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HomeMy WebLinkAbout20012499 RESOLUTION RE: APPROVE TASK ORDER FOR MATERNAL AND CHILD HEALTH SERVICES AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Task Order for Maternal and Child Health 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, commencing October 1, 2001, and ending September 30, 2002, with further terms and conditions being as stated in said task order, and WHEREAS, after review, the Board deems it advisable to approve said task order, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Task Order for Maternal and Child Health 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 task order. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 5th day of September, A.D., 2001. BOARD OF COUNTY COMMISSIONERS WELD C TY, COLORADO ATTEST: gal/ / �.�,E L <<Cl� ` eile, Ch it Weld County Clerk to the .o. 1861 o.=�.t , Glenn Vaad, Pro-Tem - BY: Deputy Clerk to the Bo�i ���►� Will. H. Jerke 7D29 DavE. Long y Attorney EXCUSED DATE OF S GNING (AYE) Robert D. Masden ;/„Date of signature: 2001-2499 HL0028 tj ≥ Memorandum TO: M.J. Geile, Chair Board of County Commissioners • FROM: Mark E. Wallace, MD, MPH, Director COLORADO Department of Public Health and R1) at Environment 4kk/;V P J DATE: August 30, 2001 SUBJECT: Maternal and Child Health Services Task Order Enclosed for Board review and approval is the Maternal and Child Health Services Task Order between the Colorado Department of Public Health and Environment (CDPHE) and Weld County Department of Public Health and Environment (WCDPHE). This task order will provide continuation funding for the Prenatal and Child Health programs at WCDPHE. In the Prenatal Program, it will be used to provide prenatal and postpartum care, including education and counseling and Prenatal Plus enhanced services for low-income women. The funding for the Child Health Program will provide well child clinic services to clients aged 0 to 16 years. These services include health and psychosocial history, age appropriate screenings, physical exams, immunizations, teaching of risk-reducing behaviors to parents, and referrals to appropriate resources for children exhibiting actual or potential physical or emotional problems. For these services, WCDPHE will receive a total reimbursement of$114,823 for the period October 1, 2001 through September 30, 200V I recommend your approval of this task order. Enclosure 2001-2499 Department or Agency Name COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT Department or Agency Number FAA Contract Routing Number 02-00544 TASK ORDER This TASK ORDER is made this 28TH day of SEPTEMBER,2001,by and between:the State of Colorado,for the use and benefit of the COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT,whose address or principal place of business is 4300 Cherry Creek Drive South,Denver,Colorado 80246,hereinafter referred to as"the State";and,the BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY(a political subdivision of the state of Colorado),whose address or principal place of business is 915 10th Street, 3rd Floor,Greeley,Colorado 80631,for the use and benefit of the Weld County Department of Public Health and Environment,whose address or principal place of business is 1555 North 17"Avenue,Greeley,Colorado 80631,hereinafter referred to as"the Contractor". FACTUAL RECITALS Section 29-1-201, 8 C.R.S.as amended,encourages governments to make the most efficient and effective use of their powers and responsibilities by cooperating and contracting with each other to the fullest extent possible to provide any function,service,or facility lawfully authorized to each of the cooperating or contracting entities. All State contracts with its political subdivisions are exempt from the state of Colorado' State's personnel rules under section 24-50-101 et seq.,and the State procurement code under section 24-101-101,et seq.,C.R.S.,as amended. The State has received Title V funds from the United States Department of Health and Human Services(HHS) under the Maternal and Child Health Services Block Grant(MCH)The State's Division of Family and Community Health Services(DFCHS)is charged with the administration of funds from Title V of the MCH Block Grant.These Title V MCH funds are to be used"for the purpose of enabling each State: (A)to provide and to assure mothers and children(in particular those with low income or with limited availability of health services)access to quality maternal and child health services; (B)to reduce infant mortality and the incidence of preventable diseases and handicapping conditions among children,to reduce the need for inpatient and long-term care services,to increase the number of children(especially preschool children)appropriately immunized against disease and the number of low income children receiving health assessments and follow-up diagnostic and treatment services,and otherwise to promote the health of mothers and infants by providing prenatal,delivery,and postpartum care for low income,at- risk pregnant women,and to promote the health of children by providing preventive and primary care services for low income children; (C) to provide rehabilitation services for blind and disabled individuals under the age of 16 receiving benefits under Title XVI,to the extent medical assistance for such services is not provided under Title XIX;and, (D)to provide and to promote family-centered,community-based,coordinated care for children with special health care needs and to facilitate the development of community-based systems of services for such children and their families"(Title V of the Social Security Act,Sec. 501.[42 U.S.C.701](1)A). The State has formulated a comprehensive statewide plan to carry out a Maternal and Child Health Services program (Program),funded by Title V MCH funds. This comprehensive statewide plan allocates Title V MCH funds to the implementation of the Program through various participating agencies in order to provide these health care services to the people of the state of Colorado. It is the express intent of the parties that in order to support community-based determinations as to the use of the 1 MCH funds while contributing to a coordinated, efficient,statewide program for the use of those funds. Local public health agencies,such as the Contractor,shall provide leadership, in coordination with public and private community partners, in the development and implementation of county or district maternal and child health plans. The State shall provide:guidance and technical assistance to the Contractor to support the implementation of its MCH plan for federal fiscal year 2001-2002 and for the development of its MCH Plan for the following federal fiscal years. Each state that receives MCH funds from the HHS must demonstrate to the HHS that it has served three(3)distinct population groups with those MCH funds. These three(3)distinct population groups are:"the perinatal population", which is defined to include women of childbearing age,pregnant women,and mothers;the"child and adolescent population",which is defined to include infants,children,and adolescents from birth through age twenty(20); and, "children with special health care needs population",which is defined to include those children who have,or might have,special health care needs. Under this Task Order,the Contractor shall provide the core public health services of assessment,policy development,and assurance on behalf of the perinatal population and for the child and adolescent population as described and defined in"Attachment A","Core Public Health Services Delivered by MCH Agencies",which is incorporated herein by this reference,made a part hereof,and attached hereto. The parties acknowledge that the Contractor shall provide services to the children with special health care needs(cshcn) population through a separate contract with the State. However, under this Task Order,the Contractor shall assess the needs of the cshcn population and develop a plan for the future delivery of services to that population while it also assesses the needs of,and develops plans for the continued delivery of services to,the perinatal and the child and adolescent populations. The Contractor's decision to provide,or not provide,direct patient care services should be based on an assessment of the capacity of the community's public and private providers to meet the direct health care needs of its perinatal and child and adolescent population. The services or activities under this Task Order may be carried out by the Contractor itself,or through subcontracts with other providers or,through collaborative partnerships with other community partners. Finally,as to the State,authority exists in the Law and Funds have been budgeted,appropriated,and otherwise made available, and a sufficient uncommitted balance thereof remains available for subsequent encumbering and payment in Fund Number 100,Organizational Unit Code 6520,Appropriation Code 585,and Object Code 5420 under Master Contract Routing Number 00-FAA 00008. All required approvals,clearances,and coordination have been accomplished from and with all appropriate agencies. NOW THEREFORE,in consideration of their mutual promises to each other,stated below,the parties hereto agree as follows: A. PERIOD OF PERFORMANCE AND TASK ORDER TERMINATION. In accordance with section 24-30-202(1),C.R.S.,as amended,the effective date of this Task Order is the date the State Controller approves this Task Order.The initial term of this Task Order shall commence on the effective date of this Task Order and continue through and including September 30,2002,unless sooner terminated by the parties pursuant to the terms and conditions of this Task Order and the Master Contract.The Contractor may only commence performance under this Task Order as of its effective date. The State shall have no financial obligation to the Contractor for any work or services or,any costs or expenses, incurred by the Contractor prior to the effective date of this Task Order. The total term of this Task Order,including any renewals or extensions hereof,may not exceed five(5)years. B. SCOPE OF WORK. The Contractor,in accordance with the terms and conditions of the Master Contract and this Task Order,shall perform and complete in a timely and satisfactory manner all work in accordance 2 with the following: 1. Operational Plan Implementation. The Contractor shall implement its"Local Agency Maternal and Child Health Operational Plan"(Operational Plan)for those services and activities which will be completed in federal fiscal year 2001-2002(October 1,2001,through September 30,2002). This Operational Plan was previously developed by the Contractor, in consultation with the State, in federal fiscal year 2000-2001 based on an assessment of the health status needs of its maternal-child populations and of the health system resources of its community. This Operational Plan is incorporated herein by this reference,made a part hereof,and attached hereto as "Attachment B" 2. The Operational Plan is designed to:a. contribute to the accomplishment of the State's priorities, performance measures,and outcome measures,as identified in"Attachment C",which is incorporated herein by this reference,made a part hereof,and attached hereto;b.move a local public health agency out of the direct personal care provider role when it is possible for other community providers to provide quality primary and preventive care;c.provide for the continuation of the core public health services of assessment,policy development,and assurance on behalf of the maternal-child populations;d. assure access to direct care and services for vulnerable women,children,and adolescents,such as those who are low-income,uninsured,under insured,or who live in rural or under served areas,or who are from ethnic or cultural minority communities and may experience language or cultural barriers to services;and, e.contribute to a comprehensive health improvement plan, if a local public health agency chooses to develop this plan,as described in"Healthy People 2010", "Public Health Infrastructure Development Objective l l". A. Direct Care Services to Women of Childbearing Age: Under this Task Order,the Contractor shall provide public health services to enhance the health status of women of childbearing age. All pregnant women seeking prenatal care shall be provided with information about,and be referred to,comprehensive prenatal care services. The Contractor shall also assure that all individuals seeking reproductive health services:are provided with information about pregnancy planning;are advised of the consequences of unintended pregnancies;and,are referred to comprehensive family planning services that ensure confidentiality. If the Contractor does provide medical prenatal and postpartum care,then the Contractor shall: I. provide prenatal and postpartum care, including education and counseling, in accordance with the"Prenatal Care Guidelines". A copy of these guidelines has been made available to the Contractor by the State as of the effective date of this Task Order. 2. offer the following program components to pregnant women: a. coordinated care between medical providers and the Contractor, including assistance in securing delivery services; b. referrals and assistance in seeking continuous infant and child health care;c. free pregnancy testing in order to provide appropriate medical referrals for women with positive tests;and, d. free pregnancy testing in order to provide contraceptive education, medical referrals,and non-prescriptive contraceptives, if appropriate,to women with negative pregnancy tests,and referral to a local family planning provider. 3. Individual records on each prenatal patient shall be maintained by the Contractor and are subject to audits,either self or independent,to be determined by the State. 3 4. The Contractor shall use all program income generated from the collection of patient fees and patient or third party donations only for perinatal services which further the objectives of the legislation under which this Contract is entered into. In accordance with Title V,Section 501 (b)(2)and Section 505(2)(d),the Contractor shall not impose any charge for services provided to patients at or below 100%of the poverty level. As of the effective date of this Contract,federal poverty guidelines have been provided to the Contractor by the State. The Contractor may charge patients who are between 100%and 185%of the poverty level based on a sliding fee scale. The Contractor shall advise patients at or below 133%of poverty level to apply for Medicaid. B. Provision of CBC/KCP and CCHP+Program Information: The Contractor shall: 1. inform potentially eligible applicants or recipients that the"Colorado Baby Care/Kid's Care Program"(CBC/KCP),a program within Medicaid,exists and that these potentially eligible applicants or recipients should apply for coverage under that program through the local county department of social services; 2. inform potentially eligible applicants or recipients that the Colorado Child Health Plan Plus+(CCHP+)exists; 3. inform potentially eligible applicants or recipients that CBC/KCP and CCHP+ may be a potential source of payment for a child's care; 4. inform potentially eligible applicants or recipients that in order to receive continuing coverage under CBC/KCP and/or CCHP+they must complete an application as soon as possible(CBC/KCP allows for up to sixty(60)calendar days of presumptive eligibility for pregnant women who are registered with Medicaid); 5. obtain from Medicaid and the CCHP+,and have present at its facility,current information regarding eligibility for,and the services provided under CBC/KCP and CCHP+;and, 6. have registration forms for CCHP+available at all times. C. Direct Care Services For Children And Adolescents: If the Contractor chooses to provide direct health care services to infants,children,or adolescents,then its public health nursing assessments and interventions shall be consistent with the recommendations for child health care as delineated in the State's"Child Health Manual"and other policies and guidelines which have been,or will be,made available to the Contractor as of the effective date of this Task Order. If the Contractor chooses to provide direct health care services,then the Contractor shall provide all of the following direct care services: 1. child and adolescent health clinic services, as indicated and appropriate, including: a. a complete health and psychosocial history and unclothed physical exam; b. age-appropriate screening, including but not limited to,developmental screening by the providers or other appropriate community resources; c. age-appropriate immunizations; 4 d. age-appropriate anticipatory guidance and teaching of risk-reducing behaviors to parents,children,and adolescents,including but not limited to,teaching injury prevention techniques,prevention of motor vehicle injuries and death through the use of infant and child car seats and seat belts; e. nursing management and/or referral(s)to appropriate resources for children exhibiting actual or potential problems in their physical and/or, developmental and/or psychosocial/emotional status; and, f. an assessment of adolescent protective and risk-taking behaviors including the use of alcohol,tobacco,and other drugs;depression and school adjustment;sexual activity;involvement as either a victim or perpetrator of violence;motor vehicle safety; and the provision of intervention services or referrals when appropriate. 2. Home Visitation Services: Home visitation services as indicated to infants, children,and their families. The primary purpose of these visits is public health nursing intervention designed to reduce the risk of injury and disease to the child and to strengthen child and family development. 3. HCP Referrals: Case finding(s)and medical referral(s)through the above child health activities for children eligible for the State's Health Care Program for Children with Special Needs. 4. Other Referrals: Appropriate referrals for all children who fail screening tests or who are in need of medical or other diagnosis or treatment. The Contractor shall document its attempts to follow up on these referrals. 5. Submission of Direct Care Documentation: If the Contractor chooses to provide direct child and adolescent health clinic services,then on or before January 15, 2002,for federal fiscal year 2000-2001 (October 1,2000,through September 30, 2001)and on or before January 15,2003 for federal fiscal year 2001-2002 (October 1,2001 through September 30,2002), and on January 15,of any subsequent renewal year,the Contractor shall submit to the State,the following documentation: a. a copy of the aggregate results of a qualitative audit completed on at least ten percent(10%)of the Contractor's active child health clinic records,using the State's"Child Health Impact Tool",or a similar audit mechanism approved by the State, indicating that seventy-five(75%)of all problems,identified through public health nursing assessments, have been appropriately referred,mitigated,or resolved; b. evidence that ninety percent(90%)of all two(2)year old children enrolled at the Contractor's child health clinics for at least one(1)year are current on all recommended immunizations, including but not limited to,Hemophilus B; 5. Submission of Final Expenditure Report and Numbers Served Report for Federal Fiscal Year 2000-2001. On or before January 15,2002,the Contractor shall submit to the State for review and approval a"Year End Budget and Numbers Served Report"for federal fiscal year 2000-2001. This report shall contain: a completed"Number of Individuals Served(Unduplicated)Under Title 5 V Report", for those services provided by the Contractor in federal fiscal year 2000-2001. A sample format is incorporated herein by this reference,made a part hereof,and attached hereto as "Attachment D". On or before January 15,2002,the Contractor shall submit to the State for review and approval a"Final Fiscal Expenditures Report". The Contractor shall report actual expenditures and match separately for the perinatal and child health programs showing both the maternal and child health spending and the associated match. The report shall be signed by a certified official of the Contractor. A sample format is incorporated herein by this reference,made a part hereof,and attached hereto as"Attachment E". 6 Submission of Local MCH Plan for Federal Fiscal Year 2002-2003. On or before May 1,2002, and on May 1,for any subsequent renewal year,the Contractor shall submit a"Local Maternal and Child Health Plan"(LMCH Plan)for federal fiscal year 2002-2003. A sample format,which the Contractor may use, is incorporated herein by this reference,made a part hereof,and attached as "Attachment F". The LMCH Plan for federal fiscal year 2002-2003 shall include an assessment of the community health needs,a final report for the Contractor's FFY 2000-2001 MCH Operating Plan,a progress report for the Contractor's FFY 2001-2002 activities,and the Contractor's future plans to address the priority needs for all three(3)maternal-child populations, i.e.the perinatal population,the child and adolescent population,and the children with special health care needs population. The federal fiscal year 2002-2003 LMCH Plan shall be based on a reassessment of the qualitative and quantitative data,then available to the Contractor. The federal fiscal year 2002-2003 LMCH Plan shall: A. assess the health status needs of women of childbearing age,pregnant women,mothers, infants,children,and adolescents,and children with special health care needs,of the county,district,or area served by the Contractor; B. in collaboration with local stakeholders and consumers,reassess the health system and related service resources of the community served by the Contractor; C. prioritize the health care needs of the community to be addressed by the Contractor;and, D. describe the activities or services to be carried out under the federal fiscal 2002-2003 LMCH Plan,utilizing the descriptors of direct care services,enabling services, population based services,or infrastructure building activities,as defined in Attachment A. These current services or new services or activities may be:current services or activities which effectively address identified health care needs of the community;or, new services or activities designed to address unmet or emerging health care needs of the community. These current or new services or activities may include the provision of direct health care services, information and referral services,follow up services,case management services; injury or disease prevention services,activities,or initiatives,or health promotion services or activities. These current or new services or activities may also include projects designed to build the Contractor's,or the local community's, infrastructure,whichever is appropriate,for effective health status improvement. These services or activities may include the creation of a community planning structure to develop needed health care resources,or carrying out a needs assessment. The services or activities chosen by the Contractor should be"Best Practice"or"Evidence Based" approaches as identified by a review of the applicable literature,through the Contractor's past successful experience,or innovative approaches based on a review of the applicable literature and consultation with experts. 7. Submission of Federal Fiscal Year 2002-2003 Budget Estimate Form. On or before May 1,2002, and May 1,of any subsequent renewal year,the Contractor shall submit to the State for review and approval a"Budget Estimate Form"for the provision of services to the perinatal population,the 6 child and adolescent population,and the cshcn population for the federal fiscal year 2002-2003 LMCH Plan. A sample format,which the Contractor may use, is incorporated herein by this reference,made a part hereof,and attached hereto as"Attachment G ". 8. Submission of Final Expenditure Report and Numbers Served Report for Federal Fiscal Year 2001-2002: On or before January 15,2003, and January 15,of any subsequent renewal year, the Contractor shall submit to the State for review and approval a"Year End Budget and Numbers Served Report"for federal fiscal year 2001-2002. This sample format is previously referenced and identified as"Attachment D". This report shall contain:a narrative progress report, a completed"Number of Individuals Served(Unduplicated)Under Title V Report", . On or before January 15,2003,the Contractor shall also submit to the State for review and approval a"Final Fiscal Expenditures Report". A sample format has previously been incorporated and made a part hereof as Attachment E. The Contractor shall report the actual expenditures and the match separately for the perinatal and child health programs showing both the maternal and child health spending and associated match. The report shall be signed by a certified official of the Contractor. 1. Assistance and Support to the Contractor. It is the duty of the State:to provide technical assistance to the Contractor;to support the Contractor's implementation of its LMCH Plan for federal fiscal year 2001-2002;and implementation of its MCH Plan for any subsequent renewal years,;and,to assist the Contractor in the development of an information based LMCH Plan for federal fiscal year 2002-2003. Accordingly,the State shall: A. on or before March 1,2002, and March I,of any subsequent renewal year,provide an update of the Contractor's service area specific maternal and child health services data set to be utilized by the Contractor in developing its LMCH Plan; B. provide on-going consultation services to the Contractor on the use of the maternal and child health services data set in the Contractor's assessment and planning process; C. research all available data sources to obtain additional service area specific data, particularly any race or ethnic health disparity data,to add to the maternal and child health services data set and provide that updated information to the Contractor; D. provide consultation services to the Contractor regarding community-based assessment and planning resources, including model tools and processes;and, E. provide consultation services to the Contractor regarding"Best Practice"and "Evidence-Based"activities or interventions to address the Contractor's identified health status needs. 2. Review of Federal Fiscal Year 2002-2003 LMCH Plan and Budget Estimate Form. Within sixty (60)calendar days after the date of the Contractor's submission of the federal fiscal year 2002-2003 LMCH Plan and its accompanying Budget Estimate Form,and sixty(60)calendar days after the date of submission for any subsequent renewal year,the State shall complete its review and written comments on that LMCH Plan. Any State recommendations or requested changes or additions to the Contractor's LMCH Plan and Budget Estimate Form shall be provided to the Contractor by the State on or before July I,2002 or July 1,of any subsequent renewal year. The Contractor and State program staff shall negotiate an agreement, if necessary,regarding any State proposed recommendation(s)or requested change(s)or modification(s)by August 1,2002 or August 1,of any subsequent renewal year. The approved federal fiscal year 2002-2003 LMCH Plan and Budget Estimate Form shall be incorporated as an attachment to the Contractor's new Maternal and Child Health services contract or renewal letter for the term beginning October 1, 7 2002 or comparable document in any subsequent renewal year. C. COMPENSATION: In consideration of those services timely and satisfactorily performed by the Contractor under this Task Order,the State shall cause to be paid to the Contractor an amount not to exceed ONE HUNDRED FOURTEEN THOUSAND EIGHT HUNDRED AND TWENTY THREE DOLLARS,($114,823.00)for the initial term of this Task Order. Of this total financial obligation of the State to the Contractor under this Task Order,$114,823.00 are identified as attributable to a funding source of the United States and$0.00 are identified as attributable to a funding source of the state of Colorado. Payments under this Task Order are subject to verification by the State that the Contractor has fully and satisfactorily complied with the terms and conditions of this Task Order. The Contractor shall maintain original documentation for all costs related to the Contractor's performance under this Task Order for a period of six(6)years following the date of termination of this Task Order. D. PAYMENT MECHANISM. Monthly reimbursements under this Task Order shall be paid to the Contractor by the State based upon one-twelfth(1/12)of the projected cost of this Task Order. E. ADDITIONAL PROVISIONS. 1. Restriction on Use of Title V Funds: Title V funds may not be used to pay for any item or service (other than an emergency item or service)furnished by an individual or entity convicted of a criminal offense under the Medicare or any State health care program(i.e.,Medicaid,Maternal and Child Health,or Social Services Block Grant Programs). 2. Smoke-free Environment: The Contractor shall provide all services to all program participants and employees in a smoke-free environment. In accordance with Public Law 103-227, also known as the Pro-Children Act of 1994,smoke-free shall mean that smoking is not permitted in any portion of any indoor facility owned, leased,or otherwise contracted for by the Contractor if that facility is routinely or regularly used for the provision of child care or health services to any child under the age of 18 when those services are funded all or in part with Federal funds. 3. Limitation on Charges for Services. The Contractor shall not charge for services those individuals of families who are at or below the official poverty line as defined by the Office of Management and Budget(OMB)in accordance with Title V, Section 501 (B)(2)and Section 505 (2)(d). As of the effective date of this Contract,the 100%of poverty income guideline for farm or non-farm families is currently at$8,590 for an individual;$11,610 for a family of 2;$14,630 for a family of 3;$17,650 for a family of 4;$20,670 for a family of 5;$23,690 for a family of 6;$26,710 for a family of 7;and,$29,730 for a family of 8. For families of more than eight,the Contractor shall add$3,020 for each additional member to determine the appropriate poverty income guideline. These poverty income guidelines may change during the term of this Contract. If new poverty income guidelines are received by the State from the OMB,then the State shall forward these new poverty income guidelines to the Contractor. The Contractor shall use the new poverty income guideline upon receipt. 8 • 4. Use of Sliding Fee Scale: If the Contractor imposes any charges for services to clients who are above 100%of poverty level,then these charges must be based on a sliding fee scale which takes into account the client's family size, income,and available resources. These charges and the sliding fee scale must be made available to all clients and the general public,and must be based on the Contractor's usual and customary cost for the service. Clients must understand that they will not be denied services because of an inability to pay any of the sliding fee charges. 5. Confidentiality: The Contractor shall protect the confidentiality of all applicant or recipient records and other materials that are maintained in accordance with this Task Order. Except for purposes directly connected with the administration of this Contract,no information about or obtained from any applicant or recipient shall be disclosed in a form identifiable with the applicant or recipient without the prior written consent of the applicant or recipient,or a minor applicant's or recipient's parent or guardian or,as otherwise properly ordered by a court of competent jurisdiction. The Contractor shall have written policies governing the access to,and duplication and dissemination of,all such information. The Contractor shall advise its employees,agents,servants,and subcontractors, if any,that they are subject to these confidentiality requirements. 6. Title VI Compliance: The Contractor shall ensure that the provisions of Section 601 of Title VI of the Civil Rights Act of 1964 are carried out. That Act states that"no person in the United States shall on the ground of race,color,or national origin,be excluded from participation in,be denied the benefits of,or be subjected to discrimination under any program or activity receiving Federal financial assistance".The Office of Civil Rights has concluded that it is the responsibility of any program which is a recipient of funds from the Department of Health and Human Services to ensure that clients who do not speak or understand English well be provided interpretation services to ensure that the service provider and the client can communicate effectively. The Contractor shall have policies and procedures to ensure that interpretation services are available for clients with Limited English Proficiency and will advise such clients that an interpreter will be provided for them. Even if a client has their own interpreter,they shall be advised that the Contractor will provide an interpreter if the client so chooses. 7. Authorization to Subcontract: The State authorizes the Contractor to subcontract some,or all,of the services which are to be performed under this Task Order. However,a subcontractor is subject to all of the terms and conditions of this Task Order. Additionally,the Contractor remains ultimately responsible for the timely and satisfactory completion of all work performed by any subcontractor(s)under this Task Order. If the Contractor desires to subcontract some,or all,of the services which are to be performed under this Task Order,then the Contractor shall obtain the prior,express,written consent of the State before entering into any subcontract. 8. The State may prospectively increase or decrease the amount payable under this Task Order through a"Task Order Change Order Letter". A sample Task Order Change Order Letter is incorporated herein by this reference,made a part hereof,and attached hereto as"Attachment H". To be effective,the Task Order Change Order Letter must be:signed by the State and the Contractor;and,approved by the State Controller or an authorized designee thereof. Additionally,the Task Order Change Order Letter shall include the following information: A. Identification of the related Master Contract by its contract routing number and this Task Order by its contract number,and the affected Task Order paragraph number(s); B. The type(s)of service(s)or program(s)increased or decreased and the new level of each service or program; 9 C. The amount of the increase or decrease in the level of funding for each service or program and the new total financial obligation; D. The intended effective date of the funding change;and, E. A provision stating that the Task Order Change Order Letter shall not be valid until approved by the State Controller or such assistant as he may designate. Increases or decreases in the level of contractual funding made through this task order change order letter process during the initial or renewal terms of this Task Order may be made under the following circumstances: F. If necessary to fully utilize appropriations of the state of Colorado and/or non- appropriated federal grant awards; G. Adjustments to reflect current year expenditures; H. Supplemental appropriations,or non-appropriated federal funding changes resulting in an increase or decrease in the amounts originally budgeted and available for the purposes of this Task Order; I. Closure of programs and/or termination of related contracts or task orders; J. Delay or difficulty in implementing new programs or services;and, K. Other special circumstances as deemed appropriate by the State. Upon proper execution and approval,the Task Order Change Order Letter shall become an amendment to this Task Order. Except for the General and Special Provisions of the Master Contract,the Task Order Change Order Letter shall supersede this Task Order in the event of a conflict between the two. It is expressly understood and agreed to by the parties that the task order change order letter process may be used only for increased or decreased levels of funding, corresponding adjustments to service or program levels,and any related budget line items. Any other changes to this Task Order,other than those authorized by the task order renewal letter process described below,shall be made by a formal amendment to this Task Order executed in accordance with the Fiscal Rules of the State of Colorado. If the Contractor agrees to and accepts the proposed change,then the Contractor shall execute and return the Task Order Change Order Letter to the State by the date indicated in the Task Order Change Order Letter. If the Contractor does not agree to and accept the proposed change, or fails to timely return the partially executed Task Order Change Order Letter by the date indicated in the Task Order Change Order Letter,then the State may,upon written notice to the Contractor,terminate this Task Order twenty(20)calendar days after the return date indicated in the Task Order Change Order Letter has passed. The written notice shall specify the effective date of termination of this Task Order. In the event of termination under this clause,the parties shall not be relieved of their respective duties and obligations under this Task Order until the effective date of termination has occurred. 9. The State may renew this Task Order through a"Task Order Renewal Letter",a sample of which is incorporated herein by this reference,made a part hereof,and attached hereto as Attachment I". To be effective,the Task Order Renewal Letter must be:signed by the State and the Contractor; and,approved by the State Controller or an authorized designee thereof. Additionally,the Task Order Renewal Letter shall include the following information: 10 A. Identification of this Task Order by its contract routing number and affected paragraph number(s); B. The type(s)of service(s)or program(s), if any, increased or decreased and the new level of each service or program for the renewal term; C. The amount of the increase or decrease, if any,in the level of funding for each service or program and the new total financial obligation; D. The intended effective date of the renewal;and, E. A provision stating that the Task Order Renewal Letter shall not be valid until approved by the State Controller or such assistant as he may designate. Upon proper execution and approval,the Task Order Renewal Letter shall become an amendment to this Task Order. Except for the General and Special Provisions of the Master Contract,the Task Order Renewal Letter shall supersede this Task Order in the event of a conflict between the two. It is expressly understood and agreed to by the parties that the task order renewal letter process may be used only to: renew this Task Order;increase or decrease levels of funding related to that renewal;make corresponding adjustments to service or program levels,and,adjust any related budget line items. Any other changes to this Task Order, other than those authorized by the task order change order letter process described above,shall be made by a formal amendment to this Task Order executed in accordance with the Fiscal Rules of the state of Colorado. If the Contractor agrees to and accepts the proposed renewal term,then the Contractor shall execute and return the Task Order Renewal Letter to the State by the date indicated in the Task Order Renewal Letter. If the Contractor does not agree to and accept the proposed renewal term,or fails to timely return the partially executed Task Order Renewal Letter by the date indicated in the Task Order Renewal Letter,then the State may,upon written notice to the Contractor,terminate this Task Order twenty(20)calendar days after the return date indicated in the Task Order Renewal Letter has passed. This written notice shall specify the effective date of termination of this Task Order. If the Task Order is terminated under this clause,then the parties shall not be relieved of their respective duties and obligations under this Task Order until the effective date of termination has passed. F.ATTACHMENTS. All attachments to this Task Order are incorporated herein by this reference and made a part hereof as if fully set forth herein. In the event of any conflict or inconsistency between the terms and conditions of this Task Order and those of any attachment hereto,the terms and conditions of this Task Order shall control. II • IN WITNESS WHEREOF,the parties hereto have executed this Task Order as of the day first above written. CONTRACTOR: STATE: BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY For the use and benefit of the WELD COUNTY DEPARTMENT OF STATE OF COLORADO PUBLIC HEALTH AND ENVIRONMENT (a political subdivision of the state of Colorado) Bill Owe s.Governor By: By: ile For the Exec ve it ctor Chair (09/05/2001) Colorado Department of FEIN: 84-6000813 Public Health and Environ e If Corporation,Town/City/County,Mid or Equivalent: PROGRAM APPROVAL: pp ATTEST(Affix r��► �fe jJ;'' A 1861 ,4v•By: IV—Nu/ '%i ` '1 Deputy Clerk to t APPROVALS: COLORADO DEPARTMENT OF LAW COLORADO DEPARTMENT OF PERSONNEL OFFICE OF THE ATTORNEY GENERAL OFFICE OF THE STATE CONTROLLER Ken Salazar,Attorney General Arthur L.Barnhart,State Controller By: By: nc-Z--(9 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT �V BY: t_ ° L/,����E Mark E. Wallace, MD, MPH•Director 12 Hello