HomeMy WebLinkAbout940743 RESOLUTION
RE: APPROVE PURCHASE OF SERVICES AGREEMENT BETWEEN HEALTH DEPARTMENT AND
NORTHERN COLORADO HEALTH NETWORK, INC. , DBA NORTHERN COLORADO AIDS
PROJECT, 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 Purchase of Services Agreement
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
Northern Colorado Health Network, Inc. , dba Northern Colorado AIDS Project,
commencing April 1, 1994, and ending March 31, 1995, with further terms and
conditions being as stated in said agreement, and
WHEREAS, after review, the Board deems it advisable to approve said
agreement, 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 Purchase of Services Agreement 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 Northern Colorado
Health Network, Inc. , dba Northern Colorado AIDS Project, be, and hereby is,
approved.
BE IT FURTHER RESOLVED by the Board that the Chairman be, and hereby is,
authorized to sign said agreement.
The above and foregoing Resolution was, on motion duly made and seconded,
adopted by the following voteon the 1st day of August, A.D. , 1994.
lea,
WELDD OF TYUNCY ORADISSIONERS
ATTEST: WELD COUNTY, COLORADO
� A
Weld County Clerk to the Board i7/' = .g/ 4d4/ Y�'�9 'Ii)
W. H. Webster, Chairman
r
BY: �( / �_ EXCUSED
C Deputy Clerk to t r Dale,K. Hall, -Tem
APPROVED AS TO FORM: /'�r'--9-f �'�1�
eo e/E. Baxter
-a'n-ir A, ...- cfrVatAr.......,C
County At orne `'— Constance L. Harbert
EXCUSED
Barbara J. Kirkmeyer
940743
///_ ' / WI
lit .^,...,i\ r.
PURCHASE OF SERVICES AGREEMENT
THIS "�)}A',,IGREEMENT, made and entered into this / ��- day
of /I 4 4; f, 1994, by and between the County of Weld, State of
Coloradb, by and through the Board of County Commissioners of Weld
County, hereinafter referred to as "Weld County" on behalf of the
Weld County Health Department, hereinafter referred to as "Health
Department" , and Northern Colorado Health Network, Inc. , d/b/a the
Northern Colorado AIDS Project (NCAP) , hereinafter referred to as
"Contractor. "
WITNESSETH
WHEREAS, Health Department has been awarded Ryan White
C.A.R.E. Title II funds from the Colorado Department of Health for
use in establishing a consortium for care services for persons
infected and affected by the HIV virus in Weld, Larimer, and Morgan
Counties ( "the program") ; and
WHEREAS, Health Department desires to contract for case
management and coordination of the consortium services; and
WHEREAS, Contractor desires to provide the case management and
coordination of the consortium services; and
WHEREAS, the parties desire to reduce the terms of their
agreement to writing.
NOW THEREFORE, for and in consideration of the covenants,
conditions, agreements, and stipulations hereinafter expressed, the
parties do hereby agree as follows:
1 . Recitals
The above recitals are hereby incorporated herein.
2 . Term of Agreement
This Agreement shall be effective from the date of its
signing, nunc pro tunc April 1, 1994 through March 31,
1995.
Page 1 of 7 Pages
940743
3. Compensation
In consideration of the services to be provided by Contractor
as set forth hereinafter, Health Department agrees to pay
Contractor on a monthly basis for services provided during
that month, pursuant to the terms of this Agreement and the
budget amounts set forth in Attachment "B", attached hereto
and incorporated herein.
Contractor shall submit an invoice on a form as set forth in
Attachment "A" attached hereto and incorporated herein, to
Health Department at the end of each month services are
provided. The invoice will clearly itemize the services
provided and the expenses incurred, as well as the number of
hours worked by each personnel. Health Department agrees to
reimburse Contractor within thirty (30) days after submission
of the required reporting information on the monthly invoice
form.
4 . Services to be Provided by Contractor
A. Contractor shall provide one Client Advocate for the
program who will perform active community outreach with
clients, perform in-home assessments, and coordinate with
local health care providers to obtain referrals of newly
diagnosed HIV positive persons .
B. Contractor shall require the Client Advocate to
coordinate with the Health Department' s Case/Program
manager in the performance of their duties .
C. Contractor shall provide the services outlined in the
"NCAP Workplan" , Attachment "C", attached hereto and
incorporated herein.
D. Contractor shall provide said services to affected
persons residing in Northeastern Colorado including, but
not limited to, the counties of Weld, Larimer, and
Morgan.
Page 2 of 7 Pages
940743
E. Contractor agrees to abide by and take responsibility for
assuring the items outlined in the "Colorado Ryan White
Title II 1994 Consortium Assurances" , "Attachment D",
attached hereto and incorporated herein.
F. Contractor shall develop and/or abide by existing
confidentiality protocols in accordance with professional
standards and applicable statutes, including, but not
limited to, C.R.S. 25-4-1401, et. seq. (HIV infection and
AIDS) and C.R.S. 18-4-412 medical records) .
G. Contractor shall abide by the reporting requirements and
time frames described in the CDH Guidance for the
Development of Title II Funded Consortia Workplans, 1994-
1995, Attachment "E", attached hereto and incorporated
herein.
H. Contractor shall submit a monthly billing to the Health
Department for reimbursement by using the invoice in
Attachment "A" . The billing shall provide documentation
regarding each line item for which reimbursement is
requested.
I . Contractor shall arrange to have a financial audit
performed in the final quarter of this agreement and
prior to March 1, 1995. The firm to perform the audit
must be independent of Contractor, staff, volunteers, or
board and must be approved by the Health Department prior
to performing the audit.
5 . Parties ' Relationship
The parties to this Agreement intend that the relationship
between them contemplated by this Agreement is that of
independent entities working in mutual cooperation. No
employee, agent, or servant of one party shall be or shall be
deemed to be an employee, agent, or servant of another party
to this Agreement.
Page 3 of 7 Pages
940743
6 . Limitations - Liabilities - Indemnification
Each party shall not be responsible or liable for acts or
omissions or failure to act by the other party. Accordingly,
Health Department agrees to indemnify and hold Contractor
harmless from any and all liability incurred by acts,
omissions, or failures to act by Health Department and,
likewise, Contractor agrees to indemnify and hold Health
Department harmless from any and all liability incurred by
acts, omissions, or failures to act by Contractor, pursuant to
the terms of this Agreement. Because Health Department is a
department of the Weld County government, Contractor
acknowledges that its agreement to indemnify and hold harmless
Health Department extends to Weld County, its employees,
agents, subcontractors, and assignees. The term "liability"
includes, but is not limited to, any and all claims, damages,
and court awards including costs, expenses, and attorney fees
incurred as a result of any act or omission by the applicable
party who acted or failed to act.
7 . Non-Assignment
This Agreement shall not be assignable without prior written
consent of Health Department or Contractor, whichever is the
non-assigning party.
8 . To Whom Services Are to be Provided
Health Department and Contractor assure compliance with Title
VI of the Civil Rights Act of 1964, that no person shall, on
the grounds of race, color, sex, religion, age, national
origin, or individual handicap, be excluded from participation
in, be denied the benefits of, or be subject to discrimination
under any provision of this Agreement.
Page 4 of 7 Pages
940713
9. Termination
Either party may terminate this Agreement for cause upon ten
( 10) days written notice and for any reason so long as thirty
(30) days written notice of its intent to so terminate is
given to the other party. If this Agreement is so terminated,
Health Department shall pay that compensation to Contractor
which duly reflects the actual number of hours not previously
reimbursed during which Contractor documents that Contractor
provided services pursuant to this Agreement.
10. Notices
Any notice provided for in this Agreement shall be in writing
and shall be served by personal delivery or by certified mail,
return receipt requested, postage prepaid, at the addresses
set forth in this Agreement, until such time as written notice
of a change is received from the party wishing to make a .
change of address. Any notice so mailed and any notice served
by personal delivery shall be deemed delivered and effective
upon receipt or upon attempted delivery. This method of
notification will be used in all instances, except for
emergency situations when immediate notification to the
parties is required.
HEALTH DEPARTMENT:
Weld County Department of Health
c/o Judy Nero
1517 16th Avenue Court
Greeley, CO 80631
CONTRACTOR:
Northern Colorado AIDS Project
c/o Joan Cmar, Executive Director
P.O. Box 182
Ft. Collins, CO 80522
Page 5 of 7 Pages
940713
S
11. Modification and Breach
This Agreement contains the entire Agreement and understanding
between the parties to this Agreement and supersedes any other
agreements concerning the subject matter of this transaction,
whether oral or written. No modification, amendment,
novation, renewal, or other alteration of or to this Agreement
and the attached exhibits shall be deemed valid or of any
force or effect whatsoever, unless mutually agreed upon in
writing by the undersigned parties. No breach of any term,
provision, or clause of this Agreement shall be deemed waived
or excused, unless such waiver or consent shall be in writing
and signed by the party claimed to have waived or consented.
Any consent by any party hereto, or waiver of, a breach by any
other party, whether express or implied, shall not constitute
a consent to, waiver of, or excuse for any other different or
subsequent breach.
12 . Incorporation of Contractual Provisions
This Agreement is expressly made subject to all laws and
regulations of the United States and the State of Colorado.
Contractual provisions required by such laws and regulations,
but not having been set forth herein, are hereby incorporated
by this reference as though expressly set forth in full. All
parties to this Agreement are hereby put on notice and charged
with the responsibility of compliance with such contract
provisions as required by law.
13. Severability
If any term or condition of this Agreement shall be held to be
invalid, illegal, or unenforceable, this Agreement shall be
construed and enforced without such a provision, to the extent
this Agreement is then capable of execution within the
original intent of the parties.
14 . Funding
No portion of this Agreement shall be deemed to create an
obligation on the part of the County of Weld, State of
Colorado, or Health Department to expend funds not otherwise
appropriated during the term of this Agreement.
Page 6 of 7 Pages
Q1 ft'7.4'2
15. Records
Each party agrees to keep any and all records and information
confidential, in compliance with all laws and regulations
concerning the confidentiality of such records .
16. Inurement
This Agreement shall inure to the benefit of the heirs,
assigned, and successors in interest of the parties hereto.
17. No Third Party Beneficiary Enforcement
No portion of this Agreement shall be deemed to constitute a
waiver of any immunities the parties or their officers or
employees may possess, nor shall any portion of this Agreement
be deemed to have created a duty of care with respect to any
person not a party to this Agreement.
It is expressly understood and agreed that enforcement of the
terms and conditions of this Agreement and all rights of
action relating to such enforcement shall be strictly reserved
to the undersigned parties, and nothing contained in this
Agreement shall give or allow any claim or right of action
whatsoever by any other person no included in this Agreement.
It is the express intention of the undersigned parties that
any entity other than the undersigned parties receiving
services or benefits under this Agreement shall be deemed an
incidental beneficiary only.
IN WITNESS WHEREOF, the parties have hereunto set their hand
and seals this { day of �[ri� rf , 1994, nunc
pro tunc May 25, 1994 . _r
WELD COUNTY HEALTH DEPARTMENT NORTHERN COLORADO AIDS PROJECT R
legit \AK.4w1
John S. Pickle, M.S.E.H.
7727/99 -11 D,si4y
Date
Page 7 of 7 Pages
940713
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
fl !fir°` % / ( !' ic ;
W. H. Webster,\/Chairman 0Se %>9
OCr u1t /j J9(19
Date
ATTEST:
Weld County Clerk to the Board
940743
Attachment A
PERSONNEL
Buddy Training
Case Management
Support Services
Consortium
Psychological Counseling
total personnel
AUDIT
MILEAGE
Buddy
Support
Case management
Psy
PRINTING
Buddy
Support
Consortium
POSTAGE
Support
Consortium
PUBLIC RELATIONS
Buddy
PHONE
Buddy
Case management
Psy
Total
94(" .43
Attachment B
PERSONNEL
Buddy Training 1,325
Case Management $22,287
Support Services $ 4887
Consortium $ 3,236
Psychological Counseling $ 5,284
total personnel $37,019
AUDIT $ 1,619
MILEAGE
Buddy $ 265
Support $ 100
Case management $ 50
Psy 50
total mileage $ 465
PRINTING
Buddy 590
Support $ 100
Consortium $ 1,000
total printing $ 1,690
POSTAGE
Support $ 200
Consortium $ 1000
total postage 1,200
PUBLIC RELATIONS
Buddy $ 220
PHONE
Buddy 30
Case management $ 200
Psy
$ 200
total phone 430
Total $42,643
940743
•
Attachment C
Northern Colorado AIDS Project
Tax Identification Number
84-1035151
•
Contact Person
Joan Cmar, Executive Director
Northern Colorado AIDS Project
Post Office Box 182
Fort Collins, Colorado 80522
(303) 223-6227
940713
Northern Colorado AIDS Project
Narrative
Description of the Locality to be Served:
Geographic
The Northern Colorado AIDS Project (NCAP) is located in Fort Collins, Colorado and
primarily serves Larimer County, with recent expansion into Weld and Morgan
Counties. Fort Collins is the largest city in Larimer County with a population of 90,000.
The three counties are rich in agriculture, mountains, and rural communities. Colorado
State University and the University of Northern Colorado are located in the NCAP
catchment area.
Population Characteristics
As of December 31, 1993, 108 cases of AIDS have been reported in this tri-county area:
52 reported cases in Larimer county resulting in 27 deaths; in Weld County, 46 reported
cases and 26 deaths; and 10 cases with 7 deaths in Morgan County. These statistics
unfortunately do not reflect the number of persons living with AIDS who reside in these
areas but were diagnosed elsewhere nor the number of HIV infected individuals who
have not yet progressed to AIDS.
Larimer, Weld, and Morgan Counties have a total population of 339,896. A
disproportionate number of Hispanics reside in these three Colorado counties. All three
counties have the same percentage of males and females, 49% and 51% respectively.
With the exception of females, NCAP clients closely reflect the demographics of our
community. Furthermore, NCAP actively pursues diverse gender, cultural, and racial
representation on its Board of Directors.
Existing Services
The existing services in Larimer County include the Northern Colorado AIDS Project,
the Colorado State University Student Health Center, the Larimer County AIDS
Coalition, the Larimer County Health Department and limited private practice health
professionals. NCAP provides case management services, a buddy program, and
support services to HIV affected individuals. The Colorado State University (CSU)
Student Health Center services the needs of CSU students including education and
testing. The Larimer County AIDS Coalition is an organization that provides education
to the communities in Larimer County. The Larimer County Health Department offers
HIV counseling and testing.
Service Gaps
Historically, HIV affected individuals have expressed concerns regarding the lack of
sufficient services. Consequently, many individuals residing in northern Colorado have
chosen to receive their medical care in metropolitan area, specifically Denver. Outside
of the services provided by the Northern Colorado AIDS Project, there are no HIV/AIDS
case management services and limited psychological counseling and/or support groups.
1
9407?.3
Description of the Service Plan:
The Planning Process
Three meetings involving the Weld County Health Department, The Northern Colorado
AIDS Project, and representatives of Morgan County were held to develop the service
plan. Both HIV infected and affected individuals were represented in the planning
process.
The Service Plan
The Northern Colorado AIDS Project (NCAP) will provide case management, buddy
program training in Fort Morgan, Greeley, and Fort Collins, psychological counseling,
support groups and consortia development and coordination. NCAP currently works
with 42 HIV infected individuals. In the past,NCAP has welcomed two new clients per
month. Therefore, 24 new clients are expected to utilize NCAP's services in the next
year. With this estimation, NCAP would have a total of 66 clients at year's end. The
referral network will serve as a means of reaching and serving newly diagnosed HIV
infected individuals. Because of confidentiality issues, health care professionals can not
divulge names of newly diagnosed patients. Therefore, NCAP must rely heavily on
physician recommendation. To combat this problem, the Executive Director is
developing a rapport with local physicians to encourage utilization of available services.
The Service Integration
A Networking Agreement is used as a tool for referrals. Please see attachment A.
Furthermore, referrals will be made from the Referral/Support Services listing
distributed by the Colorado Department of Health. NCAP currently has networking
agreements with over 40 agencies,including Plan de Salud del Valle,Disabled Resources
of Larimer County, Hospice of Northern Colorado, Social Services of Larimer and Weld
Counties and the Weld County Health Department.
The Implementation Plan
The Northern Colorado AIDS Project (NCAP) will provide case management, buddy
program training in Fort Morgan, Greeley, and Fort Collins, psychological counseling,
support groups and consortia development and coordination. These activities will take
place throughout the year.
Description of the Consortium Membership:
Consortium Members and Services
Consortium Members Services Provided
Northern Colorado AIDS Project Case management, buddy program
training psychological counseling,support
groups and consortia development and
coordination.
2
940` l
•
Consortium Members and Services [cont]
Consortium Members Services Provided
NorMedco Home health and respite care
Hospice of Northern Colorado Home health and respite care, support
groups
Bonell Good Samaritan Center Long term and respite care
Weld County AIDS Coalition Education
Island Grove Treatment Center Residential,out-patient,and detoxification
services
Planned Parenthood of the HIV testing and counseling,birth control
Rocky Mountains information
University of Northern Colorado HIV testing and counseling,birth control
Student Health Center information
Centennial Area Health Education Center Education
Northeast Colorado Health Department Education
Social Security Administration Living Assistance
Choices for Independent Living Living Assistance
Weld County Health Department Education, HIV testing, and counseling
The Networking Agreement is used between member agencies in order to provide a
quality and continuum of care. Please see attachment A.
Member Agencies Receiving Consortium Funds
The Northern Colorado AIDS Project (NCAP) will receive consortium funding on a
contractual basis to provide case management, buddy program training, psychological
counseling,support groups and consortia development and coordination. The Northern
Colorado AIDS Project is a community cased, volunteer, non-profit organization
committed to serving those people impacted by HIV/AIDS in the Northern Colorado
Community. NCAP strives to increase awareness and understanding of the AIDS
epidemic and endeavors to empower persons affected by HIV/AIDS.
NCAP's client services include: support groups for HIV infected individuals, their
partners, families, and friends; a network of other community, advocacy, and referral
organizations for persons with HIV infection;and volunteer(buddy) services for persons
with AIDS. NCAP offers an AIDS information line that provides updated information
and referral. The outreach program incorporates a speaker's bureau, brochures, a video
tape and book library, and community networking and information sharing.
Form of Agreement Between Agencies
A Networking Agreement is used as the form of agreement between agencies. Please
see attachment A.
3
94.0'741
Reporting and Evaluation
NCAP will collect data according to the Uniform Reporting System. The case manager
will conduct an initial interview to establish an individual as a client. During this visit,
the information required by the URS is obtained. This information will be reported on
a quarterly basis. Additionally, information will be collected and reported regarding the
number of new clients and individuals who are positive may not become clients), where
the individual was referred from, agencies and services that referrals are made to, and
the needs of the clients.
To evaluate the success in responding to the needs of the client, the case manager will
assess and document the needs during the intake interview. This will establish a
baseline for evaluation. As time progresses, the needs will be reviewed by the client, the
case manager and select consortium members. Likewise, the Northern Colorado AIDS
Project has plans to develop a cost effectiveness evaluation tool.
4
�e11°71q
Budget
Table I - Budget Justification
Object/Class Category Total Funds Requested % of Total Budget
Personnel $24,388 69
Fringe Benefits 4,024 60
Travel 445 38
Equipment 0 0
Supplies 549 50
Contractual 3` OO �299A. 100
Other 3,490 47
Audit 0 0
Indirect Charges `jJ 32
TOTAL $41,024 N% 59
Impact of Services
Historically, HIV affected individuals have expressed concerns regarding the lack of
sufficient services. Consequently,many individuals residing in northern Colorado have
chosen to receive their medical care in metropolitan area, specifically Denver. Outside
of the services provided by the Northern Colorado AIDS Project, there are no HIV/AIDS
case management services and limited psychological counseling and/or support groups.
These funds would continue current services and allow for expansion. Currently, the
case manager/executive director's time is limited due to funds. An increase in funds
will allow for a full time equivalent position. This will in turn yield more
comprehensive services.
Table II - Budget Justification
Category of Service Funds Requested % of FTE Number of Clients
Primary Medical Care $ 0 0 0
Dental Care 0 0 0
Mental Health 3,665 15 18
Rehabilitation Care 0 0 0
Support Services 13,943 58 22
Case Management 23,416 94 66
Home Health Care 0 0 0
Home-based Hospice 0 0 0
Contractual 2,000 8 12
TOTAL $1,024 175 NA
Clients
NCAP currently has 42 clients in the following distribution: no infants or children, 6
infected and 4 affected women; and 12 family members.
5
9407?,3
Impact of Services
Historically, HIV affected individuals in Larimer County have expressed concerns
regarding the lack of sufficient services. Consequently, many individuals have chosen
to receive their medical care in metropolitan area, specifically Denver. One goal of
NCAP is to provide those services being sought elsewhere. Outside of the services
provided by the Northern Colorado AIDS Project, there are no HIV/AIDS case
management services and limited psychological counseling and/or support groups.
These funds would continue current services and allow for expansion. Currently, the
case manager/executive director's time is limited due to funds. An increase in funds
will allow for a full time equivalent position. This will in turn yield more
comprehensive services.
Explanation of the Plan
The Northern Colorado AIDS Project (NCAP) will provide case management, buddy
program training in Fort Morgan, Greeley, and Fort Collins, psychological counseling,
support groups and consortia development and coordination.
Case management services will provide an avenue for clients to access needed services
and resources. Often clients are overwhelmed with the complexities of the disease that
they need help accessing services. The coordinated services of NCAP help relieve some
of the burden of the client and the family. Additional buddy program training will
allow for more volunteers. The buddy program was established to give a helping hand
to those HIV/AIDS individuals in need.
Expansion of Services
These funds would continue current services and allow for expansion. Currently, the
case manager/executive director's time is limited due to funds. An increase in funds
will allow for a full time equivalent position. This will in turn yield more
comprehensive services. Furthermore, it is expected that 24 new clients will be served
in the upcoming year.
Quality Assurance
Quality assurance will be insured by use of several evaluation tools. To evaluate the
success in responding to the needs of the client, the case manager will assess and
document the needs during the intake interview. This will establish a baseline for
evaluation. As time progresses, the needs will be reviewed by the client, the case
manager and select consortium members. The executive director, case manager, and
contract personnel will be evaluated annually to assure quality of services performed.
Staff will remain update on HIV/AIDS by attending seminars and lectures. The
Networking Agreement will be used to confirm quality care and services between
agencies. Likewise, the Northern Colorado AIDS Project has plans to develop a cost
effectiveness evaluation tool.
To guarantee confidentially, client files will be locked at all times with limited access.
Only select personnel will have access to client files.
6
940,1.3
From ; COPYCO Printing PHONE No. ; 226 4236 Mar.21 1994 12:44PM Pet
Nnrthnrn Colorado AIDS Projoct.
Ryan White CAR1•i Act 1'Vnding fiscal. year April 1 , 1994 through March 31 , 19c
(' � a.ri11 be
The amount of 141619 :Lc ul)ocated coming;
1 . An audit of The Nort1Hrn Colorado A) D8 Projraat (NCAP)
conducted f J primary y 1995.cu (4695) and buddy (49?4) categories.
Out of the curt.L. Duddy Truinin($ (ttEt. 1P430)
Ft. Morgan: ono u'I.I;rti xrEonne7ining ond of Juno
435 for Mi l ealse, 4110 S
consultation five hours = 86tl personnel !
el each)
_ 14101
5
(three monthly vi.uitc at 1 .> hours
Ft. Collino: two night hour truininge - and of May, end of Soptr.+mbar
{4220 for personnel, no mileage monthly two hour meeting° = 43P8 personnel
Greeley: one e:1.i;ht hour training end of July
160 mileage, personnel = 8110
consultation five hours 68 personnel., mileage = $660
Preparation time = 23 hours = 431)
Booklet - 410/booklet x 1111 books = 844.0 - end of May ; ( 1 ? buddies for
Ft. Collins x 2, 12 for Greeley, 8 for Pt. Morgan)
Public relations - four newspaper ads - ono for each training S220
ads; to be placed two weeks prior to each training
Printing = 8100
Long distance phone calls cost = 830
3. Cacomanagement ,
60% of funding for NCAP = $72,537 personnel 4}22�F87
travo.L = $50; long distance phone = 4200; p-r
4. Psychological Counooling < <•�
55% of funding for lon �NCAP =distance>phone = 8200; personnel. = 15284
travel = 830; t�
roquirements: masters level in the field of social worker, psycholog
counseling; final approval is left up to the fiscal agent
94.0743
From CppyCp Printing
PFD 226 4238 Mar.21 1994 12:44PM P02
h awEa. (out of to+en) = !4100, pot;t•'�gr. — iFF Uo
5, support pe Groups a
personnel . i�4�a71
printing = in Notes Park t,y end oY June
collateral group Morgan by end ei' oul.y
buddy support group in £'t. ga ed August buddy support group in Greeley by
Buddy support group in Yorks Collins by end et Juno and October
G. (ionsortia postage _ $G1000
personnel -91235; printing •- 21000; P
services to Lrxrimor, Weld, Morgan counties
NCA3' will function vu consortia developing and coordinating vgoney.
Duties: new:1 t{ nr
22 1 ) resource idc:ntifiacl:lon, P) update resource guide, attend 3) olettoorc
qu Govemeetings i)
coordination of consortia mooting(;, �) complete needs
r
meetings and state iota byi).aws,r8)rcomp) etenassurances} as listed,
assessment, 7) comp by
9) development of cost effectiveness evaluation
i.
7. Consortia/executive board will review budget status at six months
of grant to evaluate
potential
executive ta
otnalline item changes. The final decision e will be made by
o-
rya p e
I '
9409, ,3
Attachment D
Colorado Ryan White Title II 1994 Consortium Assurances
In order to receive assistance from the State, the Consortium hereby assures the State that:
A. Within the established locality in which the consortium will operate, the population and
subpopulations of individuals and families with HIV disease have been identified by the
consortium;
B. The consortium's service plan addresses the special care and service needs of the
populations and subpopulations identified in the established locality;
C. The consortium will comply with all data collection and reporting requirements as mandated
by HRSA and the Colorado Department of Health;
D. The consortium will be a single coordinating entity that will integrate the delivery of
services among the populations and subpopulations identified in the established locality;
E. The consortium will coordinate and expand existing programs before any new programs are
created;
F. The consortium shall deliver case management services that link available community
support services to appropriate specialized medical services;
G. The consortium will include participation by individuals with HIV disease in the assessment
of service needs and the planning of the delivery of services;
H. The consortium has or will create a mechanism to evaluate the success of the consortium
in responding to the identified needs and the cost effectiveness of the mechanisms employed
by the consortium to deliver comprehensive care;
I. The consortium has or will adopt by-laws by which the consortium will operate. The by-
laws will include the definition of a "member" of the consortium and a description of the
process the consortium must follow in including new members. Membership definitions and
processes will clearly demonstrate an open and inclusionary intent which will give all
segments of the HIV service provider community an opportunity to participate on a
continuous and ongoing basis. By-laws will also include a description of the process for
selecting a lead agency; this process will ensure all consortium members have an
opportunity to be considered for the role of lead agency, if interested, and to participate in
selection of the lead agency; and
•
940713
J. All non-profit agencies receiving $25,000.00 or more in Title 11 funds will ensure an annual
independent financial audit is conducted and a report submitted as specified in Section
II,F, of the 1994-95 Title II Consortia Workplan Guidance document.
Signature Date
940'.13
ATTACHMENT E
COLORADO DEPARTMENT-OF-HEAL
TH
GUIDANCE FOR
CON CONSORTIA WORKPLANS,F TITLE II FUNDED
1 94-95
(Excerpt from pages 5-6)
D. Repotting ReQuirements: Contractors must provide statistical and program
achievement information and assurances to the Colorado Department of Health
in a manner that meets the requirements of the Health Resources and Services
Administration (HRSA) of. the U.S. Department of Health and Human
Services (DHHS). This information includes:
1. Statistical and Program Achievement Effective July 1, 1994, HRSA
will implement the Annual Administrative Report (AAR) of the
Uniform Reporting System (URS). All contractors receiving Title II
funds MUST comply with the reporting requirements of the AAR. A
comprehensive list of information that contractors will be required to
include in reports effective July 1, 1994, is attached to this document.
The Colorado Department of Health will provide training and technical
assistance relating to the requirements of this reporting system.
Because the AAR requirements become effective in July 1994, the
1994-95 project period will be a transitional time with the following
reporting requirements:
a) A quarterly narrative and statistical report must be submitted for
the period of April 1, 1994, to June 30, 1994. This report will be due
by July 30, 1994. Quarterly Report Forms and instructions for their
completion are included in Section V of this document. Narrative
reports should include discussions of: progress in achievement of
goals and objectives; problems and concerns encountered in
completing activities within each category of service; plans to respond
to any barriers encountered; and highlights of noteworthy
achievements/developments.
b) Effective July 1, 1994, contractors will be required to subit
mit
monthly reports meeting the requirements of the AAR/URS. Spec
concerning the methods each contractor will use to provide reports will
be developed during the months of April-June 1994, with the input of
contractors. However, ALL contractors must plan to maintain the
information contained in the standard AAR attached to this document,
and be able to report on this data for the period commencing July 1,
1994.
c) Additionally, cornmencingwith'the quarter beginning July`1-, 1994,3..; -
contractors will be required to submit end-of-quarter reports which
include a narrative report on their activities correlated with the AAR
940'71.'3
data. The content and methodology to be used for these quarterly
reports will also be developed during the months of April-June.
d) Contractors will also be required, using the data collected with the
reporting methods (to be developed) mentioned above, to produce an
annual aggregate AAR to be submitted to HRSA. The methodology
ly
for submitting this report will also be developed during April-June
the assistance of CDH. The initial annual report to HRSA will
require data for the period beginning July 1, 1994, to December 31,
1994. All ensuing reporting periods will be based on calendar year,
e.g., January 1, 1995, to December 31, 1995. However, in the event
a contract is not renewed prr year riod commencing
1995 shall be April
1995, from the reporting period for calendar
January 1, 1995, to March 31, 1995.
9407^.3
STANDARD
ANNUAL ADMINISTRATIVE REPORT
(ONE REPORT FROM EACH RYAN WHITE-FUNDED PROVIDER)
for use by
Title I Programs and Title II Consortia,
and Home- and Community-based Programs
1. UNIQUE PROVIDER NUMBER
2. REPORTING PERIOD
3. ORGANIZATION NAME, CONTACT PERSON, ADDRESS AND PHONE
NUMBER
4. ZIP CODE OF PRINCIPAL PROVIDER SITE
5. TOTAL NUMBER OF SITES FOR PROVIDER
6. PROVIDER TYPE
Hospital or hospital-based clinic
Public-funded community health center
Public-funded community mental health center
Other community-based service organization
PWA coalition
Health department
Other public agency
Solo/group private health practice
Other
Unknown
7. OWNERSHIP STATUS
Public/local
Public/state
Public/federal
Private/nonprofit
Private/for profit
Unincorporated
Unknown
8. MINORITY COMPOSITION OF BOARD AND/OR STAFF
9. TOTAL UNDUPLICATED NUMBER OF CLIENTS SERVED
(EXCLUDING ANONYMOUS CLIENTS)
10. NUMBER OF NEW CLIENTS SERVED
11. NUMBER OF ANONYMOUS CLIENTS SERVED
12. NUMBER OF CLIENTS BY GENDER
13. NUMBER OF CLIENTS BY RACIAL/ETHNIC HERITAGE
White (Non-Hispanic)
Black (Non-Hispanic)
Hispanic
Asian/Pacific Islander
American Indian/ Aleutian/ Native American/ Eskimo
20
94.(1"7.4,n
STANDARD
ANNUAL ADMINISTRATIVE REPORT (CON'T)
14. NUMBER OF CLIENTS BY AGE GROUP
Under 13 Years of Age
13 - 19 Years of Age
Age 20 and Over
15. ESTIMATED PERCENT OF ADULT/ADOLESCENT CLIENTS
BY HIV EXPOSURE CATEGORY (Medical Care Providers Only)
Men Who Have Sex With Men
Injection Drug Use
Men Who Have Sex With Men AND Injection Drug Use
Heterosexual Contact
Other/ Undetermined
16. ESTIMATED PERCENT OF CLIENTS WHO HAVE HIV (non-AIDS)
17. ESTIMATED PERCENT OF CLIENTS WITH AN AIDS DIAGNOSIS
18. NUMBER OF OFFICE BASED HEALTH SERVICES BY TYPE OF
SERVICE
Medical Care Visits
Dental Care Visits
Mental Health Treatment/ Therapy/ Counseling Visit
Substance Abuse Treatment/ Counseling Visits
Rehabilitation Services
19. NUMBER OF CASE MANAGEMENT ENCOUNTERS
Face to Face Encounters
Other Encounters
20. NUMBER OF VISITS FOR HOME HEALTH CARE
Paraprofessional
Professional
Specialized
21. NUMBER OF HIV/AIDS CLIENTS THAT RECEIVED CERTAIN OTHER
SERVICES
Residential Hospice Care
In-Home Hospice Care
Buddy/ Companion
Client Advocacy
Other Counseling
Day or Respite Care
Emergency Financial Assistance
Housing Assistance
Food Bank/ Home Delivered Meals
Transportation
Education/ Risk Reduction
Foster Care/ Adoption
Other Services
•
21
94071.3
STANDARD
ANNUAL ADMINISTRATIVE REPORT (CON'T)
•
22. HIV/AIDS FUNDING BY SOURCE'
Title I CARE
Title II CARE
Title III CARE
Section 329, 330, 340
HIV Pediatric Demonstration Projects
Other Federal
State/ Local Public Sources
Other Sources
Total Funding
23. HIV/AIDS EXPENDITURES BY CATEGORY
Direct Service Staff
Medications
Other Direct
Contracted Services
Total Expenditures
24. FULL TIME EQUIVALENT HIV/AIDS PAID STAFF
25. FULL TIME EQUIVALENT HIV/AIDS VOLUNTEERS
26. ADDITIONS TO PAID HIV/AIDS STAFF
Physicians
Nurses, Physician Assistants, Nurse Practitioners
Dentists
Licensed Mental Health Staff
Case Managers
Clerical/ Support Staff
22
� , mEmoRAnDum 1r 0and .L
111 1€ W.H. Webster, Chairman _, �4 c
R.
oard of County Commissioners Jul 2'Y `Y9 -'
Date
h� Ens ^
COLORADO John Pickle, Director, Health Department'_ "' j 715
From T" I _ 9 ^ "r"1)77
ontract with North Colorado AIDS Project (NCAP)
SubJeci
Enclosed for Board approval is a contract between Weld County
Health Department and the Northern Colorado AIDS Project (NCAP) .
The Health Department was awarded the Ryan White C.A.R.E. Title
II funds from the Colorado Department of Health to continue the
consortium of care services for persons with HIV disease in Weld
and Larimer counties . As part of this effort, the Health
Department will subcontract with NCAP to provide case management
services for Larimer County and the coordination of the Northern
Colorado Care Consortium.
For these services, NCAP will receive $41,024 for the period
April 1, 1994 through March 31, 1995.
I recommend approval of this contract.
94 0 74 3
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