HomeMy WebLinkAbout20003174.tiff RESOLUTION
RE: APPROVE TASK ORDER FOR HIV INTERVENTION 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 HIV Intervention
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
January 1, 2001, and ending December 31, 2001, 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 HIV Intervention 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 18th day of December, A.D., 2000.
BOARD OF COUNTY COMMISSIONERS
W LD COUNTY, COL RADO
C
ATTEST: tinCit
Barbara J 4irkmey r, Chair
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re
Weld County Clerk to the4f/i
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Deputy Clerk to the B tr we
George . Baxter
APPRCG AS TO FORM:
Dale K. Hall
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2000-3174
HL0027
#01 . 0
0(\(\ rmil Memorandum
' C TO: Barbara J. Kirkmeyer, Chair,Board of County Commissioners
FROM: Mark E. Wallace, MD, MPH, Director,
Department of Public Health and
COLORADO Environment �/ ��
DATE: December 14, 2000 U"`►uN
SUBJECT: HIV Intervention Task Order
Enclosed for Board review and approval is the HIV Intervention Task Order to become part of
the five-year master contract between the Colorado Department of Public Health and
Environment and Weld County.
This task order is for the provision of HIV education and prevention services to both individuals
and groups, and also to provide public information services. For these services, Weld County
will receive an amount not to exceed $14,707 for the time period January 1, 2001 through
December 31, 2001.
I recommend your approval of this task order. 1T.i
Enclosure '1
2000-3174
DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLIC
HEALTH AND ENVIRONMENT
Department or Agency Number
FHA
Contract Routing Number
01-00129
TASK ORDER
THIS TASK ORDER is made this 24th of November 2000,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 17th Avenue.Greeley.Colorado
80631,hereinafter referred to as"the Contractor".
WHEREAS,section 29-1-201, 8 CRS.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, and to this end all State contracts with its political subdivisions are exempt from the States personnel rules
and the State procurement code;
WHEREAS,the State has formulated a comprehensive State plan,with associated budgets, relative to the State's
programs and services which allocates funds to local health agencies in order to provide certain purchased services
to the people of Colorado;
WHEREAS,such funding is to be allocated through task order contracts with local health agencies;
WHEREAS,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(s) 100,Organizational Unit Code(s)Mil Appropriation Code(s)377. Program Code(s)
9012,and Object Code(s)42Q under Master Contract Routing Number 00 FAA 00008 and Contract Encumbrance
Number PO FHA SET0100129;
WHEREAS,pursuant to 25-4-1401, 8 CRS.,as amended,the general assembly declares that infection with human
immunodeficiency virus(HIV),the virus which causes acquired immune deficiency syndrome(AIDS), is an
infectious and communicable disease that endangers the population of this state;
WHEREAS,pursuant to 25-4-1405, 8 CRS.,as amended,it is the duty of state to investigate sources of HIV
infection and to use every proper means to prevent the spread of the disease;
Page I of 7
,9,DC6,3774/
WHEREAS,pursuant to 25-4-1405, 8 CRS., as amended, it is the duty of state,as part of disease control efforts,to
provide public information and risk-reduction education,to conduct health information programs to inform the
general public of the medical and psychosocial aspects of HIV infection, including updated information on how
infection is transmitted and can be prevented, and the necessity for testing;
WHEREAS,pursuant to the Catalog of Federal Domestic Assistance(CFDA)Number 93.940,the State has been
awarded monies by the U.S. Department of Health and Human Services,Centers for Disease Control and Prevention
(CDC)for Human Acquired Immunodeficiency Syndrome(AIDS)prevention by means of intervention education;
WHEREAS,as of the made date of this Contract,the State has a currently valid Group II purchasing delegation
agreement with the Division of Purchasing within the Colorado Department of Personnel;
WHEREAS,the Contractor was selected by the State in accordance with the applicable provisions of the Colorado
Procurement Code as the lowest responsive and responsible bidder pursuant to Request for Proposals(RFP)number
RO-SET0001 to provide HIV intervention services in rural communities;
WHEREAS,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 CONTRACT TERMINATION. The effective date of this
Task Order is January 1.2001,or on the date this Task Order is approved by the State Controller,
whichever is later.The term of this Task Order shall commence on January 1.2001,and continue
through and including December 31.2001,unless sooner terminated by the parties pursuant to the terms
and conditions of the Master Contract.The total term of this Task Order, including any extensions or
renewals hereof may not exceed two(2)years.
B. GENERAL STANDARDS.The subject matter of this Contract concerns the prevention of contracting
and transmitting HIV infection in Rural Communities. The Contractor has been selected to perform HIV
intervention services in accordance with RFP number RO-SET0001 and the Contractor's response to that
RFP, as modified by this Contract.The RFP is incorporated herein by this reference,made a part hereof,
and attached hereto as"Attachment A".The Contractor's Response to the RFP is incorporated herein
by this reference,made a part hereof, and attached hereto as"Attachment B".
C. MODIFICATIONS TO THE PROPOSAL.
Based upon recommendations of the review panel and discussions with the Contractor,the
Contractor shall provide the following services:
• Provide Public Information to the general population of Weld County, Colorado.
• Provide Group Level Intervention to Community groups, Hispanic groups,Junior High
school students,agencies serving youth,Gay,Lesbian,Bisexual,and Transgendered,
Men who Have Sex with Men,and Injection Drug Users who reside in Weld County,
Colorado.
Page 2 of 7
• Provide Individual Level Intervention Outreach to Latino,Gay, Lesbian,Bisexual,and
Transgendered,Men who have Sex with Men,and Injection Drug Users who reside in
Weld County,Colorado.
D. DUTIES AND OBLIGATIONS OF THE CONTRACTOR.
Prior to purchase or production,the Contractor shall submit all proposed printed
materials to the State, via the Project Officer,for approval by the State Material Review Panel.
2. The Contractor shall maintain internal medical and administrative records(including,but not
limited to, labslips and counseling session notes)in a manner which ensures the confidentiality
and security of those records in accordance with all applicable statutes including,but not limited
to,25-1-107 CRS.et seq(Named reporting of certain diseases and conditions—access to medical
records—confidentiality of reports and records), 18-4-412 CRS.et seq(medical records)and 25-
4-1404 CRS.,(HIV Infection and Acquired Immune Deficiency Syndrome-Use of Reports).
3. The Contractor shall perform intervention services in accordance with"Definitions for HIV
Prevention Interventions and Standards of Practice,"as approved on May 24, 1999 by the Core
Planning Group of Coloradans Working Together: Preventing HIV/AIDS,a copy of which was
supplied to the Contractor with the RFP.
4. The Contractor shall provide to the State four(4)narrative progress reports which are due within
five(5)business days after the end of the period.These reports shall describe and evaluate the
interventions conducted. March,June, September,and December billings will not be reimbursed
until such time as delinquent progress reports have been received. Reports shall be submitted to
the State to the attention of Clarence White.4300 Cherry Creek Drive South. DCEED-A3
Denver,Colorado, 80246.Time frames to be addressed are as follows:
Progress Period Due Date
January-March,2001 April 7,2001
April-June,2001 July 10,2001
July-September,2001 October 6,2001
October-December,2001 January 8,2002
5. The Contractor shall use data collection forms to be provided by the State.
6. The Contractor shall develop and maintain referral agreements with agencies providing other HIV
intervention services, including but not limited to,mental health,substance abuse prevention and
treatment,family planning,clinical,and other services that support behavior change.
7. The Contractor shall participate in State sponsored contractor meetings and trainings and the
District Collaboration.
8. The Contractor shall participate in quarterly program and intervention observation site visits with
the assigned State project officer.
Page 3 of 7
E. COMPENSATION
I. The State shall, in consideration of those services satisfactorily and timely performed by the
Contractor under this Contract,cause to be paid to the Contractor a sum not to exceed
FOURTEEN THOUSAND SEVEN HUNDRED SEVEN DOLLARS(14.707.00) for the initial
term of this Contract. Of the total financial obligation of the State referenced above, one hundred
percent is identified as attributable to a funding source of the United States government.
2. The State shall reimburse the Contractor for expenditures in accordance with the budget below.
The Contractor's transfer of funds from one line item to another must have prior, written approval
of the State:
Individual Level Intervention Group Level Intervention
Personnel/Fringe 2,097.00 Personnel/Fringe 4,500.00
Travel 132.00 Travel 400.00
Supplies 50.00 Supplies 100.00
Contractual 400.00 Contractual 300.00
Other 50.00 Other 150.00
Indirect 260.00 Indirect 518.00
2,989.00 5,968.00
Public Information TOTALS:
Personnel/Fringe 4,300.00 Individual Level Intervention 2,989.00
Travel 400.00 Group Level Intervention 5,968.00
Supplies 250.00 Public Information 5,750.00
Contractual 100.00
Other 200.00
Indirect 500.00 GRAND TOTAL: $14,707.00
5,750.00
F. PAYMENT MECHANISM.
1. To receive compensation under this Contract,the Contractor shall submit a signed monthly billing
statement,an example of which is incorporated herein by reference,made a part hereof,and
attached hereto as"Attachment C",within sixty(60)calendar days of the end of the billing
period for which services were rendered. Billing statements shall:reference this Contract by its
contract number,which number is located on page one of this document; state the applicable
performance dates,the names of payees;a brief description of the services performed during the
relevant performance dates;expenditures incurred;and,the total reimbursement requested.
Reimbursement during the initial,and any renewal term of this Contract shall be conditioned upon
affirmation by the State that all services were rendered by the Contractor in accordance with the
terms of this Contract.Billing statements shall be sent to:
Colorado Department of Public Health and Environment,
4300 Cherry Creek Drive South,DCEED-HIV-A3, Denver,CO 80246.
Page 4 of 7
2. The State may prospectively increase or decrease the amount payable under this Task Order
through a Task Order Change Order Letter,a sample of which is incorporated herein by this
reference,made a part hereof,and attached hereto as"Attachment D". 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 and this Task Order by their respective
contract routing numbers and affected 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;
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.
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. This written notice shall specify the effective date of
termination of this Task Order. If this 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.
Increases or decreases in the level of contractual funding made through this task order change
order letter process during the initial,or renewal,term of this Task Order may only 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;
Page 5 of 7
J. Delay or difficulty in implementing new programs or services;and,
K. Other special circumstances as deemed appropriate by the State.
3. 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
E". 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:
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 retum 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 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 of this Task
Order and those of any attachment hereto,the terms and conditions of this Task Order shall control.
Page 6 of 7
IN WITNESS WHEREOF,the parties hereto have executed this Task Order as of the day first above written.
CONTRACTOR:
STATE:
BOARD QFF COUNTY COMMISSIONERS STATE OF COLORADO
OF WELD COUNTY Bill Owens,Governor
(a polif I subdivision oft a state of Colorado)
By: By:
Na e: Barbara J. Kirkmeyer For th E ecutive erector
Title: Chair (12/18/2000) Depar ment of Public
FEIN: 84-6000813 Health and Environment
ATTEST: ,-� PROGRAM APPROVAL:
(.e:I) � ��:� EZa�
$1861 i S'i 5 4i
By: // ��ii�..l ��q1►1� B
gK �� y ;?}�; �•n,a;. � is Sc eiger,Fisca fficer
Deputy Clerk to the Bo
APPROVALS:
Colorado Department of Law Colorado Department of Personnel
Office of the Attorney General Office of the State Controller
Ken Salazar,Att n Gen ral Arthur L. Barnhart,State Controller
By: By: ' (• t'�--I.G:_.((1— L:1 JO'.
WELD COUNTY DEPARTMENT OF
PUBLIC AN ENVI
BY: waki/�
Mark E. Wallace, MD, MPH-Director
Page 7 of 7
STATE OF COLORADO
Bill Owens,Governor pF;cpzo
Jane E.Norton,Executive Director �8'
N
Dedicated to protecting and improving the health and environment of the people of Colorado
♦ 4 4, r
4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division t • 4.,
Denver,Colorado 80246-1530 8100 Lowry Blvd. '1876'
Phone(303)692-2000 Denver CO 80230-6928
located in Glendale,Colorado (303)692-3090 Colorado Department
of Public Health
http://www.cdphe.state.co.us and Environment
INVITATION TO BID
DATE: October 4, 1999
RFP NO: RO-SET0001
DIRECT INQUIRIES TO: ROBERT M. O'NEILL
PHONE NO: (303) 692-2074
DATE RFP DUE: Friday. 11/12/99 @2:00 PM MST
Bids properly marked as to RFP NO., DATE and HOUR of opening, subject to the conditions herein stipulated and
in accordance with the specifications set forth and/or attached hereto, will be accepted at the address listed below,
prior to the date and time listed for the bid opening. All bids shall be quoted F.O.B. destination, unless otherwise
specified, to the delivery location or jobsite listed herein.
SEALED COMPETITIVE PROPOSAL FOR:
HIV INTERVENTION SERVICES IN RURAL COMMUNITIES
RETURN PROPOSAL TO:
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
ASD-PURCH-A2
4300 CHERRY CREEK DRIVE SOUTH
DENVER, CO 80246-1530
Prices shall be quoted F.O.B. destination and include delivery to the CDPHE.
SEE ATTACHED PAGES FOR TERMS AND CONDITIONS AND RFP REQUIREMENTS.
IMPORTANT: Bidders should read the entire bid document before submitting bid.
RFP'S MUST BE SIGNED IN INK
VENDOR
ADDRESS
TYPED OR PRINTED SIGNATURE
Handwritten Signature by Authorized Officer or Agent of Vendor
TERMS
Terms of less than 30 calendar days will not be considered.
TITLE
DATE PHONE # FAX#
The above bid is subject to Terms and Conditions on attached sheets.
RETURN THIS COPY
Please be advised that telegraphic or electronic bids (Fax, Western Union, Telex, etc.) cannot be accepted directly
in the Purchasing Office as a sealed bid. Bidders are urged to read the bid thoroughly before submitting a bid.
Low Tie Bids: Low tie bids shall be decided in accordance with the provision of C.R.S., Section 24-103-202.5, as
it currently exists or is hereafter amended, which gave a preference to resident bidders. Any bidder who wishes
to be considered a "resident bidder"for purposes of the tie bid procedure provided in C.R.S., Section 24-103-202.5
shall include with their bid proof that he/she meets the definition of resident bidder as set forth in either C.R.S.,
Section 24-103-101(6)(a) or C.R.S., Section 24-103-101(6)(b).
Pursuant to C.R.S., Section 24-30-202.4 (as amended), the State Controller may withhold debts owed to state
agencies under the vendor offset intercept system for: (a) unpaid child support debt or child support arrearages;
(b) unpaid balance of tax, accrued interest, or other charges specified in Article 22, Title 39, C.R.S.; (c)unpaid loans
due to the Student Loan Division of the Department of Higher Education; (d) owed amounts required to be paid
to the Unemployment Compensation Fund; and (e) other unpaid debts owing to the State or any agency thereof,
the amount of which is found to be owing as a result of final agency determination or reduced to judgment as
certified by the controller.
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
FOR
HIV INTERVENTION SERVICES IN RURAL COMMUNITIES
RFP#CDPH&E-RO-SET0001
I. ADMINISTRATIVE INFORMATION
A. ISSUING OFFICE: This Request for Proposal (RFP) is issued for the Colorado Department of Public
Health & Environment by the Purchasing Section for the benefit of the STD/HIV Education and
Training Program. CDPH&E Purchasing is the SOLE point of contact concerning this RFP. All
communication must be done through the CDPH&E Purchasing.
B. PURPOSE: This RFP provides prospective offerors with sufficient information to enable them to
prepare and submit proposals for consideration by the STD/HIV Education and Training Program to
satisfy the need for expert assistance in the completion of the goals of this RFP.
C. SCOPE: This RFP contains the instructions governing the proposal to be submitted and the material to
be included therein; mandatory requirements which must be met to be eligible for consideration; and
other requirements to be met by each proposal.
D. SCHEDULE OF ACTIVITIES
Table 1- Schedule of Activities
ACTIVITIES: TIMELINE (Local Time)
1. RFP NOTICE PUBLISHED ON THE BIDS SYSTEM October 7, 1999
2. PROSPECTIVE OFFERORS WRITTEN INQUIRY DEADLINE October 21, 1999 3:00 p.m.
(NO QUESTIONS ACCEPTED AFTER THIS DATE)
3. PROPOSAL SUBMISSION DEADLINE(SUBMIT 8 COPIES OF November 12, 1999 2:00 p.m.
THE PROPOSAL [INCLUDES THE ORIGINAL])
4. CONTRACT PERIOD Variable based on offeror request and
panel recommendations for 1,2,or 3 year
funding. Anticipate mid-January start
date. Budget period January-December
E. INQUIRIES: Offerors may make written or fax inquiries concerning this RFP to obtain clarification of
requirements. No inquiries will be accepted after the date and time indicated in the Schedule of
Activities. Send all inquiries to:
Co Dept of Public Health&Environment(Purchasing)
4300 Cherry Creek Drive So.(A-2)
Denver, CO 80246-1530
FAX: (303) 782-4883
RFP No. RO-SET0001 Inquiry
Response to offeror's inquiries will be published as a modification on the Bid Information and
Distribution(BIDS)system by Purchasing in a timely manner. Offerors should not rely on any other
statements that alter any specification or other term or condition of the RFP.
F. MODIFICATION OR WITHDRAWAL OF PROPOSALS: Proposals may be modified or withdrawn by the
offeror prior to the established due date and time.
G. PROPOSAL SUBMISSION: Proposals must be received on or before the date and time indicated in the
Schedule of Activities. Late proposals will not be accented. It is the responsibility of the offeror to
ensure that the proposal is received by the CDPH&E Purchasing Section on or before the proposal
opening date and time. Offerors mailing their proposals shall allow sufficient mail delivery time to
ensure receipt of their proposals by the time specified. The proposal package shall be delivered or sent
by mail to:
CDPH&E Purchasing A-2
4300 Cherry Creek Drive So
Denver,Co. 80246-1530
Attention: R.M. O'NEILL
One copy of the State of Colorado Invitation for Bid form MUST be signed in ink by the offeror or an
officer of the offeror legally authorized to bind the offeror to the proposal.The signed Invitation for Bid
form is to be included with the proposal copy that is marked ORIGINAL.
Proposals which are determined to be at a variance with this requirement may not be accepted.
Proposals must be submitted and sealed in a package. The outer envelope of the package must include the
following information:
OFFEROR'S NAME
RFP NO
PROPOSAL DUE DATE&TIME
The Purchasing Section desires and encourages that proposals be submitted on recycled paper, printed on both
sides. While the appearance of proposals and professional presentation is important,the use of non-recyclable or
non-recycled glossy paper is discouraged.
H. ADDENDUM OR SUPPLEMENT TO REQUEST FOR PROPOSAL: In the event that it becomes
necessary to revise any part of this RFP,an addendum will be sent via the BIDS system.
ORAL PRESENTATIONS/SITE VISITS: Offerors may be asked to make oral presentations or to make
their facilities available for a site inspection by the evaluation committee. Such presentations and/or site
visits will be at the offeror's expense.
J. ACCEPTANCE OF RFP TERMS: A proposal submitted in response to this RFP shall constitute a
binding offer. Acknowledgment of this condition shall be indicated by the autographic signature of the
offeror or an officer of the offeror legally authorized to execute contractual obligations. A submission in
response to this RFP acknowledges acceptance by the offeror of all terms and conditions including
compensation, as set forth herein. An offeror shall identify clearly and thoroughly any variations
between its proposal and the State's RFP. Failure to do so shall be deemed a waiver of any rights to
subsequently modify the terms of performance,except as outlined or specified in the RFP.
K. PROTESTED SOLICITATIONS AND AWARDS: Any actual or prospective offeror or contractor who
is aggrieved in connection with the solicitation or award of a contract may protest to the state purchasing
director or the head of a purchasing agency,as appropriate. The protest shall be submitted in writing
within seven working days after such aggrieved person knows,or should have known,of the facts giving
rise thereto.
Ref. Section 24-109, 101 et. seq.,C.R.S.,as amended; Section 24-109, 201 et.seq.,C.R.S. as amended; Section
R-24-109-101 through R-24-109-206,Colorado Procurement Rules.
L. CONFIDENTIAL/PROPRIETARY INFORMATION: Any restrictions of the use or inspection of
material contained within the proposal shall be clearly stated in the proposal itself. Written requests for
confidentiality shall be submitted, by the offeror with the proposal. The offeror must state specifically
what elements of the proposal are to be considered confidential/proprietary. Confidential/proprietary
information must be readily identified, marked and separated/packaged from the rest of the proposal. Co-
mingling of confidential/proprietary and other information is NOT acceptable. Neither a proposal, in its
entirety, nor proposal price information will be considered confidential and proprietary. Any informa-
tion that will be included in any resulting contract cannot be considered confidential.
The Purchasing Section shall determine the validity of any written request for confidentiality. If the
parties do not agree as to the disclosure of data, the Purchasing Section shall inform the bidder in writing
what portions will be disclosed. The written decision of the Purchasing Section will be sent to the
offeror. Ref. Section 24-72-201 et. seq., C.R.S.,as amended, Public(open)Records.
M. RFP RESPONSE MATERIAL OWNERSHIP: All material submitted regarding this RFP becomes the
property of the State of Colorado. Proposals may be reviewed by any person after the "Notice of Intent
to Make an Award" letter has been issued, subject to the terms of Section 24-72-201 et. seq., C.R.S., as
amended, Public(open) Records.
N. PROPOSAL PRICES: Estimated proposal prices are not acceptable. Proposal prices should be best and
final offer, unless otherwise stated in the RFP. The proposal price will be considered in determining the
apparent successful offeror.
O. SELECTION OF PROPOSAL: All offerors will be notified in writing regarding the results of the RFP
evaluation. Upon review and approval of the evaluation committee's recommendation for award, the CDPHE
will issue a "Notice of Intent to Make an Award" letter to the apparent successful offeror.
P. AWARD OF CONTRACT: The award will be made to that offeror whose proposal, conforming to the
RFP,will be determined to be most responsive and responsible to the State of Colorado,price and other
factors considered. A contract must be completed and signed by all parties. In the event the parties are
unable to enter into a contract,the State may elect to cancel the "Notice of Intent to Make an Award"
letter and make the award to the next most responsive and responsible offeror.
Q. ACCEPTANCE OF PROPOSAL CONTENT: The contents of the proposal(including persons specified
to implement the project)of the successful offeror will become contractual obligations if acquisition
action ensues. Failure of the successful offeror to accept these obligations in a contract, purchase
document,delivery order or similar acquisition instrument may result in cancellation of the award and
such offeror may be removed from future solicitations.
R. STANDARD CONTRACT: The State of Colorado will incorporate standard State contract provisions
(Special Provisions)into any contract resulting from this RFP.
S. RFP CANCELLATION: The State reserves the right to cancel this Request for Proposal at any time,
without penalty.
T. STATE OWNERSHIP OF CONTRACT PRODUCTS/SERVICES: Proposals, upon established opening
time, become the property of the State of Colorado. All products/services produced in response to the
contract resulting from this RFP will be the sole property of the State of Colorado,unless otherwise
noted in the RFP. The contents of the successful offeror's proposal will become contractual obligations.
U. INCURRING COSTS: The State of Colorado is not liable for any cost incurred by offerors prior to
issuance of a legally executed contract or procurement document. No property interest, of any nature
shall occur until a contract is awarded and signed by all concerned parties.
V. MINORITY-OWNED/WOMAN-OWNED BUSINESS ENTERPRISE PARTICIPATION: It is the
State's intent to achieve the goals of the Governor's Executive Orders D0055-87 and D0005-94 regarding
minority/woman-owned businesses. Offerors are reminded it is illegal to discriminate.
W. NON-DISCRIMINATION: The offeror shall comply with all applicable state and federal laws, rules and
regulations involving non-discrimination on the basis of race,color, religion, national origin, age or sex.
X. REJECTION OF PROPOSALS: The State of Colorado reserves the right to reject any or all proposals
and to waive informalities and minor irregularities in proposals received and to accept any portion of a
proposal or all items proposed if deemed in the best interest of the State of Colorado.
Y. PARENT COMPANY: If an offeror is owned or controlled by a parent company, the name, main office address
&parent company's tax identification number shall be provided in the proposal. The tax identification number
provided must be that of the offeror responding to the RFP.
Z. NEWS RELEASES: News released pertaining to this RFP shall NOT be made prior to execution of the contract
without prior written approval of CDPHE.
AA. CON 1 RACT CANCELLATION: CDPHE reserves the right to cancel, for cause, convenience or lack of fiscal
funding, any contract resulting from this RFP by providing timely notice to the contractor.
BB. CERTIFICATION OF INDEPENDENT PRICE DETERMINATION:
1. By submission of this proposal each offeror certifies,and in the case of a joint proposal each party,thereto
certifies as to its own organization,that in connection with this procurement:
(a) The prices in this proposal have been arrived at independently, without
consultation,communication, or agreement, for the purpose of
restricting competition,as to any matter relating to such prices with any
other offeror or with any competitor;
(b) Unless otherwise required by law,the prices which have been quoted in
this proposal have not been knowingly disclosed by the offeror and will
not knowingly be disclosed by the offeror prior to opening,directly or
indirectly to any other offeror or to any competitor; and
(c) No attempt has been made or will be made by the offeror to induce any
other person or firm to submit or not to submit a proposal for the
purpose of restricting competition.
2. Each person signing the Invitation for Bid form of this proposal certifies that:.
(a) He is the person in the offeror's organization responsible within that
organization for the decision as to the prices being offered herein and
that he has not participated,and will not participate, in any action
contrary to(1 Xa)through(l Xc)above; or
b) He is not the person in the offeror's organization responsible within that organization for the
decision as to the prices being offered herein but that he has been authorized in writing to act as
agent for the persons responsible for such decision in certifying that such persons have not
participated, and will not participate, in any action contrary to(1)(a)through(1Xc)above,and as
their agent does hereby so certify;and he has not participated,and will not participate, in any
action contrary to(l)(a)through(l)(c)above.
3. A proposal will not be considered for award where(1)(a),(1)(c),or(2)above has been
deleted or modified. Where(l)(b)above has been deleted or modified,the proposal will
not be considered for award unless the offeror furnishes with the proposal a signed
statement which sets forth in detail the circumstances of the disclosure and the head of
the agency, or his designee, determines that such disclosure was not made for the
purpose of restricting competition.
CC. TAXES: CDPHE, as purchaser, is exempt from all federal excise taxes under Chapter 32 of the Internal
Revenue Code(Registration No. 84-730123K)and from all state and local government use taxes(Ref.
Colorado Revised Statutes Chapter 39-26.114(a)). Our Colorado State and Local Sales Tax Exemption
Number is 98-02565. Seller is hereby notified that when materials are purchased in certain political sub-
divisions(for example- City of Denver)the seller may be required to pay sales tax even though the
ultimate product or service is provided to the State of Colorado. This sales tax will not be reimbursed by
the State.
DD. ASSIGNMENT AND DELEGATION: Except for assignment of antitrust claims, neither party to any
resulting contract may assign or delegate any portion of the agreement without the prior written consent
of the other party.
EE. AVAILABILITY OF FUNDS: Financial obligations of the State payable after the current fiscal year are
contingent upon funds for that purpose being appropriated,budgeted and otherwise made available. In
the event funds are not appropriated,any resulting contract will become null and void,without penalty to
the State of Colorado.
FF. INDEPENDENT CONTRACTOR CLAUSE: All personal service contracts must contain the following
clause:
"The contractor shall perform its duties hereunder as an independent contractor and not as an employee.
Neither the contractor nor any agent or employee of the contractor shall be or shall be deemed to be an
agent or employee of the state. Contractor shall pay when due all required employment taxes and
income tax withholding, shall provide and keep in force worker's compensation(and show proof of such
insurance)and unemployment compensation insurance in the amounts required by law,and shall be
solely responsible for the acts of the contractor, its employees and agents."
GG. INDEMNIFICATION: To the extent authorized by law,the contractor shall indemnify, save and hold
harmless the State, its employees and agents,against any and all claims,damages, liability and court
awards including costs,expenses,and attorney fees incurred as a result of any act or omission by the
contractor or its employees, agents,subcontractors,or assignees pursuant to the terms of the contract
resulting from this RFP.
HH. VENUE: The laws of the State of Colorado,U.S.A. shall govern in connection with the formation,
performance and the legal enforcement of any resulting contract. Further,Title 24,C.R.S.as amended,
Article 101 through 112 and Rules adopted to implement the statutes govern this procurement.
II. INSURANCE: If the RFP so states,the contractor shall obtain,(at its own expense)and maintain at all times
during the terms of this agreement, insurance in the following kinds and amounts:
A. Standard Workers' Compensation and Employer Liability as required by state statute, including occupational
disease,covering all employees on or off the work site,acting within the course and scope of their employment.
B. General and/or Personal Injury and/or Professional and/or Automobile Liability-(including bodily injury,
personal injury and property damage) with the following coverage, depending on the policy format:
1. Occurrence basis policy-combined single limit of$600,000.
2.Annual Aggregate limit policy-not less than$1 million plus agreement that vendor will
purchase additional insurance to replenish the limit to $1 million if claims reduce the annual aggregate
below$600,000.
3.Claims-Made policy-Combined single limit of$600,000 plus an endorsement that extends coverage 2
years beyond the policy expiration date.
C. Vendor shall provide such other insurance as may be required by law. The State of Colorado shall be named
as an additional insured on all liability policies. The insurance shall include a provision preventing cancellation
without 60 calendar days prior written notice to the State by certified mail. Vendor shall provide the following
documentation to the State within 7 working days of a request therefor, unless otherwise provided:
A. Certificate/s of adequate insurance coverage, each with a reference to the State being named as an additional
insured, or
B. Certificate/s of adequate insurance coverage and an endorsement/s of additional insured coverage.
II. BACKGROUND,PURPOSE,FUNDING,ELIGIBILITY,TIME FRAME
BACKGROUND
This RFP is supported by federal HIV Prevention funds through Cooperative Agreement Number U62/CCU802031-15.
CDPH&E staff and the community planning group,Coloradans Working Together: Preventing HIV/AIDS(CWT)
developed key documents to aid the offeror in completing their application in response to this RFP:
• The 2000 Rural Plan for HIV Prevention("the Rural Plan") lays out the estimated number of individuals at-risk
of HIV infection,the units and types of services that an operational HIV intervention system should be prepared
to provide for each district.
• The Coalition HIV Prevention Plans for 1998-2000 describes detailed priorities for each district in terms of: the
specific populations to be served; sub-populations of high concern; behavior change factors that providers should
target for each priority population; ranking of interventions that show the most promise of changing prioritized
risk behaviors;the mix of services for persons with or without HIV infection; guidance concerning community
strengths and challenges.
• The 2000 Definitions for HIV Prevention Interventions and Standards of Practice describes the interventions and
how they should be conducted.
These documents can be found on the Internet on the BIDS system at (http://www.state.co.us)or will be mailed to you
with the RFP document if you indicated you would not be able to retrieve information from a web page.
PURPOSE
The purpose of this RFP is to support a three-tiered system(see the Intervention section for a definition of the tiers)of
integrated Human Immunodeficiency Virus(HIV) intervention services within rural areas of Colorado. The intent is to
support one collaborative project or system in each HIV prevention community planning district throughout the state. A
collaboration is a series of informal and formal relationships between and among individuals and organizations designed
to further programmatic goals and objectives. For the purpose of this application a collaboration must consist of a
minimum of three collaborators that serve at least two counties within a district.
ELIGIBILITY
Offeror agencies, involved in the collaboration, must:
I)have an office in the district to be served or have a memorandum of understanding with an agency in the district;
and
2) be an individual; a public or private non-profit agency possessing a tax exempt status under section 501 (c)(3)of the
IRS code; public or private for-profit agency; or a governmental agency(such as a local health department or university).
This RFP is intended to support HIV interventions in the counties described in Table 2-Funding Available By District.
TIME FRAME
Funding will begin on approximately January 24, 2000. Proposals may be submitted for one, two, or three year funds. In
some instances the proposal review panel may recommend that a project be funded for only one year. Project
performance may result in a project being funded for only one year. Seventy percent of funds will be awarded to
multiple year projects, leaving 30%of funds for one year projects ending December 31, 2000. Some applicants who
apply for multiple year funding may be awarded single year funding, based on recommendations of the RFP Review
Panel. Tier Three incentive funds may be awarded on an annual basis.
FUNDING
A total of$213,504 is available to support HIV interventions in the rural districts. Funds will be awarded district-by-
district. Dollars may be shifted between districts if funds go unawarded for a particular district.
Breakdown of Funding in the RFP Dollar Amount Available
Funding for public information, individual interventions, group interventions and $105,384.00
population interventions broken down by district and episodes of service. (See Table 2-
Funding Available By District below.)
Funding for counseling and testing($35,240)and prevention case management $53,120.00
($17,880). Funds are available competitively to all Tier Two systems across all of the
districts.
Funding for Tier Three innovative projects targeting hard-to-reach rural populations. $55,000.00
Funds are available competitively to all Tier Two systems across all of the districts.
Total $213,504.00
Table 2 outlines the districts,the number of episodes of service to be provided by type of intervention and the dollar
amount available to provide services in each district.
Table 2-Funding Available By District
District Counties in the District Episodes of Service Dollar Amount
District I Rio Blanco,Moffat,Jackson,Routt Public Information 259 $2,996
District Counties in the District Episodes of Service Dollar Amount
Individual Interventions 89
Group Interventions 42
Population Interventions 92
District 2 Larimer, Weld,Northern Adams Public Information 2439 $29,438
Individual Interventions 842
Group Interventions 423
Population Interventions 919
District 3 Sedgewick, Washington,Phillips,Lincoln,Kit Public Information 485 $5,527
Carson,Logan,Yuma,Cheyenne, Morgan,
Eastern Adams Individual Interventions 168
Group Interventions 75
Population Interventions 167
District 4 Montrose,Gunnison,Mesa, Delta,Ouray, San Public Information 1258 $14,676
Migel
Individual Interventions 417
Group Interventions 208
Population Interventions 459
District 5 Eagle,Grand, Lake,Garfield, Summit, Park, Public Information 763 $9,019
Pitkin
Individual Interventions 258
Group Interventions 128
Population Interventions 281
Rural District 6 Clear Creek,Douglas,Gilpin, Southern Adams Public Information 706 $8,417
Individual Interventions 237
Group Interventions 121
Population Interventions 265
District 7 Hinsdale,Montezuma,La Plata,Dolores, San Public Information 509 $5,887
Juan,Archuleta
Individual Interventions 171
Group Interventions 83
Population Interventions 181
District 8 Chaffee,Rio Grande,Mineral,Alamosa, Public Information 558 $6,349
Saguache,Conejos,Costilla,Teller,Custer
Individual Interventions 192
District Counties in the District Episodes of Service Dollar Amount
Group Interventions 87
Population Interventions 192
Rural District 9 Pueblo, Las Animas, Huerfano,Elbert, Public Information 1379 $16,788
Fremont
Individual Interventions 486
Group Interventions 243
Population Interventions 488
District 10 Baca, Bent,Otero,Prowers, Kiowa,Crowley Public Information 316 $3,565
Individual Interventions 110
Group Interventions 48
Population Interventions 107
District 11 Ute Mountain Ute Reservation,Southern Ute Public Information $2,722
Reservation Individual Interventions
Group Interventions 80
Population Interventions
TOTAL $105,384.00
The level of funding will be based on the number and quality of proposals received, the budget requests, and the
availability of funds for HIV Prevention from the Centers for Disease Control and Prevention(CDC). This RFP or
subsequent awards may be amended pending increases or decreases in the amount of funds received by the CDC or
failure to meet project objectives.
MATCHING FUNDS
CDPH&E is not the sole source of funding for HIV interventions in Colorado. In assessing how close the rural HIV
prevention system is to achieving the levels of service described in the Rural Plan, it will be necessary to consider all
HIV intervention services,not just those funded by CDPHE. A collaborative system should include several partners who
have other private or public sources of funds but agree to work together toward the shared goals of the project. These
funds would be considered as"match" in a collaborative application. Other examples of matching funds include in-kind
donations,volunteer staffing and other sources of funds.
CONTRACTS
The successful collaborators will carry out the project(s)under line item,cost reimbursement purchase orders or
contracts with the State of Colorado. Reimbursement requests must be submitted monthly;reimbursement for services
may be held if the contractor does not comply with progress report requirements.
III.STATEMENT OF WORK
The goal of HIV prevention is to lower the risk of becoming infected with HIV or infecting others.The objective of this
RFP is to implement interventions that change risk behavior and are accessible and acceptable to those who are most
vulnerable to HIV. To accomplish this, important considerations must be addressed in terms of the audience(s)to be
served; the intervention(s)to be implemented;the evaluation of their effectiveness;the acceptability of the intervention
and strategies with regard to culture,disability,and diversity. CDPHE and CWT have developed guidance on these areas
which must be addressed in your proposal. The documents to use as a resource are described below.
TARGET AUDIENCE
Target audiences may be described in terms of risk behavior(e.g., men who have sex with men, injection drug users,or
the heterosexual partners of people who are infected or at-risk),race/ethnicity, or other characteristics(e.g. age, gender,
disability status, socioeconomic status). The HIV community planning process identified behavioral, race/ethnicity, and
subpopulation priorities for each area of the state. Detailed priorities for local areas and specific populations are found in
the Coalition HIV Prevention Plans for 1998-2000.
Collaborative projects must be able to demonstrate access to and the ability to competently serve the populations listed in
the Rural Plan and to match or exceed the percentages reflected in the people of color demographics for all the counties
they propose to serve. In addition,at least 10%of the services must be targeted to clients who disabled,deaf or hard of
hearing.
INTERVENTIONS
An HIV intervention system can come in three levels of intensity,or tiers, based on the needs and capabilities of the
community,the availability of other public or private funds to support the system,and the amount of money allocated to
the district as described in Table 2, Funding Available By District. At a minimum,a Tier One System will be funded in
each rural district. Insufficient funds exist to support both a Tier One and Tier Two in any particular district.
Tier One- A Tier One system consists of: public information(print or electronic media, posters,brochures, flyers,etc.)
featuring factual HIV information and toll-free referral to the closest available HIV interventions and other supportive
services; marketing of CDPH&E partner counseling and referral services, prevention case management and other
services which will travel to client locations;targeted availability of condoms and other risk-reduction materials;
connection to community mobilization efforts in the district, if any exist.
Tier Two- A Tier Two system is multiple contractors working collaboratively towards common objectives to create an
integrated intervention system from the client's perspective.Tier Two systems must demonstrate the intent and ability to
provide a mix of interventions at strategic locations.The goals for the mix of interventions and the number of episodes of
the interventions to be delivered in each District are laid out in Table 2, Funding Available By District. Some of these
services must be provided with funding from sources other than CDPH&E. The HIV intervention systems described in
the Rural Plan will require additional funding to be fully implemented,but an operational Tier Two system must
demonstrate at least a partial implementation of the applicable district plan.
CDPH&E will conduct a public forum for potential providers of HIV interventions to describe:the intent to fund a
collaboration of local agencies to provide a spectrum of HIV services,the levels and types of services described in the
Rural Plan for the districts,and steps on how to develop a collaboration.The dates and locations are included with your
RFP documents.
Tier Three-Tier Three incentives promote innovation in Tier Two systems,especially as it applies to the delivery of
effective interventions targeted to at-risk hard to reach populations. Innovations may include new and untried
interventions or the adaptation of effective interventions to local conditions,culture and populations.
Tier Two and Three support collaborations that include one or more of the following interventions delivered in
accordance with the definitions and standards found in the document 2000 Definitions for WV Prevention Interventions
and Standards of Practice.
Individual level interventions(ILl):
• outreach
• individual health education
Group level interventions(GLI)
• group risk reduction education
• comprehensive health programs for youth
Population Level Interventions(PEI)
• community identification projects(e.g., examine substance use and its relationship to risk behavior)
• community level interventions
• community-based work plan around needle exchange(nothing in this RFP is intended to violate state and
federal prohibitions on lobbying or Sections 18-18-425 through 18-18-430 of the Colorado Revised
Statutes [see Attachment D])
Prevention Case Management(PCM)
• prevention case management
Counseling,Testing and Referral(CTR)
• CTR provided in conjunction with the interventions listed above and delivered in a non-clinical setting.
If an anonymous option is offered, CTR must be provided in collaboration with a local health department
or the CDPH&E. HIV testing is a medical procedure and must be done under the license of a physician
either directly or through a collaborative relationship.
Public Information (PI)
• public information
Other types of work will not be supported with funds from this RFP.
EVALUATION OF THE INTERVENTIONS
Projects must conduct process evaluation. Formative evaluation is highly recommended when developing or changing an
intervention with a particular target audience. Outcome evaluation is recommended, but not required at this time. Staff
from the CDPH&E Program Evaluation and Technical Assistance Unit(PETA)will be available to help funded
applicants develop these types of evaluation. The 2000 Definitions for HIV Prevention Interventions and Standards of
Practice,Chapter 3 provides a thorough description of the various types of evaluation and gives examples.
STANDARDS FOR COMPETENCE REGARDING CULTURE,DISABILITY AND OTHER DIVERSITY
As a condition of funding, all projects must adopt, implement and evaluate, in conjunction with CDPH&E,their efforts to
comply with the Standards for Competence Regarding Culture, Disability and Other Diversity. Three separate Standards
have been passed by CWT that promote competence/proficiency in regard to culture and other diversity.The first
decision item related specifically to culture and communities of color,the second to disability status,and the third to
other diversity issues(age,gender,substance use,socioeconomic status,sexual orientation, linguistics,disabilities and
geographic settings including migrant, seasonal and resort workers). The Standards are contained in Chapter 2 of the
2000 Definitions for HIV Prevention Interventions and Standards of Practice.
DISTRICT AND POPULATION PLANS
This RFP reflects the priorities and guidance contained in the 1998-2000 Comprehensive Plan for HIV Prevention.The
core material for this state wide plan was developed by 24 active constituent District and Population Coalitions,
representing every geographic area of the state and groups disproportionately affected by the epidemic.Your proposal
MUST be written in response to the District and/or Population Plans relevant to the target audience you intend to serve.
You are encouraged to read the Plans and to base your proposal on the District and/or Population Plan relevant to the
target audience you intend to serve(see Coalition HIV Prevention Plans for 1998-2000).
IV. OFFEROR RESPONSE FORMAT
Tier One,Two and Three proposals require different types and amounts of information. Two application forms, 1) HIV
Intervention Application for Services in Rural Communities-Tier One and 2) HIV Intervention Application for Services
in Rural Communities - Tier Two/Three, are presented in this section as the offeror response format and as the actual
application that can be reproduced and used as your application. You may submit this information in another format but
the information requested in these forms must be included in your application in order for your application to be
considered complete. Proposal application/forms will be available on diskette or e-mail in the following formats: Corel
WordPerfect 8 or Microsoft Word 97. These will be provided upon request. Contact Karen Proctor at(303)692-2733 to
order.
Submit 8 copies of your proposal,including the original. The proposal must not exceed 10 single sided pages and be
es e single
based on the 10 pages.The page limit g ' S only first
proposal eceeds 10 DOENOT include the budget tables,the read
ssu assurances or the
entire
evaluation
the
will
memorandum of understanding.
Proposals will be assessed on the materials presented. Therefore, it is important that proposals be complete and
applicants recognize that opportunity for revision or augmentation may not exist. CDPH&E may seek written
clarification of information provided by offerors in their proposal at any time if necessary.
A proposal must be submitted by each agency/individual applying for funds within a collaboration. The proposal will
need to contain information about the relationships between the collaborators,common operational plans and budget
information. Separate awards will be given to the individual entities in the collaboration.
HIV INTERVENTION APPLICATION FOR SERVICES IN RURAL COMMUNITIES -
TIER ONE
Individual or Agency is registered on the BID System
O yes; O no;(check the box that applies)
Prerequisite- An applicant must be registered on the BID System to apply for funds(see http://www.state.co.us for
information on how to register for the BID System). You can register online or through the mail. If you indicated you
would not be able to retrieve information from a web page,you will be mailed the BID System information with the RFP.
Invitation for Bid Form
Please note the Invitation for Bid Form must be completed, signed, and attached as the first page of your proposal. See
the Proposal Submission section for information on how to complete the form.
Funds are requested to provide service in District (insert the District Number)
Please note the eligibility criteria and the Districts and their associated counties in Table 2. A separate proposal must be
submitted for each District if you intend to serve more than one District.
One,Two,or Three Year Contract
Funds are requested for(check only one box): O Year 2000 only; O 2000-2001 (submit a budget for 2000 and a budget projection
for 2001); O 2000-2002 (submit a budget for 2000 and budget projections for 2001 and 2002).
Scope of Work: The applicant agrees to provide:
• public information and toll-free referral to the closest available HIV interventions and other supportive services;
• marketing of CDPH&E partner counseling and referral services, prevention case management and other services
which will travel to the client;
• targeted availability of condoms and other risk-reduction materials in high risk locations throughout the district;
♦ connection to community mobilization efforts in the district, if any exist.
Agree O yes; ❑ no; (check the box that applies)
Description of the Organization: Provide evidence that you or your agency has the experience to conduct the scope of
work described above.
Standards for Competency and Proficiency: Describe how services will be made accessible to people with disabilities
and those who are deaf or hard-of-hearing. Describe how members of the target audience(s)will be involved in planning,
implementation,and evaluation of this project.
Target Audience(s): Provide an estimate of the number of episodes of public information to be provided in 2000(see
Table 2-Funding Available By District)and describe to whom the service will be provided and where.
Evaluation Plan: Describe how you will measure and track the activities described in the scope of work.
Budget: Budgets for Tier One projects are usually under$3000(see Table 2-Funding Available By District). Districts
who have been allocated a larger dollar amount are not precluded from electing to provide a Tier One project rather than
a Tier Two or Three project. Complete the Summary of Budget Request And Matching Funds table to describe the total
dollar amount requested by budget category(personnel,fringe,travel,equipment, supplies,contractual,and operating
expenses)and private and public(local,state,and federal)matching funds that support this project.
HIV INTERVENTION APPLICATION FOR SERVICES IN RURAL COMMUNITIES -
TIER TWO/THREE
Individual or Agency is registered on the BID System
O yes; O no;(check the box that applies)
Prerequisite- An applicant must be registered on the BID System to apply for funds(see httn://www.state.eo.us for
information on how to register for the BID System). You can register online or through the mail. If you indicated you
would not be able to retrieve information from a web page, you will be mailed the BID System information with the RFP.
Invitation for Bid Form
Please note the Invitation for Bid Form must be completed, signed, and attached as the first page of your proposal. See
the Proposal Submission section for information on how to complete the form.
Funds are requested to provide service in District (insert the District Number)
Please note the eligibility criteria and the Districts and their associated counties in Table 2. A separate proposal must be
submitted for each District if you intend to serve more than one District.
Tier Two and/or Tier Three Project
Funds are requested for(check the box that applies): O Tier Two Project only; O Tier Two Project with Tier Three Funding
Request.
One,Two,or Three Year Contract
Funds are requested for(check only one box): O Year 2000 only; O 2000-2001 (submit a budget for 2000 and a budget projection
for 2000; O 2000-2002 (submit a budget for 2000 and budget projections for 2001 and 2002).
Experience and Ability of the Applicant
Describe your prior experience and/or ability to serve the target audience(s).
Describe your prior experience and/or ability to provide the intervention(s).
NOTE:If you received CDPH&E funding to provide services in 1999,describe the following information:the percentage of
objectives met for each intervention;the collaborative efforts you took to implement the intervention;the successes and barriers you
encountered;and the actions you took to overcome the barriers. Describe the staff trainings and/or change in policy or practice you
adopted to implement the Standards for Cultural Competency and Proficiency,and Diversity. Describe or attach your Access Plan for
serving people who are deaf,hard of hearing or disabled.
Collaboration
Describe the relationships between the collaborating organizations and the mutual responsibilities you have to each other
in completing the proposed activities. Complete a Memorandum of Understanding with each collaborating agency or
individual and submit them as an attachment to your proposal. DO NOT SEND GENERAL LETTERS OF SUPPORT.
Table 3-Summary of Budget Request And Matching Funds
Budget Category Dollar Amount Dollar Amount Dollar Amount Dollar Amount Total
Requested from of Matching of Matching of Matching
CDPH&E Funds Funds Funds
Individual or Agency
(insert the name)
Personnel/fringe
Travel
Equipment
Supplies
Contractual
Operating
Total Direct
Indirect Cost
Total
Sign the Assurances below.
We hereby affirm that:
• materials produced or purchased with these monies will be submitted to the Material Review Panel prior to printing or
purchase;
• personal identifiers related to HIV infection,or AIDS will not be released and adequate security of confidential information
will be maintained to protect clients;
• the proposed program is coordinated with other HIV prevention providers in our geographic area;
• we will comply with the Standards for Competence Regarding Culture,Disability and Other Diversity.
• we will comply with all applicable Colorado Board of Health Rules and Regulation,and state and federal legislation
(Americans with Disabilities Act,Civil Rights Act,etc.);
• we have written this proposal in response to our District and/or Population Plans and our proposal is relevant to the target
audience we intend to serve;
• this program does not duplicate other programs in the our geographic area serving the target audience described in this
proposal;
• we will submit quarterly progress reports with demographic data describing and evaluating activities by the deadlines;
• we will use all CDPH&E approved forms for processing payment reimbursement and data collection;
• we will develop and maintain referral agreements with other agencies providing HIV intervention services that we do not
provide,as well as agencies providing mental health,substance abuse prevention and treatment,family planning,clinical and
other services that support behavior change.
Organization's Name:
Signature: Title:
Table 4-Collaboration to Accomplish The Operational Plan
Complete a row for each intervention directed at a particular target audience. Add additional rows and/or pages, if needed.
Name of Agency or Number of State the intervention State the target State the When will the State the objective(s)
Individual in the episodes of to be provided audience to be served geographic area intervention be to be completed(see
Collaboration service of the (state only one) (county)to be completed? Operational Plan
intervention to served section)
be delivered in
2000
Example:HIV Services Inc. 763 public information injection drug users Eagle;Pitkin May I, 2000 obj. I; indicator 4-3
Example:Marble HIV Services 285 individual health injection drug users Eagle;Pitkin November 15, 2000 obj. 2;indicator 4-3
education
.cam ....±..
r: p .. rth
l7` Y
_. .. _a ...� m<-s ,u u;� ° �a a.,..,uV�..v • :-.to rt- ..._,, :i4 d:
An"episode of service" occurs whenever a client experiences an intervention, such as participating in a group or reading a public information poster. It is not
identical to"clients served" in that the same person may experience multiple episodes; for instance, if an individual is tested three times,this would be considered
three episodes.
If different agencies or individuals are serving the same target audience with the same intervention in the same
geographic area as described above table,explain how the services are not duplicative.
Target Audience
In addition to the Table 4 - Collaboration to Accomplish The Operational Plan, provide the following information.
Describe how members of the target audience(s) will be/have been involved in planning, implementation, and evaluation.
Describe how the target audience(s) will be recruited to participate in the intervention(s).
If you are providing counseling,testing and referral (CTR), describe what proportion of the overall target audience will
be provided CTR and provide a justification for this number. Describe which intervention CTR will be provided with
and how CTR will be delivered along with the other intervention.
Operational Plan
In addition to the Table 4- Collaboration to Accomplish The Operational Plan, provide the following information
(breakout out your response to the questions below if you are proposing both a Tier Two and Three project)
Provide at least one clear, measurable, realistic,time-phased, behavioral objective for each intervention. Number the
objectives and link the objective to behavioral indicators from the 1998-2000 HIV Comprehensive Plan listed in
attachment C. List the objective number in the last column in Table 4- Collaboration to Accomplish The Operational
Plan on the row that corresponds with the agency that will be providing the intervention.
For example: Objective 2:By November 15, 2000, increase by 10%above baseline(as described in the CDPH&E Impact
Evaluation)the number of injection drug users in Eagle and Pitkin county that report cleaning needles and works every time in the
last three months. Behavioral indicator 4-3.
Describe how you will implement the intervention according to its definition and standards.
Describe the degree to which the intervention will be consistent with the recommendations contained within the
appropriate District and/or Population Coalition Plan(see Coalition HIV Prevention Plans for 1998-2000)and the Rural
Plan.
Standards for Competency and Proficiency:
Describe the staff trainings or change in policy or practice you will adopt to implement the Standards for Cultural
Competency and Proficiency,and Diversity.
Describe or attach your Access Plan for providing services to people with disabilities and those who are deaf or hard-of-
hearing.
Complete the table below to compare the demographics(age, gender,ethnicity, challenges, and risk)of the county or
counties you intend to serve, with the proposed target audience for this project, and your agency. For some demographic
variables data may not be available. Demographic information can be found through county governments or the US
Census(www.census.gov ).
Table 5 - Comparison of Demographics
NA=Not applicable; ND=No data available
Demographic By percent describe the demographics of the By percent describe By percent describe the
County(ies)in the District the demographics of demographics of the
the Proposed Target Staff Board of Directors
Name the Name the Name the Name the Audience (if applicable),and/or
county county county county Volunteers
Children(ages 0-12)
Adolescents(ages 13-19)
Young Adults(ages 20-24) --__
Adults(older than age 25)
Total for Age 100% 100 %
Male
Female
Transgendered
Total for Gender 100% 100%
kr.�
African American
Asian American
Latino ����
•
Demographic By percent describe the demographics of the By percent describe By percent describe the
County(ies)in the District the demographics of demographics of the
the Proposed Target Staff,Board of Directors
Name the Name the Name the Name the Audience (if applicable),and/or
county county county county Volunteers
Native American
White
Total for Ethnicity 100% 100%
Challenge .t : ;""4,-432' 3_ "sx: i frfq. xbfr.
People with a developmental,
physical, mental and/or
emotional disability
People who are deaf
People who are hard-of-
hearing
People without a disability
Total for Challenges 100% 100%
" " G`"u�n`.i'1;rX c ,„ 5 t-,;,,�o-r r L ? ( . -'ga . ";;egg p .z i y�R
M`'- E . "`#)'. *.33 d 'rr �+,ec"'&`3e 4,S"....,..
Men who have sex with men
(MSM)
Sexual partners of opposite
sex(POS)
Injection drug users(IDU)
Perinatal transmission
MSM/IDU
Women who have sex with
women
Other modes of transmission
(tattooing,piercing,exposure
to blood and blood products)
Total for Risk 100% 100%
If the demographics of the proposed target audience does not match the county(ies)demographics for serving people of
color, explain how your collaboration as a whole will meet these targets.
Evaluation Plan
Describe how you will conduct process evaluation for each intervention in the operational plan.
Describe which interventions will receive formative evaluation and your plan for formative evaluation.
Complete questions A-C if you are applying for Tier Three funding.
A. Describe the scientific basis (i.e., summary of the literature, community assessment, formative evaluation in the local
community) for the proposed innovative intervention.
B. Describe why it should be considered a new approach to reaching hard-to-reach rural populations.
C. Explain how you will evaluate the outcome of this approach on risk behaviors and disseminate the information to
other HIV prevention providers throughout Colorado.
Budget Request and Justification:
Complete the following budget request and justification template(personnel and fringe,travel,equipment, supplies,
operating, indirect charges).
Table 6 Budget Request and Justificationit
4 ® i t �' x-,may _
�g� . }�y 4 t i.�� i
ti a' 4 ., ar _;+`{ :- .; ' '5.'n , r�-i°t "' +r p I.Pr :ws :ci a
a Cin 22. as ' . -. a R., ': U+ ` y :. /. ' ''°� a 9 i e : i a" r Ty r?• k . y.,"...,:-.......:..11......_...,:.`..:............,..:!. ..:.. :'..2'. C ..u:,...;„y. is ,-4 ,_.,.
(liO1k:. ,t,tiell! j i,iiPii ( . ..,, .__ . Lii)nlil• Atitsltielli __
t� �7�t��lq�F 47ehI.:., .E
Mileage
a ,. p s,.^..,.. . 7„ t` ?i'� �y„ na u fi ,+,rv.' g'" '4 �.
,ra. .' ' 4''t1� ,- ':`,41::":,:‘z 's oi':x ,#fi A tta, ..)t I,StilL ' '�4€1°i7S &soy ;fe. ,II1r)IIIGr.
Total Mileage $
Lodging
Total Lodging $
Per Diem
Total Per Diem $
Airfare
Total Airfare $
TOTAL TRAVEL ' $
(1-.v,,Iviie)'t �"-1 itt• �., ."i' La,,ik, e I L;e,,.k)ot.i ,d�i5 :;. it7e EuISII.P59
Equipment(TV,VCR,flip chart,etc.)
' t...,t:t,+<£ s s et..try ."...7`a -..r n„i „ §b tit 4''D ' ;$•'^- ' . "
Total Equtpment 1- ,., r
t>itia�t�eor
-'Ilil!t; -, LII t, nl4� F Ie•,. C, _ . ,101. 11'
_ 3
_' .. t..^.1.'
•
Office Supplies(paper,pens,notebooks,tablets,flip chart paper,markers,etc.)
Total Office Supplies $
Program Supplies (condoms, lubricants,brochures,posters, latex gloves,Orasure kits, venipuncture supplies,buttons,etc)
Note: CDPH&E will not be supplying condoms,lubricants and brochures in 2000,so you must request the
funds below and purchase the materials from the manufacturer/distributor of your choice.)
Total Program Supplies
}
T4Ttl SUPPJ., S - ,_
s°F'4nt' O= t ,}i ,r iifIJI lII k ' 'I Ii i�t a' n't e. By, t ,. Vlllifl �
a-?E V yi i t '£
��, a • t •1¢3't^1
4 6 6Xli C Vy t � .. � ,.* i x- xr". is za `f',X + �, • °t ' w 44 §^ s$
t il':.eZ.4t . I
E a�.,eihlcn, �ciprt,. a}i �
tInnt..-, - t,dP i.O It .P,tUir -tinSe)ulil
;k�y,lll aft�(i
I .. [._
Printing(flyers,brochures,posters,reports,etc.)
eil'al°hl lziflul�)r il; t11 X14"4 1 Etakrr C,;Xy, [ldlf h Ati ®1Wp •-
Total Printing $
Postage
Total Postage $
Room and Audiovisual Rental
Total Room and Audiovisual Rental $
Honoraria,incentives, refreshments
Total Honoraria, incentives,refreshments }f , - • $ a , ,tet
Staff Training
#�iAmfr .:!` t} e � ` t's F ., •
� '. a ... ' Yr
Other(list the items)
.-• ,. 41U1lt; �K:1)1' li�lti� +MPif
$
Total Other
TOTAL OPERATING
'](NDI i lY .. ra 4x t f . 4, • 4v. +,
met"' 1 gr, a
e a o s dr r 9@.1� i . � ' 81 . s.;
$Atill b .c s' x r ` 2 kk Y�,r rB a a ht)18.t � &� 5xA J ry
Indirect Charges(legal fees, rent, utilities,cleaning supplies, audit cost, interest payments, liability insurance, general
postage, general office equipment,building maintenance,etc.)
TOTAL INDIRECT
b' _ t.i 14...r.4111$54-1J 1 7 tp 9t1�1 C! ) s v ' .-1
:At"l °f� t�"6lty . �1°ra r 7D o1 tFr f�sie e t .
�t.�.J 'yi"°' Xe �l f)[ s x )ar ° x � ,�.+�".ta
The standard reimbursement for testing is $28 for pre and posttest counseling and $21 for a second posttest for persons
with HIV infection.The range is$11-21 for pretest, $7 for posttest,and $21 for the second posttest for persons with
HIV infection.
Jyk ¢4u YeY #.s'R Hj
TotalC "R %v at; R ° r ,.;.F. ��$ .. 3�,:.r'
Table 7-Summary of Budget Request And Matching Funds for Collaborators
List the budget request from CDPH&E to your agency and describe all private and public(local, state, and federal) matching funds that will support this project.
Provide the same information for the other agencies or individuals involved in the collaboration in your District. Add pages as needed.
Name of Agency or
Individual in the
Collaboration
Budget Category Dollar Dollar Dollar Dollar Dollar Dollar - Dollar Dollar Total Total
Amount Amount of Amount Amount of Amount Amount of Amount Amount of Amount Match
Requested Matching Requested Matching Requested Matching Requested Matching Requested
from Funds from Funds from Funds from Funds
CDPH&E CDPH&E CDPH&E CDPH&E
Personnel/fringe
Travel
Equipment
Supplies
Contractual
Operating
Counseling and Testing
Total Direct
Indirect Cost
Total Request
Projected Budget
2001 —111
Projected Budget
2002
Table 8 -Year 2000 Budget Breakdown by Intervention
Amount Requested by Your Agency Only
Individual Level Group Level Population Level Prevention Case Public Information Counseling,Testing Total Amount
_ Intervention Intervention Intervention Management and Referral Requested
Personnel/ $ $ $ $ $ $ $
fringe
Equipment $ $ $ $ $ $ $
Supplies $ $ $ $ $ $ $
Contractual $ $ $ $ $ $ $
Travel $ $ $ $ $ $ $
Other $ $ $ $ $ $ $
Indirect $ $ $ $ $ $ $
Total $ $ $ $ $ $ $
Number of
Episodes of
Service
NOTE: The total dollar amount requested by your agency in Table 7 and Table 8 should be the same.
•
•
Complete and attach the Assurances
We hereby affirm that:
• materials produced or purchased with these monies will be submitted to the Material Review Panel prior to printing or
purchase;
• personal identifiers related to HIV infection,or AIDS will not be released and adequate security of confidential information
will be maintained to protect clients;
• the proposed program is coordinated with other HIV prevention providers in our geographic area;
• we will comply with the Standards for Competence Regarding Culture, Disability and Other Diversity.
• we will comply with all applicable Colorado Board of Health Rules and Regulation, and state and federal legislation
(Americans with Disabilities Act,Civil Rights Act, etc.);
• we have written this proposal in response to our District and/or Population Plans and our proposal is relevant to the target
audience we intend to serve;
• this program does not duplicate other programs in the our geographic area serving the target audience described in this
proposal;
• we will submit quarterly progress reports with demographic data describing and evaluating activities by the deadlines;
• we will use all CDPH&E approved forms for processing payment reimbursement and data collection;
• we will develop and maintain referral agreements with other agencies providing HIV intervention services that we do not
provide,as well as agencies providing mental health,substance abuse prevention and treatment, family planning,clinical and
other services that support behavior change.
Organization's Name:
Signature: Title:
Complete and attach Memorandum of Understanding from collaborating agencies.
Memorandum of Understanding
For a Joint HIV Intervention Project Between
(insert name of agency/individual)
and
(insert name of agency/individual)
The (insert name of agency/individual) and (insert name of agency/individual) agree to form ajoint collaborative venture
to provide (insert the name of the intervention(s) targeting(insert the name of the target audience) in (insert the location
of the intervention).
The (insert name of agency/individual) agrees to provide:
♦ (insert the service or material that the agency will provide);
• (insert the service or material that the agency will provide);
• (insert the service or material that the agency will provide).
The (insert name of agency/individual)agrees to provide:
♦ (insert the service or material that the agency will provide);
♦ (insert the service or material that the agency will provide);
• (insert the service or material that the agency will provide).
Both(insert name of agency/individual)and (insert name of agency/individual)agree to provide:
• (insert the service or material that the agency will provide);
• (insert the service or material that the agency will provide);
• (insert the service or material that the agency will provide);
♦ (insert the service or material that the agency will provide).
This agreement is in effect until(insert date or could be ongoing). The agreement is open to mutual review and
modification as appropriate.
Name: Name:
Title: Title:
Date: Date:
V. PROPOSAL EVALUATION
A. PROPOSAL EVALUATION PROCESS
The sole objective of the review process and the proposal review panel will be to recommend the offerors whose
proposals are most responsive to the state of Colorado's needs while within available monetary resources. The
specifications within the RFP represent the minimum performance necessary for a response. A minimum score of 40
has been established for Tier Two Projects and a minimum score of 50 has been established if a Tier Three Project
is also proposed. Proposals that fall below that score will be rejected, and if all proposals fall below that score, all may
be rejected. In such case, the RFP may or may not be resolicited. depending on the particular situation.
In cases where only one proposal is received in response to the REP within a district, it will be reviewed and scored. If it
meets the minimum score, it may be accepted.
If more than one proposal is received for a given district, CDPH&E will convene the proposal review panel to judge the
merits of the proposals received in accordance with the evaluation factors stated in the RFP. The proposal(s) with the
highest average scores will be recommended for award to provide services within the District. Proposals that are not
funded as Tier Two Projects may be considered for Tier One projects, pending availability of funds, with preference
given to Districts where a Tier One project would be the only funded project in the District.
If a collaborative proposal includes an out-of-compliance intervention, but the remaining interventions are acceptable and
the overall proposal is recommended for funding, CDPHE may restrict the funds for the out-of-compliance intervention.
As a condition for funding to proceed, the applicant must accept and fulfill provisions of a time-limited improvement
plan involving capacity building activities.
B. EVALUATION FACTORS
Evaluation factors have been assigned a point value based on its relative importance to the selection process. Each panel
member will score every factor for each proposal. The total score for each proposal will be the average sum of all scores
for all the factors.
The total possible score is 100 points for a Tier Two Project and 120 if a Tier Three Project is also proposed; each factor
is worth 4 points. The following proposal score sheet lists the evaluation factors for Tier two projects numbered 1 to 25
and the evaluations factors for Tier Three projects lettered A to E.
Proposal Score Sheet
' ' r �' lLittti u.
�r«'s'».
cyi"trip aa'"* izafl /0= x>�t" MPT". . a#k v
1.Prior experience and/or ability in providing the Criterion Not described clearly no prior clearly extensive
intervention. experience and/or experience and/or
ability ability
Score
2. Prior experience and/or ability in serving the target Criterion Not described clearly no prior clearly extensive
audience(s). experience and/or experience and/or
ability ability
Score
3. The relationships between collaborators are clearly Criterion Not collaborators collaborators
described and documented. described relationships are elationships are
not described clearly described and
or are unclear documented
Score
4. The mutual responsibilities between collaborators Not collaborators roles/ ollaborators roles/
are clearly described in the memorandum of described responsibilities areresponsibilities arc
not described clearly described and
understanding. or are unclear documented
5. The proposed interventions are not duplicative of Criterion Not described described but clearly not
other services provided in the same geographic area possibly duplicative n any
to the same target audience. duplicative in areas with ongoing
significant areas ways to ensure non-
duplication
•
-iontt,:t k r ► t evI � „Name of Reviewer. ,r_
gttl".jLtr .. I 1 `.;r7 M,72k po nts 3 points p' 4•••- 1*ea
Score
6. The collaboration results in the achievement of the Criterion Not described less than 25%of 50%of episodes 75%of episodes 100%of episodes
target number of episodes of service in the District. target episodes achieved achieved achieved
Score
7. The collaboration results in a spectrum of services. Criterion Not described described but an array of services
only one or two are proposed
interventions
proposed
Score
"7,5 t "j ib3 f y Pk y' x
8. Involvement of target audience in planning. Criterion Not described description of involvement in
implementing and evaluating the program involvement is planning,
minimal,unclear implementing and
evaluating is clearly
described
Score
9. Plans for target audience recruitment and participation Criterion Not described description of plans for
are realistic and adequate. plans for recruitment are
recruitment are clearly and
minimal, comprehensively
unclear, or described and
unrealistic methods are
feasible&
reasonable
Score
aa)1L pt b
.. _ auk"" x z L -t.,# �
s-, s Pik r ,.-> yx `<
tjilj {,)e -
too+' sYs- '?'5 i 21t9' ' ° �.�.�..
10. Degree to which the target audience is consistent with Criterion Not described proposed target proposed target
District/Population Coalition Plans audience is audience is clearly
clearly consistent with
inconsistent with Plans in all areas
Plans
Score
4 a.. i ..._,. o,,� _ �..^`yrT`*1•4 rv+^^ gegm _...
✓
II. The intervention's objectives are relevant,measurable Criterion Not described objectives are objectives are
and attainable. clearly not clearly relevant,
relevant, measurable,or
measurable,or attainable
attainable
Score
12.The intervention's objectives includes those about Criterion Not described none of the most objectives are
changing risk behavior in target populations. objectives are behaviorally based
behaviorally
based
Score
13. The intervention(s)is/are consistent with the Criterion Not described intervention is intervention is
definitions. consistent with consistent with all
few to none of of the definitions
the definitions
Score
14. The intervention(s)is/are consistent with the standards. Criterion Not described intervention is intervention is
consistent with consistent with all
few to none of of the standards and
the standards has elevated their
own standards
z rp
of ReY
fewer
t21;:-'fr s "" �>a k:2}p8ints points 4pbtncs • 111„.eit
Score
15. The proposed interventions are consistent with the Criterion Not described intervention is intervention is
District and Population Plans. not consistent consistent with the
with the District both the District
Plan or and Population
Population Plans Plans
Score
16. The proposed number of episodes of service are Criterion Not described less than 25%of 50%of number of 75%of number of number of episodes of
consistent with the Rural Plan number of episodes episodes of episodes of service service are consistent
of service will be service will be will be delivered with the Rural Plan
delivered delivered
Score
,"".
7,0k
� m.a ,-_..
v:ii.ij sj r 7 u�r �Y. + Tr{!,3h„, r �§I Lk c '',. :. 9 ' rt `" 4, ,'c +'
17.The project is accessible to people with Criterion Not described description of description clearly
disabilities and those who are deaf or hard-of-hearing how project will shows project will
be accessible to be accessible to
people with people with all
disabilities is disabilities and deaf
minimal or and hard of hearing
unclear
Score
18.In conjunction with collaborators the project Criterion Not described less than 25% 26-50%match 51%-7.4%match 75-100%match
matches the percentages reflected in the people of match between between county between count) between county and
color demographics for all the counties they propose county and target and target and target target audience
to serve. audience audience audience
Score
.)u
Jr a e a I. Hof Review
t Ix `�. s •Onts, �� . p0 i � 1fl
4
•
l9. The project is adapted will adapt to meet the Criterion Not described description of description shows
diverse needs of the target audience. how project will clearly that project
adapt to meet will adapt to meet
target audience's target audience's
needs is minimal/ needs .
unclear
Score
s �"' � F `a.' y�r'e +y zY 2 z 3Y
t'
f � a
_1'iyt p.�dSi-U'.aa � ..,,..,,. .,�.�.......c,a ` u.A4. ' Gr' ,'E�a� "���.yr � '° . ,�zo-.,. .___'_ _.1
20. The evaluation is tied to the intervention's Criterion Not described description of description of how
objectives. how objectives objectives will be
will be measured measured is clear&
is minimal/ comprehensive and
unclear methods are
feasible&
reasonable
Score
21. Evaluation plan includes description of formative Criterion Not described formative eval. Formative eval. is
evaluation which collects information to help design a described is clearly&
successful program and/or tests the minimal/ comprehensively
unclear described and
strengths/weaknesses of the intervention(s)before
methods are
implementation. feasible&
reasonable
Score
a47rame of Reviewer:
, d' ..,
r I n p tq x ' :2 points,: 3 ioints 4 pon� ,r,t, ..
_._. ._ ._.. �....b
22. Evaluation plan describes how activities Criterion Not described description of description of how
described in the operational plan will be measured how activities activities will be
and tracked. will be measured measured and
and tracked is tracked is clear,
minimal/ detailed&
unclear comprehensive&
methods are
feasible&
reasonable
Score
�4k* b'YA k xq` ^fFr ' .: `� y K d A."". a;
` ≥ • •
23. Costs are explained and accurate. Criterion Not described budget is poorly budget is clearly
explained & not presented and
accurate accurate
Score
24.Costs are reasonable to complete the project. Criterion Not described budget is not budget is
reasonable to reasonable and
complete the looks for cost
project savings
Score
25. Matching funds enable the project to achieve the Criterion Not less than 25%of so%of number of 75 V/0 of the numbernumber of episodes of
number of episodes episodes of of episodes of will service are consistent
District target for the number of episodes of services. described of service will be service will be he delivered with the Rural Plan
delivered delivered
Score
.. . r -t 9w' ... a "^Ysrk y .� `» r
'� „gam a . £ z
a
t a )it t 1t '' ° 1sz H t °' dame of Reviewer
wa
€y a
r l:Sp a�� ..�.ar.-.. ti r�7�1 +'F;tr Oin ' c 2pola Qolnfs, „Cc, .< .x
�� JK r9 �' ,'-'7
�'
A.The scientific basis(i.e.,summary of the literature, Criterion Not described description of the scientific basis is
community assessment,formative evaluation in the scientific basis is clearly and
local community)for the proposed innovative minimal/unclear comprehensively
justified
intervention is sound.
Score
B. The proposal describes a novel&potentially Criterion Not described description of description of how
successful approach to accessing reaching hard-to- how populations populations will be
reach rural populations. will be accessed accessed is clear&
is minimal/ comprehensive&
unclear methods are
feasible&
reasonable
Score
C.The potential success of the intervention for Not described description of the description of the
changing behavior in hard-to-reach rural populations potential success potential success of
is described. of intervention in intervention in
changing changing behavior
behavior is is clear&
minimal or comprehensive
unclear
1
D. The proposal describes how the evaluation will Criterion Not description of how description of how
changes in risk changes in
measure the interventions' outcome on risk behaviors described risk
behavior are behavior are measured
in the target audience. measured is is clear&
minimal/ comprehensive and
unclear methods are feasible
&reasonable
Score
0
r' , & .• v's{,ror ya *e� �„ �;r
3ttjL t1� at b CteW Name of Reviewer
2apoin 3 po ns 4 po tt
F
,�.... ._'�.,..,�. a, .,�. nYS_ .v Yf ^','Ck .# ..^" xmdo.xu3 ;K . .a+'•. e..:= -
E.The plan describes how evaluation results will be Criterion Not described description of description of how
distributed to relevant& interested parties. how results will results will be
be distributed is distributed is clear
minimal/ &comprehensive&
unclear
methods are
feasible&
reasonable
Score
c t.t y x b�ismsio �
1, II. lisilt^
e.tr, ,iz #r x ar d :.
Recommendations Based on the Proposal Review
I recommend funding this Tier Two Project 0 yes; 0 no; (check the box that applies)
If yes,I recommend funding this project: (check only one)
for the number of years requested 0 yes; 0 no;
for one year only 0 yes; 0 no. •
Describe the rationale for single year funding:
With restrictions 0 yes; 0 no;(check if applicable)
Describe the restrictions:
Tier Three Project
I recommend funding this Tier Three Project(can only be funded as an extension of a funded Tier Two Project) 0 yes; 0 no; (check the box that applies)
With Restrictions 0 yes; 0 no;(check if applicable)
Describe the restrictions:
Signature of Reviewer:
VI. LIST OF ATTACHMENTS
Attachment A: Coalition HIV Prevention Plans for 1998-2000
Attachment B: The 2000 Rural Plan for HIV Prevention
Attachment C: Behavioral Indicators from the 1998-2000 Comprehensive Plan
Attachment D: Laws Regarding Needle Exchange
Attachment E: Definitions for HIV Prevention Interventions and Standards of Practice
ATTACHMENT C: Behavioral Indicators from the 1998-2000 Comprehensive Plan
Indicate what goal in behavioral change your proposed intervention will accomplish for the target population chosen.
Indicator 2-1 Target population: Men who have sex with men who have multiple partners Target behavior change: Increase
condom use during oral sex
Indicator 2-2 Target population: Men who have sex with men who have multiple partners Target behavior change: Increase
condom use during anal sex
Indicator 2-3 Target population: HIV+men who have sex with men Target behavior change: Increase condom use during oral
or anal sex
Indicator 2-4 Target population: Men who have sex with men who have multiple partners Target behavior change: Decrease
number of sexual partners
Indicator 3-1 Target population: Women and men who inject drugs Target behavior change: Increase condom use during
vaginal,oral,and anal sex with opposite-sex partners
Indicator 3-2 Target population: Women and men who inject drugs Target behavior change: Decrease number of opposite-sex
partners for oral,anal,or vaginal sex
Indicator 3-3 Target population: Female sex partners of men who inject drugs Target behavior change: Increase condom use
during oral,anal,or vaginal sex with men
Indicator 3-4 Target population: Female sex partners of men who inject drugs Target behavior change: Decrease number of
male partners for oral,anal,or vaginal sex
Indicator 3-5 Target population: Men who have sex with men who also have sex with women Target behavior change: Increase
condom use during vaginal sex
Indicator 3-6 Target population: Men who have sex with men who also have sex with women Target behavior change: Decrease
number of vaginal sex partners
Indicator 3-7 Target population: Women who have sex with women who also have sex with men Target behavior change:
Increase condom use for oral,anal,or vaginal sex
Indicator 3-8 Target population: Heterosexual men who have sex with women who are HIV+or at higher risk Target behavior
change: Increase condom use during oral,anal,or vaginal sex
Indicator 3-9 Target population: Heterosexual women who have sex with men who are HIV+or at higher risk Target behavior
change: Increase condom use during oral, anal,and vaginal sex with men
Indicator 3-10 Target population: Heterosexual men who have sex with women who are HIV+or at higher risk Target behavior
change: Decrease number of sex partners for oral,anal,or vaginal sex
Indicator 3-11 Target population: Heterosexual women who have sex with men who are HIV+or at higher risk Target behavior
change: Decrease number of sex partners for oral,anal,and vaginal sex with men
Indicator 4-1 Target population: Men who have sex with men who also inject drugs Target behavior change: Increase cleaning of
needles and works
•
Indicator 4-2 Target population: Men who have sex with men who also inject drugs Target behavior change: Decrease sharing of
needles and works
Indicator 4-3 Target population: Women and men who inject drugs Target behavior change: Increase cleaning of needles and
works
Indicator 4-4 Target population: Women and men who inject drugs Target behavior change: Decrease sharing of needles and
works
Indicator 4-5 Target population: Women and men who inject drugs Target behavior change: Increase number requesting harm
reduction services
Indicator 4-6 Target population: Women and men who inject drugs Target behavior change: Increase number requesting
substance abuse treatment services
Indicator 5-1 Target population: Women Target behavior change: Increase proportion of women voluntarily being tested for
HIV before or during pregnancy
Indicator 5-2 Target population: Pregnant women Target behavior change: Increase proportion of HIV+women voluntarily
participating in a drug regimen to prevent perinatal infection
ATTACHMENT D: LAWS PERTAINING TO NEEDLE EXCHANGE
18-18-425. Drug paraphernalia- legislative declaration.
(I) The general assembly hereby finds and declares that the possession,sale,manufacture,delivery,or advertisement of drug
paraphernalia results in the legitimization and encouragement of the illegal use of controlled substances by making the drug culture
more visible and enticing and that the ready availability of drug paraphernalia tends to promote,suggest,or increase the public
acceptability of the illegal use of controlled substances. Therefore,the purposes of the provisions controlling drug paraphernalia are:
(a) To protect and promote the public peace, health,safety, and welfare by prohibiting the possession, sale, manufacture,and
delivery, or advertisement, of drug paraphernalia;and
(b) To deter the use of controlled substances by controlling the drug paraphernalia associated with their use.
18-18-426. Drug paraphernalia-definitions. As used in sections 18-18-425 to 18-18-430,unless the context otherwise requires:
(I) "Drug paraphernalia"means all equipment,products,and materials of any kind which are used, intended for use,or designed for
use in planting,propagating,cultivating, growing,harvesting,manufacturing,compounding, converting,producing,processing,
preparing,testing,analyzing,packaging, repackaging,storing,containing,concealing,injecting, ingesting, inhaling,or otherwise
introducing into the human body a controlled substance in violation of the laws of this state. "Drug paraphernalia" includes,but is not
limited to:
(a) Testing equipment used, intended for use,or designed for use in identifying or in analyzing the strength,effectiveness,or purity
of controlled substances under circumstances in violation of the laws of this state;
(b) Scales and balances used, intended for use,or designed for use in weighing or measuring controlled substances;
(c) Separation gins and sifters used, intended for use,or designed for use in removing twigs and seeds from or in otherwise cleaning
or refining marihuana;
(d) Blenders,bowls,containers,spoons,and mixing devices used, intended for use,or designed for use in compounding controlled
substances;
(e) Capsules,balloons, envelopes, and other containers used, intended for use,or designed for use in packaging small quantities of
controlled substances;
(0 Containers and other objects used, intended for use,or designed for use in storing or concealing controlled substances;or
(g) Objects used, intended for use,or designed for use in ingesting, inhaling,or otherwise introducing marihuana,cocaine,hashish,or
hashish oil into the human body,such as:
(I) Metal,wooden,acrylic,glass,stone,plastic,or ceramic pipes with or without screens,permanent screens,hashish heads,or
punctured metal bowls;
(II) Water pipes;
(III) Carburetion tubes and devices;
(IV) Smoking and carburetion masks;
(V) Roach clips,meaning objects used to hold burning material,such as a marihuana cigarette that has become too small or too short
to be held in the hand;
(VI) Miniature cocaine spoons and cocaine vials;
(VII) Chamber pipes;
(VIII) Carburetor pipes;
(IX) Electric pipes;
(X) Air-driven pipes;
(X1) Chillums;
(XII) Bongs;or
(XIII) Ice pipes or chillers.
18-18-427. Drug paraphernalia-determination-considerations.
(1) In determining whether an object is drug paraphernalia,a court, in its discretion,may consider, in addition to all other relevant
factors,the following:
(a) Statements by an owner or by anyone in control of the object concerning its use;
(b) The proximity of the object to controlled substances;
(c) The existence of any residue of controlled substances on the object;
(d) Direct or circumstantial evidence of the knowledge of an owner, or of anyone in control of the object,or evidence that such
person reasonably should know,that it will be delivered to persons who he knows or reasonably should know,could use the object to
facilitate a violation of section 18-18-425 to 18-18-430.
(e) Instructions,oral or written, provided with the object concerning its use;
(f) Descriptive materials accompanying the object which explain or depict its use;
(g) National or local advertising concerning its use;
(h) The manner in which the object is displayed for sale;
(i) Whether the owner,or anyone in control of the object, is a supplier of like or related items to the community for legal purposes,
such as an authorized distributor or dealer of tobacco products;
(j) The existence and scope of legal uses for the object in the community;
(k) Expert testimony conceming its use.
(2) In the event a case brought pursuant to sections 18-18-425 to 18-18-430 is tried before a jury,the court shall hold an evidentiary
hearing on issues raised pursuant to this section. Such hearing shall be conducted in camera.
18-18-428. Possession of drug paraphernalia-penalty. (1) A person commits possession of drug paraphernalia if he possesses drug
paraphernalia and knows or reasonably should know that the drug paraphernalia could be used under circumstances in violation of the
laws of this state.
(2) Any person who commits possession of drug paraphernalia commits a class 2 petty offense and,upon conviction thereof,shall be
punished by a fine of not more than one hundred dollars.
18-18-429. Manufacture,sale,or delivery of drug paraphernalia-penalty. Any person who sells or delivers,possesses with intent to
sell or deliver,or manufactures with intent to sell or deliver equipment,products,or materials knowing,or under circumstances where
one reasonably should know,that such equipment,products,or materials could be used as drug paraphernalia commits a class 2
misdemeanor.
18-18-430. Advertisement of drug paraphernalia-penalty. Any person who places an advertisement in any newspaper,magazine,
handbill,or other publication and who intends thereby to promote the sale in this state of equipment, products,or materials designed
and intended for use as drug paraphernalia commits a class 2 misdemeanor.
6
Request for Funding
for
HIV Prevention Services in Rural Communities
for 2000 - 2002
by
Weld County Department of Public Health & Environment
1555 N. 17th Ave
Greeley, CO 80631
Contact Person: Tara Wafal
970-304-6420- EXT. 2387
t.
STATE OF COLORADO
Bill Owens,Governor
Jane E.Norton, Executive Director ct;Spzqp
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division " '• 49 M.
Denver,Colorado 80246-1530 8100 Lowry Blvd. + •
i a
Phone(303)692-2000 Denver CO 80230-6928 reps`
located in Glendale,Colorado (303)692-3090 Colorado Department
hup://www.cdphestace.co.us of Public Health
and Environment
INVITATION TO BID
• DATE: October 4, 1999
RFP NO: RO-SET0001
DIRECT INQUIRIES TO: ROBERT M. O'NEILL
PHONE NO: (303) 692.2074
DATE RFP DUE:.Friday. 11/12/99 P2:00 PM MST
Bids properly marked as to RFP NO., DATE and HOUR of opening, subject to the conditions herein stipulated and
in accordance with the specifications set forth and/or attached hereto, will be accepted at the address listed below,
prior to the date and time listed for the bid opening. All bids shall be quoted F.O.B. destination, unless otherwise
specified, to the delivery location or jobsite listed herein.
SEALED COMPETITIVE PROPOSAL FOR:
HIV INTERVENTION SERVICES IN RURAL COMMUNITIES
RETURN PROPOSAL TO:
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT •
ASD-PURCH-A2
4300 CHERRY CREEK DRIVE SOUTH
DENVER. CO 80246-1530
Prices shall be quoted F.O.B. destination and include delivery to the CDPHE.
SEE ATTACHED PAGES FOR TERMS AND CONDITIONS AND RFP REQUIREMENTS.
IMPORTANT: Bidders should read the entire bid document before submitting bid.
REP'S MUST BE SIGNED IN INK
VENDOR Weld County Department of Public Health & Environment
ADDRESS 7555 N 17th 0>rpnur Creeln_y- CO 80631
Dale K. Hall, Chair, Weld County Board of Commissioners
TYPED OR PRINTED S NA
Handwritten Signature by Authorized Officer or Agent of Vendor
TERMS
Terms of less than 30 calendar days will not be considered. '
TITLE Chair
DATE 11/10/99 PHONE # 970-356-4000 FAX# 970-352-0242
The above bid is subject to Terms and Conditions on attached sheets.
RETURN THIS COPY
HIV INTERVENTION APPLICATION FOR SERVICES IN RURAL COMMUNITIES -
TIER TWO/THREE
ip9ivianai or Agency is registered on the BID System
IYJ yes; O no; (check the box that applies)
Prerequisite- An applicant must be registered on the BID System to apply for funds(see http://www.state.co.us for
information on how to register for the BID System). You can register online or through the mail. If you indicated you
would not be able to retrieve information from a web page, you will be mailed the BID System information with the RFP.
Invitation for Bid Form
Please note the Invitation for Bid Form must be completed, signed, and attached as the first page of your proposal. See
the Proposal Submission section for information on how to complete the form.
the District Number)
are requested to provide service in District (insert
Please note the eligibility criteria and the Districts and their associated counties in Table 2. A separate proposal must be
submitted for each District if you intend to serve more than one District.
Tier Two and/or Tier Three Project
Funds are requested for(check the box that applies): /Tier Two Project only; O Tier Two Project with Tier Three Funding
Request.
One,Two,or Three Year Contract �
Funds are requested for(check only one box): 0Year 2000 only; x"2000-2001 (submit a budget for 2000 and a budget projection
for 2001), on:2000-2002 (submit a budget for 2000 and budget projections for 2001 and 2002).
Experience and Ability of the Applicant
Describe your prior experience and/or ability to serve the target audience(s).
Describe your prior experience and/or ability to provide the intervention(s).
NOTE: If you received CDPH&E funding to provide services in 1999,describe the following information: the percentage of
objectives met for each intervention;the collaborative efforts you took to implement the intervention;the successes and barriers you
encountered;and the actions you took to overcome the barriers. Describe the staff trainings and/or change in policy or practice you
adopted to implement the Standards for Cultural Competency and Proficiency,and Diversity. Describe or attach your Access Plan for
serving people who are deaf,hard of hearing or disabled.
Collaboration
Describe the relationships between the collaborating organizations and the mutual responsibilities you have to each other
in completing the proposed activities. Complete a Memorandum of Understanding with each collaborating agency or
individual and submit them as an attachment to your proposal. DO NOT SEND GENERAL LETTERS OF SUPPORT.
Experience and Ability of the Applicant
The Weld County Department of Public Health and Environment(WCDPHE) was
established in 1938; the second health department in the state of Colorado. The health
department serves 157,232 residents of Weld County and encompasses 4000 square miles. The
mission of WCDPHE is to preserve, promote and protect a healthy life and safe environment for
all people in Weld County. Financial support of WCDPHE consists of county funding, 37.4%,
service for fee, 31.6%, contracts and grants, 28.7% and miscellaneous, 2.3%.
WCDPHE provides an STD clinic and is the Anonymous and Confidential HIV testing
site. In addition, WCDPHE has up-to-date media equipment including an LCD, and numerous
meeting rooms to accommodate workshops and presentations.
The HIV educator is part of the Health Promotion Team in the Public Health Education
and Nursing Division. The HIV educator hold a BS degree in Community Health and has taught
high risk students and the Latino population in Weld County. She is a First Aid and CPR
instructor, including HIV/AIDS prevention and education. She is also involved with WCAC and
ACE. The following is a review of the prevention intervention provided by WCDPHE during
1999.
Public Information: PI
All objectives were met or exceeded for 1999. WCDPHE collaborated with teachers and
organizations in order to provide HIV prevention education to community schools and agencies.
The University of Northern Colorado (UNC), Aims Community College, area schools, Planned
Parenthood, CDPHE, the homeless shelter, Independence Stampede committee members, and the
Weld County AIDS Coalition(WCAC) were included in these collaborative efforts. WCDPHE
and WCAC collaborated with members of the faith community for the annual Candlelight
Memorial Service and with many area businesses and merchants for the annual HIV awareness
walk "A Walk in the Park".
The only barrier encountered was the restrictions placed on what types of materials were
available at certain community education booths (i.e. condoms, family planning information)
The HIV Public Information program at WCDPHE is very established and a welcomed asset to
the county and community.
Group Risk Reduction: GLG
All objectives were met or exceeded for 1999. The majority of collaborative efforts were
with Trademark Alternative High School. Trademark provided members and a meeting location
for the Teen Advisory Board (TAB), as well as ongoing support of the peer education program
targeting high risk youth.
The successes of PeerVention during 1999 included the completion of the 6-session
curriculum and the completion of the brochure in order to market the program. A number of
these presentations were piloted with the TAB and other area agencies serving high risk youth. A
barrier that was encountered is the length of time that was needed to plan and develop the
curriculum which delayed the expected implementation date. This barrier was reframed as an
important part of the process. Other peer education ideas from other agencies in the state were
explored and integrated into our curriculum as well.
1
2
Street and Community Outreach: ILI
For this intervention WCDPHE collaborated with UNC and Gerald Ernst, independent
contractor and activist. Due to decreased funding and available hours, scope of work continued to
be revised and only 20% of projected objectives were met.
Successes included completion of the Adapt Outreach training by the program
coordinator and observation of outreach training. Materials were also provided for a campus
outreach event planned by the UNC Gay, Lesbian, Bisexual, Transgendered Alliance. Barriers
for WCDPHE outreach included the decrease in funding and difficulty accessing the
Latino/Hispanic population in Weld County. This resistance is being overcome by meeting with
key members of the Latino community in order to gain a better understanding of the community,
ways to access and build relationships, and their involvement in providing outreach and
education.
Cultural Competence
The health department employs 78 individuals who work in Public Health Education and
Nursing, Environmental Health and Administration. Over 30% of the WCDPHE employees are
Hispanic/Latino to provide and improve services to the non-English speaking clients. Because of
the diversity within this population, efforts are made to recruit employees with skills in the
various dialects. This is an ongoing and evolving process for WCDPHE and includes the
following: I) Attendance at Latino conferences and training, capacity building and cultural
competency by the HIV educator; 2)Peer Educators trained in cultural competency/diversity
using "A Youth Leader's Guide to Building Cultural Competence" as a resource; 3) Ongoing
involvement with the Latino/Hispanic community. Speakers at the Candlelight Memorial
represent the diversity of the county. Educational brochures in both English and Spanish are
available at community booths and presentations.
Access Plan for Serving People who are Deaf, Hard of Hearing or Disabled
Presentations, workshops, and other HIV prevention events are held at locations which
ensure access to people with disabilities. Special attention is given to ensuring accessible parking,
entrance, hallways, doors, meeting room, and restrooms of the facility. Interpreters for the deaf or
hard of hearing can be requested for meetings, presentations, and events through the Northern
Colorado Center on Deafness.
Collaboration
The WCDPHE HIV educator is collaborating with agencies and individuals in Weld and
Larimer counties to provide a comprehensive approach to HIV prevention in District 2. Our goal
is to establish and sustain a durable partnership within this district to increase the accessibility and
availability of a spectrum of HIV prevention services. We are requesting the funding for this
district be divided equally between the two counties, as reflected in the budget section. Although
Larimer County represents 60%and Weld, 40%, of the population of the district, there are fewer
established services in Weld County. Consensus was reached and we agreed to a split the funding
to improve the services in Weld County.
The target population for District 2 are high risk individuals identified in the 2000 Rural
3
Plan for HIV Prevention, including men who have sex with men, those at risk through
heterosexual activity and/or intravenous drug use, youth, people of color, the deaf, hard of
hearing, physically, visually, or mentally impaired.
In District 2, collaborating agencies in Larimer and Weld County can provide public
information, risk reduction education, HIV prevention training, condom and latex distribution,
off-site HIV testing, out reach activities and referral. Collaborating agencies are Northern
Colorado AIDS Project(NCAP), Gerald Ernst, private contractor for outreach, the American
Chapter of the Red Cross (Weld), Trademark Learning Center and other established
collaborations. Larimer County agencies are focusing primarily on target populations in Larimer
County and WCDPHE is concentrating on Weld County population due to geographic logistics
and to avoid duplication of services.
WCDPHE 's primary proposed interventions are HIV prevention training, risk reduction
education and continuation of the individual outreach begun in 1999. WCDPHE and their partners
will communicate regularly regarding requests for speakers, presentations, and other services to
assure that services are not duplicative. Cross referrals between Weld and Larimer Counties will
better serve individuals in District 2.
The WCDPHE HIV educator coordinates the Weld County AIDS Coalition (WCAC) and
works collaboratively with its members to plan and implement the WCAC sponsored events and
HIV educational presentations. The members of the coalition reflect the high risk groups in Weld
County. Efforts have already begun to make this a primary platform for building relationships
with the Latino and gay/lesbian communities.
The American Red Cross Weld County Chapter will provide HIV prevention training,
both English and Hispanic curriculum, for interested agencies, businesses and community groups.
By recruiting and training members of the target populations we can increase the capacity for HIV
prevention in Weld County.
Trademark Learning Center in Greeley, an alternative highschool for high risk youth, will
provide students for the Teen Advisory Board and Peervention Program. WCDPHE will continue
to work with UNC on HIV/AIDS educational events and with the local Weld County junior high
and high schools to provide group risk reduction intervention targeting youth using the
Peervention program. Planned Parenthood and other Weld County organizations provide printed
HIV/AIDS materials and referrals to individuals. Gerald Ernst, will provide ongoing technical
assistance with these groups. The local businesses, schools, faith community, service agencies and
community groups are part of the planning process for public, group and individual level
interventions.
The WCDPHE will support the project through other funding sources, including
nursing/tech staff to participate in educational presentations, bar outreach, condom distribution,
STD clinic, HIV counseling and anonymous and confidential testing. Gerald Ernst, who has
worked with Larimer County agencies to implement successful outreach programs, is contracting
with WCDPHE to assist with local efforts. We intend to increase counseling and testing services
and offer these off site with risk reduction education and individual outreach.
A quarterly meeting will be held with Larimer and Weld County partners to share
information,resources and strategies, collectively evaluate our progress and adjust strategies.
The WCAC will meet monthly to advise the HIV educator and assist with coalition and project
4
objectives. Communication among all agencies is a strong component of this project.
Target Audience
The Hispanic/Latino population in Weld County according to the 2000 Rural Plan for HIV
Prevention is 24% of the 151, 108 residents. Estimates from agencies serving this population
suggest it is 33%. Therefore, 33% of our efforts will target the Hispanic population.
During the planning process for this project, several members of the Latino community
met with us to discuss the barriers and interest for increasing HIV prevention efforts in that
community. The director of the Latino recreational center in Greeley and a representative of the
Weld County Head Start program (who is also Red Cross certified in HIV Prevention) are
interested in establishing a foundation for better health services in Weld County. Recruiting
efforts for additional partners will target local Latino business leaders, both men and women,
members of the faith community, service agencies, the Guadelupe Center for the Homeless, the
Latino Chamber of Commerce, schools with a high number of Hispanics, Probation, Lu Lac
Chapter and Cesar Chevez Cultural Center at UNC, PlatteValley Youth Correctional Facility,
Front Range Behavioral Health Center and several local citizens.
Through Group Level Intervention, the HIV educator and The American Red Cross will
provide HIV prevention training to these key individuals so they, in turn, can provide risk
reduction education to many others in their communities.
MSM and IDU are targeted more indirectly in Weld County through public information
and risk reduction education because of the conservative nature of its citizenry. It is estimated
that 2.7 % of the male population between 18-59 years are men having sex with men(MSM). Of
these 1321, 281 are at high risk. We have established a relationship with the UNC Gay, Lesbian,
Bisexual, Transgendered Alliance over the past year. We believe this is a key group to help
identify barriers to providing more education and outreach in Weld County. This population will
be addressed through GLI by providing Red Cross HIV Prevention training, and risk reduction
education with speakers and panel presentations.
There are an estimated 548 people between 18 - 59 are at potential risk for HIV infection
•
through intravenous drug use. 363 are at highest risk by sharing needles. Again, due to the
conservative citizenry,more concentrated ILI and risk reduction interventions will be given as
identified by program personnel. We are pilot testing new venues for public information
campaigns and individual interventions through collaboration with Gerald Ernst.
Approximately 10% of the population of Weld County has one or more disabilities,
physical, mental, hearing, developmental,visual or other. This means 15,108 citizens are effected
by some type of disability in Weld County, and 3624 are of Hispanic origin. All groups and
individuals are assessed on a cultural spectrum prior to or at the beginning of each presentation,
event or activity and their needs taken into consideration during implementation. Individuals with
disabilities will be recruited by WCAC and will play an important role in targeting this
population. Accessability and appropriate materials are considered high priority and every
accommodation will be made to meet these needs.
Teen advisors from the Trademark Learning Center provide insight and assistance in
addressing the high risk youth in Weld County. Adolescents represent 11.8 % of the population
of Weld County and approximately 15,000 are in Weld District 6 (Greeley-Evans) schools. HIV
5
is the 7'h leading cause of death in this age group in the 15 - 24 year olds. 25% newly diagnosed
cases of HIV are among people 22 years and younger. Given the long latency period of 10 - 12
years, most of the reported AIDS cases in 20 - 24 years olds were most likely a result of exposure
during teen years. GLI through peer education and panel presentations are the most effective
means of education for this population.
Operational Plan
During 2000, WCDPHE is focusing on building a solid relationship with the Latino and
Gay/Lesbian/Bisexual/Transgendered (GLBT)populations. Community organization is a primary
responsibility of the WCDPHE HIV educator and the WCAC. The interventions and activities
for 2001, 2002 will be developed by a group representative of the population in Weld County. On
going collaboration to meet the needs of District 2 residents is a goal for both Larimer and Weld
Counties. Interventions for 2000 include public information activities, group level risk reduction
programs and individual outreach activities all coordinated by the HIV educator at WCDPHE.
Public Information (PI)
Public information is an important prevention intervention. It is imperative to promote
HIV/AIDS information in the public arena. Although the number of new cases in Colorado has
decreased steadily over the past 6 years, trends towards high risk behavior have increased. For this
reason, dissemination of factual information is a necessity, especially in rural areas where myths
and discrimination are prevalent. The following interventions, which are a combination of
public/population interventions, will provide PI to a minimum of 1,720 individuals or half the
number designated for District 2. To accomplish this in part, a collaborative brochure will be
developed describing HIV/AIDS prevention services available in District 2.
WCDPHE is the lead agency for the Weld County AIDS Coalition(WCAC) with the HIV
educator serving as the coordinator. The WCAC, established in 1987, is a diverse group of
community volunteers committed to prevention of HIV/AIDS through education. The WCAC
plans and implements several events during the year that are an established part of our
community's activities.
Objective 1. In the spring of 2000,WCAC will sponsor the 6'h Annual Candlelight
Memorial Service in observance of the International AIDS Candlelight Memorial and
Mobilization. The event is held at a local house of worship and rotated yearly. Interested clergy
and community members from across Weld County participate in music, meditation, poetry,
memories and lighting candles for those who have died from complications of AIDS and those
infected with HIV.
Objective 2. In the fall of 2000,the WCAC will sponsor another longstanding event, the 9th
Annual "A Walk in the Park". The event is a 5K walk held at Bittersweet Park in Greeley.
Local businesses donate prizes for the participants to show their support for HIV/AIDS
awareness. Educational materials and refreshments are provided by the WCAC.
Both events are publicized through a multi-media campaign. Press releases are sent to all
newspapers in Weld County (17), public service announcements are aired on 5 local radio
6
stations, including KGRE, the Latino station in Weld County. The Greeley Tribune covers both
events as a way of supporting HIV/AIDS awareness. KFKA radio station is an annual sponsor of
the "Walk in the Park" and provides time for radio interviews with the HIV educator and WCAC
Coalition members prior to the event. Posters are placed throughout the county for both events.
For the Candlelight Service, Houses of Worship publish the information in their weekly news
bulletins.
Objective 3. In December 2000, WCAC will observe World AIDS Day by promoting the
Red Ribbon campaign for local businesses. Information will be sent to the 11 largest
employers in Weld County regarding World AIDS Day on how to request these ribbons for their
employees. Phone calls will be made by the HIV educator to other smaller business and The
Greeley Tribune newspaper publishes the information prior to the event.
Objective 4. A minimum of 6 panel presentations and 6 HIV/AIDS presentations will be
provided by the WCAC and HIV educator. During the past 3 years, the HIV educator has
provided presentations surrounding HIV/AIDS to community groups/agencies/organizations on
request. New venues for public information including local Rotary, Kiwanis and other service
clubs are to be explored during 2000. Due to decreased funding, members of the WCAC
Speakers Bureau will provide the majority of these presentations. Panel members include people
who have lost adult children to AIDS complications, persons living with HIV, medical providers,
health educators and others who have been affected by AIDS. Panel presentations using members
of the bureau have proved to be very interactive using a question/answer format.
In addition to the above objectives, the WCDPHE maintains a large library of educational
materials and video loans to support HIV/AIDS information. These materials are culturally
appropriate and alternative formats are available for the disabled. NCAP has agreed to provide
public information and other interventions in Weld and Larimer Counties. We will refer requests
to their Speakers Bureau if we are unable to meet the demands for presentations through the HIV
educator and WCAC Panel/Speakers Bureau.
Group Level Intervention GLI
Objective 5. The Peervention educators will provide a minimum of 15 risk reduction
presentations in class rooms, community groups and agencies serving high risk youth by
December 31, 2000. The HIV educator at WCDPHE coordinates two primary group level
interventions. Through the following interventions, WCDPHE will provide GLI to a minimum of
421 individuals in 2000. Because these are targeting specific populations, they are also considered
population interventions.
The first is a continuation of the PeerVention Project started in 1999 with assistance of an
established group of adolescent volunteers in collaboration with Trademark Learning Center. Risk
reduction education is offered to junior high and high school classes in Weld County including
the alternative and charter schools. Trademark represents an alternative school with a greater
proportion of Hispanic and other high risk students. Their support of this project is a key factor in
its success over the past year.
However, high risk students are included in all classrooms today. According to the
7
government's Youth Risk Behavior Survey, 68 %of high school seniors, 70% of males and 66%
of females, report having had sexual intercourse. 27% of the seniors report having had one or
more partners up to that time, including 31%of the males and 23% of the females. Today, 10%of
all sexually active teens have chlamydia. STD/HIV education is an important component for all
audiences but particularly for teens. Of the 15 million new STD cases diagnosed each year in
United States, 3 million are adolescents. This, along with the increased risk of HIV infection and
unwanted pregnancy, illustrates the need for intervention. The majority of these pregnancies
(78%) are unplanned. Weld County has the second highest rate of teen pregnancy in the state and
is designating teen pregnancy prevention as a priority.
The "PeerVention" curriculum was developed in 1999 by the HIV educator and peer
educators from UNC and Weld County schools. The curriculum is presented in a series or as
individual topics by a "guest speaker",the peer educator or HIV educator. The topics include
HIV/AIDS, STDs, birth control, date rape, belief systems, and attitudes. The curriculum for each
topic is highly interactive and incorporates the educational standards developed by School
District Six. Panel discussions provided by the WCAC are available with the "PeerVention"
program series as an adjunct to the HIV/STDs topics. This particular intervention has been highly
effective, giving a personal face to HIV.
A brochure describing the "PeerVention" program was developed with input from the
Teen Advisory Board and staff at Trademark Learning Center. The HIV educator and 4 teen
educators (ages 17-20) are currently distributing the brochures to schools and agencies
throughout Weld County. Four peer educators are in place and available for presentations. They
were trained through WCDPHE in HIV/STDs. Education is ongoing through the supervision of
the HIV educator. The publication "Peer to Peer": Youth Preventing HIV Infection together"
developed by Advocates for Youth is used as an ongoing resource. Peer educators benefit from
this experience and improve their communication and presentation skills and are more likely to
model safe behaviors. Research shows people are more likely to listen to someone similar to
themselves. Curriculum review and revision is an ongoing process involving the HIV educator
and PeerVention volunteers.
Objective 6-A minimum of 2 HIV Prevention Education workshops will be provided
through the American Red Cross and coordinated by WCDPHE in 2000 with expansion in
2001,2003 to 4 per year. The second GLI is in collaboration with the American Red Cross
Weld County Chapter and the Centennial Red Cross Chapter in Ft. Collins. Through HIV
Prevention training, we can increase the number to individuals and agencies in Weld and Larimer
Counties with HIV prevention skills. During 2000, the WCAC and the HIV educator will recruit
members of the target audience to participate in the prevention training workshops provided by
the Red Cross. Both chapters have agreed to provide the training in English and Spanish. The
WCAC has three certified trainers available, two of which are Hispanic/Latino. One is a
counselor at the Platte Valley Youth Correction Center and the other is a counselor/educator at
the Weld County Head Start program. Both serve a large number of high risk individuals in the
targeted populations and are committed to HIV/AIDS and STD prevention. We will
cooperatively provide venues, training materials, refreshments, supplies and personnel as needed.
By increasing the number of certified instructors, we can increase the capacity for risk
8
reduction education and individual outreach. A foundation for a community based HIV/AIDS
prevention effort can be established by training leaders and key people in the targeted
populations. Individuals in the Hispanic/Latino and the Gay, Lesbian, Bisexual community will
be recruited to participate in the HIV Prevention training through the WCAC. The 3 day training
will take place in groups of six or more according to the Red Cross protocol. Individuals can
attend a training sponsored by either chapter to provide more flexibility for the participants.
Objective 7. By December 2000, a minimum of 3 HIV prevention workshops for
community members of the Hispanic/Latino and GLBT will take place in Weld County.
For 2001-2002, we expect to increase this number to 6 per year. To reach the target
populations, the WCAC and the WCDPHE will begin planning and implementation of group
level education in these communities using the new instructors. One possible format for
education in the Latino community is a traditional gathering of friends at a person's home to
discuss the issues and enjoy refreshments. The Ft. Collins Women's Center is using this model
in Larimer County and following the discussion with testing. Because we want to establish a
foundation with these communities for addressing a variety of health issues, emphasis is placed
on developing these methods. Key informant interviews with community leaders as well as
community members will help lay this foundation.
Individual Level Intervention ILI
Objective 8. By June 2000, recruitment and training of 6 volunteer/staff will take place.
Objective 9. By July 1, 2000, 50 surveys will be given to individuals at proposed outreach
sites and by December 1,2000, 50 additional surveys will be given to the same population.
Objective 10- By December 31,2000, 8 outreach activities will take place in Weld County.
This will increase to at least one each month during 2002 and 2003.
During 2000, the majority of the ILI to 842 individuals in District 2 will be conducted by
Peervention, Gerald Ernst, and other volunteers. WCDPHE is committed to increasing this ILI
in Weld County through collaboration with Gerald Ernst, volunteers from the community,the
HIV educator and a bi-lingual health educator/office technician involved in community outreach
for cancer prevention. Matching funds for staff time and latex supplies will be provided by the
WCDPHE Public Health Education and Nursing Division. It is a goal of this agency to increase
the number of clients accessing our counseling and testing services for 2000 - 2002.
Outreach volunteer and the staff will participate in an initial 8 hour training which
includes HIV 101, field safety, effective approaching skills for the target audience, referral
sources and outreach experience. Training will be a collaborative effort between the HIV
educator, Gerald Ernst and the Red Cross. A confidentiality agreement will be signed by
everyone participating in the activities.
The target population is the Hispanic/Latino community, MSM, IDU (as identified), and
others involved in risky behaviors, primarily in the 21 - 45 year age group. A focus group from
the GGLBT Alliance and the Latino/Hispanic community will help identify the bars with the
highest number of patrons since there are no gay-identified bars in Weld County at this time. A
9
10 questions survey developed in 1999 will be used as a baseline to assess the HIV knowledge
and types of high risk behaviors. Volunteers to participate in outreach will be recruited from
these groups. Educational materials are printed in Spanish and English and volunteer(s) will be
bilingual.
Outreach will consist of distribution of materials, individual information sharing on high
risk behaviors, needle sharing and substance abuse. Outreach volunteers strive to motivate
clients to change high risk behavior. The volunteers will disseminate verbal and written
information and safer sex kits to patrons and seek to establish a circumstance where
reinforcement can take place. A Public Information table will be set up in a separate area with
materials for patrons to take with them. Maintaining area volunteer and clients respect and
comfort is essential to the success of the outreach.
Evaluation
Public Information - Formative evaluation through discussions and input from the
WCAC is ongoing during the year. Feedback from participants and volunteers for the WCAC
events is solicited by the WCAC member and the HIV educator before and after each event. A
formal summary will be included in the quarterly reports to the CDPHE Contract Supervisor.
Process evaluation includes tracking the number of 1)educational materials distributed, 2)
condoms distributed, 3)PSAs and news releases distributed, 4)participant at the WCAC events,
5) number of presentations to community groups. This information is accumulated and reported
quarterly to the CDPHE Epidemiology division and used by the WCAC and WCDPHE for future
planning. For educational presentations, a pre/post test is used to evaluate change in knowledge
and/or attitude. These results are accumulated and used for revising the presentations and
reported to the CDPHE quarterly. A narrative report will accompany these results submitted
quarterly to the Contract Supervisor.
Group Level Intervention - Formative evaluation for this intervention includes focus groups
and key informant interviews with the Hispanic/Latino population, the GLBT Alliance, the high
risk youth and teachers. During 1999,the Teen Advisory Board and teachers from Trademark
Learning Center and District 6 schools provided feedback to the project. In addition, key
informant interviews were conducted with members of the Latino community as described in the
target population section.
Pre and post tests will be administered to both youth and adult at presentations and/or
panel discussions. These tests collect both demographic data and measure change in knowledge
and attitude. If a series of presentations is provided by the Peervention team, a behavior change
is also measured. General evaluation forms are distributed at each presentation and will provide
formative evaluation information the HIV educator, peer educators and staff.
Process evaluations includes tracking the number of 1) educational workshops and panel
discussions, 2)participants at each workshop/presentation, 3) other peer educator activities, and
4) condoms and educational materials distributed. These are submitted to the CDPHE
Epidemiology division quarterly. A narrative is submitted to the Contract Supervisor including
progress toward objectives and activities for HIV prevention.
Individual Level Intervention - Formative evaluation includes the 10 question survey of
10
individuals described in the operational plan and will provide baseline information on current
condom use. This same survey will be conducted again by December 31, 2000 to evaluate
change in knowledge and behavior and gather feedback. Process evaluation includes tracking the
following number of I) clients, 2) educational materials, 3) referrals, 4) safer sex kits. This
information will be sent to the CDPHE Epidemiology division on a quarterly basis. A narrative
report summarizing the activities will be included in the quarterly report to the HIV Contract
Supervisor.
11
Collaboration and Objectives
Agency Intervention Episode Target Audience Target Date County Objective
WCDPHE/WCAC Candlelight Service 1000 All population April/May 2000 Weld Ind.2.1,.2.3.,3.5,
3.8, 3.9,3.10,
3.11
WCDPHE/WCAC "Walk in the Park" 1000 All population August/Sept 2000 Weld Ind.2.1,2.3,3.1,
3.8, 3.9, 3..10,
3.11
WCDPHE/WCAC World AIDS Day 1000 All population Nov/Dec 2000 Weld - Ind.2.1,2.3,3.5,3.
8,3.9,3.10,3.11
WCDPHE/WCAC HIV/AIDS 200 Community groups By Dec 31, 2000 Weld Ind.2.1-2.4,3.1-
panel/presentation Hispanic groups 3.11,4.1
Service clubs
Trademark/WCDPHE Peervention 450 Jr.& highschool Dec. 31, 2000 Weld High risk Youth
workshops students and agencies 2.1 - 2.4;3.I -
serving youth 3.11
Red Cross/WCDPHE HIV Prevention Tr. 12 Latino, GGLBT Dec.31, 2000 Weld All
(MSM & IDU) •
Red Cross/WCDPHE HIV Education 100 Latino, GGLBT Dec. 31, 2000 Weld All
workshops (MSM, IDU)
Gerald Emst/WCDPHE Recruit/Train 6 - 8 Latino, GGLBT June, 2000 Weld 2.1 - 2.4;3.1 - 11
Volunteer (MSM, IDU) Greeley
Gerald Ernst/WCDPHE Survey 100 Latino, GGLBT 6/1/2000, Weld All
(MSM, IDU) 12/31/2000 Greeley
Gerald Ernst/WCDPHE Bar Outreach 100 Latino, GGLBT Dec.31, 2000 Weld- All
(MSM, IDU) Greeley
12
Summary of Budget Request
Budget Category CDPHE funds WCDPHE Red Cross Trademark WCAC
PersonneUFringe (13.3%) $10896.67 (. HIV educator) $11408.72 $720.00 $600.00 $2000.00
(In Kind) (Volunteers)
Travel - Greeley to Denver $607.50 $30.00
18 trips= 2250 mi $324.00
Misc - 1100 mi $931.50 for 3450 mi@ .27
Supplies - office $150.00
Training supp $150.00 $250.00
Condoms/Latex (2000) $400.00 $400.00
Contract Services with $800.00
Gerald Ernst
Operating Costs
Flyers, brochures $100.00 $300.00
Postage, printing $300.00
Room/AV Rental In Kind In Kind
Honoraria, incentives, refresh $300.00 $300.00
for Staff/Volunteer training
Indirect Costs (9.52%) $1278.36
Total Request $14,706.53 $12,258.72 $1000.00 $600.00 $2750.00
Total Match $16,608.72 ,.
Projected Budget 2001 $18,430.00 $15,322.40 $1250.00 $750.00 $3437.00
Projected Budget for 2002 $23,037.00 $19153.00 $1560.00 $937.00 $4296.00
13
Budget Breakdown by Intervention
for CDPHE and all funds reported on the Budget page.
Intervention Public Information/ Group Level Individual Level
Community Level
Personnel/Fringe $9735.39 $10,155.00 $5734.61
Travel $400.00 $435.00 $126.50
Supplies -
condom/latex $50.00 $200.00 $550.00
Training supp $100.00 $200.00 $100.00
Office $150.00
Contractual $100.00 $300.00 $400.00
Operating costs:
Flyers, Brochures $200.00 $150.00 $50.00
Postage, Printing $100.00 $150.00 $50.00
Honoraria, Incentives
Refreshments $300.00 $200.00 $100.00
Total Indirect: $1278.36 (on CDPHE funds)
Total: $11,135.39 $11,790.00 $7111.11
# Episodes Service 3,200 562 208
Complete and attach the Assurances
We hereby affirm that
• materials produced or purchased with these monies will be submitted to the Material Review Panel prior to printing or
purchase;
• personal identifiers related to HIV infection,or AIDS will not be released and adequate security of confidential information
will be maintained to protect clients;
• the proposed program is coordinated with other HIV prevention providers in our geographic area;
• we will comply with the Standards for Competence Regarding Culture, Disability and Other Diversity.
• we will comply with all applicable Colorado Board of Health Rules and Regulation, and state and federal legislation
(Americans with Disabilities Act, Civil Rights Act, etc.);
• we have written this proposal in response to our District and/or Population Plans and our proposal is relevant to the target
audience we intend to serve;
• this program does not duplicate other programs in the our geographic area serving the target audience described in this
proposal;
• • we will submit quarterly progress reports with demographic data describing and evaluating activities by the deadlines;
• we will use all CDPH&E approved forms for processing payment reimbursement and data collection;
■ • we will develop and maintain referral agreements with other agencies providing HIV intervention services that we do not
• provide,as well as agencies providing mental health,substance abuse prevention and treatment, family planning, clinical and
other services that support behavior change.
Organization's Name: Weld County Department of Public Health & Environment
Signatuu: .! �{ Title•
jc(fe: DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
1555 ORH AVENUE
GREELEY, COLORADO 80631
ADMINISTRATION (970) 304-6410
PUBLIC HEALTH EDUCATION & NURSING (970) 304-6420
Will II FAX (970) 304-6416
0 ENVIRONMENTAL HEALTH SERVICES (970) 304-6415
• FAX (970) 304-6411
COLORADO
Memorandum of Understanding
For a joint HIV Intervention Project between
American Red Cross (Weld County)
and Weld County Department of Public Health & Environment
The American Red Cross and The Weld County Department of Public Health & Environment
agree to form a joint collaborative venture to provide HIV prevention training to community
members targeting the high risk population including the Latino community.
The American Red Cross agrees to provide:
• HIV Prevention Training for community members utilizing both the English and
Hispanic curriculum.
• Provide the materials to participants completing the training.
• Provide re-certification in the HIV Prevention model as needed.
The Weld County Department of Public Health & Environment agrees to provide:
• Recruitment of participants from various community groups and agencies
targeting the high risk and Latino populations.
• Provide a location and supplies for the trains.
The American Red Cross and The Weld County Department of Public Health& Environment
agree to:
• Increase the capacity for HIV Prevention education in Weld County by increasing
the number of qualified individuals who can provide culturally appropriate HIV
education to members of their communities.
This agreement is in effect until December 31, 2000 and may continue through 2002 with
agreement of both parties. This agreement is open to mutual review and modification as
appropriate.
� /L
Name: (^ /�p' Name:�/ y(/O c�
Title: Alk.Acril-oL£q,cp1; ( ookDcNnr r1 Title: /,-c2C1a1k ✓igAse u
Date: 8' Nov 99 Date: /Vtift
Akit
DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
1555 N 17TH AVENUE
� GREELEY, COLORADO 80631
ADMINISTRATION (970) 304-6410
PUBLIC HEALTH EDUCATION &NURSING (970) 304-6420
Ewe FAX (970) 304-6415
ENVIRONMENTAL HEALTH SERVICES (970) 304-6415
FAX (970) 304-6411
COLORADO
Memorandum of Understanding
For ajoint HIV Intervention Project between
Trademark Learning Center and
Weld County Department of Public Health & Environment
The trademark Learning Center and Weld County Department of Public Health & Environment
agree to form a joint collaboration venture to provide HIV/STD Peer Prevention Education
targeting high risk youth in Greeley and Weld County.
The Trademark Learning Center agrees to provide:
• Individuals/students to serve on the Teen Advisory Board and as potential peer
educators for HIV/STD prevention education to high risk youth in Weld County.
• A location for the Teen Advisory Board meetings held 1-2 times a month for 2000
and additional years if agreed to by both parties.
The Weld County Department of Public Health& Environment agrees to provide:
• Opportunities for students of Trademark to have input on the Peervention
Program.
• Receive educational programing on HIV/STD and related issues for the students
and staff.
• Support for other health promotion projects.
Both Trademark Learning Center and Weld County Department of Public Health&
Environment agree to provide:
• Information and education to schools and community groups in Weld County on
HIV/STD and related issues. •
• Serve as a resource and a model for other community groups and projects for
HIV/STD prevention and other health related issues for high risk youth, their
educators and their parents.
This agreement is in effect until December 31, 2000 and may continue through 2001 with
agreement of both parties. This agreement is open to mutual review and modification as
appropriate.
Name: Leee � C�Ge.,c) Name: (Kin U"`vv‘,.,.
Title: 7y Get14v nirrnoita .Sltic*to,4-di Title: Lk.
Date: /1/ 9P Date: //- `/- / t7
J77v--10-99 05: 33P NC' 970-484-4497 97 484 4497 P-02
NW-11-1999 01'56 ._ .
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Wald Caas DIOntai d addle IMO and Enekotat'ad
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DEPARTMENT OF PUBLIC HEALTH& ENVIRONMENT
1555 N I1TH AVENUE I •.1 t GREELEY.COLORADO 80631 gH€r• ^ ADMINISTRATION(970)304-6410
PUBLIC HEALTH EDUCATION do NURSINFG
(970)3304 6
, iii e
ENVIRONMENTAL HEALTH SERVICES(970)304-6415
FAX(970)304-6411
ei .RADO Me orandnm 0f Upderarandin><
For a Joint HIV PreventioP Project Between
• Weld County Department of Public Health&Environment
Northern Colorado AIDS Project
• e Weld County Deportment of Public Hesitb and Envitouroei t(WCDPHE)and Notthom Colorado AIDS Ptojeet
CAP)sgtoe to form a joint collaborative vent re to provide Group Level lnntetveadons(OL Men.Yo• catkin(ILO,and stabile Infatuation Campaign(PIC)targeting Mon who have
le of Color(specifically people of Hispanic/Latino origin).Persons with Disabilities(including mental i ktrss.
than RWV/AIDS),end Women in Latimer and Weld Counties.
a Wald County DepaRmaat of Public Health&Bnvicoamese`:agrees to provide: Weld and Latimer
Infiormadm and luf-sal to individuals mitring information shout prevention services
Counties Resource information needed to scare a collaborative information brochurebrochureabout prevention services
throughout Weld and Latium Counties.Opportunities
when requests come through
sties m par icipme in Group Level Interventions in Weld County
• Wald Drpat>ment of Public Health and Environment
^he Northers Colorado AIDS Project agrees to provide
Information end referral to individuals seeking information about prevention services in Weld County
Resource information needed to ante a collaborative information brochure about prevention services
throughout Lorimer and Weld Counties. requests hen w
mss m participate in Grout Level interventions in Weld Countycame through
OPPotam
NCAP.
loth Northers Colorado AIDS Project and the Weld Comity Departstast of Public Health d:Environment
tgree to provide:
Collaboration on the development of a two county information brochure about prevention services
throughout Weld and Latimer Counties. eld County.
• CoWboration end evaders�erLeve�tNtumntiioon Programs(OLI)and Public Information
• Collaboration when developing Group
Campaigns(PIC).
• agreement is effective from Jaunty,2000 through December 31,2003.end may be continues beyond this
This egreaneu t is open to mutual review and modification as appropriate.
•
�� timea- `�� watt..
altS Tide:
Isle:
,M0.4.. Dam: //'a/i
TOTAL P.04
ATI'ACUM EN1 C IN-9•t,,z_,E NUM,sra — —CONTRACT REIMBURSEMENT STATEMENT
TO: FROM:
FAX: ( ) DATE OF EXPENDITURE:
TYPE OF FROM: Final
PROGRAM: Bill?
❑ Yes
FEDERAL ID TO: ❑ No
NUMBER:
Reimbursement
Description of Expenditure Local Agency Match Total
Amount Requested
GRAND TOTAL
This is to certify that the above expenses were incurred per Contract # and we are requesting reimbursement for same.
SIGNATURE (CONTRACTOR): DATE:
I hereby certify that all contract requirements have been met and the amounts are correct. Payment is authorized.
AUTHORIZED DESIGNEE (STATE): DATE:
1I
Contractor Notified of Reimbursement Amour.,Change`
O Yes ❑No Initial:
[Date] Sample Contract Change Order Letter Attachment D
State Fiscal Year 19** -**, Contract Change Order Letter Number**, Contract Routing Number**-*****
Pursuant to paragraph ** of the contract with contract routing number**-*****and contract encumbrance number
*********** (as amended by Contract Renewal Letter**•contract routing number**-*****,and/or Contract Change
Order Letter**, contract routing number**-***** if any),hereinafter referred to as the"Original Contract"(a copy of
which is attached hereto and by this reference incorporated herein and made a part hereof)between the State of Colorado,
Department of Public Health and Environment and Contractor's Legal Name for the term from ********* **
through********* **,**** the parties agree that the maximum amount payable by the State for the eligible
services referenced in paragraph **of the Original Contract is increased/decreased by dollar amount DOLLARS
($*.**)for a new total financial obligation of the State of dollar amount DOLLARS ($*.**), The revised work plan,
which is attached hereto as"Attachment 1",and the revised budget,which is attached hereto as"Attachment 2",are
incorporated herein by this reference and made a part hereof. The first sentence in paragraph'* of the Original Contract
is hereby modified accordingly. All other terms and conditions of the Original Contract are hereby reaffirmed. This
amendment to the Original Contract is intended to be effective as of********* ** ****, However, in no event shall this
amendment be deemed valid until it shall have been approved by the State Controller or such assistant as he may
designate.
Please sign,date, and return all **originals of this Contract Change Order Letter by********* ** **** to the attention
of: ************ ************,Colorado Department of Public Health and Environment,4300 Cherry Creek
Drive South,Denver,Colorado 80246,Mail Code: *****-** One original of this Contract Change Order Letter will
be returned to you when fully approved.
Contractor's Legal Name STATE OF COLORADO
(legal type of entity) Bill Owens,Governor
By: By:
For the Executive Director
Print Name: DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT
Title:
FEIN:
APPROVALS:
CONTROLLER: PROGRAM: '
By: By:
Arthur L. Barnhart
Page 19 of 18
Sample Contract Renewal Letter Attachment E
State Fiscal Year 19** - **, Contract Renewal Letter Number**, Contract Routing Number**-*****
Pursuant to paragraph ** of the contract with contract routing number**-***** and contract encumbrance number
*********** (as amended by Contract Change Order Letter**, contract routing number**-***** and/or Contract
Renewal Letter**,contract routing number**-***** if any), hereinafter referred to as the"Original Contract"(a copy
of which is attached hereto and by this reference incorporated herein and made a part hereof)between the State of
Colorado,Department of Public Health and Environment and Contractor's Legal Name, for the renewal term from
********* ** ****,through ********* ** **** the parties agree that the maximum amount payable by the State for
the eligible services referenced in paragraph ** of the Original Contract is increased/decreased by dollar amount
DOLLARS, ($*.**)for a new total financial obligation of the State of dollar amount DOLLARS, ($*,**). The revised
work plan,which is attached hereto as"Attachment I",and the revised budget,which is attached hereto as"Attachment
2", are incorporated herein by this reference and made a part hereof. The first sentence in paragraph **of the Original
Contract is hereby modified accordingly. All other terms and conditions of the Original Contract are hereby reaffirmed.
This amendment to the Original Contract is intended to be effective as of********* **,****. However, in no event
shall this amendment be deemed valid until it shall have been approved by the State Controller or such assistant as he
may designate.
Please sign,date,and return all ** originals of this Contract Renewal Letter by ********* ** **** to the attention of:
************ ************,Colorado Department of Public Health and Environment,4300 Cherry Creek Drive
South,Denver,Colorado 80246,Mail Code: *****-**. One original of this Contract Renewal Letter will be returned
to you when fully approved.
Contractor's Legal Name STATE OF COLORADO
(legal type of entity) Bill Owens, Governor
By: By:
For the Executive Director
Print Name: DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT
Title:
FEIN:
APPROVALS:
STATE CONTROLLER: PROGRAM:
By: By:
Arthur L. Barnhart
Hello