HomeMy WebLinkAbout981548 RESOLUTION
RE: APPROVE CONTRACT FOR EARLY AND PERIODIC SCREENING, DIAGNOSIS AND
TREATMENT PROGRAM 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 the Early and Periodic
Screening, Diagnosis and Treatment Program between the County of Weld, State of Colorado,
by and through the Board of County Commissioners of Weld County, on behalf of the Weld
County Health Department, and the Colorado Department of Public Health and Environment,
commencing July 1, 1998, and ending June 30, 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 the Early and Periodic Screening, Diagnosis and
Treatment Program between the County of Weld, State of Colorado, by and through the Board
of County Commissioners of Weld County, on behalf of the Weld County Health Department,
and the Colorado Department of Public Health and Environment be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said contract.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 24th day of August, A.D., 1998, nunc pro tunc July 1, 1998.
BOARD OF COUNTY COMMISSIONERS
WEL COUNTY, COLORADO
ATTEST:
Constance L. ar ert, Chair
;
Weld County Cler „I - //� ,l I r
I ..-O 1' W. H. b er, ro-Te
Deputy Clerk to th71r� e
eorge EBaxter
PR• ED AS O FORM:
Dale K. Hall
county ito -y r— USED
Barbara J. Kirkmeyer
981548
HL0024
112-i 3/aide-
APPROVED WAIVER FORM CONTRACT DEPARTMENT OR AGENCY NAME
Early and Periodic Screening,Diagnostic, COLORADO DEPARTMENT OF
and Treatment Program PUBLIC HEALTH AND ENVIRONMENT
DEPARTMENT OR AGENCY NUMBER
FAA
CONTRACT ROUTING NUMBER
9900604
CONTRACT
THIS CONTRACT is made this 1st day of July, 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,The 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".
WHEREAS,as to the State, authority exists in the Law and Funds have been budgeted, appropriated, and
otherwise made available and a sufficient uncommitted balance thereof remains available for subsequent
encumbering and payment in Fund Number 100,Appropriation Account 653 and Organization Number
6020, under Contract Encumbrance Number EPS9900604;
WHEREAS, Early and Periodic Screening, Diagnostic,and Treatment(EPSDT) services are required
services under the Medicaid program for needy individuals under age 21;
WHEREAS,the State has been awarded federal monies from the Colorado Department of Health Care
Policy and Finance to implement EPSDT administrative case management,outreach,and support services
to eligible EPSDT families;
WHEREAS,these administrative case management, outreach, and support services are to be implemented
by the State through subcontracts with local health agencies;
WHEREAS, as of the effective date of this Contract,the State has a currently valid Group II purchasing
delegation agreement with the Division of Purchasing within the Colorado Department of Personnel;
WHEREAS, Section 29-1-201, 8 C.R.S., as amended, encourages governments to make the most efficient
and effective use of their powers and responsibilities by cooperating and contracting with each other to the
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97/.syx
fullest extent possible to provide any function, service, or facility lawfully authorized to each of the
cooperating or contracting entities, and to this end all State contracts with its political subdivisions are
exempt from the State's personnel rules and the State procurement code;
WHEREAS, it is the express intent of the parties that eligible clients are provided administrative case
management and outreach services under this Contract in a manner that encourages their participation in
the EPSDT Program;
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 other, stated below, the parties
hereto agree as follows:
A. EFFECTIVE DATE AND TERM. The effective date of this Contract is July 1, 1998, or on
such other date as this Contract is approved by the State Controller,whichever is later. The initial
term of this Contract shall commence on July 1, 1998, and continue through and including June
30, 1999, unless sooner terminated pursuant to the terms and conditions of this Contract. •
B. DUTIES AND OBLIGATIONS OF THE CONTRACTOR
1. The Contractor shall perform EPSDT administrative case management, outreach, and
support services as more fully described in"Attachment B",which is incorporated herein
by this reference, made a part hereof, and attached hereto. These services shall be
performed in accordance with any additional guidelines and/or training provided by the
State in Weld County.
2. The Contractor shall provide EPSDT administrative case management services based
upon a projected monthly average of 1,886 eligible clients and shall ensure that these
services are supervised by a registered professional nurse or a state nurse consultant.
3. The Contractor shall ensure that all personnel assigned to perform EPSDT administrative
outreach, and case management are available for all scheduled training,beginning with
initial training,within a reasonable time period after being assigned to perform EPSDT
duties under this Contract.
4. The Contractor shall cooperate with the State to ensure that the program planning,
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evaluation, and monitoring requirements described in Attachment B are met. This
cooperation includes, but is not limited to, participation in mutually agreed upon site
reviews at the Contractor's location and, any other meetings required by the State.
5. The Contractor shall provide services to all program participants and employees in a
smoke-free environment. Smoking may not be permitted in waiting areas,examination
rooms, or formal sessions providing education, therapy, or similar services. Designated
smoking areas may be established for staff, program participants, family members, and
visitors. The service delivery environment shall remain smoke free because the Contractor
prohibits smoking inside county buildings.
6. The Contractor is responsible for maintaining an inventory of all equipment purchased
with State funds. This inventory shall include: serial number(s),type(s)of equipment,
location(s),and any other appropriate identifying information. The Contractor shall
provide the State with a written inventory by June 30. 1999, for the initial term of this
Contract and,on each June 30th thereafter for each renewal term of this Contract.
7. The Contractor shall protect the confidentiality of all applicant/recipient records
and other materials that are maintained pursuant to this Contract. Except for
purposes directly connected with the administration of this Contract, no
information about or obtained from any applicant/recipient, which information is
in the possession of the State, shall be disclosed in a form identifiable with an
applicant/recipient without the prior, express, written consent of that
applicant/recipient or a minor applicant/recipient's parent or guardian or, as may
otherwise be properly ordered by a court of competent jurisdiction. The
Contractor shall have written policies governing access to, and the duplication and
dissemination of, all such information.
8. The Contractor shall meet the EPSDT documentation requirements described in
Attachment B. The Contractor shall submit documentation for those services provided by
the Contractor on a monthly basis. This documentation shall show those services which
have been provided to EPSDT clients by the Contractor. This monthly documentation
shall be submitted on the"Monthly Report form", which is attached hereto as
"Attachment C", which attachment is incorporated herein by this reference and made a
part hereof. The Contractor shall submit an annual, unduplicated total of households and
eligibles receiving EPSDT administrative case management services upon request by the
State.
9. The Contractor shall submit a"Monthly Reimbursement Statement"using the form
attached hereto as"Attachment D", which attachment is incorporated herein by this
reference and made a part hereof.
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10. If requested by the State,the Contractor shall submit an annual summary of the hours
expended by the Contractor's registered professional nurses in the supervision of EPSDT
program activities. The Contractor's required in kind match, if any, shall be as shown on
the budget, "Attachment A", which attachment is incorporated herein by this reference
and made a part hereof.
11. Within sixty(60) calendar days after the end of the initial, or any renewal, term of this
Contract, the Contractor shall submit to the State a document which shows the totals for
all eligible households and clients receiving EPSDT administrative case management,
outreach, or support services.
12. Within sixty(60) calendar days after the end of the initial, or any renewal,term of this
Contract, the Contractor shall submit to the State an actual accounting of its expenditures
for that term of this Contract, in a format substantially similar to the budget, using the
actual expenditures form, "Attachment F",which is incorporated herein by this reference,
made a part hereof, and attached hereto.
C. DUTIES AND OBLIGATIONS OF THE STATE.
In consideration for those services timely and satisfactorily performed by the Contractor
under this Contract, the State shall cause to be paid to the Contractor a sum not to exceed
TWENTY FIVE THOUSAND FOUR HUNDRED AND TWENTY FIVE
DOLLARS,{S25.425.00). Of this total financial obligation of the State to the Contractor
under this Contract,(512.712.501, is derived from a funding source of the United States.
Of this total financial obligation of the State to the Contractor under this Contract,
(512,712.501 is derived from a funding source of the State of Colorado.
2. Payment pursuant to this Contract shall be made as earned, in whole or in part, from
available State funds encumbered in an amount not to exceed TWO MILLION.SEVEN
HUNDRED NINETY-FOUR THOUSAND.NINE HUNDRED SEVENTY
DOLLARS,($2,794.970.001, for the purchase of EPSDT Services. Of this total financial
obligation of the State,($1.397.485.001 is derived from a funding source of the United
States. Of this total financial obligation of the State,($1.397.485.001 is derived from a
funding source of the State of Colorado. It is further understood and agreed that the
maximum amount of funds available for fiscal year 1998-1999 for the purchase of EPSDT
Services is in the amount of(52.794.970.001.
The liability of the State, at any time, for such payments shall be limited to the
unencumbered remaining balance of such funds. If there is a reduction in the total funds
appropriated for the purposes of this Contract,then the State, in its sole discretion, may
proportionately reduce the funding for this Contract or terminate this Contract in its
entirety.
3. Payments shall be made only after the State receives signed,duplicate Monthly
Reimbursement Statements from the Contractor requesting reimbursement in accordance
with the categories and line items of the budget. The budget is set forth in Attachment A.
These Monthly Reimbursement Statements shall also report those amounts expended by
the Contractor from matching funds if such funds have been provided for in the budget.
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An initial supply of the Monthly Reimbursement Statement forms shall be supplied to the
Contractor by the State. Thereafter,the Contractor may request additional forms from the
State.
4. The expenditure of funds by the Contractor under this Contract shall be governed by the
budget. The Contractor shall have the right to move funds from one line item to another,
except that:
A. The equipment line item may not be increased by more than 10%without the
prior express, written consent of the State;
B. Indirect charges must conform to the terms of the budget;
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 E". 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.
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
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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.
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;
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.
6. The State may renew this Contract through a"Contract Renewal 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 Contract Renewal Letter must be: signed by the State and the Contractor;and,
approved by the State Controller or an authorized designee thereof. Additionally,the Contract
Renewal 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), if any, increased or decreased and the new
level of each service or program for the renewal term;
C. The amount of the increase or decrease, if any, in the level of funding for each
service or program and the new total financial obligation;
D. The intended effective date of the renewal; and,
E. A provision stating that the Contract Renewal Letter shall not be valid until approved
by the State Controller or such assistant as he may designate.
Upon proper execution and approval,the Contract Renewal Letter shall become an
amendment to this Contract. Except for the General and Special Provisions of this Contract,
the Contract Renewal 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 contract renewal letter
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process may be used only to: renew this Contract; increase or decrease levels of funding
related to that renewal; make corresponding adjustments to service or program levels, and,
adjust any related budget line items. Any other changes to this Contract, other than those
authorized by the change order letter process described above, 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 renewal term,then the Contractor shall
execute and return the Contract Renewal Letter to the State by the date indicated in the
Contract Renewal Letter. If the Contractor does not agree to and accept the proposed renewal
term, or fails to timely return the partially executed Contract Renewal Letter by the date
indicated in the Contract Renewal 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 Contract Renewal 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.
GENERAL PROVISIONS
1. 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 REOUIRED EMPLOYMENT TAXES AND INCOME TAX ANDI,OCAL
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 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
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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 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. 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-110,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,
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.
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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 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.
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 I 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(I)copy of the audit repo(*)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).
13. The Contractor shall grant to 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 six(6)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.
14. 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.
15. 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 six(6)years 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
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by the federal government.
16. 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.
17. 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.
18. 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.
19. 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.
20. 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
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.
21. Neither the Contractor nor the State shall be liable to the other for any delay in,or failure of performance of,any covenantor 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.
22. 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 ft Sea,,,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.
23. 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.
24. 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.
Page 10 of 14
25. 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.
26. 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.
27. 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.
28. 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.
29. 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 tennination date and shall be enforceable as provided herein in the event of a failure to perform or comply by a party
to this Contract.
30. Notwithstanding any other provision of this Contract to the contrary,no term or condition of this Contract shall be consumed 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, sea.,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 el
seq.,C.R.S.,as now or hereafter amended.
31. 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.
32. The parties hereto agree that venue for any action related to this Contract shall be in the City and County of Denver,Colorado.
33. 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.
34. 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.
E. SPECIAL PROVISIONS
CONTROLLER'S APPROVAL
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.
Page 11 of 14
FUND AVAILABILITY
2. Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds for that purpose being
appropriated,budgeted,and otherwise made available.
BOND REQUIREMENT
3. If this contract involves the payment of more than fifty thousand dollars for the construction,erection,repair,maintenance,or
improvement of any building,road.bridge,viaduct,tunnel,excavation or other public work for this State,the contractor shall,before entering
upon the performance of any such work included in this contract,duly execute and deliver to the State official who will sign the contract,a good
and sufficient bond or other acceptable surety to be approved by said official in a penal sum not less than one-half of the total amount payable by
the terms of this contract. Such bond shall be duly executed by a qualified corporate surety conditioned upon the faithful performance of the
contract and in addition,shall provide that if the contractor or his subcontractors fail to duly pay for any labor,materials,team hire,sustenance,
provisions,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 actor 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 24-34402),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 advertisements;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 roles,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.
(f) A labor organization,or the employees or members thereof will not aid,abet,incite,compel or coerce the doing of any act defined in
Page 12 of 14
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 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 to enter into such litigation to protect the interest of the State
of Colorado.
COLORADO LABOR PREFERENCE
6a. Provisions of CRS 8-17-101&102 for preference of Colorado labor are applicable to this contract if public works within the State are
undertaken hereunder and are financed in whole or in part by State funds.
b. When a construction contract for a public project is to be awarded to a bidder,a resident bidder shall be allowed a preference against a
non-resident bidder from a state or foreign country equal to the preference given or required by the state or foreign country in which the non-
resident bidder is a resident. If it is determined by the officer responsible for awarding the bid that compliance with the subsection.06 may cause
denial of federal funds which would otherwise be available or would otherwise be inconsistent with requirements of Federal law,this subsection
shall be suspended,but only to the extent necessary to prevent denial of the moneys or to eliminate the inconsistency with Federal requirements
(CRS 8-19-101 and 102).
GENERAL
7. The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the interpretation,execution,and
enforcement of this contract. Any provision of this contract whether or not incorporated herein by reference which provides for arbitration by any
extra-judicial body or person or which is otherwise in conflict with said laws,rules,and regulations shall be considered null and void. Nothing
contained in any provision incorporated herein by reference which purports to negate this or any other special provision in whole or in part shall be
valid or enforceable or available in any action at law whether by way of complaint,defense,or otherwise. Any provision rendered null and void by
the operation of this provision will not invalidate the remainder of this contract to the extent that the contract is capable of execution.
8. At all times during the performance of this contract,the Contractor shall strictly adhere to all applicable federal and state laws,rules,
and regulations that have been or may hereafter be established.
9. 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 child 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.
11. The signatories aver that to their knowledge,no state employee has any personal or beneficial interest whatsoever in the service or
property described herein.
Page 13 of 14
IN WITNESS WHEREOF, the parties hereto have executed this Contract on the day first above written.
Contractor: Weld County Board of Commissioners State of Colorado
(Full Legal Name) ROY ROMER,GOVERNOR
By ���ei. fg.'/
Constance L. Harbe
Position (Title) Chair (08/24/98) By
84-6000-813
Social Security Number or Federal I.D.Number Department of
PUBLIC HEALTH AND ENVIRONMENT
If Corporation, Town/City/County, or Equivalent:
PROGRAM APPROVAL: _
Attest(Affix Seal)
r 1 V By WELD CO `►.' LT DEPARTMENT
Cr'iiFlf{#HhC:+'4EFX�rr �'��TM .:��iEy'o�:},. a.fi.r,..` ,, E16llMfg'.C'.Ialt B • , .,i
Deputy Clerk t., JOHN S. PICKLE, M.S.E.H.
DIRECTOR
APPROVALS:
ATTORNEY GENERAL CONTROLLER
By By
• Gale A.Norton Cli d W.W. 1-CfPateCCQ
Page 14 of 14
ATTACHMENT A
APPLICANT: Weld County Health Department
PROJECT: EPSDT
DETAILED BUDGET FOR THE PERIOD: July 1,1998 to June 30,1999
Annual Number Total Source of CDH Funds
DIRECT COST Salary Months %Time Amount Applican Requests EPbUi Refugee Other To!T
Rate Budget Required and Othe from CD CDH CDH
PERSONNEL SERV 1.00
Case Mgr. 21,753 12 100% 21,753 21,753 21,753 21,753
ContractuallFee for Service:
Supervising Personnel:
Nurse 50,077 12 5% 2,504 2,504 0 0 0
Fringe Benefits Rate Incl.Above
Total Personnel Services 24,258 2,504 21,753 21,753 ' 0 0 21,753
OPERATING EXPENSES:
(includes Building/Facility
Cost not part of Indirect)
Operating 400 400 400 400
Subtotal Operating 400 0 400 400 0 0 400
TRAVEL:
800 800 800 800
Subtotal Travel 800 0 800 800 800
EQUIPMENT:
Subtotal Equipment 0 0 0 0 0
Total Direct Costa(Personnel+Operating+Travel+Equip) 25,458 2,504 22,953 22,953 0 0 22,953
Administrative/Indirect Cost-10.77%TDC- _ 2,742 270 2,472 2,472 0 0 2,472
TOTAL YKUJECI LWI 28,200 2,774 25,425 25,425 I 0 6 23,425
Source ofFunding for"Applicant and-Other"
2,774
Total Applicant an $2,774
"This contract will pay the actual approved rate for indirect costs finalized by the Colorado Department
"This contract will pay the actual approved rate for indirect costs finalized by the Colorado Department
of Health and subject to the maximum rates allowed by the Family and Community Health Services
Division,Colorado Department of Health. The finalized rate will be retroactive to the beginning of the contract.
ATTACHMENT B
7/1/98 - 6/30/99
The following definitions and functions are intended to serve as guidelines for contracting agencies to utilize in
meeting their required EPSDT administrative outreach and case management functions.
I. DEFINITIONS
A. At-risk client: The EPSDT-eligible client with identified actual and/or potential health care needs,
which may require outreach and case management efforts more intensive than the non-at-risk
EPSDT-eligible clients. The at-risk or priority clients may include clients in families with no
established linkage to health care and/or assistance with provider selection, newborns and infants
up to age two, teenagers,particularly those newly enrolled in Medicaid, pregnant EPSDT-eligible
clients, refugee children in need of EPSDT administrative and case management services, children
and youth requiring preventive health and corrective treatment services or assistance with referral
services for children with special health care needs,pregnant women eligible for enhanced
prenatal services and clients identified by EPSDT subsystem reports as being in need of follow up
and referral services.
B. Early Childhood Connections for Infants,Toddlers and Families: The statewide,coordinated
system of services made available through the Individual Disabilities Education Act,Infant and
Toddler Section, as governed by the Colorado Department of Education. Services include an
early intervention system of supports and services that are directed at meeting the needs of infants
and toddlers with disabilities and their families.
C. Enrollment Facilitator: A non governmental agency contracted with Colorado Medicaid to enroll
or disenroll Medicaid clients in a managed care plan. The Enrollment Facilitator will also
maintain updated managed care provider information including both prepaid health plan and
PCPP providers.
D. EPSDT outreach and case management:The EPSDT administrative outreach and case
management services provided by the EPSDT Outreach and Case Manager which are
complementary to health care services provided by the Medicaid provider. The services are aimed
at the promotion of health,the prevention of disease and improved access to health care services.
The EPSDT administrative service includes,but may not be limited to: (1)contacting EPSDT-
eligible clients to provide in-depth explanation of the PDSDT Program and its importance in the
medical benefits which are available. (2)offering assistance and information to the EPSDT-
eligible client which will facilitate overcoming barriers which might impede the client's access to
the provision of the EPSDT services;(3)clarifying, if needed, the role of the primary care
provider and, when appropriate, the managed care/prepaid health plan, including Health
Maintenance Organizations,(4)the client's obligation to maintain the linkage between the
child/youth and the primary care physician;(5)maintaining periodic contact,as needed and
feasible, with the EPSDT client to encourage the utilization of EPSDT services needed or
promoted by referrals and assisting with referrals as needed;(6)contacting clients not currently
receiving assistance under the"Colorado Works Act"to inform them of the possibility of
continued eligibility for Medicaid;(7)initiating collaborative activities with other child-related
health and social services agencies and resources within each county and referring EPSDT clients
as needed to those agencies and resources. (8)In selected counties,services provided by the
EPSDT outreach and case manager shall include assistance with the EPSDT and managed care
inform process, including referral to the Enrollment Facilitator,at the time of application for
1
Medicaid in local social service agencies and presumptive eligibility sites.
E. EPSDT Outreach and Case Manager: The individual responsible for providing the EPSDT
Program administrative services of outreach and case management to EPSDT-eligible children
and their families.
F. EPSDT-enrolled client: Any individual under the age of 21 declared as eligible for Medicaid by
the appropriate county department of social services pursuant to federal and state laws and
regulations.
G. Managed Care Inform Process:The process which occurs at the time of a client's application for
Medicaid, and at each eligibility redetermination, in the local county social service office or
presumptive eligibility site. The process include: provision of information regarding the basic
principles,benefits and requirements of the Colorado Medicaid Program, including, where
applicable, information concerning Medicaid prepaid health plans and options; explanation of the
client's rights and responsibilities with respect to selecting a managed care provider, including
information about an Enrollment Facilitator and that failure to select a provider may result in
mandatory assignment of a provider;distribution of applicable brochures, including the Colorado
Medicaid brochure,the Primary Care Physician Program(PCPP)brochure and,if applicable,
information about the Enrollment Facilitator and managed care enrollment process which may be
specific to the county, and where applicable, stressing the importance of a managed care provider
and promoting initial and timely contact with the Enrollment Facilitator to select a prepaid health
plan and a primary care.
H. Medicaid Provider/vendor: Any entity or individual who has met the certification requirement
established by the State to participate in the Colorado Medicaid Program, and who provides
covered EPSDT medical/dental services,goods and/or devices in accordance therewith.
Prenatal Plus Program. The health care program option that includes a package of enhanced
Medicaid prenatal services addressing nutritional and psychosocial behaviors that could impact
pregnancy outcome.
J. Prepaid Health Plan(PPHP): A commercial health care plan contracting with Colorado Medicaid
to provide comprehensive health care services, coordination, and monitoring of patient utilization
of services through the utilization of primary care physicians. The primary care physicians agree
to serve as gatekeepers for comprehensive health services, including EPSDT services, as provided
to Medicaid clients.
K. Primary Care Physician(PCP):A Colorado Medicaid enrolled physician who has agreed to serve
as the"gatekeeper"for all medical care received by Medicaid clients,who have chosen him/her
within the Primary Care Physician Program or Health Maintenance Organization. EPSDT
medical screenings are conducted by the selected primary care physician or a qualified provider
upon referral from the PCP, when applicable.
L. Primary Care Physician Program(PCPP):The health care program option in which EPSDT-
eligible clients select a physician who agrees to enroll or has enrolled in the Primary Care
Physician Program Under this program,the physician accepts the responsibility of the clients'
health care,guaranteeing a 24 hour access arrangement. Under this program the physician will
also refer the EPSDT-eligible client to other Medicaid providers, for medical care,and other
health care services as needed.
2
M. Provider Interface: The responsibility of the EPSDT Outreach and Case Manager to work with
local Medicaid providers. This process may include: (1) identifying providers in a local county or
adjacent client-accessible counties, who will deliver medical screening, diagnostic and treatment
services, dental, orthodontia, vision, hearing, or other services to the EPSDT-eligible client;(2)
explaining to the providers the nature and intent of the EPSDT Program, including the PCP
referral requirement;(3) referring interested providers to the coordinator of the Primary Care
Physician Program at HCPF for assistance in acquiring more information concerning the role of
the primary care physician; (4) acting as a resource to providers who have identified families in
need of assistance with EPSDT administrative case management services.
N. Screening: An EPSDT medical service provided to EPSDT-eligible clients by a Medicaid primary
care physician, by a provider qualified to furnish medical screening services upon referral from
the primary care physician or managed care system,or by other qualified providers in areas
without available primary care physicians.
The EPSDT medical service screening includes (a partial EPSDT screening is any screen less than
all of the 5 required components):
-Comprehensive health and developmental history with physical and mental health components
- Comprehensive unclothed physical examination
-Appropriate immunizations according to age and health history
- Laboratory tests, including blood lead levels
-Health education, including anticipatory guidance
•
O. Subcontract: A written agreement between Health and local health agencies and/or other local
agencies which shall serve as a basis for EPSDT administrative outreach and case management
activities at the local level.
P. Training and Technical Assistance: Work performed under the direction of Health to assist
Medicaid providers in developing and providing enhanced prenatal services.
II. EPSDT ADMINISTRATIVE OUTREACH/CASE MANAGEMENT
The EPSDT Outreach and Case Manager offers and provides,when requested and/or necessary:
A. Provides outreach and/or case management activities for the EPSDT-eligible client upon written
or verbal request by the client or upon referral from Medicaid providers or other agencies. The
administrative activities may include,but not be limited to,the following types of responsibilities:
1. Initiate face-to-face, telephone or mail contacts to explain the EPSDT Program and the
administrative case management role,assist in the identification of health care needs,
assist in requests for referrals for preventive health services; assist in clarification and/or
answering questions, including, where applicable,questions/information regarding
managed care.
2. Provide mailings,as indicated,that include provider listings,descriptions of basic
EPSDT services,screening schedules,brochures and case management information
(hours of operation and business cards). Work with the local social service agencies,
outreach sites,and other agencies where individual families apply for Medicaid to assure
that such materials are available.
3
3. Maintain and update a list of the names, addresses and telephone numbers of Medicaid-
enrolled providers and managed care organizations from whom EPSDT medical, dental,
hearing,and vision care may be obtained.
4. Facilitate provider interface by promoting the linkage of the EPSDT-eligible client with
the primary care physician or HMO and through EPSDT advocacy efforts in the
provider community, and through other activities as defined in Section I of this exhibit.
5. Coordinate with nurse supervisor and initiate and/or participate in interagency
coordination with public health and other human resource agencies as appropriate upon
consultation with the nurse supervisor.
6. Upon consultation with the nurse supervisor make home visits to difficult-to-reach
EPSDT-eligible clients or coordinate for this service with other community agencies that
also provide home visitation services.
7. Facilitate,upon request of client or provider, referrals for Medicaid-covered services.
8. As resources are available, and in consultation with the State office, provide assistance
with the inform process, including assistance with provider selection,at selected local
county social service departments.
B. In selected counties agreed upon by CDPHE and local agencies,EPSDT administrative case
management staff will provide assistance with the managed care inform process in local social
service agencies and presumptive eligibility sites.
C. The EPSDT Outreach and Administrative Case Manager will utilize data provided by HCPF and
local social service agencies which provide information for the provision of EPSDT
administrative outreach and case management activities and will notify the State EPSDT office in
writing of any errors,discrepancies, inaccuracy or unavailability of information received from the
State or local social service agency which impede the provision of EPSDT administrative
outreach and case management activities.
D. The EPSDT Administrative Case Manager works under the supervision of a registered nurse
currently licensed in Colorado. The designated nurse supervisor assures that the EPSDT Outreach
and Case Manager's activities are performed as identified in this Exhibit B.
III. EPSDT PROGRAM SUPPORT SERVICES
A. The EPSDT Outreach and Case Manager offers and provides,when requested and/or necessary:
1. Assistance with scheduling appointments for EPSDT Program screening services.
2. Assistance with scheduling appointments for follow-up diagnostic and treatment services,
including medical,dental,vision care and hearing services.
3. Information to the EPSDT-eligible client concerning the availability of transportation
assistance which is offered through the local county department of social services or the
Colorado Foundation for Medical Care(CFMC).
4. Referral assistance to the local county department of social services for the EPSDT-
4
eligible client requiring transportation assistance.
5. Assistance with provider selection in selected areas as appropriate and when resources
permit.
B. The EPSDT Outreach and Case Manager provides the additional support services of:
1. Maintaining the lists of the names, addresses and telephone numbers of agencies or
human resource groups who have expressed a willingness to furnish uncovered services
at little or no expense to the EPSDT-eligible client and/or family.
2. Referring clients in all categories of the WIC target population to the local WIC Program
available within each county.
3. Initiating and promoting of collaborative activities with Head Start, Early Childhood
Connections, Family Healthline, Family Resource Centers, Bright Beginnings, the
Colorado Child Health Plan Plus(CCHP+), school districts and other child health related
social agencies which are available within each local county to promote the availability
and utilization of the services.
C. The EPSDT Case Manager works with the regional and local coordinators of the Health Care
Program for Children with Special Needs(HCP)whereby families and EPSDT-enrolled clients
will be informed of the availability of HCP services and referred for these services as appropriate.
D. The EPSDT Case Manager facilitates the referral of EPSDT-eligible clients needing uncovered
treatment,health services or social services,and clients who lose Medicaid eligibility to
community and rural health centers, CCHP+,Colorado Indigent Care Program,Title V agencies,
or other community agencies that provide assistance, either at no cost or on a sliding fee scale, to
low income populations.
IV. EPSDT PROGRAM DOCUMENTATION REQUIREMENTS
A. The EPSDT Case Manager maintains documentation that identifies EPSDT administrative
outreach/case management activities on behalf of the EPSDT-eligible client.
B. The EPSDT Case Manager assures that documentation of the outreach and case management
activities occurs and that the documentation includes the following:
1. Written materials utilized by the EPSDT Outreach and Case Manager to facilitate the
administrative services provided for the EPSDT-eligible clients(brochures,reminder
cards, etc.).
2. Written or computerized documentation of all administrative EPSDT outreach and case
management activities which occurred.
C. The EPSDT Case Manager shall assure that these materials and/or client documentation are
available to HCPF or Federal reviewers upon written request and shall submit to the State monthly
a computerized summary of EPSDT activities.
D. The EPSDT Outreach and Case Manager maintains up-to-date program manuals,records, and/or
procedures that:
•
5
I. Describe the methods used to assure that outreach and administrative case management
services are provided appropriately and in a timely manner.
2. Describe the function of written and/or computerized documentation available at the
local agency and/or health offices.
3. Assure that information is available to local agencies and/or health offices that can be
accessed for determination of compliance with State plan requirements.
4. Describe how all activities performed by the EPSDT Outreach and Case Manager are
monitored by the local RN supervisor,or by a nurse consultant at CDPHE.
V. PLANNING, EVALUATION,MONITORING
A. Site reviews by Colorado Department of Health EPSDT staff will be arranged on a mutually
agreed upon basis with local EPSDT staff. Site reviews will include:
I. Names of agency sites reviewed with listing of the assigned EPSDT Outreach and Case
Manager(s)and the designated RN supervisor.
2. Review of EPSDT outreach and case management activities, including written materials,
designed to assure that EPSDT clients receive requested assistance in a timely manner.
3. Review of EPSDT Procedure Manual for accuracy and content of required materials.
4. Review of collaborative activities with medical providers including managed care
organizations, WIC, HCP,Child Find,Family Healthline,Family Resource Centers,
Bright Beginnings, Early Childhood Connections, and other child health related social
agencies.
5. Review of compliance status with standards developed for mandated activities. This
includes review of computerized documentation for completeness and accuracy.
6. Review of agency written protocols/guidelines for outreach and case management,
including at-risk client definitions. Review of measures to be taken to bring activities
into compliance with federal requirements.
7. Review of agency written protocols for nurse supervision.
8. Discussion of EPSDT Case Manager needs,concerns and requests.
9. Input from the nurse supervisor on EPSDT issues, needs, etc.
10. Training activities provided to EPSDT Outreach and Case Managers and/or RN
supervisor as needed.
EXH 5/98
6
ATTACHMENT C
EPSDT Statistical Report
Report For :
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - -- - - - - -
Date Completed:
County:
- - - --- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
NEW HOUSEHOLDS REQUESTING SERVICE
Service Request Form:
Baby Care/Kids Care Form:
SPA (TANF Application) :
Direct Contact by HH/Client :
TOTAL :
- - - - --- - - - - - --- - - - - - - -- - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - -- - - - -- - -- - -- - - -
SPECIAL REFERRAL SOURCES
WIC:
Other Agencies (not Social Services) :
Accretions List :
- - - - -- - - -- - - - --- - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - -- - -- - --- - -- --- -- -- - - - -
Partial Registrations :
New Households Requesting Service (Previous Month) - -
No Contact :
Total Contacts :
Total Households Served:
Unduplicated Clients in Households Served:
Referrals Households
Referrals to PCP :
Referrals to Public Health Nurse :
Referrals to Other Primary Health/
Medical Provider:
Referrals to Dentist :
Referrals to Vision:
Referrals to Hearing :
Referrals to HMO:
Referrals to WIC:
Referrals to Social Services
for Transportation:
Referrals to Other Programs :
Contacts Households
Scheduling Assistance :
Reminders/Follow Up Contacts :
Assistance to Providers
on Behalf of Clients :
Assistance to Non-EPSDT Clients :
EPSDT Program Activities :
Changes in Office Location, Phone Number, or Staff :
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ATTACHMENT E
STATE OF COLORADO
Roy Romer, Governor —--
Patti Shwayder, Executive Director of;CO
kg.-_^^x'0
Dedicated to protecting and improving the health and environment of the people of Colorado ��-
4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division * � Iiii� 1 +,
Denver,Colorado 80246-1530 8100 Lowry Blvd. f "•
Phone(303)692-2000 Denver CO 80220-6928 1876,
Located in Glendale, Colorado (303)692-3090 Colorado Department
hup://wwwe dphc.stateco.u> of Public Health
and Environment
, 1997
State Fiscal Year 19_ - Contract Routing Number Change Order Letter No.
In accordance with paragraph _of the Original Contract with contract routing number and contract encumbrance
number , as amended by Change Order Letter routing number , and Renewal Letter routing number
[strike if inapplicable] hereinafter referred to in total as "the Original Contract" (a copy of which is attached hereto and by this
reference incorporated herein and made a part hereof) between the State of Colorado, Department of Public Health and
Environment, Division and, , covering the period from , 199 ,
through , 199, the parties agree that the maximum amount payable by the State for the eligible services ill
Paragraph _of the Original Contract is increased/decreased [strike inapplicable] by DOLI,ARS (S
_) for a new total of DOLLARS ($ ). This funding change is in accordance with th
revised work plan, which is incorporated herein by this reference, made a part hereof, and attached hereto as "Attachment A" and
the revised budget, which is incorporated herein by this reference, made a part hereof, and attached hereto as "Attachment B"
(strike inapplicable]. The first sentence in paragraph_of the Original Contract is hereby modified accordingly. All other term
of conditions of the Original Contract are hereby reaffirmed by the parties.
This amendment to the Original Contract is intended to be effective as of , 199 , but in no event shall it be deem
valid until it shall have been approved by the State Controller or such assistant as he may designate.
Please sign, date and return all originals of this letter as soon as possible to: , at the Colorado
Department of Public Health and Environment, Division, 4300 Cherry Creek Drive South,
Mail Code: , Denver, CO 80246. One original of this letter will be returned to you when fully approved
Contractor: State of Colorado
Full Contractor Name Roy Romer, Governor
By: By:
Signature For the Executive Director
Colorado Department of
Print Name: Public Health and Environment
Title:
APPROVALS:
PROGRAM CONTROLLER
By: By:
ATTACHMENT F
ACTUAL EXPENDITURES ANNUAL REPORT
APPLICANT:
PROJECT:
ACTUAL EXPENDITURES
FOR THE PERIOD:
Annual Number Total Source of Funds
Salary Months Amount *Applicant :Requested
Rate Budget C
PERSONAL SERVICES: g Required -ati�;0ther from CDH'
Contractual/Fee for Service:
Supervising Personnel:
Fringe Benefits: Rate =
Sub total Personal Services
OPERATING EXPENSES:
(includes Building/Facility
Cost not part of Indirect)
Sub total Operating
TRAVEL:
Sub total Travel
EQUIPMENT:
Sub Total Eqiupment
Administrative/Indirect Cost
Source of Funding for 'Applicant and Other'
Local:** $ **
Medicaid: $
Patient Fees: $
Other: $
Total Applicant and Other $
"Are these local funds used to match any other grant? Yes
No
Signature of Director or Authorized Representative
ATTACHMENT I;
State Fiscal Year - Contract Routing Number
Contract Renewal Letter No.
Pursuant to paragraph of the contract with routing number and contract encumbrance number
(as amended by Change Order Letter routing number , and/or Contract Renewal Letter routing number
if any), hereinafter referred to as the "Original Contract" (a copy of which is attached hereto and by this reference
made a part hereof) between the State of Colorado, Department of Public Health and Environment and
, for the renewal term from through , _, the parties
agree that the maximum amount payable by the State for the eligible services referenced in paragraph_of the
Original Contract is increased/decreased by DOLLARS ($ ) to a new total of
DOLLARS ($ ). The revised work plan, which is attached hereto as
"Attachment A", and the revised budget, which is attached hereto as "Attachment B", are both made a part hereof and
incorporated herein by this reference. The first sentence in paragraph of the Original Contract is hereby modified
accordingly. All other terms and conditions of the Original Contract are hereby reaffirmed.
This amendment to the Original Contract is intended to be effective as of , but in no event shall
it be deemed valid until it shall have been approved by the State Controller or such assistant as he may designate.
Please sign, date, and return all _originals of this Contract Renewal Letter by _to the attention of:
Colorado Department of Public Health and Environment
Mail Code:
4300 Cherry Creek Drive South
Denver, Colorado 80222-1530
One original of this Contract Renewal Letter will be returned to you when fully approved.
Contractor: State of Colorado:
Full Legal Name Roy Romer, Governor
By:
Signature
By:
Print Name: For the Executive Director
Colorado Department of Public Health
Title: and Environment
APPROVALS:
PROGRAM
CONTROLLER
By: By:
Clifford W. Hall
mEmoRAnDum
1119 o. Constance L. Harbert, Chair
To Board of County Commissioners Date August 20, 1998
COLORADO
From John Pickle, Director, Health Department
Subject:
EPSDT Program
Enclosed for Board review and approval is a contract between the Colorado Department of
Public Health and Environment and Weld County Health Department for the Early and Periodic
Screening , Diagnosis and Treatment Program.
This contract authorizes WCHD to provide case management, outreach and support services for
children ages 0 to 21 who are on Medicaid. Emphasis is on educating families about well child
services that are age appropriate and helping them to utilize these services that are available in
our community. EPSDT case managers can assist families who are having problems gaining
access to Medicaid services and can also refer them to other resources. The contract provides for
hiring one Office Technician II as the EPSDT case manager.
For these services the Health Department will be reimbursed a sum not to exceed $25,425 for the
time period July 1, 1998 through June 30, 1999.
I recommend your approval of this contract
Enc.
981548
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