HomeMy WebLinkAbout990080.tiff RESOLUTION
RE: APPROVE CONTRACT FOR HIV COUNSELING AND TESTING 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 HIV Counseling and
Testing 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 January 1, 1999, and
ending December 31, 1999, 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 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 13th day of January, A.D., 1999, nunc pro tunc January 1, 1999.
BOARD OF COUNTY COMMISSIONERS
LD COUNTY, LO DO
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Dale K. Hall, Chair
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HL0025
DEPARTMENT OF HEALTH
6 1517 16TH AVENUE COURT
GREELEY, CO 80631
ADMINISTRATION (970) 353-0586
' HEALTH PROTECTION (970) 353-0635
W�`PO PREVENTIVE HEALTH (970) 353-0639
C FAX (970) 356-4966
COLORADO
TO: Dale Hall, Chairman
Board of County Commissioners
DATE: January 11, 1999
FROM: John Pickle, Director, Health Departmentc/4-41 ,0±.....a.„
SUBJECT: HIV Counseling and Testing Contract
Enclosed for Board review and approval is a contract between Weld County Health Department
(WCHD) and the Colorado Department of Public Health and Environment for the HIV
counseling and testing services.
For providing these services, the Health Department will be reimbursed an amount not exceed
$3,982 for the time period January 1, 1999 through December 31, 1999.
I recommend your approval of this contract.
Enclosure
990080
Department or Agency Name
COLORADO DEPARTMENT OF
PUBLIC HEALTH AND
ENVIRONMENT
Department or Agency Number
FHA
Contract Routing Number
99-00027
CONTRACT
This CONTRACT is made this 23rd day of November, 1998, by and between: the State of Colorado,
for the use and benefit of the DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT,
whose address or principal place of business is 4300 Cherry Creek Drive South,Denver. Colorado
80246, hereinafter referred to as "the State"; and, Weld County Health Department, whose address
or principal place of business is. 1517 16th Avenue Court. Greeley, CO 80631 hereinafter referred
to as "the Contractor".
WHEFtEAS, authority exists in the Law and Funds have been budgeted, appropriated, and otherwise
made available, and a sufficient uncommitted balance thereof remains available for encumbering and
subsequent payment of this Contract under Encumbrance Number SOD9900027, in Fund Number 100,
Appropriation Account 365, and Organization Number 3830;
WHEREAS,the State has formulated comprehensive plans relative to the statewide control of Sexually
Transmitted Disease (STD)and Human Immunodeficiency Virus (HIV)Infection;
WHEREAS, the State has received funding from the Centers for Disease Control and Prevention (CDC)
for Human Acquired Immunodeficiency Syndrome (AIDS) detection by means of counseling and testing
services;
WHEREAS, in order to implement said comprehensive plan,the State has established provisions by
which to provide supplementary support to various local health departments substance abuse treatment
centers, family planning clinics and community based service organizations;
WHEREAS, per Section 25-4-1405 7 C.R.S. as amended, 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;
Page 1 of 19 Pages
j ji'cit,)
WHEREAS, the State has established an anonymous counseling and testing program at select contracted
local county health departments' Counseling and Testing Sites (CTS)for persons considered to be at high
risk for HIV infection;
WHEREAS,the Contractor has chosen to provide confidential and anonymous counseling and testing
services for antibody to HIV;
WHEREAS, as of the made date of this Contract, the State has a currently valid Group H purchasing
delegation agreement with the Division of Purchasing within the Colorado Department of Personnel;
WHEREAS, ibis procurement is exempt from the Colorado Procurement Code and rules because the
Contractor is a governmental agency;
WHEREAS, all required approvals, clearances, and coordination have been accomplished from and with
all appropriate agencies.
NOW THEREFORE, in consideration of their mutual promises to each, stated below, the parties hereto
agree as follows:
A. EFFECTIVE DATE AND TERM. The effective date of this Contract is January 1. 1999.
The initial term of this Contract shall commence on January 1. 1999, and continue through and
including December 31, 1999.
B. DUTIES AND OBLIGATIONS OF THE CONTRACTOR.
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,
sexually transmitted disease (STD)clinic, substance abuse treatment center(SATC)).
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:
Page 2 of 19 Pages
a. the administration of a Colorado Department of Public Health and Environment
(CDPHE) specified informed consent form (sample attached and by this reference made
part hereof as Attachments A and B), or approved equivalent ,
b. a client-centered 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 of test results,
g. making every effort to ensure that all clients who test HIV antibody positive receive
posttest counseling,
h. referring clients who test positive for follow-up medical and counseling services as
appropriate,
i. referring clients who test negative and are engaging in high risk behaviors for follow-up
counseling services as appropriate,
j. ensuring that those positive clients who do not return for results or are lost for follow-up
are referred to the CDPHE;
k. ensuring that all positive clients are referred to CDPHE Disease Control Specialist for
sex and needle-share partner referral.
3. The Contractor understands that this contract amount will be based on client risk.
"High/increased risk" clients have a history since 1978 of one or more of the following:
• injection drug use,
• sex with a person with HIV/AIDS,
• sex with a man who has sex with men,
• sex with an injection drug user,
• an STD,
• exchanging money or drugs for sex.
All other persons would be considered low/no risk;
4. The Contractor shall abide by the current policy regarding the retention of HIV testing records as
outlined in the "Colorado Department of Public Health and Environment 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" (6 CCR-1009-9,
Colorado Board of Health), attached hereto and by this reference made part hereof as
Attachment C and D, respectively.
5. The Contractor may(but is 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 CDPHE as sex/needle-share partners of HIV infected persons or persons who are at
high/increased risk for HIV infection, as described in Part B, paragraph three of this contract,
will not be denied services because of inability to pay.
6. All counselors providing counseling and testing services must have successfully completed the
Page 3 of 19 Pages
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 continuing education course 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 continuing education course.
7. The Contractor shall maintain internal medical and administrative records, including but not
limited to, labslips and counseling session notes, in a manner which ensures confidentiality and
security of those records in accordance with the Rules and Regulations of the Colorado Board of
Health (AttachmentsD)and 25-4-1401, et seq., 7 C.R.S. as amended, attached hereto and made
part hereof as Attachment E.
8. The Contractor shall designate an HIV Counseling and Testing Coordinator and provide the
name of this person 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.
9. All counselors providing counseling and testing must be evaluated annually by the HIV
Coordinator, his/her designee, State staff and/or their designee. This evaluation will include
counselor self-assessments, observation or role-play of a counseling session. The evaluation
tools will be provided by the State.
10. The Contractor agrees to an annual collaborative agency review of counseling sessions to be
conducted by the State. This review can include: observations, chart reviews, and individual
interviews with the HIV Counseling and Testing Coordinator and/or line-staff counselors.
a. If the annual agency evaluation indicates problems in the quality of HIV prevention
counseling services being provided,the Contractor agrees to develop with the State an
agency-centered quality improvement plan. The terms of this plan will be determined at
that time by the Contractor and the State.
b. If the terms of the quality improvement plan are not met within the agreed upon time
period without just cause for the delay provided, the Contractor agrees that the contract
amount may be reduced via a Change Order Letter or this contract may be terminated in
good faith by the State.
11. The Contractor shall fully and legibly complete the HIV 1 Serology lab slip(Attachment F) for
each person tested. 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
Page 4 of 19 Pages
FP 1213
12. The Contractor shall, for each client posttest counseled, fully and legibly complete the
Counseling Follow-up form on the reverse side 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. The State shall provide to the Contractor a
quarterly Testing Site Activity Report within sixty days following the end of the quarter.
13. Additionally, the contractor agrees to the following:
a. Compliance with the standard of cultural competence and proficiency,
b. To effectively and respectfully provide HIV prevention services to people with
disabilities and those who are deaf and hard of hearing,
c. To effectively and respectfully address the diverse needs of the populations we
serve in terms of age, gender, substance abuse, socioeconomic status, sexual
orientation, linguistics, disabilities, and geographic settings including migrant,
seasonal or resort workers.
C. COMPENSATION AND CHANGE PROCEDURES.
1. The State shall, in consideration of the services satisfactorily performed by the Contractor under
this Contract, cause to be paid to the Contractor a sum not to exceed Three Thousand Nine
Hundred Eighty Two Dollars, ($3.982.001 for the initial term of this Contract. Of the total
financial obligation of the State referenced above,Three Thousand Nine Hundred Eighty Two
Dollars are identified as attributable to a funding source of the United States government and,2
dollars are identified as attributable to a funding source of the State of Colorado.
2. The Contractor agrees that the contract amount for testing services will be based on testing
volume at this agency during the previous year and the following budgetary criteria;
a. Pretest counseling for all persons with high/increased risk accepting HIV
antibody testing at the CTS, at twenty-one dollars ($21.00)per client.
b. Pretest counseling for all persons with high/increased risk accepting HIV
antibody testing at the STD clinic at seventeen dollars ($17.00) per client.
c. Posttest counseling for all persons with high/increased risk accepting HIV
antibody testing at the CTS and STD clinic at seven dollars ($7.00) per client.
d. HIV screening sessions for all persons with high/increased risk accepting HIV
antibody testing at the family planning clinic at eleven dollars ($11.00) per
client.
Page 5 of 19 Pages
e. Posttest counseling for all persons testing HIV antibody positive at the family
planning clinic at eighteen dollars($18.00) per client.
f. Second posttest counseling for all persons testing HIV antibody positive at the
CTS, STD clinic, and family planning clinic at twenty-one dollars ($21.00) per
client.
3. The State shall provide free laboratory services for all persons accepting HIV antibody testing
through the CTS and those clients testing through family planning clinics and/or STD who report
having engaged in high/increased risk behavior as described in Part B, paragraph three of this
contract;
4. The State shall provide via facsimile a quarterly statement by the eleventh working day of the
end of the quarter for which reimbursement is to be provided. This quarterly statement will
reflect the number of pretest and posttest counseling sessions by risk for that quarter. In order
to be reimbursed under the terms of this contract,the Contractor shall review and verify
this statement by signature and return it to the State within twenty-one (21) days following
receipt of the statement. Failure to notify the State of any discrepancies or to verify this
statement by signature within 21 days following receipt of the statement will result in a forfeit of
reimbursement eligibility for that quarter.
5. The Contractor will perform an average of twenty eight (28) high/increased HIV tests per
calendar quarter(every 3 mos). If testing volume falls 20% below this average the
Contractor agrees that they may be subject to a corresponding reduction in the contract
amount based on the actual percent reduction in testing.
6. The following budget shall govern the expenditure of funds by the Contractor, as well as
subsequent reimbursement by the State:
a. Reimbursement will be made in four equal payments of Nine Hundred Ninety Five
Dollars and Fifty Cents ($995.50)minus laboratory processing fees described in (b)
below for family planning and STD clients and following receipt of the verified
quarterly statement described in Part C paragraph 4 of this contract.
b. The State shall reduce quarterly reimbursement rates by a rate not to exceed five dollars
($5.00) for each individual testing through the family planning and STD clinic who does
not report having participated in high/increased risk behavior(no/low risk client) as
defined in Part B, paragraph three of this contract. The total amount of the reduction
will be transferred to the State Laboratory to cover the laboratory processing services for
no/low risk clients;
c. The contractor may choose to charge clients as outlined in Part B, paragraph five
of this contract.
7. The State may prospectively increase or decrease the amount payable under this Contract
through a"Change Order Letter", a sample of which is incorporated herein by this reference,
Page 6 of 19 Pages
made a part hereof, and attached hereto as "Attachment G". To be effective, the Change Order
Letter must be: signed by the State and the Contractor; and, approved by the State Controller or
an authorized designee thereof. Additionally, the Change Order Letter shall include the
following information:
A. Identification of this Contract by its contract number and affected paragraph
number(s);
B. The type(s) of service(s) or program(s) increased or decreased and the new level
of each service or program;
C. The amount of the increase or decrease in the level of funding for each service or
program and the new total financial obligation;
D. The intended effective date of the funding change; and,
E. A provision stating that the Change Order Letter shall not be valid until
approved by the State Controller or such assistant as he may designate.
8. Upon proper execution and approval,the Change Order Letter shall become an amendment to
this Contract. Except for the General and Special Provisions of this Contract, the Change Order
Letter shall supersede this Contract in the event of a conflict between the two. It is expressly
understood and agreed to by the parties that the change order letter process may be used only for
increased or decreased levels of funding, corresponding adjustments to service or program
levels, and any related budget line items. Any other changes to this Contract, other than those
authorized by the contract renewal letter process described below, shall be made by a formal
amendment to this Contract executed in accordance with the Fiscal Rules of the State of
Colorado.
9. If the Contractor agrees to and accepts the proposed change,then the Contractor shall execute
and return the Change Order Letter to the State by the date indicated in the Change Order Letter.
If the Contractor does not agree to and accept the proposed change, or fails to timely return the
partially executed Change Order Letter by the date indicated in the Change Order Letter, then the
State may, upon written notice to the Contractor, terminate this Contract twenty(20) calendar
days after the return date indicated in the Change Order Letter has passed. Such written notice
shall specify the effective date of termination of this Contract. In the event of termination under
this clause, the parties shall not be relieved of their respective duties and obligations under this
Contract until the effective date of termination has occurred.
10. Increases or decreases in the level of contractual funding made through this change order letter
process during the initial or renewal terms of this Contract may be made under the following
circumstances:
A. If necessary to fully utilize appropriations of the State of Colorado and/or non-
appropriated federal grant awards;
Page 7 of 19 Pages
B. Adjustments to reflect current year expenditures;
C. Supplemental appropriations, or non-appropriated federal funding changes
resulting in an increase or decrease in the amounts originally budgeted and
available for the purposes of this Contract;
D. Closure of programs and/or termination of related contracts;
E. Delay or difficulty in implementing new programs or services; and,
F. Other special circumstances as deemed appropriate by the State.
Page 8 of 19 Pages
GENERAL PROVISIONS
I. The parties warrant that each possesses actual, legal authority to enter into this Contract.
The parties further warrant that each has taken all actions required by its applicable law,
procedures, rules, or by-laws to exercise that authority, and to lawfully authorize its
undersigned signatory to execute this Contract and bind that party to its terms. The
person or persons signing this Contract, or any attachments or amendments hereto, also
warrant(s)that such person(s) possesses actual, legal authority to execute this Contract,
and any attachments or amendments hereto, on behalf of that party.
2. THE CONTRACTOR SHALL PERFORM ITS DUTIES HEREUNDER AS AN
INDEPENDENT CONTRACTOR AND NOT AS AN EMPLOYEE OF THE
STATE. 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. THE CONTRACTOR SHALL PAY
WHEN DUE ALL REQUIRED EMPLOYMENT TAXES AND INCOME TAX
AND LOCAL HEAD TAX ON ANY MONIES PAID PURSUANT TO THIS
CONTRACT. THE CONTRACTOR ACKNOWLEDGES THAT THE
CONTRACTOR AND ITS EMPLOYEES ARE NOT ENTITLED TO
UNEMPLOYMENT INSURANCE BENEFITS UNLESS THE CONTRACTOR OR
A THIRD PARTY PROVIDES SUCH COVERAGE AND THAT THE STATE
DOES NOT PAY FOR OR OTHERWISE PROVIDE SUCH COVERAGE. THE
CONTRACTOR SHALL HAVE NO AUTHORIZATION,EXPRESS OR
IMPLIED. TO BIND THE STATE TO ANY AGREEMENTS,LIABILITY, OR
UNDERSTANDING EXCEPT AS EXPRESSLY SET FORTH HEREIN. THE
CONTRACTOR SHALL PROVIDE AND KEEP IN FORCE WORKERS'
COMPENSATION(AND SHOW PROOF OF SUCH INSURANCE) AND
UNEMPLOYMENT COMPENSATION INSURANCE IN AMOUNTS REOUIRED
BY LAW.AND SHALL BE SOLELY RESPONSIBLE FOR THE ACTS OF THE
CONTRACTOR,ITS EMPLOYEES AND AGENTS.
3. If this Contract is in the nature of personal/purchased services, then the State reserves the
right to inspect services provided under this Contract at all reasonable times and places
during the term of this Contract. "Services", as used in this clause, includes services
performed or written work performed in the performance of services. If any of the
services do not conform with the terms of this Contract,then the State may require the
Contractor to perform the services again in conformity with the terms of this Contract,
with no additional compensation to the Contractor for the reperformed services. When
defects in the quality or quantity of the services cannot be corrected by reperformance,
then the State may: require the Contractor to take all necessary action(s)to ensure that
the future performance conforms to the terms of the Contract; and, equitably reduce the
payments due to the Contractor under this Contract to reflect the reduced value of the
services performed by the Contractor. These remedies in no way limit the other
Page 9 of 19 Pages
remedies available to the State as set forth in this Contract.
4. If, through any cause attributable to the Contractor's action(s) or inaction(s), the
Contractor: fails to fulfill, in a timely and proper manner, its duties and obligations under
this Contract; or, violates any of the agreements, covenants, provisions, stipulations, or
terms of this Contract, then the State shall thereupon have the right to terminate this
Contract for cause by giving written notice thereof to the Contractor. Such written
notice shall be given at least ten (10) calendar days before the proposed termination date
and shall afford the Contractor the opportunity to cure the default or state why
termination is otherwise inappropriate. If this Contract is terminated for default, then all
finished or unfinished data, documents, drawings, evaluations, hardware, maps, models,
negatives, photographs, reports, software, studies, surveys, or any other material,
medium or information, however constituted,which has been or is to be produced or
prepared by the Contractor under this Contract shall, at the option of the State, become
the property of the State. The Contractor shall be entitled to receive just and equitable
compensation for any services or supplies delivered to, and accepted by, the State. If
applicable, the Contractor shall return any unearned advance payment it received under
this Contract to the State. Notwithstanding the above, the Contractor is not relieved of
liability to the State for any damages sustained by the State because of the Contractor's
breach of this Contract. The State may withhold any payment due to the Contractor
under this Contract to mitigate the State's damages until such time as the exact amount
of the State's damages from the Contractor's breach of this Contract is determined. If,
after terminating this Contract for default, it is determined for any reason that the
Contractor was not in default, or that the Contractor's action or inaction was excusable,
then such termination shall be treated as a termination for convenience, and the rights
and obligations of the parties shall be the same as if this Contract had been terminated
for convenience, as described herein.
5. The State may, when the interests of the State so require, terminate this Contract in
whole or in part, for the convenience of the State. The State shall give written notice of
such termination to the other party specifying the part(s) of the Contract terminated.
Such written notice shall be given to the other party at least thirty(30) calendar days
before the effective date of termination. If this Contract is terminated for convenience,
then all finished or unfinished data, documents, drawings, evaluations, hardware, maps,
models, negatives, photographs, reports, software, studies, surveys, or any other
material, medium or information, however constituted, which has been or is to be
produced or prepared by the Contractor under this Contract shall, at the option of the
State, become the property of the State. The Contractor shall be entitled to receive just
and equitable compensation for any services or supplies delivered to, and accepted by,
the State. If applicable, the Contractor shall return any unearned advance payment it
received under this Contract to the State. This paragraph in no way implies that a party
has breached this Contract by the exercise of this paragraph. If this Contract is
terminated by the State as provided for herein, then the Contractor shall be paid an
Page 10 of 19 Pages
amount equal to the percentage of services actually performed for, or goods actually
delivered to, the State, less any payments already made by the State to the Contractor for
those services or goods.
However, if less than sixty percent(60%) of the services or goods covered by this
Contract have been performed or delivered as of the effective date of termination, then
the Contractor shall also be reimbursed (in addition to the above payment) for that
portion of those actual "out-of-pocket" expenses (not otherwise reimbursed under this
Contract) incurred by the Contractor during the term of this Contract which are directly
attributable to the uncompleted portion of the services, or the undelivered portion of the
goods, covered by this Contract. In no event shall reimbursement under this clause
exceed the total financial obligation of the State to the Contractor under this Contract. If
this Contract is terminated for default because of the Contractor's breach of this
Contract, then the provisions of paragraph 4 above shall apply.
6. If this Contract involves federal funds, or compliance is otherwise federally mandated,
then the Contractor shall comply with the requirements of the following:
A. Office of Management and Budget Circulars A-87, A-21,or A-122, and A-102
or A-I 10, as applicable;
B. the "Hatch Act"(5 U.S.C. 1501-1508) and Public Law 95-454, Section 4728.
These federal statutes declare 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 U.S.C.
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 U.S.C. 6101 et seq, 42 U.S.C. 2000d, 29 U.S.C. 794. These Acts mandate
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;
E. the"Americans with Disabilities Act" (Public Law 101-336; 42 U.S.C. 12101,
12102, 12111 - 12117, 12131 - 12134, 12141 - 12150, 12161 - 12165, 12181 -
12189, 12201 - 12213 and 47 U.S.C. 225 and 47 U.S.C. 611);
F. if the Contractor is acquiring an interest in real property and displacing
households or businesses in the performance of this Contract, then 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); and,
Page II of 19 Pages
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).
H. Section 2101 of the Federal Acquisition Streamlining Act of 1994, Public Law
103-355, which prohibits the use of federal money to lobby the legislative body
of a political subdivision of the State.
7. By signing and submitting this Contract, the Contractor affirmatively avers 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 U.S.C. 701 et
seq.); and,
B. the Contractor hereby certifies that it is not presently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded from
covered transactions by any federal department or agency. The Contractor
agrees to comply with all applicable regulations pursuant to Executive Order
12549, including, Debarment and Suspension and Participants' Responsibilities,
29 C.F.R. 98.510 (1990).
C. the Contractor shall comply with all applicable regulations pursuant to Section
319 of Public Law 101-121, Guidance for New Restrictions on Lobbying,
including, Certification and Disclosure, 29 C.F.R. 93.110 (1990).
8. If this Contract involves the expenditure of federal or state funds, then this Contract is
subject to, and contingent upon, the continued availability of those funds for payment
pursuant to the terms of this Contract. If those funds, or any part thereof, become
unavailable as determined by the State, then the State may immediately terminate this
Contract.
9. To be considered for payment, billings for payments pursuant to this Contract must be
received within a reasonable time after the period for which payment is requested; but in
no event no later than ninety(90)calendar days after the relevant performance period
has passed. Final billings under this Contract must be received by the State within a
reasonable time after the expiration or termination of this Contract; but in no event no
later than ninety (90)calendar days from the effective expiration or termination date of
this Contract.
10. Unless otherwise provided for in this Contract, "Local Match"shall be included on all
billing statements, in the column provided therefor, as required by the funding source.
Page 12 of 19 Pages
11. The Contractor shall not use federal funds to satisfy federal cost sharing and matching
requirements unless approved in writing by the appropriate federal agency.
12. In accordance with Office of Management and Budget (OMB)Circular A-133 (Audits of
States, Local Governments, and Non-Profit Organizations), if the Contractor receives
federal funds from any source, including State pass through money, in an aggregate
amount in excess of $300,000.00 (June 24, 1997), in a State fiscal year(July 1 through
June 30), then the Contractor shall have an annual audit performed by an independent
certified public accountant which meets the requirements of OMB Circular A-133.
If the Contractor is required to submit an annual indirect cost proposal to the State for
review and approval,then the Contractor's auditor shall audit the proposal in accordance
with the requirements of OMB Circulars A-21 (Cost Principles for Educational
Institutions), A-87 (Cost Principles for State, Local and Tribal Governments), or A-122
(Cost Principles for Non-Profit Organizations), whichever is applicable. The Contractor
shall furnish one(1)copy of the audit report(s)to the State's Accounting Office within
thirty(30)calendar days of issuance; but in no event later than nine (9) months after the
end of the Contractor's fiscal year. If(an) instance(s)of noncompliance with federal
laws and regulations occurs, then the Contractor shall take all appropriate corrective
action(s)within six(6) months of the issuance of(a) report(s). The Contractor shall
grant the State, or its authorized agents, access to the Contractor's relevant records and
financial statements. The Contractor shall retain all such records and financial
statements for a period of three (3)years after the date of issuance of a final audit report.
This requirement is in addition to any other audit requirements contained in other
paragraphs of this Contract.
13. Unless otherwise provided for in this Contract, for all contracts with terms longer than
three(3) months, the Contractor shall submit a written progress report, if required by this
Contract, specifying the progress made for each activity identified in this Contract.
These progress reports shall be in accordance with the procedures developed and
prescribed by the State. The preparation of progress reports in a timely manner is the
responsibility of the Contractor. If the Contractor fails to comply with this provision,
then such failure: may result in a delay of payment of funds; or, termination of this
Contract. Progress reports shall be submitted to the State no later than the end of each
calendar quarter, or at such other time as may otherwise be specified.
14. The Contractor shall maintain a complete file of all records, documents,
communications, and other materials which pertain to this Contract. Such materials
shall be sufficient to properly reflect all direct and indirect costs of labor, materials,
equipment, supplies, and services, and other costs of whatever nature for which a
contract payment was made. These records shall be maintained according to generally
accepted accounting principles and shall be easily separable from other records of the
Contractor. Copies of all such records, documents, communications, and other materials
shall be the property of the State and shall be maintained by the Contractor, in a central
location as custodian for the State, on behalf of the State, for a period of three(3) years
Page 13 of 19 Pages
from the date of final payment under this Contract, or for such further period as may be
necessary to resolve any pending matters, including, but not limited to, audits performed
by the federal government.
15. The Contractor authorizes the State, or its authorized agents or designees, to perform
audits or make inspections of its records for the purpose of evaluating its performance
under this Contract at any reasonable time during the term of this Contract and for a
period of three (3)years following the termination of this Contract. As such, the
Contractor shall permit the State, any appropriate federal agency or agencies, or any
other duly authorized governmental agent or agency,to monitor all activities conducted
by the Contractor pursuant to the terms of this Contract. Such monitoring may include,
but is not limited to: internal evaluation procedures, examination of program data,
special analyses, on-site checks, formal audit examinations, or any other reasonable
procedures. All monitoring shall be performed by the State in such a manner that it shall
not unduly interfere with the work of the Contractor.
16. If the Contractor obtains access to any records, files, or information of the State in
connection with, or during the performance of, this Contract, then the Contractor shall
keep all such records, files, or information confidential and shall comply with all laws
and regulations concerning the confidentiality of all such records, files, or information to
the same extent as such laws and regulations apply to the State. Any breach of
confidentiality by the Contractor or third party agents of the Contractor shall constitute
good cause for the State to cancel this Contract, without liability to the State. Any State
waiver of an alleged breach of confidentiality by the Contractor, or third party agents of
the Contractor, does not constitute a waiver of any subsequent breach by the Contractor,
or third party agents of the Contractor.
17. Unless otherwise agreed to in this Contract,or in a written amendment executed and
approved pursuant to Fiscal Rules of the State of Colorado, the parties agree that all
material, information, data, computer software, documentation, studies, and evaluations
produced in the performance of this Contract for which the State has made a payment
under this Contract are the sole property of the State.
18. If any copyrightable material is produced under this Contract, then the State, and any
applicable federal funding entity, shall have a paid in full, irrevocable, royalty free, and
non-exclusive license to reproduce, publish, or otherwise use, and authorize others to
use, the copyrightable material for any purpose authorized by the Copyright Law of the
United States as now or hereinafter enacted. Upon the written request of the Contractor
shall provide the State with three (3)copies of all such copyrightable material.
19. If required by the terms and conditions of a federal or state grant, the Contractor shall
obtain the prior approval of the State and all necessary third parties prior to publishing
any materials produced under this Contract. If required by the terms and conditions of a
Page 14 of 19 Pages
federal or state grant, the Contractor shall also credit the State and all necessary third
parties with assisting in the publication of any materials produced under this Contract.
20. Neither the Contractor nor the State shall be liable to the other for any delay in, or failure
of performance of, any covenant or promise contained in this Contract; nor shall any
delay or failure constitute default or give rise to any liability for damages if, and only to
the extent that, such delay or failure is caused by a supervening cause. As used in this
Contract, "supervening cause" is defined to mean: an act of God, fire, explosion, action
of the elements, strike, interruption of transportation, rationing, court action, illegality,
unusually severe weather, war, or any other cause which is beyond the control of the
affected party and which, by the exercise of reasonable diligence, could not have been
prevented by the affected party.
21. It is expressly understood and agreed to between the parties that the enforcement of the
terms and conditions of this Contract, and all rights of action related to such
enforcement, shall be strictly reserved to the State and the named Contractor. Nothing
contained in this Contract shall give or allow any claim or right of action whatsoever to
or by any third person. Nothing contained in this Contract shall be construed as a waiver
of any provision of the Colorado Governmental Immunity Act, section 24-10-101 et seq.,
C.R.S., as amended. It is the express intent of the State and the named Contractor that
any person or entity, other than the State or the named Contractor, receiving services or
benefits under this Contract shall be deemed an incidental beneficiary only.
22. To the extent that this Contract may be executed and performance of the obligations of
the parties may be accomplished within the intent of this Contract, the terms of this
Contract are severable. If any term or provision of this Contract is declared invalid by a
court of competent jurisdiction, or becomes inoperative for any other reason, then such
invalidity or failure shall not affect the validity of any other term or provision of this
Contract.
23. The waiver of a breach of a term or provision of this Contract shall not be construed as a
waiver of a breach of any other term or provision of this Contract or, as a waiver of a
breach of the same term or provision upon subsequent breach.
24. If this Contract is in the nature of personal/purchased services, then, except for accounts
receivable, the rights, duties, and obligations of the Contractor cannot be assigned,
delegated, or otherwise transferred, except with the prior, express, written consent of the
State.
25. Except as otherwise provided for herein, this Contract shall inure to the benefit of, and
be binding upon, the parties hereto and their respective successors and assigns.
Page 15 of 19 Pages
26. Unless otherwise provided for in this Contract, the Contractor shall notify the State,
within five (5)working days after being served with a summons, complaint, or other
pleading in a case which involves any services provided under this Contract and which
has been filed in any federal or state court or administrative agency. The Contractor shall
immediately deliver copies of any such documents to the State.
27. This Contract is subject to such modifications as may be required by changes in
applicable federal or state law, or federal or state implementing rules, regulations, or
procedures of that federal or state law. Any such required modification shall be
automatically incorporated into, and be made a part of, this Contract as of the effective
date of such change as if that change was fully set forth herein. Except as provided
above, no modification of this Contract shall be effective unless such modification is
agreed to in writing by both parties in an amendment to this Contract that has been
previously executed and approved in accordance with applicable law.
28. Notwithstanding anything herein to the contrary, the parties understand and agree that all
terms and conditions of this Contract, and the exhibits and attachments hereto,which
may require continued performance or compliance beyond the termination date of this
Contract shall survive such termination date and shall be enforceable as provided herein
in the event of a failure to perform or comply by a party to this Contract.
29. Notwithstanding any other provision of this Contract to the contrary, no term or
condition of this Contract shall be construed or interpreted as a waiver, express or
implied, of any of the immunities, rights, benefits, protections, or other provisions of the
Colorado Governmental Immunity Act(CGIA), section 24-10-101, et seq., C.R.S., as
now or hereafter amended. The parties understand and agree that liability for claims for
injuries to persons or property arising out of the alleged negligence of the State of
Colorado, its departments, institutions, agencies, boards, officials, and employees is
controlled and limited by the provisions of section 24-10-101 et seq., C.R.S., as now or
hereafter amended.
30. The captions and headings used in this Contract are for identification only, and shall be
disregarded in any construction of the terms, provisions, and conditions of this Contract.
31. The parties hereto agree that venue for any action related to this Contract shall be in the
City and County of Denver, Colorado.
32. All attachments to this Contract are incorporated herein by this reference and made a
part hereof as if fully set forth herein. In the event of any conflict or inconsistency
between the terms of this Contract and those of any attachment to this Contract, the
terms and conditions of this Contract shall control.
Page 16 of 19 Pages
33. This Contract is 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 Fiscal
Rules of the State of Colorado.
Page 17 of 19 Pages
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.It'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,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 State contracts or sub-contracts.
During the performance of this contract,the contractor agrees as follows:
(a)The contractor will not discriminate against any employee or applicant for employment because of race,creed,color,national origin,sex,marital status,
religion,ancestry,mental or physical handicap,or age.The contractor will take affirmative action to insure that applicants are employed,and that
employees are treated during employment,without regard to the above mentioned characteristics.Such action shall include,but not be limited to the
following:employment upgrading,demotion,or transfer,recruitment or recruitment advertising;lay-offs or terminations;rates of pay or other forms of
compensation;and selection for training,including apprenticeship.The contractor agrees to post in conspicuous places.available to employees and
applicants for employment,notices to be provided by the contracting officer setting forth provisions of this non-discrimination clause.
(b)The contractor will,in all solicitations or advertisements for employees placed by or on behalf of the contractor,state that all qualified applicants will
receive consideration for employment without regard to race,creed,color,national origin,sex,marital status,religion,ancestry,mental or physical
handicap,or age.
(c)The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or
understanding,notice to be provided by the contracting officer,advising the labor union or workers'representative of the contractor's commitment under the
Executive Order,Equal Opportunity and Affirmative Action,dated April 16, 1975,and of the rules,regulations,and relevant Orders of the Governor.
(d)The contractor and labor unions will furnish all information and reports required by Executive Order,Equal Opportunity and Affirmative Action of
April 16, 1975,and by the rules,regulations and Orders of the Governor,or pursuant thereto,and will permit access to his books,records,and accounts by
the contracting agency and the office of the Governor or his designee for purposes of investigation to ascertain compliance with such rules,regulations and
orders.
(e)A labor organization will not exclude any individual otherwise qualified from full membership rights in such labor organization.or expel any such
individual from membership in such labor organization or discriminate against any of its members in the full enjoyment of work opportunity because of
race,creed,color,sex,national origin,or ancestry.
(0 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.
(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
Form 6-AC-02C(GEN060197)Revised 06/01/97
Page 18 of 19 Pages
•
' in accordance therewith,and such other sanctions as may be imposed and remedies as may be invoked as provided in Executive Order,Equal Opportunity
and Affirmative Action of April 16, 1975,or by rules,regulations,or orders promulgated in accordance therewith,or as otherwise provided by law.
(h) The contractor will include the provisions of paragraphs(a)through(h)in every sub-contract and subcontractor purchase order unless exempted by
rules,regulations,or orders issued pursuant to Executive Order,Equal Opportunity and Affirmative Action of April 16, 1975,so that such provisions will
be binding upon each subcontractor or vendor. The contractor will take such action with respect to any sub-contracting or purchase order as the contracting
agency may direct,as a means of enforcing such provisions,including sanctions for non-compliance;provided,however,that in the event the contractor
becomes involved in,or is threatened with,litigation,with the subcontractor or vendor as a result of such direction by the contracting agency,the contractor
may request the State of Colorado in enter into such litigation to protect the interest of the State of Colorado.
COLORADO LABOR PREFERENCE
6a. Provisions of CRS 8-17-101&102 for preference of Colorado labor are applicable to this contract if public works within the State are undertaken
hereunder and are financed in whole or in part by State funds.
b. When a construction contract for a public project is to be awarded to a bidder,a resident bidder shall be allowed a preference against a non-resident
bidder from a state or foreign country equal to the preference given or required by the state or foreign country in which the non-resident bidder is a resident.
If it is determined by the officer responsible for awarding the bid that compliance with 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. My 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. Pursuant to CRS 24-30-202.4(as amended),the state controller may withhold debts owed to state agencies under the vendor offset intercept system for.
(a)unpaid child support debt of chi Id support arrearages;(b)unpaid balance of tax,accrued interest,or other charges specified in Article 22,Title 39,CRS;
(c)unpaid loans due to the student loan division of the department of higher education;(d)owed amounts required to be paid to the unemployment
compensation fund;and(e) other unpaid debts owing to the state or any agency thereof,the amount of which is found to be owing as a result of final
agency determination or reduced to judgment as certified by the controller.
10. The signatories aver that they are familiar with CRS 18-8-301,et seq.,(Bribery and Corrupt Influences)and CRS 18-8-401,et seq.,(Abuse of Public
Office),and that no violation of such provisions is present.
II. The signatories aver that to their knowledge,no state employee has any personal or beneficial interest whatsoever in the service roperty described
herein. WELD 7PARTMENT
IN WITNESS WHEREOF,the parties hereto have executed this Contract on the day first above written. ��
Y:
Contractor: Weld County Clerk to the Board State of Colorado JOHN S. PICKLE, M.S.E.H.
(Ful Name) ROY ROMER,GOVERNOR DIRECTOR
By � (111!13/991
e
c7c...
Position(Title) Cha T By
846000813.8
Social Security Number cr Federal I.D.Number Department
/�, of PUBLIC HEALTH AND ENV}WONMENT
If Corpiii /Cop.orn, � '!�' }, PROGRAM APPROVAL:,. ,'. L.A.Kole ',Jr.,Fiscal Officer By
APPDe ut : "p Vi fil , APPROVALS STATE CON ROLLER
ply Caleo the
ATTORNEY GENERAL Altar .a�� .*443,1CONTROLLERAR L) . B
By er `
/ rF Martin By B U
gre A•?ik% jstant Attorney S General Clifford W.Hall
Farm 6-AC-02C(GEN060197)Revised 06/0110ate Services Paegit79which is the last of 19 Pages
ATTACHMENT A
What is an HIV test?
This test looks for antibodies to Human Immunodeficiency Virus,the virus that causes
AIDS. Your body makes antibodies to fight HIV,so if the test finds the antibodies, it
means you have the virus. If you are infected you can give HIV to someone else
through sex or sharing needles,or to your baby, even if you look and feel fine.
This test is voluntary. You should understand the good and bad things about testing
before you decide to take the test.
Why you might want to be tested:
• If you have HIV you can get medicine to help you stay healthy.
• If you test positive for the virus,you can learn how to keep from giving it to
your partners.
• If you are pregnant now,or might get pregnant,and you learn that you have
HIV,there is medicine you can take so that your baby probably won't get HIV.
• If you find out you have HIV you can get help to tell past partners; they can get
tested without knowing any information about you.
• If you don't have HIV right now,the counselor can help you make a plan so you
never get it.
• Whether you have HIV or not,you can help your friends and your community
by finding out how to keep the virus from spreading around.
Why you might not want to be tested:
• If you find out you have HIV,it can cause wont'about getting sick,or dying.
• The process of getting tested may be embarrassing or frightening.
• There is a very small risk of medical problems from getting your blood drawn.
• If you test positive,your name is kept at the State Health Department. In some
cases,they can give your name to other people.
HIV Antibody Test Consent Form-COUNSELING AND TESTING SITE OVER
AMiTAONICRCTS
ATTACHMENT A
Confidentiality & Privacy:
If you test positive,your records are kept at this test site and at the State Health
Department. Your name and test result can be given out in some situations:
• When a public safety worker,emergency medical service provider,staff member
of a detention facility,health care provider, or a custodial employee of the
department of corrections or department of institutions has been exposed to your
blood or other bodily fluids,your name and test result can be given to these
people and their doctors.
• If the director of the state or local health department has good information that
you are a danger to the public healthy,he can require you to get counseling so
you won't infect other people. If you continue to do things that can pass HIV to
other people,he can issue court orders for evaluation and more counseling,and
eventually,can order you taken into custody.
• Your test result can be released to a medical worker in order to protect your own
life or health,if you have a medical emergency
• The law may change in the fixture,allowing your name to be released in other
circumstances.
Some places in Colorado can test you for HIV without using your name. If you are
worried about giving your name, ask the counselor if this site offers testing without
names. If it does not,you can ask the counselor for a list of places that do offer er testing
without having to give your name. Ask for more information on things you have
questions about. After all your questions are answered,if you want to have the HIV
antibody test please sign your name below.
I have read this page and have had a chance to have my questions answered. I
understand the information on this form and give my consent to have my blood
drawn and tested for the HIV antibody.
Signature or Unique Identifier&Date
Unique Identifier: 1ST&3RD Isttsr of nester i maiden numb 1ST&lest letter of father's
first nrns.t ST utter of Went fast none.lenient r of cliental none. fer of birth&tea
•
HMI Antibody Test Consent Form-COUNSELING AND TESTING SITE
AMTIACHNOIC S
ATTACHMENT B
What is an HIV test?
This test looks for antibodies to Human Immunodeficiency Virus,the virus that causes
AIDS. Your body makes antibodies to fight.WV,so if the test finds the antibodies,it
means you have the virus. If you are infected you can give HIV to someone else
through sex or sharing needles,or to your baby,even if you look and feel fine.
This test is voluntary. You should understand the good and bad things about testing
before you decide to take the test.
Why you might want to be tested:
• If you have HIV you can get medicine to help you stay healthy.
• If you test positive for the virus,you can leant how to keep from giving it to
your partners.
• If you are pregnant now,or might get pregnant,and you learn that you have
HIV,there is medicine you can take so that your baby probably won't get HIV.
• If you find out you have HIV you can get help to tell past partners; they can get
tested without knowing any information about you.
• If you don't have HIV right now,the counselor can help you make a plan so you
never get it.
• Whether you have HIV or not,you can help your friends and your community
by finding out how to keep the virus from spreading around.
Why you might not want to be tested:
• If you find out you have HIV,it can cause worry about getting sick,or dying.
• The pnxess of getting tested may be embarrassing or frightening.
• There i.s a very small risk of medical problems from getting your blood drawn.
• If you test positive,your name is kept at the,State Health Department. In some
cases,they can give your name to other people.
HIV Antibody Test Consent Form-ONGOING CARE SITE OVER
kMRAOa1Qa0O
ATTACHMENT B
Confidentiality & Privacy:
If you test positive,your records are kept at this test site and at the State Health
Department. Your name and test result can be given out in some situations:
• Your HIV test and results are part of your medical record at this office. Your
test and result could be released as part of a legal action involving your medical
records.
• When.a public safety worker,emergency medical service provider,staff member
of a detention facility,health care provider,or a custodial employee of the
department of corrections or department of institutions has been exposed to your
blood or other bodily fluids,your name and test result can be given to these
people and their doctors.
• If the director of the state or local health department has good information that
you are a danger to the public health,he can require you to get counseling so
you won't infect other people. If you continue to do things that can pass•HIV to
other people,he can issue court orders for evaluation and more counseling, and
eventually,can order you taken into custody.
• Your test result can be released to a medical worker in order to protect your own
life or health, if you have a medical emergency
• The law may change in the future,allowing your name to be released in other
circumstances.
Some places in Colorado can test you for HIV without using your name. Ifyou are
worried about giving your name, ask.the counselor if this site offers testing without
names. If it does not,you can ask the counselor for a list of places that do offer testing
without having to give your name. Ask for more information on things you have
questions about. After all your questions are answered,if you want to have the HIV
antibody test please sign your name below:
I have read this page and have had a chance to have my questions answered. I
understand the information on this form and give my consent to have my blood
drawn and tested for the HIV antibody.
Signature& Date
HIV Antibody Test Consent Form-ONGOING CARE SITE
wwTAONIO400
ATTACHMENT C
Colorado Department of Public Health and Environment
Retention of HIV Negative and Positive Tests Results
Revised May 17, 1995
•
Because of public discussion about the Colorado Department of Public Health and
Environment (CDPHE) 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 H. Part III 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. Part
III was revised as of May 17, .1995, to reflect a Colorado Board of Health review of the policy in
effect since May 1, 1993.
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 CDPHE and the test site, i.e., counseling and
testing site(CTS), tuberculosis clinic, STD clinic; drug treatment center, family
planning clinic, etc.
B. NW 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 NW positive tests. Records
resulting from compliance with CRS 25-4-1405(1) ["it is the duty of state and local
health officers to investigate sources of NW 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 NW
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 HN 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
ia.Rdoosteoh.954,ar.mrx 1
ATTACHMENT C
states that the results will be kept in locked files at the CDPHE and the test site.
Greater than 100,000 confidential tests have been conducted in the past 6 3/4
years.
D. The CDPHE 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
Management) 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.
fizamplm:
1. If an infected person hes a prior negative HIV test: A person is found to be
!:M$ocs b e.ss mmem.rm 2
ATTACHMENT C
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,peke up to 6 months to seroeonvert 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.
In this example, it would not be necessary to notify partners prior to February 28,
1991.
2. If a Danner has a negative NW 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 sate 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 HIV epidemic and
for evaluating use of publicly-funded test sites. Such analyses are performed
throughout the United States.
M. Revised CDPHE Policy Concerning HIV Negative Tests
A. Computer and hard copies of HIV negative test records with patient names and risk
factors held by the CDPHE, with a blood collection date more than two years old
have been destroyed by purging and supervised shredding, respectively.
B. CDPHE computer files of HN negative test records, dated more than 120 days
after the blood specimen was collected, 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
IAwpdoaWokssrc meedld 3
ATTACHMENT C
Attachment A for detailed data items.
C. On an ongoing basis the computer file of the H1V negative test held by the
CDPHE 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 CDPHE has reviewed the test report for quality assurance of data entry. This
process Will take no longer than 120 days after the blood specimen is collected.
Hard copies will be shredded at that time.
D. The CDPHE requires that its Confidential Counseling and Testing Site (CTS)
contractors, i.e., local health department CTS which provide only HIV counseling
and testing services, develop and adhere to an HIV record retention policy. This
policy must be adopted by the local board of health with the opportunity for public
comment and input through an open public forum conducted at least every two
years. Other mechanisms for input into the record retention policy and the need for
art anonymous testing option in that area must'be available in addition to the public
forum, including anonymous testimony in writing or through an organization. The
CDPHE recommends, but does not require, that local health departments adopt the
CDPHE HIV record retention policy. Any alternative policy must address the
following areas: 1) linkage of personal identifiers, behavioral risk information and
results; time frames, if any for delinkage, (The CDPHE strongly encourages that
any alternative record retention policy include the delinking of personal identifying
information from risk information 120 days from the date of testing.), 2) the
availability of anonymous testing, 3) time frames for destruction of records, 4)
method and supervision for destruction of records, 5) approval of record retention
policy by the Colorado State Archivist, 6) procedures for hard (paper) records and
electronic (computer) records, 7)procedures for records of negative results and
positive results and 8) inclusion of record retention information in the client
consent form.
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 CDPHE will follow the procedures of III A-C, but will not
require the contracting clinic to follow these procedures.
E. The CDPHE revised consent forms advise clients of both contracted CTS and sites
providing ongoing medical care of how HIV negative test records will be handled.
If a CTS chooses to adopt an alternative record retention policy, the consent form
must include information on how records are retained both at the site and at
CDPHE. Alternative consent forms must be approved by CDPHE.
If negative, the Cfl client will be informed that:
1. the test results become part of the record kept by the CTS and how
I:\vpion\eos9Aradienfd 4
ATTACHMENT C
those records are retained;
2. test results held by the CDPHE:
a. the identifying information will be linked to risk factor
information for no more than 120 days after the blood
specimen collection date;
b. the risk factor and test result information will be used for
statistical purposes without the identifying information
provided by the client; and
c. records consisting of the client's identifying information
and test results will be kept by the CDPHE for two years.
• If negative, the client of a contracted site providing ongoing care :
1. the test becomes part of the medical record kept by the clinic,
protected by medical record laws;
2. for test records held by the CDPHE:
a. the identifying information will be linked to risk factor
information for no more than 120 days after the blood
specimen collection date;
b. the risk factor and test result information will be used for
statistical purposes without the identifying information
provided by the client; and
c. records consisting of the client's identifying information
and test results will be kept by the CDPHE for two years.
Consent forms must 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.
IV. CDPHE Policy Concerning HIV Positive Tests
A. HIV positive test records held by the CDPHE will not be delinked and will be
retained indefinitely. Local health department CTS which provide only HIV
counseling and testing services must develop and adhere to a HIV record retention
policy. See III D above.
B. HIV positive test records held by CDPHE contracted tuberculosis, STD, drug.
la pdocAbeh.ssiameetml 5
ATTACHMENT C
treatment facilities, and other facilities which provide ongoing medical care are
protected by medical laws.
C. The CDPHE revised consent forms advise both contracted CTS and sites providing
ongoing care of how positive test records will be handled. If a CTS chooses to
adopt an alternative record retention policy, the consent form must include
information on how tecords are retained both at the site and at CDPHE.
Alternative consent forms must be approved by CDPHE.
lA.pmnwm rAwm.mer 6
•
ATTACHMENT C
Attachment
Data Items Collected on the HIV I Serology Lab Slip
Items retained for specimens with negative results;items retained in each database are indicated by an x. All
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 I
I:\rpeocs boh.9Sm&nee 7
ATTACHMENT C
Data Items Name File Risk File
Patient Hx Since '78 all items x
• Patient Sex Exposure Since '78 all items x
Referral to Specific Agency x x J
Posttest Provider Code x x
Posttest ID Number x
Posttest Counselor Initials x
.r
Date of Posttest Counseling x x
Referred to CDH, Date Referred x x
Data item in shaded area no longer collected (effective 4/8/921.
in five-year aggregate
•
•
LA.poueae.asme al 8
ATTACHMENT D
6 CCR-1009-9 effective 6/30/97
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 Colorado Department of Public
Health and Environment (CDPHE) 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 who provide HIV
counseling and testing through a contractual agreement with the CDPHE must
consider the need for an anonymous HIV testing option in their jurisdiction. The
consideration of this option must provide an opportunity for public comment in a
public forum at a minimum of every two years. Other mechanisms for input into the
need for an anonymous testing option in that jurisdiction must be available in addition
to the public forum, including anonymous testimony in writing or through an
organization. Local Boards of Health must document the following: notification of
interested parties and the public, time allowed between notification and the public
forum, accessibility in both location and time of the public forum, and the response to
public comment in the decision process. Local boards of health electing to provide
confidential HIV testing with an anonymous option must do so in conjunction with
counseling and testing sites (CTS); i.e., CDPHE designated sites which screen
individuals for HIV infection without providing on-going health care. This will be
done through a contractual agreement with the CDPHE. Local boards of health may
elect, at the time of contract renewal, to provide confidential testing with an
anonymous option.
Hung 1
ATTACHMENT D
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 CDPHE 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. When hospitals and laboratories transmit disns. reports electronically
using systems and protocols developed by the department that ensure protection of
confidentiality, such reporting is acceptable and is considered good faith reporting.
All cases are to be reported with the patient's name, date of birth, sex, address
(including city and county), name and address .of the reporting physician or agency;
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 reporting 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 clinical 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 diseac ;
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.
.A4RACM1pWiRMI 2
•
• ATTACHMENT D
Regulation 2. Reporting by Laboratories
Laboratories shall report every test result that is diagnostic of or highly
correlated with or indicates HIV infection. The report shall include the name, date of
birth, sex and address of the individual from whom the specimen was submitted.
Such test results shall be reported by all in-state laboratories and by out-of-state
laboratories that maintain an office or collection facility in Colorado or arrange for
collection of specimens in Colorado. Results must be reported by the laboratory
which performs the test, but an in-state laboratory which sends specimens to an out-
of-state referral laboratory is also responsible for reporting the results. The
laboratory shall also report the name and address of the attending physician and any
other person or agency referring such specimen for testing.
When associated with other clinical or laboratory evidence of HIV infection,
the Board of Health defines a.CD4 test result of either CD4 count <500 mm3 or
CD4% <29% as a primary immunologic measure indicating severe HIV infection
and, when the count is <200 mm3, as defining AIDS. Laboratories shall report CD4
counts <500 mm3 OR CD4% <29%. 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 HIV infection.
Laboratories may fulfill the requirement to report CD4 counts <500 mm3 or
CD4%<29% by allowing authorized personnel of the Department of Public Health
and Environment 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
AMTTACINOMM RMI 3
ATTACHMENT D
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. 254-1404 (1)(B), 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 CDPHE 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.
Regulation 5. Investigations To Confirm The Diagnosis And Source Of HIV
Infection And To Prevent HIV Transmission
It is the duty of state and local health officers to conduct investigations to confirm
the diagnosis and sources of HIV infection and to prevent transmission of HIV. Such
investigations shall be considered official duties of the health department or health •
agency. Such investigations may include, but are not limited to:
1. 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;
AMnACM.aaas, 4
ATTACHMENT D
2. 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. Ir.iriirlg
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 CDPHE 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 CDPHE STD/AIDS Program.
3. All persons performing partner notification interviews will have
completed courses concerning introduction to sexually transmitted
liicease interviewing and partner notification, as specified by the
CDPHE.
B. j tification of Results
1. Of all HIV tests performed at a CTS, 90% of those persons 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. honer Notification
If CDPHE 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
MATTA[IAKIIIM 1IS 5
ATTACHMENT D
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 (CDPHE 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 CDPHE
through use of a CDPHE specified form.
A Semis 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 CDPHE
specified form. Documentation of investigation outcomes will
include disposition codes as specified by the CDPHE, dates and
location of counseling, and dates and location of testing (if done).
Regulation 7. Operational Standards
A. c_41
J. 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
AUTTACINCHMR.lI 6
ATTACHMENT D
results, b) explain the significance of both positive and negative test
results, c) discuss and/or modify the'risk-redaction plan, d) refer
clients who test positive for follow-up medical and counseling
services.
B. CQltsent Form
1. A consent form specified by the CDPHE or an approved equivalent
must be used at all CTS.
C. j Ling 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. Losfidentiality and Record Maintenance
1:Contracting agencies must have and adhere to an HIV record
retention policy. Any record retention policy must be adopted by
the local board of health with the opporttmity for public comment
and input through an open public forum conducted at least every
two years. Other mechanisms for input into the record retention
policy must be available in addition to the public forum, including
AMITACMWIRfLM 7
•
ATTACHMENT D
anonymous testimony in writing or through an organization.
Any policy must address the following areas:
a) linkage of personal identifiers, behavioral risk information
and results; time frames, if any for deliakage, (The CDPHE
encourages that any record retention policy include the
delinking of identifying information from risk information
120 days from the date of testing.),
b) the availability of anonymous testing,
c) time frames for destruction of records,
d) method and supervision for destruction of records,
e) approval of record retention policy by the Colorado State
Archivist,
f) procedures for bard (paper) records and electronic
(computer) records,
g) procedures for records of negative results and positive
results
h) inclusion of record retention information in the client consent
form
2. Per C.R.S. 254-1404.5 (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 CDPHE on the
posttest reimbursement form submitted to the CDPHE within 30
days of the date the blood specimen was collected.
Regulation 8. Evaluation Standards and Penalties
A. Each CTS's compliance with these standards will be evaluated by the
oilowina:
1. A•semi-annual analysis by the CDPHE 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 the
CDPHE staff. This on-site observation will include observation of
counselors at each CTS performing HIV pre H pre and posttest prevention
MAlTACMIPOHMLO! 8
ATTACHMENT D
and risk-reduction counseling.
3. A semi-annual analysis of testing trends (anonymous vs.
confidential) conducted by CDPHE staff.
4. A semi-annual review of counseling and partner notification forms
for completion and accuracy conducted by CDPHE staff.
5. A minimum of one annual audit of charts for all contracting
agencies, conducted by CDPHE staff.
6. Accuracy and completion of the posttest counseling reimbursement
form submitted to the CDPHE.
B. allure 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 CDPHE 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.
•
Nun ... 9
•
•
ATTACHMENT E
•
PART 14
HIV INFECTION AND ACQUIRED
IMMUNE DEFICIENCY SYNDROME •
Law mien For a niaat,-Liability Without Fault and the Amy Plague Compel a Net,
Appends to Cases ofrtaas[mioa-Tewasi{led Dime-,see 61 U.Cola L Rev.t 1(1990):for
anide,"Fatpleytes.Privacy Rig6aabtAIL1$'ae"19 Cob.Law.1:39(1990).
25-4-1401. Legislative tied}radon.The general assembly hereby declare
that infection with human irmnunodefteiemcy virus, the virus which auies
etotiltiralimtnune deftcienry,;yadrome (AIDS), referred to in this pan 14
as." ", is an infectious nd mmmuniable disease that endangers the
• population of this state.The if assembly.further declares that reporting
• of:HTV infection to public hetllth officials is casual to amble a better under-
• standing of the disease,the scope of exposure,the impact on the community,
and the means of control; that effbrts to control the disease should include •
public education, counseling.and voluntary testing that restrictive enforce.
meat measures should be-used ly.when =tsar/ to protect the public
health;and that having AIDS or the HIV infection, being presumed to have
the HIV infection,or seeking testing for the presence of such infection should
not serve as the basis for discriminatory actions or the prevention of access
to services. The general assembly further declares that the purpose of this
part 14 is to protect the public health and prevent the spread of said disease.
• Sate:Entireseetion amended L 90,p.,1309,§ 1,effective May 24.
25.4-1402. Reports of HIV infection. (1) •Every attending physician in
this state shall make a report to the state or local department of health, in
• a form and within a time period designated by the state department of health,
on every individual known by said physician to have a diagnosis of AIDS, • .
• HIV-sated illness,or HIV infeelion,including death'from HIV infection.
12) Alt other persons u—ii-g a.ease of HIV infection in hospitals,dine
saltitsriuirss, penal blatant,trod other private or public institutions shall
make a report to the an or;Wad department of health;in a form and within
• atilt period designated by the state department of health, on every indi
• ibis"! laving a.diagnosis.of AIDS.!WV-related illness, or HIV infection •
m1' eluding death f om.HlV infeexi t . . • .
(3) ' Repeated,L 90,p. 1314,§ 10,effective May 24.'1990.
(4) The reports required to be made under the provisions of subsections :
(I) and (2) of this section shall contain the name, date of birth, sets, and
address of the individual reported on and the name and address of the physi-
cian or other person making the report
(5) Good faith reporting or disclosure pursuant to this section or section
2:.-1403 shall not constitute libel or slander or a violation of the right of
privacy or privileged communication.
(6) Any person who in good faith complies completely with this part 14
shall be immune from civil and criminal liability for any action taken in
compliance with the provisions of this part 14. Compliance by a physician
with the reporting requirements of this part 14 and with any regulations
promulgated by the state department of health relating thereto shall fulfill
any duty of such physician to a third party. •
.
• Source: L 87,p. 1130;§ 1.
25.4-1403. Reports of positive HIV tests. All laboratories or persons per-
• forming laboratory tests for HIV shall report to the state department of health
or appropriate local department of health,in a form and within a time period
designated by the state department of health, the name, date of birth, sex.
and address of any individual whose specimen submitted for,examination
tests positive for HIV as defined by the state board of health. Such report
shall include the test results and the name and address of the attending physi-
cian and any other person or agency referring such positive specimen for
•
testing. .
•
Source:Entire section amended,L 90,p. 1310,§ 3,effective May 24. .
•
25.4-1404. Use of reports. (1a The Pubes health reports required to be
_ submtted by sections 25-4-1402 ad 2.5.4-1403 and records insulting from
compliance with section 25.4-1405(1)oft held by.the state or.loal•depan-
ro mat of health or any health are or facility, third-party payor,
physician, clinic, )sbontay, blood be*, other agency.shall be strictly
.�a shall not be released,shared with
any or institution,,or tradaSkt., 'aeon subpoena, search warrant,
•
. disczvcry peneeeduamor'otherwise;except under any of the following car.
eu P
(a) information for statistic!' purposes in
(a) Release maybe to of elate-ide ntifiei . •
a manner such that coo istma a of to the extent necessary
( ) Release may bend of i4 and related rnla and regulations
concerning o ra ie the provisions a� me of KW infection by
the tratmeat,
public health,officials. nd in
(c) Release may be monde of such informer to media a l to a studiedemagency to the pieta necessary protect or life
of the namedzfficerParty- of the teal or state department of health may
ak report-e officer of child abuse to spades responside ee for receiving or invest-
make a ofchild abuse
Sabi reports in accordance with the applicable
provisices of the"Ould Mt Of 19$7"set forth in pat 3 of article
3 of title 19.C.RS.'However,3a liee event a report is made, only the follow-
•
ing information shall by included in the m
(I) The name,address,and SiOrder
irspotssnitic for the child:
(II) The name askadthens ape
(U1). The tame and addles el. _an is ally to be responsible
for thestapedgpl abuse ta is
(iv);.Thegeneral.Penn elf Want-
(2) No officer or employee oftke state or.local department of health shall
be examined in any judic al, eateatthe. legislative.or other proceeding as
" to the existence or centwpdt of any.individnare Mon retained by-such depart
• meat putauant to this pan 14•a so to the existence of the contents of reports
received pursuant to sections 2544-IC and 25-4-1403 or the results of inves-
tigations in section 25.4.1405.nit'provision shall not may.to individuals .
who are under restrictive amino MUM=to section 25-4.1406 or 25-4-1407.
•
(3) Information AIDS end;HIV.iafeetion in medical records
held by a facility that tagging Madill are is considered medical
information, not pvbi a health'teak and Is Protec eel from unauthorized
v.i_ 10;1-412;C,R.S.
disclosure as provided in saxasa,
seen=(1)amended and(3) L 90, p.1310, §4,effective May 24;
(1)(d)added,L 93,P. 1610,14,elTeCtive June 6.-_ . .
(7) (a) Whcn investigating tiiv mtectton, state aria local neactn aepan- ,
' . • merits, within their iopc6cive jurisdictions, may inspect and have access to i
- ' medical and laboratory records relevant to the investigation of HIV infection. ,
(b) (I) Notwithstanding the provisions of paragraph(a)of this subsection •
.(7), any medical or laboratory records on enrolled research.subjects of.an _ . •.. .
approved research protocol and held by the researcher, as defined in section . •
25-4-1402.5. shall not be subject to review and inspection by state or local
health departments. This.paragraph (b) does not restrict review and inspec- •
don by state or local health departments of medical or laboratory records.
. of enrolled research subjects held by the researcher when investigating condi-
tions or diseases that are not exempt under section 25-4-1402.5(1).
(II) This paragraph(b)is repealed,effective July 1, I994. .
(7.5) (a) When,a public safety worker. emergency medial serviep pro-
viler, orstaff member of a deteiulon thality has been exposed to blood • •
or other bodily fluid which there is a reason to believe may be infectious
• with HIT state and local Slab departments within their respective jurlsdww
;ions may assist in evaluation and treatment of any involved persons by:
ti) AA xessing information'on tbetine dent and any persons involved to .
determine whether a potential eipesure to HIV occurred; •
(II) Examining testing such involved persons to determine HIV info •
-
Lion when the ha of as exposure Las been established by the state or local
health department : • •
(III)• Cotamuniating relevant information and laboratory test results on
the involved persons to such persons'attending physicians or directly to the
• involved persons if the confidentiality of such information and test results •
is acknowledged by the recipients and adequately protected, as determined
by the state or local health department;and
(IV) Providing eounsefmg to the involved persons on the potential health
risks and treatment resulting from aposttre • : . .
(b) The employer of an exposed person shall ensure that relevant infor-
'nation and laboratory let msttbs on the invoked person are kept confiden •
-
tial Stull infuriation and laboratory' results are considered medical
information and protected from noiaathorized disclosure. .
•
(8) (a) No physician, health worker, or other person and no hospital. • .
• clinic,sudsier;laboratory,or other private or public institution shall test,
or shall cause by any means io•have iested.'any specimen of any patient
.for HIV iafeaiaa without the knowledge and consent of the patient;except .
that knowledge and conceit need not begivea. •..; • .
(I) Winn a health are provide• or a custodial employe£ of the
department:of cotrections'or the department of institutions is exposed to
.blood or ocher bodily fluids shit may be infectious with HIV,': . .
(IL`) .When a patient's medical condttioa is such that..knowledge la con- : .
sent cannot be obtained; _ . . ,
(III) -When-the testing is done as•part of Seroprevalence.surveys if all ": •
`.petsonaI identifiers are removed from the specimens prior to the laboatory c.
:testing; -
(IV) When the patient to be tested is sentenced to aid in the custody • . .
. of the department of corrections or is committed to the Colorado mental
.'health institute at Pueblo and confined to the forensic ward or the minimum
or maximum security ward of such institute;
(V) When a person is bound over for trial of a sexual offense as set forth
in section 18-3,415,C.R.S.,and is tested by a health care provider or facility •
other than one which exclusively provides HIV testing and counseling. •
(b) Any patient tested for HIV infection pursuant to this subsection (8)
without his knowledge and consent shall be given notice promptly; person- - •
ally, and confidentially that a test sample was taken and that the results
of such test may be obtained upon his request.
•
Source.IP (3), (5), and (8XaXI) amended. (7.5) added, and (8)(aXV) R
& RE, L 90, pp. 1311, 1312, § § 5. 6, effective May 24; (7) amended, L. •
91, p. 996, §2, effective April 20:(8xaXIV) amended, L 91, p. 1145, § 12, '
effective May 18.' ,
•
•
25-4.1406. Public. health procedures for persons with HIV infection.
(1) Orders directed to individuals with HIV infection or restrictive mea-
sures on individuals with HIV infection, as described in this part 14, shall
be used as the last resort when other measures to protect the public health ,
have failed, including all reasonable efforts, which shall be documented, to
obtain the voluntary cooperation of the Individual who may be subject to
such an order. The orders and measures shall be applied serially with the s.
bait intrusive moan used fiat The burden of proof shall be°A MC state
or local health department to show that specified pounds exist for the issu-
anx of the orders or restrictive measures and that the terrns and Conditions •
imposed are no more restritivilhasineeetaarY to Mote=the public health.
(2) When the esotattive director tithe state department of health or the
director of the in department of heitth,within his tan ective jurisdiction,
knows or has reason to believe,beau*of Medial or epideaiolpgieal infor-
mation,that a person has HIV infection and is a danger to the public health,
he may issue an order to:
(a) Requite a person to be examined and tested to determine whether
he has HIV infection:
(b) Requite a person with HIV infection to report to a qualified physician
a•health worker for counseling on the disease and for information on how
to avoid infecting other;
(c) Direct a person with HIV infection to case and desist from speci-
fied conduct which endangers the health of others,but only if the executive
director or local director has determined that dear and convincing evidence
exists to believe that such person has been ordered to report for'cosmseliag
or e has rea to
de demonCOUllSestrate
by a Which endangers the halt of ahem.
n or health worker and
. continua to damoosttau behavior
(3) If a pawn violates a case and desist order issued putsurnt to para-
graph (e) of subsection (2) of this section and it is shown that the person
is a danger to others,the executive*Mot'of t e state department of health
or the director of the local department of health may enforce the cease and
desist order by imposing such tsstrietions upon the person as are necessary
to prevent the specific midst which endangers the health of others.Restric-
tions may include required pardeipathin in evaluative, therapeutic, and
counseling program, Any resauden sail be in writing;setting forth the
name of the person to be restricted'and the initial period of time, not to
exceed three months,during which the order shall remain effective,the terms
of the restrictions,and such other conditions as may be necessary to protect. •
ter public heath: Restrictions shall be imposed in-the least restrictive man-
rev necessary to protect the public health.The executive director or the direc-
tor issuing an order pursuant to this subsection (3) shall review petitions
for reconsideration from the person affected by the order. Restriction orders
issued by directors of local departments of health shall be submitted for
• review and approval of the executive director of the state department of
health.
Source(2Xc)and(3)amended,L 90,p. 1312,§7,effective May 24.
.'1I
•
• - 25-4-11407. Emergency public health procedures. (I) • When the proce-
dures of section 25-4-1406 have been exhausted or cannot be satisfied as •
a result of threatened criminal behavior and the executive director of the •
state department of health or the director of a local department of health,
within his respective jurisdiction, knows or has reason w believe, because
ofaedical information,that a pass has I$IV infection and that such person
presents an imminent danger to the public health, the executive director or
local director may bring an action in district court, pursuant to rule 65 of
the Colorado rules of civil procedure, to enjoin such person from engaging
in or continuing to enpge in specific conduct which endangers the public
health.The executive director or local direectarshall request the district attor-
ney to file such action in the district court,but,if the district attorney refuses
to act, the executive director or local director may file such action and be
represented by the attorney general. .
(2) Under the cirwtpltances outlined in subsection (I) of this section,
in what'to the,igjunc*n adder,the district court may issue other'Imo-
Prise court orders inclining.bet not. d as order to take such pllson .
into cmtody, for a period not,to pea r e+ ty-two hours, and place him
in a Sdiity datepated or appeoved by S neeeitdve director. A custody -
order issued for the purpose of coensling add testing to determine whether
suet pact has HIV infection wovide for the immediate release from
o soda and from the MOW of Pada Who trams neptive and may Pro"
vide for couneeling or Niter MoPpirm to be imposed as any
Para who teals positive,The Tao ill Subject of the order shall
k given soda of the alder promptly., ,and confidentially stating
the•grounds and provisions of the or er ` tall person that he
hoc a right to cif se rto comply.*lib puck ttLJL. AMA right to be present
at a hating to taon the otdermyl,thpt Ij.May have an attorneystlptar
on his behalf in said hearing. If such palm notheets testing or treatment.
no invasive medical procedures shall be rad an prior toa hearing being •
held pursuant tosubeecuio(9)4if Ibis section-
(3) Any order issued by the district court Pursuant to subsection (2) of
this section shall be subject to review taco= hearing.Notice of the place,
date, and time of the court hearing shad bo!>tivem promptly, personally,and •
confidentially to the puxsoo who is the subject Of the court order.Such hear=
ing shall be conducted by the court no later than forty-eight hours after the
issuance of the order. Such person has a right to be present at the hearing
and may have an attorney appear on his behalf in mid hearing. Upon conclu-
sion of the hearing,the court shall issue appropriate orders affirming,modi- •
fying.or dismissing the order. •
(4) The burden of proof shall be on the state or local department of health
. to show by dear and convincing evidence that pounds exist for the issuance
of any dust order pursuant tsubsection(1)or(2)of this section.
(5) Any hearing conducted by the district court pursuant to subsection
(1)or(2)of this section shall be dosed and confidential,and any transcripts
or records relating thereto shall also be confidential.
(6) Any order entered by the district court pursuant to subsection (1)
or(2) of this section shall impose terms and conditions no more restrieti4e
than necessary to protect the public health.
Source L 87,p. 1135,§ 1.
•
25-4-1408. Rules and regulations. The state board of health may adopt
such rules and regulations as are in its judgment necessary to carry out the
provisions of this part 14.
Source.L 87,p. 1136,§ 1.
CJS See 39A CJS.Health and anima.
•
meat 5 S 3.5.4.48. •
•
25-4-1409. Penalties. (1) Apy attending physician or other.health care
provider required to make a report pint to season 25-4-1402 or any •
laborawry or person required to make a moon.pursuant to section 25.4-4403
s a class 2 petty offense and, upon
who it a fine of not more than three hun-
conviaiion thereof, shall be punished by
d(2) Any physician
or other health care provider, any officer or employee
of the state department or a local department of health,or any person,
or corporation which violates section.25.4-1404 by releasing.or Use wing
public confidential public health reports or by otherwise breach 8
fi-
dentishty requirements of said section is guilty of a'misdemeanor and, upon
conviction thereof;shall be puninbed by a fine of not las than five hundred
donnas, or by imprisonment in the
county nor more than thanfive sixth moatusand Uor more than twenty-four months,
county jail for not less months
• or by both such fiat and imprisonment.
• Son Entire section amended.1-90,p. 1312,§ 8,effective May 24.
•
25-4.1410. Repeal of part.(Repealed)
Repeated,L 90,p. 1314,§ 10,effective May 24, 1990.
•
Y
ever••CoYkady Dept of Public Health and Frnhor°' ATTACHMENT F
_• Pi Box 1Phone . 2.3 Deriver3090 .CO 90217 HIV Serology _
AtBe laboratory and Radiation Semces
um Duress. Phone DATE RECEIVED/SPECIMEN NUMBER
- Address IAB i)bEOfCY: : .
a.
liv 1 . . iBv s
CityCityState 71Pv
_ �.Ebi O.Hlea BsaetNs O
me Date Collected Symptoms of HN ., O Repiiesdly Rana
ea. She Code • Month Day Year IsNWon: OS WESTERN 0 Podtiva O
se O Jan. BLOT: 0 NSW 0
O Feb. 9 Testing History: FAT Re.AT C. 0 kdssedaste r
her ®®'a®i ®ID O March®at: O Nat Dees C.
a Tint O O C April T O Date last: _ / / BANDS: 17 O
— I.3®® ®® OMay ®® 240
®®®® ®® O June t® ID a.If available: 31 0 -
®T®![� CSC ®a' OJuly ® •
e m T41 O
O M Tr;®T® ®i O Aug. ® Results: nie NS RED 51 O
®'®1 ® ®® O Sept. ® Donated Blood, 55 O
me X� X Cr..,it ®® O Oct. it t Plasma or Sperm: t& Be - 66 O
ova TIM® it O Nov. ® I 120 O
ITT CC):si I' '• O Dec. Cs:•® Date last _/ / 160 O
ees
Sex: a ®
m Patient's Name Oa First,OD) Date of Birth
Race/Ethaidty: Age Math Day Year
C White.not Hispanic Jan. .
sm Address '^ Bh& not Hispanic O Feb.
ter C Hispado I' o 7, Mach o, CO.' it 3
C Atlr1/Paciflc Isl. I- i:: April 3:- f. 1
m City State 21p C Am.Indian/AK Native i i May ₹: 7.1- . 3
_ i Other 3. :3 ._. June _3 3 ) 3.
a Patient's Phone al : July ?: . 71
em. . 'Ca— _ Aug. -6, 3: a.
_ -6. S . Sept. -6. 6. 6
MI •Use No. 2 pencil,blue or black ink pen. 7 7 -- Oct. 7 7 7
ma
I.: e: Nov. 3 e e
•Fill ovals completely. ;S B. ._ Dec. I e' 9. 9.
iim •Make no stray m this form.arks on s
elm
Sexual Orientation(Client report regardless of behavior) Store 1978,Patient History of:
— Injected drug use NO YES
me HOMOSEXUAL HETEROSEXUAL BISEXUAL Receiving blood transfusicci/Prorkirds are 1986 NO YES
as Syphilis,Gonorrhea.Qdanydia,Herpes or Hep B NO YES
me Number of differed partners in past 12 months Receiving money or dugs for soc NO YES
mi OoeEnWdul exposure to body fluids 01GW) NO YES
C _ — _ Sexual abuse or auk NO YES
e. 0 1.3 44 7-9 10-19 20+ Suspected Pednatd Section NO YES
a If Yes,is this a child of an HV+woman• NO YES
ma What types of sex do you have?(mark all that apply) Since 1978.Stand Papuan:wi h e(n):
PM Male NO YEs
ter Ore) NP YES Female NO YES
am Vaginal NO YES Person with HEy/AIDS NO YES
- Anal Nb YES Man who has sea with men NO YES
_ injection drug user NO YES
— Other(specify)
PQ1s0n with hemophilia NO YES
a Person paid money or dugs for set NO YES
Did you use a condom the last time you had sex? During pretest counseling,was a
ear NO YE5 specific risk reduction plan developed? NO YES
MI
OM The last time you had unsafe sea,(sex without a condom) During pretest counseling,did the counselor
we were you drunk or high? NO YES make a referral to a specific agency?
aer Are you currently pregnant? NO YES UNK (mark all that apply)
N M None needed at this time v. :. NO YES
PM Local Use Only 1 . STD clinic
: Family Planning
_ : Substance Abuse Treatment
_ .. -. __ - Mental Heakh Provider
_ Behavioral Support
cTT r,.......h r.,..., General Medical Care
PRETEST GUIDE
NOTES : .
1s
? . . ... - !
_-- ;-ccs; has 0uif. .. .--..
y{.$:15'9 col-tali 1:. aa.C.J:-a4; Y.C. I... a.,::. ... . ..,,�'.
t ttG F•.,. -'tit's'rte H1Rr•• JO ?8' :1M+v .4t.s.:.'1:f,^ v Vile.1c:C eBG:'•.
. ... .. . - n .... },... .:.... .mow; .y.. . .: 't.'r -.. •
� ?Gr� ....
,.. .._
:.
.•.:t^. ' SP' Lf^ V1 ''p O�:Li;. 1 ..... J;_�4 '•. f -. .. .. y:Ji:
INTRODUCTION
!•"" •' seH introductionrole.,:`. ;: oue,e - .. . .
,,. • confidentiality;description"What concerns do you have?". ..
_ pur9ose of session 1)assessment of patient risk,2)development of risk reduction plan,and 3)collection
of apdcinren . .
RISK ASSESSMENT' r sc '''', _.--
• reason for testing::: c, _;r :c:':•y,
• assess knowledge of HIV infection psrticulariy transmission
. _ • determine.date of last Unsafe exposure add.need-for retest T ' •
• determine and document clients and client partners'risk(see reverse) -
• recommend testing or deferment of testing based on risk
•
•
RISK REDUCTION
• determine how client is currently avoiding infection;praise positive behaviors .. •
discuss risk reduction options _ _ _ .
• make referrals to services as needed •
- DEVELOP PLAN TO MODIFY BEHAVIOR - —
— 1t -tar_r
IIIIIIIIIIIIIIIIIIIIIiIIIIIIIIIIIIIIIIIIIIIIIII
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ill 6 • 5 °ia
m. 1 i '^°N O3?ltJ33d810N
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~. 5 5 •env 591 ON Lasualr1501 lumpy aAag waned fa04
a0 a
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rn II t L. Mdv ' , palasun°J Isar °d alga ci+. ON '
a • CT) 'a. a wing own;io Map OE umiwi 5u!laaunoo Jsausod&WOW;upped atp pa
Sr,‘ Cal 6 I .gad /-7 Paloall°J alas 3003
• CO , •uer
0 sum Rao worm 917308 OO ra^uaa'1Pn°S&ilia 11aai3 hn&g3 00Eb'£VSUIV/CLLS-3HdcD
MI (.0 :01 NOLRIOd SIRL N 111138 ENV Cf31.O311OJ 3LVO AO SAVO 0£MI-HIM 3131dWOJ
I
ATTACHMENT G
SAMPLE
Date
State Fiscal Year 19-_-_ Contract Routing Number
Change Order Letter No.
In accordance with paragraph_of the contract with routing number and contract ' ,ranee
number -(a;amended by Change Order Letter routing number • . « Renewal
Later routing number _if my),hereinafter mefared to as .. "• ' . . a copy of which is
attached hereto and try this reference made a part hereof)between . of
Public Health.a'.oyjt211g10C and covering 'kh
199_through_ 199_,the parties agree that .•
the eligible services referenced in paragraph_of the • ':: : ', « _
DOLLARS(S )toe new total • • (S_
_J in accordance with the revised work plan attached A"and • - •
budget attached hereto as"Attachment B",both of which are • -'fend incorporated herein by
this mcfckence. The first sentence in paragraph_of the On ••• , modified accordingly.
All other terms or caall.tinns of the Original Contract are . - • '•
This amendment to the Original Contract is intended as of 199__,butinix
event shall it be den •• : ' . . ,. IOW. tate • •ller or such assistant as he
may d ca net e•
Please sign,date,and return all_on ' Order , 19 to the
attention of
andEnvironment
43 i Drive
• .,, 0222-1530
One original of - - • returned to you when fully approved.
State of Colorado:
Fun Roy Romer,Governor
Sig• By:
For the Executive Director
• Colorado Department of Public Health
and Environment
APPROVALS: APPROVALS:
PROGRAM CONTROLLER
By:
L.A.Koleski,•Jr. By.
TO: Dale K. Hall, Chair, Weld County Board of County
itp 41.1 Commissioners
Wi`P C FROM: Cyndy Giauque, Assistant Weld County Attorney
DATE: April 13, 1999
COLORADO
RE: Changes to contract previously approved by the BOCC
Dale:
Attached is a copy of a letter from the CDPHE, Disease Control and Environmental
Epidemiology Division concerning a contract between the CDPHE and the Weld County Health
Department for HIV Counseling and Testing which was approved by the Board on January 13,
1999. After the contract was returned to the State for their signatures, one of the Assistants at the
Attorney General's office determined that certain changes should be made to the contract.
The changes are set forth in the letter, and do not change the basic agreement in the contract.
One paragraph has been moved to another section; a provision that would reduce the contract
amount if testing volume falls 20% below a certain average was deleted from the contract; and a
breakdown of fees for each type of counseling and testing service provided was also deleted,
since the payment is made quarterly for one quarter of the total amount agreed upon and is not
based upon each specific service rendered.
The State has faxed copies of the pages where changes were made, and requires that the pages be
initialed. Since the Board has already approved the contract, and these changes do not
substantially alter the agreement, we did not believe that it was necessary to present the matter to
the Board again. If you would like to initial the relevant pages, we will ensure that the pages are
forwarded to the State so that the program will continue.
If you have any questions or would like to further discuss this matter, do not hesitate to contact
me.
Thanks.
Cyndy
copy: Bruce Barker
l'il-1h 999 V_.:=4 CDPHE 1.°_E ' C. -
RECEIVED ,. : ''°gSTATE OF cOLOFADO
~
Bill Owens,Governor .�"� r
Jane E.Norton,Executive Director kv`- ,�
Dedicated to protecting and improving the health and environment of the people of Colorado ��f._ o��c�'r'-._lei,
4300 Chem Creek Dr.5. Laboratory and Radiation Services Division y,\� �,
Denver,Colorado 80246-153(1 8100 Lowry Blvd. .fsoa
Phone(303)692-2000 Denver CO 80220-6928 _
Located in Glendale,Colorado (303)692-3090 Cdot&Department
hao://www.cdphesrate.co.us of Public Health
and Environment
March 11, 1999
Ms.Judy Nero (970)356-4966
Weld County Health Department
1517 16'"Avenue Court
Greeley CO 80631
Ms.Nero,
On the advice of Assistant Attorney General Richard Pennington,we have made changes to your HIV counseling
and testing contract that should clarify compensation and change procedures under the terms of the contract.
Attached you will find the affected pages(5-8).
Specifically,please note the following changes:
► Projected activity was moved front part C, "Compensation and Change Procedures'(formerly paragraph
C.5)to part B,"Duties and Obligations of the Contractor"(now paragraph B.14).
• The second sentence of former paragraph C.5.which stated If testing volume falls 20% below this average
the Contractor agrees that they may be subject to a corresponding reduction in the contract amount based
on the actual percent reduction in testing"has been removed. However,please be aware that the State is
obligated to fully utilize appropriated federal grants. Therefore,in accordance with paragraph C.5.the
State may alter contractual funding based on performance or activity.
• The breakdown of fees for each type of counseling and testing service provided(formerly paragraph C.2)
was removed from the contract. While this information is used to determine your total contract amour,'., it
is not a consideration in your quarterly reimbursements (e.g.regardless of your activity and site types, you
will be reimbursed one quarter of your contract amount each quarter).
Please review the attached replacement pages at your first opportunity_ if the changes are acceptable,please
acknowledge acceptance in a formal letter,initial each of the page changes,and return the letter and approved
changed pages. If you would like to accelerate the approval process,you may fax your acknowledgment and follow
with the original in the mail. Once we receive your authorization,we can forward your revised contract to the
Attorney General's office for final approval. We would like to have your contract fully executed by April 15 to
prevent delaying your first quarter reimbursement
If you have questions or require further documentation,please do not hesitate to contact us.
Sin rely,
nifix Ro nnder a J rdan
Contract Cooed etor Unit Supervisor,H1V/STD Operations&Development
Disease Conte and Environmental Epidemiology Division Disease Control and Environmental Epidemiology Division
Phone: (303)692-2682 Fax: (303)787-0904 Phone:-(303)692-2709 Fax:(303)782-4904
e-mail:iennifer.snYder@state.co.us e-mail:rebecca.jordan@state.co-us
CC:Ruth West
fli*-12-1 OE:;Si =L'F'HE DCEEL 303732539 P.0/0s
FP 1213
12. The Contractor shall,for each client posttest counseled, fully and legibly complete the
Counseling Follow-up form on the reverse side 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. The State shall provide to the Contractor a
quarterly Testing Site Activity Report within sixty days following the end of the quarter.
13. Additionally,the contractor agrees to the following:
a. Compliance with the standard of cultural competence and proficiency,
b. To effectively and respectfully provide HIV prevention services to people with
disabilities and those who are deaf and hard of hearing,
c. To effectively and respectfully address the diverse needs of the populations we
serve in terms of age,gender,substance abuse,socioeconomic status, sexual
orientation, linguistics,disabilities,and geographic settings including migrant,
seasonal or resort workers.
14. The State has projected that during the term of this Contract the Contractor will perform 112
HIV risk reduction counseling and testing sessions with individuals who report having engaged
in high/increased risk behavior for HIV infection as defined in Part B. 3.of this Contract.The
Contractor is expected to perform an average of 28 of the above described sessions each calendar
quarter.
C. COMPENSATION AND CHANGE PROCEDURES.
1. The State shall, in consideration of those services satisfactorily and timely performed by the
Contractor under this Contract,cause to be paid to the Contractor a sum not to exceed THREE
THOUSAND NINE HUNDRED EIGHTY TWO DOLLARS($3.982.0U1 for the initial term
of this Contract. Of the total financial obligation of the State referenced above,ThreeThousand
Nine Hundred Eighty Two Dollars are identified as attributable to a funding source of the
United States government and,SO State dollars are identified as attributable to a finding source
of the State of Colorado.
1. The State shall provide free laboratory services for all persons accepting HIV antibody testing
through the CTS and those clients testing through family planning clinic who report having
engaged in high/increased risk behavior for HIV infection as described in Part B.3 of this
Contract.
Page 5 of 19
I'liiR-12-1 /o 30.7 -- -
3. The State shall provide to the Contractor via facsimile a quarterly statement by the fifteenth
working day of the end of the quarter for which reimbursement is to he provided_ This quarterly
statement shall reflect the number of test, pretest and posttest counseling sessions by risk for that
quarter. Notwithstanding General Provision 9, in order to be reimbursed under the terms of
this Contract,the Contractor shall review. verify and sign this statement and return it to
the State within twenty-one calendar days following receipt of the statement. Failure to
notify the State of any discrepancies or to verify this statement by signature within this time
period shall result in a forfeit of reimbursement eligibility for that quarter.
4. The following budget shall govern the expenditure of funds by the Contractor, as \:eii as
subsequent reimbursement by the State:
a. Reimbursement shall he made in four equal payments of Nine Hundred Ninet) Five
Dollars and Fifty Cents($995.50)minus laboratory processing fees described in(b)
below for family planning clients and following receipt of the verified quarterly
statement described in Part C. 3 of this Contract.
h. The State shall reduce quarterly reimbursements by a rate not to exceed five dollars:
($5.00)for each individual tested through a family planning clinic who does not report
having participated in high/increased risk behavior(no'low risk client)as defined in Part
B, paragraph three of this contract. The total amount of the reduction will be transferred
to the State Laboratory to pay the fees for laboratory processing services for nohow risk
clients.
5. The State may prospectively increase or decrease the amount payable under this Contract
through a "Change Order Letter",a sample of which is incorporated herein by this reference,
made a part hereof,and attached hereto as"Attachment G". To be effective,the Change Order
Letter must be: signed by the State and the Contractor; and,approved by the State Controller or
an authorized designee thereof. Additionall-., the Change Order Letter shall include the
following information:
A. Identification of this Contract by its contract number and affected paragraph
number(s);
B. The type(s)of service(s)or program(s)increased or decreased and the new level
of each service or program_
C. The amount of the increase or decrease in the level of funding for each service 3r
program and the new total financial obligation;
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MAP-1.L-1999 l'_;- CLF'HE i!CEEL. =u_ 39= F'.04 C9`•
D. The intended effective date of the funding change; and,
E. A provision stating that the Change Order Letter shall not be valid until
approved by the State Controller or such assistant as he may designate.
Upon proper execution and approval, the Change Order Letter shall become an amendment to
this Contract. Except for the General and Special Provisions of this Contract,the Change Order
Letter shall supersede this Contract in the event of a conflict between the two. It is expressly
understood and agreed to by the parties that the change order letter process may be used only for
increased or decreased levels of funding,corresponding adjustments to service or program levels.
and any related budget line items. Any other changes to this Contract,other than those
authorized by the contract renewal letter process described below, shall be made by a formal
amendment to this Contract executed in accordance with the Fiscal Rules of the State of
Colorado.
If the Contractor agrees to and accepts the proposed change,then the Contractor shall execute
and return the Change Order Letter to the State by the date indicated in the Change Order Letter.
If the Contractor does not agree to and accept the proposed change, or fails to timely return the
partially executed Change Order Letter by the date indicated in the Change Order Letter, then the
State may, upon written notice to the Contractor,terminate this Contract twenty (20)calendar
days after the return date indicated in the Chang_ Order Letter has passed. Such written notice
shall specify the effective date at'termination of this Contract. In the event of termination under
this clause,the parties shall not be relieved of their respective duties and obligations under this
Contract until the effective date of termination has occurred.
Increases or decreases in the level of contractual funding made through this change order letter
process during the initial or renewal terms of this Contract may be made under the following
circumstances:
A. If necessary to fully utilize appropriations of the State of Colorado and/or non-
appropriated federal grant awards;
B. Adjustments to reflect current year expenditures;
C Supplemental appropriations,or non-appropriated federal funding changes
resulting in an increase or decrease in the amounts originally budgeted and
available for the purposes of this Contract;
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c�k'
MHR-1-'-1'x+9'? UE `_;_ CL'F'HE ECEEL' 30 77E 25:I91-7, P.05/05
D. Closure of programs and/or termination of related contracts;
E. Delay or difficulty in implementing new programs or services; and,
F. Other special circumstances as deemed appropriate by the State.
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TOTAL P.05
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