 CROWN-RESIN(LABORATORY) 249.00 124.50
2751 PFM CROWN,BASE METAL 320.00 160.00
2791 CAST CROWN,BASE METAL 254.00 127.00
2920 RECEM ENT CROWN 50.00 25.00
2930 SSC,PRIMARY 73.00 36.50
2931 SSC,PERMANENT 102.00 51.00
2940 SEDATIVE FILLING 32.00 16.00
2§50 CORE BUILDUP(INCLUDING ANY PINS) 86.00 43.00
FAMILY EDUCATIONAL NETWORK OF WELD COUNTY/MIGRANT HEAD START
DENTAL FEE SCHEDULE
illi«tIaIIIithi.�{ o!i 0iiD > 11!!!iIIIHIIIIIII{IIMI III { i«i t�l � k4niDIioml I{I€III I I i�t `il����II�SjI}�ilr� �i «gDBNTAL(Ce{BAiDIIfo I�« ji�$i'i±i 't{IllIk ii ,
2980 CROWN REPAIR BY REPORT 60.00 30.00
3110 DIRECT PULP CAP 19.00 9.50
3220 PULPOTOMY 41.00 20.50
3310 RCT,SINGLE CANAL 190.00 95.00
3320 RCT,TWO CANALS 255.00 127.50
3330 RCT,THREE CANALS 337.00 168.50
3990 EMERGENCY ROOT CANAL 50.00 25.00
4241 ROOT PLANING,ONE QUADRANT 68.00 34.00
4355 GROSS DEBRIMENT 80.00 40.00
4910 PERIO MAINTENANCE 50.00 25.00
is r 11I j({IIIIIIiiI1ll€KIWI ( 31.;:
4999 PERIO PROCEDURES BY REPORT By Report 0919 I«rllri ii ) ' ti f II ( i Milli
5110 COMPLETE MAXILLARY DENTURE By Report 00'IIIIri II II'IIl{ l�llI1E�illltIll i {.; rt,'
� t1{ pii` I4UiI4 1
5120 COMPLETE MANDIBULAR DENTURE By Report S 3 I I i I£jiditi{iii 41
5211 UPPER PARTIAL-RESIN BASE By Report t ii 7{3{{ `! f {Iii i 4
P ItI11pi{}}� EE{{ X {{ II 14 I Ii�'���f�{��I����iitS4II'fil' i,
5212 LOWER PARTIAL-RESIN BASE By Report itpiiili JII Id liitt(„I �11111II III IIi....,
P I « I I t E (
r it(i!ii
5610 REPAIR RESIN DENTURE BASE By Report 3{ III• I N'i
P iftil 4Ii;�!(;�_j 'Ili{luiilut IS) !
5620 REPAIR CAST FRAMEWORK By Report I ( -{ I'I t4I ti�i
I I !I' Ho mono
5630 REPAIR OR REPLACE BROKEN CLASP By Report III MINI TIIIIII� Ir{��IIIIIIIIIB'i�6k,"
I=(( {MI I Ili li �i , (�
I0IP' ii«o«III'iili 4 i « i 1I Iii' « 4I 1 iliiill
5640 REPLACE BROKEN TEETH By Report s 4 uI
VIII yIn111111 i I06(961,;66:
5710 REBASE MAXILLARY DENTURE By Report 33 iki i₹iii li i.tk II II .
66
p Hit iitlVl I al.III I Ii 4,4,
5711 REBASE MANDIBULAR DENTURE By Report hut � �I 1... s II IIIfl IIP1ii{lih'k .,q i�
i r 131:Ilillt 116 11 r
5740 OFFICE RELINE,UPPER DENTURE By Report HI I � it!Of li,II! I i� ill li I!I 11111:
5741 OFFICE RELINE,LOWER DENTURE By Report {1Ip����I ����I]I3IiIiI1all IIIii IIHlIrati{Ii IIIhiI DI it!
7110 EXTRACTION,FIRST TOOTH 48.00 24.00
7130 REMOVAL OF EXPOSED ROOTS 66.00 33.00
7210 SURGICAL EXTRACTION-ERUPTED TEETH 91.00 45.50
7220 SOFT TISSUE EXTRACTION 80.00 40.00
7230 PARTIAL BONY EXTRACTION 109.00 54.50
7240 COMPLETE BONY EXTRACTION 109.00 54.50
7285 HARD TISSUE BIOPSY 87.00 43.50
7286 SOFT TISSUE BIOPSY 65.00 32.50
9110 EMERGENCY PALLIATIVE TREATMENT 22.00 11.00
9230 ANALGESIA(N2 O2) Up To 20.00 10.00
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9240 I.V.SEDATION By Report Dh 0II} 1i i 1 P0Iiti ll6F JI14 'I�rilri su;k,i{ I I r a kk}h
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9310 CONSULTATION/HOME VISIT 22.00 t
9630 DRUGS AND MEDICAMENTS By Report II lib�.I�I11in1 �«u i.
P I�IN + i« I P. ! Iit « kI pt94 ipgud n«Es �{F:
9920 BEHAVIOR MANAGEMENT Up To$30.00 II 1IH IIIIObIH I �I IbIIIHIIIIIHIIIIlllbIIIIIH{hIIIhIIII�
9997 FAILED APPOINTMENT Up To$20.00 IC)IIi1i Iiil lllil i{I VIII*I di {I I tl I«E i{:I/ *th i ik ll i ,'Y
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99909006919690069994911.9098094069999099994991106946%
PURCHASE OF SERVICES AGREEMENT
THIS AGREEMENT, made and entered into this day of January, 2004 by and 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 Division of Human Resources' Family Educational Network of Weld County
hereinafter referred to as "FENWC" and St. Mary's Family Practice Residency, hereinafter referred to as
"Health Center."
WITNESSETH
WHEREAS, FENWC is required to provide medical/dental services according to the Head Start
Performance Standards 45CFR 1304-1, 3,4, & 5.
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as
follows:
1. The Health Center shall provide the health services for the Migrant Head Start eligible children.
Services and appropriate documentation will be complete by the end of the program year.
a. The Health Center will schedule appointments for referred children, for preventive health
care, i.e., physical examinations and immunizations.
The Health Center will see ill children at the clinic, as needed and assess children who
may be in need of medical services.
b. FENWC will provide transportation for children and families to make appointments as
necessary.
2. The Health Center agrees to provide all physical examinations and update immunizations,
hematocrit, blood pressure, hearing , vision, and height and weight necessary for any Migrant
Head Start child.
3. FENWC agrees to reimburse the Health Center at the rate of$30.00 per encounter, for health
services not to exceed 500. for a total reimbursement not to exceed $15,000.00. Children must
have a written referral to receive services above and beyond Physical Examinations.
Prescriptions will not be covered in the above cited rate.
4. FENWC will not be charged for those children covered by Medicaid or private insurance.
Medicaid numbers shall be provided at the time of the appointment and the Health Center shall
send the billing to the appropriate agency.
5. The Health Center will submit itemized bills according to child and service to:
Family Educational Network of Weld County
Migrant Head Start Program
attn: Health Specialist
PO Box 1805
Greeley, CO 80632
6. This Agreement may be modified upon the written consent of both parties.
7. Services provided by the Health Center that are not reimbursed by FENWC will be designated as
a non-federal match/in-Kind contribution to the FENWC Program on behalf of the Health Center.
Non-Federal Match/In-Kind Contributions must be submitted with the bills.
8. The Health Center and FENWC mutually agree that this Agreement may be canceled by either
party after a thirty(30) day written notice. This Agreement will be terminated immediately in the
event funding for the Head Start Program is stopped.
9. The term of this Agreement is from February 2, 2004 through November 30, 2004.
10. The Health Center assures that it carries adequate liability and malpractice insurance.
11. Assurances:
a. The Health Center agrees that it is an independent contractor and that its officers,
employees, and clients do not become employees of Weld County, and therefore are not
entitled to any employee benefits as Weld County employees, as a result of the execution
of this Agreement.
b. FENWC, the Weld County Board of Commissioners, its officers and employees, shall not
be held liable for injuries or damages caused by any negligent acts or omissions of the
Health Center, its employees, volunteers, or agents while performing this Agreement.
The Health Center, its officers and employees, shall not be held liable for injuries or
damages caused by any negligent acts or omissions of FENWC, its employees,
volunteers, or agents while performing functions as described in this Agreement. The
Health Center shall provide adequate liability and worker's compensation insurance for all
of its employees, volunteers agents engaged in the performance of this Agreement, as
required by the Colorado Worker's Compensation Act. Likewise, FENWC, by and
through the Board of Weld County Commissioners, shall provide adequate liability and
workers'compensation insurance for all employees of FENWC engaged in the
performance of this Agreement.
c. No officer, member, or employee of Weld County and no member of their governing
bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or
the proceeds thereof.
d. The Health Center understands that monitoring and evaluation of the performance of this
Agreement shall be conducted by the Weld County Division of Human Resources and the
results provided to the Weld County Board of Commissioners.
e. The Health Center and FENWC assure compliance with Title VI of the Civil Rights Act of
1986, and that no person shall, on the grounds of race, creed, color, sex, handicap, or
national origin be excluded from participation in, be denied the benefits of, or be
otherwise subjected to discrimination under the approved Agreement.
IN WITNESS WHEREOF, the parties hereunto have caused this Agreement to be duly executed
as of the day and year first herein above set forth.
WELD COUNTY BOARD OF ST. MARY'S FAMILY PRACTICE
C NTY COMZSIONE� RES E �
Robert D. Masden, Chairperson Robert Ladenbu er, CEO
FEB 2 3 2004
WELD COUNTY DIVISION
OF HUMAN SERVICES
Walt Qr J. eck an, Executive Director
„vinO1-O SS3
ATTEST: jail � ' '' !" za```
By: n a�1
Deputy Clerk to the t a
g A
PURCHASE OF SERVICES AGREEMENT
THIS AGREEMENT, made and entered into this /, day of February, 2004 by and 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 Division of Human Resources' Family Educational Network of Weld County
hereinafter referred to as "FENWC" and the Montrose Memorial Hospital, Olathe d.b.a., Olathe Medical
Clinic hereinafter referred to as "Health Center."
WITNESSETH
WHEREAS, FENWC is required to provide medical/dental services according to the Head Start
Performance Standards 45CFR 1304-1, 3,4, & 5.
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as
follows:
1. The Health Center shall provide the health services for the Migrant/Seasonal Head Start Centers
located at 290 Hap Court, Olathe. Services and appropriate documentation will be complete by
the end of the program year.
a. The Health Center will schedule appointments for referred children.
b. The Health Center will see ill children at the clinic, as needed and assess children who
may be in need of medical services.
b. FENWC will provide transportation for children and families to make appointments as
necessary.
2. The Health Center agrees to provide physical examinations as needed and update
immunizations, hematocrit, blood pressure, hearing, vision, and height and weight necessary for
any Migrant Head Start child.
3. FENWC agrees to reimburse the Health Center at the rate of$25.00 per child, for health services
not to exceed 200, physical examinations for$25.00 per child not to exceed 50, and
immunizations at $5.00 per shot not to exceed 40 shots for a total reimbursement not to exceed
$6,450.00. Children must have a written referral to receive services above and beyond Physical
Examinations. Prescriptions will not be covered in the above cited rate.
4. FENWC will not be charged for those children covered by Medicaid or private insurance.
Medicaid numbers shall be provided at the time of the appointment and the Health Center shall
send the billing to the appropriate agency.
5. The Health Center will submit itemized bills according to child and service to:
Family Educational Network of Weld County
Migrant Head Start Program
attn: Julie Mallory
PO Box 1805
Greeley, CO 80632
6. This Agreement may be modified upon the written consent of both parties.
7. Services provided by the Health Center that are not reimbursed by FENWC will be designated as
a non-federal match/in-Kind contribution to the FENWC Program on behalf of the Health Center.
Non-Federal Match/In-Kind Contributions must be submitted with the bills.
8. The Health Center and FENWC mutually agree that this Agreement may be canceled by either
party after a thirty(30)day written notice. This Agreement will be terminated immediately in the
event funding for the Head Start Program is stopped.
Y
9. The term of this Agreement is from March 1, 2004 through November 30, 2004.
10. The Health Center assures that it carries adequate liability and malpractice insurance.
11. Assurances:
a. The Health Center agrees that it is an independent contractor and that its officers,
employees, and clients do not become employees of Weld County, and therefore are not
entitled to any employee benefits as Weld County employees, as a result of the execution
of this Agreement.
b. FENWC, the Weld County Board of Commissioners, its officers and employees, shall not
be held liable for injuries or damages caused by any negligent acts or omissions of the
Health Center, its employees, volunteers, or agents while performing this Agreement.
The Health Center, its officers and employees, shall not be held liable for injuries or
damages caused by any negligent acts or omissions of FENWC, its employees,
volunteers, or agents while performing functions as described in this Agreement. The
Health Center shall provide adequate liability and worker's compensation insurance for all
of its employees, volunteers agents engaged in the performance of this Agreement, as
required by the Colorado Worker's Compensation Act. Likewise, FENWC, by and
through the Board of Weld County Commissioners, shall provide adequate liability and
workers'compensation insurance for all employees of FENWC engaged in the
performance of this Agreement.
c. No officer, member, or employee of Weld County and no member of their governing
bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or
the proceeds thereof.
d. The Health Center understands that monitoring and evaluation of the performance of this
Agreement shall be conducted by the Weld County Division of Human Resources and the
results provided to the Weld County Board of Commissioners.
e. The Health Center and FENWC assure compliance with Title VI of the Civil Rights Act of
1986, and that no person shall, on the grounds of race, creed, color, sex, handicap, or
national origin be excluded from participation in, be denied the benefits of, or be
otherwise subjected to discrimination under the approved Agreement.
IN WITNESS WHEREOF, the parties hereunto have caused this Agreement to be duly executed
as of the day and year first herein above set forth.
WELD COUNTY BOARD OF OLATHE MEDICAL CLINIC
C NTY CO MISSIONERS
Robert D. Masden, Chairperson FEB 2 3 2004
to WE� TY I IVISI N OF HUMAN SERVICES
Wa ckman, Executive Director
_?co sr-o 553
ATTEST: �/ �/� E La
By: ti1'
Deputy Clerk to the Boat. , MontroselfAemorial Hospital
PURCHASE OF SERVICE AGREEMENT
This Agreement made and entered into this day of February, 2004, by and 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 Division of Human
Resources' Family Educational Network of Weld County Migrant Seasonal Head Start
Program, hereinafter referred to as "FENWC," and Midwestern Mental Health Center,
hereinafter referred to as "Mental Health."
WITNESSETH:
WHEREAS, FENWC is required to provide therapeutic services for
Migrant/Seasonal Head Start eligible children, in accordance with 45-CFR-1304,
Migrant/Seasonal Head Start Performance Standards, and
WHEREAS, FENWC wishes to provide consultation services to parents of Migrant
Head Start eligible children and families, and
WHEREAS, Mental Health has the staff and facilities to provide such services, and
WHEREAS, the parties wish to establish an on-going policy for the provision of
services.
NOW, THEREFORE, in accordance with the mutual benefits, responsibilities, and
considerations set forth herein, the parties hereto covenant and agree as follows:
1. Engagement of Mental Health. FENWC hereby retains Mental Health and Mental
Health hereby accepts engagement by FENWC upon the terms and conditions
hereinafter set forth.
2. Term. Subject to provisions contained herein, the term of the Agreement shall
commence on February 29, 2004 through February 28, 2005. This Agreement shall
be subject to review and renewal by the parties annually.
3. Nature of Agreement. During the term of the Agreement, Mental Health agrees to
make its services available to FENWC. The maximum number of hours of service
520 hours annually as mutually agreed to by FENWC and Mental Health. Hours are
to be determined by the Head Start Center Director, the Western Slope Regional
Director and the FENWC Disabilities and Mental Health Specialist on a weekly
basis.
4. Scope of Work. Mental Health will provide the following mental health services to
FENWC Head Start and Migrant/Seasonal Head Start eligible families, children, and
staff:
• Assist in planning and administering bilingual/multi-cultural mental health
program activities and services.
Train Migrant/Seasonal Head Start Staff.
➢ Observe children and consult with teacher and other staff.
• Assist in providing special help for children with atypical behavior or
development.
➢ Orient parents and work with them to achieve the objectives of the mental
health program. Provide group and individual therapy, as appropriate.
➢ Take appropriate steps in conjunction with health and education services to
refer children for diagnostic examination to confirm that their emotional or
behavioral problems do not have a physical basis.
➢ Provide mental health related services to FENWC staff.
The scope of such services shall be guided by FENWC. Mental health services shall be
provided to those children and families referred by FENWC. Mental Health shall provide
FENWC with written reports summarizing said services which shall fulfill the legal
requirements of the parties hereto. Such reports shall be maintained by FENWC.
5. Scheduling of Engagements. Mental Health shall schedule services so as to be
rendered during hours meeting the needs of FENWC and its clients. Hours are to
be determined by the Head Start Center Director, the Western Slope Regional
Director and the FENWC Disabilities and Mental Health Specialist on a weekly
basis.
6. Equipment and Supplies. FENWC shall provide Mental Health with all facilities,
equipment, supplies, and the like, as are reasonably necessary in order for Mental
Health to perform its obligations under the Agreement. Notwithstanding the
foregoing, Mental Health shall supply small portable equipment as is usual for such
- services.
7. Nature of Relationship. The relationship between FENWC and Mental Health is
strictly that of independent entities and is not an agency or employment relationship.
No party is an employee, agent or representative of any other party by virtue of this
Agreement nor shall any such party have any expressed or implied right to authority
to assume or create any obligation or responsibility on behalf of or in the name of
any other party by virtue of the Agreement. Contractor also acknowledges that it will
not be entitled to participate, by reason to this Agreement, in any employee benefits
provided by FENWC. FENWC as contracted to receive services only and is
interested in the results of Mental Health's efforts. Mental Health shall be solely and
entirely responsible for its own acts and omissions during the performance of this
Agreement.
8. Mental Health Representatives. In connection with the mental health services
provided hereunder, FENWC will interact administratively with such individual as
Mental Health may designate. The Mental Health Program Director shall assign a
therapist who is registered with the Colorado Department of Regulatory Agencies, or
is clinically supervised by an individual who is so registered, to provide services
pursuant to this Agreement. By registration, it is understood that the mental health
therapist or his/her supervisor shall be a graduate of an accredited mental health
curriculum and in good standing with his/her accrediting organization.
9. Billing Information. Immediately following the provision of services, Mental Health
shall provide to FENWC on a form that is acceptable to both parties, specific billing
and utilization information for the services rendered. This bill will include the
Contracted Provider Tracking Sheet (Attached) signed by the center director and
the regional director. Mental Health shall make available to FENWC all financial
records relating to Mental Health's services at the request of FENWC. Mental
Health shall submit to FENWC, an aggregate statement listing all charges and the
Contracted Provider Tracking Sheet on a monthly basis.
10. Fees. Mental Health shall charge FENWC for services performed on an hourly
basis. Services for consultation with teachers, work with families, and individual
children shall be calculated at the rate of$25.00 per hour, 520 units per year, not to
exceed a total cost of$13,000.00. Medicaid or private insurance will be billed first
for the families that have coverage before FENWC will be billed. Services for
Migrant Head Start staff shall be calculated at the hourly rate of$60.00 per hour for
staff with no health insurance or limited benefits for mental health services.
Services for medications needed for mental health issues shall be calculated as
$100.00 for an initial visit and $75.00 for each additional visit after. Supplies, if
necessary and authorized by FENWC, shall be payable at the Meant Health's usual
and customary charge. Preparation of evaluation reports, preparation and
attendance at staffing and all other consulting services is included in the
aforementioned fee schedule of$25.00 per hour. Under no circumstances may the
fee schedule be modified without the express prior written authorization of the
parties hereto.
11. Compensation. In consideration of the rehabilitation services provided by Mental
Health, FENWC shall pay Mental Health within thirty (30) days from receipt of
Mental Health's aggregate monthly statement.
12. Confidentiality. Mental Health and FENWC agree not to disclose any personal or
privileged information to third parties without first obtaining the written consent of
responsible party thereof, unless otherwise permitted or required under applicable
law.
13. Indemnification. Mental Health shall indemnify, defend and hold harmless
FENWC from any claims, losses, damages, liabilities, costs, expenses or
obligations, including but not limited to attorneys' fees, court costs and punitive or
similar damages, arising out of or resulting from any act or omission by Mental
Health or any of its employees, agents or representatives in the furnishing of mental
health services or supplies, or arising out of or resulting from the negligent,
fraudulent, dishonest or other acts or omissions of Mental Health or its employees,
agents or representatives in its performance under the terms of this Agreement.
Likewise, FENWC, the Weld County Board of County Commissioners, its officers
shall indemnify, defend and hold harmless Mental Health from any claims, losses,
damages, liabilities, costs, expenses or obligations, including but not limited to
attorneys' fees, court costs and punitive or similar damages, arising out of or
resulting from any act or omission by FENWC or any of its employees, agents of
representatives in the furnishing of comprehensive educational services of supplies,
or arising out of or resulting from the negligent, fraudulent, dishonest or other acts of
omissions of FENWC or its employees, agents or representatives in its performance
under the terms of the Agreement.
14. Representations. Mental Health neither represents nor warrants that the services
provided hereunder shall assure FENWC of accreditation or licensure by the
Colorado Department of Social Services, Colorado Department of Education, by any
other accrediting body, or by any licensing agency.
15. Employment Covenant. It is agreed and understood by both parties that neither
Mental Health nor FENWC shall hire or attempt to hire the other party's employees
during the term of this Agreement or for a period of twelve (12) months thereafter,
without mutual consent.
16. Liability Insurance. Mental Health will carry at its own expense professional
liability insurance coverage in the amounts equal to at least $1 ,000,000 annual in
aggregate.
17. Termination. Either Mental Health or FENWC may terminate the independent
contractor relationship established by this Agreement with or without cause, by
giving thirty (30) days written notice to the other party.
18. Interruptions. Neither party to this Agreement shall be liable to the other for delays
in delivery of failure to deliver or otherwise to perform any obligation under this
Agreement, where such failure is due to any cause beyond his reasonable control,
including but not limited to Acts of God, fire, strikes, war, flood, earthquakes or
Governmental action.
19. Entire Agreement, Amendment, Waiver. This Agreement merges all previous
negotiations between the parties hereto and constitutes the entire agreement and
understanding between the parties with respect to the subject matter of this
Agreement. No alteration, modification or change of this Agreement shall be valid
except by an agreement in writing executed by the parties hereto.
20. Notices. Any notice required to be given under this Agreement shall be in writing
and shall be sent by certified mail, return receipt requested, postage pre-paid, to
Mental Health at:
Midwestern Mental Health Center
P.O. Box 1208
Montrose, CO. 81402
ATTN: Marion Ring
And to FENWC at:
Weld County Division of Human Services
Family Educational Network of Weld County
PO Box 1805
Greeley, CO 80632
ATTN: Terril Rector, Ph.D.
21. Assignment. This Agreement is not assignable by FENWC without the express
written consent of Mental Health.
22. Severability. If any provision of this Agreement or the application thereof to any
person or circumstance shall be invalid or unenforceable to any extent, it is the
intention of the parties that the remainder of this Agreement and the application of
such provision to other persons or circumstances shall not be affected thereby and
shall be enforced to the greatest extent permitted by law.
23. Captions. The captions contained in this Agreement are for convenience or
reference for the parties and are not intended in any manner whatsoever to
construe, define or limit the scope or intent of this Agreement or any provisions
hereof.
24. Counterparts. This Agreement may be executed in one or more counterparts,
each of which when so executed shall be an original, but all of which together shall
constitute one agreement.
IN WITNESS WHEREOF, the parties hereunto have caused this Agreement to be duly
executed as of the day and year first herein above set forth.
Weld County Board of County Midwestern Mental Health Center
Commissioners
,,di\a :\O • ii
Robert D. Masden, Chairperson Jon Gordon M. Ed., Executive Director
FEB 232004
Division of Human Services
Walt1#12a44
kman, Executive Director
Attest:
Weld County Clerk to , e�p
I., , E.<(,
By: Y � cff° t
ik
Deputy Clerk to the Board m k\
ATTESTING TO BOARD OF COUNTY
COMMISSIONER SIGNATURES ONLY
oOV-O SS3
Contracted Provider Tracking Sheet
To be rcturnctI to Menial Health and Disabilities Specialist at
tIiNW(`Ilead Start with bill for services
MONTH---
CCSL+' SLP 01' PT kin NAME
Location:
Home/ HS INC). OR GROUP/ CD
CENTER/ Time Time Purpose Therapy,Observation, Training OTHERS IN GROUP SIGN
CHILD'S/GROUP NAME DATE Other Started Ended for Staff
Regional Director Signalure_
jf,,; MEMORANDUM
DATE: February 19, 2004
ipC. TO: Robert D. Masden, Chair, Board of CountyWICommissioners
COLORADO FROM: Walt Speckman, Executive Director ' I jy01
SUBJECT: Purchase of Service Agreements with Various
Migrant Head Start Providers
Enclosed for Board approval are Purchase of Service Agreements between the Weld County Division
of Human Services' Family Educational Network's Migrant Head Start Program and the following
providers:
1. Lyle Yost,DDS -Provide dental screenings for up to 40 Migrant/Seasonal Head Start children.
2. Walker Pharmacy-Fill prescriptions prescribed by a Medical provider licensed in the State of
Colorado for families/children enrolled in the Migrant Head Start Program.
3. Sodexho - The Food Center will provide Breakfast at a cost of$1.43 per meal, Lunch at a cost
of$2.66 per meal, 2 Snacks at a cost of$.78 per snack, and Supper at a cost of$2.66 per meal
for approximately 70 Migrant/Seasonal Head Start children and approximately 21 adults.
4. Mike Ho,Skyline Dental-Provide dental screening/examination for up to 70 Migrant/Seasonal
Head Start children.
-5. thpin B3h1er -Coordinate health se c and collaboration beY ecn,the familie's of
]R�egi children, lth c ios/ der d WC st .N 'N/' N
N
6. St. Mary's Family Practice Residency - Provide health services for Migrant/Seasonal Head
Start children, i.e., physical examinations and update immunizations, provide needed medical
services to ill children. J y
A /'A. .' V � . A
7. R p1iie Calde,}oue - C dfhate heth'servic and collab6iationbetween the/'afi ilies of
Par a ch fen,' ealt}-c1in / wider and FE C staff. `vN��' \\ - " N
8. Montrose Memorial Hospital - Provide health services for Migrant/Seasonal Head Start
children,i.e.,physical examinations and update immunizations,provide needed medical services
to ill children.
9. Beth BIAS- C96raipate and dyersee Indivichl 1 Education Plans(IB#ys)/Thdividual Family
Se ice Plans SP's)and collaboratidn between theytilies of childCen with abilities, d
ocal Education Age es (LEAs `,\ /: \ vy
10. Midwestern Mental Health Center-Provide mental health services to FENWC Head Start and
Migrant/Seasonal Head Start eligible families, children, and staff.
2004-0553
If you have further questions, please call me at extension 3317.
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