HomeMy WebLinkAbout20013204.tiff RESOLUTION
RE: APPROVE MEMORANDUM OF UNDERSTANDING FOR PROVISION OF CHEST
X-RAYS AND OTHER SERVICES AND AUTHORIZE CHAIR TO SIGN - PLAN DE
SALUD DEL VALLE FAMILY HEALTH 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 a Memorandum of Understanding for
the Provision of Chest X-Rays and other services 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 Plan de Salud del Valle Family
Health Center, commencing upon full execution of said Memorandum of Understanding, and
ending December 31, 2002, with further terms and conditions being as stated in said
Memorandum of Understanding, and
WHEREAS, after review, the Board deems it advisable to approve said Memorandum of
Understanding, 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 Memorandum of Understanding for the Provision of Chest
X-Rays and other services 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 Memorandum of Understanding.
2001-3204
HL0028
MEMORANDUM OF UNDERSTANDING FOR PROVISION OF CHEST X-RAYS AND OTHER
SERVICES - PLAN DE SALUD DEL VALLE FAMILY HEALTH CENTER
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 19th day of November, A.D., 2001.
BOARD OF COUNTY COMMISSIONERS
WELD C NTY, COLORADO
ATTEST: LU/f �' � �► d“.;7 M. J. eile, Ch 'r
Weld County Clerk to the , 4
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( i ' + Glenn Vaad,
BY: .. iii f:,.:: A
Deputy Clerk to the BI�•U MC ' �"��E
Willia . Jerke
APPROVEDfORM: J
7avi E. Long
' of y�orhey .
j / R bert D. Masden
Date of signature: /fir`/
2001-3204
HL0028
Memorandum
Ke;
I "S\*t
TO: M.J. Geile, Chair
111 Board of County Commissioners
FROM: Mark E. Wallace, MD, MPH, Director
• Department of Public Heaj annd�
COLORADO Environment
DATE: November 15, 2001
SUBJECT: Memorandum of Understanding for the
Provision of Services
Enclosed for the Board review and approval is a memorandum of understanding between Weld
County on behalf of the Department of Public Health and Environment and Plan de Salud del
Valle Family Health Center for the provision of chest x-rays and other services.
Earlier this month, WCDPHE was awarded funding from the Colorado Department of Public
Health and Environment for use in establishing a targeted testing project to detect and treat
tuberculosis infection in children residing in the Sylmar Mobile Manor mobile home community
and also any adults who may be associated with these children. Under the provisions of this
memorandum of understanding, Salud will provide a Medical Health Van to be used by
WCDPHE and by Salud staff on the day(s) designated for the testing and on the day(s)
designated for reading the test results. Salud will also provide chest x-rays and interpretation for
all patients referred under the targeted testing project.
For these services, Weld County agrees to reimburse Salud for any chest x-rays that may be
ordered at a rate not to exceed $45 per x-ray and not to exceed 170 chest x-rays. The term of this
memorandum of understanding is from the date of its signing through December 31, 2002. It
may be renewable if funds continue to be available.
I recommend your approval of this memorandum of understanding.
Enclosure
2001-3204
MEMORANDUM OF UNDERSTANDING
THIS MEMORANDUM OF UNDERSTANDING("MOU") is made and entered into this
19th day of Nuvember , 2001, 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 Department of Public Health and Environment, ("WCDPHE"), and Plan de Salud
del Valle Family Health Center("SALUD").
BACKGROUND INFORMATION
WHEREAS, WCDPHE has received funds for use in establishing a targeted testing
project ("TTP") to detect and treat tuberculosis infection ("TB") in children residing in a specified
area in Weld County, Colorado, more particularly known as the Sylmar Mobile Manor, and any
adults who may be associated with said children; and
WHEREAS, WCDPHE desires that SALUD provide certain services which are required
in order to implement TTP; and
WHEREAS, SALUD desires to provide certain services in cooperation with WCDPHE
which are required in order to implement TTP; and
WHEREAS, the parties desire to reduce the terms of their understanding to writing, as
follows:
1. Term of MOU. This MOU shall be effective from the date of its signing through
December 31, 2002, and may be renewable, in the event that funds continue to be available.
Thirty days prior to the termination of this MOU, if either party wishes to continue this
agreement, that party shall serve such notice on the other party. The parties may then negotiate a
renewal of this MOU.
2. Compensation. WCDPHE agrees to reimburse SALUD for any chest x-rays that
may be ordered at a rate not to exceed $45.00 per ordered chest x-ray, not to exceed 170 chest x-
rays.
SALUD shall submit an invoice to WCDPHE at the end of each month services are
rendered. The invoice will clearly delineate the services provided, and the total number of chest
x-rays which have been performed. WCDPHE agrees to make payment within thirty (30) days
after invoices have been submitted.
3. Services to be Provided by SALUD SALUD shall provide services as set forth
in the outline attached to and incorporated into this MOU as Exhibit A, which includes, but is not
limited to, a Medical Health Van as set forth in this MOU, and a staff member, whose name shall
be specified to WCDPHE, and who shall at all times be employed by, and be an employee of
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SALUD, who will have the following qualifications, and SALUD shall perform the following
duties:
Qualifications of Staff.
1). The designated Staff person shall meet or exceed any and all qualifications
and requirements of Colorado law and the Rules of the State of Colorado
Department of Public Health and Environment("CDPHE")to administer
TB skin tests in the State of Colorado. The designated Staff person shall
also be skilled in performing such tests on small children.
2). The designated Staff person shall have a valid driver's license for the State
of Colorado, and shall be responsible for driving the Mobile Health Van,
which is properly insured under the requirements of the State of Colorado.
SALUD Duties:
1.) Provide a Medical Health Van to be used by WCDPHE and by Staff for
SALUD on the day and during the hours designated for the testing.
Provide a Medical Health Van to be used by WCDPHE on the day and
during the hours designated for reading the test results.
2.) Provide chest x-rays for all patients referred under the TTP. A chest x-ray
shall consist of two views and an interpretation.
3.) SALUD, its employees and agents, shall be bound by all applicable existing
protocols, professional standards, and applicable statutes in its performance
under this MOU.
4. Services to be provided by WCDPHE: WCDPHE will provide the services as
set forth in the outline attached to this MOU as Exhibit A, including, but not limited to, the
following:
1.) appropriate supplies and disposal of medical waste.
2.) Paperwork for documentation.
3.) Staff to administer tests, complete risk assessment, read tests, conduct
counseling, complete referral forms, and provide other applicable services.
5. Parties' Relationship. The parties to this MOU intend that the relationship
between them contemplated by this MOU is that of independent entities working in mutual
cooperation. No employee, agent, or servant of any party shall be deemed to be an employee,
agent, or servant of another party of this MOU. The Staff designated by SALUD shall at all times
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be an employee of SALUD and said Staff shall be subject to all of the rights, responsibilities, and
benefits associated with being an employee of SALUD. At no time shall the Staff from SALUD
be considered an employee of WCDPHE for any reason. The Staff designated by WCDPHE shall
at all times be an employee of WCDPHE and said Staff shall be subject to all of the rights,
responsibilities, and benefits associated with being an employee of WCDPHE. At no time shall
the Staff from WCDPHE be considered an employee of SALUD for any reason.
6. Limitations - Liabilities - Indemnification. Each party shall not be responsible
or liable for acts, omissions, or failure to act by the other party. Accordingly, to the extent
permitted by law, WCDPHE agrees to indemnify and hold SALUD harmless from any and all
liability incurred by acts, omissions, or failures to act by WCDPHE, and, likewise, SALUD agrees
to indemnify and hold WCDPHE harmless from any and all liability incurred by acts, omissions, or
failures to act by SALUD, pursuant to the terms of this MOU. Because WCDPHE is a
department of Weld County Government, SALUD acknowledges that this agreement to
indemnify and hold harmless WCDPHE extends to Weld County, its employees, agents,
subcontractors and assignees. The term "liability" includes, but is not limited to, any and all
claims, damages, and court awards including costs, expenses, and attorney fees incurred as a
result of any act or omission by the applicable party who acted or failed to act.
7. Non-Assignment. This MOU shall not be assignable without prior written
consent of WCDPHE or SALUD, whichever is the non-assigning party.
8. Provision of Services. WCDPHE and SALUD assure compliance with Title VI
of the Civil Rights Act of 1964, that no person shall, on the grounds of race, color, sex, religion,
age, national origin, or individual handicap, be excluded from participation in, be denied the
benefits of, or be subject to discrimination under any provision of this MOU.
9. Termination. Either party may terminate this MOU for cause upon ten (10) days
written notice, and for any reason, so long as thirty (30) days written notice of its intent to so
terminate is given to the other party. If this MOU is so terminated, WCDPHE shall pay that
compensation to SALUD which duly reflects the actual amounts due and owing to SALUD for
which SALUD documents that SALUD provided services pursuant to this MOU, and which
amounts have not previously been paid.
10. Notices. Any notice provided for in this MOU shall be in writing and shall be
served by personal delivery or by certified mail, return receipt requested, postage prepaid, at the
addresses set forth in this MOU, until such time as written notice of a change is received from the
party wishing to make a change of address. Any notice so mailed and any notice served by
personal delivery shall be deemed delivered and effective upon receipt or upon attempted delivery.
This method of notification will be used in all instances except for emergency situations when
immediate notification to the parties is required.
WCDPHE: Weld County Department of Public Health and Environment
c/o Judy Nero
3
1555 N. 17th Avenue
Greeley, Colorado 80631
•
SALUD: Plan de Salud del Valle
Ed Hendrikson, PhD., PA-C
1115 2"a Street
Fort Lupton, CO 80621
11. Modification and Breach. No modification, amendment, novation, renewal, or
other alteration of or to this MOU and the attached exhibits shall be deemed valid or of any force
or effect whatsoever, unless mutually agreed upon in writing by the undersigned parties. No
breach of any term, provision, or clause of this MOU shall be deemed waived or excused, unless
such waiver or consent shall be in writing and signed by the party claimed to have waived or
consented. Any consent by any party hereto, or waiver of, a breach by any other party, whether
expressed or implied, shall not constitute a consent to, waiver of, or excuse for any other different
or subsequent breach.
12. Incorporation of Contractual Provisions. This MOU is expressly made subject
to all laws and regulations of the United States and the State of Colorado. Contractual provisions
required by such laws and regulations,but not having been set forth herein, are hereby
incorporated by this reference as though expressly set forth in full. MI parties to this MOU are
hereby put on notice and charged with the responsibility of compliance with such contract
provisions as required by law.
13. Severability. If any term or condition of this MOU shall be held to be invalid,
illegal, or unenforceable, this MOU shall be construed and enforced without such a provision, to
the extent this MOU is then capable of execution within the original intent of the parties.
14. Funding. No portion of this MOU shall be deemed to create an obligation on the
part of the County of Weld, State of Colorado, or WCDPHE to expend funds not otherwise
appropriated during the term of this MOU.
15. Records. Each party agrees to keep any and all records and information
confidential, in compliance with all laws and regulations concerning the confidentiality of such
records. The medical records for each patient shall be maintained at the WCDPHE.
16. No Third Party Beneficiary Enforcement. No portion of this MOU 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 MOU be deemed to have created a duty of care with respect
to any person not a party to this MOU.
It is expressly understood and agreed that enforcement of the terms and conditions of this
MOU and all rights of action relating to such enforcement shall be strictly reserved to the
undersigned parties, and nothing contained in this MOU shall give or allow any claim or right of
action whatsoever by any other person not included in this MOU. It is the expressed intention of
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the undersigned parties that any entity other than the undersigned parties receiving services or
benefits under this MOU shall be deemed an incidental beneficiary only.
The parties hereto have read the foregoing and hereby state that this Memorandum of
Understanding accurately states their agreement.
WELD COUNTY DEPARTMENT OF PLAN DE SALUD DEL VALLE
P�LIC HEALTH
AND EN NMENT
M _
Mark E. Wallace, M.D. MPH 'By:
il - its - OI /=-7; -)/
Date Date
BOARD OF COUNTY COMMISSIONERS
WELD C TY, COLORADO
ATTEST: J4 „�,{��j
oi
Weld County Clerk to e. :' L - a / he,
aA M.J. Geile, Chair (11/19/2001)
air
By: Cri Y.
Deputy Clerk to t November 19, 2001
UN Date
5
EXHIBIT A
Targeted Testing Project by Weld County Health Department and Salud
A Targeted Testing Project will be conducted by Weld County Health Department with
cooperation and collaboration of the Plan de Salud del Valle Family Health Center and the
management of Sylmar Mobile Manor. The target population consists of children between the
ages of 1-5. The Hispanic residents are at higher risk of having been exposed to TB due to their
country of origin (Mexico), congregate living arrangement, and the occurrence of three adult and
two pediatric cases in this community. Because of the two pediatric cases associated with this
trailer park, a targeted testing project is ideal to detect any latent TB infection among the
children who reside at the park. Although these children are not contacts to the known cases,
they share a common environment and lifestyle.
A tuberculin skin testing clinic will be held at the trailer park December 4, 2001 with the
readings on December 6, 2001. This activity will entail the testing of children between the ages
of 1-5. If other residents express an interest in being tested, they will be given TB information;
the adults will be tested if the children are positive. Two days later, the health team will return to
the site to read the arms of those tested. For those who have a reading of >10mm or have
symptoms consistent with TB, they will be referred for a chest x-ray. A medical evaluation will
take place and treatment for latent tuberculosis infection will be initiated. The patient will
receive medications on a monthly basis and a monthly assessment for adverse side effects to the
medication. The patient will be followed through the completion of treatment. The ARPE form
can be used to evaluate the yield and success of this activity.
Pretest Activities
SALUD
➢ Sign Memorandum of Understanding
WELD COUNTY
➢ Promotional flyers for distribution on November 26 and a targeted flyer for November 30
➢ Printing of rent vouchers and chest x-ray referrals
➢ Identify a treat for the children who will be tested (ice cream?)
➢ Order sufficient supplies to conduct the testing
➢ Secure adequate staff and arrange for comp time or adjusted schedules
Testing Day
SALUD
➢ Mobile health van
➢ Staff to drive the van
➢ Staff to administer the skin test. Staff will be skilled in testing small children.
WELD COUNTY
➢ Staff to administer the skin test, complete the risk assessment, and distribute the rent
voucher
➢ Testing supplies and disposal of medical waste
➢ Paperwork for documentation
Page 1 of 2
EXHIBIT A
Reading Day
SALUD
➢ Mobile health van
➢ Staff to drive the van
WELD COUNTY
➢ Staff to read the skin tests, document the results, and counsel the positives
➢ Do not forget the rulers
➢ Referral forms to obtain chest x-ray at Salud for all children who are symptomatic or
have a skin test reading >10mm
➢ Validate the rent vouchers
Follow-up of Positives
SALUD
➢ Patient referrals entitle the patient to chest x-ray. Clinic appointments are recommended
to assure that the x-ray technician is there. An option will also exist for walk-ins
provided they show up before 3:30. The chest x-ray will be two views and an
interpretation. The reimbursement fee will not exceed $45.00.
WELD COUNTY
➢ Staff will pick-up the chest x-rays and deliver them to Dr. Fellars. Dr. Fellars will make
the medical recommendations. He will write the script for medications when appropriate.
WCHD will order the medications from the State and deliver them to the patient.
➢ Staff will counsel the parent about the importance of uninterrupted treatment, side effects,
and need for monthly visits.
➢ Staff will collect and process sputum if needed.
➢ Staff will maintain the medical record
➢ If the patient has medical questions or concerns, they will contact WCHD.
Page 2 of 2
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