HomeMy WebLinkAbout940673 RESOLUTION
RE: APPROVE CONTRACT FOR PERSONAL CARE BOARDING HOME PROGRAM 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 Contract for the Personal Care
Boarding Home 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 Health Department, and the Colorado Department of Health, commencing July
1, 1994, and ending June 30, 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 Contract for the Personal Care Boarding Home 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 Health Department, and
the Colorado Department of Health 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 20th day of July, A.D. , 1994, nunc pro tune
July 1, 1994.
BOARD OF COUNTY COMMISSIONERS
ATTEST: /UAW% WELD COUNTY, OL/O�RADO
O IX
Weld County Clerk to the Board /U4
W . Webster, C irman
BY: C 1A_16. . L Yct4L_\.
Deputy Clerk to the Board Da e . all, P o-Tem
APPROVED AS TO FORM: EXCUSED
George E. Baxter
v -- e
ounty Attorn / Constance L. Harbert
EXCUSED
Barbara J. Kirkmeyer
940673
n '
Form 6-AC-02A IR 5185)
DEPARTMENT OR AGENCY NUMBER
260000
CONTRACT ROUTING NUMBER
950139
CONTRACT
THIS CONTRACT, made this, 0 day of J U( LL /772 / , by and between the State of Colorado for the use and benefit of
the Colorado Department of Public Health and Environment, 4300 Cherry Creek Drive South, Denver, Colorado 80222, hereinafter referred to as the
State, and the Weld County Health Department, 1517 16th 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
unencumbered balance thereof remains available for payment in Fund Number 246 ,
APPR code 795 , Contract Encumbrance Number FMA HFD950139 and
WHEREAS, required approval, clearance and coordination has been accomplished from and with appropriate agencies; and
WHEREAS,the Contractor and the State mutually agree that the services of approved public health staff, under the administrative oversight
of the Contractor, are the most efficient and effective way of providing the desired 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 shall provide,through the services of approved public health staff,services which include the annual resurveys of personal
care hoarding homes and the investigation of all complaints lodged against personal care boarding homes in Weld County. The State shall retain
responsibility for inspections and complaint investigations of alternative care facilities.
2. Minimal contract fulfillment for this contract period shall include the following activities:
A) resurveys and all associated monitoring of personal care boarding homes and personal care boarding homes designated as
residential treatment facilities for the mentally ill (RTF MI) in Weld County following all relevant rules, regulations, guidelines, forms, and procedures
as detailed on Attachment 1, by this reference incorporated herein. The State will keep the Contractor apprised of additions, deletions, or changes
in the regulations covering personal care boarding homes;
BI resurveys of all complaints lodged against personal care boarding homes and personal care boarding homes designated as
residential treatment facilities for the mentally ill(RTF MI) in Weld County following the complaint procedures established by the State Health Facilities
Division as detailed on Attachment 2, by this reference incorporated herein; and
C) notification by the contractor of the local ombudsman of each survey upon entering a facility for inspections and forwarding
all deficiency lists from annual inspections and complaint investigations, with plans of correction to the local ombudsman.
3. All correspondence, notifications, or recommendations required hereunder shall be addressed to the individuals at the addresses herein
set forth:
LL1LZ-C,1 I e � /} V
q' /ot13
Mr. John Pickle
Weld County Health Department
1517 16th Avenue
Greeley, Colorado 80631
Colorado Department of Health
Health Facilities Division
Residential Program Administrator 3e-e � 4 du/heel
4300 Cherry Creek Drive South
Denver, Colorado 80222.1530
4. The State shall, in consideration of said services and reporting by the Contractor, cause to he paid to the Contractor an amount not to
exceed NINE THOUSAND EIGHT HUNDRED FIVE DOLLARS ($9,805.00). Reimbursement shall he made at the flat rate of $265 per facility survey
for all facilities listed on Attachment 3 and shall include investigation of all complaints against the facility occurring within the contract period,payable
upon submission of deficiency reports to the facility operator and to the State. Payment shall be made for services as identified below:
a) All survey and monitoring activity necessary to determine the facility's compliance with the State's licensure regulations and
b) Investigative activities necessary to resolve all complaints against the facilities listed on Attachment 3 occurring within the
contract period. Resolution includes following the complaint procedures on Attachment 2.
5. Reimbursement shall be made upon receipt of signed billings,submitted in duplicate, requesting reimbursement. Billing shall include names
of facilities surveyed and complaints investigated, dates, amount and totals requested. The Contractor shall submit with each monthly billing for
reimbursement (if not before) copies of the following documents for State facility files maintained pursuant to statute: deficiency lists, and plans of
correction. Also to be submitted are copies of transmitting correspondence to and from facilities and complaint investigations. Reimbursement shall be
contingent upon affirmation of the State and satisfactory compliance with the terms of this contract.
6. The State may, in order to facilitate training in survey and revisit procedures and monitor the performance the Contractor, participate
in survey activity with the Contractor.
7. In order to allow for timely processing of reimbursements to the counties and facilitate the State's fiscal yearend accounting processes,
surveys should be performed prior to May 30, 1995. However, all surveys and investigations must be completed during the contract period.
8. The Contractor and the State shall adhere to the following procedures:
a) Unlicensed facilities: The Contractor will immediately notify the State of facilities conducting business without the necessary
license;
b) Licensed facilities: The Contractor shall submit all relevant information to the State for state licensure enforcement action as
indicated. While necessary enforcement actions will be the responsibility of the State, the Contractor's staff may he called upon to support the
documentation of their findings.
9. The term of this contract is from July 1, 1994 to June 30, 1995, and shall include the facilities listed on Attachment 3, by this reference
incorporated herein.
10. Changes in total reimbursement amounts for the above-named services in consideration of increased or decreased workload accomplished
shall be made by a mutually signed letter of approval which shall serve as an amendment, and shall include the following:
a) Identification of contract by contract number and number of affected paragraph;
b) amount of increase or decrease in funding and new contract total;
c) effective date of the funding change; and
d) authorized signatures of the Contractor, an the State Controller. It is understood that no change except in funding amount
shall be made through letter of approval. R fIi&l yvg e
Page 2 of 6 pages
940673
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 worker's 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 3 of y2' Pages
Rev. 06/01/92
940673
GENERAL PROVISIONS--Page f 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 p "od of three
years after the date of issuance of the audit report. This contract
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 !4 of Pages
Rev. 06/01/92
940673
•
SPECIAL PROVISIONS
CONTROLLER'S APPROVAL
1. 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; lay-offs 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, 1975, 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 Governor 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 recce,creed,color,
sex,national origin,or ancestry. -
(I) 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-028
Revised 1193
395-53-01-1022
page_ of.--P/ pages
9406'73
(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 obn`tractor
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 Slate 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 are 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 Leg���111,,,Name) W ld County. CO rado STATE OF COLO A
�A (e/L2g
ROY R E , R
07/25/94 for
W. H. Webster By
Chairman, Weld County Board •5 EXECUTIVE DIRECTOR
Position(Title) of Commissioners
6000813
ci IS«tar N mhero Po cr D.Hum DEPARTMENT HEALTH
If Corporation:) OF
G (
;test(Seal) ` WELD COUNTY HEALTH DEPARTM T
By
TErfta@D1QCouary Clerk _aid
JOHN S. PICKLE, M.S.E.H.
DIRECTOR
APPROVALS VERIFIED INFDRN r i—, ;;Dpi
ATTORNEY GENERAL CONTROLLER The original and lW0 COplai,0(ihlS contract
have been signed by all sf
By By m litadlrylato er,la
aPveco Ls.
Form C Page which is the last of.. pages
Revised 1/1)93 93 •See instructions on reverse side.
395-53-01-10J0
PROGRAM APPROV L
94067•
ATTACHMENT 1
Procedure for Conducting
Personal Care Boarding Home Inspections
1 . Colorado Department of Health, Health Facilities Division
(State) , provides the Local Health Department (Contractor) with a
list of all personal care boarding homes in the county contract,
including the number of beds, and license expiration date, at the
time the contract is submitted to the local Health Department for
approval .
2 . State sends a license renewal packet to each facility 90 days
prior to the license expiration date . , A copy of the cover letter
sent with the renewal forms will be sent by the State to the
Contractor with the monthly status report . Contractor will notify
the State in writing at least 45 days in advance of the expiration
date if the Contractor has reasons to request a delay in processing
the license. In the event of timely notification, the decision to
renew or deny the license will be made by the State with the input
from the Contractor.
3 . Contractor surveys on a cyclical basis determines by workload
requirements , with all surveys being performed within the contract
period.
4 . Following the annual inspection, the Contractor shall prepare
a cover letter and Deficiency List as appropriate and send this
list to the facility within 10 calendar days of the survey date .
Contractors with a computer system that is compatible with that of
the State will be trained to complete survey forms and
documentation using the State' s system.
5 . The facility has 10 calendar days from the date on the cover
_ letter submitted with the Deficiency List to submit a plan of
correction (POC) . The POC must include a specific response to each
deficiency and a completion date for the corrections . Completion
dates should not exceed 60 days from the date of the survey.
Surveyor review shall be completed within 7 calendar days of
receipt of the POC to determine its acceptability, and up to an
additional 10 days is allowed for interaction with the facility to
obtain an acceptable plan. Surveyor discretion may be used in cases
where the facility demonstrates that sufficient progress has been
made in correcting the deficiencies (the facility may provide bids,
purchase orders, written time frames, etc. to demonstrates
progress) .
6 . Within 5 calendar days of receipt of a POC acceptable to the
Contractor, a copy of the Deficiency Lists and the POC shall be
sent by the Contractor to the State Residential Program. The
Deficiency List with a plan of correction shall also be sent to the
local ombudsman.
Pageirofinages
940673
7 . The Contractor shall conduct revisits and monitoring visits to
the surveyed facilities as needed at the direction of the
Contractor.
S . The State has the discretion to modify time frames at the
request of the Contractor.
9 . On a monthly basis, the State notifies the Contractor in
writing of pending applications, completion of initial surveys,
newly licensed facilities, pending renewals, and results of surveys
within the county or the contract service area. In addition, the
State will notify the Contractor of changes in policies and
procedures, if any, as part of the monthly status report .
10 . The State is responsible for conducting an on-site initial
survey for new applicants to the personal care boarding home
program.
11 . The State will call the Contractor whenever in the contract
service area for investigations, fire safety inspections, surveys ,
or revisits .
132 . Contractor will notify the State of facilities conducting
business without a necessary license and supply documentation for
appropriate enforcement actions .
Page ..g of X1-2 Pages
940F73
ATTACHMENT 2
Complaint Investigation Procedures
If a complaint on a Personal Care Boarding Home is received by the
Colorado Department of Health, the caller will be referred to the
appropriate local health department to file their complaint . If
the complaint is received by letter at the Colorado Department of
Health, the letter will be faxed or sent to the local health
department for investigation.
1 . When a written complaint is received by the local health
department, it should be acknowledged in a timely manner, by
telephone or letter, as deemed appropriate by the local health
department . (If the complaint is received by telephone, it is not
necessary to acknowledge receipt of the complaint . )
2 . The complaint should be prioritized. If the complaint is one
in which the residents are in imminent danger, an investigation
should be initiated within three working days . Other complaints
should be prioritized according to the seriousness of the complaint
and investigated as appropriate, but in all cases , as soon as
possible to ensure the safety of the residents . The Colorado
Department of Health should be notified as soon as possible when
the local health department receives a complaint in which the
residents are in imminent danger.
3 . When local health department investigators go to the facility
to conduct the complaint investigation, they should go unannounced,
at the appropriate time of day or night as determined in the time
frame identified in the complaint . Local health department
investigators have access to the facility twenty- four hours a day.
4 . During the course of the investigation, the investigator
should interview the appropriate resident (s) , family member (s) , and
staff; review records and policies if appropriate, conduct a
facility tour to observe resident/staff interactions, resident
care, dietary or environmental concerns, or anything else pertinent
to the complaint . If the resident has been hospitalized, or
transferred to another facility, it may be necessary to review
those records and observe and interview the resident in the
hospital or other such facility. It may also be necessary to
obtain copies of medical records .
5 . At the conclusion of the investigation, a brief exit
conference should be conducted with the facility operator and other
staff as appropriate . The exic conference may be done by
telephone .
1
Page X of Pages
osnIrl
6 . A narrative report should be written within ten days of
completion of the investigation. The findings for each allegation
should be addressed in the report and a deteLinination should be
made as to the validity of each allegation.
7 . Deficiencies should be cited if the facility is found to be
out of compliance with applicable regulations . The deficiency list
should be prepared and sent to the facility utilizing the same
procedures established in Attachment 1 . Upon receipt of an
acceptable plan of correction, a revisit may be conducted as deemed
appropriate by the local health department .
8 . Upon completion of the investigation, the complainant should
be notified of the outcome of the investigation, by telephone or in
writing, as deemed appropriate by the local health department . The
narrative report and deficiency list with acceptable plan of
correction (when applicable) should be sent to the Colorado
Department of Health, as soon as possible upon completion of the
investigative report .
9 . The Colorado Department of Health will delete all names from
the investigative report . The report will be maintained in a file
available for public viewing.
3—
Page ,60 of ,12- Pages
9400573
ATTACHMENT 3
PCBH PROVIDERS BY COUNTY
HFD DATA SYSTEMS
ADDRESS CITY LIC EXPIRE SURVEY DT LIC BEDS
PCBH REPORT: 05/25/94: LARIMER COUNTY
230344-PCBHONLY-AUTUMN HOUSE I 2115 EAGLE DRIVE LOVELAND 04/21/95 02/23/94 6
2303A1-PCBHONLY-AUTUMN HOUSE II 2127 EAGLE DRIVE LOVELAND 03/24/95 02/23/94 8
230365-PCBHONLY-EDEN VALLEY LIFESTYLE VILLAGE 6263 N. COUNTY ROAD 2 LOVELAND 06/24/95 12/14/93 16
230349-PCBHONLY-ELDERCARE SOUTH 1633 RANAE DRIVE LOVELAND 02/08/95 04/02/93 8
230305-PCBHONLY-EVERGREEN HOME 1829 KINNISON DRIVE FORT COLLINS 04/17/95 02/09/93 5
230329-PCBHONLY-FORT COLLINS GOOD SAMARITAN RETIREMENT V 508 WEST TRILBY ROAD FORT COLLINS 10/31/94 04/23/93 27
230360-PCBHONLY-FRIENDSHIP HOMES 1312 EAST PITKIN STRE FORT COLLINS 07/16/94 04/22/93 3
2303RW-PCBHONLY-GOLDEN YEARS ELDERLY HOME 2372 IDAHO PLACE LOVELAND 12/29/94 11/10/93 5
230345-PCBHONLY-HERITAGE HAUS 208 19TH STREET S.E. LOVELAND 04/20/95 02/04/93 12
230373-PCBHONLY-LOVELAND GOOD SAMARITAN VILLAGE 2101 SOUTH GARFIELD A LOVELAND 05/06/95 01/06/93 40
23036U-PCBHONLY-NEW MERCER COMMONS 900 CENTRE AVENUE FORT COLLINS 08/17/94 / / 120
230386-PCBHONLY-PINE VALLEY INC. 238 EAST RIVERSIDE DR ESTES PARK 06/02/94 02/16/93 5
230387-PCBHONLY-PRIMROSE PLACE 541 EAST 3RD STREET LOVELAND 07/07/94 11/18/92 3
2303A2-PCBHONLY-SANCTUARY, THE 231 WEST 4TH STREET LOVELAND 02/21/95 03/10/94 11
230399-PCBHONLY-SEXTON'S BOARD AND CARE 3835 GOODELL LANE FORT COLLINS 03/14/95 06/21/93 3
230314-PCBHONLY-SHAMROCK MANOR 2711 SOUTH TAFT HILL FORT COLLINS 03/07/95 03/08/94 8
230321-PCBHONLY-SIERRA VISTA 821 DUFFIELD COURT LOVELAND 04/08/95 11/18/92 10
230326-PCBHONLY-SILVER HARE SENIOR BOARD AND CARE 2320 W. PROSPECT ROAD FORT COLLINS 09/27/94 10/20/93 8
230376-PCBHONLY-SPLIT RAIL MANOR 1109 GREENBRIAR DRIVE FORT COLLINS 02/12/95 10/20/93 8
230389-PCBH-RTF-CHOICE HOUSE (MI) 214 SOUTH WHITCOMB FORT COLLINS 07/12/94 04/27/93 8
230390-PCBH-RTF-PROMISE HOUSE (MI) 218 SOUTH WHITCOMB FORT COLLINS 07/12/94 04/27/93 5
PCBH REPORT: 05/25/94: WELD COUNTY
230310-PCBHONLY-BERNEITA'S BOARD AND CARE HOME 1605 11TH AVENUE GREELEY 11/02/94 01/07/94 12
230327-PCBHONLY-BONELL GOOD SAMARITAN CENTER 708 22ND STREET GREELEY 03/10/95 05/27/93 41
230362-PCOHONLY-ELIZABETH & JOE'S TLC 611 18TH STREET GREELEY 03/27/95 03/04/93 4
230333-PCBHONLY-GRAYCARA CARA 195 GANDY AVENUE KEENESBURG 01/30/95 01/25/94 14
230374-PCBHONLY-GRAYCARA WEST 3705 CARSON AVENUE EVANS 02/13/95 05/28/93 14
230307-PCBHONLY-HALF-WAY HOME FOR THE ELDERLY 601 28TH AVENUE GREELEY 04/21/95 02/03/94 3
230315-PCBHON LY-LOR ETTA & GARY'S GUEST HOME 1429 - 14TH STREET GREELEY 08/16/94 01/17/94 6
230317-PCBHONLY-TRIANGLE CROSS RANCH I 24823 FIRST STREET GALETON 06/14/95 02/12/93 4
230343-PCB NON LY-TRIANGLE CROSS RANCH II 36049 WELD CO- ROAD 5 GALETON 05/08/95 02/12/93 4
230355-PCBHONLY-TRIANGLE CROSS RANCH III 36051 WELD CO. ROAD 5 GALETON 05/08/95 02/12/93 4
2303E8-PCBHONLY-TRIANGLE CROSS RANCH IV 36053 WELL COUNTY ROA GALETON 01/04/95 11/10/92 4
230372-P CBHON LY-WARE HI ME BOARD AND CARE 1429 12TH AVENUE GREELEY 03/10/95 02/25/94 4
230308-PCBH -VINTAGE WALK 535 31ST AVENUE GREELEY 03/09/95 03/01/94 3
230395-PCBH-RTF-WELD MENTAL HEALTH CENTER/STANEK 1513 9TH AVENUE GREELEY 12/02/94 01/07/94 12
230393-PCBH-RTF-WELD MENTAL HEALTH CENTER/ACF 515 13TH AVENUE GREELEY 12/02/94 04/22/93 9
230391-PCBH-RTF-WELD MENTAL HEALTH CTR/ATU (MI) 1309 10TH AVENUE GREELEY 08/31/94 04/22/93 16
:e
19& /
Psgct3—e€_1-2 Pages
940673
ATTACHMENT 4
Colorado Department of Health Contacts
All written correspondence, deficiency lists, complaint
investigations , monthly reports and billing forms should be sent
to: JoAnn Lingk, Colorado Department of Health, Health Facilities
Division, 4300 Cherry Creek Drive South, Denver, CO 80222 - 1530 .
Her telephone number is 303- 692 -2846 .
Terry Zamell can be contacted at 303 -692-2884 for consultation. In
an emergency, the receptionist at the main desk can be contacted at
303 - 692-2800 to forward information to the appropriate individual .
Jeff Amirani can be contacted at 303 - 692 -2803 for training or
questions concerning the computer system.
Pine /Page--1-2 of 12 Pages 940673 3
STATE OF COLORADO
Roy Romer,Governor F COQ
Patricia A.Nolan,MD,MPH, Executive Director 4 2pq'7�
Dedicated to protecting and improving the health and environment of the people of Colorado T% :;b
4300 Cherry Creek Dr.S. Laboratory Building '
Denver,Colorado 80222-1530 4210 E.11th Avenue �/
Phone(303)692-2000 Denver,Colorado 80220-3716 4(176_,
(303)691-4700 Colorado Deparunent
h Vn e n / S of Public Health
11 CLG and Environment
Date
State Fiscal Year 19_ Routing Number
Contract Renewal
In accordance with Paragraph of routing number of
contract number FMA (copy attached and by this
reference made a part hereof) between the State of Colorado Department
of Public Health and Environment (Health Facilities Division) and
covering the period of , 19 through
, 19 the undersigned agree that the maximum amount
payable by the State is being creased by $ to a new total of
The first sentence in Paragraph is hereby modified accordingly per
amended attachment _ The terms and conditions of the original
contract shall remain the same.
This amendment to the contract is intended to be effective as of
/ / , but in no event shall it be deemed valid until it shall be
approved by the State Controller or such assistant as he may
designate.
Please sign, date and return all copies of this letter on or before
, 19 to:
Joann Lingk, Health Facilities Division A-2
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South
Denver, Colorado 80222-1530
A verified copy of this letter will be returned to you when it is
fully approved.
Name: State of Colorado
Roy Romer, Governor
By:
By:
Title: For the Executive Director
Colo. Dept . of Pub. Hlth. & Env.
Program Approval
By: By:
Health Facilities Division State Controller or Authorized
Designee
e
O A(lc wn
f IL
mEmoRAnDum , ,Y
V I` a W.H. Webster, Chairmanu. nli
S
To $Oarrl of rnnnty rnrnnicc;nnnrs Date 7,: "7nl�r x&. i4 •
COLORADO
From {
Subject: Personal Care Boarding Home Contract
Enclosed for Board approval is a contract between the Weld County Health
Department and the Colorado Department of Health for the Personal Care
Boarding Home Program.
The Health Department will be responsible for annual inspections of 16
facilities in Weld County and 21 facilities in Larimer County. WCHD will also
be responsible for investigating complaints for the facilities in Weld and
Larimer Counties.
For these services, the Health Department will receive an amount not to exceed
$9,805. Reimbursement shall be made a the flat rate of $265 per facility
survey. The term of the contract shall be from July 1, 1994 to June 30, 1995.
We feel this is a valuable service for a critical public health population,
the elderly and mentally ill that cannot care for themselves. I recommend
continuation of this program and approval of the contract.
940 673
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