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Home My WebLink About20041315.tiff RESOLUTION RE: APPROVE TASK ORDER OPTION TO RENEW LETTER#3 FOR FAMILY PLANNING 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 Task Order Option to Renew Letter#3 for Family Planning 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 July 1, 2004, and ending June 30, 2005, with further terms and conditions being as stated in said letter of renewal, and WHEREAS,after review,the Board deems it advisable to approve said letter of renewal,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 Task Order Option to Renew Letter#3 for Family Planning 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 letter of renewal. The above and foregoing Resolution was,on motion duly made and seconded,adopted by the following vote on the 5th day of May, A.D., 2004. BOARD OF COUNTY COMMISSIONERS !f9' WE COUNTY CO ORAD Robert D. Masden, Chairi i�� I Strto "44•41.- William H erke, Pro-Tem er to the Board /tsr M. J...-ile APP AS TO F • �� David . Long I C � my Attorney I'nn Vaad Date of signature: 3---)11-sty 2004-1315 ll HL0031 Memorandum WING TO: Rob Masden, Chair Board of County Commissioners From: Mark E. Wallace,MD, MPH,Director COLORADO Department of Public Health an Environment 44Q I DATE: April 29,2004 SUBJECT: Option to Renew Letter#3 for the Family Planning Program Enclosed for Board review and approval is Task Order Option to Renewal Letter#3 between the Colorado Department of Public Health and Environment (CDPHE) and Weld County for the Family Planning Program. Under the provisions of this renewal letter, Weld County will be reimbursed an amount not to exceed $146,002 for the time period July 1, 2004 through June 30, 2005 for the Department of Public Health and Environment to provide contraceptive services to both men and women in their reproductive years. These services will include education and counseling, comprehensive health and social histories, physical examinations, supplies, follow-up and/or referral services. I recommend your approval of this option to renew letter. Enclosure 2004-1315 RECEIVED MAY 2 6 2004 April 27,2004 TASK ORDER OPTION TO RENEW LETTER Attachment D Task Order Option to Renew Letter Number#3. Contract Routing Number 05 FLA 00023 State Fiscal Year 2004-2005 Family Planning Program This Task Order Option to Renew Letter is issued pursuant to paragraph D. of the Master Contract identified by contract routing number 00 FAA 00008 and paragraph C.4. of the Task Order identified by contract routing number 02 FLA 00026 and contract encumbrance number PO FLA FPP0200026. This Task Order Option to Renew Letter is between the COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT and BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY. The Task Order has been amended by Task Order Option to Renew Letter#2 contract routing number 04 FLA 00074 Task Order Option to Renew Letter #1 contract routing number 03 FLA 00041 Task Order Change Order Letter#1,contract routing number 02 FLA 00�and Task Order Change Order Letter#2 contract routing number 03 FLA 00258.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 July 01,2004 through June 30 2005. The maximum amount payable by the State for the work to be performed by the Contractor during this renewal term is One Hundred Fortv_Six Thousand,Two Dollars ($146,002.00)for an amended total financial obligation of the State of Fm6 LIwJM&D t.)C JTV- S Ix holt ft3b <I 4linbjLN 1WCI T$V E 130 s 0524,,9Ar co ). This is an increase of ef It+tai D 7.OQI of the amount payable from the previous term. She Budget for this renewal term is incorporated heiem by this reference, made a part hereof, and attached hereto as"Attachment 1". The first sentence in paragraph C. of the Original Task Order is modified accordingly. All other terms and conditions of the Original Task Order are reaffirmed. This Task Order Option to Renew Letter is effective upon approval by the State Controller, or designee,or on July 01,2004 whichever is later. Please sign,date,and return all 4 originals of this Task Order Option to Renew Letter by June 01.2004.to the attention of: Laura Montoya,Colorado Department of Public Health and Environment,Mail Code: PSD-WHS-A5,4300 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. BOARD OF COUNTY COMMISSIONERS OF STATE OF COLORADO WELD COUNTY Bill Owens,Governor (a political subdivision of the state of Colorado) for the use and benefit of WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT By: Sun By: Name: Robert D. Masden 05/05/2004 For the Executive D ector Title: Cha i r +si` DEPARTMENT O UBLIC HEALTH FEIN: 8460018 , B i AND ENVIRONME etA (Se PROGRAM APPROVAL: .1 1861 (' J• �.'. . ., //� By: .. %; ' By: P.vtf��YL.IM.*r&(_PP ALL CONTRAC�` � D BY THE STATE CONTROLLER CRS 24-30-202 requires that the State !lla,, Sprove 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: Arthur L. Barnhart WELD COUNTY DEPARTMENT OF PUBLIC HALF: D EN MENT By: Date: _ 7_ o€-f BY. Revised:08/30/02 Mark E. Wallace, MPH•D' Attachment 1 Agency/Institution Name: Colorado Department of Public Health and Environment Contractor's Legal Name: Board of County Commissioners of Weld County Contract Routing Number of the Original Contract or Task Order: 02 FLA 00026 Contract Encumbrance Number of the Original Contract or Task Order: PO FLA FPP0200026 Term of the Original Task Order: July I,2001 -June 30,2002 Current Award: Title X federal funding from the United States government provides: S 96,178.00 for routine family planning services (to be billed at $ 16,029.67 a month,July through December). All federal funds must be fully expended by December 31,2003. Funding source from the State of Colorado provides: $ 49,824.00 for routine family planning services (to be billed at $ 8,304.00 a month,January through June). $ 146,002.00 Total Current Award Family planning services will be provided by the Contractor for approximately 1,608 target clients. Funds Awarded- Contract Life-to-Date Routing Number: Term State Funds Federal Funds Total Funding 02 FLA 00026 07/01/01 -to- 06/30/02 $ 40,796 $ 56,717 $ 97,513 02 FLA 00262 07/01/01 -to- 06/30/02 $ 20,250 $ - $ 20,250 03 FLA 00041 07/01/02 -to- 06/30/03 $ 49,282 $ 79,442 $ 128,724 03 FLA 00258 07/01/02 10- 06/30/03 $ - $ 12,592 $ 12,592 04 FLA 00074 07/01/03 -to- 06/30/04 $ 38,378 $ 83,466 $ 121,844 -to- $ - $ - $ -to- $ - $ - $ Subtotal of All Previous Documents: $ 148,706 $ 232,217 $ 380,923 Contract Routing Number of the Current Document: 05 FLA 00023 Contract Encumbrance Number of the Current Document: PO FLA FPP0200026C Term of the Current Document: 07/01/03-06/30/04 Not to Exceed Amount of Current Document: $ 49,824 $ 96,178 $ 146,002 Total Value of All Documents: $ 198,530 $ 328,395 $ 526,925 J:\Fiscal\Contract Attacl ments\FP FY05\Weld\Attactmient I 6/25/200412:02 PM DELEGATE AGENCY EXPENDITURE/REVENUE REPORT FAMILY PLANNING PROGRAM-WHS-CDPHE Attachment A AGENCY NAME: PERIOD: COMPLETED BY: DATE: E ® I s Column (A) Column (B) I Column (C) Family Planning CDPHE-WHS Program-(Non- Funding CDPHE funding) Combined Total Personal Services Salary $ - $ - $ - Fringe @% _ #DI_V/0! Subtotal Personal Services " " "*^" Contractual Services - - Clinician I $ - $ - $ -- - Lab&X-ray - Other _ - Subtotal Contractual Services $'- . a •� �` ,�.., ._ . '=yam.. _ Operating Expenses _- - Supplies $ _ $ $ - Training Other Travel Equipment _ - - Subtotal Operating Expenses _-; - Total Direct Costs Indirect Costs @% I $ - $ - $ TOTAL EXPENDITURES __. .. .:.. w r. „ .,₹--, 'nakt ,.. :, Inkind $ __. $ $ TOTAL COSTS " Rg. Family Planning CDPHE-WHS Program-(Non- Funding CDPHE funding) Combined Total CDPHE-Women's Health family planning contracts $ - $ - $ _ Patient Fees Patient Donations - Medicaid State Children's Health Ins(CHP+) Local government County and City grants and contracts _ Inkind(Other Donations) Other public health insurance(TRICARE/CHAMPUS,CHAMPVA) Private Health Insurance _ Temporary Assistance for Needy Families(TANF) Other(specify private grants,fundraising,MCH,Social Service Block grant,Medicare, - - - TOTAL Unspent Funds-This Period $ - $ - - $ Unspent Funds-Prior Periods _ _ - Balance Unspent Funds ; $ (white-02/25/04 J:\fiscaacontract attachments\fyo4 FPUttachment A-Revised Expendenditure-Revenue Report\Sheet] Colorado Department of Public Health and Environment • Contract Reimbursement Statement-Family Planning Program To: Family Planning Program ATTACHMENT B PSD-Women's Health Section-A5 WHS phone - 303-692-2492 4300 Cherry Creek Drive South fax this form to Laura Montoya Denver, CO 80246-1530 fax#: 303-691-7900 FPP Agency Tax ID Number Contract Number Month /Year Please submit within 10 days of end of month and by June 30. Amount requested for: $ Federal -Title X Family Planning Services Dollars (July- December 2004) $ State Family Planning Services Dollars (January-June 2004) $ Other Total amount requested: $ - This is to certify that these services were provided per above referenced contract and reimbursement is requested for same. Signature Date Print Name Phone ( ) I hereby certify that all contract requirements have been met and the amounts billed are correct. Payment is authorized. (CDPHE Authorized Designee) Date J:\Fiscal\Contract AttachmentslFamily Planning Invoice\Form Laura Montoya(4/15/04)303-692-2485 Form B-Revised 4/15/04 This page describes the funding that is included in your contract for FY05, July 1, 2004 to June 30, 2005. Please review the line items carefully and keep a copy, as this is the only place this information will be described in detail. This limited amendment or task order option to renew for FY05 includes funding for family planning services to an estimated 1,608 target patients, based on the numbers served in calendar year 2003. Federal Title X funding (must be spent by 12-31-04) FP services-based on target patients served in CY2003 and funding formula $ 88,983 Chlamydia testing (Title X and STD funding)-based on tests provided in 2003 $ 3,087 HPV testing-based on estimated number of ASC-US results in 2003 $ 4,108 Total federal funding = $ 96,178 To be billed at 1/6th July through December, 2004 = $16,029.67per month State family planning funding (must be spent by 6-30-05) FP services-based on target patients served in CY2003 and funding formula $ 47,708 HPV testing-based on estimated number of ASC-US results in 2003 $ 2,116 Total state funding = $ 49,824 To be billed at 1/6th January through June, 2005 = $8,304 per month Total amount of FY05 federal + state funding = $146,002 Please contact us with any questions regarding funding amounts. You may be contact Candace Grosz at 303.692.2482, Christine Mandl at 303.692.2486 or Karen Trierweiler at 303.692.2481. J:\FISCAL\contracts\FP FY05\memo signature&$amts\Weld.doc -2- Hello