HomeMy WebLinkAbout20000081 RESOLUTION
RE: APPROVE CONTRACT AMENDMENT#1 FOR CANCER PREVENTION PROGRAM
AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with Contract Amendment#1 for the Cancer
Prevention Program between the County of Weld, State of Colorado, by and through the Board
of County Commissioners of Weld County, on behalf of the Weld County Department of Public
Health and Environment, and the Colorado Department of Public Health and Environment,
commencing February 1, 2000, and ending August 14, 2000, with further terms and conditions
being as stated in said amendment, and
WHEREAS, after review, the Board deems it advisable to approve said amendment, 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 Contract Amendment#1 for the Cancer Prevention Program
between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Weld County Department of Public Health and
Environment, and the Colorado Department of Public Health and Environment be, and hereby
is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said amendment.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 12th day of January, A.D., 2000.
BOARD OF COUNTY COMMISSIONERS
W LD COUNTY, COL RADO
ATTEST:amil1► '�� ph
Barbara J. • eye , Chair
Weld County Clerk to th^ r;"
��' �
�� M. J. teile, Pro-Tem
BY: 6 �' G Me J
Deputy Clerk to the B•4 (I "1\ EXCUSED
- r e E Baxter
APPROVED AS TO FORM:
Dale K. Hall
aunty Atto enemy dba/
lenn Vaad .�
,//'' 2000-0081
P- /it HL0027
Department or Agency Name
COLORADO DEPARTMENT OF
PUBLIC HEALTH AND ENVIRONMENT
Department or Agency Number
FLA
Contract Routing Number
00-00251
CONTRACT AMENDMENT#1
This AMENDMENT is made this 28TH day of JANUARY, 2000,by and between: the State of Colorado, for the
use and benefit of the 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 WELD COUNTY DEPARTMENT OF HEALTH,whose address or principal place of business
is 1555 N. 17th Avenue,Greeley, CO 80631, hereinafter referred to as"the Contractor".
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 11001,Organization Code [73401, and Appropriation Code 17731,under Contract
Encumbrance Number FLAPPGOOWAXMAN;
WHEREAS,the parties entered into an Original Contract,effective date August 15, 1999, Contract encumbrance
number FLAPPGOOWAXMAN, Contract routing number 00-00062 whereby the Contractor was to provide to the
State breast cancer screening,cervical cancer screening,and diagnostic services for older low income and
uninsured/underinsured Colorado women;
WHEREAS,the Original Contract is part of a class of contracts which are administered by the State under a phase I
waiver from the Office of the State Controller;
WHEREAS,the State has received additional funding from the Centers for Disease Control and Prevention
(CDCP)to provide Intensive Case Management Services;
WHEREAS,as of the made date of this Amendment, the State has a currently valid Group II purchasing delegation
agreement with the Division of Purchasing within the Colorado Department of Personnel;
WHEREAS,this procurement is exempt from the Colorado Procurement Code and Rules because the Contractor is
a governmental entity or, this procurement is a Sole Source Procurement made in accordance with the provisions of
section 24-103-205, 10 C.R.S., as amended,and Procurement Rule R-24-103-205-01;and,
WHEREAS, all required approvals, clearances, and coordinations have been accomplished from and with all
appropriate agencies.
Page 1 of 3
NOW THEREFORE, in consideration of their mutual promises to each other, stated below,the parties hereto
agree as follows:
1. Consideration for this Amendment to the Original Contract, Contract encumbrance number
FLAPPGOOWAXMAN Contract routing number 00-00062 consists of the payments and services which
shall be made pursuant to this Amendment, and the promises and agreements herein set forth.
2. It is expressly agreed to by the parties that this Amendment is supplemental to the Original Contract,
Contract routing number 00-00062, effective date August 15, 1999, hereinafter referred to as the"Original
Contract",which is incorporated herein by this reference, made a part hereof, and attached hereto as
"Attachment 1". All terms, conditions, and provisions thereof, unless specifically modified herein, arc to
apply to this Amendment as though they were expressly rewritten, incorporated, and included herein.
3. It is agreed to by the parties that the Original Contract is, and shall be, modified, altered, and changed in
the following respects only:
A. Paragraph C..2. of the Original Contract is amended to read:
It is further understood and agreed that the maximum amount of funds available for the period of
15 August, 1999 through 14 August,2000 for the purchase of breast and cervical cancer
screening and diagnostic services is One Million Eiaht Ilu..dred TA...d, E:el.t Thousand,
Thee Dollar3($1,828,003)ONE MILLION,NINE HUNDRED SEVENTY-ONE
THOUSAND, THREE HUNDRED SEVENTY ONE DOLLARS,($1,971,371). The liability
of the State,at any time,for such payments shall be limited to the remaining unencumbered
amount of such funds..
B: The original Statement of Work,Attachment A to the Original Contract, shall be deleted in its
entirety and replaced with a new Statement of Work, which is incorporated herein by this
reference, made a part hereof, and attached hereto as "Attachment A-1".
4. The effective date of this Amendment is February 1,2000.
5. Except for the"General Provisions"and"Special Provisions"of the Original Contract, in the event of any
conflict, inconsistency, variance, or contradiction between the terms and provisions of this Amendment and
any of the terms and provisions of the Original Contract,the terms and provisions of this Amendment shall
in all respects supersede,govern,and control. The Special Provisions shall always control over other
provisions of the Original Contract or any subsequent amendments thereto. The representations in the
Special Provisions to the Original Contract concerning the absence of bribery or corrupt influences and
personal interest of State employees are presently reaffirmed.
6. FINANCIAL OBLIGATIONS OF THE STATE PAYABLE AFTER THE CURRENT FISCAL YEAR
ARE CONTINGENT UPON FUNDS FOR THAT PURPOSE BEING APPROPRIATED, BUDGETED,
AND OTHERWISE MADE AVAILABLE.
Page 2 of 3
7. THIS AMENDMENT SHALL NOT BE DEEMED VALID UNTIL IT SHALL HAVE BEEN
APPROVED BY THE CONTROLLER OF THE STATE OF COLORADO OR SUCH ASSISTANT AS
HE MAY DESIGNATE.
IN WITNESS WHEREOF, the parties hereto have executed this Amendment on the day first above written.
CONTRACTOR: WELD COUNTY BOARD OF STATE:
COMMISSIONERS
WELD COUNTY DEPARTMENT OF HEALTH STATE OF COLORADO
Bill Owens,Governor
By: / } u
Name (01/ 2/2000 YFhe Executive Director
Barbara J. Kirkmeyer. Chair
Title Department of Public
846000813
FE N Number Health and Environment
/W,
Attestation: (Se Gv' PROGRAM APPROVAL:
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yerano J tJI
AYV[la]�fALA$�lgy4m{ eur�{{�,�yg�a�l�/4/ ` F�.• t11� �..
Deputy Clerk to the Boar. t,
APPROVALS:
COLORADO DEPARTMENT OF LAW COLORADO DEPARTMENT OF PERSONNEL
OFF ICE OF THE ATTORNEY GENERAL OFFICE OF THE STATE CONTROLLER
Ken Salazar,Attorney General Arthur L. Barnhart,State Controller
l
By: By: A / . �,� (
Page 3 of 3
ATTACHMENT A
REVISED STATEMENT OF WORK
Colorado Women's Cancer Control Initiative
Effective date-February I, 2000
The Contractor shall provide breast and cervical cancer screening and diagnostic services to all identified
eligible women age 40 years and older in accordance with the "Schedule of Services", which is
incorporated herein by this reference, made a part hereof, and attached hereto as "Attachment B".
2. The Contractor shall only request reimbursement from the State for allowable screening and diagnostic
services for a woman who meets all of the following eligibility criteria:
A. The woman lives in Colorado, or lives in a state bordering Colorado and receives breast and/or
cervical health care in Colorado;
B. The woman's family has a family income at or below 200% of the federal 1999-2000 poverty
guidelines established by the United States Department of Health and Human Services. The
poverty guidelimes are incorporate herein by this reference,made a part hereof, and attached
hereto as "Attachment C". The reported family income must be verified by the Contractor by
appropriate documentation from all participating women to ensure that their income qualifies
them for participation in the program;
C. Not have health insurance that would cover these services(women with Medicare-Part B
coverage are not eligible for these services);and
D. Not have had a mammogram or Pap test in the past 12 months.
3. The Contractor shall utilize the following guidelines as the standard for breast and cervical cancer
screening, rescreening and diagnostic services:
A. Breast Cancer Screening
An annual clinical breast examination for women age 40 years and older.
Annual screening mammograms shall be targeted to women age 50 years and older.
At least 75% of the women enrolled for mammography in the CWCCI shall be age 50 years
and older. Women age 40-49 years shall not exceed 25% of the women enrolled for
mammography. For women age 40-49 years,priority for mammography shall be given to
those women who have any of the following risk factors:
1. A first degree relative(mother, sister,daughter) who developed breast cancer prior to age
50 years;
2. Two or more first degree relatives(mother, sister,daughter) who developed breast cancer
at any age;
Page 1 of 5
3. A personal history of breast cancer; or,
4. A clinical breast examination symptomatic for cancer.
The Contractor shall use the"Assessment and Management of Breast Complaints"and the CWCCI
"Breast Imaging Algorithm" as guidelines for following women with breast abnormalities. These
guidelines are incorporated herein by this reference,made a part hereof, and attached hereto as
"Attachment Al" and "Attachment A2" respectively. Additionally,the Contractor shall use the
"Evaluation of Common Breast Problems: A Primer for Primary Care Providers" as a guide for
following women with breast abnormalities.
B. Cervical Cancer Screening
An annual Pap test and pelvic examination for women with an intact cervix who are age 40 years
and older. After three(3) or more consecutive annual satisfactory normal Pap tests, the interval
can be increased to every three(3)years at the discretion of the provider. The Contractor shall
use the American College of Obstetricians and Gynecologists(ACOG)Technical Bulletin#183,
August 1993, "Cervical Cytology: Evaluation and Management of Abnormalities" and the Journal
of the American Medical Association(JAMA 1994;271; 1866-9)article"Interim Guidelines for
the Management of Abnormal Cervical Cytology"as a guide for tracking women with cervical
abnormalities.
C. Rescreening Services
The Contractor shall counsel all women about the purpose of breast and cervical cancer screening
and the recommended rescreen intervals when they enter the program. The counseling shall
emphasize that rescreening can lead to reduced mortality. The Contractor shall establish and
maintain a system for notifying women when they are eligible for a breast and cervical cancer
rescreen examination. Priority for breast and cervical cancer screening shall be given to women
previously screened through the CWCCI.
D. Diagnostic Services Reimbursed through CWCCI
The Contractor shall provide all reimbursable diagnostic services directly or develop agreements
with other providers to offer these services. All reimbursed diagnostic services shall be performed
in an out-patient setting. The Contractor is eligible for reimbursable diagnostic services only for
those women who were screened through the CWCCI.
E. Diagnostic and Treatment Services Not Reimbursable through CWCCI
The Contractor shall identify all available sources of diagnostic and treatment services not
reimbursed through this Contract, and shall refer all women with abnormal findings who require
these services to appropriate medical practitioners for prompt diagnosis, evaluation, and treatment.
F. CWCCI Reimbursement. The Contractor shall accept CWCCI reimbursement for allowable
screening and diagnostic services in accordance with the Schedule of Services as payment in full
for those services. The Contractor shall not bill a woman for the difference between its
normal billing charge and the CWCCI reimbursement rate.
Page 2 of 5
G. Use of Qualified Personnel Only. The Contractor shall use only qualified personnel who are
licensed or certified professionals to conduct medical examinations, operate equipment, conduct
tests,and interpret results. Medical personnel performing the clinical breast examinations shall:
be physicians, nurse practitioners,physician assistants, or nurse midwives;or,be deemed
qualified by the Contractor's Medical Director only after receiving sufficient formal medical
training to perform these clinical services.
H. Use of Laboratories. Cytology laboratories shall comply with the federal Clinical Laboratory
Improvement Act of 1988 (CLIA-88).
I. Mammography centers shall be certified by the Food and Drug Administration(FDA) and shall
comply with the Mammography Quality Standards Act of 1992.
4. The Contractor shall notify the CWCCI whenever it enters into agreements with, or changes,providers of
mammography and cytology laboratory services.
5. The Contractor shall provide culturally sensitive services to the target priority populations as defined by the
CWCCI. The target priority populations are:uninsured and under-insured older women who are racial,
ethnic, or cultural minorities, including but not limited to,African Americans,American Indians,
Asian/Pacific Islanders,Hispanics,and Lesbians; women with disabilities; and, women who live in hard to
reach communities in urban and rural areas.
6. The Contractor shall provide data to the CWCCI on forms designated by the CWCCI. The data shall
include,but is not limited to: the total number of women screened for breast and cervical cancer; the
clinical results of all exams; and,the results from tracking and follow-up for symptomatic women or
women with a screen detected abnormality. This data shall be integrated into the Service Delivery System,
the Tracking and Follow-up System, the Case Compliance Summary System, and the Fiscal Management
System, all of which are maintained by the CWCCI.
7. Funding for a Case Manager is provided in the Schedule of Services. This funding is to facilitate client
enrollment, data completion, and data submission to the CWCCI. This finding is Fifty Dollars(S50.00)
for each case annually and is based upon the Contractor's compliance with the following standards of
performance by the Contractor. Failure to accept funding for the Case Manager does not exempt the
Contractor from meeting these compliance standards.
A. Use of Case Enrollment Forms. Case Enrollment Forms(Personal History Form, Consent and
Release of Medical Information and Clinical Services Form) shall be submitted to the CWCCI for
90%or more of the cases within 60 days of the date of the most recent service performed and
shall be submitted with essential information properly completed in 90%or more of the cases.
B. Submission of Test Results. .Manunogram results shall be submitted to the CWCCI in 90%or
more of the cases within 60 days of the service being provided and shall have the essential
information reported properly and accurately in 90%or more of the cases submitted. This
information shall be submitted on the CWCCI designated form which includes all required data
elements.
Page 3 of 5
C. Tickler System. The Contractor shall have a system in place to assure clients who need short
interval rescreening procedures(i.e., 3 -6 months)are reminded of the need for these procedures
and shall assist those clients as needed in obtaining those services.
8. Funding for Intensive Case Management Services shall be available as of February I, 2000. This funding is
to facilitate follow-up activities for women with abnormal screening results(when diagnostic testing is not
completed during the initial screening visit) and/or a diagnosis of cancer. Abnormal results qualifying for
intensive case management services are defined as follows:
Clinical Breast Examinations- discrete palpable mass, bloody or serous nipple discharge, nipple
or areolar scaliness and/or skin dimpling or retraction.
Mammography- suspicious abnormality,biopsy should be considered; highly suggestive of
malignancy, appropriate action should be taken; or assessment is incomplete,need additional
imaging evaluation.
PAP Test-high-grade squamous intra epithelial lesion(hsil)and/or squamous cell carcinoma.
This funding is an additional S150 per event per client and is based upon consistent adherence to the
following standards of performance by the Contractor.
A. The Contractor Shall assure or document attempts to assure that women with abnormal screening
results, receive all appropriate diagnostic services within 60 days of the abnormal finding.
B. The Contractor shall assure that treatment services are available to all women with a diagnosis of
cancer regardless of the woman's ability to pay for those services.
C. The contractor shall develop a care plan using the CWCCI designated form per event per client
assessed to need intensive case management services. Each care plan will:
1. Address client's needs and be reassessed and revised as needed upon receipt of diagnostic
results;
2. Set goals with time frames and delineate who is responsible for meeting these goals;
3. Document efforts made to meet the identified needs; and,
4. Be developed by the case manager,nurse coordinator,provider, or other staff with the
appropriate skills in collaboration with the client.The client shall acknowledge her
agreement with and commitment to the plan.
5. Be submitted to the state, within 60 days of the abnormal finding, along with the
Radiological Report form in the case of mammography abnormality and/or the Clinical Services
form in the case of CBE or cervical abnormality.
Page 4 of 5
D. Diagnostic follow-up information for all women, including those referred to outside health care
providers for these diagnostic procedures, shall be provided to the CWCCI on the Breast and Cervical
Diagnostic Follow-up Report forms. Timeliness standard: 90%or more of the cases shall be submitted
within 60 days of the date of detection of the abnormality;accuracy standard: 90%or more of the cases
shall be submitted with essential information properly complete; lost to follow standard: no more than 10%
of women shall be lost to follow-up. A copy of the documented follow-up efforts shall be submitted to the
CWCCI with the appropriate diagnostic follow-up form.Minimum follow-up efforts shall be those defined
in the CWCCI follow-up policies.
E. The CWCCI computer generated breast and cervical follow-up forms shall be accurately
completed and submitted for 90%or more of the cases within 60 days of the date of form production.
F. All women with a cervical final diagnosis of CIN II or more severe, or a breast malignancy, shall
have treatment status information submitted to the CWCCI. Timeliness, accuracy and lost-to-follow
standards as defined in paragraph D above shall also apply.
Payment of the Case Manager fee and/or intensive case management services fee is predicated on the
Contractor's continued compliance with the above standards. Any of the above standards on which there
has been non-compliance shall require the Contractor to develop,submit and adhere to a remediation plan
and bring the standard(s) into compliance within thirty days. More than two breaches of compliance
regardless of remediation, or any one without an approved remediation plan within thirty days during the
term of this Contract may result in cessation of funding for the Case Manager and/or Intensive Case
Management Services or termination of the Contract for default without liability of any kind to the State.
9. The Contractor shall send at least one agency representative to the mandatory annual Service
Provider meeting
Page 5 of 5
'i t \C
1 1_.
COLORADO
MEMORANDUM
TO: Barbara Kirkmeyer, Chair, Board of County
Commissioners
FROM: Pat Persichino, Interim Director, Department of Public
Health and Environment
DATE: January 10, 2000
SUBJECT: Amendment to Cancer Prevention Contract
Enclosed for Board review and approval is Contract Amendment#1 to the contract
between the Weld County and Colorado Departments of Public Health and Environment
for breast and cervical cancer screening and diagnostic services for women aged 40 and
over.
This amendment will provide additional funding in the amount of$150 per event per
client for intensive case management services for women with abnormal screening results
and/or a diagnosis of cancer. These follow-up activities have been provided in the past
by Weld County Health Department staff with no reimbursement from the State. The
time period of this amendment is from February 1, 2000 through the end of the contract
period, August 14, 2000.
Health Department staff recommends your approval of this amendment.
Enclosure
2000-0081
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