HomeMy WebLinkAbout940023.tiff RESOLUTION
RE: APPROVE CONTRACT FOR HIV COUNSELING AND TESTING SERVICES WITH COLORADO
DEPARTMENT OF HEALTH 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 HIV Counseling
and Testing Services between the Colorado Department of Health and Weld County
Health Department, commencing January 1, 1994, and ending December 31, 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 for HIV Counseling and Testing Services
between the Colorado Department of Health and Weld County Health Department be,
and hereby is, approved, nunc pro tunc January 1, 1994.
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 January, A.D. , 1994.
BOARD OF COUNTY COMMISSIONERS
ATTEST: / y// /9 WELD COUNTY, COLORADO
Weld County lerk to�h.€"` 6 rd EXCUSED
W. H. Webster,, C airm n
BY:
Deputy to the Boar Dale Ha 1, Pro- e
APPROVE S TO FORM: r r-
ope Baxter
ounty Attor ey Constance L. Harber
Barbara J. Kirkmeyer
940023
/41-0 02o
STATE OF COLORADO
COLORADO DEPARTMENT OF HEALTH a co
� ro
Dedu alai to protecting and:moon vn,G the hr.11th anti �w �,Qg
ern et or the people of Colorado
H`
4300 Chern Creek Dr.S. Laboralor. 8u'ldiny
Denver.Colorado 802!2-1 530 4210 E. I 1 th Avenue • ;ei•'
Phone: 303:692-2000 Denver.Colorado 00220-3716
3031691-4700
00 Row Romer
Governor
Patricia i.Nolan.ND.NPH
December 20 , 1993 ExecuineDvector
John Pickle
Weld County Health Department
1517 16th Avenue Ct.
Greeley, Colorado 80631
Dear Mr. Pickle:
Enclosed please find a copy of your calendar year 1994 contract for
HIV counseling and testing services.
There have been a few changes made to the contract this year. The
most important changes reflect: 1) the expansion of anonymous
testing which allowed existing counseling and testing sites (CTS)
to provide confidential and anonymous testing if they and their
local boards of health elected to do so (per C.R. S . 25-4-1405 . 5) ,
2) the requirement for all CTS to use a Colorado Department of
Health specified consent form, and 3) reimbursement for pretest
counseling of high/increased risk patients will now be sixteen
dollars ($16 . 00) .
Please review this contract now and let us know immediately if
there are any changes that you wish to see incorporated. If we do
not hear from you by December 31, we will assume that you agree •
with the terms of this contract: Thank you for your time and
attention to this matter. If you have any questions , please do not
hesitate to call your Colorado Department of Health, STD/AIDS
section contact person, or contact Maureen Bush at (303) -692-2689 .
S 'n lx,
c(�11r��1,
y ay
Prog Ma ager
Operations and Development
Enclosures
cc : Jill Burch
9/100@i. rimed on Recycled Paper
Form 6-AC-02A(R 1/ES)
DEPARTMENT OR AGENCY NUMBER
26000--FAA
CONTRACT ROUTING NUMBER
940819
CONTRACT
THIS CONTRACT, made this 1st day of January, 1994, by and between the State of
Colorado for the use and benefit of the Department of Health, 4300 Cherry Creek Drive South,
Denver, Colorado 80222-1530 hereinafter referred to as the State, and Weld Counts, Health
Department. 1517 16th Avenue Court. Greeley. CO 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 100 , APPR code 365 , Contract Encumbrance Number FAA
SOD940819; and
WHEREAS, the State has formulated comprehensive plans relative to the statewide
control of Sexually Transmitted Disease (STD) and Human Immunodeficiency Virus (HIV)
Infection; and
WHEREAS, in order to implement said comprehensive plan, the State has established
provisions by which to provide supplementary support to various local health departments and
community based service organizations; and
WHEREAS,the Colorado General Assembly has recognized the provision of confidential
counseling and testing services as the preferred screening service for the detection of HIV
infection; and
WHEREAS, the State has established an anonymous counseling and testing program at
select State and contracted local county health department's Counseling and Testing Sites (CTS)
for persons considered to be at high risk for HIV infection; and
WHEREAS, the Contractor has chosen to provide confidential counseling and testing
services for antibody to HIV. Those persons wishing to receive services anonymously will be
referred to a site providing confidential and anonymous services.
WHEREAS, the Contractor, a County Health Department (CHD), is considered by the
State to be an appropriate agency to provide the services as herein set forth,
NOW THEREFORE, it is hereby agreed that for and in consideration of their mutual promises
Page 1 of 9 Pages
940023
•
Form 6-AC-02A(R 1/88)
DEPARTMENT OR AGENCY NUMBER
26000--FAA
CONTRACT ROUTING NUMBER
940819
CONTRACT
THIS CONTRACT, made this 1st day of January, 1994, by and between the State of
Colorado for the use and benefit of the Department of Health, 4300 Cherry Creek Drive South,
Denver, Colorado 80222-1530 hereinafter referred to as the State, and Weld County Health
Department, 1517 16th Avenue Court, Greeley. CO 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 100 , APPR code 365 , Contract Encumbrance Number FAA
SOD940819; and
WHEREAS, the State has formulated comprehensive plans relative to the statewide
control of Sexually Transmitted Disease (STD) and Human Immunodeficiency Virus (HIV)
Infection; and
WHEREAS, in order to implement said comprehensive plan, the State has established
provisions by which to provide supplementary support to various local health departments and
community based service organizations; and
WHEREAS,the Colorado General Assembly has recognized the provision of confidential
counseling and testing services as the preferred screening service for the detection of HIV
infection; and
WHEREAS, the State has established an anonymous counseling and testing program at
select State and contracted local county health department's Counseling and Testing Sites (CTS)
for persons considered to be at high risk for HIV infection; and
WHEREAS, the Contractor has chosen to provide confidential counseling and testing
services for antibody to HIV. Those persons wishing to receive services anonymously will be
referred to a site providing confidential and anonymous services.
WHEREAS, the Contractor, a County Health Department (CHD), is considered by the
State to be an appropriate agency to provide the services as herein set forth,
NOW THEREFORE, it is hereby agreed that for and in consideration of their mutual promises
Page 1 of 9 Pages
940023
to each other, hereinafter stated, the parties hereto agree as follows:
1. The Contractor agrees to provide HIV risk reduction counseling and antibody testing
services according to the terms outlined in this contract;
a. Funds will support two basic types of testing programs, Provider Initiated testing
and Patient Initiated testing. Provider Initiated testing will consist of testing at facilities that
provide routine risk assessment and ongoing medical care (family planning clinics, STD clinics,
etc.). Patient Initiated testing consists of testing at Counseling and Testing Sites (CTS) and CTS
outreach where clients go to receive HIV testing services only;
2. The Contractor agrees that counseling and testing services for each individual will include
the following: a) the administration of a Colorado Department of Health (CDH) specified
informed consent form, (sample attached and by this reference made part hereof as Attachments
A and B), b) a risk assessment, c) a discussion and development of a risk reduction plan for the
client, d) drawing blood sample for laboratory processing, e) transportation of blood to
laboratory, f) informing clients in person of test results, g) explaining the significance of both
positive and negative test results to the client, h) referring clients who test positive for follow-up
medical and counseling services as appropriate, i) make every effort to ensure that all clients
who test HIV positive receive posttest counseling, j) ensuring that those positive clients who do
not return for results or are lost for follow-up are referred to the CDH and k) ensuring that all
positive clients are referred to CDH Disease Intervention Specialists for sex and needle share
partner referral;
3. The Contractor agrees that reimbursement for testing services will be based on service
units. A pretest counseling session is considered one service unit; a posttest counseling session
is considered another service unit;
4. The Contractor further agrees that reimbursement will also be based on client risk.
"High/increased risk" clients have a history since 1978 of one or more of the following: 1)
injection drug use, 2) sex with a person with HIV/Acquired Immune Deficiency Syndrome
(AIDS), 3) sex with a man who has sex with men, 4) sex with an injection drug user, 5) more
than three sex partners in the last year, 6) an STD, 7) receiving money or drugs for sex. All
other persons would be considered low/no risk including individuals who have received blood
or blood products between 1978 and 1986;
5. For Provider Initiated (non-CTS, family planning clinics, STD clinics etc.) and Patient
Initiated testing the following standards apply:
a. Contractor will be reimbursed at a rate of sixteen dollars ($16.00) per pretest
service unit for high/increased risk clients as defined in this contract.
b. Contractor will be reimbursed at a rate of five dollars ($5.00) per posttest service
unit for high/increased risk clients as defined in this contract.
Page 2 of 9 Pages
9900023
c. Contractor may choose to charge clients as outlined in paragraph seven of this
contract;
6. The Contractor agrees to abide by the current policy regarding the retention of HIV
testing records as outlined in the "Colorado Department of Health Retention of HIV Negative
and Positive Tests Results" and the "Rules and Regulations Pertaining to the Reporting,
Prevention, and Control of AIDS, HIV Related Illness, and HIV Infection" (sample attached and
by this reference made part hereof as Attachment C and D, respectively);
7. Contractors may (but are not required to) charge clients. Contractors choosing to collect
fees may do so by the method they find most appropriate (sliding scale, flat administrative fee,
donation, etc.). A fee waiver is left to the Contractor's discretion. Clients who are referred by
the Colorado Department of Health as sex/needle share partners of HIV infected persons or
persons who are at high risk for HIV infection will not be denied services because of inability
to pay;
8. The Contractor agrees to provide to the State an annual report of fees collected within
thirty days of the end of the contract period. Fees collected plus contract reimbursement for
services provided should not exceed an annual average of sixteen dollars ($16.00) per service
unit for all clients served;
9. All counselors providing counseling and testing services must have successfully completed
the Centers for Disease Control (CDC) course "HIV Prevention Counseling" or an approved
equivalent. All counselors providing ten or more pre or posttest counseling sessions per
calendar quarter (every 3 months) are required to attend one State approved HIV counselor
update per year. Those Contractors which do not have any counselors providing ten or more
pre or posttest counseling sessions per calendar quarter are required to have a minimum of one
counselor per year attend a State approved HIV counselor update;
10. The Contractor agrees to maintain internal medical and administrative records (labslips,
counseling session notes) in a manner which ensures confidentiality and security and is consistent
with procedures for clinical services;
11. Contractors shall designate an HIV Counseling and Testing Coordinator and provide the
name of this person, as well as the name of all employees providing counseling and testing
services, to the State within thirty days of the effective date of this contract. The Coordinator
will serve as the contact person with State staff to resolve operational issues. Such issues will
include but not be limited to: laboratory report form completion, billing and reimbursement,
counselor training, evaluation and modification of counseling services;
12. All counselors providing counseling and testing must be evaluated annually by the HIV
Coordinator, his/her designee, and/or State staff with an evaluation instrument provided by the
State. Copies of completed evaluations will be submitted to the State;
Page 3 of 9 Pages
94092
13. The Contractor agrees to fully and legibly complete for each person tested the HIV 1
Serology lab slip. All lab slips must specify the source of the client services (where they were
tested) along with the provider. Specific codes used to indicate the source of the client services
are as follows:
Source Code
CTS 0214
STD 0114
FP 1213
14. The Contractor further agrees, for each client posttest counseled, to fully and legibly
complete the lower perforated portion (Counseling Follow-up form) of the provider copy (top
white copy) of the HIV 1 Serology lab slip provided by the State. The completed Counseling
Follow-up forms shall be submitted to the State within forty-five days after the date of pretest
counseling. If a clients returns for posttest counseling more than 30 days after their pretest, the
Contractor will not be eligible for reimbursement for that posttest counseling session. The State
shall provide to the Contractor a monthly Testing Site Activity Report within sixty days
following the end of the month;
15. The State shall provide free laboratory services, regardless of risk, for all persons
accepting HIV antibody testing;
16. The State will, in consideration of all services outlined in this contract, cause to be paid
to the Contractor a sum not to exceed Four Thousand Eight Hundred Fifty-Six Dollars
($4.856.00) for the period beginning January 1, 1994, and continuing through December 31,
1994, subject to change based upon differences between estimated and actual funding
appropriations and legislative approval, and conditioned upon affirmation by the State that
services were rendered in accordance with this contract as follows:
a. The State will provide via facsimile a monthly statement of reimbursement
eligibility by the eleventh working day of the end of the month for which reimbursement
is to be provided. These monthly statements will reflect the number of pretest and
posttest counseling sessions (service units) eligible for reimbursement during that month.
The Contractor will have 21 days following receipt of the statement in which to verify
these statements by signature or inform the State of any discrepancies. Failure to notify
the State of any discrepancies or to verify these statements by signature within 21 days
following receipt of the statement will result in a forfeit of reimbursement eligibility for
that month;
17. The following budget shall govern the expenditure of funds by the Contractor, as well
as subsequent reimbursement by the State:
a. Pretest counseling for all persons with high/increased risk accepting HIV
antibody testing at the CHD, at sixteen dollars ($16.00) per service unit.
Page 4 of 9 Pages
940023
b. Posttest counseling for all persons with high/increased risk accepting HIV
antibody testing at the CHD, at five dollars ($5.00) per service unit.
c. A base amount of $400.00 will be provided for testing site operation.
18. The term of this contract is beginning January 1, 1994, and continuing through December
31, 1994;
19. Changes in total reimbursement amounts for above named services in consideration of
increased or decreased levels of utilization in the original contract shall be made by a mutually
signed Letter of Approval approved by the State Controller or his designee in the form attached
hereto as Attachment E, subject to the following conditions:
a. Identification of contract by contract number and number of affected paragraph;
b. Amount of increase or decrease in funding and amount of change in number of
clients to be served;
c. Intended effective date of funding change;
d. Authorized signatures of the Contractor, the Program, the Health Department and
the State Controller or an approved designee. It is understood that no change
except funding amounts and the resulting change in client numbers, may be made
through the Letter of Approval. Any other changes will be made by an
amendment to this contract;
e. A provision stating that the change shall not be deemed valid until approved by
the State Controller or such assistant as he may designate. Upon proper
execution and approval, such Letter shall become an amendment to this Contract
and, except for the General and Special Provisions in the Contract, the Letter
shall supersede the Contract in the event of a conflict between the two.
20. The State and Contractor agree that additional funds may be awarded to expand or extend
activities. Should such funds become available, they will be awarded by an amendment to this
contract.
Page 5 of 9 Pages
940023
COLORADO DEPARTMENT OF HEALTH - hereinafter, under the General Provisions referred to as
"Health" .
GENERAL PROVISIONS -- page 1 of 2 pages
1. The contractor shall perform its duties hereunder as an independent contractor and
not as an employee. Neither the contractor nor any agent or employee of the contractor
shall be or shall be deemed to be an agent or employee of the state. Contractor shall
pay when due all required employment taxes and income tax withholding, shall provide and
keep in force workers! compensation (and show proof of such insurance) and unemployment
compensation insurance in the amounts required by law. Contractor will be solely
responsible for its acts and the acts of its agents, employees, servants and
subcontractors during the performance of this contract.
2. Contractor authorizes Health, or its agents, to perform audits and to make
inspections for the purpose of evaluating performance under this contract.
3. Either party shall have the right to terminate this agreement by giving the other
party thirty days notice by registered mail, return receipt requested. If notice is so
given, this agreement shall terminate on the expiration of the thirty days, and the
liability of the parties hereunder for the further performance of the terms of this
agreement shall thereupon cease, but the parties shall not be relieved of the duty to
perform their obligations up to the date of termination.
4. This agreement is intended as the complete integration of all understandings
between the parties. No prior or contemporaneous addition, deletion, or other amendment
hereto shall have any force or effect whatsoever, unless embodied herein in writing. No
subsequent novation, renewal, addition, deletion, or other amendment hereto shall have
any force or effect unless embodied in a written contract executed and approved pursuant
to the State Fiscal Rules.
5. If this contract involves the expenditure of federal funds, this contract is
contingent upon continued availability of federal funds for payment pursuant to the
terms of this agreement. Contractor also agrees to fulfill the requirements of:
a) Office of Management and Budget Circulars A-87 , A-21 or A-122, and A-102 or
A-110, whichever is applicable;
b) the Hatch Act (5 USC 1501-1508) and Public Law 95-454 Section 4728. These
statutes state that federal funds cannot be used for partisan political purposes of any
kind by any person or organization involved in the administration of federally-assisted
programs;
c) the Davis-Bacon Act (40 Stat. 1494, Mar. 3, 1921, Chap. 411, 40 USC
276A-276A-5) . This act requires that all laborers and and mechanics employed by
contractors or sub-contractors to work on construction projects financed by federal
assistance must be paid wages not less than those established for the locality of the
project by the Secretary of Labor;
d) 42 USC 6101 et seq, 42 USC 2000d, 29 USC 794. These acts require that no
person shall , on the grounds of race, color, national origin, age, or handicap, be
excluded from participation in or be subjected to discrimination in any program or.
activity funded, in whole or in part, by federal funds; and
Page 6 of 9 Pages
Rev. 06/01/92 940023
GENERAL PROVISIONS--Page 2 of 2 es
e) the Americans with Disabilities Act (Public Law 101-336; 42 USC 12101, 12102,
12111 - 12117, 12131 - 12134, 12141 - 12150, 12161 - 12165, 12181 - 12189, -12201 - 12213
and 47 USC 225 and 47 USC 611. -
f) if the contractor is acquiring real property and displacing households or
businesses in the performance of this contract, the contractor is in compliance with the
Uniform Relocation Assistance and Real Property Acquisition Policies Act, as amended
(Public Law 91-646, as amended and Public Law 100-17, 101 Stat. 246 - 256) ;
g) when applicable, the contractor is in compliance with the provisions of the
"Uniform Administrative Requirements for Grants and Cooperative Agreements to State and
Local Governments (Common Rule) .
6. By signing and submitting this contract the contractor states that:
a) the contractor is in compliance with the requirements of the Drug-Free
Workplace Act (Public Law 100-690 Title V, Subtitle D, 41 USC 701 et seq. ) ;
b) the contractor is not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from covered transactions by any federal
department or agency.
7. To be considered for payment, billings for payment pursuant to this contract must
be received within 60 days after the period for which payment is being requested and
final billings on the contract must be received by Health within 60 days after the end
of the contract term.
8. If applicable, Local Match is to be submitted on the monthly payment statements, in
the column provided, as required by the funding source.
9. If Contractor receives $25,000.00 or more per year in federal funds in the
aggregate from Health, Contractor agrees to have an annual audit, by an independent
certified public accountant, which meets the requirements of Office of Management and
Budget Circular A-128 or A-133, whichever applies. If Contractor is required to submit
an annual indirect cost proposal to Health for review and approval, Contractor's auditor
will audit the proposal in accordance with the requirements of OMB Circular A-87, A-21
or A-122. Contractor agrees to furnish one copy of the audit reports to the Health
Department Accounting Office within 30 days of their issuance, but not later than nine
months after the end of Contractor's fiscal year. Contractor agrees to take appropriate
corrective action within six months of the report's issuance in instances of
noncompliance with federal laws and regulations. Contractor agrees to permit Health or
its agents to have access to its records and financial statements as necessary, and
further agrees to retain such records and financial statements for a period of three
years after the date of issuance of the audit report. This contract DOES 100%
contain federal funds as of the date it is signed. This requirement is in addition to
any other audit requirements contained in other paragraphs within this contract.
10. Contractor agrees to not use federal funds to satisfy federal cost sharing and
matching requirements unless approved in writing by the appropriate federal agency.
Page 7 of 9 Pages
Rev. 06/01/92
940023
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 penil 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.provender 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 Stare 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 affumative 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 reavitment advertisings:lay-offs or temninations: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 io 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 Govcmor 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 seee,creed,color,
sex,national origin.or ancestry.
(f)A labor organization.or the employees or members thereof will not aid,abet,incite,compel or coerce the doing of any act defined in this contract to be
discriminatory or obstruct or prevent any person from complying with the provisions of this contract or any order issued thereunder,or attempt,either directly
or indirectly,to commit any act defined in this contract to be discriminatory. -
Form 6-AC-02B
Revised 1/93
395-53-01-1022
page_8 of 9 pages
940023
(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 noncompliance; 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.
=OLORADO 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
ire 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
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
he 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
.therwise 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
liminate the inconsistency with Federal requirements(CRS 8-19.101 and 102)
;ENERAL
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
onvact.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
s otherwise in conflict with said laws,rules,and regulations shall be considered null and void.Nothing contained in any provision incorporated herein by reference
ehich 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.
lefence.orotherwise.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
ontract 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
<en 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).
ad 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:
N WITNESS WHEREOF,the parties hereto have executed this Contract on the day first above written.
:ontractor:
Full Legal Name) WELD COUNTY HEALTH DEPARTMENT STATE OF COLORADO
ROY ROMER,COVE NOR
WFbg-COUNTY BOA 0 COMMISSIONERS
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'osition(Title) CHAIRMAN PRO-TEM
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94 0023 PROGRAM aoPpnval : � s
ATTACHMENT A
HIV Antibody Pretest Information
The HIV Antibody Test and AIDS
The test that you are about to have is a test for the HIV (Human Immunodeficiency Virus)
antibody. HIV is the virus which can cause AIDS.
AIDS (acquired immunodeficiency syndrome) is a serious disease that is caused when HIV
damages a part of the body's immune system (its natural defenses). This makes it difficult for the
body to fight off other diseases.
It is not known whether everyone infected with the virus will develop AIDS. Some people
have had the virus for many years without becoming sick. Even though these people are healthy,
they can pass the virus to others through sex or shared needles. A woman infected with HIV can
pass the virus to her baby during pregnancy. Anyone who has the virus can pass it on.
The HIV antibody test is a simple blood test. When someone is infected with the virus, the
body makes a kind of protein called antibody. It will take at least one month or as long as six
months after infection for the antibodies to appear. If the test finds antibody in your blood, this
means you have the virus and can pass it on. The results of this test are very good. However, no
test is 100% correct. If you think your results are wrong, please request a repeat test. This test
cannot tell you whether you have AIDS or if you will develop AIDS.
In order to do the test for HIV, about a tablespoon of blood will be taken from your arm
with a sterile needle. As a result of this procedure, you may experience some temporary
discomfort and bruising.
Reasons You May Want to Take This Test
HIV infection is an important medical problem. If you have the virus you need to know.
You will want to learn about healthcare measures that may help you stay healthy and keep from
developing AIDS.
If you find out you have the virus, you will want to tell your sex partner(s) or people you
have shared needles with so they can get tested too. You will need to learn about "safer sex" and
other ways to protect your partner's health and to keep yourself from becoming exposed again. If
you find out you do not have the virus, your counselor will discuss ways to avoid getting HIV, the
virus that causes AIDS.
Reasons You May Not Want to Take This Test
Finding out that you have the virus (HIV) can be upsetting. You might become worried
about developing AIDS or infecting others. For this reason it is important to consider who in your
life is available to talk to and help you when you receive your results. Also, there are counselors,
volunteers and support groups to help you with these feelings.
The Counseling and Testing Process
In a short time, you will go to a private room where a trained counselor will talk
with you about HIV and AIDS. The counselor will talk about what you do or have done that put(s)
you at risk for HIV infection. This information is important in determining your risk and interpreting
your test results. You are encouraged, but not required, to give information about risk, your sex,
race/ethnicity or sexual orientation. Together you will develop a plan to decrease your risk. S/he
will also talk with you about the test and answer any questions you may have about HIV and AIDS.
G:\wpdocs s\forms\consent.new
940023
The counselor will take some blood from your arm and send it to the lab for testing. Your test
results will be back in this office in 10-14 days, and you must return for the results in person.
Confidentiality
At confidential testing sites, you are asked to give identifying information, such as name,
address, birth date and telephone number. The information that is collected during confidential
testing is useful if the site needs to contact you if there is a problem with your test and retesting is
needed, if you cannot return for results or if new information about HIV infection becomes available
that would be helpful to you. Written results will only be provided to persons testing confidentially
and with a picture ID at the time of posttest.
Colorado law forbids release of your HIV antibody test results to any other government
agency, person, doctor, hospital, clinic, employer, or insurance company. However, a person
might be concerned that records may be released or that the law may change. If this is a concern
for you, you must be tested at a site providing anonymous testing. If you test anonymously , no
personal identifiers (i.e. name, address, phone number, date of birth) are collected. You cannot be
reached in the future. If a person is tested anonymously, they may voluntarily provide personal
identifying information after counseling. If you have any questions, please discuss this with your
counselor.
A paper copy of this test will be kept in locked files at the Colorado Department of Health
and at this Counseling and Testing Site. If your test is positive, a complete record with all the
information on the laboratory form will be kept in locked files indefinitely.
If your test is negative, the paper copy of the test will be kept at the Colorado Department
of Health and this testing site in locked files for 120 days. After 120 days the information is
placed into two unlinkable files. One file has your name, age, test results and address/phone
number and will be destroyed after two (2) years. The other file has your risk behaviors without
your name and will be used for statistical purposes only.
Only authorized health workers have access to these records. Colorado law forbids release
of your test results to any other government agency, person, doctor, hospital, clinic, employer, or
insurance company. Written test results can be provided, but only directly to you and in person.
Unless you tell someone, no one else will know your test results.
If your test is positive, you will need to think of how to tell your sex and needle-sharing
partners that they need to be tested for HIV. A trained disease control specialist will talk with you.
The results of this test will be given to you only in person, not by phone or mail. This is
done to be sure that the results go only to you.
I have read these two pages and have had a chance to have my questions answered. I
understand the information on this form and freely give my consent to have my blood drawn and
tested for the HIV antibody.
Signature Date
Witness Date
G:\wpdoc s\forms\c o ns ent.new
940023
ATTACHMENT B
HIV Antibody Pretest Information
The HIV Antibody Test and AIDS
The test that you are about to have is a test for the HIV (Human Immunodeficiency
Virus) antibody. HIV is the virus which can cause AIDS.
AIDS (acquired immunodeficiency syndrome) is a serious disease that is caused
when HIV damages a part of the body's immune system (its natural defenses). This
makes it difficult for the body to fight off other diseases.
It is not known whether everyone infected with the virus will develop AIDS. Some
people have had the virus for many years without becoming sick. Even though these
people are healthy, they can pass the virus to others through sex or shared needles. A
woman infected with HIV can pass the virus to her baby during pregnancy. Anyone who
has the virus can pass it on.
The HIV antibody test is a simple blood test. When someone is infected with the
virus, the body makes a kind of protein called antibody. It will take at least one month or
as long as six months after infection for the antibodies to appear. If the test finds
antibody in your blood, this means you have the virus and can pass it on. The results of
this test are very good. However, no test is 100% correct. If you think your results are
wrong, please request a repeat test. This test cannot tell you whether you have AIDS or if
you will develop AIDS.
In order to do the test for HIV, about a tablespoon of blood will be taken from your
arm with a sterile needle. As a result of this procedure, you may experience some
temporary discomfort and bruising.
Reasons You May Want to Take This Test
HIV infection is an important medical problem. If you have the virus you need to
know. You will want to learn about healthcare measures that may help you stay healthy
and keep from developing AIDS.
If you find out you have the virus, you will want to tell your sex partner(s) or people
you have shared needles with so they can get tested too. You will need to learn about
"safer sex" and other ways to protect your partner's health and to keep yourself from
becoming exposed again. If you find out you do not have the virus, your counselor will
discuss ways to avoid getting HIV, the virus that causes AIDS.
Reasons You May Not Want to Take This Test
Finding out that you have the virus (HIV) can be upsetting. You might become
worried about developing AIDS or infecting others. For this reason it is important to
consider who in your life is available to talk to and help you when you receive your results.
Also, there are counselors, volunteers and support groups to help you with these feelings.
(over)
g:lwpdocslcnsnt b 793 (ongoing care)
940023
The Counseling and Testing Process
In a short time, you will go to a private room where a trained counselor will talk
with you about HIV and AIDS. At this confidential testing site, you are asked to give
identifying information, such as name, address, birth date and telephone number. The
information that is collected during confidential testing is useful if the site needs to contact
you if there is a problem with your test result and retesting is needed or if new information
about HIV infection becomes available that would be helpful to you. The counselor will
talk about what you do or have done that put(s) you at risk for HIV infection. This
information is important in determining your risk and interpreting your test results. You are
encouraged, but not required, to give information about risk, your sex, race/ethnicity or
sexual orientation. Together you will develop a plan to decrease your risk. S/he will also
talk with you about the test and answer any questions you may have about HIV and AIDS.
The counselor will take some blood from your arm and send it to the lab for testing. Your
test results will be back in this office in 10-14 days, and you must return for the results in
person.
Confidentiality
This test becomes part of your confidential medical record and will be kept by this
clinic. It is protected by Colorado law CRS 18-4-412. Medical records can be released
with your informed consent and are also subject to some discovery actions.
In addition, a paper copy of this test will be kept in locked files at the Colorado
Department of Health. If your test is positive, a complete record with all the information
on the laboratory form will be kept in locked files at the Colorado Department of Health
indefinitely.
If your test is negative, the paper copy of the test will be kept at the Colorado
Department of Health in locked files for 120 days. After 120 days the information is
placed into two unlinkable files. One file has your name, age, test results and
address/phone number and will be destroyed after two (2) years. The other file has your
risk behaviors without your name and will be kept for statistical purposes only.
Only authorized health workers have access to these records. Colorado law forbids
release of your test results to any other government agency, person, doctor, hospital,
clinic, employer, or insurance company. Written test results can be provided, but only
directly to you and in person. Unless you tell someone, no one else will know your test
results. The results of this test will be given to you only in person, not by phone or mail.
This is done to be sure that the results go only to you.
I have read these two pages and have had a chance to have my questions
answered. I understand the information on this form and freely give my consent to have
my blood drawn and tested for the HIV antibody.
Signature Date
Witness Date
g:\wpdocs\cnsnt b.793 (ongoing care)
940023
ATTACHMENT C
Colorado Department of Health
Retention of HIV Negative and Positive Tests Results
May 1, 1992
Because of public discussion about the Colorado Department of Health maintaining records
on persons who test negative for HIV in the State Laboratory, the Department reviewed state law
concerning the protection of confidentiality of HIV negative records and reassessed its need to
keep records of and statistical data on HIV negative tests. The findings are presented in parts I
and IL Part HI of this document describes changes in policy and records management that can
assure the public that the HIV negative information will be used only for legitimate disease
control, epidemiologic, and medical-legal requirements.
I. Current Status
A. Records of HIV antibody tests kept by state and local departments of health
are as follows: positive tests reported by any laboratory or physician and
negative tests performed at the State Laboratory. Local health departments may
also have records of HIV tests performed under research protocols in laboratories
other than the State Laboratory. Records of HIV negative tests performed at the
State Laboratory are kept at both the Colorado Department of Health and the test
site, i.e., counseling and testing site (CTS), tuberculosis clinic, STD clinic, drug
treatment center, family planning clinic, etc.
B. HIV negative tests submitted from state-funded HIV counseling and testing
programs and performed at the State Laboratory have the same level of
confidentiality protection, physical and legal, as do HIV positive tests. Records
resulting from compliance with CRS 254-1405(1) ["it is the duty of state and local
health officers to investigate sources of HIV infection and use every proper means
to prevent the spread of the disease"] are protected under CRS 25-4-1404(1).
Since CRS 25-4-1405(2) states that "it is the duty of state and local health officers,
as part of disease control efforts, to provide...confidential voluntary testing and
counseling," the Department considers all tests performed at state-funded HIV
counseling and testing programs to be a proper means of preventing the spread of
HIV. Hence, records of all tests at these sites are confidential, and the Department
will treat them confidentially. This view is supported by the Attorney General's
office.
There have been no breaches of confidentiality of either HIV positive or negative
tests held by state or local health departments.
C. State-funded HIV counseling and testing began in July 1985, and every person
tested at a counseling and testing program has signed a written consent form
which states that the results will be kept in locked files at the Colorado
Department of Health and the test site. Greater than 100,000 confidential tests
have been conducted in the past 5 3/4 years.
1 /
�v
!` 940023
D. The Colorado Department of Health has no lists or secret files of HIV negative
persons with certain risk behaviors.
E. In a survey recently conducted by the Governor's AIDS Council, 5 of 10 states
with some form of named HIV reporting [including Colorado] kept results of
HIV negative tests. The states keeping HIV negative test records were Missouri,
Oklahoma, Kentucky, Idaho, and Colorado; states not keeping such records were
Minnesota, Arizona, South Carolina, New Jersey, and Oregon. Reasons why
states did or did not retain HIV negative test records were not collected.
II. The Value of HIV Negative Test Records to State and Local Health Departments
A. The standard of practice in all laboratories, public and private, hospital or
office, is to maintain records of all tests performed, whatever the results. This
is useful to the client if he/she wants to verify the date and result of a test. It is
important for the laboratory, if case results are questioned at a future date or
tests on a single patient from multiple providers give conflicting results; the State
Laboratory would have records of its work and could perform repeat assays of
serum as necessary. Federal laboratory regulations (42 CFR Part 74 et al.,
Subpart J--Patient Test Managment) require that:
Records of test requisitions must be maintained for at least two years. The
laboratory must assure that the requisition includes--(1) The patient's name
or other method of specimen identification to assure accurate reporting of
results;
The laboratory must maintain a system to ensure reliable specimen
identification, and must document each step in processing, testing, and
reporting patient specimens to assure accurate test results are reported.
A legally reproduced record of each test result, including preliminary
reports, must be preserved by the testing laboratory for a period of at least
two years after the date of reporting.
B. HIV negative tests prevent wasting limited state resources for partner
notification and avoid unnecessary intrusion into partner's lives.
Examples:
1. If an infected person has a prior negative HIV test: A person is found to be
positive on November 20, 1991. He had a negative test on September 1, 1991.
The earliest date of infection would be 6 months prior to August 31, 1991, i.e.
February 28, 1991 (because it may take up to 6 months to seroconvert from
negative to positive after infection). Disease control specialists normally interview
an infected person about his/her sexual and/or needle sharing partners during the
one year prior to the positive test result and then attempt to notify these partners.
2 / (v
940023
In this example, it would not be necessary to notify partners prior to February 28,
1991.
2. If a partner has a negative HIV test: If a partner has a negative HIV test in
October 1991 and last had sex with an infected person in March 1991, there is no
need to notify the partner that s/he had been exposed to HIV.
These examples happen approximately 600 times per year, and having a record of
a negative HIV test conserves $30,000 per year in state expenditures for partner
notification. In addition, the HIV negative test records prevent unnecessary
intrusion and anxiety caused by informing a person they were potentially exposed
to HIV when they were not.
C. HIV negative tests may be useful for research purposes. Researchers at Denver
Disease Control use HIV negative tests as part of their study to measure the
incidence of HIV infection. Research on the differences in behavior between HIV
negative and HIV positive persons is important for determining which prevention
strategies work.
D. Statistical analyses of proportion of persons tested positive by various risk
factors are essential for epidemiologic monitoring of the spread of the my
epidemic and for evaluating use of publicly-funded test sites. Such analyses are
performed throughout the United States.
III. Revised Colorado Department of Health Policy Concerning HIV Negative Tests
A. Hard copies of records with patient names and risk factors on HIV negative tests
prior to April 30, 1990, have been destroyed by supervised shredding.
B. Computer files of HIV negative test records prior to April 30, 1992, have been
permanently altered to create two unlinkable files: the name file and the risk file.
The name file contains name, personal identifiers, locating information, date of
birth, demographic information, provider information, testing history, symptom
data, ID number, date (month/day/year), and test result and posttest information.
The risk file contains demographic information, risk factors, provider information,
testing history, symptom data, date (month/year), and test result and posttest
information. See Attachment A for detailed data items.
C. On an ongoing basis for tests, the computer file of the HIV negative test held by
the Department of Health will have the name unlinked from risk factor information
as soon as the testing site reports whether the person returned for post-test
counseling and after the Colorado Department of Health has reviewed the test
report for quality assurance of data entry. This process will take no longer than 60
days after the blood specimen is collected. Hard copies will be shredded at that
time.
3 / to
940023
D. The Colorado Department of Health requires that its Confidential Counseling and
Testing Site contractors, i.e., local health department CTS which provide only HIV
counseling and testing services, follow the same procedure as described in III A-C
above.
For HIV negative tests performed in tuberculosis, STD, drug treatment facilities,
and other facilities which provide ongoing medical care, the test is considered part
of the medical record of the treating clinic. For HIV negative tests collected at
these locations, the Colorado Department of Health will follow the procedures of
III A-C, but will not require the contracting clinic to follow these procedures.
E. The Colorado Department of Health revised consent form advises CTS clients of
how test records will be handled depending on whether the results are positive or
negative.
If positive,
the records, including identifying information, risk factor
information, and test results, will be held indefinitely.
If negative, the client will be informed that:
1. the identifying information will be linked to risk factor information for no
more than 60 days after the blood specimen collection date;
2. the risk factor and test result information will be used for statistical purposes
without the identifying information provided by the client; and
3. records consisting of the client's identifying information and test results will
be kept by the Colorado Department of Health and CTS for two years.
The consent form has also been revised to inform all counseling and testing clients
that they are encouraged, but not obligated, to answer questions on the laboratory
submission form regarding demographic and risk factors.
4 1
C 940023
Attachment
Data Items Collected on the HIV 1 Serology Lab Slip
Items retained for specimens with negative results;items retained in each database are indicated by an x. Alf
data items for specimens testing indeterminate or positive are retained.
Data Items Name File Risk File
Pretest ID Number x
ELISA Results x x
Western Blot Results x x
Date Collected M/D/Yr M/Yr
Pretest Counselor Initials x
Testing History x x
Date Last Test x x
Results Last Test x x
Symptoms of HIV x x
Provider Name x x
Provider Code x x
Provider Address, City, State, Zip x
Patient Name x
Patient Address x
Patient City, State, Zip x x
Patient Phone x
Patient DOB x
Patient Age x x
Patient Race x x
Patient Sex x x
Patient Sex Preference/Orientation x
Number Sex Partners in Last Year x
Greatest Number Sex Partners x
Influence of Drugs/Alcohol x
Type of Sex/Condom Use x
Patient Hx Since '78 all items x
5 ICe
94002
Data Items Name File Risk File
Patient Sex Exposure Since '78 all items x
Referral to Specific Agency x x
Posttest Provider Code x x
Posttest ID Number x
Posttest Counselor Initials x
Date of Posttest Counseling x x
Referred to CDW,Date Referred .x x .
Data item in shaded area no longer collected (effective 4/8/92).
mkm H:\wpdocs\contract\rcrdretn.fnl 6 / / 940021 021
ATTACHMENT D
11/93
STATE OF COLORADO
COLORADO BOARD OF HEALTH
•
RULES AND REGULATIONS
PERTAINING TO THE REPORTING, PREVENTION, AND CONTROL OF
AIDS, HIV RELATED ILLNESS, AND HIV INFECTION
Colorado has a comprehensive public health AIDS/HIV control law:
Colorado Revised Statutes Title 25, Article 4, Sections 1401 et seq. These
regulations are intended to provide detail and clarification for selected parts
of the above cited statute. The statute covers subject matters not included
in these regulations.
C.R.S. 25-4-1405.5 (2) (a) (I) requires the Department of Health to
conduct an anonymous counseling and testing program for persons
considered to be at high risk for infection with HIV. The provision of
confidential counseling and testing for HIV is the preferred screening service
for detection of HIV infection. Local boards of health may elect to conduct
anonymous and confidential testing in conjunction with counseling and
testing sites (CTS); i.e., sites which screen individuals for HIV infection
without providing on-going health care. This will be done through a
contractual agreement with the Department of Health. Contracts are for a
12-month period beginning in January of each year. Local boards of health
may elect, only at the time of contract renewal, to provide confidential and
anonymous testing. Once contractual agreements have been reached, no
agency will be eligible to elect anonymous testing until completion of that
contract period.
Per C.R.S. 25-4-1405.5 (2) (a) (II), Regulations 6-8 are the performance
standards for confidential and anonymous HIV CTS and the Department of
Health staff.
Regulation 1 . Reporting by physicians, health care providers, hospitals, and
others
Diagnosed cases of AIDS, HIV related illness, and HIV infection,
regardless of whether confirmed by laboratory tests, shall be reported to the
state or local health department or health agency within 7 days of diagnosis
by physicians, health care providers, hospitals, or any other person providing
treatment to a person with HIV infection.
1 a! - -
940023
All cases are to be•reported with the patient's name, age, sex, address
(including city and county), name and address of responsible physician; and
such other information as is needed to locate the patient for follow-up. For
cases reported from a public anonymous testing site as provided by C.R.S.
25-4-1405.5, The patient's name and address and the name and address of
the responsible physician are not required.
. Reports on hospitalized patients may be made part of a report by the
hospital as a whole.
Research activities of persons performing clincal research on persons
with AIDS, HIV-related illness, or HIV infection whose research activity:
1 . involves the study of HIV treatment or vaccine effectiveness or is
basic biomedical research into the cellular mechanisms causing HIV
infection or HIV-related disease;
2. meets the research exemption criteria of C.R.S. 25-4-1402.5(3);
and
3. has been approved by the Board of Health pursuant to C.R.S. 25-4-
1402.5(2)
shall be exempt from meeting the reporting requirements for AIDS, HIV-
related illness, and HIV infection.
Regulation 2. Reporting by Laboratories
Cases of AIDS, HIV related illness, and HIV infection shall also be
reported with the information required in Regulation 1 by laboratories
whether or not associated with a hospital, and by out of state laboratories
that maintain an office or collection facility in Colorado or arrange for
collection of specimens in Colorado. Laboratories shall report:
1 . Any of the following positive serologic tests: (a) repeatedly reactive
elisa test; (b) positive supplementary test such as Western blot; (c)
positive test for antigenemia [all of the above according to test
manufacturer's directions]; (d) positive polymerase chain reaction
test in persons less than 13 years of age; or (e) positive latex
agglutination test for HIV.
2. Positive viral culture for HIV.
3. CD4 counts < 500 mm3 or CD4% <29% regardless of HIV test
results.
When associated with other clinical or laboratory evidence of HIV
infection, the Board of Health defines a CD4 test result in the range listed
above as the primary immunologic measure indicating severe HIV infection
279-
940023
and when less than 200 mm3, as defining AIDS. The Department shall
destroy personal identifying information on all persons with CD4 results in
the reportable range if investigation subsequent to the report finds no
evidence of infection. Laboratories may fulfill the requirement to report CD4
counts < 500 mm3 or CD4% <29% by allowing authorized personnel of
the Department of Health to have access to such records.
Laboratories shall follow the same procedures for reporting as are
required of other reporting sources in Regulation 1 .
Report of test results by a laboratory does not relieve the attending
physician of his/her obligation to report the case or diagnosis, nor does
report by the physician relieve the laboratory of its obligation.
Regulation 3. Information sharing
Information concerning cases of AIDS, HIV related illness, or HIV
infection shall be shared between the appropriate local health department or
health agency and the state health department, as provided by C.R.S.
25-4-1404, And in a timely manner, usually within the timeframe for
reporting in Regulation 1 .
These requirements shall not apply if the state and local health agencies
mutually agree not to share information on reported cases.
Regulation 4. Confidentiality
All public health reports and records held by the state or local health
department in compliance with these regulations shall be confidential
information subject to C.R.S. 25-4-1404. The public health reports and
records referred to in C.R.S. 25-4-1404 shall include, but not be limited to,
the forms and records designated by the Colorado Department of Health for
institutions and agencies which screen individuals for HIV infection without
providing ongoing health care, such as a public HIV counseling and testing
site.
Reasonable efforts shall be made by the department to consult with the
attending physician or medical facility caring for the patient prior to any
further follow-up by state or local health departments or health agencies.
3 /
9e.0023
Regulation 5. Investigations to confirm the diagnosis and source of HIV
infection and to prevent HIV transmission
Investigations may be conducted pursuant to C.R.S. 25-4-1405 et seq.
To confirm the diagnosis and sources of HIV infection and to prevent
transmission of HIV and shall be considered official duties of the health
department or health agency. Such investigations may include, but are not
limited to:
(a) review of pertinent, relevant medical records by authorized
personnel, if necessary to confirm the diagnosis, to investigate
possible sources of infection, to determine objects and materials
potentially contaminated with HIV and persons potentially exposed
to HIV. Such review of records may occur without patient consent
and shall be conducted at reasonable times and with such notice
as is reasonable under the circumstances;
(b) performing follow-up interview(s) with the case or persons
knowledgeable about the case to collect pertinent and relevant
information about the sources of HIV infection, materials and
objects potentially contaminated with HIV, and persons who may
have been exposed to HIV.
Regulation 6. Objective Standards
A. Training
1 . All persons providing HIV pre and posttest prevention and
risk-reduction counseling at a CTS will have completed the
HIV Serologic Test Counseling course or an equivalent of not
less than 16 hours of training, approved by the Department
of Health STD/AIDS Program.
2. All persons providing HIV pre and posttest prevention and
risk-reduction counseling at a CTS will have a minimum of 8
hours of relevant HIV/STD or allied health services
continuing education annually, approved by the Department
of Health STD/AIDS Program.
3. All persons performing partner notification interviews will
have completed courses concerning introduction to sexually
transmitted disease interviewing and partner notification, as
specified by the Department of Health.
B. Notification of Results
1 . Of all HIV tests performed at a CTS, 90% of those persons
4 el
94.0023
testing'HIV positive will receive results and posttest risk-
reduction counseling.
2. Of all HIV tests performed at a CTS, 80% of those persons
testing HIV negative will receive results and posttest
prevention and risk-reduction counseling.
C. Partner Notification
If Department of Health staff provide partner notification for a
CTS, then the following standards do not apply to the CTS.
1. Of the 90% of HIV positive individuals receiving results and
posttest counseling, 100% will be assigned for partner
notification interview. A minimum of 75% of those
assigned for a partner notification interview will receive an
interview. Agencies providing partner notification services
(Department of Health and local health departments) will
have a partner index (defined as the number of unsafe
partners identified for whom identifying information was
sufficient to initiate notification, divided by the number of
interviewed HIV positive persons with unsafe behavior in the
past year) of 0.8. Effective January 1, 1995, the
acceptable partner index will be 1 .0. Documentation of this
activity will be provided to the Department of Health through
use of a Department of Health specified form.
A contact is defined as a person named by an infected
person as having been an unsafe sex partner/needle share
partner of that infected person. If sufficient locating
information (name, age, sex, phone number, recent address,
work address) is obtained to conduct an investigation, such
a contact is defined as an initiated contact.
2. Of all in-state initiated contacts, 60% must be located and
offered HIV prevention and risk-reduction counseling and/or
testing as documented by the results of the investigation on
the Department of Health specified form. Documentation of
investigation outcomes will include disposition codes as
specified by the Department of Health, dates and location of
counseling, and dates and location of testing (if done).
Regulation 7. Operational Standards
A. Counseling
5 o7
l 91.0023 _
1 . All counselors at a CTS performing HIV pretest prevention
and risk-reduction counseling will: a) conduct a risk
assessment, b) discuss and develop a risk-reduction plan,
i.e., identify with the client specific behaviors that can
realistically be changed to reduce risk, c) fully and legibly
complete for each person tested the HIV 1 Serology lab slip.
2. All counselors at a CTS performing HIV posttest prevention
and risk-reduction counseling will: a) inform clients in person
of test results, b) explain the significance of both positive
and negative test results, c) discuss and/or modify the risk-
reduction plan, d) refer clients who test positive for follow-
up medical and counseling services.
B. Consent Form
1 . A consent form specified by the Department of Health must
be used at all CTS. There will be no provision for an
approved equivalent of the consent form.
C. Testing Parameters
1 . CTS will not provide anonymous testing to any person 12
years of age or younger.
2. If a counselor judges that a client is unable to understand
either counseling or the testing process, e.g., because the
client is under the influence of drugs or alcohol, the
counselor may defer testing.
D. Written Results
1 . CTS may only provide written results to persons testing
confidentially. To receive written results, the CTS must be
presented with photo identification from the person
requesting written results at the time of posttest.
2. Contracting agencies may not give written results to any
person testing anonymously.
E. Confidentiality and Record Maintenance
1 . Contracting agencies must abide by the Board of Health
policy on the Retention of HIV Negative Tests (adopted
January 1992 and re-adopted March 1993) and the
confidentiality protocol adopted by the Department of
Health.
6 17
94002
2. Per C.R.S. 25-4-1404.5 (2) (a) (II), a person may provide
personal identifying information after counseling, if the
person volunteers to do so. Contracting agencies must
document this information when volunteered, and provide
this information to the Department of Health on the posttest
reimbursement form submitted to the Department of Health
within 30 days of the date the blood specimen was
collected.
Regulation 8. Evaluation Standards and Penalties
A. Each CTS' compliance with these standards will be evaluated by
the following:
1 . A semi-annual analysis by Department of Health staff of the
number of persons receiving HIV antibody testing and the
proportion of persons testing receiving results per contracted
agency.
2. A minimum of one on-site observation conducted annually
by Department of Health staff. This on-site observation will
include observation of counselors at each CTS performing
HIV pre and posttest prevention and risk-reduction
counseling.
3. A semi-annual analysis of testing trends (anonymous vs.
confidential) conducted by Department of Health staff.
4. A semi-annual review of counseling and partner notification
forms for completion and accuracy conducted by
Department of Health staff.
5. A minimum of one annual audit of charts for all contracting
agencies, conducted by Department of Health staff.
6. Accuracy and completion of the posttest counseling
reimbursement form submitted to the Department of Health.
B. Failure of a CTS to comply with and meet these standards may
result in one or more of the following action(s):
1 . The CTS may meet with the Department of Health to
develop a plan for improving performance in specified areas.
2. The CTS may be given a probationary period to comply and
meet the standards.
3. The CTS may be reevaluated by the end of the probationary
period.
4. Failure to meet and comply with the standards may result in
contract termination.
9(10023
ATTACHMENT E
STATE OF COLORADO
COLORADO DEPARTMENT OF HEALTH - of•co .,
Dedicated tont protecting
and improving r the health and �>
environment of people of Colorado �„ o
4300 Cherry Creek Dr.S. Laboratory Building L\ «t
Denver,Colorado 80222-1530 4210 E.11th Avenue
Phone:(303)692-2000 Denver,Colorado 80220-3716 '{E76"%
(303)691-4700 Roy Romer
Governor
Patricia A.Nolan,MD,MPH
Date Executive Director
State Fiscal Year 19 - Routing Number_-
_
Change Order Letter No. _
In accordance with Paragraph _ of contract routing number - , , (copy attached and
by this.reference made a part hereof) between the State of Colorado Department of Health (Disease
Control and Environmental Epidemiology Division, Communicable Disease Section) and
covering the period of , 19_ through
, 19_the undersigned agree that the maximum amount payable by the State for eligible HIV
counseling and testing services in Paragraph _ is being increased by $ to a new total of
$ . The first sentence in Paragraph _ is hereby modified accordingly. 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 have been approved by the State Controller or such assistant as he may
designate.
Please sign, date, and return all copies of this letter on of before , 19_to:
Audrey Christensen
Colorado Department of Health
DCEED-ADM-A3
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.
State of Colorado:
• Roy Romer, Governor
(Contractor)
By: By:
Name Lee Thielen, Assistant Director
Title For the Executive Director
Colorado Department of Health
APPROVALS:
By: By:
Lee Koleski, Fiscal Officer State Controller or
Disease Control and Environmental Authorized Designee
Epidemiology Division
94002 3
®primed on Re(if paper
it mEmoRAnDum
W Constance L. Harbert, Chairman
To Board of County Commissioners January 3, 1994
Date
COLORADO John S. Pickle, M.S.E.H. , Director, W.C.H
From
Subject: HIV Counseling and Testing Service Contract
Enclosed for Board approval is the calendar year 1994 HIV Counseling and Testing
Services Contract.
The rate of reimbursement per contact has reverted back to approximately that of
calendar year 1993, $16.00. The overall contract amount has risen by $1,800.00,
along with the projected caseload.
We feel that this is a critical public health service and would appreciate your
approval of this contract.
If you have any questions, please contact me.
JSP/kh-2697
940023
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