HomeMy WebLinkAbout961169.tiff RESOLUTION
RE: APPROVE MULTI-YEAR CONTRACT RENEWAL FOR PERSONAL CARE
BOARDING HOME CONTRACT BETWEEN HEALTH DEPARTMENT AND
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT, HEALTH
FACILITIES DIVISION, 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 Multi-Year Contract Renewal for the
Personal Care Boarding Home 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, Health
Facilities Division, commencing July 1, 1996, and ending June 30, 1997, with further terms and
conditions being as stated in said contract renewal, and
WHEREAS, after review, the Board deems it advisable to approve said contract
renewal, 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 Multi-Year Contract Renewal for the Personal Care Boarding
Home 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, Health Facilities Division, be, and
hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said contract renewal.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 3rd day of July, A.D., 1996, nunc pro tunc July 1, 1996.
BOARD OF COUNTY COMMISSIONERS
���
XCOUNDO
1-4--
11301/42=' Barbara J. Kirkme er, Chair ,%
1861i t . el.j�� ty Clerk to the Board Vii'
e E. Baxt ro- e
Deputy Clerj o the Board
Dale K. Hall
APP AST RM =7 X114 ,
Constance L. Harbert
Ley(At4.,
o my Attorne
W. H. ester
961169
d- NZ-2 Sr/9r HL0022
•
cr +T
Form 6-AC-02A(R 5/85) c � '--�
95 I,��• -j P:I IO: OO DEPARTMENT OR AGENCY NUMBER
FM
CONTRACT ROUTING NUMBER
HFD960006
CONTRACT
THIS CONTRACT, made this 6 kday of 6//i..y /fqr , by and between the State of Colorado for the
use and benefit of the Colorado Department of Public Health and Environment, 4300 Cherry Creek Drive South, Denver,
Colorado 80222, hereinafter referred to as the State,and the Weld County Health Department, 1517 16th Avenue,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 Numberzrf.G ,
APPR code a4f, Contract Encumbrance Number FMA HFD960006 and
WHEREAS, required approval, clearance and coordination has been accomplished from and with appropriate
•agencies; and
WHEREAS, the Contractor and the State mutually agree that the services of approved public health staff, under
the administrative oversight of the Contractor, are the most efficient and effective way of providing the desired services
as herein set forth,
Now therefore, it is hereby agreed that for and in consideration of their mutual promises to each other, hereinafter
stated, the parties hereto agree as follows:
1. The Contractor shall provide, through the services of approved public health staff, services which include the
annual resurveys of personal care boarding homes and the investigation of all complaints lodged against personal care
boarding homes in Weld County. The State shall retain responsibility for fire safety inspections and inspections and
complaint investigations of alternative care facilities.
2. Minimal contract fulfillment for this contract period shall Include the following activities:
A) resurveys and all associated monitoring of personal care boarding homes and personal care boarding
homes designated as residential treatment facilities for the mentally ill (RTF MI) in Weld County following all relevant rules,
regulations, guidelines, forms, and procedures as detailed on Attachment 1, by this reference incorporated herein. The
State will keep the Contractor apprised of additions, deletions, or changes In the regulations covering personal care
boarding homes;
8) Investigations of all complaints lodged against personal care boarding homes and personal care
boarding homes designated as residential treatment facilities for the mentally ill (RTF MI) in Weld County following the
complaint procedures established by the State Health Facilities Division as detailed on Attachment 2, by this reference
incorporated herein; and
C) notification by the contractor of the local ombudsman of each survey upon entering a facility for
inspections and forwarding all deficiency lists from annual Inspections and complaint investigations, with plans of
correction to the local ombudsman.
3. All correspondence, notifications, or recommendations required hereunder shall be addressed to the
individuals at the addresses herein set forth:
Page i of t, pages
961169
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Mr.John Pickle
Weld County Department of Health
1517 16th Avenue
Greeley, Colorado 80204
Colorado Department of Health
Health Facilities Division
Residential Program Administrator
4300 Cherry Creek Drive South
Denver, Colorado 80222-1530
4. The State shall, in consideration of said services and reporting by the Contractor, cause to be paid to the
Contractor an amount not to exceed NINE THOUSAND TEN DOLLARS ($9,010.00) for the period 7/1/95 through 6/30/96.
Reimbursement shall be made at the flat rate of$265.00 per facility survey for each facility listed on Attachment 3 and shall
Include investigation of all complaints against the facility occurring within the contract period, payable upon submission of
deficiency reports to the facility operator and to the State. Funding for the second year and subsequent years Is explained
in Attachment A,which should be signed at the time the contract is renewed. The State shall notify the Contractor of the
procedure each year at the appropriate time. Funding for subsequent years is contingent upon continued appropriateness
and acceptance by the Contractor of the contract conditions. Payment shall be made for services as identified below:
a)All survey and monitoring activity necessary to determine the facility's compliance with the State's licensure
regulations and
b) Investigative activities necessary to resolve all complaints against the facilities listed on Attachment 3
occurring within the contract period. Resolution includes following the complaint procedures on Attachment 2.
5. Reimbursement shall be made upon receipt of signed billings, submitted in duplicate, requesting reimbursement
(Attachment 4). Billing shall include names of facilities surveyed and complaints investigated, dates, amount and totals
requested. The Contractor shall submit with each monthly billing for reimbursement Of not before) copies of the following
documents for State facility files maintained pursuant to statute: deficiency lists,and plans of correction.Also to be submitted
are copies of transmitting correspondence to and from facilities and complaint investigations. Reimbursement shall be
contingent upon affirmation of the State and satisfactory compliance with the terms of this contract.
6. The State may, in order to facilitate training in survey and complaint investigation procedures and monitor the
performance the Contractor, participate in survey activity and complaint investigations with the Contractor.
7. In order to allow for timely processing of reimbursements to the counties and facilitate the State's fiscal year-end
accounting processes,surveys should be performed prior to May 30, 1996. However,all surveys and investigations must
be completed during the contract period.
8. The Contractor and the State shall adhere to the following procedures:
a) Unlicensed facilities: The Contractor will immediately notify the State of facilities conducting business
without the necessary license;
b) Licensed facilities: The Contractor shall submit all relevant information to the State for state licensure
or enforcement action as indicated. While necessary enforcement actions will be the responsibility of the State, the
Contractor's staff may be called upon to support the documentation of their findings.
9. The term of this contract is from July 1, 1995 through June 30, 1998, and shall include the facilities listed on
Attachment 3, by this reference incorporated herein.
Page 2 of 8 pages
961169
,..1
ken
10. Changes in total reimbursement amounts for the above-named services in consideration of increased or
decreased workload accomplished shall be made by a mutually signed letter of approval (Attachment 5)which shall serve
as an amendment, and shall include the following:
a) Identification of contract by contract number and number of affected paragraph;
b) amount of increase or decrease in funding and new contract total;
c) effective date of the funding change;and
d) authorized signatures of the Contractor,and the State Controller. It is understood that no change except-
in funding amount shall be made through letter of approval.
•
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Page 3 of 8 pages
961169
COLORADO DEPART
MENT OF PUBLIC HEALTH AND ENVIRONMENT - hereinafter, under the General
Provisions referred to as "Health"
GENERAL PROVISIONS - page I of 2 pages
1. The contractor shall perform its duties hereunder as an independent contractor and
not as an employee. Neither the contractor nor any agent or employee of the contractor
shall be or shall be deemed to be an agent or employee of the state. Contractor shall pay
when due all required employment taxes and income tax withholding, shall provide and keep
in force worker' s compensation (and show proof of
such insurance) and unemployment
compensation insurance in the amounts required by law. Contractor will be solely.
responsible for its acts and the acts of its agents, employees, servants, and
subcontractors during the performance of this contract.
2. Contractor authorizes Health, or its agents, to perform audits and to make
inspections for the purpose of evaluating performance under this contract.
3. Either party shall have the right to terminate this agreement by giving the other
party thirty days notice by registered mail, return receipt requested. If notice is so
given, this agreement shall terminate on the expiration of the thirty days, and the
liability of the parties hereunder for the further performance of the terms of this
agreement shall thereupon cease, but the parties shall not be relieved of the duty to
perform their obligations up to the date of termination.
4. This agreement is intended as the complete integration of all understandings between
the parties. No prior or contemporaneous addition, deletion, or other amendment
subsequent novation, renewal, addition, deletion, or other amendment hereto shall have any
force or effect unless embodied in a written contract executed and approved pursuant to
the State Fiscal Rules.
5. If this contract involves the expenditure of federal funds, this contract is
contingent upon continued availability of federal funds for payment pursuant to the terms
of this agreement. Contractor also agrees to fulfill the requirements of:
a) Office of management and Budget Circulars A-87, A-21 or A-122, and A-102 or
A-110, whichever is applicable;
b) the Hatch Act (5 USC 1501-1508) and Public Law 95-454 Section 4728. These
statutes state that federal funds cannot be used for partisan political purposes- of any
kind by any person or organization involved in the administration of federally-assisted
programs;
c) the Davis-Bacon Act (40 Stat. 1494, Mar. 3, 1921, Chap. 411, 40 USC 276A-276A-
5) . This act requires that all laborers and mechanics employed by contractors or sub-
contractors to work on construction projects financed by federal assistance must be paid
wages not less than those established for the locality of the project by the Secretary of
Labor;
d) 42 USC. 6101 et seq., 42 USC 2000d, 29 USC 794 . These acts require that no
person shall, on the grounds of race, color, national origin, age, or handicap, be
excluded from participation in or be subjected to discrimination in any program or
activity funded, in whole or in part, by federal funds; and
Page 4 of 8 Pages
Rev. 06/01/92
961169
GENERAL PROVISIONS
- page b"2 of 2 pages
e) the Americans with Disabilities Act (Public Law 101-336; 42 USC 12101, 12102,
12111 -12117, 12131 - 12134, 12141 - 12150, 12161 - 12165, 12181 - 12189, 12201 - 12213
and 47 USC 225 and 47 USC 611.
f) if the contractor is acquiring real property and displacing households or
businesses in the performance of this contract, the contractor is in compliance with the
Uniform Relocation Assistance and Real Property Acquisition Policies Act (Public Law 91-
646, as amended, and Public Law 100-17, 101 Stat. 246 - 256) ;
g) when applicable, the contractor is in compliance with the provisions of the
"Uniform Administrative Requirements for Grants and Cooperative Agreements to State and
Local Governments (Common Rule) .
6. By signing and submitting this contract the contractor states that:
a) the contractor is in compliance with the requirements of the Drug-Free
Workplace Act (Public Law 100-690 Title V, Subtitle D, 41 USC 701 et seq.) ;
b) the contractor is not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from covered transactions by any federal
department or agency.
7. To be considered for payment, billings for payment pursuant to this contract must
be received within 60 days after the period for which payment is being requested and final
billings on the contract must be received by Health within 60 days after the end of the
contract term.
8. If applicable, Local match is to be submitted on the monthly payments statements,
in the column provided, as required by the funding source.
9. If Contractor receives $25,000.00 or more per year in federal funds in the aggregate
from Health, Contractor agrees to have an annual audit, by an independent certified public
accountant, which meets the requirements of Office of Management and Budget Circular A-128
or A-133, whichever applies. If Contractor is required to submit and annual indirect cost
proposal to Health for review and approval, Contractor's auditor will audit the proposal
in accordance with the requirements of OMB, Circular A-87, A-21 or A-122. Contractor
agrees to furnish one copy of the audit reports to the Health Department Accounting Office
within 30 days of their issuance, but not later than nine months after the end of
Contractor's fiscal year. Contractor agrees to permit Health or its agents to have access
to its records and financial statements as necessary, and further agrees to retain such
records and financial statements for a period of three years after the date of issuance
of the audit report. This contract does 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 funds to satisfy federal cost sharing and
matching requirements unless approved in writing to the appropriate federal agency.
•
Page 5 of 8 Pages
Rev. 06/01/92 961169
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En
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CONTROLLER'S APPROVAL SPECIAL PROVISIONS
I.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 ma
provision is applicable to any contract involving the payment of money by the State.
y designate.This
FUND AVAILABILITY
2.Financial made Lions o t
i oblaigations of the State of Colorado payable after the current fiscal year are contingent u
and otherwise
upon funds for that purpose being enraptured:budgeted.
BOND REQUIREMENT
3.If this contract involves the payment of more than fifty thousand dollars(or the construction,erection.repair,main
,bridge,vidue4 tunnel.excavation or other public work for this State,the contractor sha14 before entering u
this contract.duly execute nl.and vetiver the State of who me aintenance.or improvement sock of any building.
contract.
in a, lysum not leas deliver
r to th the total amount will sign the contract,a good and.sumcient bond or otherperformance of any work included
said o e vial a penal faithful s than one-half
ne-ha f f the can payable by the terms of this contract.Stich bond shall be�aaeexecuted
cute surety a to qualified approvedcrpoby
labor, eo did n team hire,nthesustenance.p,performance
or once of e Contract
tt�a In addition,shall provide that if the contractor or his subcontractors fai a pay for oory
labor,mesaacted to be done or fails to pay any person who vende supplies rental machi tired by such contractor or his subcontractor n erf m duly f any
an amount not exceeding the sum specified in the bond,together interest the rate equipment in the prosecution .sat performance pay of the work
filed.no claim in i of the con arisingof ight per centnlesse chk on is ex me paY li a sed aid
m the a i of o Sram oc ntrtraar o may
der such contract shall be audited,allowed or per annum.rtified rcashier's
such c bond is caeca
Y accepted in lieu of a bond.This provision is in compliance
with CRS 3S- 6 check or a bank moil edilremd asfd
INDEMNIFICATION CRS 78-26-t06. money order payable
--
.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
agents,subcontractors,or assignee:pursuant to the terms of this contract.
act or omission by the contractor,or its employees,
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 O
1975.Pursuant thereto,the following provisions shall be contained in all State contracts or tub-con:racrr. PPortunity and Affirmative Action,dated April 16.
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 ins=that applicants
employees are treated during employmem,without regard to the above mentioned
employment upgrading,demotion,or transfer,recruitment or characteristics.Such actions ate)include. Per or other for arc employed,and that
selection for training,including a =Marmot advertising[;lay-offs or terminations;rarer of siq but not�limited to�following:
notices to be apprenticeship.The contractor agrees to post in conspicuous places-available to employees and applicants employment.
and
provided by the contracting officer setting forth provisions of this non-discrimination clause.
P Yment.
(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
ofavreceive consideration for employment without reregardio race-creed,color,national origin.sex,marital status,religion,antes[
re
ry,mental or physical handicap:
(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
I6, 1975, and by the rules, regulations and Orders of the Governor.or pursuant thereto-and will
contracting agency and the office of the Governor or his designee for purposes and Affirmative Action of April
gn of investigation to ascerttaiintcompliance wit access to his h such rules,,regulations and ordeds.and accounts by rs.
(e)(e labor
membership in 111 not exclude xcl any or individual of a againstquali of i(tom full f membership full enjoyment
sex.national origin,or ancestry. rights in such labor organization,or expel any such individual
J Ymen[of work opportunity because of nlee,sad,color.
(0 A labor organization.or the employees or members thereof will not aid.abet-incite,compel or coerce the doing of any act defined in this contract to be
discriminatory or obstruct or prevent any person from complying with the provisions of this contract or any order issued thereunder,or attempt,either directly
or indirectly,to commit any act defined in this contract to be discriminatory.
Fonts 6-AC-028
Revised I/93
395-53-01-1022
page 6' of 8 page*
961169
(g)In the event of the contractor's non-compliance with the non-discrimination clauses of this contract or with any of such rules,regulations,or orders,
this contract may be canceled. terminated or suspended in whole or in part and the contractor may be declared ineligible for further State contracts in
•
accordance with procedures•authorized in Executive Order,Equal Opportunity and Affirmative Action of April 16. 1975 and the rules,regulations,or
orders promulgated in accordance therewith,and such other sanctions as may be imposed and remedies as may be invoked as provided in Executive Order,
Equal Opportunity and Affirmative Action of April 16, 1975. or by rules,regulations,or orders promulgated in accordance therewith,or as otherwise
provided by law.
(h)The contractor will include the provisions of paragraphs(a)through(h)in every sub-contract and subcontractor purchase order unless exempted by
rules,regulations,or orders issued pursuant to Executive Order,Equal Opportunity and Affirmative Action of April 16.1975,so that such provisions will
be binding upon each subcontractor or vendor.The contractor will take such action with respect to any sub-contracting or purchase order as the contracting
agency may direct,as a means of enforcing such provisions,including sanctions for non.compliancr provided,however,that in the event the contractor
becomes involved in,or is threatened with•litigation,with the subcontractor or vendor as a result of such direction by the contracting agency,the contractor
may request the State of Colorado to enter into such litigation to protect the interest of the State of Colorado.
COLORADO LABORPREFERENCE '
6a.Provisions of CRS 8-17-101&102 for preference of Colorado labor are applicable to this contract if public works within the State are undertaken hereunder and
are financed In whole or in pan 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 county equal to the preference given or required by the state err 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 this subsection A6 may came 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 Decency 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 batted pursuant thereto shall be applied in the InterpMation,execution,and enforcement of this
contract Any provision of this contract whether or not incorporated herein by reference which provides for arbitration by any extra-judicial body or person or which
is otherwise in conflict with said laws,rules,and regulations shall be considered nil and void.Nothing contained in any provision incorporated herein by reference
which purports to negate this or any other special emulsion in whole or in part shall be valid orenforceable or available in any action at law whether by way of complaint,
defence,or otherwise.Any provision rendered null and void by the operation of this provision will not invalidate the remainder of this contract to the extent that the
contract is capable of execution.
8.At all times during the performance of this contract.the Contractor shall strictly adhere to all applicable federal and state laws,rules,and regulations that have
been or may hereafter be established.
9.The signatories aver that they are familiar with CRS 18-8-301,ex.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.
10.The signatories aver that to their knowledge,no state employee has-any personal or beneficial interest whatsoever in the service or property described herein:
IN WITNESS WHEREOF,the ponies hereto have executed this Contract on the day tint above written.
Contractor:
(Full Legal Name) � ' STATE OF COLD DO
•
DALE K. HALL (6/19/95) �=8 ROY ROM GOVER
WELD COUNTY ROAR cTSSTONRRS
net: rag, S Pxtcunve Diatcrot for
position(Title) CHA-s-Damn'. am \
84-6000813 - / I 'L
ai v.irr
hilliest, DEPARTMENTIf Corporation:) •= b r
OF PUBLIC HEALTH & ENVIRONMENT
Attest(Seal) •
WELD CO T DEPAR ENT
By
Hamm wxee Or2of oczdtNwtcw..ocws oard •
JOHN S. PICKLE, M.S.EH.
APPRO ALS • DIRECTOR
ATTORNEY GENERAL CONTROLLER
By (signal
COPY ..By THIS 'ad 1WO copies of this
contract nave teen slgrted by ell
elate nisei* requirgd by law to
Rorer 6-AC-O2C approveRewired 1/93 Page which it the last of $ pages
i_____
395.5}01.1030 •See instructions on serene side. ��//
PROGRAM APPROVAL: eld4i4n..- 163
STATE OF COLORADO
Roy Romer,Governor
Patti Shwayder,Acting Executive Director �
pFco�.p
cE (�
Dedicated to protecting and improving the health and environment of the people of Colorado -
4300 Cherry Creek Dr.S. Laboratory Building •
Denver,Colorado 80222-1530 4210 E.11th Avenue • '
Phone(303)692-2000 Denver,Colorado 80220-3716 •r876"
(303)691-4700 Colorado Department
of Public Health
ATTACHMENT A and Envtronment
MULTI-YEAR CONTRACT RENEWAL FORM
Date p�_ i - fl `1'70:0033
Routing Number4F-p-Th.--nn.,
State Fiscal year 19 9?-
Contract Renewal li r,r2 46 vvu 6
In accordance with Paragraph 4 of routing number Nrip bnr,nl> of contract number FMA
}#Fp9G•oro(,. , (copy attached and by this reference made a part hereof) between the State of Colorado
Department of Public Health and Environment (Health Facilities Division) and Weld County Health Department
covering the period of 71,/z_y ,sr , 1936 through -y. r•rc= ,, , 19fa- the undersigned agree that the
maximum amount payable by the State is $7 L-gs• .,
The first sentence in Paragraph 4 is hereby modified accordingly. The terms and conditions of the original contract
shall remain the same. In the event of any conflict, inconsistency, variance, or contradiction between the provisions
of this letter and any of the provisions of the original contract or any amendments thereto, the provisions of this
change order letter shall in all respects supersede, govern, and control.
This amendment to the contract is intended to become effective as of i_?/c i/y4 , but in no event shall it be
deemed valid until it shall be approved by the State Controller or such assistant as he may designate.
Please sign, date, and return all copies of this letter on or before (: e -- 0 / — , 199E to:
Terry Zamell, Health Facilities Division A-2
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South
Denver, Colorado 80222-1530
A verified copy of this letter will be returned to you when it is fully approved.
-4‘09{4.P tLHealth Depart •nt State of Colorado
CCity:(
oy Romer G
I
1861 07/03/.%6
ELD COUNTY For the Executive Director
,� I �Dw!ovaICOMMISSIONERS Colo. Dept. of Pup}, WHtf14 Et1fr M1 *7,
®kse) .� Ceht5
o . y
Health Facilities Division State Controller or' !
Designee
WELD COUNTY HEALTH DEPARTMENT
BY; 51.‘
✓ y�/v� /
JOHN S. PIt;Rt t�
Page 8 of 8 pages DIRECTOR
1
ATTACHMENT 1
Procedure for Conducting
Personal Care Boarding Home Inspections
1. The Colorado Department of Public Health and Environment,
Health . Facilities Division (State) , provides the Local Health
Department (Contractor) with a list of all personal care boarding
homes in the county contract, including the number of beds, and
license expiration date, at the time the contract is submitted to
the Local Health Department for approval.
2. The State sends a license renewal packet to each facility 90
days prior to the license expiration date. A copy of the cover
letter sent with the renewal forms will be sent by the State to the
Contractor with the,monthly status report. Contractor will notify
the State in writing at least 45 days in advance of the expiration
date if the contractor has reasons to request a delay in processing
the license. In the event of timely notification, the decision to
renew or deny the license will be made by the State with the input
from the Contractor.
3 . Contractor surveys on a cyclical basis, determined by workload
requirements, with all surveys being performed within the contract
period.
4. Following the annual inspection, the Contractor shall prepare
a cover letter and deficiency list as appropriate and send this
list to the facility within 10 calendars days of the survey date.
Contractors with a computer system that is compatible with that of
the State will be trained to complete survey forms and
documentation using the State' s Aspen computer system.
5 . The facility has 10 calendar days from the date on the cover
letter submitted with the deficiency list to submit a plan of
correction (POC) . The POC must include a specific response to each
deficiency and a completion date for the corrections. Completion
dates should not exceed 60 days from the date of the - survey.
Surveyor review shall be completed within 7 calendar days of
receipt of the POC to determine its acceptability,and up to an
additional 10 days is allowed for interaction with the facility to
obtain an acceptable plan. Surveyor discretion may be used in
cases where the facility demonstrates that sufficient progress has
been made in correcting the deficiencies (the facility may provide
bids, purchase orders, written time frames, etc. to demonstrate
progress) .
6. Within 5 calendar days of receipt of a POC acceptable to the
Contractor, a copy of the deficiency list and POC shall be sent by
the Contractor to the State Residential Program. The deficiency
list with POC shall also be sent to the local ombudsman.
961169
7. The Contractor shall conduct revisits and monitoring visits to
the surveyed facilities as needed, at the discretion of the
Contractor.
8 . The State has the discretion to modify time frames at the
request of the Contractor.
9 . On a monthly basis, the State notifies the Contractor in
writing of pending applications, completion of initial surveys,
newly licensed facilities, pending renewals, and results of surveys
within the county or the contract service area. In addition, the
State will notify the Contractor of changes in policies and
procedures, if any, as part of the monthly status report.
10. On a monthly basis, the Contractor notifies the State of
surveys completed and complaints investigated.
11. The State is responsible for conducting an on-site initial
survey for new applicants to the personal care boarding home
program.
12 . The State will call the Contractor whenever in the contract
service area for surveys, revisits or complaint investigations.
13 . The Contractor will notify the State of facilities conducting
business without a necessary license and supply documentation for
appropriate enforcement actions .
14. Contractors using the State' s Aspen computer program for the
preparation of deficiency lists shall, on a monthly basis, copy the
deficiency lists onto a diskette and send the diskettes to the
State so the deficiency lists can be loaded onto the State
database.
961169
ATTACHMENT 2
Complaint Investigation Procedures
If a complaint on a Personal Care Boarding Home is received by the
Colorado Department of Public Health and Environment, the caller
will be referred to the appropriate local health department to file
their complaint. If the complaint is received by letter at the
Colorado Department of Public Health and Environment, the letter
will be faxed or sent to the local health department for
investigation.
1. When a written complaint is received by the local health
department, it should be acknowledged in a timely manner, by
telephone or letter, as deemed appropriate by the local health
department. (If the complaint is received by telephone, it is not
necessary to acknowledge receipt of the complaint. )
2 . The complaint should be prioritized. If the complaint is life
threatening, an investigation should be initiated within three
working days. Other complaints should be prioritized according to
the seriousness of the complaint and investigated as appropriate.
The Colorado Department of Public Health and Environment should be
notified when the local health department receives a life
threatening complaint.
3 . When local health department investigators go to the facility
to conduct the complaint investigation, they should go unannounced,
at the appropriate time of day or night as determined in the time
frame identified in the complaint. Local health department
investigators have access to the facility twenty-four hours a day.
4 . During the course of the investigation, the investigator
should interview the appropriate resident (s) , family member(s) , and
staff; review records and policies if appropriate, conduct a
facility tour to observe resident/staff interactions, resident
care, dietary or environmental concerns, or anything else pertinent
to the complaint. If the resident has been hospitalized, or
transferred to another facility, it may be necessary to review
those records and observe and interview the resident in the
hospital or other such facility. It may also be necessary to
obtain copies of medical records .
5 . At the conclusion of the investigation, a brief exit
conference should be conducted with the facility operator and other
staff as appropriate. The exit conference may be done by
telephone.
6. A narrative report should be written within ten days of
completion of the investigation. The findings for each allegation
should be address in the report and a determination should be made
as to whether deficient practices were found.
961169
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7. Deficiencies should be cited if the facility is found to be
out of compliance with applicable regulations . The deficiency list
should be prepared and sent to the facility utilizing the same
procedures established in Attachment i. Upon receipt of an
acceptable plan of correction, a revisit may be conducted as deemed
appropriate by the local health department.
8 . Upon completion of the investigation, the complainant should
be notified of the outcome of the investigation, by telephone or in
writing, as deemed appropriate by the local health department. The
narrative report and deficiency list with acceptable plan of
correction (when applicable) should be sent to the Colorado
Department of Public Health and Environment; as soon as possible
upon completion of the investigative report.
9 . The Colorado Department of Public Health and Environment will
delete all names from the investigative report. The report will be
maintained in a file available for public viewing.
•
961169
ATTACHMENT 3
HFD FACILITY MASTER SYSTEM: PCBH REPORT:
HFD ID TYPE FACILITY NAME ADDRESS CITY LIC EXPIRE SURVEY DT LIC BEDS
PCBH REPORT: 05/09/96: LARIMER COUNTY
230344-PCBHONLY-AUTUMN HOUSE I 2115 EAGLE DRIVE LOVELAND 04/20/96 02/08/96 6
2303A1-PCBHONLY-AUTUMN HOUSE II 2127 EAGLE DRIVE LOVELAND 03/23/96 02/08/96 8
230365-PCBHONLY-EDEN VALLEY LIFESTYLE VILLAGE 6263 N COUNTY ROAD 29 LOVELAND 06/24/96 05/05/95 16
230329-PCBHONLY-FORT COLLINS GOOD SAMARITAN RETIREMENT V 508 W TRILBY ROAD FORT COLLINS 10/31/96 02/07/96 27
230360-PCBHONLY-FRIENDSHIP HOMES 1312 E PITKIN STREET FORT COLLINS 07/06/96 01/18/96 3
230373-PCBHONLY-LOVELAND GOOD SAMARITAN VILLAGE 2101 SOUTH GARFIELD A LOVELAND 05/06/97 05/30/95 40
230376-PCBHONLY-MAJESTYCK MANOR 1109 GREENBRIAR DRIVE FORT COLLINS 09/17/96 01/24/96 8
23036U-PCBHONLY-NEW MERCER COMMONS 900 CENTRE AVENUE FORT COLLINS 05/18/97 06/28/95 120
230386-PCBHONLY-PINE VALLEY BOARD & CARE 238 E RIVERSIDE DRIVE ESTES PARK 06/02/96 06/15/95 5
230399-PCBHONLY-SEXTON'S BOARD AND CARE 3835 GOODELL LANE FORT COLLINS 04/02/97 11/08/95 4
230314-PCBHONLY-SHAMROCK MANOR 2914 W PROSPECT RD FORT COLLINS 04/03/97 01/27/95 8
230326-PCBHONLY-SILVER HARE SENIOR BOARD 'N' CARE 2320 W PROSPECT ROAD FORT COLLINS 10/29/96 02/07/95 8
2303HV-PCBHONLY-SUNSHINE HOUSE BOARD AND CARE HOME 2413 MATHEWS STREET FORT COLLINS 10/22/96 11/28/95 5
230389-PCBH-RTF-CHOICE HOUSE (MI) 214 S WHITCOMB FORT COLLINS 07/12/96 02/15/96 8
230390-PCBH-RTF-PROMISE HOUSE (MI) 218 S WHITCOMB FORT COLLINS 07/12/96 02/15/96 5
PCBH REPORT: 05/09/96: WELD COUNTY
230327-PCBHONLY-BONELL GOOD SAMARITAN CENTER 708 22ND STREET GREELEY 03/10/97 02/29/96 41
2303DK-PCBHONLY-GARDEN SQUARE OF GREELEY 1663 29TH AVENUE PLAC GREELEY 02/23/97 06/15/95 34
230333-PCBHONLY-GRAYCARA 195 GANDY AVENUE KEENESBURG 01/30/97 10/10/95 14
230374-PCBHONLY-GRAYCARA WEST 3705 CARSON AVENUE EVANS 02/13/97 11/30/95 14
230307-PCBHONLY-HALF-WAY HOME FOR THE ELDERLY 601 28TH AVENUE GREELEY 04/30/97 10/25/95 3
230315-PCBHONLY-LORETTA & GARY'S GUEST HOME 1429 - 14TH STREET GREELEY 08/16/96 01/04/96 6
230317-PCBHONLY-TRIANGLE CROSS RANCH I 24823 FIRST STREET GALETON 06/14/96 06/20/95 4
230343-PCBHONLY-TRIANGLE CROSS RANCH II 36049 WELD CO ROAD 51 GALETON 05/08/97 06/20/95 4
230355-PCBHONLY-TRIANGLE CROSS RANCH III 36051 WELD CO ROAD 51 GALETON 05/08/96 06/20/95 3
2303E8-PCBHONLY-TRIANGLE CROSS RANCH IV 36053 WELD CO ROAD 51 GALETON 01/04/97 06/20/95 4
230308-PCBHONLY-VINTAGE WALK 535 31ST AVENUE GREELEY 04/17/97 01/31/96 3
230395-PCBH-RTF-WELD MENTAL HEALTH CTR/STANEK 1513 9TH AVENUE GREELEY 12/02/96 12/04/95 12
230391-PCBH-RTF-WELD MENTAL HEALTH CTR/ATU (MI) 1309 10TH AVENUE GREELEY 09/15/96 04/26/95 16
2303E5-PCBH-RTF-WELD MENTAL HEALTH CTR/FRONTIER 1103 5TH STREET GREELEY 10/30/96 12/11/95 6
961168
r1 .,
ATTACHMENT 4
Colorado Department of Public Health and Environment Contacts
All written correspondence, deficiency lists, complaint
investigations, monthly reports, diskettes and billing forms should
be sent to: JoAnn Lingk, Colorado Department of Health, Health
Facilities Division, 4300 Cherry Creek Drive South, Denver, CO
80222-1530.
Terry Zamell can be contacted at 303-692-2884 for consultation. In
an emergency, the receptionist at the main desk can be contacted at
303-692-2800 to forward information to the appropriate individual.
Rhonda Lee can be contacted at 303-692-2873 for training or
questions concerning the computer system.
961169
.
STATE OF COLORADO
Roy Romer,Governor
Patti Shwayder,Acting Executive Director o9-Coto
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr.S. Laboratory Building ' i' rill j *
Denver,Colorado 80222.1530 4210 E. 11th Avenue
Phone(3031 692-2000 Denver,Colorado 80220-3716 .ra76'
1303 691-4700 Colorado Department
ATTACHMENT 5 of Public Health
and Environment
AMENDMENT TO CONTRACT FORM
Date Routing Number
State Fiscal year 19_
Contract Renewal
In accordance with Paragraph of routing number of contract number FMA
, (copy attached and by this reference made a part hereof) between the State of Colorado
Department of Public Health and Environment (Health Facilities Division) and covering the
period of , 19 through , 19 the undersigned agree that the maximum amount
payable by the State Is being _creased by $ to a new total of$
•
The first sentence in Paragraph, is hereby modified accordingly per amended attachment . The terms and
conditions of the original contract shall remain the same. In the event of any conflict, Inconsistency, variance, or
contradiction between the provisions of this letter or any of the provisions of the original contact or any amendments
thereto, the provisions of this change order letter shall in all respects supersede, govern, and control.
This amendment to the contract is intended to become effective as of /_/ , but in no event shall it be
deemed valid until it shall be approved by the State Controller or such assistant as he may designate.
Please sign, date, and return all copies of this letter on or before , 19 to:
Terry Zamell, Health Facilities Division A-2
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South
Denver, Colorado 80222-1530
A verified copy of this letter will be returned to you when it is fully approved. • .
Name: State of Colorado
Roy Romer, Governor
By:
By:
Title: For the Executive Director
Colorado Department of Public Health&Environment
Program Approval
By: By:
Health Facilities Division State Controller or Authorized
Designee
WELD COUNTY HEAVH DEPARTMENT
Page_ of pages $Y. _ g , //
JOHN S. PICKLE
DIRECTOR 961169
mEmoRAnDum
`
Date Barbara Kirkmeyer, Chair •3
To
COLORADO Board of County Commissioners July 1, 199 "c" —`c
From
John Pickle, Director, Health Department
Subject: Renewal of he Personal Care Boarding Home Contract
Enclosed for Board review and approval is a renewal form for the Personal Care Boarding Home
Contract between Weld County Health Department and the Colorado Department of Public
Health and Environment.
Under the provisions of this renewal, Weld County Health Department will be responsible
for annual inspections of 15 personal care boarding home facilities in Weld County and 15
facilities in Larimer County. WCHD will also be responsible for investigating complaints for the
facilities in Weld and Larimer counties. For these services, Weld County will be reimbursed at
the rate of$265 per facility surveyed not to exceed $7,685 for the time period July 1, 1996
through June 30, 1997.
This is a valuable service for a critical public health population, the elderly and mentally will
who cannot care for themselves. I recommend your approval of this renewal letter.
Enclosures
961169
STATE OF COLORADO
Of COto Roy Romer, Governor O
Paid Shwayder, etin Sand tive Director «� ��;
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr.S. Laboratory Building
Denver,Colorado 802221530 4210 E.11th Avenue s/gj6 r
Phone(303)692-2000 Denver,Colorado 80220-3716 Colorado Department
(303)691-4700
of Public Health
May 17, 1996 and Environment
Mr. Judy Nero
Weld County Health Department
1517 16th Street
Greeley, CO 80631
Dear Judy:
Thank you for your telephone call relating to the error made in
placing the attachments into the envelopes before mailing out .
I am sending the correct attachments, please dispose of the incorrect
ones.
I apologize for any inconvenience caused.
Yours Sincerely,
Gary Mandair
HFD Fiscal Officer.
Hello