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HomeMy WebLinkAbout960740 RESOLUTION RE: APPROVE CONTRACT FOR RYAN WHITE TITLE II FUNDING BETWEEN COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT AND HEALTH DEPARTMENT AND AUTHORIZE CHAIR 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 Ryan White Title II funding between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Health Department, and the Colorado Department of Public Health and Environment, commencing April 1, 1996, and ending March 31, 1997, 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 Ryan White Title II funding between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Health Department, and the Colorado Department of Public Health and Environment be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair 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 24th day of April, A.D., 1996, nunc pro tunc April 1, 1996. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORAD 4/EX '0 44 /---4',/,4z/J_A___ \ / 7) -/Y-1e7A92/</— a� c 'y Barbara J. Kirkmeyer,,Chair �'96' I -to o y y Clerk to the Board J n Lf4- C / lfo ; C�� ., II � rge Baxter, P -T ♦Deputy Clerk r the Board Dale K. Hall APP AS TO FORM: (121erv,;"4.,t� p dice yZ--- Constance L. Harbert n y Attorne V 1k 2 . W. H. ebster 960740 dC ; HL; 677+/E HL0022 Prom 6-AC-02A(R 1/88) DEPARTMENT OR AGENCY NUMBER FAA CONTRACT ROUTING NUMBER 96-05217 CONTRACT THIS CONTRACT, made this 25th day of March 199¢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 the Weld County Health Department. 1517 16th Avenue Court Greeley. Colorado 80631 hereinafter referred to as the Contractor. WHEREAS, authority exists in the Law and Funds have been budgeted, appropriated and otherwise made available and a sufficient unencumbered balance thereof remains available for payment in Fund Number 1n, APPR code 33, Contract Encumbrance Number FAA SOD9605217; and WHEREAS, required approval,clearance and coordination has been accomplished from and with appropriate agencies; and WHEREAS,the State has been awarded funding from the U.S. Department of Health and Human Services, Bureau of Health Resources Development, Health Resources and Services Administration for the development and operation of a Human Immunodeficiency Virus (HIV)care consortia(Consortia)to improve the quality, availability and organization of health care and support services for individuals and families with HIV; and WHEREAS, the Contractor is considered by the Consortium and the State to be an appropriate agency to perform the services as herein set forth, NOW THEREFORE, it is hereby agreed that for and in consideration of their mutual promises to each other, hereinafter stated, the parties hereto agree as follows: 1. The Contractor will provide the services outlined in the "Weld County Health Department Workplan" (copy attached and made a part hereof as Attachment A). 2. The Contractor will provide said services to affected populations in Northeastern Colorado including the counties of Weld, Larimer and Morgan. 3. The Contractor agrees to abide by the assurances outlined in the "Colorado Ryan White Title II 1994 Consortium Assurances" (included within Attachment A). 4. The Contractor will develop and/or abide by existing confidentiality protocols in accordance with professional standards and applicable statutes including,but not limited to, C.R.S. 25-4-1401 et seq(HIV infection and AIDS) and C.R.S. 18-4-412 (medical records). Page 1 of 6 Pages 5. The Contractor will abide by the Reporting Requirements and Time Frames described in the CDH Guidance for the Development of Title II Funded Consortia Workplans, 1996-1997 (copy attached and made a part hereof as Attachment B). 6. The State will, in consideration of said services by the Contractor, cause to be paid to the Contractor an amount not to exceed $98,480 (NINETY-EIGHT THOUSAND FOUR HUNDRED EIGHTY DOLLARS for the period beginning April I, 1996 and continuing through March 31, 1997. The dollar amount is subject to change based on differences between estimated and actual funding appropriations and legislative approval. Reimbursement shall be conditioned upon affirmation by the State that services were rendered in accordance with this contract, as follows: a) Upon receipt of a monthly reimbursement statement, submitted in duplicate, requesting reimbursement and delineating expenses incurred, payment shall be conditioned upon affirmation by the State of full and satisfactory compliance with the terms of this contract. b) Reimbursement may be withheld if quarterly narrative reports are delinquent. Contractor must notify the State two weeks before the due date of report to advise of reason for reporting delays. 7. The following budget shall govern the expenditure of funds by the Contractor as well as subsequent reimbursement by the State. Transfer of funds from one line item to another in excess of $10,000 (Ten Thousand Dollars) must have prior written approval of the State: Personnel $26,958 Fringe $ 4,583 Travel $ 1,500 Supplies $ 1,200 Contractual $47,191 Other $ 7,200 Indirect Charges $ 9,848 TOTAL $98,480 8. Changes in reimbursement amounts for any of the budget periods for the above-named services in consideration of increased or decreased levels of utilization from the levels funded in the original contract shall be made with the approval of the Contractor, the State, the Program, and the State Controller as evidenced by a mutually signed Change Order Letter (copy attached and by this reference made a part hereof as Attachment C) which shall include the following: a. Identification of contract by contract number and number of affected paragraph; b. Type of services increased, decreased, or extended; c. Amount of increase or decrease in funding and new total for current year; d. Intended effective date of funding changes; e. Authorized signatures of the State, the Program, the Contractor and the State Controller or an assigned designee. It is understood that no change except funding amount will be made through the Change Order Letter. 9. The term of this contract is beginning April 1, 1996 and continuing through March 31, 1997. Page 2 of 6 Pages 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-11O, 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 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 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, 1O1 Stat. 246 - 256); Requireg)mentshfor Grant tsaand Cooperative vector is in compliance with Administrative Agreements to State and Local Governments (Common Rule). Page 3 of 6 Pages Rev. 06/01/92 (GEN070595) GENERAL PROVISIONS — Page 2 of 2 pages 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 %r 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 4 of 6 Pages Rev. 06/01/92 (GEN070595) SPECIAL PROVISIONS CONTROLLER'S APPROVAL 1 .This contract shall not be deemed valid until it shall have been approved by the Controller of the State of Colorado or such assistant as he may designate. This provision is applicable to any contract involving the payment of money by the State. FUND AVAILABILITY 2.Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds for that purpose being appropriated,budgeted, and otherwise made available. BOND REQUIREMENT 3. If this contract involves the payment of more than fifty thousand dollars for the construction,erection, repair, maintenance,or improvement of any building,road.bridge,viaduct,tunnel,excavation or other public work for this State,the contractor shall,before entering upon the performance of any such work included in this contract,duly execute and deliver to the State official who will sign the contract,a good and sufficient bond or other acceptable surety to be approved by said official in a penal sum not less than one-half of the total amount payable by the terms of this contract. Such bond shall be duly executed by a qualified corporate surety conditioned upon the faithful performance of the contract and in addition,shall provide that if the contractor or his subcontractors fail to duly pay for any labor,materials,team hire,sustenance,provisions,provendor or other supplies used or consumed by such contractor or his subcontractor in performance of the work contracted to be done or fails to pay any person who supplies rental machinery,tools,or equipment in the prosecution of the work the surety will pay the same in an amount not exceeding the sum specified in the bond,together with interest at the rate of night 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 provlsfoar shall be contained in all State contracts or rub-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 affirotativeaction 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 advettisings;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 eontractor 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 compliancewith 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 anceetry. (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. page 5 of 6 pages Form 6-AC-02B(GHN070595) Revived 1/93 395-53-01-1022 (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 accordancewith procedures,authorized in Executive Order,Equal Opportunity and Affumative 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 order issued pursuant to Fxncraive 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 6s. 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 the 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,ct 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. State of Colorado Contractor: ROY ROMER, GOVERNOR (Full Legal Name) Weld County Health yeoartment ^ / Z Vv BY 1✓J = % ... ,_ '- i , z Li ,_,_yy/ 04/24/96 •� 0 CHAIR, WELD COUNTY BOARD OF COMMISSIONERS By - X�e-- ry.'►;tt813 Baron , * Department PUBLIC HEALTH AND ENVIRONMENT iaiiY pity Number or Federal I.D.Number of l`n /Co ,ty ,r iv WELD COUNT AL D I{RT NT 1i. /��� BY: )��► , APPROVALS JOHN S✓PICKLE ••�� ll DIRECTOR \� stint ✓� ,, . ! lark Ns BOARD CONTROLLER )( €817CR4i9itX4Crri' e y*PR p; r f ATTORNEY GENERAL C0f6P L " eras By ..- By._. g lay's, . . .Gale A. Norton .: r yage Form 6A (GIN070595) Assistant A ooney Genera l = ' Revised 1/93 PROGRAM APPROVAL: ��"'�' I 395-53-0t-1030 State Services Section Contractor: Weld County Health Department for the Northern Colorado Care Consortium Funded Agencies: Weld County Health Department - lead agency (Tax ID # 84-6000813) Northern Colorado AIDS Project - contractual (Tax ID # 84-1035151) Northeast Colorado Health Department - contractual (Tax ID # 84-6002486) Contact Person: Gabrielle Vergara HIV Resource Coordinator Weld County Health Department 1517 16th Avenue Court Greeley, Colorado 80631 (970) 353-0639 960710 Northern Colorado Care Consortium Proposal Description of the locality to be served: Geographic boundaries: The geographic boundaries covered by the Northern Colorado Care Consortium (NCCC) encompass Larimer, Weld, Morgan, Logan, Phillips, Sedgewick, Washington, and Yuma counties. These counties constitute those counties currently covered by the Weld County Health Department(WCHD), the Northern Colorado AIDS Project(NCAP), and the Northeast Colorado Health Department(NCHD). Characteristics of the population: Through December 31, 1995, there have been 164 AIDS and 106 HIV cases reported in northern Colorado. Currently,NCAP and the HIV Resource Coordinator, of the Weld County Health Department, serve an average of 65 HIV infected individuals monthly, approximately 70% and 30% being diagnosed with AIDS and HIV, respectively. This does not include individuals for whom there is no client level information, which averages approximately 40 individuals a month. Of those individuals provided services, 78 percent are Caucasian, 6 percent Black, and 16 percent Hispanic. All individuals currently receiving services are over the age of 20 years. Existing services: The existing HIV related services in Larimer county include those services provided by the Northern Colorado AIDS Project and the Larimer County AIDS Coalition. NCAP provides case management, client advocacy, a Buddy program, support groups, education, and financial assistance for individuals living in Larimer county, who are infected or affected by HIV. Beginning this spring,NCAP will also provide HIV testing and counseling. The Larimer County AIDS Coalition provides HIV and AIDS related education, and tries to heighten the awareness of HIV infection and the incidence of AIDS within the communities of Larimer county. HIV related services in Weld county are provided by the Weld County Health Department and the Weld County AIDS Coalition. The HIV Resource Coordinator of the Weld County Health Department provides case management and support services for clients residing in Weld, Morgan, Logan, Yuma, Sedgewick, Phillips, and Washington counties. The Weld County Health Department also provides HIV related education, and HIV testing and counseling. The Weld County AIDS Coalition provides educational support for Weld county. The HIV related services available in northeast.Colorado include HIV related education and HIV testing and counseling, provided by the Northeast Colorado Health Department, and limited case management, provided by the HIV Resource Coordinator of the Weld County Health Department. Various other agencies, in northern Colorado, also offer services to HIV infected individuals and their families. These services include, but are not limited to, hospice, home health care, respite care, drug and alcohol treatment, spiritual support, financial assistance, transportation services, and other services not directly related to HIV infection. 960710 Service gaps: An issue with many individuals infected with HIV, who are living in northern Colorado, is the lack of sufficient services and availability of health care professionals. Consequently, many of these individuals have chosen to move or travel to, more metropolitan areas for their care. In the past five years, the Weld County Health Department and the Northern Colorado AIDS Project have been working to provide better case management and community liaison for infected individuals to help ensure a complete continuum of care for the infected individual and his/her family. Nonetheless, gaps in services still exist. Some of the current gaps identified by HIV infected individuals and care givers include: dental care, transportation,prescription drugs, emergency financial assistance, buddy/companion services, mental health counseling, primary medical care, and substance abuse treatment. Individuals living in northeast Colorado especially suffer because of their geographic isolation, and from lack of service providers (medical and nonmedical) in that area. Description of the service plan: Planning process: The members of the Northern Colorado Care Consortium, which includes service providers, community based organizations providing HIV related services, and individuals infected with HIV, were brought together to review the findings of the client and service provider needs assessments, conducted in November of 1994, and the findings of the ongoing client evaluations conducted throughout the year. From these assessments and evaluations, the unmet needs of HIV infected individuals living in northern Colorado were identified and prioritized. Based on these findings, and the views of current service providers and infected individuals, the Consortium developed a service plan for the April 1996-March 1997 funding period. A list of goals and objectives to improve the quality, availability, and organization of health care and support services, for HIV infected individuals and families, was developed. Service plan: The purpose of the Northern Colorado Care Consortium is to improve the quality, availability, and coordination of health care and support services for all individuals infected or affected by HIV disease. The overall goals of the Consortium are: • To provide a comprehensive continuum of care for individuals infected or affected by HIV disease through coordinated case management in Larimer, Weld, Morgan, Logan, Washington, Yuma, Sedgewick, and Phillips counties. • To increase the knowledge of resources that are available to individuals infected or affected by HIV disease in these counties. • To address the specific needs of women, children, and family members infected or affected by HIV disease. • To increase the number of providers and services for individuals infected or affected by HIV disease. • To enhance public understanding of, and attention to, issues facing individuals infected or affected by HIV disease. 2 960740 The Weld County Health Department will serve as lead agency, receiving funds on behalf of the Northern Colorado Care Consortium. The HIV Resource Coordinator, of the Weld County Health Department, will provide case management, client advocacy, education/risk reduction, and support services to HIV infected individuals and their families, who are living in Weld, Morgan, Logan, Washington, Yuma, Sedgewick, and Phillips counties. The HIV Resource Coordinator will have set office hours at the Northeast Colorado Health Department's Fort Morgan and Sterling offices. The HIV Resource Coordinator will also coordinate the activities of the Consortium, and will be responsible for the reporting and contractual duties to the State Health Department. The Northern Colorado AIDS Project located in Fort Collins will contract with the Weld County Health Department to provide case management, client advocacy, education/risk reduction, and support services to HIV infected individuals and their families living in Larimer county. Through grants, other than Ryan White,NCAP will continue assisting in the expansion of the Buddy program in northern Colorado, and will also continue providing outreach and education to populations currently not being served. The Northeast Colorado Health Department will also contract with the Weld County Health Department for a part-time nurse and a part-time, culturally competent, outreach worker. The nurse will act as a liaison between the HIV Resource Coordinator and HIV infected individuals living within NCHD's catchment area. The role of the outreach worker will be to reach populations, living in Morgan, Logan, Washington, Yuma, Sedgewick, and Phillips counties, currently not receiving services or who are receiving inadequate services. All three funded agencies will also be providing financial assistance, through a voucher program, to HIV infected individuals and their families,to ensure access to necessary services and resources. Assistance will be provided for dental and medical services, and emergency financial assistance to assist with expenses related to food,housing,rent,utilities, medications, or other critical personal needs. It is projected that approximately 120 HIV infected/affected individuals will be served in northern Colorado. Reaching and serving newly diagnosed individuals: Newly diagnosed individuals can be reached through the State Disease Control Specialist, through service and health care providers, and through the local health departments. When The State Disease Control Specialist contacts a newly diagnosed individual she informs that person of the services offered by the Consortium. The local health departments provide HIV testing and counseling, and are aware of the services provided by the Consortium and they, too, will inform an individual, who receives a positive test result, of these services. As well, the HIV Resource Coordinator, and the staff of the Northern Colorado AIDS Project and the Northeast Colorado Health Department have contacted many service providers to inform them of the services available through the Consortium. Public service announcements and news releases are also done periodically to help increase community awareness, and are often a source of self-referral. 3 960740 Service integration: Referrals between agencies are made on a case by case basis. The HIV Resource Coordinator and the staff of NCAP and NCHD have established contacts with many agencies in their respective communities, who will act as a point of contact when a referral to that agency is needed. An on-going goal of the Consortium has been to identify new HIV related services and providers. As new services are identified,the HIV Resource Coordinator and the staff of NCAP will inform providers and clients of these services. A referral to the Weld County Health Department, to NCAP, or to the Northeast Colorado Health Department can be made by a telephone call or letter. The Northern Colorado Care Consortium is currently working on a formal referral system to ensure proper documentation of HIV status. Case management services will be provided by the HIV Resource Coordinator and by the staff of the Northern Colorado AIDS Project. An initial interview is done with an individual to establish him or her as a client, and (1) to obtain general demographic information from the client, (2)to determine the client's unmet meeds, and(3)to develop a service plan for that client. The service plan includes what services are needed, and the means/methods for accessing these services. The family and/or significant others are included in the development of the service plan, whenever possible. The HIV Resource Coordinator or the staff of NCAP will help link the client with health care, psycho-social services, and coordinate access to other support services, to ensure a complete continuum of care for that individual. The HIV Resource Coordinator or NCAP staff will also develop, with the client, a system for monitoring and evaluating the service plan, and for following up with the client to ensure that the client's needs are being met. Clients will also receive a monthly mailing/newsletter to keep them up-to-date on new services and resources. Implementation plan: Based on the purpose and the overall goals of the Consortium, the following is a implementation plan that the members of the Consortium, the HIV Resource Coordinator, the Northern Colorado AIDS Project, and the Northeast Colorado Health Department will undertake during the 1996- 1997 funding period. HIV Resource Coordinator and the Northern Colorado Care Consortium Objective#1: The HIV Resource Coordinator will publicly announce(through media releases) the award of Ryan White Care Act funds to northern Colorado for the period of April I, 1996 through March 31, 1997. Objective#2: The HIV Resource Coordinator will continue with office hours in Fort Morgan and Sterling at the Northeast Colorado Health Department, to provide case management and support services to clients living in northeast Colorado.. Objective#3: The HIV Resource Coordinator will update all referral contacts in Weld, Logan, Morgan, Yuma, Washington, Phillips, and Sedgewick counties. Objective#4: The HIV Resource Coordinator and members of the Consortium will continue recruiting support for the activities of the Consortium, and recruiting potential members, particularly among the infected/affected and Spanish communities. 4 96070 Objective#5: The HIV Resource Coordinator and the members of the Consortium will continue to identify service providers, in northern Colorado, who are willing and able to care for individuals infected with HIV. Objective#6: The HIV Resource Coordinator will continue to promote the availability of Ryan White services in northern Colorado. Objective#7: The HIV Resource Coordinator will continue in sending a monthly mailing with the Resolute newsletter to all clients in Weld county and northeast Colorado. Northern Colorado AIDS Project Objective#1: NCAP staff will contact all service providers, in Larimer county, and renew service agreements and rJerral materials. Objective#2: NCAP staff will put up posters in areas frequented by people in designated high risk categories, which will outline NCAP's services. Objective#3: NCAP staff will interview three injection drug users to determine the needs and means to access this population. Objective #4: NCAP staff will have updated and distributed the resource directory for Larimer county. Objective#5: NCAP staff will start a four part educational series of representations for newly infected individuals that will educate them on nutrition, medications, terminology, and transmission prevention. Northeast Colorado Health Department Objective#1: NCHD staff will continue to promote and advocate for the continuation of a support group in Logan and Morgan counties. Objective #2: NCHD staff will continue to promote the availability of Ryan White related services in northeast Colorado. Objective#3: NCHD staff will continue to conduct outreach activities to communities of northeast Colorado, targeting communities and care providers of at-risk persons. Objective #4: NCHD staff will continue to conduct outreach activities to the Spanish speaking communities of northeast Colorado, and will be available for translation to monolingual, Spanish speaking, persons as needed in educational and service activities related to Ryan White. Objective#5: NCHD staff will initiate the development of interpreter services for HIV at-risk persons, including training and compensation. Objective#6: NCHD staff will increase coordination of culturally appropriate and accessible services including outreach, education, and case management for HIV infected and affected individuals in northeast Colorado. 5 960740 Collaborative Efforts Objective#1: NCAP, WCHD, and NCHD will collaborate on a monthly newsletter that will be distributed to all clients in the Consortium's catchment area. Objective#2: NCAP, WCHD, and NCHD will initiate a client advisory board made up of infected clients,who will meet quarterly to assess the services provided by the consortium agencies. Objective#3: NCAP staff will coordinate with WCHD to expand services in Weld county, including dividing current support group into infected Persons and Friends and Family groups, and expanding the Buddy program and other volunteer services. Objective#4: NCAP, WCHD, and NCHD will continue working together in developing a formal referral system to appropriately document HIV status. Objective#5: NCAP, WCHD, and NCHD will provide case management and other Ryan White services to 120 individuals (including clients without client-level information) in northern Colorado. Description of Consortium Membership: Lead Fiscal Agent: The Weld County Health Department will receive and administer funds on behave of the Northern Colorado Care Consortium. This decision was made upon agreement by the members of the Consortium(see Appendix I for documentation). • Consortium members and services: Misti Aas, Psychotherapist- individual counseling services and local support group facilitator Social Security Administration -point of access for individuals applying for Social Security Disability and/or Supplemental Security Income, and Medicare Don Cooper. Citizen- source of knowledge and perspective Steve Johnson. PLWA - source of knowledge and perspective Terry Kearns, Medical Social Worker-provides coordination of services and resources for patients upon discharge from the North Colorado Medical Center Youth Surveillance Bureau- surveillance of convicted high risk youth Logan County Department of Social Services - point of access for individuals applying for public benefits in Logan county Morgan County Department of Social Services - point of access for individuals apply for public benefits in Morgan county Alliance Home Health Care-home health care Ackerman & Associates -provide mental health services Karlyn Khaler-coordinator for the Home and Community Based Services program in Morgan county Centennial Area Health Education Center- HIV related education for health care providers Salud Community Health Center- primary medical care Pat Honaker. Parent- source of knowledge and perspective Larimer County Health Department- HIV related education 6 960740 Hospice of Larimer County - in-home health care, bereavement support services, and case management Weld County Health Department-public health agency Northeast Colorado Health Department-public health agency Northern Colorado AIDS Project-community based organization providing HIV related services Coordination between member agencies: All members of the Consortium are aware of the services provided by each of the member agencies and organizations, and are familiar with the role of the HIV Resource Coordinator and the Northern Colorado AIDS Project, and will make referrals as necessary so that services aren't unnecessarily duplicated. Description of member agencies receiving HIV care consortium funds: The Weld County Health Department,the Northern Colorado AIDS Project, and the Northeast Colorado Health Department will be receiving Ryan White funds for the 1996-1997 grant year. The Weld County Health Department is a public health agency supported by county tax dollars, state and federal grants, and fees for services provided. The mission of the Weld County Health Department is "to prevent disease and to promote the health of county citizens". This is accomplished by monitoring the environment of the county and the health of its residents;by the development of policies and programs; and by assuring that the basic health services (including HIV testing and counseling) are being provided. The Weld County Health Department will receive funds to provide case management and support services in Weld, Morgan, Logan,Yuma, Phillips, Sedgewick, and Washington counties. The Weld County Health Department will also be receiving funds for the coordination of Consortium activities. The Northern Colorado AIDS Project will be subcontracting with the Weld County Health Department to provide case management and support services in Larimer county. NCAP is a community based, non-profit organization committed to serving those individuals impacted by HIV and AIDS in northern Colorado. NCAP strives to increase awareness and understanding of the AIDS epidemic, and supports endeavors to empower persons affected by HIV and AIDS. Services provided by NCAP include: case management, client advocacy, education and risk reduction, support groups, information and referral services, and volunteer (Buddy) services for persons with AIDS. NCAP also sponsors an outreach program that incorporates a speaker's bureau,brochures, a video and book library, and community networking and information sharing. The Northeast Colorado Health Department will also be subcontracting with the Weld County Health Department to expand its outreach program, and to provide a person to act as a liaison with the Weld County Health Department and the Northern Colorado AIDS Project, and to act as a point of access to services. As a public health agency, the Northeast Colorado Health Department provides services similar to those provided by the Weld County Health Department, including HIV testing and counseling. 7 960710 Form of agreement between agencies: The lead agency, Weld County Health Department, and the contractual agencies,Northern Colorado AIDS Project and Northeast Colorado Health Department have an agreement in the form of a contract. Reporting and Evaluation Plan: Plan for data collection: The HIV Resource Coordinator and the Northern Colorado AIDS Project will collect data according to the Standard Annual Administrative Report(SAAR). The HIV Resource Coordinator or the staff of NCAP will conduct an initial interview to establish an individual as a client. During this visit the information required by the SAAR will be obtained. This information will then be reported to the Colorado Department of Public Health and Environment on a monthly basis. The HIV Resource Coordinator and NCAP staff will also collect information from clients to identify the number of new clients, the number of client contacts, the types of services provided, who referred the client, agencies and service providers that referrals are made to, and the needs of the clients. Plan for evaluation: To evaluate the success in responding to the needs of the clients, the HIV Resource Coordinator or NCAP staff will assess the needs of the client during the intake interview. These needs will then be documented in the form of a service plan, and will establish a baseline for evaluation. As the needs of the clients are met, this too will be documented. This information will be compared to the services available within the geographic boundaries of the Consortium. This comparison will be used to evaluate the success of the HIV Resource Coordinator and the staff of the Northern Colorado AIDS Project in meeting the needs of the clients. This will also help to determine gaps in services that exist in the eight counties supported by the Consortium. Plan for evaluating the cost-effectiveness of the program: Cost-effectiveness of the programs supported by HIV care consortium funds is difficult to determine in that standardized cost-for-service for such things as case management, support groups, buddy/companion service, etc. has never been determined. The HIV Resource Coordinator and the staff of NCAP, however, attempt to assist clients in finding cost-effective alternatives to expensive services and treatments. As well, when determining the budget for the Northern Colorado Care Consortium, a decision is made to how many individuals can be served at current funding levels. We strive to serve the maximum number of individuals with current allocations. The Consortium will also continue to be represented at the Governor's AIDS Council Disbursements Committee, to help establish standardized costs-for-service. 8 360740 Colorado Ryan White C.A.R.E. Act Title II Budget Request - April 1, 1996, to March 31, 1997 Table I: Ryan White Title II Funds Requested Budget Request % of Total Budget Object Class/Category Project Funding Period Personnel $26,958 27% Fringe Benefits 4,583 5% Travel 1,500 2% Equipment Supplies 1,200 1% Contractual 47,191 48% Other 7,200 7% Audit non-profit $25,000≥ Indirect Charges 9,848 10% Total 98,480 100% Table II: Breakdown by Proposed DIV Service Category Budget Request % of Total Budget Category of Service Current Funding Period Primary Medical Care $2,383 2% Dental Care 2,383 2% Mental Health Rehabilitation Care Support Services 36,809 37% Case Management 56,905 59% Home Health Care Home-based Hospice Care Drug Reimbursement Not applicable Not applicable Insurance Continuation Not Applicable Not applicable Contractual Total 98,480 100% g:\wpdocs\96rwbudg.tbl 960740 WELD COUTNY HEALTH DEPARTMENT (APRIL 1, 1996 - MARCH 31, 1997) Table III DESCRIPTION AMOUNT OTHER TOTAL THIS FUNDS THIS PROGRAM REQUEST PROGRAM BUDGET TOTAL PERSONNEL $31,541 $1,920 $33,461 OPERATING/MAINTENANCE Travel/Mileage 1,500 1,500 Telephone Printing/copying 1,200 1,200 Postage Educational Materials (Please Specify) Rent/Mortgage Office Supplies Training (Staff Develop- 560 560 ment) Equipment 700 700 Audit Subcontracts 47,191 47,191 Other 7,200 7,200 TOTAL - Direct Costs 88,632 3,180 91,812 **INDIRECT COSTS (fig- ured at % for this 9,848 7,090 16,938 request.) TOTAL FUNDS 98,480 10,270 108,750 ** A 10% indirect cost (which is calculated on the total direct costs of this request, not the total program budget) will be allowed for all project requests. Indirect costs hereby refer to the costs of any agency doing business but are not specifically related to the program. These related agency costs are necessary to agency operation and support the proposed program. Indirect costs are often referred to as overhead in many organizations. Indirect costs may not include any of the program-specific line items listed under operating/maintenance and must be justified in the budget narrative. H \WPDOCS\INDIREC .TBL 960740 NORTHERN COLROADO AIDS PROJECT (APRIL 1, 1996 - MARCH 31, 1997) Table III DESCRIPTION AMOUNT OTHER TOTAL THIS FUNDS THIS PROGRAM REQUEST PROGRAM BUDGET TOTAL PERSONNEL $33,840 $4,000 $37,840 OPERATING/MAINTENANCE Travel/Mileage 800 200 1,000 Telephone 700 700 1,400 • Printing/copying 700 300 1,000 Postage Educational Materials (Please Specify) Rent/Mortgage 1,600 1,600 Office Supplies 600 600 Training (Staff Develop- ment) Equipment Audit 1,800 1,800 Subcontracts Other 750 500 1,250 TOTAL - Direct Costs 38,590 7,900 46,490 **INDIRECT COSTS (fig- 3,859 3,859 ured at % for this request.) TOTAL FUNDS 42,449 7,900 50,349 ** A 10% indirect cost (which is calculated on the total direct costs of this request, not the total program budget) will be allowed for all project requests. Indirect costs hereby refer to the costs of any agency doing business but are not specifically related to the program. These related agency costs are necessary to agency operation and support the proposed program. Indirect costs are often referred to as overhead in many organizations. Indirect costs may not include any of the program-specific line items listed under operating/maintenance and must be justified in the budget narrative. N:\WPDCC5\INDIRECT.THL 960740 NORTHEAST COLORADO HEALTH DEPARTMENT (APRIL 1, 1996 - MARCH 31, 1997) Table III DESCRIPTION AMOUNT OTHER TOTAL THIS FUNDS THIS PROGRAM REQUEST PROGRAM BUDGET TOTAL PERSONNEL $4,000 $4,000 OPERATING/MAINTENANCE Travel/Mileage 200 200 Telephone Printing/copying 110 110 Postage Educational Materials (Please Specify) Rent/Mortgage Office Supplies Training (Staff Develop- ment) Equipment Audit Subcontracts Other TOTAL - Direct Costs 4,310 4,310 **INDIRECT COSTS (fig- ured at % for this 432 432 request.) TOTAL FUNDS 4.742 '4,742 ** A 10% indirect cost (which is calculated on the total direct costs of this request, not the total program budget) will be allowed for all project requests. Indirect costs hereby refer to the costs of any agency doing business but are not specifically related to the program. These related agency costs are necessary to agency operation and support the proposed program. Indirect costs are often referred to as overhead in many organizations. Indirect costs may not include any of the program-specific line items listed under operating/maintenance and must be justified in the budget narrative. H:\WPDDCS\INDIRECT.TDL 36®710 Budget Justification: Table I: Personnel -The total funds for this category are $26,958, which is 27%of the entire budget. Staff will be utilized to carry out the Weld County Health Department's role as the fiscal agent, coordination of the Consortium, and to fulfill the goals of the implementation plan as stated in this document. Fringe Benefits -The total funds for this category are $4,583, which is 5% of the entire budget. Fringe benefits are provided to support the quality staff needed to carry out the activities of this project. Travel-The total funds for this category are $1,500,which is 2% of the entire budget. Travel funding will support the HIV Resource Coordinator in providing case management and in coordinating the activities of the Consortium. Supplies -The funds for this category are $1,200, which is 1% of the entire budget. This funding provides printing and postage to support the HIV Resource Coordinator in her duties. Contractual-The funds for this category are $47,191, which is 48% of the entire budget. This funding allows the two subcontracting agencies (the Northern Colorado AIDS Project and the Northeast Colorado Health Department) to fulfill their part of the service and implementation plans. Other-The funds for this category are $7,200, which is 79% of the entire budget. This funding will provide access to medical,dental, and support services. Indirect charges - The funds for this category are$9,848, which is 10%of the entire budget. This funding is for standard indirect services of the Weld County Health Department. Table II: Primary Medical Care - Vouchers are available to assist clients in payment for medical care. Total funds for primary medical care are $2,383 ($2,100 direct and $283 indirect). No FTE's are supported by this funding. Approximately 15 clients will be served. Dental Care- Vouchers are available to assist clients in payment for dental care. Total funds for dental care are $2,383 ($2,100 direct and$283 indirect). No FTE's are supported by this funding. Approximately 10 clients will be served. Support Services - Funding will be used to provide emergency financial assistance, food supplements and other miscellaneous support services. Total funds for support services are$36,809 ($31,578 direct and$5,231 indirect). Total FTE's supported by this funding is 0.55. Approximately 70 clients will be served. Case Management - Funding will be used to provide case management services. Total funds for case management are $56,905 ($48,563 direct and $8,342 indirect). Total FTE's supported by this funding is 1.95. Approximately 80 clients will be served. 9 960740 Information pertaining to the following is found within the narrative of this application: • how services provided will improve the quality, availability, and organization of health care and support services for individuals and families with HIV disease • explanation of the plan • description of measurable units of service provided with these funds • methods of evaluation 10 960740 Addendum I 960740 Colorado Ryan White Title II 1994 Consortium Assurances In order to receive assistance from the State, the Consortium hereby assures the State that: A. Within the established locality in which the consortium will operate, the population and subpopulations of individuals and families with HIV disease have been identified by the consortium; B. The consortium's service plan addresses the special care and service needs of the populations and subpopulations identified in the established locality; C. The consortium will comply with all data collection and reporting requirements as mandated by HRSA and the Colorado Department of Health; D. The consortium will be a single coordinating entity that will integrate the delivery of services among the populations and subpopulations identified in the established locality; E. The consortium will coordinate and expand existing programs before any new programs are created; F. The consortium shall deliver case management services that link available community support services to appropriate specialized medical services; G. The consortium will include participation by individuals with HIV disease in the assessment of service needs and the planning of the delivery of services; H. The consortium has or will create a mechanism to evaluate the success of the consortium in responding to the identified needs and the cost effectiveness of the mechanisms employed by the consortium to deliver comprehensive care; I. The consortium has or will adopt by-laws by which the consortium will operate. The by- laws will include the definition of a "member" of the consortium and a description of the process the consortium must follow in including new members. Membership definitions and processes will clearly demonstrate an open and inclusionary intent which will give all segments of the HIV service provider community an opportunity to participate on a continuous and ongoing basis. By-laws will also include a description of the process for selecting a lead agency; this process will ensure all consortium members have an opportunity to be considered for the role of lead agency, if interested, and to participate in selection of the lead agency; and 12 960740 J. All non-profit agencies receiving $25,000.00 or more in Title II funds will ensure an annual independent financial audit is conducted and a report submitted as specified in Section II,F, of the 1995-96 Title II Consortia Workplan Guidance document. (The CFDA number for Title II funds is 93-9170). g41C Ora. 02 - 20 - R!o Signature U Date 13 960740 COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT GUIDANCE FOR THE DEVELOPMENT OF TITLE II FUNDED CONSORTIA WORKPLANS, 1996-97 960740 I. GENERAL INFORMATION A. Introduction: The Colorado Department of Health is receiving a 12-month grant under the federal Ryan White C.A.R.E. Act of 1990 to "improve the quality, availability and organization of health care and support services for individuals and families with HIV disease." [Sec. 2611] Grant funds are restricted to specific types of activities and services. Grant funds may be used for the development and operation of HIV care consortia; home- and community-based care services; continuum of health insurance coverage; and the provision of treatments. It is the intention of the Act that funds be distributed in a manner consistent with the epidemiology of reported AIDS cases within the State. Fifteen (15) percent of funds must be used to serve infants, children, women and families with HIV. B. Definitions: 1. HIV Care Consortia: An HIV care consortium, as defined in the Ryan White C.A.R.E. Act, is "an association of one or more public, and one or more nonprofit private, health care and support service providers and community-based organizations." [Sec. 2613 (a) (1) and (2)] Consortia are established and operate within areas most affected by HIV disease to provide a comprehensive continuum of care to individuals and families with HIV disease. 2. Home- and Community-based Care: Home- and Community-based Care is defined as those skilled health services provided to an individual with HIV disease in his/her home pursuant to a written plan of care established by a case management team. 3. Continuum of Health Insurance Coverage: Continuum of Health Insurance Coverage is defined as financial assistance provided to eligible low-income individuals with HIV disease in maintaining a continuity of health insurance or receiving medical benefits under a health insurance program, including risk pools. 4. Provision of Treatments: Provision of Treatments is defined as the provision of treatments that have been determined to prolong life or prevent the serious deterioration of health arising from HIV disease. C. Overview: Under the auspices of the Governor's AIDS Council a subcommittee was formed to determine general disbursements of Title II funds. Determinations were made of funding amounts for each consortia area. Individual consortium will make their own decisions of how best to disburse those funds within their own geographic area. 1 960740 D. Goal of the Program: It is the goal of the Colorado Department of Health to fund activities and services throughout the State in order to "improve the quality, availability and organization of health care and support services for individuals and families with HIV disease." [Sec. 2611] • 960;7'0 II. STATEMENT OF WORK A. Period of Performance: The period of performance for this project is from April 1, 1996, through March 31, 1997. B. General Responsibilities: 1. To the maximum extent possible, ensure that HIV-related health care and support services provided will be without regard to the ability of the individual to pay for such services and without regard to the current or past health condition of the person with HIV disease. 2. Ensure that services will be provided in a setting that is accessible to low-income individuals with HIV disease and provide outreach to low-income individuals with HIV disease to inform them of the services available through this grant. 3. Conduct all programs in accordance with the accepted workplan, including remaining within the proposed budget and performing tasks within the specified time-frame. 4. Identify a project staff member to work with the Colorado Department of Health. 5. Work cooperatively with the Colorado Department of Health with the review and evaluation of program progress and the independent peer review program designed to assess the quality and appropriateness of health and support services provided through this grant. C. Specific Responsibilities and Eligibility Requirements: 1. Responsibilities: a) To provide comprehensive outpatient, essential health and support services for individuals and families with HIV infection. Services include (but are not limited to): i) essential health services: case management; medical, nursing and dental care; diagnostics; monitoring; medical follow-up services; mental health; developmental and rehabilitation services; home health; and hospice care. ii) essential support services: transportation; attendant care; homemaker services; day or respite care; benefits advocacy; advocacy services provided through public and nonprofit private entities; nutrition; housing referral; child welfare and family services (including foster care and adoption); and provision of information and counseling on living with HIV. 3 960740 b) To coordinate and expand existing services, and to identify service gaps. The consortium is the single coordinating body that will integrate the HIV services within a particular locality. If a locality has sub-populations with unique service requirements which cannot be adequately met by a single coordinating body, an additional consortium could receive Title II funds. 2. Eligibility Requirements: A consortium does not have to provide the services directly. Alternatively, it can coordinate the services. In addition, a consortium is not required to become a legally incorporated entity. Funds can be received by a lead member agency, on behalf of a consortium. In order to be eligible to receive funding, a consortium must comply with the following requirements: a) Membership: A consortium must include agencies and community-based organizations which provide services to populations and sub-populations with HIV infection within the community; represent the populations and sub-populations affected by HIV in the community; and are located in areas where these groups reside. Additionally, a consortium should include representation by persons with HIV infection. b) Service Plan: i) A consortium must undertake a needs assessment and establish a service plan based on the results of the needs assessment in consultation with the public health agency that provides or funds ambulatory and outpatient HIV-related health services; other entities that directly provide ambulatory HIV health services; community-based organizations that are organized solely for the purpose of providing HIV-related support services to individuals with HIV infection; and in Ryan White Title I cities, the HIV Health Services Planning Council. ii) The consortium must assure that persons with HIV infection participate in the planning process, and that needs will be addressed through the coordination and expansion of existing programs before new programs are created; in metropolitan areas, the geographic area to be served by the consortium corresponds to the boundaries of local health and support service delivery systems, to the extent practicable; in rural areas, the consortium will provide case management services to link support services to specialized medical services; the full continuum of health and social services needed for persons with HIV infection has been considered; and adequate planning has occurred to meet the special needs of families with HIV infection, including family centered care. c) Reporting and Evaluation: The consortium must create a mechanism to evaluate its success in responding to identified needs and the cost-effectiveness of the 4 960740 mechanisms employed by the consortium to deliver comprehensive care. The results of these evaluations must be reported to the State. Data and information about the evaluation methodology the consortium used must also be available to the State. D. Reporting Requirements: Contractors must provide statistical and program achievement information and assurances to the Colorado Department of Health in a manner that meets the requirements of the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (DHHS). This information includes: 1. Statistical and Program Achievement: All contractors receiving Title II funds MUST comply with the reporting requirements of the AAR and provide quarterly narrative reports and up-to-date fiscal information.. a) Four quarterly narrative and statistical reports must be submitted for the period of April 1 to June 30; July 1 to September 30; October 1 to December 31, 1996; and January 1 to March 31, 1997. These reports will be due by July 15 and October 15, 1996 and January 15 and April 15, 1997, respectively. Narrative reports should include discussions of: progress in achievement of goals and objectives; problems and concerns encountered in completing activities within each category of service; plans to respond to any barriers encountered; and highlights of noteworthy achievements and developments. b) Contractors are required to submit monthly reports meeting the requirements of the AAR/URS. For the upcoming grant year, just a few changes have been made, along with the necessary instructions and will be sent to you as soon as possible. c) Contractors are also required to produce an annual aggregate AAR to be submitted to HRSA. The reporting period is based on the calendar year, e.g., January 1 through December 31 of any given year. However, in the event a contract is not renewed for the new project period commencing April 1, 1996, the reporting period for calendar year 1996 shall be from January 1, 1996, to March 31, 1996. All contractors must plan to complete standard scannable AAR which will be sent to you as soon as possible. Mayatech has been unable to mail out the new forms due to the federal government furloughs. The year-end form will be completed for the January 1, 1995 through December 31, 1995 time period and will be due in our office in March, 1996. E. Assurances: Consortia submitting workplans are required to sign the enclosed assurances and include them as an attachment to the workplan. F. Annual financial audit: All non-profit agencies receiving $25,000.00 or more in Ryan White Title II funds must have an annual financial audit conducted by an independent auditor. The audit report must be received by CDH no later than 90 days after the last day 5 960740 of the project period. Necessary and reasonable costs associated with this audit may be paid from the agency's grant funds. G. Responsibilities of the Colorado Department of Health: 1. Designate a contact person to coordinate the work of the contractors. 2. Assist contractors in the preparation of reports. 3. Provide training, technical assistance and guidance in the implementation of the AAR/URS reporting systems. 4. Regularly monitor the progress of the work under the contract. 5. Conduct at least one evaluation session with the contractor. 6. Provide additional technical assistance as requested by the contractor. H. Compensation: The Colorado Department of Public Health and Environment will reimburse the contractor all contract-related expenses incurred during the quarter following the submission of a financial status and program achievement report and a signed request for reimbursement. 6 9607x0 III. WORKPLAN GUIDELINES A. Workplan Submission: Submit two (2) copies of the workplan, including the original, to Karen Ringen, at the address below, no later than 2:30 p.m. on February 23, 1996. Please note it will take approximately 4-6 weeks to process contracts within CDPHE; therefore, if it is possible to submit workplans earlier, final contracts will be available sooner. The address is: Colorado Department of Public Health and Environment DCEED-STD-A3 4300 Cherry Creek Drive So. Denver, CO 80222-1530 B. Guidelines for Writing the Workplan: 1. The workplan narrative should not exceed ten (10) pages, be single spaced, in standard 10 or 12 point type, and use one-inch top, bottom and side margins. 2. The workplan shall have a cover-page which indicates: a. the HIV Care Consortium name which, in further references, shall be referred to as "Contractor"; b. the list of agencies, including federal tax identification numbers, to receive funds under this grant; and c. the name, address and phone number of a contact person appointed by the submitting consortium. 3. The workplan should clearly and concisely address how the contractor "improve[s] the quality, availability and organization of health care and support services for individuals and families with HIV disease." [Sec. 2611] 4. The workplan should include, as an addendum, evidence of strong local community support from persons with HIV disease, local health authorities and medical providers. • 5. The workplan should include, as an addendum, the signed assurances included with this document. 6. The proposal should be clear and specific since it will serve as the basis for evaluation and will be included in the performance-based contract when awarded. C. Workplan Format: Agencies submitting workplans are required to write a narrative 7 96074:0 describing the consortium and to submit budgets which reflect the responsibilities and eligibility requirements of the consortium. 1. Narrative a) Description of the locality to be served, including: 1) the geographic boundaries and how they correspond to the boundaries of the local health and social services delivery systems; 2) the characteristics of the populations affected by HIV in the locality, based on the incidence of AIDS and the prevalence of HIV; 3) the existing HIV services available in the geographic area; and 4) service gaps, based on the assessment of existing service capacity and unmet needs. b) Description of the service plan, including: 1) the planning process by which the service plan was developed, including a description of how the public health agency, other local providers of ambulatory services (if the public health agency is not a direct service provider), and AIDS service organizations were consulted; and how persons with HIV infection participated in the development of the plan; 2) the service plan: what services will be provided and by which organizations; how many persons with HIV infection will be served by the proposed service; and what the methodology will be for reaching and serving persons newly diagnosed with HIV disease in the service area. Please include the demographic information that is used in the AAR; 3) the service integration: how referrals between agencies will be made; a description of the plan for case management; and 4) the implementation plan: based on the service plan, what activities will be undertaken and when; and which organization will be responsible for coordinating the specific activities in the implementation plan. c) Description of the consortium membership, including: 1) name of lead agency and documentation that all consortium members had the opportunity to be considered for the role of lead agency and agree to the selection of the designated 8 960740 lead agency in their region; 2) a list of members and what services they provide, including a description of the coordination between member agencies in order to provide a quality and continuum of care; 3) a description of member agencies which will be receiving HIV care consortium funds; and 4) a description of the form of agreement between the agencies. d) Description of the plan for reporting and evaluation, including the mechanism the consortium will use to collect data from consortium members to evaluate its success in responding to the identified needs; and to evaluate the cost-effectiveness of the services provided. 2. Budget: Submitting agencies must submit completed budget tables and justifications which reflect the consortium budget as a whole and completed budget tables and justifications from each individual agency requesting funds under this program. a) Budget Tables: The enclosed budget tables should be completed according to the attached instructions. b) Budget Justification: The budget justification must reflect the amounts requested in the budget tables. The budget justification shall be broken out into two parts: 1) Table I: Description and Justification of Budget: Each object class/category should be justified by responding to these points: a) Object Class/Category b) Total funds requested for the Object Class/Category c) What percent of the total budget does this represent? d) Describe how the proposed object class/category will "improve the quality, availability and organization of health care and support services for individuals and families with HIV disease." [Sec. 2611] 2) Table II: Description and Justification of Planned HIV Service: The amounts in each of the object class/categories can be broken down into direct and indirect costs for service. Each of the proposed HIV services should be justified by responding to these points: 9 960740 a) Planned HIV service b) Total funds requested for this service (direct plus indirect costs) c) What is the number of full time equivalent employees (FTEs) that will be supported with the specified funds? d) Number of clients to be served by this service (4/1/96 - 3/31/97). At least 15 percent of services shall be provided to "infants, children, women and families with HIV disease." [Sec. 2612 (b)] Provide the number of clients to be served in each of these categories. e) Describe how the service will "improve the quality, availability and organization of health care and support services for individuals and families with HIV disease." [Sec. 2611] 0 Explain the plan, including specific tasks to be performed, for providing the planned HIV service: How will clients benefit? g) Using quarterly objectives, what measurable units of service will be provided with these funds (e.g., number of clients, number of client contacts, etc.)? h) If planning an expansion of existing services, how many additional clients will be served? i) Describe the methods that will be used to monitor and assure the quality of the service. 10 960 ,740 IV. BUDGET REQUEST INSTRUCTIONS PLEASE NOTE: To make this as simple as possible, since we really do not know the amount of the award for 1996-97, please submit your budget using the Scenario II - Final that we arrived at in the disbursement committee negotiations, or if you had already done a 20% decrease from this year's contract, that figure will be fine. Just keep in mind that the numbers will have to be adjusted when the actual pool of money is determined. (Karen and I wrote the grant application as if we were receiving level funding - we might as well ask for what we'd like to have.) So far, we know that we are receiving one quarter of level funding with which to begin the grant period. The tables and forms included in this section are to be completed by each consortium requesting funds under this project. Table I and II should contain combined information from all subcontracting agencies and the lead agency. The agency-level budgets should then be included as an addendum to the proposal. (Attention! Please note that I've simplified these antiquated forms - but the basic budget information is the same and will have to be set up in this bifurcated manner, i.e. object/class and service categories.) The information requested in Table I: Ryan White Title II Funds Requested and Table II: Breakdown by Proposed HIV Service Category is based on the total budget request, but is itemized in different formats. The totals on both tables should agree. The figures from these forms will be transferred directly to your monthly billing statements as beginning balances. Table III can be completed by the lead agency and the subcontractors can complete additional copies to detail direct and resulting indirect costs. CDPHE needs this information because it shows that other funds are being used in support of AIDS services as well as Ryan White funds. Each consortium must maintain a level of effort from year to year and we need to have that available for HRSA. The HIV SERVICE CATEGORIES DEFINITIONS are attached, but the term contractual is explained below: Contractual: Services the consortium has been contracted to provide but are not provided by the lead/fiscal agency who sub-contracts with other providers in the consortium. This category is to be used solely by the lead/fiscal agency in order to track the flow of funds through sub-contracts. 11 960740 Colorado Ryan White Title II 1994 Consortium Assurances In order to receive assistance from the State, the Consortium hereby assures the State that: A. Within the established locality in which the consortium will operate, the population and subpopulations of individuals and families with HIV disease have been identified by the consortium; B. The consortium's service plan addresses the special care and service needs of the populations and subpopulations identified in the established locality; C. The consortium will comply with all data collection and reporting requirements as mandated by HRSA and the Colorado Department of Health; D. The consortium will be a single coordinating entity that will integrate the delivery of services among the populations and subpopulations identified in the established locality; E. The consortium will coordinate and expand existing programs before any new programs are created; F. The consortium shall deliver case management services that link available community support services to appropriate specialized medical services; G. The consortium will include participation by individuals with HIV disease in the assessment of service needs and the planning of the delivery of services; H. The consortium has or will create a mechanism to evaluate the success of the consortium in responding to the identified needs and the cost effectiveness of the mechanisms employed by the consortium to deliver comprehensive care; I. The consortium has or will adopt by-laws by which the consortium will operate. The by- laws will include the definition of a "member" of the consortium and a description of the process the consortium must follow in including new members. Membership definitions and processes will clearly demonstrate an open and inclusionary intent which will give all segments of the HIV service provider community an opportunity to participate on a continuous and ongoing basis. By-laws will also include a description of the process for selecting a lead agency; this process will ensure all consortium members have an opportunity to be considered for the role of lead agency, if interested, and to participate in selection of the lead agency; and 12 960740 J. All non-profit agencies receiving $25,000.00 or more in Title II funds will ensure an annual independent financial audit is conducted and a report submitted as specified in Section II,F, of the 1995-96 Title II Consortia Workplan Guidance document. (The CFDA number for Title II funds is 93-9170). Signature Date 13 960740 STATE OF COLORADO Roy Romer,Governor of.cow Patti Shwayder,Acting Executive Director <_ o- Dedicated to protecting and improving the health and environment of the people of Colorado � Main Building Laboratory Building i s * 4300 Cherry Creek Dr.S. 4210 E.11th Avenue 1876 Denver,Colorado 80222-1530 Denver,Colorado 802 20-3 71 6 Colorado Department Phone(303)692-2000 (303)691-4700 of Public Health Date and Environment State Fiscal Year 19_-_ Routing Number _- Change Order Letter No. In accordance with Paragraph 4 of routing number_- , of contract number , (copy attached and by this reference made a part hereof) between the State of Colorado Department of Public Health and Environment (Disease Control and Environmental Epidemiology Division) and covering the period of , 19_ through , 19_ the undersigned agree that the maximum amount payable by the State for eligible services in Paragraph_is being increased by$ 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. BUDGET 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 or before , 19_ to: Audrey Christensen Colorado Department of Public Health and Environment 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 • By: By: Name Lee Thielen, Assistant Director Title For the Executive Director Colorado Department of Health APPROVALS: By: By: L. A. Koleski, Jr., Fiscal Officer State Controller or Disease Control and Environmental Authorized Designee Epidemiology Division Atiefle� JC n . iY mEmoRAnDum r _ . 2 wok Barbara Kirkmeyer, Chair u To Board of County Commissioners Date Aprrlt;8p,l ,`�� tl`kb, , COLORADO From �. � w v John Pickle, Director, Health Department 57‘.4 Subject: Ryan White Contract Enclosed for Board approval is a contract between Weld County Health Department and the Colorado Department of Public Health and Environment for the fifth year of funding from Ryan White Title II monies. Under the provisions of the contract, the Health Department will provide case management services for HIV affected populations in Northeastern Colorado including but not limited to Weld, Larimer and Morgan counties. The Health Department will also process pass through funding to pay for clients' health care visits through a voucher system. Norther Colorado AIDS Project(NCAP) and the Northeast Colorado Health Department will subcontract with WCHD to provide case management services. For these services, the Health Department will receive an amount not to exceed $98,480 for the period April 1, 1996 through March 31, 1997. Of these funds, $47, 191 will be sub-contracted to the two other agencies listed above. I recommend your approval of this contract. Enclosure 960740 Hello