HomeMy WebLinkAbout940816.tiff RESOLUTION
RE: APPROVE CANCER CONTROL CONTRACT BETWEEN THE HEALTH DEPARTMENT AND THE
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT AND AUTHORIZE
CHAIRMAN 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 Cancer Control Contract
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 Health Department, and
the Colorado Department of Public Health and Environment, commencing August 1,
1994, and ending July 31, 1995, with further terms and conditions being as stated
in said contract, and
WHEREAS, after review, the Board deems it advisable to approve said
contract, 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 Cancer Control Contract 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 Health Department, and the Colorado
Department of Public Health and Environment be, and hereby is, approved:
BE IT FURTHER RESOLVED by the Board that the Chairman be, and hereby is,
authorized to sign said contract.
The above and foregoing Resolution was, on motion duly made and seconded,
adopted by the following vote on the 31st day of August, A.D. , 1994, nunc pro
tunc Augus 1, 1994.
Pda-el BOARD OF COUNTY COMMISSIONERS
ATTEST: e WELD COUNTY, COLORADO
Weld County Clerk to the Board
W. . Webster, Cha. an
BY:y B'
eputy ler to the Board DaleQ K. Hall, P o- em
APPROV TO FORM:
/Geo elT. Baxter
my A torney Cons ance L. Harbert
arbara J. Kirkmeyer
940816
Form 6-AC-02A(R 5/91) Department orH��y Name
Health
Department or Agency Number
260000-- FAA
Contract Routing Number
950409
CONTRACT
THIS CONTRACT, made this 1st day of August 1994, by and between the State of Colorado for the use and benefit of
the Department of PUBLIC HEALTH AND ENVIRONMENT, 4300 Cherry Creek Drive South, Denver, Colorado 80222-1530
hereinafter referred to as the State and Weld County Department of Health, 1517 - 16 Avenue Court, Greeley, Colorado 80631
hereinafter referred to as the contractor.
WHEREAS,authority exists in the Law and Funds have been budgeted, appropriated and otherwise made available and a
sufficient uncommitted balance thereof remains available for encumbering and subsequent payment of this contract under Encumbrance
Number FAA PPG950409, in Fund Number 100 , Appropriation Account 773 , and Organization 7340.
WHEREAS,required approval,clearance and coordination has been accomplished from and with appropriate agencies:and
WHEREAS, the State has entered into a Cooperative Agreement with the Centers for
Disease Control to provide breast and cervical cancer screening and diagnostic services; and
WHEREAS, the intent of the Cooperative Agreement is to increase screening and
diagnosis among all groups of women in the state, with special efforts to reach those women who
are of low income, uninsured, underinsured, minority, Native American and/or served by Health
Resources and Services Administration primary care centers and/or Title X Family Planning fund
recipients; and
WHEREAS, the Contractor is considered by the State to be an appropriate agency which
has the facilities, personnel and capability to provide the services as herein set forth.
NOW THEREFORE, it is hereby agreed that for and in consideration of their mutual
promises to each other, hereinafter stated, the parties hereto agree as follows:
1. The Contractor will provide breast and cervical cancer screening and diagnostic services
as provided for in the budget, a copy of which is attached and by reference made part hereof as
Exhibit A, for women aged 40 and over.
2. The Contractor will provide cervical cancer screening (and related diagnostic services) to
women aged 20 to 39 who receive family planning services as provided for in the budget, a copy
of which is attached and by reference made part hereof as Exhibit B.
3. The Contractor will provide Colposcopy with biopsy services for women aged 20 to 39
who receive family planning services as provided for in the budget, a copy of which is attached
and by reference made part hereof as Exhibit C.
4. The Contractor agrees to utilize nationally accepted guidelines for women as the standard
for breast and cervical cancer screening as follows:
Page l of 9 Pages
/�'_C)( O ‘7%/68 •&
Uterine Cervix
An annual Pap smear with a pelvic examination. After three or more consecutively
satisfactory normal annual examinations, the Pap smear may be performed less frequently
at the physicians discretion.
Breast
An annual physical breast examination.
A mammogram every 1 - 2 years between the ages of 40 and 49; yearly at age 50 and
older. Women aged 50 and over should represent 75% of the women screened over the
term of the contract.
3. The Contractor agrees that only qualified personnel who are licensed or certified
professionals will conduct medical examinations, operate the equipment, conduct the tests and
interpret results.
Cytology laboratories must be in compliance with the federal Clinical Laboratory Improvement
Act of 1988 (CLIA-88).
Mammography centers must be accredited by the American College of Radiology (ACR).
Mammography centers must also be certified by the Health Care Financing Administration
(HCFA) to be a supplier of screening mammography services in the Health Insurance for the
Aged and Disabled Program (Medicare) and must meet state radiation regulations.
Mammography centers will allow and cooperate with on-site inspections for at least, but not
limited to the items in Exhibit D from the Cancer Control Program or it's agent. The Cancer
Control Program will notify the mammography center and the contractor of any deficiencies
identified through the inspection, recommended actions, specified time frames for remediation,
and required response.
If the Contractor continues to utilize a facility after receiving notification that:
• the cytology laboratory is found not to be in compliance with CLIA-
88 regulations;
• the mammography center has major deficiencies identified by an on-
site inspection and is not approved for service; _
• the mammography center has not been accredited by the ACR or made application
for ACR accreditation as authorized by the CDC; or
• the mammography center is not in compliance with HCFA or state radiation
regulations,
the Cancer Control Program may deny reimbursement for services provided by the laboratory or
mammography center after the date of notification. This paragraph does not preclude the State
from any other remedy provided by law.
Page 2 of 9 Pages
4. The Contractor agrees to receive prior approval from the Cancer Control Program to enter
into agreements with, or to change providers of mammography and cytology laboratory services.
5. The Contractor agrees to seek reimbursement for services only for those women who meet
the following eligibility criteria:
• Be a resident of Colorado as defined by the Colorado Resident Discount Program;
• Have family income at or below 200% of the federal poverty level:
• Not have health insurance that would cover these services;
• Not have had a mammogram or Pap in the past 12 months;
• Meet the Clinical Eligibility Criteria established by the program.
6. The Contractor agrees to provide data on the program designated forms or pre-approved
substitutes to the Colorado Women's Cancer Control Initiative including total number of women
screened for breast and cervical cancer, clinical results of abnormal exams, and tracking and
follow-up data to be integrated with the cervical cancer tracking and follow-up system (CCTFS)
and the Colorado Mammography Advocacy Project (CMAP) maintained by the Cancer Control
Program.
7. The Contractor agrees to refer all women with abnormal findings who require treatment
services not covered by the program to the appropriate facilities for prompt diagnosis, evaluation
and treatment.
8. The administrators of the Colorado Cancer Control Program shall have the authority to
conduct annual program performance reviews of services provided through this project.
Administrative and clinical records of patients receiving services through this project shall be
made available to the reviewers for this purpose.
9. The State will, in consideration of said services by the Contractor, cause to be paid to the
Contractor a sum not to exceed the following amounts based on the age and type of service
provided to the women:
NINE THOUSAND THREE HUNDRED SEVENTY-EIGHT Dollars ($9,378), for the
period beginning August 1,1994 and ending July 31, 1995 for approximately 50 women
aged 40 and over for all services as prescribed in the budget attached as Exhibit A.
SIX THOUSAND FOUR HUNDRED THIRTY Dollars ($6,430), for the period
beginning August 1, 1994 and ending January 31, 1995 for approximately 104 women
aged 20 to 39 for new screens as prescribed in the budget attached as Exhibit B.
TEN THOUSAND SIXTY-EIGHT Dollars ($10,068), for the period beginning August
1, 1994 and ending January 31, 1995 for approximately 50 women aged 20 to 39 for
Colposcopic exams as prescribed in the budget attached as Exhibit C.
The total contract amount in not to exceed the sum of the three separate budgets which is
TWENTY-FIVE THOUSAND EIGHT HUNDRED SEVENTY-SIX Dollars ($25,876).
For subsequent periods, the amount will be mutually determined and set forth in a letter to be
signed by the State and the Contractor, and approved by the State Controller. A sample of the
Letter of Renewal is attached and by reference made part hereof as Exhibit E. Payment will be
made by the State based on estimated, if requested by the Contractor, and actual services
Page 3 of 9 Pages
t
940815
provided, and conditioned upon affirmation by the Colorado Cancer Control Program that
services were rendered in accordance with this contract, as follows:
a) The Contractor can elect to either receive payment in advance or bill monthly. A
signed Contract Reimbursement Statement (CRS), a copy of which is attached and
by reference made part hereof as Exhibit F, is required before any payment can
be made on this contract. For advance payment, the Contractor must prorate the
amount expected to be expended (not to exceed one-twelfth of the annual budget)
in each of the first two months of the quarter during the contract term. A signed
Monthly Expenditure Report(MER), copies of which are attached and by reference
made part hereof as Exhibits G, H, and I, must be submitted each month
regardless of the payment method selected. For an advance payment, total
reimbursement will be adjusted on the MER submitted for the third month of each
quarter. This adjustment will be based on the difference between the actual
amount expended, verified through the tracking and follow-up system, and the
payments already received. New advances will not be granted until all previous
advances are cleared. All required forms and supporting documentation must be
submitted in a satisfactory manner for payment to be made. Forms should be
submitted within 30 days after of delivery of the first service. Total
reimbursement shall not exceed the total contract amount.
b) The monthly MERs (Exhibits G, H, and I) must be submitted by the 30th of the
month following the month for which the service was rendered. A CRS (Exhibit
F) must accompany the MER if payment has not been requested in advance.
c) In accordance with P.L. 101-345, patient charges for services provided will be
made according to a schedule of charges that is made available to the public, and
that is adjusted to reflect the income of the women involved. No patient charges
will be imposed on any woman with an income of 200% or less of the federal
poverty line.
d) Any program income generated such as donations shall be used by the program for
cancer prevention and control purposes which further the objectives of the
legislation under which this contract is made.
e) The contractor agrees that Medicare rates, which are changed on an annual basis,
will be used for establishing the reimbursement rates for breast and cervical cancer
screening and diagnostic services. The current year's rates are those contained on
the MERs (Exhibits G, H, and I).
10. Changes in reimbursement amounts for the above-named services in consideration of
increased or decreased levels of utilization and/or the Medicare rate change from the levels
funded in the original contract shall be made with approval of the Contractor, the State (Cancer
Control Program) and the State Controller as evidenced by a mutually signed Letter of Approval,
a copy of which is attached and by reference made part hereof as Exhibit J.
11. The Contractor agrees, to the best of his or her knowledge and belief, that:
a) No Federal appropriated funds have been paid or will be paid, by or on behalf of
the contractor to any person for influencing or attempting to influence an officer
or employee of any agency, a Member of Congress, an officer or employee of
Page 4 of 9 Pages
940R1 5
Congress, or an employee of a Member of Congress in connection with the
awarding of any Federal contract, the making of any Federal grant, the making of
any Federal loan, the entering into of any cooperative agreement, and the
extension, continuation, renewal, amendment, or modification of any Federal
contract, grant, loan, or cooperative agreement.
b) If any funds other than Federal appropriated funds have been paid or will be paid
to any person for influencing or attempting to influence an officer or employee of
any agency, a Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with this Federal contract,
grant, loan, or cooperative agreement, the Contractor shall complete and submit
Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with
its instructions.
c) The Contractor shall require that the language of this certification be
included in the award documents for all subawards at all tiers (including
subcontracts, subgrants, and contracts under grants, loans and cooperative
agreements) and that all subrecipients shall certify and disclose accordingly.
12. The term of this contract is beginning August 1, 1994, and continuing through July 15,
1996.
Page 5 of 9 Pages
940RI
COLORADO DEPARTMENT OF HEALTH - hereinafter, under the General Provisions referred to as
"Health" .
GENERAL PROVISIONS -- page 1 of 2 pages
1. 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 workers.' compensation (and show proof of such insurance) and unemployment
compensation insurance in the amounts required by law. Contractor will be solely
responsible for its acts and the acts of its agents, employees, servants and
subcontractors -during the performance of this contract.
2. Contractor authorizes Health, or its agents, to perform audits and to make
inspections for—the purpose of evaluating performance under this contract.
3. Either party shall have the right to terminate this agreement by giving the other
party thirty days notice by registered mail, return receipt requested. If notice is so
given, this agreement shall terminate on the expiration of the thirty days, and the
liability of the parties hereunder for the further performance of the terms of this
agreement shall thereupon cease, but the parties shall not be relieved of the duty to
perform their obligations up to the date of termination.
4. This agreement is intended as the complete integration of all understandings
between the parties. No prior or contemporaneous addition, deletion, or other amendment
hereto shall have any force or effect whatsoever, unless embodied herein in writing. No
subsequent novation, renewal, addition, deletion, or other amendment hereto shall have
any force or effect unless embodied in a written contract executed and approved pursuant
to the State Fiscal Rules.
5. If this contract involves the expenditure of federal funds , this contract is
contingent upon continued availability of federal funds for payment pursuant to the
terms of this agreement. Contractor also agrees to fulfill the requirements of:
a) Office of Management and Budget Circulars A-87, A-21 or A-122, and A-102 or
A-110, 'whichever is applicable;
b) the Hatch Act (5 USC 1501-1508) and Public Law 95-454 Section 4728. These
statutes state that federal funds cannot be used for partisan political purposes of any
kind by any person or organization involved in the administration of federally-assisted
programs;
c) the Davis-Bacon Act (40 Stat. 1494, Mar. 3, 1921, Chap: 411, 40 USC
276A-276A-5) . This act requires that all laborers and and mechanics employed by
contractors or sub-contractors to work on construction projects financed by federal
assistance must be paid wages not less than those established for the locality of the
project by the Secretary of Labor;
d) 42 USC 6101 et seq, 42 USC 2000d, 29 USC 794. These acts require that no
person shall, on the grounds of race, color, national origin, age, or handicap, be
excluded from participation in or be subjected to discrimination in any program or.
activity funded, in whole or in part, by federal funds; and
Page 6 of 9 Pages
Rev. 06/01/92
940F1S
GENERAL PROVISIONS--Page 2 O. 2 pages
e) the Americans with Disabilities Act (Public Law 101-336; 42 USC 12101, 12102,
12111 - 12117, 12131 - 12134, 12141 - 12150, 12161 - 12165, 12181 - 12189, 12201 - 12213
and 47 USC 225 and 47 USC 611.
f) if the contractor is acquiring real property and displacing households or
businesses in the performance of this contract, the contractor is in compliance with the
Uniform Relocation Assistance and Real Property Acquisition Policies Act, as amended
(Public Law 91-646, as amended and Public Law 100-17, 101 Stat. 246 - 256) ;
g) when applicable, the contractor is in compliance with the provisions of the
"Uniform Administrative Requirements for Grants and Cooperative Agreements to State and
Local Governments (Common Rule) .
6. By signing and submitting this contract the contractor states that:
a) the contractor is in compliance with the requirements of the Drug-Free
Workplace Act (Public Law 100-690 Title V, Subtitle D, 41 USC 701 et seq.) ;
b) the contractor is not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from covered transactions by any federal
department or agency. •
7. To be considered for payment, billings for payment pursuant to this contract must
be received within 60 days after the period for which payment is being requested and
final billings on the contract must be received by Health within 60 days after the end
of the contract term.
8. If applicable, Local Match is to be submitted on the monthly payment statements, in
the column provided, as required by the funding source.
9. If Contractor receives $25,000.00 or more per year in federal funds in the
aggregate from Health, Contractor agrees to have an annual audit, by an independent
certified public accountant, which meets the requirements of Office of Management and
Budget Circular A-128 or A-133, whichever applies. If Contractor is required to submit
an annual indirect cost proposal to Health for review and approval, Contractor's auditor
will audit the proposal in accordance with the requirements of OMB Circular A-87, A-21
or A-122. Contractor agrees to furnish one copy of the audit reports to the Health
Department Accounting Office within 30 days of their issuance, but not later than nine
months after the end of Contractor's fiscal year. Contractor agrees to take appropriate
corrective action within six months of the report's issuance in instances of
noncompliance with federal laws and regulations. Contractor agrees to permit Health or
its agents to have access to its records and financial statements as _necessary, and
further agrees to retain such records and financial statements for a period of three
years after the date of issuance of the audit report. This contract- 100% does
contain federal funds as .of the date it is signed. This requirement is in addition to
any other audit requirements contained in other paragraphs within this contract.
10. Contractor agrees to not use federal funds to satisfy federal cost sharing and
matching requirements unless approved in writing by the appropriate federal agency.
Page 7 of 9 Pages
Rev. 06/01/92 940P1 �.
•
SPECIAL PROVISIONS
CONTROLLER'S APPROVAL
I.This contract 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.This
provision is applicable to any contract involving the payment of money by the State.
FUND AVAILABILITY
2.Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds for that purpose being appropriated,budgeted,
and otherwise made available.
• BOND REQUIREMENT
3.If this contract involves the payment of more than fifty thousand dollars for the construction,erection,repair,maintenance,or improvement of any building.
road,bridge,viaduct,tunnel,excavation or other public work for this State,the contractor shall,before entering upon the performance of any such work included
in this contract,duly execute and deliver to the State official who will sign the contract,a good and sufficient bond or other acceptable surety to be approved by
said official in a penal sum not less than one-half of the total amount payable by the terms of this contract.Such bond shall be duly executed by a qualified corporate
surety conditioned upon the faithful performance of the contract and in addition,shall provide that if the contractor or his subcontractors fail to duly pay for any
labor,materials,team hire sustenance,provisions,provendor or other supplies used or consumed by such contractor or his subcontractor in performance of the work
contracted to be done or fails to pay any person who supplies rental machinery,tools,or equipment in the prosecution of the work the surety will pay the same in
an amount not exceeding the sum specified in the bond,together with interest at the rate of eight per cent per annum.Unless such bond is executed,delivered and
filed,no claim in favor of the contractor arising under such contract shall be audited,allowed or paid.A certified or cashier's check or a bank money order payable
to the Treasurer of the State of Colorado may be accepted in lieu of a bond.This provision is in compliance with CRS 38-26-106.
INDEMNIFICATION
4. 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 this contract.
DISCRIMINATION AND AFFIRMATIVE ACTION
5.The contractor agrees to comply with the letter and spirit of the Colorado Antidiscrimination Act of 1957, as amended, and other applicable law respecting
discrimination and unfair employment practices(CRS 24-34-402),and as required by Executive Order,Equal Opportunity and Affirmative Action,dated April 16,
1975.Pursuant thereto,the following provisions shall be contained in all State contracts or sub-contracts.
•
During the performance of this contract,the contractor agrees as follows:
(a) The contractor will not discriminate against any employee or applicant for employment because of race,creed, color, national origin, sex,
marital status, religion,ancestry,mental or physical handicap,or age.The contractor will take affirmative action to insure that applicants are employed,and that
employees are treated during employment,without regard to the above mentioned characteristics. Such action shall include,but not be limited to the following:
employment upgrading,demotion,or transfer,recruitment or recruitment advertisings;layoffs or terminations;rates of pay or other forms of compensation;and
selection for training, including apprenticeship.The contractor agrees to post in conspicuous places,available to employees and applicants for employment,
notices to be provided by the contracting officer setting forth provisions of this non-discrimination clause.
(b)The contractor will,in all solicitations or advertisements for employees placed by or on behalf of the contractor,state that all qualified applicants will
receive consideration for employment without regard to race,creed,color,national origin,sex,marital status,religion,ancestry,mental or physical handicap.
or age. -
(c) The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or
understanding,notice to be provided by the contracting officer,advising the labor union or workers'representative of the contractor's commitment under the
Executive Order,Equal Opportunity and Affirmative Action,dated April 16, 1975,and of the rules,regulations,and relevant Orders of the Governor.
(d)The contractor and labor unions will furnish all information and reports required by Executive Order,Equal Opportunity and Affirmative Action of April
16, 1'975, and by the rules,regulations and Orders of the Governor,or pursuant thereto,and will permit access to his books,records,and accounts by the
contracting agency and the office of the Govemor or his designee for purposes of investigation to ascertain compliance with such rules,regulations and orders.
(e)A labor organization will not exclude any individual otherwise qualified from full membership rights in such labor organization,or expel any such individual
from membership in such labor organization or discriminate against any of its members in the full enjoyment of work opportunity because of see,creed,color,
sex,national origin,or ancestry.
(f) A labor organization,or the employees or members thereof will not aid,abet,incite,compel or coerce the doing of any act defined in this contract to be
discriminatory or obstruct or prevent any person from complying with the provisions of this contract or any order issued thereunder;or attempt,either directly
or indirectly,to commit any act defined in this contract to be discriminatory.
Form 6-AC-02B
Revised 1/93
395-53-01-1022
page 8 of 9 pages
940E1
(g)In the event of the contractor's non-compliance with the non-discrimination clauses of this contract or with any of such rules,regulations,or orders,
this contract may be canceled,terminated or suspended in whole or in part and the contractor may be declared ineligible for further State contracts in
accordance with procedures,authorized in Executive Order,Equal Opportunity and Affirmative Action of April 16, 1975 and the rules,regulations,or
orders promulgated in accordance therewith,and such other sanctions as may be imposed and remedies as may be invoked as provided in Executive Order.
Equal Opportunity and Affirmative Action of April 16, 1975,or by rules,regulations,or orders promulgated in accordance therewith, or as otherwise
provided by law.
(h)The contractor will include the provisions of paragraphs(a)through(h)in every sub-contract and subcontractor purchase order unless exempted by
rules,regulations,or orders issued pursuant to Executive Order,Equal Opportunity and Affirmative Action of April 16, 1975,so that such provisions will
be binding upon each subcontractor or vendor.The contractor will take such action with respect to any sub-contracting or purchase order as the contracting
agency may direct.as a means of enforcing such provisions,including sanctions for non-compliance;provided,however,that in the event the contractor
becomes involved in.or is threatened with,litigation,with the subcontractor or vendor as a result of such direction by the contracting agency,the contractor
may request the State of Colorado to enter into such litigation to protect the interest of the State of Colorado.
COLORADO LABOR PREFERENCE
6a.Provisions of CRS 8-17-101&102 for preference of Colorado labor are applicable to this contract if public works within the State are undertaken hereunder and
are financed in whole or in part by State funds.
b.When a construction contract for a public project is to be awarded to a bidder,a resident bidder shall be allowed a preference against a non-resident bidder from
a state or foreign country equal-to the preference given or required by the state or foreign country in which the non-resident bidder is a resident.If it is determined by
the officer responsible for awarding the bid that compliance with this subsection.06 may cause denial of federal funds which would otherwise be available or would
otherwise be inconsistent with requirements of Federal law,this subsection shall be suspended,but only to the extent necessary to prevent denial of the moneys or to
eliminate the inconsistency with Federal requirements(CRS 8-19-101 and 102)
GENERAL
7.The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the interpretation,execution,and enforcement of this
contract.Any provision of this contract whether or not incorporated herein by reference which provides for arbitration by any extra-judicial body or person or which
is otherwise in conflict with said laws,rules,and regulations shall be considered null and void.Nothing contained in any provision incorporated herein by reference
which purports to negate this or any other special provision in whole or in part shall be valid or enforceable or available in any action at law whether by way of complaint,
defence,or otherwise.Any provision rendered null and void by the operation of this provision will not invalidate the remainder of this contract to the extent that the
contract is capable of execution.
8.At all times during the performance of this contract,the Contractor shall strictly adhere to all applicable federal and state laws,rules,and regulations that have
been or may hereafter be established.
9.The signatories aver that they art familiar with CRS 18-8-301,et.seq.,(Bribery and Corrupt Influences)and CRS 18-8-401,et.seq.,(Abuse of Public Office).
and that no violation of such provisions is present.
10.The signatories aver that to their knowledge,no state employee has any personal or beneficial interest whatsoever in the service or property described herein:
IN WITNESS WHEREOF,the parties hereto have executed this Contract on the day first above written.
Contractor:
(Full Legal Name) Weld County Department of STATE OF COLORADO
/,'J Health /// / ,//J ,} ROY ROMER,GOVERNOR
X (HAS �' 11_� `Oy/AV
By _j--C_ for
Position(Title) WELD COUNTY BOARD OF COMMIS IONERS *5 EX roa
846000813 B •
5«i nrN or
t v7 DEPARTMENT
If Corporation:) I� 1 OF PUBLIC HEALTH AND ENVIRONMENT
Attest(Seal)
By • WELD COUNTY HEALTH DEPARTMENT
ryaahe .a iv Tova,Ciq/Caw,wt:krx ��
OHN S. PICKLE, M.S.E.H.
GALE A. NORTON APPROVALS DIRECTOR
ATTORN Y A .iNEY GENERAL CONTROLLER -
:111.2 W ALVIN E. MASStNBURCiff••/��� .1 L, (.1. l .tl(
Form 6-AC-02C -ssistant Attorney Genes
Revised 1/93 General Legal Services Page 9 which is the last of 9 pages
395-5}01-1030 •See instructions on reverse side.
PROGRAM APPROVAL: /1(177:-.744
940E!
Exhibit A
COLORADO WOMEN'S CANCER CONTROL INITIATIVE
ANNUAL EXPENDITURE REPORT 1994 - 95
Women Aged 40 and Above
AGENCY: Weld County Health Department F7SCALYEAR: 94-95
SERVICE REIMBURSEMENT NUMBER TOTAL
PROVIDED RATE OF AMOUNT
PROCEDURES
SCREENING
Clinical BreastExam/PelvicExam _ $54,23 50 $2711.50
Pap Lab(by Cytotech) 7.60 5 0 3 8 0.0 0
Mammogram 59.63 50 2981.50
SUBTOTALS 6073. 00
DIAGNOSTIC
Repeat Clinical Breast Exam 29.80 8 238.40
Surgical/MedicalConsultation 76.58 3 229.74
Diagnostic/Repeat Mammogram 62.44 8 4 9 9.5 2
Fine Needle Aspiration(FNA) 161.44 1 161.44
Repeat Pelvic Exam 29.80 8 2 3 8.4 0
f —
Pap Lab(by Pathologist) 19.05 8 152.4 0
Colposcopy 89.32 1 8 9.3 2
ColposcopywithBiopsy 20136 2 — 402.72
SUBTOTALS 2011.94
TOTAL 8084.94
Tracking and Follow-up @15% 1212.74
Travel Allowance 8 0.3 2
TOTALANNUALCOSTS 9378.00
910F1S
6/29/94 SDMERANN.FRM
Exhibit B
COLORADO WOMEN'S CANCER CONTROL INITIATIVE
ANNUAL EXPENDITURE REPORT 1994 - 95
Women Aged 20 to 39
AGINCY:Weld County Health Department FISCALYEAR: 94-95
SERVICE REIMBURSEMENT NUMBER TOTAL
PROVIDED RATE OF AMOUNT
PROCEDURES
SCREENING
Clinical Breast Exam/Pelvic Exam $54.23 104 $5640.00
Pap Lab(by Cytotech) 7.60 104 790. 00
Mammogram 59.63
SUBTOTALS
6430. 00
DIAGNOSTIC
Repeat Clinical Breast Exam 29.80
Surgical/Medical Consultation 76.58
Diagnostic/Repeat Mammogram B2.44
Fine Needle Aspiration(FNA) 161.44
Repeat Pelvic Exam 29.80
Pap Lab(by Pathologist) 19.05
Colposcopy 89.32
Colposcopy with Biopsy 201.36
SUBTOTALS
TOTALANNUAL COSTS 6430. 00
7/5/94 SDMERANN.FRM
Exhibit C
COLORADO WOMEN'S CANCER CONTROL INITIATIVE
MONTHLY EXPENDITURE REPORT 1994 - 95
Colpos for Women Aged 20 to 39
AGENCY: Weld County Health Department FISCAL YEAR: 94-95
SERVICE REIMBURSEMENT NUMBER TOTAL
PROVIDED RATE OF AMOUNT
PROCEDURES
SCREENING
Clinical Breast Exam/Pelvic Exam $54.23
Pap Lab(by Cytotech) 7.60
Mammogram 59.63
SUBTOTALS
DIAGNOSTIC
Repeat Clinical Breast Exam 29.80
Surgical/Medical Consultation 76.58
Diagnostic/Repeat Mammogram 62.44
Fine Needle Aspiration(FNA) 161.44
Repeat Pelvic Exam 29.80
Pap Lab(by Pathologist) 19.05
Colposcopy 89.32
Colposcopy with Biopsy 201.36 50 $10068. 00
SUBTOTALS - 10068. 00
TOTAL MONTHLY COSTS 10068.00
7/5/94 SDMERANN.FRM
91OC1.
Exhibit D
Colorado Department of Health
Cancer Control Program
Mammography Technical Image Quality Evaluation
1. ACR Phantom Image Evaluation
2. Focal Spot Size Evaluation
3 . kVp Evaluation
4. Half Value Layer Evaluation
5. Exposure Reproducibility Evaluation
6. Automatic Exposure Control Evaluation
7. Breast Dose Evaluation
8. Processor Performance Evaluation
94 0P's S
Exhibit E
STATE OF COLORADO
COLORADO DEPARTMENT OF HEALTH 6oF.co��
Dedicated to protecting and improving the health and - -R
environment of the people of Colorado
o yQ
4300 Cherry Creek Dr.S. Laboratory Building x *
Denver,Colorado 80222-1530 4210 E. 11th Avenue '
Phone:(303)692-2000 Denver,Colorado 80220-3716 �'r 1896
(303)691-4700
Roy Romer
CONTRACT RENEWAL LETTER Governor
Patricia A.Nolan,MD,MPI I
Date Executive Director
Routing Number -
Contract Renewal#
According to Paragraph_ of Contract PPG , Routing Number , (copy attached and
by this reference made a part hereof) between the State of Colorado,Department of Public Health and
Environment, Prevention Division, Cancer Prevention and Control Program and
, the maximum amount of is hereby
allocated for the next fiscal year beginning.August 1,19_and ending July_, 19_.
This amount was determined using the 19 Medicare reimbursement rates for authorized services as
shown and the projected number of services to be provided as shown in Attachment 1. The first sentence
in Paragraph_Is hereby modified accordingly. The terms and conditions of the original contract shall
remain the same.
This letter of amendment to the contract is intended to be effective date , but 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 all four (4) copies of this letter and return to me by date to:
Colorado Department of Public Health and Environment
PPD-CCP-AS
4300 Cherry Creek Drive South
Denver, CO 80222-1530
An executed copy.of this letter with all the required signatures will be returned to you.
Please call me at (303) 692-XXXX if you have any questions.
Sincerely,
Agency State of Colorado:
Roy Romer, Governor
By:
By:
Name For the Executive Director
Colorado Department of Public Health and
Environment
Title
Approvals: By:
State Controller or
By: Authorized Designee
Division/Department/Program Representative
910r1 ty
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Exhibit F
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Exhibit G
COLORADO WOMEN'S CANCER CONTROL INITIATIVE
MONTHLY EXPENDITURE REPORT 1994 - 95
Women Aged 40 and Above
AGENCY: FISCAL YEAR:
SERVICE REIMBURSEMENT NUMBER TOTAL
PROVIDED RATE OF AMOUNT
PROCEDURES
SCREENING
Clinical Breast Exam/Pelvic Exam $54.23
Pap Lab(by Cytotech) 7.60
Mammogram 59.63
SUBTOTALS
DIAGNOSTIC
Repeat Clinical Breast Exam 29.80
Surgical/Medical Consultation 76.58
Diagnostic/Repeat Mammogram 62.44
Fine Needle Aspiration(FNA) 161.44
Repeat Pelvic Exam 29.80
Pap Lab(by Pathologist) 19.05
Colposcopy 89.32
Colposcopy with Biopsy 201.36
SUBTOTALS
TOTAL
Tracking and Follow-up @15%
Travel Allowance
TOTAL MONTHLY COSTS
6/29/94 SDMERANN.FRM
Exhibit H
COLORADO WOMEN'S CANCER CONTROL INITIATIVE
MONTHLY EXPENDITURE REPORT 1994 - 95
Women Aged 20 to 39
AGENCY: FISCAL YEAR:
SERVICE REIMBURSEMENT NUMBER TOTAL
PROVIDED RATE OF AMOUNT
PROCEDURES
SCREENING
Clinical Breast Exam/Pelvic Exam $ 54.23
Pap Lab(by Cytotech) 7.60
Mammogram 59.63
SUBTOTALS
DIAGNOSTIC
Repeat Clinical Breast Exam 29.80
Surgical/Medical Consultation 76.58
Diagnostic/Repeat Mammogram 62.44
Fine Needle Aspiration(FNA) 161.44
Repeat Pelvic Exam 29.80
Pap Lab(by Pathologist) 19.05
Colposcopy 89.32
Colposcopy with Biopsy 201.36
SUBTOTALS
TOTAL
Tracking and Follow-up @ 15%
TOTAL MONTHLY COSTS
8/4/94 SDMER4,FRM
940ri H;
Exhibit I
COLORADO WOMEN'S CANCER CONTROL INITIATIVE
MONTHLY EXPENDITURE REPORT 1994 - 95
Colpos for Women Aged 20 to 39
AGENCY: FISCAL YEAR:
SERVICE REIMBURSEMENT NUMBER TOTAL
PROVIDED RATE OF AMOUNT
PROCEDURES
SCREENING
Clinical Breast Exam/Pelvic Exam $54.23
Pap Lab(by Cytotech) 7.60
Mammogram 59.63
SUBTOTALS
DIAGNOSTIC
Repeat Clinical Breast Exam 29.80
Surgical/Medical Consultation 76.58
Diagnostic/Repeat Mammogram 62.44
Fine Needle Aspiration(FNA) 161.44
Repeat Pelvic Exam 29.80
Pap Lab(by Pathologist) 19.05
Colposcopy 89.32
Colposcopy with Biopsy 201.36
SUBTOTALS
TOTAL
Tracking and Follow-up @ 15%
TOTAL MONTHLY COSTS
8/4/94 SDMER2.FRM 9,7 0r/
Exhibit J
STATE OF COLORADO
COLORADO DEPARTMENT OF HEALTH 0v-coto
Dedicated to protecting and improving the health and 4"- 'P
environment of the people of Colorado o
4300 Cherry Creek Dr.S. Laboratory Building k
Denver,Colorado 80222-1530 4210 E. 11th Avenue
Phone:(303)692-2000 Denver,Colorado 80220-3716 t87
(303)691-4700 Roy Romer
CHANGE ORDER LETTER Governor
Patricia A.Nolan,MD,MPH
Date Executive Director
Routing Number -
Change Order Letter No.
Contract PPG , Routing Number , (copy attached and by this reference made a part
hereof) between the State of Colorado, Department of Public Health and Environment, Prevention Division,
Cancer Prevention and Control Program and the
maximum amount of is hereby Increased/decreased by$ _
to a new total of$
• per paragraph (s) _and_. A copy of the new budget is attached as revised Exhibit_.
The first sentence in Paragraph_is hereby modified accordingly. The terms and conditions of the
original contract shall remain the same.
This letter of amendment to the contract is intended to be effective date ,but 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 all four (4) copies of this letter and return to me by date to:
Colorado Department of Public Health and Environment
PPD-CCP-A5
4300 Cherry Creek Drive South
Denver, CO 80222-1530
An executed copy.of this letter with all the required signatures will be returned to you.
Please call me at (303) 692-XXXX if you have any questions.
Sincerely,
Agency State of Colorado:
Roy Romer, Governor
By
By
Name For the Executive Director
Colorado Department of Public Health and
Environment
Title
Approvals: By: •
State Controller or
By Authorized Designee
Division/Department/Program Representative
Printed on Recycled Paper
A fri' o f Ef�IORAf1DU�1 �) '
���'��• W.H. Webster, Chairman
O To Board of County Commissionaume Augug t 29 ?199( ; (: 29
COLORADO John Pickle, Director, Health Department rjc")
From
TO 'c `0
subject:
Cancer Control Contract
Enclosed for Board approval is a contract between the Colorado
Department of Public Health and Environment for breast and
cervical cancer screening and diagnostic services for women aged
40 and over, and for cervical screening and colposcopic services
for women aged 20 to 39 .
The services for women aged 40 and over were previously funded by
the State Health Department and payment was processed through
Salud Clinic. The State is now contracting with Weld County
Health Department directly. The time period covered by this
portion of the contract is August 1, 1994 through July 31, 1995 .
Services for women aged 20 to 39 were previously provided by the
Family Planning Contract. The time period for this portion of
the contract is from August 1, 1994 through January 31, 1995 .
The total amount of this contract is $25, 786, and I recommend
your approval .
Enclosure
940816
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