HomeMy WebLinkAbout931143.tiff RESOLUTION
RE: APPROVE CONTRACT WITH COLORADO DEPARTMENT OF HEALTH, FAMILY AND COMMUNITY
HEALTH SERVICES DIVISION, 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 between the Weld
County Health Department and Colorado Department of Health, Family and Community
Health Services Division, for the Handicapped Children's Program/Children with
Special Health Care Needs, commencing October 1, 1993, and ending September 30,
1994, 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 between Weld County Health Department and
Colorado Department of Health, Family and Community Health Services Division, for
the Handicapped Children's Program/Children with Special Health Care Needs, be,
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 3rd day of November, A.D. , 1993, nunc pro
tunc October 1, 1993.
/J BOARD OF COUNTY COMMISSIONERS
ATTEST: v l2/2 WELD COUNTY, COLORADO(
Weld County Clerk to the Board
Constance L. Harbert, Chairman
BY: 0/K/ {T, 'J L^ Q�T
Deputy Clerk to the B9rd W. . Webster, �Pro,Tem
ffLL
APPROVED AS TO FORM: 'yam* (1
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1 E.t
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arbara J. Kirkmeye
931143
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IEPARTIr.- tirralrarlallt
HEALTH
DEPARTMENT OR AGENCY NUMBER
FAA
CONTRACT ROUTING NUMBER
CONTRACT
THIS CONTRACT, Made this 1st day of October 199 3 , by and between the
State of Colorado for the use and benefit of the Department of *1 Health, Family
and Community Health Services Division. Handicapped Children's Program/Children
With Special Health Care Needs. 4300 Cherry Creek Drive South. Denver, Colorado
80222-1530 hereinafter referred to as the State or Program, and *2 Weld County
Department of 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 uncommitted balance
thereof remains available for encumbering and subsequent payment of this contract
under Encumbrance Number FAA HCP940300 in Fund Number 100 , Appropriation
Account 606 , and Organization 6820 ; and
WHEREAS, required approval , clearance and coordination has been
accomplished from and with appropriate agencies; and
WHEREAS, *3the State has been mandated to provide care coordination
services for eligible children under the Handicapped Children's Program/Children
With Special Health Care Needs (HCP/CSHCN) ; and
WHEREAS, said program allocates funds to other agencies in order to provide
these health care services to the people of Colorado; and
WHEREAS, the Contractor is considered by the State to be an appropriate
agency to provide the services to the program 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. *4The Contractor will provide Casefinding and Community Outreach, Care
Coordination, Clinic Management, Program Management and Parent and Family
Support in Weld County, as described in ATTACHMENT A, by this reference
made a part hereof.
2. The Contractor will cooperate with and provide all requested records
regarding recipients for whom services were provided under this contract
at the time that periodic chart audits occur.
3. Title V funds may not be used to pay for any item or service (other
than an emergency item or service) furnished by an individual or entity
convicted of a criminal offense under the Medicare or any State health care
program (i .e. , Medicaid, Maternal and Child Health, or Social Services
Block Grant programs) .
Page 1 of 7 pages
*(See instructions on reverse of last page)
ff/_/JD/.r !/J713
4. The State will , in consideration of said services by the Contractor,
cause to be paid to the Contractor an amount not to exceed EIGHTY-THREE
THOUSAND �UNDRED DOLLARS AND ZERO CENTS (583,G00.00) in the
manner des ed in Par r a of this contract: (.483,956.00
t
a. Upo'ri receipt by the tate of a signed monthly statement, submitted
in duplicate, to FAMILY AND COMMUNITY HEALTH SERVICES DIVISION,
HANDICAPPED CHILDREN'S PROGRAM requesting reimbursement, Attachment
'B' and by this reference made a part hereof, and conditioned upon
affirmation by the State Handicapped Children's Program that services
and reports were rendered in accordance with this contract.
b. Submitted budget to govern expenditures by Contractor are as
follows:
PERSONAL SERVICES:
Social Worker ( .5FTE) Jo Harris $12,533
Office Tech ( .8FTE) Patty Isakson 12,654
Community Health Nurse (1FTE) Vacant 30, 109
Community Health Nurse Clinics 5, 173
Fringe Benefits @ 17% 10,280
Personal Services SubTotal 570,749
TRAVEL: 5 400
TOTAL DIRECT COST 571, 149
ADMINISTRATIVE/INDIRECT COST @ 18% 512,807
TOTAL COST (DIRECT AND INDIRECT) 583,956
5. Contractor agrees to provide services to all program participants and
employees in a smoke-free environment. Smoking may not be permitted in
waiting areas, examination rooms, formal sessions providing education,
therapy, or similar services. Designated smoking areas may be established
for staff, program participants, family members, and visitors. These
designated areas should be well ventilated in order that the waiting area
and the service environment remains smoke-free.
6. Charges to recipient families under this contract will be governed by
the following policies:
a. No charges will be made to families by Contractor for care
coordination/case management regardless of income.
b. Charge for services, including attendance at specialized clinics,
must conform to the HCP/CSHCN Clinic Charge Schedule, ATTACHMENT C,
and by this reference made a part hereof.
7. The Contractor shall protect the confidentiality of all applicant or
recipient records and other materials that are maintained in accordance
with this contract. Except for purposes directly connected with the
administration of this Program, no information about or obtained from any
applicant or recipient shall be disclosed in a form identifiable with the
applicant or recipient without the prior written consent of the applicant
or recipient or a minor's parent or guardian or as otherwise properly
Page 2 of 7 pages
931143
ordered by a court of competent jurisdiction. The Contractor shall have
written policies governing access to duplication and dissemination of all
such information. The Contractor shall advise its employees, agents,
servants, and subcontractors, if any, that they are subject to these
confidentialities.
8. This Contract is subject to and contingent upon the continuing
availability of Federal funds for the purposes hereof.
9. The term of this Contract is October 1, 1993 through September 30,
1994.
Page 3 of 7 pages
931143
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 embodies herein in writing. No subsequent
novation, renewal , addition, deletion, or other amendment hereto shall have any force or
effect unless embodies 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,
which ever 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 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 4 of 7
Rev. 06/01/92
931143
GENERAL PROVISIONS--Page 2 of 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 the 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
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 5 of 7 Pages
Rev. 06/01/92
931143
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 works 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 Slate 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 advertising;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 race,creed,color,
sex,national origin,or ancestry.
(fl 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.
Forum 6-AC-02B
Revised 1/93
395-53-01-1022
page 6 of 7 page
9211di
(g) In the event of the contractor's non-compliance with the non-discrimination clauses of this contractor 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 paragraph(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,defense,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 Legal Name) Board of County Co missioners STATE OF COLORADO
f Weld C t luirtido ROY ROMER, GOVERNOR
Po',rn(T7)o
Position(Title) Chairman �d 8/93 By- , -C /�Zi i (LN._ for
84-6000813 "EXECI)4TIVE DIRECTOR
Social Security Number or Federal I.D.Number
DEPARTMENT
(If Corporation:) � �Z�� ,�f OF HEALTH
Attest(Seal) .� /J fwf'�A'y�l• VERIFIED INFORMATION COPY
Ti..;original and two copies of this
By contfi.ct have been signed by all
C ��ecre �
Corporate Secretary,or Equivalent, To ty/County Clerk state ofi ciais required by law to
approve cont4a,iti ,�
APPROVALS �-
ATTORNEY GENERAL CONTROLLER
By By
Form 6-AC-02C Page 7 which is the last of 7 pages
Revised 1/93 "...e,..v........�+.
395-53-01-1030 // [N--
PROGRAM APPROVAL:
93114n
ATTACHMENT A
COLORADO DEPARTMENT OF HEALTH
HANDICAPPED CHILDREN'S PROGRAM/
Children With Special Health Care Needs
(HCP/CSHCN)
WELD COUNTY CONTRACT ACTIVITIES -- Page 1 of 4 pages
A. CASE FINDING AND COMMUNITY OUTREACH
1. Identify the target population for low income children who are
eligible for public health services including HCP/CSHCN.
2. Identify existing health care resources in the community to determine
if all child health needs are being addressed.
3. Collaborate with community human resource agencies to assure children
are referred for needed services and to establish a network for
working together to eliminate gaps and duplication of services for
children.
4. Promote public health services available to children by using local
media, posters, and attendance at health fairs.
5. Establish and maintain communication with the local community to
inform and promote the services of the Program by contacting hospital
and nursery staffs and school personnel to explain eligibility
criteria and registration procedures.
6. Contact local HCP/CSHCN providers periodically to solve problems,
monitor quality of services and recruit new providers.
B. CARE COORDINATION
1. Assess all new families using a standardized assessment tool such as
the "Patient Status Profile" to determine their need for referral and
information and/or coordination. Develop a comprehensive care plan
based on this assessment. (Make a home visit to all families
referred and registered with the Program, when appropriate. )
2. When it is determined that a family would benefit from care
coordination initiate a plan of care or IFSP (Individual Family
Service Plan) which includes a statement of the family's strengths
and needs as identified by the family, and a strategies for enhancing
the child's development. Also included is a statement of major
outcomes expected to be achieved for the child and family along with
the criteria, procedures and time lines. Periodic statements of
progress and the need for modification or revisions are documented.
931143
WELD COUNTY CONTRACT ACTIVITIES -- Page 2 of 4 pages
3. Refer families to agencies and services for which they may be
eligible (Well-Child, EPSDT, Child-Find, Social Service Programs,
SSI) and follow up to assure contact was made.
4. Assist families who are potentially eligible for Medicaid and/or SSI
benefits with the registration or application process (i .e. help
client complete the form or accompany the client to Social Services
or the Social Security office, or make a contact on the families'
behalf with the personnel in those offices.)
5. Assure that all children on HCP/CSHCN and Medicaid are enrolled in
EPSDT. Coordinate with the EPSDT case managers to ensure each child
has an EPSDT Screening form on file.
6. Contact each family enrolled in HCP/CSHCN at the time of their
financial renewal to assure that the child and family are receiving
necessary services and that the family is aware of community services
available to them. The status of primary care and immunizations will
be determined and appropriate referrals made. In the event that the
child is not receiving primary care, the agency will assist the
family in locating that care.
7. Maintain a current health record for each HCP/CSHCN client. The
record will be integrated with the Child Health record when
appropriate. The record will contain copies of the HCP/CSHCN
registration, relevant medical and laboratory records, the acceptance
letter, clinic reports, worksheets, a serial growth chart, nursing
notes, Well Child flow sheet and a developmental assessment. The
record will be organized in a uniform manner.
8. Protect the confidentiality of all client records. Except for
purposes directly connected with the administration of this Program,
no information about or obtained from any client shall be disclosed
in a form identifiable with the patient without the prior written
consent of the client or a minor's parent or guardian or as otherwise
properly ordered by a court of competent jurisdiction. The
contractor shall have written policies governing access to
duplication and dissemination of all such information.
9. Integrate Home Intervention services into the management plan for
hearing impaired toddlers by facilitating periodic communication
between phn staff and the HIP coordinator. Include HIP progress
notes in the child's HCP/CSHCN record.
C. CLINIC MANAGEMENT
1 . Maintain a system for identifying and tracking children attending
neurology clinics. The system will list the name of the child, the
local source of medical care, the date of the next clinic visit, and
the individual responsible for follow up or care coordination.
93114a
WELD COUNTY CONTRACT ACTIVITIES -- Page 3 of 4 pages
2. Maintain a serial growth chart for each child seen in HCP/CSHCN
sponsored clinics.
3. Assure that the HCP/CSHCN Clinic Encounter Form is completed by the
clinic nurse for each child's clinic visit. Documentation will
contain a nursing diagnosis, assessment and plan for nursing action.
Plans for referral to other agencies or disciplines will be included.
Form will be included in the child's permanent record.
4. Complete an attendance list(i .e. ADDs 5, CoTrack screen or other) for
each clinic held in the agency. Submit a copy to the State HCP/CSHCN
office. The attendance list shall be reviewed following each clinic
to identify missed appointments and evaluate the need for follow up
or reappointment.
5. Evaluate the clinic caseload yearly to determine the appropriateness
of the number of clinics.
6. Distribute the schedule of local HCP/CSHCN Medical Specialty Clinics
to local physicians and other individuals who are potential sources
of referrals.
7. Assist families whose medical care is provided outside their
community in scheduling appointments and, if necessary, arranging
transportation. Attend clinics or visits when appropriate to support
the family. Follow up on any recommendations made by the physician.
D. PROGRAM MANAGEMENT
1 . Maintain a tracking system for all active HCP/CSHCN clients
2. Participate with local interagency groups to:
a. inform and educate the community about HCP/CSHCN and other
resources with the health care system;
b. advocate for children and families by participating in the
formulation of policies concerning issues related to children
with special health care needs;
c. involve parents of children with special needs in the evaluation
of programs serving their children.
3. Contact local physicians and providers of supplies and services for
feedback on HCP/CSHCN services and policies.
4. Support the integration of the Home Intervention Program (HIP) into
HCP/CSHCN services by:
a. meeting quarterly with the local HIP coordinator to plan hearing
and speech activities and services;
b. make available to the HIP coordinator HCP/CSHCN records of
children registered in the Home Intervention Program;
931143
WELD COUNTY CONTRACT ACTIVITIES -- Page 4 of 4 pages
c. file copies of the families IFSP in the child's HCP/CSHCN record
(with the parent's permission) ;
d. explore with the regional coordinator funding options when a
family does not meet criteria for Medicaid or HCP/CSHCN.
5. Identify local providers of medical services, inform them of Program
services and recruit them to provide those services for HCP/CSHCN
clients.
6. Develop and maintain a system for soliciting input from parents and
other agencies regarding policies and services for children with
special health needs.
7. Support the community's early intervention program by regularly
participating in Child Find evaluation clinics.
8. Assign an HCP/CSHCN staff person to:
a. assist families with the registration process,
b. explain the Program services to families and providers,
c. contact all families whose children receive SSI benefits to
assure their health needs are being met.
d. contact families who have overdue financial to encourage their
continued health care coverage.
9. Prepare and submit a report of the activities of the agency in the
care of children with special health care needs using the HCP/CSHCN
Annual Report, due by October 15, 1994.
10. Conduct a qualitative audit on 10% of the currently enrolled and
active Handicapped Children Program records using the HCP/CSHCN
Record Audit tool . A copy of the audit results shall be submitted
to the HCP/CSHCN nursing consultant by October 15, 1994.
E. PARENT AND FAMILY SUPPORT
1. Identify for parents existing family support groups addressing
children with special needs.
2. Establish a system to solicit and receive input from parents
regarding Program policy and services.
3. Explore the development of a parent advisory committee to comment on
local HCP/CSHCN policies and procedures
931143
ATTACHMENT C
COLORADO DEPARTMENT OF HEALTH
HANDICAPPED CHILDREN'S PROGRAM/
Children With Special Health Care Needs
(HCP/CSHCN)
CLINIC CHARGE SCHEDULE -- Page 1 of 1 page
Families at and above a +7 financial eligibility level are charged a fee at the
clinic site for attending the HCP/CSHCN clinics. Checks and/or money orders are
to be made
payable toado
Health"ogrrepartment am/ChildrenfWith and
Special Health are to be forwarded to
Care Needs.
The current schedule of clinic fees to be collected is as follows:
CLINIC TYPE FEE
Pediatric Cardiology Clinic $ 35.00
Pediatric Neurology Clinic $ 35.00
Orthopedic Clinic including $ 27.00
Scoliosis and Cerebral Palsy
Hearing Clinic $ 27.00
Plastic Clinic $ 27.00
Developmental Evaluation Clinic $ 27.00
The Handicapped Children's Program/Children With Special Health Care Needs will
provide funding for all diagnostic and laboratory tests ordered in the first
clinic visit only. Families at and above a +1 financial eligibility level are
responsible for the payment of diagnostic and laboratory tests ordered in clinic,
as of the second clinic visit. Payment for these tests is made, by the family,
directly to the provider of these services.
9-31143
STATE OF COLORADO
COLORADO DEPARTMENT OF HEALTH
Dedicated to protecting and improving the health and „�
-environment of the people of Colorado * � V.) i
4300 Cherry Creek Dr.S. Laboratory Building • 7 •
Denver,Colorado 80222-1530 4210 E.11th Avenue
Phone(303)692-2000 Denver,Colorado 80220-3716
(303)691-0700 Roy Romer
Governor
Health Care Program for Children with special Needs (HCP)
Formerly: Handicapped Children's Program Patricia A.Nolan,MD,MPH
Telephone: (303) 692-2370; FAX: (303) 782-5576 Executive Director
April 29, 1994
Mr. John S. Pickle
Director
Weld County Health Department
1517 16th Avenue Court
Greeley, Colorado 80631
Re: Handicapped Children's Program/Children With Special Health Care Needs
(HCP/CSHCN) Contract, Encumbrance Number FAA HCP940300
Dear Mr. Pickle:
Enclosed please find a fully executed copy of the above referenced Contract for your files.
This contract covers the period from October 1, 1993 through September 30, 1994.
Sincerely,
Peggy Williams, Administrative Assistant III
Health Care Program For Children With Special Needs (HCP)
(303) 692-2404
enclosure
9?1143
STATE OF COLORADO
COLORADO DEPARTMENT OF HEALTH o0
Dedicated to protecting and improving the health and `
environment of the people of Colorado + +
4300 Cherry Creek Dr.S. Laboratory Building • :16•
Denver,Colorado 80222-1530 4210 E.11th Avenue
Phone(303)692-2000 Denver,Colorado 80220-3716
(303)691-4700 Roy Romer
HEALTH CARE PROGRAM FOR CHILDREN WITH SPECIAL NEEDS Governor
Formerly Execwv.ar or D,MPH
HANDICAPPED CHILDREN'S PROGRAM/
Children With Special Health Care Needs
December 14, 1993
Ms. Constance L. Harbert
Chairman
Weld County Commissioners
1517 16th Avenue Court
Greeley, Colorado 80631
Dear Ms. Harbert:
I am writing to ask your assistance in obtaining signatures on the enclosed contract.
Three copies of this contract were returned to me in November 1993. When the contract
was mailed to the Weld County Health Department to obtain signatures there was one
original and three copies, which is the required number of contract copies. Because
a fourth copy of the contract is needed, with original signatures, I need to request
that the following people sign the enclosed contract: Donald D. Warden, Carol A.
Harding, John S. Pickle, and yourself. (Copy of signature page from one of the
contracts returned is enclosed. Also enclosed is a copy of the Resolution that was
attached to one of the contracts.)
Sally Merrow has already placed her signature on this copy of the contract for Program
Approval . As you will notice, it is also an original signature, therefore, this copy
is the one that needs to be returned to my attention at the following address:
Colorado Department of Health, Health Care Program for Children With Special Needs,
FCHSD - HCP A4, 4300 Cherry Creek Drive South, Denver, Colorado 80222-1530.
Should you have any questions regarding this matter you can contacted me at (303) 692-
2404.
Your very truly,
�p
Peggy Williams
Administrative Assistant to Program Director
Enclosure
/2/ao�13
X27 c _.e_ e
/ZetC� 4n--s-�-�of -74r // d,7 AL26
,-*;/1- (/ 931t43
felt MEMORAnDUM
IlDConstance L. Harbert, Chairman
Board of County Commissioners October 22, 1993
To
DCOLORADO John S. Pickle, Director, Weld County Health Dept. • r
From 1f
Handicapped Childrens Program Contract a� .
Subject: !q
Enclosed for Board review is a proposed contract between the Colorado Department
of Health and Weld County Health Department to continue, and enhance the
Handicapped Childrens Program (HCP) .
Funding for this program has been increased from $20,372.00 last year, to
$83,680.00 this year. This increased funding is for additional staff to address
the enhanced program activities outlined in attachment A: Casefinding and
community outreach, Care Coordination, Clinic Management, Program Management, and
Parent and Family Support.
If the Board approves this contract the additional staffing required would be:
1.0 FTE Community Health Nurse and 0.5 FTE Office Technician II.
This program has been well received in the past. Increased funding would allow
us to serve a population which up to now has been underserved. For these
reasons, we would recommend your approval of this contract.
If you have any questions, please feel free to contact me.
931143
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