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Home My WebLink About980522.tiff RESOLUTION RE: APPROVE 1998 HIV PREVENTION SERVICES CONTRACT 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 1998 HIV Prevention Services Contract 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, 1998, and ending December 31, 1998, 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 1998 HIV Prevention Services Contract 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 1st day of April, A.D., 1998, nunc pro tunc January 1, 1998. BOARD OF COUNTY COMMISSIONERS le ;Li WyfrD COUNTY, COLORADO ATTEST: e ) Constance L. Harb , Chair Weld County Clerk:603V Bo Pi J �� «0 W. H. Webster, Pro-Tem l BY: < Deputy Clerk to t e Board /Georg E. Baxter APP AS • . all y Attor �u - 7 /(:`7,`x/`e!`-- arbara J. Kirkmeyer 980522 HL0024 ( /IL ( ) rum s . ‘z, Memorandum iiiitTO: Constance L. Harbert, Chair Weld County Board of Commissioners "ElieDATE: March 23, 1998• FROM: John Pickle, MSEH COLORADO Director, Health De rtment SUBJECT: HIV Prevention Services Contract Enclosed for Board review is a contract between the Colorado Department of Public Health and Environment and the Weld County Health Department for the provision of HIV Prevention Services for rural at-risk communities, prevention case management, and public awareness. For these services, the Health Department will receive a sum not to exceed $24830.00. The term of this contract is January 1, 1998 through December 31, 1998 I recommend your approval of this contract. 980522 ATTACHMENT 1 RECEIVED NOV 2 6 1997 STD/AIDS SECTION INFORMAL REQUEST FOR FUNDING FOR HIV PREVENTION SERVICES IN COLORADO PUBLIC AWARENESS �T wisXn C- WELD COUNTY HEALTH DEPARTMENT 1517 16TH AVE. CT. GREELEY, CO 80631 CONTACT PERSON: MISTI AAS 353-0586 EXT. 2344 a I. DESCRIPTION OF ORGANIZATION The Weld County Health Department (WCHD) was established in 1938; the second health department in the state of Colorado. WCHD serves the 144,000 residents of Weld County which includes 29 incorporated towns and encompasses 4000 square miles. WCHD employs approximately 75 individuals who work in three separate divisions; Administration, Preventive Health Services, and Environmental Protection. The mission of the WCHD is to preserve, promote and protect a healthy life and safe environment for all people in Weld County. Financial support of WCHD consists of the following; county funds - 37.4%, fees for services - 31.6%, contracts and grants - 28.7%, and misc. funding - 2.3%. The governing Board of Directors for WCHD is the County Board of Commissioners and Public Health Board (see attachment C). The HIV Educator/Program Coordinator has no control of gender or ethnic make-up, or selection of the persons constituting this Board. WCHD houses a STD Clinic and also serves as both an anonymous and confidential HIV testing site. In addition, WCHD is the lead fiscal agency in Northern Colorado for the management of the Ryan White Care Act. The HIV Education program is under the umbrella of the Health Promotions Section of Preventive Health Services at WCHD. In 1997, public information on HIV/AIDS prevention and awareness was provided to approximately 780 people in Weld County through community events and educational presentations to organizations and schools. Upwards of 75,000 persons were reached through press releases, purchased ads, radio PSAs and interviews. WCHD is the lead agency for the Weld County AIDS Coalition (WCAC) with the HIV Educator serving as coordinator. In addition, individual HIV prevention counseling was provided on a weekly basis through the STD Clinic. WCHD houses an audiovisual and other educational media supply room. These supplies include over-head projectors, slide projectors, a portable TVNCR, flip charts w/ markers, an HIV virus model, and a variety of videos on heath-related issues including HIV/AIDS. The HIV Educator has ready access to all equipment. Condoms and HIV-related brochures and information is stored in the office of the HIV Educator. The HIV Educator at WCHD has been involved in HIV Education for eleven years through the University of Northern Colorado (UNC), WCAC, and currently WCHD. She is a member of the Board of Directors for the AIDS Coalition for Education (ACE). She holds a Master's Degree in Agency Counseling and is a Licensed Professional Counselor and has facilitated the HIV/AIDS support group for the past five years. II. TARGET AUDIENCE The target audience for this Public Awareness Project is all residents of Weld County , with the inclusion of youth, people of color, people with disabilities and people with hearing impairments. The Weld County AIDS Coalition, whose mission is to educate the community about HIV infection and to diminish the fears and myths associated with HIV infection and AIDS, is representative of a diverse cross-section of Weld 11 /25/97 1 .9F'0 County residents. It's 45 members include medical providers, health educators, clergy, people of color, persons from the University community, persons living with HIV, persons who have lost loved ones to complications of AIDS, as well as other interested individuals. Members of WCAC range in age from 18 to 72. The Coalition is coordinated by the HIV Educator at WCHD and meets regularly on a monthly basis, as well as providing quarterly mailed updates to all members. Meeting activities include event planning, discussion of community needs and resource sharing. The coordination of WCAC gives the HIV Educator the unique opportunity to track information, perceptions, and changes in behaviors and attitudes about HIV/AIDS in Weld County, enabling WCHD to evaluate and, if needed, re-adjust its focus and strategies based on the needs communicated by Weld County residents. WCAC recruits for new members at all PI events and presentations. In addition, formative evaluation for this intervention included the distribution of an HIV knowledge survey to clients at various agencies in Weld County (see Attachment D). These targeted agencies serve individuals of varying socioeconomic and ethnic identities. Survey respondents ranged in age from 13-47, with a mean age of 21. Results of the 108 returned surveys reflect what myths and misconceptions continue to exist and where the focus of educational efforts should lie. Although many of us working in the field of HIV prevention believe that everyone is well-informed on the basics of HIV, that is not always the case. Forty-seven percent of survey respondents did not know that an infected Mother can transmit HIV to her infant through breast milk. Twenty-eight percent of respondents believe that an individual can be infected by donating blood, 17% think that mosquitos carry the virus, and 14% believe that one can become infected through kissing. Knowledge about how HIV is transmitted and about how to avoid transmission is a prerequisite to individuals avoiding risks or taking precautions to protect themselves. WCHD's Public Awareness Intervention will reach an estimated 900 people through WCAC events, panel discussions and presentations in 1998, and an additional estimated 80,000 people through various media means. All events and presentations will be held at locations that are accessible to persons with disabilities. Interpreters for the hearing impaired can be acquired through the Northern Colorado Center on Deafness with 24-hour notice. All priority populations for CWT Dist. 2 are included under the targeted audience of all residents of Weld County. The HIV Educator is a long-time resident of Weld County. III. CULTURAL COMPETENCE AND PROFICIENCY Because one individual is coordinating this project, the "organization" will be referred to as the "HIV Educator". The HIV Educator is committed to the ongoing process of cultural competence and proficiency. The HIV Educator will attend any trainings offered through the state (or locally) on furthering cultural competence and awareness, continue to pursue Spanish language classes, and will read books specifically addressing unique concerns and needs of various ethnic identities served through the intervention. At each panel discussion or presentation the HIV Educator and/or the panel members will 930 522 11 /25/97 2 assess where each individual and the group is on a cultural spectrum. Cultural • diversity and needs will be taken into consideration during planning of WCAC events. Members of WCAC include people of color who voice the unique cultural concerns reflected by their communities. Printed materials will also be available in Spanish. The HIV Educator also has an ethnically diverse group of friends and acquaintances who help promote ongoing growth in cultural sensitivity. The HIV Educator/program coordinator will assess her cultural competence and proficiency through ongoing feedback of program participants and technical assistance through CDPHE. IV. OBJECTIVES By December 31, 1998, 35% of persons attending panel discussions and presentations will be able to list 3 ways that persons living with HIV continue to experience discrimination. By December 31, 1998, 50% of persons who participate in "A Walk in the Park" will be able to describe three ways that HIV can be transmitted. By December 31, 1998, increase by 10% (from 115 to 127) the number of people participating in WCAC's "A Walk in the Park". V. OPERATIONAL PLAN Public awareness continues to be an important HIV prevention intervention. With the media-acclaimed success of combination AIDS drug therapies, many people erroneously believe that HIV/AIDS is a disease of the past. This, along with other variables, has contributed to an alarming trend of risky behavior. Public information is imperative, particularly in a rural community where myths and discrimination surrounding HIV/AIDS seem particularly prevalent. The WCAC was established in 1987 and is a diverse volunteer group of community individuals committed to the prevention of HIV/AIDS through education. The WCHD HIV Educator serves as its coordinator. Over the years, WCAC has grown in both membership and service. The organization plans and implements several annual events that the community anticipates and looks forward to, and in turn these events continue to grow. In the spring of 1998, WCAC will sponsor a Candlelight Memorial Service in observance of the International AIDS Candlelight Memorial and Mobilization. Father Greg Ames has volunteered to host the service at St. Peters Catholic Church in Greeley. The service will include participation by other interested clergy in Weld County. Music, readings, poetry, meditations, memory sharing, and candle-lighting will remember those who have died from complications of AIDS, and honor those who are living with HIV/AIDS. In the fall of 1998, WCAC will plan and implement "A Walk in the Park". This 5K walk will take place at Bittersweet Park and will include educational information as well as refreshments and prizes donated by area merchants. The primary focus of the walk is to provide public education and awareness surrounding HIV. A number of Weld County businesses will be solicited for 11 /25/97 3 9c0 22 sponsorships for the event. "A Walk in the Park" not only draws community members together in the battle against AIDS, but also gives the Weld County businesses and merchants an opportunity to show their support for continued HIV/AIDS awareness. Both of the aforementioned events will be publicized through multi-media means. Press-releases will be sent to 17 newspapers throughout Weld County, • and PSAs will be sent to 5 radio stations in Northern Colorado. Posters advertising each event will be distributed throughout the community. For the Candlelight Memorial Service, announcements will be sent to Houses of Worship throughout Weld County to be included in their bulletins. KFKA radio is an annual sponsor of "A Walk in the Park" and is a strong supporter of the mission of WCAC. KFKA will air several radio interviews with the WCHD HIV Educator and other Coalition members in the weeks preceding the 5K walk. In observance of World AIDS Day (Dec. 1st), WCAC will promote a red ribbon campaign specifically targeting businesses throughout Weld County. Letters will be sent to the 11 largest companies in the county providing information regarding World AIDS Day, as well as the opportunity to request red ribbons for their employees. Other smaller businesses will be contacted via phone by Coalition volunteers. An announcement will also be placed in the business section of the newspaper. A panel discussion on HIV/AIDS with special theatre, dance, and musical contributions will be presented at UNC with the collaboration of the University. The panel will consist of members of the WCAC Speaker's Bureau. UNC will handle all publicity and advertising and the event will be open to the entire community. The WCAC Speaker's Bureau includes persons living with HIV, parents who have lost adult children to complications of AIDS, medical providers, health educators, and others who have been affected by HIV/AIDS. Four to six members of the Speaker's Bureau participate in each panel discussion. Panel presentations are highly interactive with the audience, with the majority of time focused on a question/answer format. • - Schools, community groups and other organizations are encouraged to request panels. These panels serve to personalize HIV/AIDS, and seek to dispel myths about HIV transmission, as well as aiming to reduce discrimination toward persons living with HIV/AIDS and providing referrals for testing and other services. These panels are particularly valuable in classroom setting as the HIV epidemic in the US is increasingly becoming an epidemic of the young. According to the UCSF AIDS Resource Institute, one fourth of all HIV infections in the US occur in people under the age of 22, and one half of all new infections occur in people under age 25. Among teens 13-17 surveyed through WCHD, 71% did not know that HIV can be transmitted through breast milk,29% believed that mosquito bites could transmit HIV, and 21% thought that birth control pills could reduce an individual's risk for HIV infection. The HIV Educator will provide educational presentations surrounding HIV/AIDS to schools and community organizations upon request. Presentations are tailored specifically to each audience. The first of the two main themes, basic HIV facts - HIV 101,is given to groups that may not have had previous access to accurate information and may include Jr. High/High Schools, GED 11 /25/97 4 51r4-0522 classes, and Headstart program parents. The second is a focus on the protease inhibitors and media information that has given people a sense of false hope to the end of AIDS. This presentation also focuses on what works and what doesn't in HIV education and how behavior change is achieved. it is usually given to groups such as University classes and Rotary clubs. However, due to the limited financial scope of this grant, presentations will only be able to occur on a limited basis. Video loans, HIV/AIDS pamphlets, and condoms will be provided to groups and individuals on a request basis. Due to the variety of activities to be achieved in 1998, the target population should be reached through this intervention, including those who may be difficult to reach due to geography, stigma, or other factors. The recommendations of CWT District 2 list Public Information as a potential intervention for all priority statement/populations. Time Line By April 30, 1998, all participating clergy and other contributors will be lined up for the Candlelight Memorial Service. By April 30, 1998, press releases, PSAs, House of Worship bulletin announcements, and posters will be distributed throughout Weld County to invite participants to the local observance of the International AIDS Candlelight Memorial and Mobilization. By August 31, 1998, all community prize donors and business/organizational sponsors will be secured for "A Walk in the Park". By August 31, 1998, press releases, PSAs, posters and registration forms will be distributed throughout Weld County to invite participants to the 7th Annual "A Walk in the Park". By September 30, 1998, a banner will be placed over one of the major streets in Greeley commemorating AIDS Awareness Month. By October 31, 1998, an editorial focusing on one or more aspects/issues of HIV/AIDS will be written to appear in the Greeley Tribune. By November 30, 1998, major corporations in Weld County will have received a letter promoting a red ribbon campaign for World AIDS Day. By December 31, 1998, twelve panel presentation promoting HIV/AIDS awareness (utilizing the WCAC Speaker's Bureau) will be provided to schools and/or community organizations. By December 31, 1998, six tailored HIV/AIDS educational presentations will be provided to community organizations and/or schools. By December 31, 1998, twelve WCAC meetings (one each month) will be facilitated. 11 /25/97 5 • 9(4)522 VI. COLLABORATION, COORDINATION AND NON-DUPLICATION The WCHD HIV educator works collaboratively with individuals involved in WCAC in order to plan and implement the WCAC sponsored events and panel presentations. WCHD also collaborates with UNC on HIV/AIDS educational events, to the greatest extent the panel presentation planned for World AIDS Day (see attached letter of collaboration). Other organizations in Weld County such as Planned Parenthood provide printed HIV/AIDS educational materials and referrals to individuals. Lambda Community Center in Ft. Collins received supplemental funding to provide limited bar and street outreach in Weld County. The WCHD HIV Educator will assist in targeting outreach locations. WCHD has a very friendly, non- competitive and collaborative relationship with the Lambda Community Center. Resource-sharing and technical assistance will be ongoing through 1998. The Public Awareness intervention planned by WCHD utilizes group activities rather than individual outreach. In addition, WCHD's project seeks to dispel myths surrounding HIV/AIDS and reduce discrimination and stereotyping experienced by persons living with HIV/AIDS, besides providing education on transmission and behavior change. For this reason, this proposal is not duplicative of any other HIV prevention services offered in Weld County. VII. EVALUATION PLAN Formative evaluation for this proposal was achieved through continued input from community members of WCAC, past feedback from participants at WCAC events, and HIV/AIDS knowledge survey results. Process evaluation will include tracking the following: the number of video loans, other educational materials, and condoms distributed; the number of WCAC meetings facilitated; the number of panel and educational presentations given; and the number of participants at WCAC events. All of this information will be recorded in the HIV program log book. On a quarterly basis, this tracked information will be submitted to the CDPHE Epidemiology Dept. A narrative detailing general activities and accomplishments toward the outlined objectives will be included in the quarterly HIV prevention progress report to the Contract Supervisor. A pre- and post-test questionnaire will be used at panel and educational presentations to evaluate participant knowledge and effectiveness of presentations. Participants will be asked to complete an evaluation of WCAC events (a brief knowledge post-test will be included in the "Walk in the Park" evaluation). This information will assist WCHD in outcome evaluation. A Professor in the community health dept. of UNC has offered his assistance in conducting an outcome evaluation through statistical analysis of collected data. 11 /25/97 6 F22 VIII. BUDGET HIV Educator $4439.76 (6 hrs. x $14.23 x 52 wks.) Administrative Assistant $414.96 (1 hr. x$7.98 x 52 wks.) Fringe $485.47 (10% of total personnel requested) Indirect $704.90 (13.2% of total personnel and fringe) ' Travel $369.91 (9 Denver trips & 200 misc. miles) ACE Membership Fee $85.00 TOTAL REQUESTED FUNDING $6500.00 NOTE: No additional private or public funds currently support any HIV prevention activities conducted by WCHD. Activities in collaboration with the Weld County AIDS Coalition are funded by the private WCAC account. These funds cover event advertising, printing, walk t-shirts, and other materials. WCHD currently has educational materials and condoms as carry-over from 1997 HIV prevention supplies. CDPHE has agreed to provide additional materials on a request basis. 11 /25/97 7 Q''052 . 5 m ee U -, O N >. U o o = y U a) L 44 44 44 44 64 64 69 64 64 O 64 44 44 44 69 64 64 64 44 . O r, E O 72 C;r _ (.., L y > r^ Y '— 6) L d a. y C 4... C: O c7i0 Cil H O y O C N N r y L.- N 4' L CS O Cn cn v 69 44 44 44 64 69 69 69 64 C 69 64 64 64 64 69 64 64 49 O TB C) — +- y > .9 ≥ ct Q. r L -1 U 61 t%5 c3 Z - L f k.GG. ≥ Y. 10. 0 64 64 64 69 49 64 44 64 64 O 64 6A 64 44 64 64 44 44 69 e O Q F. a c. O O ca ..... •_ L—: U 11± Y R L L O C- FE w 44 44 6464 64 e 69 K 69 44 � 69 64 69 44 69 44 44 44 44 e Q Z 115 • = �U1 !� M_ Z o C:: _ .. O U r O -ttO ,y v L a a� r u C cn .- •V _ _= > t) L U 5 G0 C c+ L ?^0522 ATTACHMENT A: DEFINITION OF RURAL AND URBAN "Urban"shall be a term applied to counties that fall within the standard definition of Metropolitan Statistical Areas(MSAs), having within the county boundaries one or more population centers of 50,000 persons or more,AND which according to Colorado HIV surveillance data have a preponderance of AIDS cases, that is 250 cases or more. These counties are: Adams, Arapahoe, Boulder, Denver, El Paso,and Jefferson. In Colorado these counties are both urban by definition and account for 89% of the known AIDS cases in the state. "Rural"shall be a term applied to counties that fall within non-Metropolitan Statistical Areas OR have less than 250 reported AIDS cases. These counties are the remaining 57 counties in Colorado and account.for 11% of the known AIDS cases in the state. (Note: Larimer, Weld,Mesa,Pueblo,and Douglas counties are counties that are MSAs yet are included in the "rural" categorization for the purposes of CWT based on epidemiological characteristics.) P"0 c2e2i V • V! 0 O F 0 1 c o ° c`�n .4 M r .9 = e N _ 69 64 64 44 64 44 64 64 64 t'f 0 2 8 o Cll - 0 L1� t-,4 ,a tip M c O• U O w � � U_ ✓ 64 64 64 44 69 69 64 64 69 0 V 0 eu C7 O V 44 64 69 44 44 69 64 64 44 e O U V N r N � d � U 0 0 C.) 69 49 64 44 64 64 64 64 64 e cQ 0J re O V G 7.1 y E ^•� O C C c Summary of the Priorities contained in the 1998 - 2000 Comprehensive Plan for HIV Prevention HIV Prevention for Rural Areas Perspectives in the Comprehensive Plan There are two perspectives summarized in the state wide Comprehensive Plan relevant to providing services in rural areas: I) the perspectives of the nine rural districts (1,2,3,4,5,7,8,10, and 11) (see "CWT- Contact individuals, District/Population Coalitions"for district boundaries), 2) the perspectives of fourteen groups whose focus is on populations who reside statewide (African Americans, people with disabilities, people who are deaf or hard of hearing, injection drug users, incarcerated people, Latinos, men who have sex with men, people living with HIV, pregnant women and children, people affected by substance abuse, women at risk, migrant farm workers, high risk youth, and Colorado Department of Public Health and Environment). In general, both of these perspectives are relevant to any given prevention program. For instance, if a service provider proposes a program targeting Latinos who reside in Bent county, the service provider should consider and address the priorities of District 10 (a rural district which includes Bent county) as well as the priorities of the Latino Coalition (a population coalition concerned with Latinos state wide). The information presented in this fact sheet summarizes the two perspectives listed above. However, in summarizing these perspectives, some of the individual variations have been obscured. For instance, although District 10 generally follows the trends of the rural districts concerning priorities, it also has some unique characteristics. Service providers are strongly urged to obtain the specific plans for each district and each population they serve. These individual plans are available by calling the CWT program at (303) 692-2736. People of Color Communities Overall, the Plan places a high priority on providing HIV prevention services for communities of color in rural areas. Among the rural district coalitions, the highest level of concern was for Latinos and Latinas and Native Americans. Among the population coalitions, highest level of concern was for Latinos and Latinas, African Americans, Native Americans, and Asian Americans. There were considerable geographic variations for these priorities; individual coalition plans should be consulted. Attachment C WELD COUNTY HEALTH DEPARTMENT BOARD OF DIRECTORS Lanny Clary - Dist. 1 Vacant - Dist. 2 Donna Meier - Dist. 3 Ann Garrison - Dist. 4 Melvin Brown - Dist. 5 Nancy Fichter - Dist. 6 Ben Slater - At Large Mary Stoll - At Large °^`?r--122 ATTACHMENT D • Sex: Age 13-47 26 Male 82 Female Please answer true (T) or false (F) to each of the following. (Number and percentage of incorrect responses on corresponding line. N=108) 1) A person can get AIDS from: holding hands sharing needles 15 (14%) kissing 18 (17%) mosquito bites 30 (26%1 donating blood 13 (12%1 having a blood test 2 (2%1 public toilets sex without a latex condom 10 (9% eating in a restaurant where the cook has AIDS 2) 3 (3%) You can tell if a person is infected by looking at them. 3) 2 (2%1 A person with AIDS can pass it on through sex. 4) A pregnant woman can infect an unborn child. 5) 2 (2°%ol There is a cure for AIDS. 6) Only gay men can get AIDS. 7) You can reduce your chance of infection by: -±2.1_%1 abstaining from sex. 1 (1%) using latex condoms. 11 (tow not having sex with an IV drug user. 6 (6%1 taking birth control pills. 8) 51 (47%1 A mother can infect her baby by breast-feeding. 9) 2 (2%). AIDS reduces the body's ability to fight disease. 10) 5 (5%1 There is a vaccine to protect against AIDS. FrOC2? ATTACHMENT E: CLIENT DEMOGRAPHICS • Directions: All contractors/applicants must complete the following six tables. If your program involves direct services to clients, your percentage of effort should be based on the number of clients you estimate you will serve in 1998. Each table must total 100%. Table 1 Counties of residence % of effort in 1998 Urban ©°l(Adams.Arapahoe.Boulder.Denver.El Paso.Jefferson) Rural (The remaining 57 Colorado counties) (C0% Total 100% Table 2 Age % of effort in 1998 Children(ages 0.12) I o/o Adolescents(ages 13-19) 3 3% Youth Adults(ages 20-24) 33 °/0 Adults(older than age 25) 3 3 0/0 Total 100% Table 3 Disability % of effort in 1998 People with a developmental,physical, oY0 mental, and/or emotional disability a People who are deaf or hard of hearing ° o People without a disability qQ 9/0 Total 100% Table 4 Gender % of effort in 1998 Male 3 no Female rj00�0 Total 100% sO O x o a 0•,=. O U O a Cv U I.... O P . LA a) • > 0N Z am 0 cam: 0 o (-6 9 .= o GO tt L ,] U Q lim I o O Pr FE r"..' am u col I. 1 Ma I r ■.▪ U L v O C, 1, CO �* U 1.3% •_~ .$_ 1 Ej •_Q Q>ow .y I.., _ L1 < E le o. Cln 0 L C. U 0 0 C4 '` .� O U y C� - i Q Q i. v L r. U a y J O X oc•0 C CIU X L. Y C.) v =Col r- Ti a v_ Z. LO > a . �G u .1 •� O V Cc _ w C CZ o _ = 3 0 c c = " = = 113 3 .._ U C o v G a r 14 0 2 � _ " o 2 2 3 - 2 0 z U O E° r • N . al U 3 Y N O u > N G J m 2 N CD v C. O CM r C. u. .` 1 G0 L . 6 T a R R D O 6- _ p .J G. J - a o y O 3 CO . p O C C G o c. = o z o 'o u 3 X — O ca O -O CO C >. Y N n • x 3 L = CU omm>N El Otu r O a — p .0 .cif - < _o ;a < Ci Z = .: C] rn 2 C/1 w C., E- U ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 5""��22 Attachment F COLOR.ADANS WORKING TOGETHER - CONTACT INDIVIDUALS DISTRICT/POPULATION COALITIONS COALITION , PRIMARY CONTACT* , SECONDARY CONTACT* District 1 Stefanie Donahue Lynn Eynard (Jackson,Routt,Mofat,Rio Blanco P.O. Box 770417 P.O. Box 770417 Counties) Steamboat Springs,CO 80477 Steamboat Springs, CO 80477 (970) 879-1632 (970) 879-1632 District 2 Gerald Ernst Leslie Burkholder (Larimer, Weld, western Adams [non- 1406 Peterson Northern Co AIDS Project metro] Counties) Ft. Collins, CO 80524 107 Cameron Dr (970)224-1555 Ft. Collins, CO 80524 (970) 498-6772 (Fax) (970)223-6227 (970)223-1659 (Fax) District 3 Loreen Miller Kathy Karsting (Logan, Sedgwick,Phillips, Morgan, Northeast CO Health Dept. Northeast CO Health Dept. Washington,Yuma, Lincoln, Kit 700 Columbine St. 228 W. Railroad Road Carson,Cheyenne, eastern Adams Sterling, CO 80751 Fort Morgan, CO 80701 [non-metro] Counties) (970) 522-3741 (970) 867-49I8 (970) 522-1412(Fax) (970) 867-0878 (Fax) District 4 Jeff Basinger Maxine Pixley • (Rio Blanco,Mesa,Delta,Montrose, Western CO AID Project Colorado West Recovery Gunnison,Ouray, San Miguel P.O.Box 143 711 Grand Ave. Counties) Grand Junction, CO 81502 Glenwood Springs, CO 91601 (970)243-2437 (970)945-8439 (970)243-5791 (Fax) (970) 945-1040 (Fax) District 5 Susan Robertson Maxine Pixley (Grand, Summit,Eagle,Pitkin,Lake, Northwest CO Prevention Center Colorado West Recovery Park,Chaffee Counties) Box 2565 711 Grand Ave. Frisco, CO 80443 Glenwood Springs,CO 91601 (970)668-2077 or 1-800-819-9174 (970)945-8439 (970) 668-1737(Fax) (970)945-I040(Fax) District 6 Imani Latif Barb Jones (Denver,Boulder,Gilpin, Clear Creek, Colorado AIDS Project Colorado AIDS Project Jefferson,Douglas,Arapahoe,metro 701 E. Colfax 701 E. Colfax portions of Adams Counties) Denver, CO 80203-2005 Denver, CO 80203-2005 (303) 837-0166 (303) 837-0166 (303) 861-8281 (Fax) (303) 861-8281 (Fax) District 7 Ken Puhler (Dolores, Montezuma,La Plata, La Plata Prevention Partners Archuleta, San Juan, Hinsdale P.O. Box 140 Counties[excluding reservation Durango, CO 81302 areas]) (970) 247-5702 (970)247-9126 (Fax) *Excludes all Colorado Department of Public Health&Environment Personnel °4n0C2? "`Coalition inactive;call Bob Bongiovanni at(303)692-2736 for information. �) 1 ATTACHMENT G: ASSURANCES We hereby affirm that: • materials produced or purchased with these monies will be submitted for approval to the Material Review Panel prior to printing or purchase; • other sources of federal, state, or local funding are not being used to support this particular activity (non-duplication); • personal identifiers related to HIV infection,or AIDS will not be released and adequate security of personal information will be maintained to protect client confidentiality; • the proposed program is coordinated with other HIV prevention providers in our geographic area; • we will collaborate with other HD/prevention providers to accomplish the scope of work described in this proposal; • we will comply with the definition of cultural competence and proficiency; • we will comply with all applicable federal legislation(Americans with Disabilities Act, Civil Rights Act,etc.); • we will effectively and respectfully provide HIV prevention services to people with disabilities and people with hearing impairments; • we have written this proposal in response to our District and/or Population Plans and our proposal is relevant to the target audience we intend to serve; • this program does not duplicate other programs in the our geographic area serving the target audience described in this proposal. ORGANIZATION'S NAME: kA) Ejn COO 1.1T iaL-r\Y DEPT. NAME OF INDIVIDUAL SIGNING THIS FORM: Ir 1511 {Arm S (Please print or type) Signature Date POSITION OF THE INDIVIDUAL SIGNING THIS FORM: R 1 V '-0 VC(AtT'QTZ P"�S22 4 COLORADANS WORKING TOGETHER- CONTACT INDIVIDUALS DISTRICT/POPULATION COALITIONS COALITION _ PRIMARY CONTACT* SECONDARY C0NTACT* Deaf/Hard of Hearing Coalition Elaine Woody Ric Durity 4353 E. Colfax 4353 E. Colfax Denver,CO 80220 Denver,CO 80220 (303) 320-8526 TTY (303)320-8526 TTY (303) 320-5701 (303)320-5701 (303)3204830 (Fax) (303) 320-4830(Fax) Incarcerated Coalition Joe Mauro Colorado AIDS Project 701 E.Colfax Denver,CO 80218 (303) 837-0166 ext 106, (303) 837-9213 People Living With HIV Coalition Shannon Behning • Jo Mauro 2172 S.Trenton Way 1-105 Colorado AIDS Project Denver, CO 80231 • 701 E.Colfax • (303)337-5139 Denver, CO 80218 (303)337-2115 (303) 837-0166 (303) 837-9213 • re-1)522 `Excludes all Colorado Department of Public Health& Environment Personnel "Coalition inactive;call Bob Bongiovanni at(303)692-2736 for information. 4 UNIVERSITY OF NORTHERN COLORADO DIVISION OF STUDENT AFFAIRS STUDENT HEALTH SERVICES GREELEY, COLORADO 80639 (970) 351-2412 November 17, 1997 To Whom It May Concern: This letter is to verify the collaborative efforts between the University of Northern Colorado REV/AIDS Education Resource Committee and the Weld County Health Department and Weld County AIDS Coalition. Each year, in marking World AIDS Day the University of Northern Colorado requests the assistance of Weld County Health Dep utiuent in providing a panel for an evening presentation. The panel members consist of Persons with AIDS, family members and significant others impacted by HIV/AIDS. UNC provides the location, marketing and promotion of this event. We have collaborated over the past 4 years and could not provide the quality and power of our program without our mutual collaboration. This event is attended each year by over 100 faculty, staff, students and community members. UNC and WCHD also collaborate throughout the year with the AIDS walk, UNC Health Fair where WCHD provides HIV/AIDS information and condoms. Our working relationship is viable and ongoing and both agencies attempt to provide needed services and information per request of one another. Sincerely, 2(cG Laurie Struthers R.N.M.S. Health Education lit c''0c22 QUALITY • DIVERSITY • PERSONAL TOUCH 2 COMMITTED TO AFFIRMATIVE ACTION AND EQUAL OPPORTUNITY /// • LAMBDA COMMUNITY CENTER 1437 E Mulberry, Suite#1 V Ft. Collins, CO 80524 `I/ Phone 970.221.3247 V Fax 970.221.2139 V Outreach Cell 970.217.7488 E-Mail LambdaCenter@usa.net V http://www.fortnet.org/LambdaCommCtr "SERVING ALL COMMUNITIES OF NORTHERN COLORADO INCLUDING THE GAY, LESBIAN, BISEXUAL AND TRANSGENDER " November 24, 1997 Ms. Misti Ms, MA Weld County Health Department 1517 16th Avenue Court Greeley, Colorado 80631 Re: Collaboration between LCC and WCHD for 1998 HIV Prevention Services Dear ms.Aas: I look forward to continuing our collaborations complimenting both HIV Prevention Service Programs In Northern Colorado. As agreed, LCC will continue to do Street and Community Outreach in Northern Colorado and this letter is to verify non-duplication of services. We agree to collaborate and support each other in the following areas: 1) LCC will support and refer clients to WCHD Anonymous HIV Testing Site. 2) LCC will support,refer,help promote and assist in distributing information regarding WCHD programs,workshops and other related HIV Prevention Services during LCC Outreach. 3) LCC will offer support and assistance to WCHD regarding materials, program development, or requested information regarding HIV Prevention Services in Northern Colorado, 4) LCC will share its outreach findings and information with WCHD. 5) WCHD will assist LCC in information regarding its outreach program. — 6) WCHD will track LCC referrals and report the quantitative information to LCC. 7) WCHD and LCC will collaborate regarding competence and proficiency of both organizations and will utilize our knowledge and experiences to better serve our communities in Northern Colorado for the Prevention of HIV. I look forward to our continuing successes in the upcoming year and our joint efforts in the Prevention of HIV. It is always a pleasure working with you. You have always kept the best interest of • your community in mind regarding services. Respectfully: /2 Gerald E. Ernst Outreach Coordinator, Lambda Community Center cc: Colorado Department or Public Health and Environment Board of Directors, Lambda Community Center Pr0c22 RECEiV N0V 2 6 1997 STD/AIDS SECTION INFORMAL REQUEST FOR FUNDING FOR HIV PREVENTION SERVICES IN COLORADO PREVENTION CASE MANAGEMENT IN RURAL COMMUNITIES WELD COUNTY HEALTH DEPARTMENT 1517 16TH AVE. CT. GREELEY, CO 80631 CONTACT PERSON: MISTI AAS 353-0586 EXT. 2344 ??0' 22 I. DESCRIPTION OF ORGANIZATION The Weld County Health Department (WCHD) was established in 1938, the second oldest health department in the state of Colorado. WCHD serves the 144,000 residents of Weld County which includes 29 incorporated towns and encompasses 4000 square miles. WCHD employs approximately 75 individuals who work in three separate divisions; Administration, Preventive Health Services, and Environmental Protection. The mission of the WCHD is to preserve, promote and protect a healthy life and safe environment for all people in Weld County. Financial support of WCHD consists of the following; county funds - 3.4%, fees for services - 31.6%, contracts and grants - 28.7%, and misc. funding - 2.3%. The governing Board of Directors for WCHD is the County Board of Commissioners and Public Health Board ( see attachment C). The HIV Educator/Program Coordinator has no control of gender or ethnic make-up, or selection of the persons constituting this Board. WCHD houses a STD clinic and also serves as both an anonymous and confidential HIV testing site. In addition, WCHD is the lead fiscal agency in Northern Colorado for the management of the Ryan White Care Act. The HIV Education program is under the umbrella of the Health Promotions Section of Preventive Health Services at WCHD. In 1997, public information on HIV/AIDS prevention and awareness was provided to approximately 780 people in Weld County through community events and educational presentations to organizations and schools. Upwards of 75,000 persons were reached through press releases, purchased ads, radio PSAs and interviews. WCHD is the lead agency for the Weld County AIDS Coalition (WCAC) with the HIV Educator serving as coordinator. In addition, individual HIV prevention counseling was provided on a weekly basis through the STD Clinic. WCHD houses an audiovisual and other educational media supply room. These supplies include over-head projectors, slide projectors, a portable TVNCR, flip charts w/markers, and HIV virus model, and a variety of videos on health-related issues including HIV/AIDS. The HIV Educator has ready access to all equipment. Condoms and HIV-related brochures and information is stored in the office of the HIV Educator. The HIV Educator at WCHD has been involved in HIV Education for eleven years through the University of Northern Colorado (UNC), WCAC, and currently WCHD. She is a member of the Board of Directors of the AIDS Coalition for Education (ACE). She holds a Masters Degree in Agency Counseling, is a Licensed Professional Counselor, and has facilitated the Weld County HIV/AIDS support group for the past five years. II. TARGET AUDIENCE ro The target audience to be served through this intervention is any individual K.who has HIV infection, or is at high-risk for HIV, who is having difficulty changing their risky sexual or drug behaviors. Throughout 1997, the WCHD HIV Educator has conducted individual level education and HIV prevention counseling in WCHD STD Clinic with individuals who have been diagnosed with and STD other than HIV. Some of these clients e 0' 2? 11 /25/97 1 have experienced repeat STDS and interventions have explored the reasons why behavior change is so difficult. Through these interviews and observations, a deeper understanding of behavior change and its inherent challenges was obtained, contributing to the planning of the proposed PCM intervention. The target audience will be identified and recruited through WCHD STD Clinic and HIV testing site, as well as other area agencies serving high-risk individuals. The nurses in the WCHD STD Clinic and HIV testing site have the ability to identify clients who are diagnosed with repeat STDs, as well as persons who test confidentially for HIV on a "regular" basis. Repeat infection of STDs and multiple HIV tests (beyond the 6-month window period) indicate that an individual is continuing to practice high-risk behaviors. Other area HIV testing sites, including Planned Parenthood and Sunrise Community Health Center, will be contacted to provide referrals of potential clients for PCM. The Partner Notification specialist at WCHD will be a valuable referral source of individuals who are having a difficult time changing behaviors that put them at high-risk for HIV infection of self or others. In addition, WCHD HIV Resource Coordinator will assist in identifying and targeting those individuals living with HIV who continue to put others at risk of infection. There are many individuals continuing to practice high-risk behaviors who do not seek services from WCHD. In order to reach persons outside of the immediate agency, a collaborative relationship will be developed with other agencies serving high-risk individuals. The idea of forming a "Prevention Referral Network" was obtained from the Jefferson County Department of Health and Environment (JCDHE) PCM Program. The proposed agencies that will be involved in this network are Weld County law enforcement and probation, Island Grove Drug Treatment Center; A Woman's Place, and Greeley Transitional House. A relationship will be established (if it is not already in place) by planning trainings with key individuals in each agency. These trainings will be conducted by the WCHD HIV Educator and will focus on providing effective HIV prevention education, as well as providing information on the PCM project and each agency's potential role in the referral process. The expected case-load of ongoing WCHD PCM clients will be 5 to 8 persons at any given time (this is proportionate to the 10 hours a week allocated to this intervention). The number of individuals to be reached by the intervention in 1998 is estimated to be between 50 to 75 clients. This number will also reflect the individuals who may not be willing to participate in a long-term intervention but who are reached to some degree, none the less. When working with a person with a disability, home visits or agreement to meet at an easily accessible location can be arranged with the client. If a client has a hearing disability, advance arrangements can be made to have an interpreter from the Northern Colorado Center on Deafness present at the intervention. If a phone intervention is required, a TTY phone will be utilized. All of the populations/priority statements targeted by the CWT Dist. 2 Coalition list PCM as a recommended intervention. These statements in order or priority include; unsafe sexual contact - partners of opposite sex; sharing needles; unsafe sexual contact - both partners male; perinatal transmission; and unsafe sexual contact - both partners female. All of these populations, if individuals meet the criteria for PCM, will potentially be served by this intervention. 5`^0522 11 /25/97 2 III. CULTURAL COMPETENCE AND PROFICIENCY Because one individual is coordinating this project, the "organization" will be referred to as the "HIV Educator". The HIV Educator is committed to the ongoing process of cultural competence and proficiency. The HIV Educator will attend any trainings offered through the state (or locally) on furthering cultural competence and awareness, continue to pursue Spanish language classes, and will read books specifically addressing unique concerns and needs of various ethnic backgrounds served through the intervention. There are many cultural factors that influence behavior change. Each cultural identity has its own unique values, traditions and health beliefs. During the initial PCM session, each client will be assessed on an individual cultural spectrum (this assessment will also be ongoing). The behavior change plan will incorporate these cultural factors. The HIV Educator will assess her cultural competence and proficiency through ongoing feedback of program participants and technical assistance through CDPHE. IV. Objectives By December 31, 1998, 25% of individuals involved in PCM will be able to demonstrate how to correctly put on a condom. By December 31, 1998, 15% of clients participating in PCM will be able to identify a personal reason or "significance to self" for behavior change. By December 31, 1998, 10% of clients participating in PCM will follow through on a personal behavior change plan (as measured by follow-up surveys). V. OPERATIONAL PLAN The coordination of this PCM intervention is the HIV Educator at WCHD. Client referrals will be received through the community prevention referral network as described in the Target Audience section. Participation will always be voluntary on the part of the client. PCM sessions will be carried out in a variety of setting appropriate to the client's needs , including phone, clinic or home. Acute needs will be addressed and prevention efforts will be tailored to an individual's particular circumstances. Ideally clients will be seen on a long- term basis and PCM will not be time-limited. However, the HIV Educator will also recognize the need to terminate PCM sessions when the behavior change • plan is successful, or when repeated PCM efforts are unsuccessful. An interactive client-centered approach will be the primary foundation of the PCM relationship between the HIV Educator and the client. The counseling skills tat will be utilized by the HIV Educator include attending, reflecting feelings, paraphrasing, reframing, open questioning and non-threatening confrontation. The activities to be included in this PCM intervention are: Talking with people about what makes it hard for them to change their behavior. 11 /25/97 3 * Making an individualized plan with the client on how they can be as safe as possible in sex, drug use, or relationships. • Helping them get other services (money, food, housing, medical care, drug treatment, mental health) that help them to be safe. • Discussing why AIDS is a problem for them and their partners and how to protect themselves and their partners. * Practicing correct condom use and cleaning works. • Discussing how to maintain safe behavior. These activities support the following counseling objectives: 1) Establish and/or improve the client's self-perception of risk. 2) Identify and support behavior changes the client has already attempted. 3) Negotiate a realistic and incremental plan for reducing risk. Research on behavior change has repeatedly found four individual characteristics that seem to influence most people's ability to change: 1) Self-Efficacy - the degree to which a person feels capable of accomplishing an action or behavior (a sense of control over his/her life). 2) Assertiveness - the ability to communicate clearly what one wants and/or needs. 3) Rationality - making decisions about one's life and behavior in a fully considered way. 4) Social Affiliation - how and to what degree a person feels her/himself to be part of a larger group and how important that larger group connection is. A counseling model, developed by Joan M. Garrity, draws on a number of behavior change theories and will be the pathway of choice for WCHD PCM intervention: Knowledge/Awareness Self-Efficacy Significance to Self Cost/Benefit Analysis y Capacity-Building Provisional Try Behavior Change 11 /25/97 4 This model places particular emphasis on the prerequisite of idenifying a reason, or "significance to self", for changing a particular behavior, as well as the importance of the benefit outweighing the cost of behavior change. In addition the model recognizes that changing behavior is a difficult and unpredictable process, by establishing a plan for obstacles and setbacks. The HIV Educator will follow all counselor legal and ethical guidelines surrounding confidentiality, boundaries, dual relationships, conflict of interest, duty to warn and protect, and referral/collaboration with other agencies to assure continuity of client care. The HIV Educator will obtain ongoing clinical supervision from a licensed mental health professional chosen from her counseling network. Time-Line By January 31, 1998, a procedure will be established for client referrals from the WCHD STD clinic, HIV testing site, HIV Resource Coordinator, and Partner Notification project. By January 31 , 1998, agencies serving at-risk individuals will be contacted inviting them to participate in the proposed "Prevention Referral Network". By March 31, 1998, a training on HIV prevention strategies and the PCM program will be facilitated with key individuals from agencies interested in becoming involved in the "Prevention Referral Network". By December 31, 1998, an estimated minimum of 50 persons will have participated in the PCM intervention. By December 31, 1998, ongoing communication will have occurred between WCHD and JCDHE for resource-sharing, technical assistance and project updates. VI. COLLABORATION, COORDINATION, AND NON-DUPLICATION WCHD will collaborate with a number of agencies serving high-risk individuals throughout Weld County as a means of obtaining client referrals for this PCM intervention. These agencies will include, but not be limited to, the following; law enforcement and probation, Island Grove Drug Treatment Center, A Woman's Place, and Greeley Transitional House. Collaborative efforts with these organizations will also focus on "cooperative service venues" (i.e. possibility of meeting with client in convenient environment, such as at the referring agency; reciprocal referrals). Lambda Community Center will also provide potential referrals through their street and bar outreach efforts in Weld County. A collaborative relationship has been formed with Jefferson County Dept. of Health and Environment (JCDHE) for PCM intervention at WCHD (see attached letter of collaboration). JCDHE will share its materials, protocols, and other resources needed for technical assistance from its already established PCM or'0S22 11 /25/97 5 program. The possibitility of future collaborative research and publishing effforts have also been discussed. There are no other existing HIV PCM programs within Weld County. VII. EVALUATION PLAN Formative evaluation was conducted through WCHD STD Clinic as described in the Target Audience section, as well as through literature research surrounding behavior change theory. Ongoing psychosocial assessments to be used for process and outcome evalualtion will include; sexual history, drug history, HIV risk assessment, current knowledge and attitudes about safer sex and safer needle use behaviors, assessment of stage of behavior change, guardianship status, presence of literacy/learning problems, and/or developmental disability, criminal and/or legal involvement, mental health history, support systems/resources including Ryan White case management, relevant medical history, and cultural and religious considerations. Baseline data will be obtained at an initial session. Follow-up data after the intervention is complete will be obtained through the completion of a behavior change survey. This will be used to assess whether or not the client has initiated behavior change, maintained behavior change, or relapsed, and also whether or not the client has accessed social and medical services. JCDHE will assist in evaluation efforts of WCHD PCM program through the sharing of a computer method of tracking clients and individual behaviors, as well as providing other technical assistance in achieving both process and outcome evaluation. • "c'0522 11 /25/97 6 VIII. BUDGET HIV Educator $7399.60 (10 hrs. x $14.23 x 52 weeks) Administrative Assistant $414.96 (1 hr. x $7.98 x 52 weeks) Fringe $781 .45 (10% of total personnel requested) Indirect $1134.67 (13.2% of total personnel and fringe) Travel $269.32 (6 Denver and 215 misc. miles) TOTAL FUNDING REQUESTED $10,000.00 NOTE: No additional private or public funds currently support any HIV prevention activities conducted by WCHD. Total funding for this HIV prevention project is being requested from this state proposal. WCHD currently has educational materials and condoms as carry-over from 1997 HIV prevention supplies. CDPHE has agreed to provide additional materials on a request basis. 11 /25/97 oetr X22 7 i r " v , • 7. t I l • c � M `• - h 69 64 69 if, 44 441 64 44 64 w 1 ` E. O U_ o 64 64 64 G9 4.4 G4 4.4 G4 44 O .�L T O o 49 49 44 44 4.4 69 44 44 44 U U U y • O e 4.9 44 64 G4 44 44 44 44 G4 U 5A 1 _ 1 — . • U y V U r J Q. _ U L U U y — > ^ L • I I n I n_,in 1Ll11 V • - Summary of the Priorities contained in the 1998 - 2000 Comprehensive Plan for HIV Prevention HIV Prevention for Rural Areas Perspectives in the Comprehensive Plan There are two perspectives summarized in the state wide Comprehensive Plan relevant to providing services in rural areas: 1) the perspectives of the nine rural districts (1,2,3,4,5,7,8,10, and 11) (see "CWT- Contact individuals, District/Population Coalitions" for district boundaries), 2) the perspectives of fourteen groups whose focus is on populations who reside statewide (African Americans, people with disabilities,people who are deaf or hard of hearing, injection drug users, incarcerated people, Latinos, men who have sex with men, people living with HIV,pregnant women and children, people affected by substance abuse, women at risk, migrant farm workers, high risk youth, and Colorado Department of Public Health and Environment). In general, both of these perspectives are relevant to any given prevention program. For instance, if a service provider proposes a program targeting Latinos who reside in Bent county, the service provider should consider and address the priorities of District 10 (a rural district which includes Bent county) as well as the priorities of the Latino Coalition (a population coalition concerned with Latinos state wide). The information presented in this fact sheet summarizes the two perspectives listed above. However, in summarizing these perspectives, some of the individual variations have been obscured. For instance, although District 10 generally follows the trends of the rural districts concerning priorities, it also has some unique characteristics. Service providers are strongly urged to obtain the specific plans for each district and each population they serve. These individual plans are available by calling the CWT program at(303) 692-2736. People of Color Communities Overall, the Plan places a high priority on providing HIV prevention services for communities of color in rural areas. Among the rural district coalitions,the highest level of concern was for Latinos and Latinas and Native Americans. Among the population coalitions, highest level of concern was for Latinos and Latinas, African Americans,Native Americans, and Asian Americans. There were considerable geographic variations for these priorities; individual coalition plans should be consulted. �r'0522 7:- E.") r 0. 44 49 44 44 49 44 44 44 44 O 44 49 44 44 44 49 44 44 4? O r a a 73 N X r' L L VI C v C y cn = L y L r — 2. tai 1..C Ch Cr" C Cn "" 69 64 44 64 44 49 64 64 64 Ui C . V 44 44 64 49 44 49 44 44 44 f , U 7J U v1 ') C' y L N G > a J 44 44 49 64 69 4, 4, 64 44, 0 44 44 44 44 44 44 44 49 49 e a, a ` U s _ V U a r J �e .�lard C = ,. L O Cn {� cA 64 64 44 49 49 49 44 44 ;3`,-) 44 44 44 44 44 64 69 c.4 44 C C r_ti J M 1 a R.7. = r J .VDT • G ,, `r'. v - u u I C :.b CI J U c ` v V: 7 J _ U h J U _ _ U '."" 1 U4. a L C u 1) G C it. U .... C/� C.J E^ C — • — _ — = 4.CJ: c..) O — �' / 1 � J C. O 1.577: C —• y t.• 44 44 69 44 49 44 44 64 69 2 m I U 69 44 44 49 64 69 G9 44 44 C G.) V1 E s U 44 64 44 44 44 44 G9 49 64 0 3 U y = ".1 v L" >, Q C L U 44 69 64 69 44 69 G4 G4 49 e r.0 r C Z._ 4.1 C! y C -1z LJ C., r C y v C" 7 a� ctl u - = C O C t� 0"O 22 ATTACHMENT F: CLIENT DEMOGRAPHICS Directions: All contactors/applicants must complete the following six tables. If your program involves direct services to clients, your percentage of effort should be based on the number of clients you estimate you will serve in 1998. Each table must total 100%. Table 1 Counties of residence %of effort in 1998 Urban 0010 (Adams.Arapahoe.Boulder.Denver.El Paso.Jefferson) Rural 00(1)/C7 (The remaining 57 Colorado counties) Total 100% Table 2 Age %of effort in 1998 Children(ages 0-12) 3°1O • Adolescents(ages 13-19) i O Youth Adults(ages 20-24) 35°10 Adults(older than age 25) .35O/O _ I Total 100% Table 3 Disability %of effort in 1998 People with a developmental,physical, (059'0 mental,and/or emotional disability People who are deaf or hard of hearing 330 People without a disability 3 c)lo Total 100% Table 4 Gender %of effort in 1998 Male (0Oct° Female 4.00(0 Total 100% (J'. d c u . `O g e < L,n u I• z s.-4 0 411.. 0 O J O _ C tm —a u 4.1 adi A. C. C S.. Mr r =V R — r- .% " U c C 'J L Cal o 0 L .;1" .f w W Q < u4 O L c o co Q.. — �r Q a = L `- o ^u co QJ H ^ > 0 nn ' y 3 � co rn C.C > O = 7 L ` O !C^ R v •.k C.) U Z O 5 ; .0 > = "' V •> CZ V L W O ti •L r) .O ^(33 .w V3- �+ ti C C — ^ ° " .572 — r, i.•t. �, Chi .e c R ea = v C •U 3 C L. .2 ^ W — �L"' Attachment C WELD COUNTY HEALTH DEPARTMENT BOARD OF DIRECTORS Lanny Clary - Dist. 1 Vacant - Dist. 2 Donna Meier - Dist. 3 Ann Garrison - Dist. 4 Melvin Brown - Dist. 5 Nancy Fichter - Dist. 6 Ben Slater - At Large Mary Stoll - At Large o"n0C22 vi y . . . . C.) N . C o d . E6.Cn > . CD L R 0 N C C- `C N d to q 0 T `C T - O 0 a VCU C. O VI 0 a 6 to ..-. 0 0 et o C. G F C T °) c v L'- G :A C.) C. C Y 0 CO i T ... CD y . E O Y o >, 3 '6' k t ...7., C c_ c C a vl p C., 7 cn V it 0 — rz U Y V _ T CZ 0 C c., .0 N Q CO Z .0 .1 G Vu] V] _ u CJ m b n b o o b o o b 0ennr�� Attachment G . COLORADANS WORKING TOGETHER- CONTACT INDIVIDUALS DISTRICT/POPULATION COALITIONS COALITION _ PRIMARY CONTACT* SECONDARY CONTACT* District 1 Stefanie Donahue Lynn Eynard (Jackson,Routt, Mofat, Rio Blanco P.O. Box 770417 P.O. Box 770417 Counties) Steamboat Springs, CO 80477 Steamboat Springs, CO 80477 ' (970) 879-1632 (970) 879-1632 District 2 Gerald Ernst Leslie Burkholder (Larimer, Weld, western Adams [non- 1406 Peterson Northern Co AIDS Project metro] Counties) Ft. Collins, CO 80524 107 Cameron Dr (970) 224-1555 Ft. Collins, CO 80524 (970)498-6772(Fax) (970)223-6227 (970)223-1659(Fax) District 3 Loreen Miller Kathy Karsting (Logan, Sedgwick, Phillips,Morgan, Northeast CO Health Dept. Northeast CO Health Dept. Washington,Yuma, Lincoln, Kit 700 Columbine St. 228 W. Railroad Road Carson, Cheyenne,eastern Adams Sterling, CO 80751 Fort Morgan, CO 80701 [non-metro] Counties) (970)522-3741 (970) 867-4918 (970) 522-1412(Fax) (970) 867-0878 (Fax) District 4 Jeff Basinger Maxine Pixley (Rio Blanco, Mesa, Delta,Montrose, Western CO AID Project Colorado West Recovery Gunnison, Ouray, San Miguel P.O.Box 143 711 Grand Ave. Counties) Grand Junction, CO 81502 Glenwood Springs, CO 91601 (970)243-2437 (970)945-8439 (970) 243-5791 (Fax) (970)945-1040 (Fax) District 5 Susan Robertson Maxine Pixley (Grand, Summit,Eagle, Pitkin,Lake, Northwest CO Prevention Center Colorado West Recovery Park, Chaffee Counties) Box 2565 711 Grand Ave. Frisco,CO 80443 Glenwood Springs, CO 91601 (970) 668-2077 or 1-800-819-9174 (970) 945-8439 (970) 668-1737 (Fax) (970) 945-1040(Fax) District 6 Imani Latif Barb Jones (Denver,Boulder, Gilpin, Clear Creek, Colorado AIDS Project Colorado AIDS Project Jefferson,Douglas,Arapahoe, metro 701 E.Colfax 701 E. Colfax portions of Adams Counties) Denver, CO 80203-2005 Denver,CO 80203-2005 (303) 837-0166 (303) 837-0166 (303) 861-8281 (Fax) (303) 861-8281 (Fax) District 7 Ken Puhler (Dolores,Montezuma, La Plata, La Plata Prevention Partners Archuleta, San Juan,Hinsdale P.O. Box 140 Counties [excluding reservation Durango, CO 81302 areas]) (970) 247-5702 (970)247-9126 (Fax) "Excludes all Colorado Department of Public Health&Environment Personnel "Coalition inactive: call Bob Bongiovanni at(303) 692-2736 for information. 1 ATTACHMENT H: ASSURANCES We hereby affirm that: • materials produced or purchased with these monies will be submitted for approval to the Material Review Panel prior to printing or purchase; • other sources of federal, state,or local funding are not being used to support this particular activity (non-duplication); _ • personal identifiers related to HIV infection, or AIDS will not be released and adequate security of personal information will be maintained to protect client confidentiality; • the proposed program is coordinated with other HIV prevention providers in our geographic area; • we will collaborate with other HIV prevention providers to accomplish the scope of work described in this proposal; • we will comply with the definition of cultural competence and proficiency; • we will comply with all applicable federal legislation(Americans with Disabilities Act,Civil Rights Act, etc.); • we will effectively and respectfully provide HIV prevention services to people with disabilities and people with hearing impairments; • we have written this proposal in response to our District and/or Population Plans and our proposal is relevant to the target audience we intend to serve; • this program does not duplicate other programs in the our geographic area serving the target audience described in this proposal. ORGANIZATION'S NAME: WELD c_O O N T Y H Es LTN De-PT NAME OF INDIVIDUAL SIGNING THIS FORM: M\S t\ A R S (Please print or type) rt\-s --OS ��3...5/97 Signature Date POSITION OF THE INDIVIDUAL SIGNING THIS FORM: N\V Et()00.R rock COLORADANS WORKING TOGETHER -CONTACT INDIVIDUALS DISTRICT/POPULATION COALITIONS COALITION PRIMARY CONTACT* , SECONDARY CONTACT* Deaf/Hard of Hearing Coalition Elaine Woody Ric Durity 4353 E.Colfax 4353 E.Colfax Denver,CO 80220 Denver,CO 80220 (303)320-8526 TTY (303)320-8526 TTY (303)320-5701 (303)320-5701 (303)3204830(Fax) (303)3204830(Fax) Incarcerated Coalition Joe Mauro Colorado AIDS Project 701 E.Colfax Denver,CO 80218 (303)837-0166 ext 106 (303) 837-9213 People Living With HIV Coalition Shannon Behning Jo Mauro 2172 S. Trenton Way 1-105 Colorado AIDS Project Denver, CO 80231 701 E. Colfax (303)337-5139 Denver,CO 80218 (303)337-2115 (303)837-0166 (303) 837-9213 'Excludes all Colorado Department of Public Health& Environment Personnel **Coalition inactive;call Bob Bongiovanni at(303)692-2736 for information. Jefferson County Department of Health and Environment Promoting Health and Preventing Injury and Disease �.. • Misty Aizs HIV Prevention Coordinator Weld County Health Department 1517 16th Ave. Ct. Greeley, CO 80631 November 21, 1997 Dear Misty, It was great to speak with you about HIV Prevention Case Management(PCM) as an effective prevention intervention in local health departments. I am glad to know that you are applying for funding to implement this intervention in Weld County. • As we discussed, Jefferson County Department of Health and Environment is funded through December 1999 for PCM and has developed a model for implementing this intervention in suburban and rural communities. I would like to offer any assistance with planning and development of a PCM program in Weld County, that you may find helpful, should you be funded. We have developed materials and protocols for referrals from non-public health agencies, for example, that we will gladly share with you. Please consider us a support for your • success with PCM implementation, as we will most certainly benefit from the collaboration. Good luck with your application process. Sincerely, Donna Viverette, M.P.H. Health Education Program Supervisor • Administration: Lakewood Offices: Arvada Offices: Conifer Offices: Environmental Health 1801 19th Street 260 S. Kipling Street 6303 Wadsworth Bypass Hwys. 73&285 260 S. Kipling Street Golden, CO 80401 Lakewood, CO 80226 Arvada, CO 80003 Mountain Resource Center Lakewood, CO 80226 (303)271-5700 (303) 232-6301 (303) 275.7500 Conifer, CO 80433 (303) 232-6301 Fax: (303) 271-5702 Fax: (303) 239-7088 Fax: (303) 275-7503 (303)838-7552 Fax: (303) 239-7076 RECEIVED N0V 261997 STD/AIDS SECTION INFORMAL REQUEST FOR FUNDING FOR HIV PREVENTION SERVICES IN COLORADO RURAL AT-RISK COMMUNITIES WELD COUNTY HEALTH DEPARTMENT 1517 16TH AVE. CT. GREELEY, CO 80631 CONTACT PERSON: MISTI AAS 353-0586 EXT. 2344 I. DESCRIPTION OF ORGANIZATION t . The Weld County Health Department (WCHD) was established in 1938; the second health department in the state of Colorado. WCHD serves the 144,000 residents of Weld County which includes 29 incorporated towns and encompasses 4000 square miles. WCHD employs approximately 75 individuals who work in three separate divisions; Administration, Preventive Health Services, and Environmental Protection. The mission of the WCHD is to preserve, promote and protect a healthy life and safe environment for all people in Weld County. Financial support of WCHD consists of the following; county funds - 37.4%, fees for services - 31.6%, contracts and grants - 28.7%, and misc. funding - 2.3%. The governing Board of Directors for WCHD is the County Board of Commissioners and Public Health Board (see attachment C). The HIV Educator/Program Coordinator has no control of gender or ethnic make-up, or selection of the persons constituting this Board. WCHD houses a STD clinic and also serves as both an anonymous and confidential HIV testing site. In addition, WCHD is the lead fiscal agency in Northern Colorado for the management of the Ryan White Care Act. The HIV Education program is under the umbrella of the Health Promotions Section of Preventive Health Services at WCHD. In 1997, public information on HIV/AIDS prevention and awareness was provided to approximately 780 people in Weld County through community events and educational presentations to organizations and schools. Upwards of 75,000 persons were reached through press releases, purchased ads, radio PSAs and interviews. WCHD is the lead agency for the Weld County AIDS Coalition (WCAC) with the HIV Educator serving as coordinator. In addition, individual HIV prevention counseling was provided on a weekly basis through the STD Clinic. WCHD houses an audiovisual and other educational media supply room. These supplies include over-head projectors, slide projectors, a portable TV/VCR, flip charts w/markers, an HIV virus model, and a variety of videos on health-related issues including HIV/AIDS. The HIV Educator has ready access to all equipment. Condoms and HIV-related brochures and information is stored in the office of the HIV Educator. The HIV Educator at WCHD has been involved in HIV Education for eleven years through the University of Northern Colorado (UNC), WCAC, and currently WCHD. She is a member of the Board of Directors for the AIDS Coalition for Education (ACE). She holds a Masters Degree in Agency Counseling, is a Licensed Professional Counselor, and has facilitated the Weld County HIV/AIDS support group for the past five years. II. TARGET AUDIENCE For the intended scope of work to be completed, the target population will be women who have sex with men, with the inclusion of youth, women of color and women with disabilities/hearing impairment. The intervention applied will be group-level intervention, specifically ongoing 6-week cycling risk-reduction workshops, followed by peer-educator training to further outreach efforts. 11 /25/97 1 ?"0 22 A 90-minute focus group of 10 women ranging from 25 to 46 years of age (6 Anglo, 2 Latina, 1 Asian, and 1 African-American) was facilitated by WCHD's HIV Educator in order to assist in the planning process. In addition, a voluntary survey on HIV knowledge and personal condom usage was distributed at targeted agencies of participant recruitment; A Woman's Place, Sunrise Community Health Center, Planned Parenthood, Greeley Transitional House, UNC Health Center, and WCHD STD/Family Planning Clinic (see Attachment D). A written survey approach was used in order to receive feedback from a larger section of the target population, as well as to increase truthfulness in responding through the anonymity factor. Results of the 82 returned surveys are particularly useful in identifying barriers to practicing safer behaviors, as well as assessing any deficits in basic knowledge of HIV/AIDS. Although many of us working in the field of HIV prevention believe that everyone is well-informed on the basics of HIV, that is not always the case Forty-three percent of women respondents did not know that an infected Mother could transmit HIV through breast milk. Twenty-seven percent of respondents believed that an individual could be infected by donating blood, 16% thought that mosquitos carry the virus, and 13% believed that one can become infected through kissing. Various barriers to practicing safer sex were identified by female respondents. Ten percent of surveyed women state that they do not use condoms because they perceive that condoms "interrupt the moment". Other barriers cited include decreased sensation and embarrassment in purchasing, as well as lack of knowledge on how to use condoms. Participants will be recruited primarily through the 6 aforementioned agencies (as well as through other health care providers, women's groups, and mental health counselors), with emphasis placed on the two agencies collaborating with WCHD; A Woman's Place (a shelter for battered women) and Sunrise Community Health Center. Recruitment will involve fliers for upcoming workshops, as well as through word of mouth from agency providers and former workshop participants. In 1998, an estimated 105 women will be reached through seven 6-week risk-reduction workshops. In addition, upwards of 2500 women will be reached through peer education efforts. Risk-reduction workshops will be held at 2 alternating locations, both fully accessible for the physically-challenged. Interpreters for the hearing impaired can be acquired through the Northern Colorado Center for Deafness with 24- hour advance notice. CWT District 2 recommended that the greatest urgency of priority be placed on unsafe sexual contact, partners of opposite sex, among people of all races and ethnicities. Women was the specific population chosen for this project, due to the unique issues of empowerment and self-esteem that influence the practice of safer behaviors, as well as the increase in new infections among this population. AIDS is now the third leading cause of death in American women aged 25 to 44. Women are one of the fastest-growing groups among people diagnosed with AIDS, accounting for 20% of newly reported cases in the United States and 42% of cumulative cases worldwide. In the US, between 1991 and 1995, the number of women diagnosed as having AIDS increased by 63%, more than any other group of persons reported as having AIDS, regardless of race or mode of exposure to HIV. fr10 11l2511 /25/O2 The HIV Educator who will coordinate this program and facilitate all training • activities is a woman. III. CULTURAL COMPETENCE AND PROFICIENCY Because one individual is coordinating this project, the "organization" will be referred to as the "HIV Educator". The HIV Educator is committed to the ongoing process of cultural competence and proficiency. The HIV Educator will attend any trainings offered through the state (or locally) on furthering cultural competence and awareness, continue to pursue Spanish language classes, and will read books specifically addressing unique concerns and needs of various ethnic backgrounds served through the intervention. At the beginning of each 6-week risk reduction workshop, the HIV Educator/Trainer will assess where each individual and the group is on a cultural spectrum. The said Trainer also has an ethnically diverse group of friends and acquaintances who help promote ongoing growth in cultural sensitivity. The focus group used in the planning process of this intervention was ethnically diverse, including Anglo, Latina, African-American, and Asian women. Unique cultural needs were heard and integrated into the operational plan of the program. The.HIV Educator/program coordinator will assess her cultural competence and proficiency through ongoing feedback of program participants and technical assistance through CDPHE. IV. OBJECTIVES By December 31, 1998, 25% of women participating in risk-reduction workshops will be able to describe 3 high-risk behaviors that increase their chances of HIV transmission. By December 31, 1998, 25% of women participating in workshops and peer presentations will be able to demonstrate how to correctly put on a condom. By December 31, 1998, increase by 10% the number of women participating in risk-reduction workshops who use condoms. V. OPERATIONAL PLAN The intervention to be implemented will be a group level intervention, specifically a cycling 6-week (90 minute weekly sessions) risk-reduction workshop, titled "Relationships 201", open to any interested woman over 15 years of age. The desired number of participants for each workshop is 15 individuals. The first 6-week workshop will be given to the ongoing women's support group at A Woman's Place. This open group of 10-15 women meets on a weekly basis to discuss relationship and life struggles and triumphs and is facilitated by an on-staff counselor at A Woman's Place. For the purposes of the risk-reduction workshop, the group will become a closed group for the alotted 6 weeks (new members will not be permitted to join the workshop after the second session and existing members will be briefed on the importance of 11 /25/97 3 or 0522 attending all 6 sessions). Initially providing the risk-reduction workshop to an already existing group enables the first intervention to begin earlier in the year in order to reach a greater number of the target population, while concurrently recruiting participants for future workshops (as outlined in the Target Audience section). If there are more interested women than available space in the risk- reduction trainings, the possibility of a second concurrent workshop will be considered. The location of the risk-reduction workshops will alternate at each 6-week cycle between the two collaborative organizations; A Woman's Place and Sunrise Community Health Center. Behavior change is still the only available means to avoid contracting HIV infection, and encouraging individuals to avoid risk behaviors remains the only effective HIV-prevention strategy. Only a few behavior changes are needed to eliminate or lessen risk for HIV infection: Having sex only in a monogamous relationship with an uninfected partner; consistently using condoms if sexually active in any other circumstance; and for injection drug users (IDUs), not reusing uncleaned needles. The risk-reduction workshops will place a high degree of emphasis on attitudes towards condoms and condom usage. According to the Siecus Report Fact Sheet Volume 24, Number 10, Oct/Nov. 1995, using a condom is more than 10,000 times safer than not using a condom during intercourse, and condoms are 98% effective when used correctly with some reports indicating they are 100% effective. Studies show that for individuals to wear condoms, they must not only believe that sex with a condom can be enjoyable, but trust their technical ability to use condoms in a confident way. The proposed risk-reduction workshop, "Relationships 201", will include and address the following important factors that influence behavior change: Risk education - Accurate understanding of behaviors that confer risk, behavior changes needed to reduce risk, and the rationale underlying risk- reduction changes. Perceived personal vulnerability Personalization of risk; believing oneself to be potentially vulnerable for contracting HIV/AIDS. Behavior change intentions - Readiness for change and committing oneself to risk-reduction effort. Self-efficacy - Believing oneself capable of successfully making risk- reduction behavior changes, and perceiving that this change will protect against HIV/AIDS. Implementation skills - Behavioral competence in areas necessary for change implementation including condom use or other safer sex practices, sexual assertiveness skills to refuse risk pressures, and safer sex negotiation skills. Reinforcement of behavior-change efforts - Positive rather than negative outcomes associated with behavior-change efforts, including positive partner 11'/23/97 4 ProC22 response, self-praise and reinforcement, and belief that behavior change is consistent with peer group norms. "Relationships 201" Curriculum Session 1: Introductions and ice-breaking activities. Initiate discussion on basic HIV.facts (HIV 101) in order to clarify information and clear up misconceptions. Identify attitudes, concerns, fears, and states of mind which participants may have brought to the workshop. Session 2: Initiate a process of acceptance and/or validation of participants' feelings about their sexual choices. Associate different sexual practices with the level of risk for HIV infection. Stimulate creativity with respect to identifying non- penetrative sexual practices. Session 3: Identify and discuss barriers to practicing safer sex (i.e. partner issues, condom acquisitioNuse issues). Discuss facts/myths surrounding condoms. Increase comfort level and develop positive attitudes in regards to condom use through practice and fun activities using condoms (homework assignments may be utilized; e.g. condom acquisition). Session 4: Identify factors inhibiting ability of persons to discuss/agree upon safer sex practices with partners. Practice assertive communicatioNnegotiation skills for discussing/agreeing upon safer practices. Address gender differences in communication. Relate the effect of alcohol and drugs to the difficulty of establishing agreements with sex partners regarding safer sex. Session 5: Explore how cultural and family learning uniquely effect relationship patterns. Explore how self-esteem, relation of co-dependency, and sexuality have influenced attitudes toward practicing safer behavior. Session 6: Identify and practice self-nurturing behaviors. Provide participants the opportunity to consider the importance of committing themselves to the struggle against HIV at both a personal and community level (e.g. peer education opportunities). Complete evaluation. Closing. • 11 /25/97 5 Expected Outcomes 1) Behavior modification (e.g. increased safer sex activity, such as using condoms and maintaining monogamous relationships, decreased high-risk sexual behavior, decreased alcohol/drug use (determined by survey analysis). 2) Heightened self-esteem, and understanding of one's sexuality among participants. 3) Recruitment of a cadre of volunteers to become peer educators. The second component of this group-level intervention is a peer education program. Women who have completed a "Relationships 201" workshop will be eligible to become peer educators. Any woman who is interested will be required to go through a screening process to determine her level of appropriateness and be required to complete an additional 4 hours of training. An on-staff counselor at A Woman's Place will assist the HIV Educator in on- going supervision of the peer educators. The peer-educators will provide condoms, educational materials, and peer presentation to other women who have a similar shared identity (age, ethnicity, language, cultural norms, etc.). The presentations given by the peer educators will be fun and informal billed as "HIV Prevention Parties" and will be held at organizations that serve women and at women's homes. Peer educators will provide fliers at presentations on the upcoming "Relationships 201" workshop. Peer educators will be able to inspire and encourage their peers to adopt health seeking behaviors because they are able to share common weaknesses, strengths, and experiences. Peer educators will receive compensation for their efforts and hard work through material incentives of gift certificates to restaurants or other area merchants. These will be awarded either in smaller sums every month or in a large sum at an end of the year appreciation celebration. Time-Line By January 31, 1998, the first 6-week risk reduction workshop will begin (workshops will continue throughout the year with a one-week break between each). By January 31, 1998, area health clinics, mental health counselors, and other organizations that serve women will be provided with information regarding the "Relationships 201" workshop. By June 30, 1998, the first peer educator 4-hour training will be completed. By September 30, 1998, the second peer educator 4-hour training (for new peer educators) will be completed. By December 31, 1998, the third peer educator 4-hour training will be completed. 5.""�H 1.1 /25/97 6 . By December 31, 1998, a total of seven risk-reduction workshops, facilitated by the HIV Educator at WCHD, will be completed. By December 31, 1998, a minimum of twelve presentations (HIV Prevention Parties) - 2 each month between 6/30/98 and 12/31/98 - will be completed by the trained peer educators. CWT District 2 recommended Group Level Intervention as having primary importance in prevention activities surrounding unsafe sexual contact, partners of opposite sex....(Statement 4). VI. COLLABORATION, COORDINATION AND NON-DUPLICATION: The HIV Educator at WCHD will collaborate with two separate agencies to implement this group level intervention; A Woman's Place and Sunrise Community Health Center (see attached letters of collaboration). A Woman's Place is a resident shelter for battered women and their children. The organization also provides counseling and case management services to women who have experienced a domestic violence situation. According to the Centers for Disease Control, women who are raped, sexually abused, or survivors of domestic violence have lost the power to make decisions about whether or not to engage in sexual activity and about personal safety, and are thus at risk for unprotected sexual activity. This unprotected act puts women at risk for being infected with HIV. Sunrise Community Health Clinic provides medical, dental, and some mental health services. The WIC (Women Infants and Children) Program is housed at Sunrise as well. In addition, Sunrise Clinic is a confidential HIV testing site. Reciprocal promotion of safer sex classes will occur between WCHD and the Lambda Community Center in Ft. Collins. Resource sharing and technical assistance with each other's respective programs will be ongoing throughout 1998. Both of these agencies will play a major role in recruiting participants for the risk-reduction workshops. The site for the workshops will alternate between these two agencies. An on-staff counselor at A Woman's Place will assist in ongoing supervision of the trained peer educators. There are currently no other service providers in Weld County providing HIV risk-reduction workshops or peer educator presentations. All components of this program are new and innovative for Weld County. VII. EVALUATION Formative evaluation through the implementation of a focus group (described in the Target Audience section) was utilized. The two primary questions discussed by the focus group were; 1) What do you see as the issues of primary importance to be addressed in a relationship (risk-reduction) workshop? and 2) What are barriers to protecting yourself sexually (safer sex practices) that you have either experienced or perceived? Responses to these questions were incorporated into the workshop design/curriculum. Responses to a survey (described in the Target Audience section) were also used in program planning. 11 /25/97 7 • A pre- and post-test questionnaire will be administered to participants at the beginning and the end of the 6-week risk-reduction workshop. The questionnaire will collect demographic data on the participants and ask questions about sexual practices (including condom usage) and drug and alcohol use. An instrument measuring self-esteem will also be utilized. Additionally, participants will be asked to provide feedback on each of the six sessions on a general evaluation sheet. Participants will be given the opportunity to comment on time allotment, facilities, educational themes and other aspects of the workshop. Women will also be asked to describe 3 high- risk behaviors that increase their chances of HIV transmission. These techniques will serve as a form of process evaluation and assist in the completion of outcome evaluation. The number of workshops, participants, peer education activities, and printed materials and condoms will be tracked and submitted to the CDPHE Epidimiology Dept. on a quarterly basis. A narrative detailing general activities and accomplishments toward the outlined objectives will be included in the quarterly HIV prevention progress report to the Contract Supervisor. A Professor in the Community Health Department of UNC has offered his assistance in conducting an outcome evaluation through statistical analysis of collected data. ?0S22 11 /25/97 8 VIII. BUDGET • HIV Educator $5919.68 (8 hrs. x $14.23 x 52 wks.) Fringe $591 .96 (10% of total personnel requested) Indirect $859.53 (13.2% of total personnel requested) Peer Educator Incentives $440.00 Travel $348.83 (10 Denver trips) Conference Registration Fees $170.00 TOTAL FUNDING REQUESTED $8330.00 NOTE: No additional private or public funds currently support any HIV prevention activities conducted by WCHD. Total funding for this HIV prevention project is being requested from this state proposal. WCHD currently has educational materials and condoms as carry-over from 1997 HIV prevention supplies. CDPHE has agreed to provide additional materials on a request basis (see Attachment ;for appropriate materials currently in stock at WCHD). oct)r22 11 /25/97 9 U `-0 73 N 7 II c > > 1 69 64 G.4 69 69 GA G9 69 FA o 64 64 64 44 6A 44 6A G9 64 O — r G G ,,, L :L — V7 U I f L C.) d a. n V Cr Vl V7 0 U U N X CA LC c.' ,— c.4� v: Cr. CPI Cl) t 69 G G9 9 E. 69 6A 64 64 G4 c y 4 69 GA 44 69 4.4 GA 64 4A e .. r 1) •J ,ll y > r V U O U `.• O ' G4 4A 69 64 64 64 69 64 O 69 ;A 64 G4 64 GA 44 G9 G4 O >, n F. fn Q f� CD o ti `= _ fT O CP O Ccr O C7 cA a = N Cr Fr,,, I ,_._ ri..,, i bZ \‘\ 0 E 6 O !.-. V: V 69 69 69 64 6A 69 69 64 09 0 G4 G4 G4 GA G4 GA GA G4 G9 0 J 0 11- ,,n ,_ n _� Z � w j — 2 ", J _ L. ;i` U H C H -- -- -I _ C H O H u ?4022i • ATTACHMENT A: DEFINITION OF RURAL AND URBAN "Urban"shall be a term applied to counties that fall within the standard definition of Metropolitan Statistical Areas(MSAs), having within the county boundaries one or more population centers of 50,000 persons or more,AND which according to Colorado HIV surveillance data have a preponderance of AIDS cases,that is 250 cases or more. These counties are: Adams,Arapahoe,Boulder,Denver, El Paso, and Jefferson. In Colorado these counties are both urban by definition and account for 89%of the known AIDS cases in the state. "Rural" shall be a term applied to counties that fall within non-Metropolitan Statistical Areas OR have less than 250 reported AIDS cases. These counties are the remaining 57 counties in Colorado and account for 11% of the known AIDS cases in the state. (Note: Larimer, Weld,Mesa, Pueblo, and Douglas counties are counties that are MSAs yet are included in the "rural" categorization for the purposes of CWT based on epidemiological characteristics.) r'0 c22 • Cr 0 r o 0 L O In • 6J • C) LA g 64 69 64 64 64 64 64 64 iH 2 m -- 69 64 64 G4 64 64 64 64 cv o 68 3 , • VI ti 64 i.4 64 6H 64 64 64 iH ' O • 0 • - cn - w y O > u • O U 64 69 64 64 64 64 64 64 fA w • c0 7-2 L. - U _ Summary of the Priorities contained in the 1998 - 2000 Comprehensive Plan for HIV Prevention • HIV Prevention for Rural Areas Perspectives in the Comprehensive Plan There are two perspectives summarized in the state wide Comprehensive Plan relevant to providing services in rural areas: 1) the perspectives of the nine rural districts (1,2,3,4,5,7,8,10, and 11) (see "CWT- Contact individuals, District/Population Coalitions" for district boundaries), 2) the perspectives of fourteen groups whose focus is on populations who reside statewide (African Americans,people with disabilities,people who are deaf or hard of hearing, injection drug users, incarcerated people, Latinos, men who have sex with men, people living with HIV, pregnant women and children, people affected by substance abuse, women at risk, migrant farm workers, high risk youth, and Colorado Department of Public Health and Environment). In general, both of these perspectives are relevant to any given prevention program. For instance, if a service provider proposes a program targeting Latinos who reside in Bent county, the service provider should consider and address the priorities of District 10 (a rural district which includes Bent county) as well as the priorities of the Latino Coalition (a population coalition concerned with Latinos state wide). The information presented in this fact sheet summarizes the two perspectives listed above. However, in summarizing these perspectives, some of the individual variations have been obscured. For instance, although District 10 generally follows the tends of the rural districts concerning priorities, it also has some unique characteristics. Service providers are strongly urged to obtain the specific plans for each district and each population they serve. These individual plans are available by calling the CWT program at(303) 692-2736. People of Color Communities Overall, the Plan places a high priority on providing HIV prevention services for communities of color in rural areas. Among the rural district coalitions,the highest level of concern was for Latinos and Latinas and Native Americans. Among the population coalitions, highest level of concern was for Latinos and Latinas, African Americans,Native Americans, and Asian Americans. There were considerable geographic variations for these priorities; individual coalition plans should be consulted. rflczz Attachment C WELD COUNTY HEALTH DEPARTMENT BOARD OF DIRECTORS Lanny Clary - Dist. 1 Vacant - Dist. 2 Donna Meier - Dist. 3 Ann Garrison - Dist. 4 Melvin Brown - Dist. 5 Nancy Fichter - Dist. 6 Ben Slater - At Large Mary Stoll - At Large rn0522 ATTACHMENT D • Age 13-47 Please answer true (T) or false (F) to each of the following. (Number and percentage of incorrect responses on corresponding line. N=82) 1) A person can get AIDS from: holding hands sharing needles 11 (130/0) kissing 13 (16%) mosquito bites 22 (27%1 donating blood 9 (11%) having a blood test 2 (30/01 public toilets sex without a latex condom a (io%) eating in a restaurant where the cook has AIDS 2) 2 (3%). You can tell if a person is infected by looking at them. 3) 2 (3%) A person with AIDS can pass it on through sex. 4) A pregnant woman can infect an unborn child. 5) 1 (1%) There is a cure for AIDS. 6) Only gay men can get AIDS. 7) You can reduce your chance of infection by: ima abstaining from sex. 1 (1%) using latex condoms. 9 (11%) not having sex with an IV drug user. 4 (5%). taking birth control pills. 8) 35 (43%) A mother can infect her baby by breast-feeding. 9) 2 (3%) AIDS reduces the body's ability to fight disease. 10) '3 (4%o) There is a vaccine to protect against AIDS. ?fOc 2 Please answer the following based on your own personal experience. 11) How often do you use condoms? a) Always b) Most of the time c) Some of the time d) Never 12) If you never or rarely use condoms, what are the main reasons? (circle all that apply) a) Lack of availability b) Embarrassment in purchasing c) Interrupts the moment d) Decreases sensation e) Break easily f) Don't know how to use g) Partner will not use h) Currently in a long-term monogamous relationship i) Not sexually active j) Other 13) If you do use condoms, what are the main reasons? (circle all that apply) a) Birth control b) Protection from AIDS or other Sexually Transmitted Diseases c) Partner insists on it d) Other 14) If you do use condoms, where do you get them? a) Grocery, drug or convenience store b) Family Planning Clinic c) Friends ?^O 522 d) Partner provides them ATTACHMENT E: CLIENT DEMOGRAPHICS Directions: All contractors/applicants must complete the following six tables.If your program involves direct services to clients,your percentage of effort should be based on the number of clients you estimate you will serve in 1998. Each table must total 100%. Table 1 Counties of residence % of effort in 1998 Urban 0 O? 0 (Adams.Arapahoe.Boulder.Denver.El Paso.Jefferson) Rural 1O 00/0 (The remaining 57 Colorado counties) Total , 100% Table 2 Awe % of effort in 1998 Children(ages 0-12) Q°/o Adolescents(ages 13-19) t CVO Youth Adults(ages 20-24) G/O Adults(older than age 25) (a a/0 Total 100% Table 3 Disability %of effort in 1998 People with a developmental,physical, c'fo mental,and/or emotional disability cr/o People who are deaf or hard of hearing People without a disability 0°/0 Total 100% Table 4 Gender %of effort in 1998 Male 0014 Female t OO°(O Total 100% 0 col o 0 O CZ V IA 0 c C.) L. 6) 0 e < tlt C C. Ck Z 1 C c� 0 a 0 • 4„ _ a L U CI G L C O rr it v rcn U o C co . cc C a c...t, = O o . U .. c '4 i CI - c O 0 CC G - a U 'i, a t.r.z: E • Q < L c N L c C V E e a.) g y = > O till 3 J �,U x L X _U 1 V G -� W -C I IC > 2 ,2. - ^ 0 C a) 3 •° 3 " •° G .) _ t‘" a a� N � O = cn o � � ° cr o a� = o Q Z '' • V U N C O N > Y c- > L N L r O N F C. L O N _ I to L F O F .O U L'L O C. a N F ... _ O _ .. .. _ i a. O CA c p N C — C C b 0 G _ _ G a o p. . p C C y LO = y O CD en E c 0 a cn Co ≥` a . T. _ 3 c3 O CD _ ° s r- t., L a. U O p V `T p 'O N N C N y O O L a0-3 C N - - - L p X O 7 . . CO cc U F - � - OL ;... �:. o 'T :. R V o ex E 3 ,o = h J 1 r ca b o O O o b t� o o .�� 22 Attachment F COLORAD.ANS WORKING TOGETHER- CONTACT INDIVIDUALS DISTRICT/POPULATION COALITIONS - COALIT`. , ' I y 'PRIMARY CONTAtr SECONDARY CONTACTA District 1 Stefanie Donahue Lynn Eynard (Jackson, Routt, Mofat, Rio Blanco P.O. Box 770417 P.O. Box 770417 Counties) Steamboat Springs, CO 80477 Steamboat Springs, CO 80477 (970) 879-1632 (970) 879-1632 District 2 Gerald Ernst Leslie Burkholder (Larimer, Weld, western Adams [non- 1406 Peterson Northern Co AIDS Project metro] Counties) Ft. Collins, CO 80524 107 Cameron Dr (970)224-1555 Ft. Collins, CO 80524 (970)498-6772 (Fax) (970)223-6227 (970) 223-1659(Fax) District 3 Loreen Miller Kathy Karsting (Logan, Sedgwick, Phillips, Morgan, Northeast CO Health Dept. Northeast CO Health Dept. Washington, Yuma, Lincoln, Kit 700 Columbine St. 228 W. Railroad Road Carson, Cheyenne, eastern Adams Sterling, CO 80751 Fort Morgan, CO 80701 [non-metro] Counties) (970) 522-3741 (970) 867-4918 (970) 522-1412 (Fax) (970) 867-0878 (Fax) District 4 Jeff Basinger Maxine Pixley (Rio Blanco, Mesa, Delta, Montrose, Western CO AID Project Colorado West Recovery Gunnison, Ouray, San Miguel P.O. Box 143 711 Grand Ave. Counties) Grand Junction, CO 81502 Glenwood Springs, CO 91601 (970)243-2437 (970) 945-8439 (970)243-5791 (Fax) (970) 945-1040 (Fax) District 5 Susan Robertson Maxine Pixley (Grand, Summit,Eagle, Pitkin, Lake, Northwest CO Prevention Center Colorado West Recovery Park, Chaffee Counties) Box 2565 711 Grand Ave. Frisco, CO 80443 Glenwood Springs, CO 91601 (970)668-2077 or 1-800-819-9174 (970) 945-8439 (970) 668-1737 (Fax) (970) 945-1040(Fax) District 6 Imani Latif Barb Jones (Denver,Boulder, Gilpin, Clear Colorado AIDS Project Colorado AIDS Project Creek, Jefferson, Douglas, Arapahoe, 701 E. Colfax 701 E. Colfax metro portions of Adams Counties) Denver, CO 80203-2005 Denver, CO 80203-2005 (303) 837-0166 (303) 837-0166 (303) 861-8281 (Fax) (303) 861-8281 (Fax) District 7 Ken Puhler t (Dolores, Montezuma, La Plata, La Plata Prevention Partners Archuleta, San Juan, Hinsdale P.O. Box 140 Counties [excluding reservation Durango, CO 81302 areas]) (970) 247-5702 (970)247-9126 (Fax) ? 0' 22 *Excludes all Colorado Department of Public Health & Environment Personnel ATTACHMENT F: Titles of educational brochures/booklets currently at WCHD to be used in risk-reduction workshops and peer educator presentations: 5 Smart Steps to Condoms HIV Fast Facts: Condoms HIV Fast Facts: Young Women Women, Sex, and HIV 5 Smart Steps to Stop HIV 5 Smart Steps to Good Sex Condoms: Talking with your Partner Condoms - - What Women Need to Know About Women and AIDS Talking With Your Partner About Condoms El Condon VIH Y EL SIDA Hablar con to Pareja Sobre Los Condones ATTACHMENT G: ASSURANCES We hereby affirm that: • materials produced or purchased with these monies will be submitted for approval to the Material Review Panel prior to printing or purchase; • other sources of federal,state,or local funding are not being used to support this particular activity (non-duplication); • personal identifiers related to HD/ infection, or AIDS will not be released and adequate security of personal information will be maintained to protect client confidentiality; • the proposed program is coordinated with other HIV prevention providers in our geographic area; • we will collaborate with other HIV prevention providers to accomplish the scope of work described in this proposal; • we will comply with the definition of cultural competence and proficiency; • we will comply with all applicable federal legislation (Americans with Disabilities Act, Civil Rights Act,etc.); • we will effectively and respectfully provide HIV prevention services to people with disabilities and people with hearing impairments; • we have written this proposal in response to our District and/or Population Plans and our proposal is relevant to the target audience we intend to serve; • this program does not duplicate other programs in the our geographic area serving the target audience described in this proposal. ORGANIZATION'S NAME: kiki Elf-D COUNTY Raeli—T D€P1', NAIVE OF INDIVIDUAL SIGNING THIS FORM: in t S TV Pt-5 (Please print or type) - sk1 has tt /15 jcil Signature Date POSITION OF THE INDIVIDUAL SIGNING THIS FORM: \A\V 2,0 V CAT OR < • 980522 COLORADANS WORKING TOGETHER- CONTACT INDIVIDUALS DISTRICT/POPULATION COALITIONS .COALITION I PRIMARY CONTACT* SECONDARY:CONTACT* Deaf/Hard of Hearing Coalition Elaine Woody Ric Durity 4353 E. Colfax 4353 E. Colfax Denver, CO 80220 Denver, CO 80220 (303) 320-8526 TTY (303)320-8526 TTY (303) 320-5701 (303) 320-5701 (303) 320-4830 (Fax) (303) 320-4830 (Fax) Incarcerated Coalition Joe Mauro Colorado AIDS Project 701 E. Colfax Denver, CO 80218 (303) 837-0166 ext 106 (303) 837-9213 People Living With HIV Coalition Shannon Behning Jo Mauro 2172 S. Trenton Way 1-105 Colorado AIDS Project Denver, CO 80231 701 E. Colfax (303) 337-5139 Denver, CO 80218 (303) 337-2115 (303) 837-0166 (303) 837-9213 980522 • *Excludes all Colorado Department of Public Health & Environment Personnel SsomnTrios COMMUNITY HEALTH CENTER . INC . for everyone's health • Misti Aas, M.A. HIV Education Weld County Health Department 1517 16th Ave. Ct. Greeley, CO 80631 Ms. Aas, Sunrise Community Health Center,lnc. administration , providers and staff extend our appreciation for your interest in collaborating HIV education to our clientele. One of our interests of focus of empowerment and education is toward women in our community. A significant percentage of patients that we serve are women, many are Hispanic/Latino women from ages 15 to 60. We have a genuine interest and need to promote health education in the area of intervention and prevention of HIV/Aids. We are a counseling/testing site and are a hub for these women in that we also offer WIC services , King Soopers Pharmacy and mental health services. Our role for this proposed group level intervention will include assistance in recruitment of participants for the risk-reduction workshops, through distribution of fliers and direct client contact by service providers. In addition, Sunrise Community Health Center is one of the proposed sites for the implementation of these workshops. We encourage your continued efforts in this area and look forward to future collaboration with you toward health education in our community. Sincerely, Dennis M. Lovato 9S0522 1028 Fifth Avenue Greeley, Colorado 80631-1870 (970)356-6014 fax(970)353-9906 11 Information/Donations 351-0476 Woman's Executive Director 351-6950 Ft. Lupton Office 857-2642 Crisis Calls 356-4226 Place, Inc. Domestic violence agency for Weld County November 24, 1997 To Whom It May Concern: This letter is in regard to the collaborative efforts between A Woman's Place and the Weld County Health Department. The staff at A Woman's Place is very excited about the ongoing risk-reduction workshops for women that have been proposed by the Weld County Health Department. One of the goals of our agency is to help empower women to make healthy and responsible choices in their lives. Due to the cycle of violence that our clients have experienced, they often lack positive and assertive communication, as well as other skills needed to overcome barriers that prevent these women from protecting themselves against HIV and other STDs. To help support the success of this intervention, our agency will assist in recruiting participants by promoting the "Relationships 201" workshops to the women whom we serve. A Woman's Place will also be one of the locations for the facilitation of the risk-reduction workshops. Once the peer education program is implemented, we will collaborate with the HIV Educator at the Weld County Health Department by assisting with the provision of ongoing support to the peer educators. We encourage the continued educational efforts of the Weld County Health Department and look forward to ongoing collaboration throughout the coming year. Sincerely, 7-46:r‘ Deb Printz Women's Counselor 9030522 P.O. Box 71, Greeley, Colorado 80632 A United Way Agency P.O. Box 312, Ft. Lupton. Colorado 80621 cu -= � ..ae6a Gerald E. Ernst 970-224-0824 P. 2 LAMBDA COMMUNITY CENTER 1437 E Mulberry, Suite#1 V Ft. Collins,CO 80524 Phone 970.221.3247 V Fax 970.221.2139 V Outreach Cell 970.217.7488 E-Mail LambdaCenter@usa.net V http://www.fortnetorg/LambdaCommCtr "SERVING ALL COMMUNITIES OF NORTHERN COLORADO INCLUDING THE GAY, LESBIAN, BISEXUAL AND TRANSGENDER" November 24, 1997 Ms. Misti Ms,MA Weld County Health Department 1517 16th Avenue Court Greeley, Colorado 80631 Re: Collaboration between LCC and WCHD for 1998 HIV Prevention Services Dear Ms.Aas: I look forward to continuing our collaborations complimenting both HIV Prevention Service Programs In Northern Colorado. As agreed, LCC will continue to do Street and Community Outreach in Northern Colorado and this letter is to verify non-dupication of services. We agree to collaborate and support each other in the following areas: 1) LCC will support and refer clients to WCHD Anonymous HIV Testing Site. 2) LCC will support, refer, help promote and assist in distributing information regarding WCHD programs,workshops and other related HIV Prevention Services during LCC Outreach. 3) LCC will offer support and assistance to WCHD regarding materials, program development, or requested information regarding HW Prevention Services in Northern Colorado. 4) LCC will share its outreach findings and Information with WCHD. 5) WCHD will asst LCC in information regarding its outreach program. • 8) WCHD will track LCC referrals and report the quantitative information to LCC. 7) WCHD and LCC will collaborate regarding competence and proficiency of both organizations and will utilize our knowledge and experiences to better serve our communities in Northern Colorado for the Prevention of HIV. I look forward to our continuing successes in the upcoming year and our joint efforts in the Prevention of HIV. It is always a pleasure working with you.You have always kept the best interest of your community in mind regarding services. Respectfully: Gerald E. Ernst Outreach Coordinator, Lambda Community Center Cc: Colorado Department of Public Health and Environment Board of Directors, Lambda Community Center 9A0522 o § } ) ) � 2 2 / Ee22 ) C:4 \ p w 9 - 2 6L. Zn W $ 2 Dirt)* n . y § k z � L. .. 0 ) � = ° 9 � ) \ } § ( ei 0. F. } / § ea § Is § d 1.4 CC ( Q § ` 2 4 # O cs \ . / \ . 2 Qo - . c eu / o k Q . .c \ § to O 4 al § / 0 < . E t 2 � ( § k / \ Lu z o $ 4 g § k ) § ] ) mt \ / }/ N / ) \ E \ F. o a / § / § j . / \ } \ 9040522 Weld County Health Department HIV Prevention Contract No.SET9808287 ATTACHMENT 3 Date State Fiscal Year 19_-_ Contract Routing Number Change Order Letter No. In accordance with 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 ,covering the period of 199_through , 199_,the parties agree that the maximum amount payable by the State for the eligible services refe *,;. in paragraph of the Original Contract is being increased/decreased by DOLLARS °. )to a new total of _DOLLARS ($ )in accordance with the revised work . '`. attar . as"Attachment A"and the revised budget attached hereto as"Attachment B",both of which are made a . er: ,orated herein by this reference. The first sentence in paragraph_,of the Original Contract is '..r,' _ • 11 other terms or conditions of the Original Contract are hereby reaffirmed. This amendm.. • the Original Contract is int ti k of .0 in no event shall it be deemedvali �,v ,..r. "•s t ``: . �e.r t. ir ' .m. :. Please sign,d . � d re `, 1 a �� han rde �`.e . ntion of: Co orado an Mail Code: c t •• Creek y One original of this Change Order Letter ' t `, u y aPProved. 'w a 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: APPROVALS: PROGRAM CONTROLLER By: L. A. Koleski,Jr. By: Clifford W. Hall 9,30522 Weld County Health Department HIV Prevention Contract No.SET9808287 ATTACHMENT 4 , 1997 State Fiscal Year 19_-_ 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 , 199_through , 199 ,the parties agree that the maximum amount payable by the State for the eligible services referenced ' graph_of the Original Contract is increased/decreased by DOLLARS ($ )to a n- ''•tal of DOLLARS ($ ). The revised work plan,which is attached hereto as "Atta "' nt A", -.revised budget,which is attached hereto ' as"Attachment B",are both made a part hereof and incorporat-. ;' b ce. The first sentence in paragraph _of the Original Contract is hereby modified accordingly. • • K er ".. . ditio ``_-,the Original Contract are hereby reaffirmed. This amendment to the Original Contract is ' i. "9_,but in no event shall it be deemed !.� 1 h• - rsYl. • •. - ^ Please si:• e •. s e s t ' w the attention of .. � .: • 4300 C .. Denver,Colo • One original of this Contract • -.al Lett 711 . )-• 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 Tide: and Environment APPROVALS: PROGRAM CONTROLLER By: By: L. A. Koleski,Jr. Clifford W. Hall 990522 DEPARTMENT OR AGENCY NUMBER FHA CONTRACT ROUTING NUMBER 98-08287 CONTRACT This CONTRACT is made this 1st day of January, 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 80222-1530,hereinafter referred to as "the State", and the Weld County Health Department,whose address or principal place of business is 1517 16th Ave. Ct..Greeley.Colorado 80631 hereinafter referred to as"the Contractor". WHEREAS, authority exists in the Law and Funds have been budgeted, appropriated and otherwise made available and a sufficient unencumbered balance thereof remains available for payment in Fund Number 100, Appropriation Code 265,Contract Encumbrance Number FHA SET9$08287; WHEREAS, as of the effective date of this Contract,the State has a currently effective Group II purchasing delegation agreement from the Division of Purchasing within the Colorado Department of Personnel; WHEREAS,the State has formulated comprehensive plans relative to the statewide control of Sexually Transmitted Disease(STD)and Human Immunodeficiency Virus (FIIV)infection; WHEREAS,the State has received funding from the Centers for Disease Control and Prevention(CDCP)to assist in the prevention of, and education about,Human Acquired Immuno-Deficiency Syndrome (AIDS); WHEREAS,the Contractor, a county health department,is considered by the State to be an appropriate agency to provide the services set forth below; WHEREAS,this procurement is exempt from the Colorado Procurement Code and Rules because the Contractor is a governmental agency; and, WHEREAS, all required approvals,clearances, and coordination have been accomplished from and with all appropriate agencies. NOW THEREFORE,it is hereby agreed that for and in consideration of their mutual promises to each other,hereinafter stated,the parties hereto agree as follows: A. EFFECTIVE DATE AND TERM. The effective date of this Contract is January 1. 1998. The initial term of this Contract shall commence on January 1, 1998, and continue through and including December 31. 1998. At the option of the parties,this Contract may be renewed for two (2)successive extension terms of one(1)year each. Page 1 of 9 9040522 DUTIES AND OBLIGATIONS OF THE PARTIES. 1. The Contractor shall provide to the State HIV Prevention Services for rural at-risk communities,prevention case management, and public awareness, as set forth in the Scope of Work,which is incorporated herein by this reference,made a part hereof, and attached hereto as Attachment 1. 2. The Contractor shall maintain internal medical and administrative records in a manner which ensures the confidentiality and security of those records in accordance with all applicable statutes of the State of Colorado and,rules and regulations of the Colorado Board of Health. 3. The Contractor shall provide to the State quarterly narrative progress reports describing and evaluating the progress of all activities identified in the attached Scope of Work. The quarterly narrative progress reports are due no later than five(5)working days after the end of each quarter during the initial term of this Contract. If the Contractor fails to timely submit a quarterly narrative progress report,then the State shall not pay the Contractor's last monthly billing statement for the previous quarter until such time as the delinquent quarterly narrative progress report has been received by the State. The applicable time frames and due dates for the quarterly narrative progress reports are as follows: Progress period Due date January-March, 1998 April 7, 1998 April-June, 1998 July 8, 1998 July-September, 1998 October 7, 1998 October-December, 1998 January 8, 1999 4. The Contractor shall collaborate with the State and the CDCP in its data collection and analysis. No data or analysis shall be published by the Contractor without the prior,express, written approval of the State and the CDCP. C_, COMPENSATION.CHANGE.AND RENEWAL 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 TWENTY FOUR THOUSAND EIGHT HUNDRED AND THIRTY DOLLARS ($24,830.002 for the initial term of this Contract-January 1, 1998,through December 31, 1998. 2. To be compensated under this Contract,the Contractor shall submit a signed monthly billing statement, an example of which is incorporated herein by reference,made a part hereof, and attached hereto as Attachment 2,within sixty(60)calendar days of the end of the month for which services were rendered. The Contractor shall request reimbursement for the Contractor's salaries,fringe benefits, supplies,travel, other contracts, operating, and indirect costs which are allowable and allocable expenses related to this Contract. The monthly billing statement shall: reference this Contract by its contract number,which number is located on page one of this document; state the applicable performance dates,the names of payees,and a brief description of the services performed,expenditures incurred, Page 2 of 9 980522 and the total reimbursement requested. Reimbursement during the initial, and any extension,term of this Contract shall be conditioned upon affirmation by the State that all services were rendered by the Contractor in accordance with the terms of this Contract. 3. The following budget shall govern the expenditure of finds for the initial term of this Contract-January 1, 1998,through December 31, 1998. The Contractor's transfer of funds from one line item to another must have the prior,express,written approval of the State: Group Risk Reduction Prevention Case Management Personnel $ 5,919.68 Personnel $ 7,814.56 Fringe $ 591.96 Fringe $ 781.45 Conference Fees $ 170.00 Travel $ 269.32 Travel $ 348.83 Total Direct Costs $ 8,865.33 Other $ 440.00 Indirect Costs $ 1,134.67 Total Direct costs $ 7,470.47 Indirect costs $ 859.53 Total $10.000,00 Total $8.330,00 Public Awareness TOTAL BUDGET Personnel $4,854.72 Personnel $18,588.96 Fringe $ 485.47 Fringe $ 1,858.88 Travel $ 369.91 Conference Fees $ 170.00 Other $ 85.00 Travel $ 988.06 Total Direct costs $ 5,795.10 Other $ 525.00 Indirect Costs $ 704.90 Total Direct Costs $22,130.90 Indirect Costs $ 2,699.10 Total $6,500.00 GRAND TOTAL $24,830.00 4. 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 3. 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 types of services or programs 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; 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. Page 3 of 9 980522 5. 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. 6. 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. 7. Increases or decreases in the level of contractual funding made through this change order letter process during the initial or extension 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. 8. 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 4. 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 types of services or programs, if any, increased or decreased and the new level of each service or program for the renewal term; Page 4 of 9 980522 C. The amount of the increase or decrease,if any,in the level of finding for each service or program and the new total financial obligation; D. The intended effective date of the renewal; 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. 9. 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 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. 10. 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. 980522 Page 5 of 9 COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT-hereinafter,under the General Contract Provisions,referred to as"CDPHE". GENERAL CONTRACT PROVISIONS--page 1 of 2 pages 1. THE CONTRACTOR SHALL PERFORM ITS DUTIES HEREUNDER AS AN INDEPENDENT CONTRACTOR AND NOT AS AN EMPLOYEE. NEITHER THE CONTRACTOR NOR ANY AGENT OR EMPLOYEE OF THE CONTRACTOR SHALL BE OR SHALL BE DEEMED TO BE AN AGENT OR EMPLOYEE OF THE STATE. CONTRACTOR SHALL PAY WHENDUE ALL REQUIRED EMPLOYMENT TAXES AND INCOME TAX AND LOCAL HEAD TAX ON ANY MONIES PAID PURSUANT TO THIS CONTRACT. 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. CONTRACTOR SHALL HAVE NO AUTHORIZATION,EXPRESS OR IMPLIED, TO BIND THE STATE TO ANY AGREEMENTS,LIABILITY, OR UNDERSTANDING EXCEPT AS EXPRESSLY SET FORTH HEREIN. CONTRACTOR SHALL PROVIDE AND KEEP IN FORCE WORKERS'COMPENSATION(AND SHOW PROOF OF SUCH INSURANCE) AND UNEMPLOYMENT COMPENSATION INSURANCE IN AMOUNTS REQUIRED BY LAW,AND SHALL BE SOLELY RESPONSIBLE FOR THE ACTS OF THE CONTRACTOR,ITS EMPLOYEES AND AGENTS. 2. Contractor authorizes CDPHE,or its agents,to perform audits and to make inspections for the purpose of evaluating performance under this contract. 3. Either party shall have the right to terminate this agreement by giving the other party thirty days notice by registered mail,return receipt requested. If notice is so given,this agreement shall terminate on the expiration of the thirty days,and the liability of the parties hereunder for the further performance of the terms of this agreement shall thereupon cease,but the parties shall not be relieved of the duty to perform their obligations up to the date of termination. 4. This agreement is intended as the complete integration of all understandings between the parties. No prior or contemporaneous addition,deletion,or other amendment hereto shall have any force or effect whatsoever,unless embodied herein in writing. No subsequent novation,renewal,addition,deletion,or other amendment hereto shall have any force or effect unless embodied in a written contract executed and approved pursuant to the State Fiscal Rules. 5. If this contract involves the expenditure of federal funds,this contract is contingent upon continued availability of federal funds for payment pursuant to the terms of this agreement. Contractor also agrees to fulfill the requirements of: a) Office of Management and Budget Circulars A-87, A-21 or A-122, and A-102 or A-110, whichever is applicable; b) the Hatch Act(5 U.S.C. 1501-1508)and Public Law 95-454 Section 4728. These statutes state that federal funds cannot be used for partisan political purposes of any kind by any person or organization involved in the administration of federally-assisted programs; c) the Davis-Bacon Act(40 Stat 1494,Mar.3, 1921,Chap. 411,40 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 require that no person shall,on the grounds of race,color,national origin,age,or handicap,be excluded from participation in or be subjected to discrimination in any program or activity funded,in whole or in part,by federal funds; Rev. 05/07/97 (GEN) Page 6 of 9 980522 GENERAL CONTRACT PROVISIONS--Page 2 of 2 pages e) the Americans with Disabilities Act(Public Law 101-336;42 U.S.C. 12101, 12102, 12111 - 12117, 12131 - 0 if the contractor is acquiring real property and displacing households or businesses in the performance of this contract,the contractor is in compliance with the Uniform Relocation Assistance and Real Property Acquisition Policies Act, as amended(Public Law 91-646,as amended and Public Law 100-17, 101 Stat.246-256);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). 6. By signing and submitting this contract the contractor states that: a),the contractor is in compliance with the requirements of the Drug-Free Workplace Act(Public Law 100-690 Title V,Subtitle D,41 U.S.C.701 et seq.); b) the contractor is not presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily excluded from covered transactions by any federal department or agency. 7. To be considered for payment,billings for payment pursuant to this contract must be received within 60 days after the period for which payment is being requested and final billings on the contract must be received by CDPHE within 60 days after the end of the contract term. 8. If applicable,Local Match is to be submitted on the monthly payment statements,in the column provided,as required by the funding source. 9. If contractor receives federal funds in an aggregate amount per year from CDPHE which exceeds the applicable threshold dollar amount specified in the Office of Management and Budget Circulars A-128 or A-133,contractor agrees to have an annual audit,by an independent certified public accountant,which meets the requirements of Office of Management and Budget Circular A-128 or A-133,whichever applies.If contractor is required to submit an annual indirect cost proposal to CDPHE for review and approval,contractor's auditor will audit the proposal in accordance with the requirements of OMB Circular A-87, A-21 or A-122. Contractor agrees to knish one copy of the audit reports to the CDPHE Department Accounting Office within 30 days of their issuance,but not later than nine months after the end of contractor's fiscal year. Contractor agrees to take appropriate corrective action within six months of the report's issuance in instances of noncompliance with federal laws and regulations. Contractor agrees to permit CDPHE or its agents to have access to its records and financial statements as necessary,and further agrees to retain such records and financial statements for a period of three years after the date of issuance of the audit report. This contract(DOES/DOES NOT)contain federal funds as of the date it is signed. This requirement is in addition to any other audit requirements contained in other paragraphs within this contract. 10. Contractor agrees to not use federal fords to satisfy federal cost sharing and matching requirements unless approved in writing by the appropriate federal agency. Rev. 05/07/97(GEN) 9S0522 Page 7of9 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 fluids 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, mad.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 regardto 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. (1)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 contractor 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 980522 Page 8 of 9 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. Y' COLORADO LABOR PREFERENCE 6a. Provisions of CRS 8-17-101&102 for preference of Colorado labor arc applicable to this contract if public works within the State arc 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 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 thereat 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. IN WITNESS WHEREOF,the parties hereto have executed this Contract on the day first above written. Contractor: State of Colorado (Full Legal) Weld County Health Departtmee"ntt ROY ROMER,GOVERNOR By F%7J�GSYi.X.e..C. 7 J.f+ls i9 � Constance L. Harbert 01/98) Position(Title) Chair Wplrl en-flinty Roard of By 8481 Commissioners Social Sccuri PT!errrV.D.Number Department r1 ./�1 of PUBLIC HEALTH AND ENVIRONMENT ,, If Corporation,T IC r tilt,' 1 PROGRAM APPROV Attest(cAff�ix S I 7 r 7 ► 93s q s i LA.Kol ki,Jr.,Fiscal Officer By ! /f s Vim_. i] WELD CO ALTH EPA THE T -• •• . - � '>- '"*/County Clerk --. _ t APPROVALS BY ATTORNEY GENERAL ghN S. P1C LE, M,S.c.H, CONTROLLER DIUST9fi By By Gale A.Norton Clifford W.Hall Form 6-AC-02C(GEN060197)Revised 06/01/97 !%40522.. Page 9 of 9 Hello