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Home My WebLink About20041358 RESOLUTION RE: APPROVE APPLICATION FOR COMMUNITY HEALTH INVESTMENT PROGRAM - PLATTE VALLEY MEDICAL CENTER 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 an Application for Community Health Investment Program from 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, Area Agency on Aging,to the Platte Valley Medical Center,with terms and conditions being as stated in said application, and WHEREAS,after review,the Board deems it advisable to approve said application,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 Application for Community Health Investment Program from 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,Area Agency on Aging,to the Platte Valley Medical Center be, and hereby is, approved. The above and foregoing Resolution was,on motion duly made and seconded,adopted by the following vote on the 10th day of May, A.D., 2004. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO 4.4142/44„ LQ__0‘ Ivo Robert D. Masden, Chair I Y•• t. lerk to the Board William H. Joe, Pro-Tem rk to the Board N M. J. e APPI3OV AS TO Davi:. Long my ttorney GI nn Vaad Date of signature: 6=/9.Zif 2004-1358 HR0075 Or fl-/C (9,ds--Oy MEMORANDUM DATE May 3, 2004 ITO: Glenn Vaad, Chair, Weld County Board of Commissioners. O FROM: Walter Speckman, Executive Director, Weld County Division of • COLORADO Human Services. SUBJECT: Weld County Area Agency on Aging, Application for Dental, Hearing and Vision Program Funds. Enclosed for Board approval is the Area Agency on Aging request for additional funding of$10,000.00 for the Dental, Hearing and Vision Programs from Platte Valley Medical Center— Community Health Investment Program. The funding will be used to continue dental, hearing and vision services to seniors 60 years of age and older who live in South Weld County. You may address questions to Eva Jewell, Director of the Area Agency on Aging at extension 3331 or Pete Archuleta, Program Coordinator at extension 3330. 2004-1358 General Information Applicant Weld County Area Agency on Aging Contact Person Eva Jewell, Director Address 1551 N. 17 Ave. , PO Box 1805, Greeley, CO 80632 Phone 970-353-3800, ext. 3330 Collaborating Organizations (priority will be given to projects involving collaborating organizations) Sunrise Community Health Center, Salud Family Health Clinic (Ft. Lupton & Frederick) , Department of Social Services, Old Age Pension Program. Proposal On no more than two (2) additional pages, describe the proposed project addressing the following: • Documented Need (i.e. research data, health statistics, etc...) • Expected Results of Project • Specific Objectives, Timetables and Process utilized to research project goals • How Results will be Measured Financial Information Total Cost for Program $ 20,000 Grant Amount Requested $ 10,000 Amount of Funding Available from other Sources $30,000 Give some details of how grant funds, if approved by the CHIP Committee, will be used: See Attached Pages. If the project or program is to continue beyond the time frame for which the grant is given, how will it be funded? From funds received from the State Grant. This application, with at least one additional proposal page, and a copy of the following must be submitted to the CHIP Committee: 1) Names and addresses of applicant officers and members of its Board of Directors or governing body. 2) Articles of Incorporation and By-laws or other documents which define the applicant's purposes, membership, management and operation. 3) Statute, regulation or the applicant's Internal Revenue Service letter which shows the applicant is exempt from Federal income taxes, is not a private foundation and that donors may deduct contributions to the applicant as provided in Section 170 of the Internal Revenue Code. 4)A financial audit or other financial information for the most recent three fiscal years. 5)A detailed budget for the proposal. All applications must be submitted to the CHIP Committee no later than the month ending previous to scheduled CHIP Committee meetings (The Committee meets the second Wednesday every other month as follows: January, March, May,July, September and November). COMMUNITY HEALTH INVESTMENT PROGRAM GRANT REQUEST FOR PROGRAM YEAR BEGINNING AUGUST 1, 2004 AND ENDING JULY 31, 2005. PROPOSAL: The Weld County Area Agency on Aging has received two grants from the CHIP Committee to expand our dental, hearing and vision program into South Weld County. When we submitted the first grant request, we believed that there was a need for these services in South Weld County. We had received funding from the State,but did not have sufficient funds to actively pursue eligible seniors in South County. With the funding we have received through the CHIP Committee, we have been able to supplement matching state funds to allow our dental program to expand into South County. With the funding we are scheduled to receive from the State and funding from the CHIP Grant, we hope to continue to offer the dental, hearing and vision services in Weld County. We are asking for your consideration in assisting to fund the programs for yet another year in South County. DOCUMENTED NEED: We have found that the need for dental, hearing and vision services continues to exist in South Weld County. We will continue to use the assistance of the Fort Lupton Senior Center, Salud Family Health Clinic and other agencies in South Weld County, to provide information to seniors regarding the dental, hearing and vision programs. Seniors in South Weld County have been instrumental in notifying other seniors about the services available. We believe there are still seniors in need of services in South Weld County and will do all we can to promote the programs to these seniors. We continue to get requests for information on the dental, hearing and vision services from children whose parents live in South Weld County. We are also beginning to work with seniors we have assisted in the past needing additional services. Because we have shown a need does exist in South Weld County for the dental, vision and hearing programs, we are again asking for assistance from the CHIP Committee in making it possible to provide these much needed services. EXPECTED RESULTS OF THE PROGRAM: For Program Year 2002-2003, The Weld County Area Agency on Aging Dental Program, set a goal to assist twenty three (23) seniors within the dental, vision and hearing programs with the $20,000 grant funds we received from the CHIP Committee for the Program Year 2002-2003. We based this goal on spending an average of$850.00 per participant. At the end of the Program Year 2002-2003, twenty eight(28) participants received either dental, vision or hearing services from our programs. The participant numbers were higher than expected because we were able to work with providers that were willing to offer a discount to seniors, thus allowing more participants to be eligible for assistance. We used the CHIP funding entirely to accomplish our goal. For the Program Year 2003-2004 we set a goal to provide services to thirty(30) seniors. As of the end of March 2004, we have been able to provide assistance to eighteen (18) seniors. We have thirteen (13) participants that have been approved for assistance and are in the process of receiving services. This will give us a total of thirty-one (31)participants who will receive assistance for the Program Year 2003-2004. Meeting our goal this Program Year will be accomplished by using the $10,000 CHIP grant funding and matching the CHIP grant of$10,000 with $10,000 of AAA funds. SPECIFIC OBJECTIVES, TIMETABLES AND PROCESS UTILIZED TO RESEARCH PROJECT GOALS. For the Program Year 2004-2005, we hope to assist thirty(30) seniors in South Weld County. This number is comparable to Program Year 2002-2003 and 2003- 2004. We will continue to coordinate with Salud Family Health Clinic, the Senior Center and the other agencies in South Weld who work with or have access to seniors in need of services. We will continue to advertise the programs in the Fort Lupton and surrounding areas. We will continue to encourage local doctors (vision, hearing and dental) to make referrals for seniors who may need assistance. With the continued marketing, we believe we will be able to meet the needs of more seniors in South County. HOW WILL RESULTS BE MEASURED? The participants and services provided through these programs are tracked using SAMS 2000, our agency software. This software allows us to continue to submit progress reports as required by the CHIP Committee. We will continue to call clients on a random basis to determine their level of satisfaction for services received Due to the funding received from the CHIP Committee, we have been able to expand our dental, hearing and vision programs into South Weld County. We have contacted providers in the area who have a genuine interest in assisting seniors in need of the services that we are offering. With the funds provided by the CHIP Committee these past two Program Years, the dental, vision and hearing programs in South Weld County have been a huge success. We have been able to supplement funds received from the State and the Older Americans Program with the CHIP Grant to provide these much needed services. With the success we had in South County these last two Program Years, and with additional funding from the CHIP Committee for the 2004-2005 Program Year; the programs again can be very successful. These past two years have shown that there is a major need for dental, vision and hearing assistance in South County. It is because of the success we have experienced that we are requesting additional funding for Program Year 2004-2005. Any funds received from the CHIP Committee will be used as supplemental funds needed to continue the dental, hearing and vision services in South Weld County. The State General Funds will continue as our primary source of funding for the three programs. Platte Valley Medical Center Community Health Investment Program 2003-2004 Expenditures through April 15, 2004 Jul -Sep _MILS AAA Match $ CHIP $ Total $ Admn $ 2,712.37 $ 2,712.37 Dental $ 2,760.00 $ 1,751.90 $ 1,751.90 $ 6,263.80 Optical $ 660.86 $ 308.50 $ 308.50 $ 1,277.86 Hearing $ 175.00 $ 175.00 $ 350.00 Oct- Dec Admn $ 881.40 $ 881.40 Dental $ 2,611.60 $ 2,902.50 $2,902.50 $ 8,416.60 Optical $ 704.00 $ 1,244.69 $ 1,244.69 $ 3,193.38 Hearing $ 875.00 $ 875.00 $ 1,750.00 Sub Total $ 10,330.23 $ 7,257.59 $7,257.59 $24,845.41 Jan - Mar Admn $ 2,593.98 $ 2,593.98 Dental $ 3,444.00 $ 1,896.00 $ 1,896.00 $ 7,236.00 Optical $ 2,385.00 $ 2,385.00 Hearing $ 350.00 $ 350.00 Sub Total $ 8,772.98 $ 1,896.00 $ 1,896.00 $ 12,564.98 April 15, 2004 Admn $ - Dental $ 252.00 $ 16.50 $ 16.50 $ 285.00 Optical $ 175.00 $ 175.00 $ 350.00 Hearing $ - Sub Total $ 252.00 $ 191.50 $ 191.50 $ 635.00 Grand Total $ 19,355.21 $ 9,345.09 $9,345.09 $38,045.39 NAMES AND ADDRESSES OF APPLICANT AND MEMBERS OF ITS BOARD OF DIRECTORS OR GOVERNING BODY. BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY, COLORADO 915 Tenth Street PO Box 758 Greeley, Colorado 80632 Robert D. Madsen, Chair Glenn Vaad David E. Long, M. J. Geile William "Bill"Jerke Weld County Area Agency on Aging Eva Jewell, Director Pete D. Archuleta. Program Coordinator 1551 N. 17th Avenue, PO Box 1805, Greeley, CO 80632 970-353-3800, ext. 3331 Weld County - Elected Officials - County Commissioners Page 1 of 2 , 1 r 1'Ve rme. ₹o sir r, �. Home it Services I Departments II About Weld I Property Information I Conta' •-••a L,f r'n,T � "".•Neptn x iu.a i=ahnam vu Home > Departments > Weld County Commissioners Weld County Commissioners .0a.--_....,lib ' I 1 � 'I i'F_ _8,, 4'0,x; 1 0 1 . ...j It 4: .-. n,. . x ww .._ 0104. District 1 District 2 District 3 1 _ .i t.t ,.IIIILe i David Long Glenn Vaad Rob Masden dlong@co.weld.co.us gvaad@co.weld.co.us rmasden@co.weld.co.us At-Larne At-Lar.e P lie F II? William "Bill" Jerke Mike Geile bjerke@co.weld.co.us mgeile@co.weld.co.us The five member Board of County Commissioners is the statutory head of Weld County's governme of the commissioners are elected at large and the other three are elected from the district in which reside. As is the case with all elected county officials, commissioners must be at least 21 years of a have resided in the county for at least one year prior to their election. Their elected position must t primary employment during the term they serve. As a board, the commissioners are required to establish a budget, levy taxes, appropriate funds for http://www.co.weld.co.us/departments/commissioners.html 5/3/2004 Weld County - Elected Officials - County Commissioners Page 2 of 2 business, establish fees and licenses, purchase or otherwise acquire, own, sell, lease, trade, and of deal in real and personal property in the name of the county, receive gifts and grants for the count' approve and execute contracts and lawsuits in the name of the county. The board also is required to sit as a board of appeals to hear complaints on actions taken by couni boards, commissions and departments, as a board of equalization to hear appeals on tax assessme a county board of welfare, and to make appointments to fill vacancies in all county offices except th board of commissioners and the county council. Each commissioner has primary responsibility for one of the county's five departments and serves assistant in another. The five departments are communication services, health services, planning si engineering services, and finance, administration, central purchasing, and personnel. Their respons rotate each year. The chairman of the Board of County Commissioners is chosen by the commissioners each year ant always serves as chairman of the finance and administration department during his tenure as chair the board. Commissioners are only allowed to serve two complete elected terms under charter provisions. The board meets at 9:00 a.m. each Monday and Wednesday in the first floor meeting room at the Centennial Center Complex, 915 10th Street, Greeley. Agendas and minutes of the Board of County Commissioners can be obtained by calling this office e 356-4000, extension 4217. Send correspondence to Weld County Commissioners at the following address: 915 Tenth Street P. O. Box 758 Greeley CO 80632 Phone: 970-336-7204 Fax: 970-352-0242 http://www.co.weld.co.us/departments/commissioners.html 5/3/2004 AREA AGENCY ON AGING BOARD MEMBERSHIP LIST Adella Andrijeski Betty Jones 26416 Range View Drive 1959 26th Ave Kersey CO 80644 Greeley CO 80634 H: (970) 350-0447 H: (970) 353-7295 Al Arriessecq Mary Jones 504 N. 715t Ave. 30887 Road 88 Greeley CO 80634 Ault CO 80610 H: (970) 351-7414 H: (970) 656-3652 Germaine (Geri) Arndt Nancy Meek 505 2"d Street 4267 15th Street Ln Ft Lupton CO 80621 Greeley Co 80634 H: (303) 857-0832 H: (970) 353-2850 Susan Bromley Josie Sanchez 1621 13th Ave PO Box 13 Greeley Co 80631 Pierce CO 80650 H: (970) 352-8750 W: (970) 351-2829 W: (970) 353-3373 H: (970) 834-2173 Ruth Gartrell Phil Shovar 20076 Southgate Ave 1805 19th Ave Lot 2 Greeley CO 80631 LaSalle CO 80645 H: (970) 304-9819 H: (970) 737-2942 Commissioner Glenn Vaad Patricia Graham Weld county Centennial Center 1638 27th Ave 914 10th Street Greeley CO 80634 Greeley CO 80631 W: (970) 351-1559 O: (970) 356-4000 voice mail 4207 H: (970) 356-1124 Diane Warren Michelle Adler 1000 10th Street 3412 Trinidad St Greeley CO 80631 Evans CO 80620 W: (970) 350-9713 H: (970) 506-1242 H: (970) 330-4912 W: (970) 395-6415 REVISED 3/31/04 my POLITICAL SUBDIVISION EXEMPTION CERTIFICATE (For use by States, Territories, or Political • Subdivision thereof, or the District of Columbia) • The undersigned hereby certifies that he is Comptroller Title of Officer of Weld County Government State, Territory, or Political Subdivision, or District of Columbia and that he is authorized to execute this certificate , and that the articles specified in the accompanying order or on the reverse side hereof, are purchased from • for the exclusive use of Department of Weld County Government - Greeley, Colorado State, Territory, or Political Subdivision, or District of Columbia • It is understood that the exemption from tax in the case of sales or articles under this exemption certificate to the State, Territory, or Political Subdivision, or District of Columbia, is limited to the sale of the article purchased for their exclusive use, and it is agreed that if articles purchased tax-free under exemption certificates are used otherwise or are sold to employees or others, such fact must be reported to the manufacturer of the articles covered • by this certificate. It is also understood that the fraudulent use of this certificate to secure exemption will subject the undersigned and all guilty . parties to a fine of not more than $10,000.00 or to imprisonment for not more than five years, or both, together with costs of prosecution. COLORADO SALES TAX CERTIFICATION OF EXEMPTION NUMBER - 98-03551 • FEDERAL TAX EXEMPTION NUMBER - 84-6000-813 STATE TAX EXEMPTION ND ER - 14-02-101 / Date Hello