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Home My WebLink About981550 RESOLUTION RE: APPROVE CONTRACT FOR CHILDREN WITH SPECIAL NEEDS PROGRAM AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with Contract for the Children with Special Needs Program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Health Department, and the Colorado Department of Public Health and Environment, commencing July 1, 1998, and ending June 30, 1999, with further terms and conditions being as stated in said contract, and WHEREAS, after review, the Board deems it advisable to approve said contract, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Contract for the Children with Special Needs Program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Health Department, and the Colorado Department of Public Health and Environment be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said contract. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 24th day of August, A.D., 1998, nunc pro tunc July 1, 1998. BOARD OF COUNTY COMMISSIONERS WEL COUNTY, COLORADO 4 _. lk ATTEST: � mss �j \ �� Constance L. Harbert, Chair Weld County Clerki Qc W. H. t Po-T Deputy Clerk to th- � � eorge . Bax ' •R�� ' � A OFORM: . Hall ounty torney EXCUSED Barbara J. Kirkmeyer ,/ 981550 cc: ,/ t i�i`c_ HL0024 DEPARTMENT OR AGENCY NAME HEALTH DEPARTMENT OR AGENCY NUMBER FAA CONTRACT ROUTING NUMBER 9900384 CONTRACT THIS CONTRACT, Made this 1st day of July 1998, by and between the State of Colorado for the use and benefit of the Department of Public Health & Environment. 4300 Cherry Creek Drive South, Denver. Colorado 80222-1530 hereinafter referred to as the State, and Weld County Health Department, 1517 16th Avenue Court. Greeley, Colorado 80631 hereinafter referred to as the contractor, WHEREAS, authority exists in the Law and Funds have been budgeted, appropriated and otherwise made available and a sufficient uncommitted balance thereof remains available for encumbering and subsequent payment of this contract under Encumbrance Number FAA HCP9900384 in Fund Number 100, Appropriation Account 611, and Organization 6820; and WHEREAS, required approval, clearance and coordination has been accomplished from and with appropriate agencies; and WHEREAS, the State is charged with operating the Health Care Program For Children With Special Needs (HCP) (hereinafter referred to as the Program) and do so through its Family and Community Health Services Division, (hereinafter, the State and its Family and Community Health Services Division will be referred to collectively as the State); and WHEREAS, the State, through the Program, has been mandated to provide care coordination services for eligible children; and WHEREAS, said Program allocates funds to other agencies in order to provide these care coordination services to the people of Colorado; and WHEREAS, the Contractor is considered by the State to be an appropriate agency to provide the services to the program as herein set forth. WHEREAS, the Program either directly or through interagency collaboration provides prevention, identification, assessment, and treatment services to children with special health care needs and their families in a culturally respectful manner building on community-based resources. Page 1 of 10 pages C-1`zr55C NOW THEREFORE, it is hereby agreed that for and in consideration of their mutual promises to each other, hereinafter stated, the parties hereto agree as follows: 1. The Contractor will provide Case Finding and Community Outreach, Care Coordination, Clinic Management, Program Management, Parent and Family Involvement and Support, and Systems Development as described in ATTACHMENT A, Effectiveness Indicators For The Weld HCP Regional Office and by this reference made a part hereof. 2. The Contractor will serve State recipients and recipient families who are determined to be eligible for Program services. Recipients served will be children residing or whose families have residence in Weld County. 3. The Contractor will cooperate with and provide all requested records regarding recipients for whom services were provided under this contract at the time that periodic chart audits occur. 4. The State will, in consideration of said services by the Contractor, cause to be paid to the Contractor an amount not to exceed ONE HUNDRED SIXTY-ONE THOUSAND FOUR HUNDRED TWENTY-EIGHT DOLLARS AND ZERO CENTS ($161,428.00) for the period from July 1, 1998 through June 30, 1999. Reimbursement shall be conditioned upon affirmation by the Program that said services were rendered in accordance with the terms and conditions of this contract, as follows: a. Upon receipt of a signed monthly statement, ATTACHMENT B, Contract Reimbursement Statement, and by this reference is made a part hereof, submitted by the Contractor to the State, requesting reimbursement for personnel expenses, fringe benefit expenses, contracted services, operating expenses, travel expenses, equipment expenses, and administrative/indirect costs. Said reimbursement statement shall set forth dates, brief description of expenditures, amounts, and total reimbursement requested. Reimbursement shall be conditioned upon affirmation by the Program that said services were rendered in accordance with the terms and conditions of this contract. b The budget, ATTACHMENT C and by this reference made a part hereof, shall govern the expenditure of funds between July 1, 1998 and June 30, 1999 by the Contractor, as well as the subsequent reimbursement by the Program. c. Of the contract amount not to be exceeded, 100 percent or $161,428.00 is federal funds. Page 2 of 10 pages d. Transfer of funds from one line item to another must have written approval by the Program. 5. Payment pursuant to this contract will be made as expenses are incurred and billed monthly by the Contractor. It is understood and agreed that the maximum amount of funds, State and Federal combined, available for the contract period is TWO MILLION TWO HUNDRED THOUSAND DOLLARS AND ZERO CENTS ($2,200,000.00) The liability of the State, at any time, for such payments shall be limited to the unencumbered amount remaining of such funds. Because of the uncertainty of Maternal and Child Health Block Grant funding, the State may prospectively increase or decrease the amount payable under this contract through a "Change Order Letter", approved by the State Controller or his designee, in the form attached hereto as ATTACHMENT D, by this reference is made a part hereof, subject to the following conditions: a. The Change Order Letter ("letter") shall include the following: Identification of contract by contract number and affected paragraph number(s); ii. Identification of any service level increases or decreases and the new service level, if applicable; iii. Amount of the increase or decrease in the level of funding and the total; iv. Intended effective date of the funding change; v. A provision stating that the Change shall not be valid until approved by the State Controller or such assistant as he may designate; vi. Authorized signatures of the State, the Contractor, and the State Controller or his designee. b. Upon proper execution and approval, such Letter shall become an amendment to this contract and, except for the General and Special Provisions of the contract, the Letter shall supersede the contract in the event of a conflict between the two. It is understood and agreed that the Letter may be used only for increased or decreased funding, and corresponding adjustments to service levels and any budget line items., c. If the Contractor agrees to and accepts the Change, the Contractor shall execute and return the Letter to the State by the date indicated in the Page 3 of 10 pages Letter. In the event the Contractor does not accept the change, or fails to timely return the executed Letter, the State may, upon notice to the Contractor, terminate this contract effective at any time after twenty (20) days following the return deadline specified in the Letter. Such notice shall specify the effective date of termination. In the event of termination, the parties shall not be relieved of their obligations up to the effective date of termination. d. Increases or decreases in the level of contractual funding made through the Letter process during the term of this contract may be made under the following circumstances: If necessary to fully utilize Colorado State appropriations and/ or appropriated federal grant awards. ii. Adjustments to reflect current year expenditures. iii. Supplemental appropriations or appropriated federal funding changes resulting in an increase or decrease in the amounts originally budgeted and available for the purposes of this Program. iv. Closure of programs and/or termination of related contracts. v. Delay or difficulty in implementing new programs or services. vi. Other special circumstances as deemed appropriate by the State. 6. The State and Contractor agree that additional funds may be awarded to expand or extend contract activities. Should such funds become available, they will be awarded by an amendment to this contract. 7. The Contractor agrees to notify the Program of any changes in personnel and any anticipated vacancy savings if the vacancy is expected to exist for one month or longer. 8. The Contractor agrees to provide services to all Program participants and employees in a smoke-free environment according to Public Law 103-227, also known as the Pro-Children Act of 1994 (Act). Public Law 103-227, also known as the Pro-Children Act of 1994 (Act), requires that smoking not be permitted in any portion of any indoor facility owned . or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by Federal programs either directly or through State or local governments, by Federal grant, Page 4 of 10 pages contract, loan, or loan guarantee. The law also applies to children's services that are provided in indoor facilities that are constructed, operated, or maintained with such Federal funds. The law does not apply to children's services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment; service providers whose sole source of applicable Federal funds is Medicare or Medicaid; or facilities where WIC coupons are redeemed. Failure to comply with the provision of Public Law 103-227 may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. a. By signing this contract, the Contractor certifies that the Contractor will comply with the requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act. b. The Contractor agrees that it will require that the language of the Act be included in any subcontracts which contain provisions for children's services and that all subcontractors shall sign and agree accordingly. 9. No charges will be made to families by the Contractor for care coordination/ case management regardless of a family's income. 10. Charges for attendance and services at medical specialty clinics sponsored by the Program must conform to the Sliding Fee Schedule For HCP Clinics, ATTACHMENT E and any subsequent amendments thereto, and by this reference made a part hereof. 11. No Federal appropriated funds have been paid or will be paid by or on behalf of the State, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any contract, and the extension, continuation, renewal, amendment, or modification of any contract, grant, loan or cooperative agreement that utilizes Federal funds. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the Health shall complete and submit Standard Form - LLL, "Disclosure Form to Report Lobbying", in accordance with its instructions. 12. Title V funds may not be used to pay for any item or service (other than an emergency item or service) furnished by an individual or entity convicted of a Page 5 of 10 pages criminal offense under the Medicare or any State health care program (i.e., Medicaid, Maternal and Child Health, or Social Services Block Grant programs). 13. The Contractor certifies, by submission of this contract, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. 14. The Contractor shall protect the confidentiality of all applicant or recipient records and other materials that are maintained in accordance with this contract. Except for purposes directly connected with the administration of this Program, no information about or obtained from any applicant or recipient shall be disclosed in a form identifiable with the applicant or recipient without the prior written consent of the applicant or recipient or a minor's parent or guardian or as otherwise properly ordered by a court of competent jurisdiction. The Contractor shall have written policies governing access to duplication and dissemination of all such information. The Contractor shall advise its employees, agents, servants, and subcontractors, if any, that they are subject to these confidentialities. 15. This Contract is subject to and contingent upon the continuing availability of Federal funds for the purposes hereof. 16. The term of this contract is from July 1, 1998 and ending June 30, 1999. Page 6 of 10 pages COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT- hereinafter, under the General Contract Provisions, referred to as"CDPHE". GENERAL CONTRACT PROVISIONS --page I of 2 pages I. THE CONTRACTOR SHALL PERFORM ITS DUTIES HEREUNDER AS AN INDEPENDENT CONTRACTOR _ _ _ _ AND-NQT_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 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-I 10,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; Page 7 of 10 Pages Rev. 05/07/97(GEN) - - - - - - - - - - - - - - - - - - - - - - - - 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 - 12134, 12141 - 12150, 12161 - 12165, 12181 - 12189, 12201 - 12213 and 47 U.S.C.225 and 47 U.S.C. 611; f) if the contractor is acquiring real property and displacing households or businesses in the performance of this contract, the portractor 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 furnish 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 contain federal funds as of the date it is signed.This requirement is in addition to any other audit requirements contained in other paragraphs within this contract. 10. Contractor agrees to not use federal funds to satisfy federal cost sharing and matching requirements unless approved in writing by the appropriate federal agency. Page 8 of 10 Pages Rev. 05/07/97(GEN) SPECIAL PROVISIONS. CONTROLLER'S APPROVAL. This contract shall not be deemed valid until it shall have been approved by the Controller of the State of Colorado or such assistant as he may designate. FUND AVAILABILITY. 2. Financial obligations of the State payable after the current fiscal year are contingent upon funds for that purpose being appropriated,budgeted,and otherwise made available. BOND REQUIREMENT. 3. If this contract involves the payment of more than fifty thousand dollars for the construction,erection,repair,maintenance,or improvementof any building,road,bridge,viaduct, tunnel,excavation or other public work for this State,the contractor shall,before entering upon the performance of any such work included in this contract,duly execute and deliver to the State official who will sign the contract,a good and sufficient bond or other acceptable surety to be approved by said official in a penal sum not less than one-half of the total amount payable by the terms of this contract. Such bond shall be duly executed by a qualified corporate surety conditioned upon the faithful performance of the contract and in addition,shall provide that if the contractor or his subcontractors fail to duly pay for any labor,materials,team hire,sustenance,provisions,provendor or other supplies used or consumed by such contractor or his subcontractor in performance of the work contracted to be done or fails to pay any person who supplies rental machinery,tools,or equipment in the prosecution of the work the surety will pay the same in an amount not exceeding the sum specified in the bond,together with interest at the rate of eight per cent per annum. Unless such bond is executed, delivered and filed,no claim in favor of the contractor arising under such contract shall be audited,allowed or paid. A certified or cashier's check or a bank money order payable to the Treasurer of the State of Colorado may be accepted in lieu of a bond. This provision is in compliance with CRS 38-26-106. INDEMNIFICATION. 4. To the extent authorized by law,the contractor shall indemnify,save,and hold harmless the State,its employees and agents,against any and all claims,damages,liability and court awards including costs,expenses,and attorney fees incurred as a result of any actor omission by the contractor,or its employees,agents,subcontractors,or assignees pursuant to the terms of this contract. DISCRIMINATION AND AFFIRMATIVE ACTION. 5. The contractor agrees to comply with the letter and spirit of the Colorado Antidiscrimination Act of 1957,as amended,and other applicable law respecting discrimination and unfair employment practices(CRS 24-34-402),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 and subcontracts. During the performance of this contract,the contractor agrees as follows: (a) The contractor will not discriminate against any employee or applicant for employment because of race,creed,color,national origin,sex,marital status,religion,ancestry,mental or physical handicap,or age. The contractor will take affirmative action to insure that applicants are employed,and that employees are treated during employment,without regard to the above mentioned characteristics.Such action shall include,but not be limited to the following:employment upgrading,demotion,or transfer,recruitment or recruitment advertising;layoffs 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,dated 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. (t) 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,dated 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,dated April 16,1975,or by rules,regulations,or orders promulgated in accordance therewith,or as otherwise provided by law. page 9 of 10 pages (h) The contractor will include the provisions of paragraphs(a)through(h)in every subcontract and subcontractor purchase order unless exempted by rules,regulations,or orders issued pursuant to Executive Order,Equal Opportunity and Affirmative Action,dated April 16,1975,so that such provisions will be binding upon each subcontractor or vendor.The contractor will take such action with respect to any sub-contracting or purchase order as the contracting agency may direct,as a means of enforcing such provisions,including sanctions for non-compliance;provided,however,that in the event the contractor becomes involved in,or is threatened with,litigation,with the subcontractor or vendor as a result of such direction by the contracting agency,the contractor may request the State of Colorado to enter into such litigation to protect the interest of the State of Colorado. COLORADO LABOR PREFERENCE. 6a. Provisions of CRS 8-17-101&102 for Colorado labor are applicable to this contract if public works within the State are undertaken hereunder and are financed in whole or in part by State funds. b. When a construction contract for a public project is to be awarded to a bidder,a resident bidder shall be allowed a preference against a non-resident bidder from a state or foreign country equal to the preference given or required by the state or foreign country in which the non-resident bidder is a resident.If it is determined by the officer responsible for awarding the bid that compliance with this subsection.06 may cause denial of federal funds which would otherwise be available or would otherwise be inconsistent with requirements of Federal law,this subsection shall be suspended,but only to the extent necessary to prevent denial of the moneys or to eliminate the inconsistency with federal requirements.(CRS 8-19-101 and 102) GENERAL. 7. The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the interpretation,execution,and enforcement of this contract. Any provision of this contract whether or not incorporated herein by reference which provides for arbitration by any extra judicial body or person or which is otherwise in conflict with said laws,rules,and regulations shall be considered null and void. Nothing contained in any provision incorporated herein by reference which purports to negate this or any other special provision in whole or in part shall be valid or enforceable or available in any action at law whether by way of complaint,defense,or otherwise. Any provision rendered null and void by the operation of this provision will not invalidate the remainder of this contract to the extent that the contract is capable of execution. 8. At all times during the performance of this contract,the contractor shall strictly adhere to all applicable federal and state laws,rules and regulations that have been or may hereafter be established. 9. Pursuant to CRS 24-30-202.4(as amended),the state controller may withhold debts owed to state agencies under the vendor offset intercept system for:(a)unpaid child support debtor child support arrearages;(b)unpaid balance of tax,accrued interest,or other charges specified in Article 22,Title 39,CRS;(c)unpaid loans due to the student loan division of the department of higher education;(d)owed amounts required to be paid to the unemployment compensation fund;and(e)other unpaid debts owing to the state or any agency thereof, the amount of which is found to be owing as a result of final agency determination or reduced to judgment as certified by the controller. 10. The signatories aver that they are familiar with CRS I8-8-30I,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 as of the date and year first above written. CONTRACTOR: Weld County Board of Commissioners STATE: (Full Legal Name) Weld County Health Department STATE OF COLORADO Roy Romer,Governor By: .r�'i,�.i® V-4411--e--101.54S:4166.7 By:�F.f Constance L. Harbert (08/24/98) DEPARTMENT OF Position(Title) Chairperson,Board of County Commissioners PUBLIC HEALTH A ENVIRONMENT ^— Social Security Number or Federal, ufger/� Program Approval w Corporation,Town/Ci oun fO1 If Cor p ty,or Eq ' glen n? f"I Attest(Affix Seal) • r- , A WELD COU LT DEPARTMENT � Juv • BY: By: earparamt3eeunt r,Etptty JOHN. S. PICKLE, M.S.E.H. Deputy Clerk to th �)I ` ? ^L y: DIRECTOR ^.Ie ,4 Near APPROVALS: VI`1 i 0LLER ::O14t EY GENE' S -A 'r 'Y general CONTROLLER Ey t= I. -Hat By:Gale A.A.N rt' sistant ,Homey General Clifford W.hall State Services Section page 10 which is the last of 10 pages ATTACHMENT A HEALTH CARE PROGRAM FOR CHILDREN WITH SPECIAL NEEDS (HCP) EFFECTIVENESS INDICATORS FOR WELD HCP REGIONAL OFFICE INDICATOR 1: CASE FINDING AND COMMUNITY OUTREACH MG' staff in co!laberation -with-fcmifec .and-ether-ca: F: :city-agsne%,cs will identify - — service and support needs of children with special health care needs through community outreach and case finding. Rationale: HCP is committed to facilitating early entry into health care services and into family supports for children with special health care needs. A key role of public health agencies involves the identification of potential recipients to assure enrollment and continuity of care. Another role of public health is to develop strong referral networks which include families, health care providers and community resource agencies. Community resource agencies may include any or all of the following: schools, BOCES, Child Find, mental health, social services, Community Center Boards, child health clinics, EPSDT, WIC, respite care, Head Start, hospitals, churches, libraries, recreation centers and community health centers and managed care organizations. Process Criteria: 1 . Know the target population of children who are potentially eligible for HCP services, and the actual number of children currently registered with HCP. The target population is determined by using a formula in conjunction with census data. Analyze large discrepancies between target and actual caseloads. 2. Identify existing health care providers and support resources including translation, transportation and respite care. 3. Work with the community resource agencies to create/improve/expand a system for identification and referral of children and youth for needed services. 4. Promote public health services available to children, i.e., HCP, WIC, Well Child, EPSDT, and Immunizations by using local media, posters and attendance at health fairs, etc. 5. Distribute the local HCP clinic schedule to appropriate agencies and individuals. 6. Develop and maintain liaisons with the local community resources to maintain open communication, to promote the services of HCP and other services available to children with special needs, and to establish a network for working together to eliminate gaps or duplication of services and supports. J:\CLERICAL\PEGGY\CONTRACT\CONTY-RO\FY99\W ELD99.EIC Revised July 1997 Page 1 of 9 pages 7. Maintain communication with local HCP providers for the purpose of problem solving, monitoring quality and recruiting new providers. 8. Develop referral and follow-up care systems using available resources such as _. Colorado RespPnds To Children With Special Needs (CPCSN), NICU Consortium, Universal Newborn Hearing Screening Programs, and hospital discharge planners, to identify children who may need support, care coordination and/or referral to community resources. INDICATOR 2: CARE COORDINATION HCP staff will assure either directly or indirectly an appropriate level of care coordination to all families with children with special health care needs. HCP staff will provide care coordination for children enrolled with HCP and will be involved with other community agencies and individuals in assuring care coordination for those children with special health care needs who are not on HCP. Rationale: HCP is committed to establishing supportive, collaborative partnerships with families of children with special health care needs to assure that the needs of both the children and the families are met in a coordinated way. The provision of comprehensive services, including early identification services (diagnostic and evaluation), treatment, rehabilitation, family support and health education services will be, to the extent possible, community-based. HCP staff will be placed in the community to assure coordinated linkages between families, primary health care providers, other providers of local services, HCP specialists and tertiary medical centers. Process Criteria: 1 . Conduct an initial interview with all new families to help them determine their need for information, referral and/or care coordination using a standard tool such as the "Family Status Profile". (See attached Family Status Profile Form.) 2. Assist families who have insurance coverage, including managed care and Medicaid managed care, to understand their benefits and their disenrollment and grievance procedures. 3. Refer families to agencies and services for which they are eligible and assist them with the registration or application process, (WIC, Baby Care/Kids Care, Medicaid, SSI, etc.). Follow-up with the family to assure the family was able to make the suggested contacts. JACLERICAL\PEGGY\CONTRACT\CONTY-RO\FY99\W ELD99.EIC Revised July 1997 Page 2 of 9 pages 4. Determine the status of primary care and immunizations and make appropriate referrals. Work in collaboration with the EPSDT outreach worker if the child is on Medicaid to assure that EPSDT benefits have been explained and an EPSDT screen has been completed and billed. 5. Initiate or participate in the_development of a Care. Plan or IFSP (Individual Family Service Plan) with the family when it has been determined that a family would benefit from care coordination. This includes a statement of the family's strengths and needs as identified by the family and strategies for enhancing the child's development. Include a statement of major outcomes to be achieve by the child and family. State the criteria, procedures and time lines. Document periodic statements of progress towards meeting family goals and the need for modifications or revisions. The process for the development of a care plan or IFSP should include all the disciplines involved with the child's care, i.e., audiologist, CHIP therapist, social worker, family advocate, OT/PT, dietitian, speech therapist, etc. 6. Follow-up with family according to plans written on Care Plan or IFSP. Should HCP staff have no direct role in the IFSP or are not doing care coordination, assure that a contact with each family is made at least once a year to assure that the child and family are receiving necessary services and that the family is aware of community resources available to them. 7. Make home visits when appropriate. (Situations might include complex medical or surgical conditions or when resources or help can be provided relating to the home environment.) 8. Work in concert with the EPSDT outreach worker to review monthly listing of SSI recipients and Contact SSI families to assure that health care needs are being met. If there are needs which HCP can meet, assure that children are enrolled in the program. 9. Meet periodically with staff from local agencies such as social services, representatives from the Community Centered Board, mental health and special education services from local schools to collaborate around services to individual children and their families. 10. Work with the older children and their families to facilitate transition from pediatric services to adult health care services. (To begin at about age 12 years.) J:\CLERICAL\PEGG V\CONTRACT\CONTY-RO\FY99\W ELD99.EIC Revised July 1997 Page 3 of 9 pages 1 1 . Work with NICU Consortium contacts in hospitals to identify needs of newborns as the child prepares to leave the hospital to return to the community. Make contact with other community resources as needed. 12. Maintain a current health record for each HCP child. The record will be integrated with the Child Health Record when. appropriate. The record will contain copies of the HCP registration, relevant medical, therapy and laboratory records as needed for care coordination. The current acceptance letter/ treatment plan, Clinic Encounter Forms, a serial growth chart, nursing notes, and IFSPs. Families will be encouraged to have duplicate copies of these records. INDICATOR 3: CLINIC MANAGEMENT HCP staff will participate, in partnership with the HCP State office and specialist health care providers, in providing medical specialty care clinics in local communities where these resources are not available. Rationale: HCP is committed to providing children and families access to specialty medical clinics when specialists are not available in the local community. This situation occurs when there are no specialty services at all and when the specialists in the community are not available to families due to the families' lack of insurance, long waiting lists, or the specialists lack of expertise in working with pediatric patients. The Program promotes the concept of multi-disciplinary clinical services and encourages the attendance of therapists, social workers, nutritionists, educators, audiologists and family advocates to all HCP clinics. Process Criteria: 1 . Designs and maintains a clinic structure including identifying and scheduling clinic providers, facilities, and equipment. Sets clinic dates. Seeks referrals by contacting local doctors, Child Find, interagency councils, and Community Center Boards to inform them of the clinics. 2. Organizes, schedules and staffs each clinic using guidelines provided in the HCP Procedure Manual. Obtains a HCP Registration on each child scheduled for clinic and a consent for service signed by the parent or legal guardian. Provides the clinician with Medicaid and private insurance billing information and collects clinic fees from over-income families who do not have health insurance. 3. Completes a Clinic Encounter Form for each clinic patient. After each clinic submits Encounter Forms, a copy of the attendance list (schedule) and the dictation to the assigned Regional Office. J\CLERICAL\PEGGY\CONTRACT\CONTY-RO\FY99\W ELD99.EIC Revised July 1997 Page 4 of 9 pages 4. Assures that families have transportation to each clinic and that appropriate and competent interpretation services are available. 5. Depending on the complexity of the child's condition and the needs of the family, appropriate team members will attend and participate in the multi-county clinics. 6. Evaluates the clinic caseload, waiting list and summaries yearly to determine the number and type of specialty clinics needed. Reports findings to the Regional Office Team Leader. INDICATOR 4: PROGRAM MANAGEMENT Policy: HCP staff will maintain and continue to build on a community-based program for children with special health care needs. Included in the Program responsibilities will be eligibility determination, enrollment, care coordination, records management, tracking, referral, community needs assessment and program evaluation. The HCP manuals will be the sources of information and documentation for all policies and procedures. Rationale: HCP is committed to assuring services for all children with special health care needs. Paid services are provided to children who are uninsured or underinsured and who fall within set income and diagnostic eligibility guidelines. Based on the belief that services are best provided in the local community, all of the components of the program are located in the community (except bill paying) in the local public health agencies. HCP participates in the Early Childhood Connections' Colorado Interagency Coordinating Council (CICC) and embraces the CICC Values Statements in the development and implementation of health programs. Process Criteria: 1 . Maintain a system for processing HCP applications as described in the HCP Procedure Manual. 2. Develop a process which assists families in applying for Medicaid and SSI benefits. 3. Assist families in identifying specialist providers and managed care organizations which best meet the needs of their child. 4. Maintain a current Health Record for each HCP child, using guidelines in the Procedure Manual. J:\CLERICAL\PEGGV\CONTRACT\C ONTV-RO\FY99\W ELD99.EIC Revised July 1997 Page 5 of 9 pages 5. Coordinate with the local public health nurse and regional discipline coordinators to authorize and encumber funds according to guidelines for appropriate hospitalizations, surgical procedures, hearing aids, therapies or appliances. 6. Assure that all appropriate team members are involved in developing individual treatment plans for HCP.patients. -- 7. Periodically contact community physicians and other providers for feedback on HCP services and policies. 8. Assure that HCP services are provided in a family-centered, culturally-competent environment. Written materials will be appropriate for the reader in reading level (the standard is 6th grade level) and language. Interpretation services will be available by trained , professional or paraprofessional as needed. 9. Coordinate and/or participate in conducting a community needs assessment which identifies problems or voids within the service delivery system for children with special health care needs, defines the problems and determines the services or changes necessary to meet the identified needs. Elements involved in this process include: a. Involvement in tracking and data collection efforts of the community concerning the number of children with special health needs, the types of services needed, the types of services available, the accessibility of services, the quality of the services, whether the services are culturally competent and family centered, and a method to receive customer feedback about the services. b. Awareness of and collaboration with other community agencies and projects regarding data that is being collected and use of the data to most effectively enhance the community service system for children with special needs. c. Coordination with other agencies and organizations to jointly survey the community including families, providers and human service agencies. d. Assessing needs of the population regarding cultural sensitivity of services provided. 10. Coordinate and/or participate in the community planning process to develop goals and objectives based on the community needs assessment. J:\CLERICAL\PEGGY\CONTRACT\CONTY-RO\FY99\W ELD99.EIC Revised July 1997 Page 6 of 9 pages • 11 . Assure that HCP staff is trained in Early Childhood Connections (Part C of IDEA) including the CICC Values Statements (see attached), IFSPs, Procedural Safeguards and eligibility criteria. 12. Assure that HCP staff is trained in the eligibility criteria and referral procedures _ . for Medic:aid.,_SSI, Children's Medical.Wsiver 200, ChiJ.dren's Home-Care Based— Services Waiver (Katie Beckett - Model 200 Waiver), and EPSDT. Assure that EPSDT case managers are knowledgeable about HCP services. 13. Assure that training opportunities are provided to staff on cultural competency and family-centered care. INDICATOR 5: PARENT AND FAMILY INVOLVEMENT AND SUPPORT HCP staff will work in partnership with families to assure ongoing participation of families in all aspects of the Program. HCP staff will include input from families in policy development, planning, implementation, and evaluation of HCP programs. HCP also recognizes the need to include parents who represent the diversity of the region that the program serves. This includes parents with cultural and linguistic diversity as well as parents with different life views and/or experiences with health care. Rationale: HCP believes that parents have the primary responsibility for the care, development and well being of their child with a special health care need. HCP recognizes that working in partnership with families will strengthen the Program and the families it serves. Process Criteria: 1 . Establish a mechanism for including input from parents regarding current services, planning, policy development, implementation and evaluation of HCP Programs. The process should include a means to provide feedback to families about decisions made in these areas. 2. Develop and maintain a system of parent support that includes: a. Parent to parent support and/or support groups; b. Internal practices that support advocacy for family needs and problem solving; c. Information and education; J:\CLERICAL\PEGGY\CONTRACT\CONTY-RO\FY99\W ELD99.EIC Revised July 1997 Page 7 of 9 pages d. Linkages with community agencies to assure the availability and adequacy of resources to support the needs of families. INDICATOR 6: SYSTEMS DEVELOPMENT . Each agency will demonstrate efforts in systems development to assure quality, comprehensive, community based, efficient services for families. Rationale: HCP is committed to collaborating with other services and agencies to achieve mutually agreed upon goals which benefit families and children. Because children with special health care needs receive services from health, education, social services, and numerous community agencies, it is imperative that those agencies work together to provide comprehensive, coordinated services to families which are cost effective, efficient and avoid duplication. Process Criteria: 1 . Establish or maintain interagency collaboration through periodic meetings with representatives of the local human services agencies, the Community Center Board, the mental health agency and special education services from the school district to understand their services, to learn about their eligibility criteria, and to provide them with information about HCP and other resources within the local community. 2. Participate actively in a community interagency council (ICC) by meeting regularly for the purpose of planning and policy development. (These can be a formal or informal group of agencies, providers and parents who are interested in working together to discuss services for children with special needs, to identify barriers and gaps in the service delivery system, to develop collaborative plans for removing the barriers and gaps including writing community-based grants for improvement of local systems. 3. Help to identify community service system needs by collecting data, conducting surveys and focus groups, and observing target populations. Solicit information from agencies, providers, and families. Work collaboratiively to develop and maintain community resources. 4. Assure that there is community parent representation from families who have children with special needs in the community ICC efforts. (For example, attending meeting, contacting representatives, providing input into quality and quantity of local services.) J:\CLERICAL\PEGGY\CONTRACT\CONTY-RO\FY99\W ELD99.EIC Revised July 1997 Page 8 of 9 pages 5. Participate in the community early child identification process as an active member of the community team. This participation could include assigning staff time to directly participate in a community sponsored identification process or coordinating the agency's services such as Well Child, EPSDT, HCP and WIC, with other efforts so as to provide on-going systems of early identification for children 0-21 years J:\CLERICAL\PEGG V\CONTRACT\CONTV-RO\FV 99\W ELD99.EIC Revised July 1997 Page 9 of 9 pages - - - - - - . - - - - - - - - - - - - - INSERT YOUR HEALTH DEPARTMENT'S NAME HEALTH CARE PROGRAM FOR CHILDREN WITH SPECIAL NEEDS (HCP) 700000' FAMILY ASSESSMENT TOOL oc° CURRENT FAMILY STATUS PROFILE 4Z% Date Completed: Child's Name Date of Birth: Child's Address: County: Mother's Name: Father's Name: Legal Guardian's Name: Guardian's Employer: Home #: Work #: Message #: Completed by Signature Relationship Reviewed by R.N. Signature SUBJECTIVE DATA 1. How can we help you? 2. What are your concerns about your child's health issues? 3. Is your child visiting a doctor or clinic on a regular basis? ❑ YES 0 NO If YES: Who is your child's regular doctor or care provider? How often does your child see his/her regular doctor or care provider? What medications and/or treatments has your child's doctor recommended? Are you able to get the medications and/or treatment your child needs? ❑ YES 0 NO Have you had any difficulties getting your child's medicines? 0 YES 0 NO Have you had any problems getting the treatments that your doctor has recommended? 0 YES 0 NO Are your child's shots (immunizations) up-to-date? 0 YES 0 NO Page 1 Do you have a copy of your child's shot records and could we have a copy? ❑ YES ❑ NO 4. What other people or organizations are involved in your child's care? 5. Is there anyone involved who is helping you to pull these people and services together? ❑ YES ❑ NO If YES, What is his or her name? and What is his or her relationship to you? 6. How do your child's needs affect you and your family? 7. What are your plans and hopes for your child? Long-term: Short-term: 8. What are your child's plans and hopes for him or herself? (if applicable) Long-term: Short-term: 9. What is being done to support your child and your family to be successful with those plans? 10. What do you see as strengths in your family? 11. We know that many times families have needs that are not necessarily medical, but make it difficult to care for their family. Do you or your family have any other issues that we can help you with, i.e., housing, food, clothing? • 12 Are you able to get away from the house to do things for yourself if you need to? ❑ YES ❑ NO 13. Are you able to go to the doctor if you need to? ❑ YES ' ❑ NO 14. Are you and your family covered by Medicaid or health insurance? ❑ YES ❑ NO 15. Is there anything else we could assist you with? Page 2 OBJECTIVE DATA OBSERVED (if on-site interview conducted) use additional paper if needed ASSESSMENT FORM This form should only be used as a guide for assessment. Further studies are needed in order to quantify assessment guide and assess for validity and reliability. ASSESSMENT (place check mark in appropriate column of each question) Column A Column B Column C YES TO SOME NO DEGREE Family understands medical condition? Family following medical treatment plan including follow-up appointments? Community resources accessed? Care coordination in place? Goals set? Goals being pursued? Support systems in place? Family strengths identified? Child's needs are being met? Family's needs are being met? NOTES: 1 . If all answers fall in Column A -- may only need to follow-up in one year or as needed. 2. If most answers fall in Column A, some answers in Column B or C - may need additional follow-up and/or referrals. 3. If all answers fall in Columns B and/or C -- will need further assessment and determination of why, and I.F.S.P. ASSESSMENT FINDINGS: Page 3 FOLLOW-UP PLAN (place check mark by appropriate items) Information given only (specify) 1. 2. 3. 4. DATE TIME Conference scheduled for I.F.S.P. development. / / Home Visit scheduled / / Clinic Appointment made / / Referral made to (document date referral made) Child Find / / School District / / Community Center Board / / Social Services / / W.I.C. / / Parent Support team / / Support Group / I EPSDT / / Medicaid / / Public Health Nurse / / Other (specify) / / / / / / Family does not want interventions, Follow-up / / • Follow-up with family in one year or P.R.N. per HCP Standards. • Other (specify) J:\CLERICAL\FORMS\PTATOOL.WPD(cr.08/13/93 rev.0J/06/981pw Page 4 . . . . . . . . . . . . . . . ( . we / 2 . r. z D D / 7 _ �• \ / . . . . \ . . . ) .11 - - / \ \\ Z \ 4 Q _ 2 { ( % ( | ; Q o O k / j .5 § ■ • / f = $ a \ E id di § / § ) m § 0§ me \04 • f j • � / ( � g \ / i U \\ © f \ J 2 \ $ is / ! { \ 2 I ( ) ] co — 14 ricil ; .. a ~ CP / 0W• ' ( \ J \ ( \ [ 0 \ I ° - ) ° \ 9 ^ ° t \ \ \ So > A / / 1 5 / § = o m2 0 o \ \ \ \ \ \ ^ 7 \ E / \ i ATTACHMENT C APPLICANT: Weld County Health Department PROJECT: Health Care Program for Children with Special Needs(HCP) FOR THE PERIOD: JULY 1,1998 through JUNE 30,1999 Annual Full Total Source of Funds Salary Time Amount *Applicant Requested Rate Equivalent Required and Other from CDPHE PERSGNNEL EXPENSES: - - - - - - .- .,._ - - - Social Worker(Aurora Vergara) 31,941 0.50 15,971 15,971 CHN II(Lynn Bindel) 34,602 1.00 34,602 34,602 CHN II(Kris Embree) 37,728 0.80 30,182 8,677 21,505 Office Tech III(Eva Hammond) 21,147 0.90 19,032 19,032 Office Tech II(Luana Quiroz) 17,773 0.40 7,110 3,555 3,555 Office Tech II(Doris Rulla) 16,761 0.40 6,704 6,704 CHN II(Becky McMahan) 36,625 0.13 4,761 4,761 CHN II(Libby Conway) 34,005 0.50 17,002 7,821 9,181 CHN Supervisor(C. Weinmeister) 39,212 0.15 5,882 5,882 Fringe Benefit Rate and Expenses: 25.00% 35,312 9,350 25,962 Total Personnel Expenses 4.78 176,558 46,750 129,808 CONTRACTED SERVICES: OT/PT Regional Coordinator(Rose Thompson) 1,000 1,000 Audiology Regional Coordinator(Cheryl Johnson) 2,000 2,000 Speech Regional Coordinator(Sharon Carey) 1,000 1,000 Parent Advocate @$7/hr.20 hrs./wk. 7,280 7,280 Sub-total Contracted Services 11,280 11,280 OPERATING EXPENSES: (include only costs not part of Indirect) Respite,Transportation and Interpretation Special Project 675 175 500 Printing and Postage 500 200 300 Dedicated Phone Line(2 lines) 1,200 300 900 Minor Equipment(modem) 200 200 Staff Development 1,000 1,000 Sub-total Operating Expenses 3,575 875 2,700 TRAVEL: HCP State Office Meetings 850 850 Regional Office Travel 1,300 1,300 Sub-total Travel Expenses 2,150 2,150 EQUIPMENT: IRIS equipment requirements/upgrades: Eva Microsoft Office 97: Professional Edition with Access 97,Word 97,etc. 550 . 550 Modem: 56k bits per second(bps) 60 60 Communication software(to be specified) 200 200 Uninterrupted Power Source(UPS) 200 200 Monitor: 17" 500, .500 Sub-total Equipment Costs 1,510 1,510 Administrative/Indirect Rate and Costs Indirect Cost Rate: (salaries and fringe)(HCP 22%) 10.77% 19,015 5,035 13,980 TOTAL PROJECT COSTS 214,088 52,660 161,428 *Source of Funding for"Applicant and Other" Local: ** 52,660 ** Medicaid: Patient Fees: Other: Total Applicant and Other 52,660 **Are these local funds used to match any other grant? YES NO XX i ATTACHMENT D STATE OF COLORADO Roy Romer,Governor occoro Patti Shvvayder,Executive Director 4F: r. {r Dedicated to protecting and improving the health and environment of the peopk of Colorado 4300 Cherry Creek Dr.S. Laboratory Building a.' G',! • Denver,Colorado 60222-1530 4210 E 11th Avenue a raze• Phone(303)692-2000 Denver,Colorado 60220-3716 O03)691-4700 — Colorado Department off'1frbWic Halth , 1997 and Environment State Fiscal Year 19_-_ . Contract Routing Number Change Order l ttter No. In accordance with Paragraph_of the contract with routing number and contract number .(as amended by Change Order Letter routing number ,and/or Renewal Letter routing number a ina&t referred to as the Original Contract(copy attached and by this reference made a part hereof)between the Sao ofia otado,Department of Public Health and Environment( Division)and rt .• covering the period of , 199_through 199_,the parties the maximtnnam6unt payable bythe State for the engage services in Paragraph_of the Original Contract is being' ecreased 0%. DOLLARS(S____)to a new total of DFO =`su $idan a with the revised work plan attached hereto as Attachment A and revised budget attached h entliltttli incorporated herein. The first sentence in Paragraph_of the Original Contract is hereby modified idmgly. All other terms of conditions of the Original Contract are hereby reaffirmed. This amendment to the Original Contract is intended to be effective as of but in no event shall it be deemed valid until it shall have been approved by the State Controller or,Arch assistant a may desienate. Please sign,date and return all_originals of this letter as soon as posst Colorado Department of Public ealth ' omen Divist Mail Code: 4300 Cherry Creek Drive$"u Denver,Colorado 8 -1530 One original of this letter will be returned to yo Y aPPrro Contractor. ,,tie.. State of Colorado: Full Contractor Name Roy Romer,Governor i f By: .6.7Signallire ",,F,, , By: Print Name: az tea. For the Executive Director Colorado Department of Public Health Title: and Environment to '4 . APPROVALS: fit} APPROVALS: PROGRAM CONTROLLER By: By: Clifford W. Hall ATTACHMENT E COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT HEALTH CARE PROGRAM FOR CHILDREN WITH SPECIAL NEEDS (HCP) SLIDING FEE SCHEDULE FOR HCP CLINICS - Page 1 of 3 pages The Health Care Program for rChildren Children-with-Special Needs (HOP) is commi'tted"to the Clinic System. We want to ensure that throughout Colorado families have access to the HCP Clinics. The sliding fee schedule affects those families without insurance that have an HCP financial rating of +1 or more. The clinic physician will always bill Medicaid and private insurance for all children who have Medicaid or private insurance benefits. Clinics. Fees, and Services Cerebral Palsy, Hearing, Orthopedic, Pediatric Cardiology, Pediatric Neurology, Plastic, and Scoliosis Clinics 1. Clients with an HCP financial rating of 0 will continue to receive: • diagnostic evaluations (to include one follow up visit to interpret the results) at no cost to the family, • continuing clinic visits at no cost to the family for children who are diagnostically eligible, and • labs and X-rays at no cost to the family. 2. Clients with an HCP financial rating of+1 and +2 will receive: • diagnostic evaluations (to include one follow up visit to interpret the results) at no cost to the family, • • labs and x-rays for the diagnostic evaluation at no cost to the family, SLIDING FEE SCHEDULE FOR HCP CLINICS - Page 2 of 3 pages • continuing clinic visits for children who are diagnostically eligible at a fee for service (previously these visits were at no cost-te-ho family) -The-family-WE be asseseed a: o $10 fee per visit for a rating of +1 o $20 fee per visit for a rating of +2 and • labs and x-rays for the continuing clinic visits are the financial responsibility of the family. 3. Clients with a rating of +3 and above will: • pay a fee for service for both diagnostic evaluations and continuing clinic visits (previously the diagnostic evaluations were at no cost to the family). The family will be assessed a: • $30 fee per visit for a rating of +3 • $40 fee per visit for a rating of +4 • $50 fee per visit for a rating of +5 • $60 fee per visit for a rating of +6 • etc. • and will pay for all labs and x-rays ordered out of clinic (previously these were at no cost to the family for the diagnostic evaluation). 4. All clinic patients must be registered with HCP and complete a financial statement. SLIDING FEE SCHEDULE FOR HCP CLINICS - Page 3 of 3 pages 5. HCP is recommending that the clinic sites keep the clinic fees collected from the families. The fees collected are to support HCP --- clinic-activities such-as: = clinic supplies, clinic equipment, clinic- - - - -- furniture or parent/ professional stipends. Pediatric Clinics Children attending an HCP Pediatric Clinic without an HCP eligible diagnosis: 1. If the child's PCP requests continuing consultation from the pediatrician, the child may be seen in the HCP Pediatric Clinic and pay fee for service according to the established sliding fee. 2. Families with a financial rating of 0 will be required to pay at the +1 level. (HCP is providing access for these families, but not paying for services to children who are not diagnostically eligible.) 3. Family pays all labs and x-rays ordered out of clinic. Developmental Evaluation Clinics This policy does not address the state-wide Developmental Evaluation Clinic System. HCP is billed by each Developmental Evaluation Clinic on a fee for service basis for children with HCP benefits. A' IEmORAnDum Constance L. Harbert, Chair To Board of County Commissioners Date August 20, 1998r�" COLORADO From John Pickle, Director, Health Department ca✓ Subject: Health Care Program for Children With Special Needs Contract Enclosed for Board review and approval is a contract between the Colorado Department of Public Health and Environment and Weld County Health Department (WCHD) for the Health Care Program for Children With Special Needs Program. This contract authorizes WCHD to provide case finding, community outreach, care coordination, clinic management, program management, parent and family involvement and support, and interagency collaboration to children and their families who are determined to be eligible for services. In return for these services, the Health Department will be paid an amount not to exceed $161,428 for the time period July, 1998 through June 30, 1999. I recommend your approval of this contract. Enc. 981550 Hello