HomeMy WebLinkAbout961504.tiff RESOLUTION
RE: APPROVE PURCHASE OF SERVICES AGREEMENT BETWEEN HEALTH
DEPARTMENT AND NORTHERN COLORADO HEALTH NETWORK, INC., DBA
NORTHERN COLORADO AIDS PROJECT, 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 Purchase of Services Agreement
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
Northern Colorado Health Network, Inc., dba Northern Colorado AIDS Project, commencing
June 1, 1996, and ending June 1, 1999, with further terms and conditions being as stated in
said agreement, and
WHEREAS, after review, the Board deems it advisable to approve said agreement, 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 Purchase of Services Agreement 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 Northern Colorado Health Network, Inc.,
dba Northern Colorado AIDS Project, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said agreement.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 26th day of August, A.D., 1996, nunc pro tunc June 1, 1996.
„� BOARD OF COUNTY COMMISSIONERS
nq tows,! /LW
/ �G% 7COTYCOO
1s61 . � 9 ra J. Kirkmeyer, Chair
1tei4hav
el. ty Clerk to the Board
IfiLIF? +, FXCI JSFfl flATF nF SIr;NINn (AYF)
e E. Baxter r em
Deputy Clerk/to the Board
Dale K. Hall
APPR AS TO M: kiLzAa Jam.
Constance L. Harbert
Or W. H. Web ter
961504
0,2 NC'.lHN HL0022
CONTRACT NUMBER: 199697NCAP
PURCHASE OF SERVICES AGREEMENT
THIS AGREEMENT is made and entered into this 19W day of
1996 by and between the County of Weld, State of Colorado, by and through the
County Commissioners of Weld County, on behalf of the Weld County Health Department
("WCHD"), and the Northern Colorado Health Network, Inc., d/b/a the Northern Colorado AIDS
Project ("NCAP").
WITNESSETH:
WHEREAS, WCHD has been awarded Ryan White C.A.R.E. Title II funds from the
Colorado Department of Health and Environment for use in establishing a consortium for care
services for persons infected and affected by the HIV virus in Weld, Larimer, Morgan, Logan,
Yuma, Sedgewick, Phillips, and Washington Counties ("the program"), and
WHEREAS, WCHD desires to contract for provision of case management to persons
infected or affected by HIV in Larimer County ("Larimer County"); and
WHEREAS,NCAP desires to provide said case management to Larimer County; and
WHEREAS, the parties desire to reduce the terms of their agreement to writing.
• NOW, THEREFORE, for and in consideration of the covenants, conditions, agreements,
and stipulations hereinafter expressed, the parties do hereby agree as follows:
1. Recitals. The above recitals are hereby incorporated herein as is stated verbatim
2. Terms of Agreement. This Agreement shall be effective from the date of its
signing, nunc pro tunc April 1, 1996 through March 31, 1997.
3. Compensation. In consideration of the services to be provided by NCAP as set
forth in this Agreement, WCHD agrees to pay NCAP on a monthly bask for services provided
during that month, pursuant to the terms of this Agreement, and the budget amounts set forth in
Attachment A, attached hereto and incorporated herein.
NCAP shall submit an invoice on a form as set forth in Attachment B, attached hereto and
incorporated herein, at the end of each month services are rendered. The invoice will clearly
delineate the services provided and the expenses incurred, as well as the number of hours worked
by each personnel. NCAP shall also be required to submit copies of agency checks written for
payment of any and all vouchers. Payment shall be conditioned upon affirmation by WCHD of
full and satisfactory compliance with the terms of this Agreement. WCHD agrees to make
payment for approved invoices, or notify NCAP of denial of payment within thirty (30) days
after invoices have been submitted.
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4. Changes in Reimbursement. Changes in reimbursement amounts for any of the
amounts set forth in Attachment A shall be made only with the approval of NCAP, WCHD and
the Board of County Commissioners of Weld County, Colorado, as evidenced by a Change
Order Letter signed by all three above named parties. The Change Order Letter shall include the
following:
a. Identification of contract by contract number(199697NCAP), and relevant
budgeted amount;
b. Type of services which are being changed, and the suggested change
in the services;
c. Amount of increase or decrease in funding and new budget total for term of
this Agreement;
d. Intended effective date of funding changes;
e. Authorized signatures for each of the three above named entities.
The Change Order Letter will be used only for funding amount changes. A suggested form is
attached hereto and incorporated herein as Attachment C.
5. Vouchers. In each and every instance in which federal guidelines or consortium
guidelines, or both, provide for their use,NCAP shall use vouchers to assist in payment for
approved client services. NCAP shall use the voucher form attached hereto and incorporated
herein as Attachment D. Such services may include, but are not limited to medical or dental
care, or emergency financial assistance and the like. No voucher shall be issued without prior
approval of the HIV Resource Coordinator at WCHD. As soon as approval for a voucher has
been obtained from the HIV Resource Coordinator,NCAP may issue payment for the client
services represented on the voucher.
6. Services to be Provided by Contractor.
A. NCAP shall provide personnel who will perform active community
outreach with clients, perform in-home assessments, and coordinate with
local health care providers to obtain referrals of newly diagnosed HIV
positive persons in Larimer County.
B. NCAP shall require its personnel to coordinate with WCHD's
Case/Program Manager in the performance of NCAP's personnel's duties.
C. NCAP shall provide the services outlined in the "implementation plan",
attached hereto and incorporated herein as Attachment E.
D. NCAP Shall ensure compliance with the provisions set forth in the
Colorado Ryan White Title II 1996 Consortium Assurances, attached
hereto and incorporated herein as attachment F.
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E. NCAP shall be bound by all existing protocols, professional standards, and
applicable statutes, including, but not limited to Section 25-4-1401 C.R.S.,
et. seq. (HIV infection and AIDS), and Section 18-4-412 C.R.S. (medical
records), concerning confidentiality.
F. NCAP shall comply with the reporting requirements and time frames
described in the Colorado Department of Health Guidance for the
Development of Title II Funded Consortia Workplans, 1996-1997, a copy
of which is attached hereto and incorporated herein as Attachment G.
G. NCAP shall have a financial audit performed in the final quarter of this
Agreement and prior to March 1, 1997. The firm to perform the audit
must be independent of NCAP or NCAP's staff, volunteers, or Board, and
must be approved by WCHD prior to performing the audit. A report from
the audit must be filed with WCHD on or before March 31, 1997.
7. Parties' Relationship. The parties to this Agreement intend that the relationship
between them contemplated by this Agreement is that of independent entities working in mutual
cooperation. No employee, agent, or servant of any party shall be deemed to be an employee,
agent, or servant of another party of this Agreement.
8. Limitations -Liabilities - Indemnification. Each party shall not be responsible
or liable for acts, omissions, or failure to act by the other party. Accordingly, to the extent
permitted by law, WCHD agrees to indemnify and hold NCAP harmless from any and liability
incurred by acts, omissions, or failures to act by WCHD and, likewise, NCAP agrees to
indemnify and hold WCHD harmless from any and all liability incurred by acts, omissions, or
failures to act by NCAP, pursuant to the terms of this Agreement. Because WCHD is a
department of Weld County Government,NCAP acknowledges that this agreement to indemnify
and hold harmless the WCHD extends to Weld County, its employees, agents, subcontractors,
and assignees. The term "liability"includes, but is no limited to, any and all claims, damages,
and court awards including costs, expenses, and attorney fees incurred as a result of any act or
omission by the applicable party who acted or failed to act.
9. Non-Assignment. This Agreement shall not be assignable without prior written
consent of WCHD or NCAP, whichever is the non-assigning party.
10. Provision of Services. WCHD and NCAP assure compliance with Title VI of the
Civil Rights Act of 1964, that no person shall, on the grounds of race, color, sex, religion, age,
national origin, or individual handicap, be excluded from participation in, be denied the benefits
of, or be subject to discrimination under any provision of, this Agreement.
11. Termination. Either party may terminate this agreement for cause upon ten (10)
days written notice, and for any reason, so long as thirty (30) days written notice of its intent to
so terminate is given to the other party. If this Agreement is so terminated, WCHD shall pay that
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961.594
compensation to NCAP which duly reflects the actual amounts due and owing to NCAP for
which NCAP documents that NCAP provided services pursuant to this Agreement, and which
amounts have not previously been paid.
12. Notices. Any notice provided for in this Agreement shall be in writing and shall
be served by personal delivery or by certified mail, return receipt requested, postage prepaid, at
the addresses set forth in this Agreement, until such time as written notice of a change is received
from the party wishing to make a change of address. Any notice so mailed and any notice
serviced by personal delivery shall be delivered and effective upon receipt or upon attempted
delivery. This method of notification will be used in all instances except for emergency
situations when immediate notification to the parties is required.
HEALTH DEPARTMENT:
Weld County Department of Health
c/o Judy Nero
1517 16th Avenue Court
Greeley, Colorado 80631
CONTRACTOR:
Northern Colorado AIDS Project
do Jeff Hill
P.O. Box 182
Fort Collins, CO 80522
13. Modification and Breach. This Agreement contains the entire Agreement and
understanding between the parties to this Agreement and supersedes any other agreements
concerning the subject matter of this transaction, whether oral or written. No modification,
amendment, novation, renewal, or other alteration of or to this Agreement and the attached
exhibits shall be deemed valid or of any force or effect whatsoever, unless mutually agreed upon
in writing by the undersigned parties. Any change in the budget amount shall be by Change
Order Letter, using the procedure set forth in paragraph 4 of this Agreement. No breach of any
term, provision, or clause of this Agreement shall be deemed waived or excused, unless such
waiver or consent shall be in writing and signed by the party claimed to have waived or
consented. Any consent by any party hereto, or waiver of, a breach by any other party, whether
expressed or implied, shall not constitute a consent to, waiver of, or excuse for any other
different or subsequent breach.
14. Incorporation of Contractual Provisions. This Agreement is expressly made
subject to all laws and regulations of the United States and the State of Colorado. Contractual
provisions required by such laws and regulations, but not having been set forth herein, are hereby
incorporated by this reference as though expressly set forth in full. All parties to this agreement
are hereby put on notice and charged with the responsibility of compliance with such contract
provisions as required by law.
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15. Severability. If any term or condition of this Agreement shall be held to be
invalid, illegal, or unenforceable, this Agreement shall be construed and enforced without such a
provision, to the extent this Agreement is then capable of execution within the original intent of
the parties.
16. Funding. No portion of this Agreement shall be deemed to create an obligation
on the part of the County of Weld, State of Colorado, or WCHD to expend funds not otherwise
appropriated during the term of this Agreement.
17. Records. Each party agrees to keep any and all records and information
confidential, in compliance with all laws and regulations concerning the confidentiality of such
records.
18. No Third Party Beneficiary Enforcement. No portion of this Agreement shall
be deemed to constitute a waiver of any immunities the parties or their officers or employees
may possess, nor shall any portion of this Agreement be deemed to have created a duty of care
with respect to any person not a party to this Agreement.
It is expressly understood and agreed that enforcement of the terms and conditions of this
Agreement and all rights of action relating to such enforcement shall be strictly reserved to the
undersigned parties, and nothing contained in this Agreement shall give or allow any claim or
right of action whatsoever by any other person not included in this Agreement. It is the
expressed intention of the undersigned parties that any entity other than the undersigned parties
receiving services or benefits under this Agreement shall be deemed an incidental beneficiary
only.
th
IN W ESS WHEREOF, the parties have hereunto set their hand and seals this A — day
of 1996, nunc pro tunc April 1, 1996.
WELD COUNTY HEALTH DEPARTMENT NORTHERN COLORADO AIDS PROJECT
�_� ".: -e
J S. Pickle, M.S.E.H. By:
y4`
Date Da e
5
361504
4 EL
//4///��G,a,,, eti BOARD OF COUNTY COMMISSIONERS
weir '1 WELD COUNTY, COLO DO
1861 tp', ' ty Clerk to the Board 9 / ,_
% :Re. •"��1 tiara J. Kirkmeyer;Chair 0
®�iii Deputy la rk to the Board pp
Date
6
9615'9
ATTACHMENT A
Budget
Northern Colorado AIDS Project
April 1, 1996 to March 31, 1997
Budgeted Amount
Personnel
Case Management $36,240
Consortium
Support (support groups) 3,380
Total Personnel $39,620
Travel
Case Management $1,000
Consortium
Support 1,000
Total Travel $2,000
Supplies (Printing/Postage)
Case Management
Consortium
Support $1,500
Total Supplies $1,500
Vouchers /Direct Billing
Food Bank $1,500
Phone
Case Management $1,000
Consortium
Support 500
Total Phone $1,500
Audit $2,000
Indirect $4,812
TOTAL $52,932
9615 'i4
ATTACHMENT B
Billing Request
Agency From to
Date Submitted: Date Entered:
Signature:
Amount Requested Balance
Personnel
Case Management
Consortium
Support
Total Personnel
Travel
Case Management
Consortium
Support
Total Travel
Phone
Case Management
Consortium
Support
Total Phone
Supplies (Printing/Postage)
Case Management
Consortium
Support
Total Supplies
Vouchers/Direct Billing
Medical
Dental
Support
Food Bank
Emergency Financial
Total Direct Billing
Audit
Indirect
TOTAL BILLING
9615°4
ATTACH:KEW c
Date
Fiscal Year 19
Change Order Letter No.
In accordance with Paragraph 4 of contract number , (copy attached and by this
reference made a part hereof) 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 covering the period of
19 through , 19 the undersigned agree that the maximum amount payable
by the Weld County Health Department for eligible services as set forth in the budget in
Attachment A of said contract is being increased by $ to a new total of
$ . The budget amounts in Attachment A are hereby modified accordingly. The
terms and conditions of the original contract shall remain the same.
BUDGET
This amendment to the 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 Chairman of the Board of
County Commissioners of Weld County or such assistant as he or she may designate.
Please sign, date, and return all copies of this letter on or before , 19 to:
Judy Nero
Weld County Health Department
1517 16th Avenue Court
Greeley, Colorado 80631
A verified copy of this letter will be returned to you when it is fully approved.
Page 1 of 2 Pages
961594
NORTHERN COLORADO AIDS PROJECT WELD COUNTY HEALTH DEPARTMENT
, tom
By: By:
Date Date
ATTEST: BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
Weld County Clerk to the Board
By: Chairman
Deputy Clerk to the Board
Date
Page 2 of 2 Pages
9615 .94
ATTACHMENT D
HUMERI, COLORADO CARE COnSORMUm (nCCC)
CLIENT NAME or ACCOUNT ti: DATE:
REFERRING NCCC REPRESENTATIVE NAME AND AGENCY:
NCCC REPRESENTATIVE SIGNATURE:
SERVICE PROVIDER NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE NUMBER:
Return`to
VOUCHER PROGRAM USED:
Weld County Health Department
DIRECT FINANCIAL ASSISTANCE 1517 16th Ave.Ct.
Greeley,CO 80631
PRIMARY MEDICAL CARE
'Attn:Gabrielle Vergara
DENTAL CARE ..
TO BE FILLED OUT BY THE SERVICE/CARE PROVIDER:
PLEASE PROVIDE A BRIEF BREAKDOWN OF THE SERVICES/CARE PROVIDED AND THE
ASSOCIATED COSTS:
TOTAL REIMBURSEMENT REQUESTED
SERVICE PROVIDER SIGNATURE
FOR ADMINISTRATIVE USE ONLY: DATE SUBMITTED
(Weld County Health Department)
TOTAL REIMBURSEMENT APPROVED
BALANCE REMAINING
ACCOUNT NUMBER 961524
ATTACHMENT E
Implementation plan:
Based on the purpose and the overall goals of the Consortium, the following is a implementation
plan that the members of the Consortium, the HIV Resource Coordinator, the Northern Colorado
AIDS Project, and the Northeast Colorado Health Department will undertake during the 1996-
1997 funding period.
HIV Resource Coordinator and the Northern Colorado Care Consortium
Objective#1: The HIV Resource Coordinator will publicly announce (through media
releases)the award of Ryan White Care Act funds to northern Colorado for the period of
April 1, 1996 through March 31, 1997.
Objective#2: The HIV Resource Coordinator will continue with office hours in Fort
Morgan and Sterling at the Northeast Colorado Health Department, to provide case
management and support services to clients living in northeast Colorado..
Objective#3: The HIV Resource Coordinator will update all referral contacts in Weld,
Logan, Morgan, Yuma, Washington, Phillips, and Sedgewick counties.
Objective#4: The HIV Resource Coordinator and members of the Consortium will
continue recruiting support for the activities of the Consortium, and recruiting potential
members, particularly among the infected/affected and Spanish communities.
Objective#5: The HIV Resource Coordinator and the members of the Consortium will
continue to identify service providers, in northern Colorado, who are willing and able to
care for individuals infected with HIV.
Objective#6: The HIV Resource Coordinator will continue to promote the availability
of Ryan White services in northern Colorado.
Objective#7: The HIV Resource Coordinator will continue in sending a monthly
mailing with the Resolute newsletter to all clients in Weld county and northeast
Colorado.
Northern Colorado AIDS Project
Objective#1: NCAP staff will contact all service providers, in Larimer county, and
renew service agreements and referral materials.
Objective#2: NCAP staff will put up posters in areas frequented by people in
designated high risk categories, which will outline NCAP's services.
Objective#3: NCAP staff will interview three injection drug users to determine the
needs and means to access this population.
Objective#4: NCAP staff will have updated and distributed the resource directory for
Larimer county.
Objective#5: NCAP staff will start a four part educational series of representations for
newly infected individuals that will educate them on nutrition, medications, terminology,
and transmission prevention.
961524
Northeast Colorado Health Department
Objective#1: NCHD staff will continue to promote and advocate for the continuation of
a support group in Logan and Morgan counties.
Objective#2: NCHD staff will continue to promote the availability of Ryan White
related services in northeast Colorado.
Objective#3: NCHD staff will continue to conduct outreach activities to communities
of northeast Colorado,targeting communities and care providers of at-risk persons.
Objective#4: NCHD staff will continue to conduct outreach activities to the Spanish
speaking communities of northeast Colorado, and will be.available for translation to
monolingual, Spanish speaking,persons as needed in educational and service activities
related to Ryan White.
Objective#5: NCHD staff will initiate the development of interpreter services for HIV
at-risk persons, including training and compensation.
Objective#6: NCHD staff will increase coordination of culturally appropriate and
accessible services including outreach,education, and case management for HIV infected
and affected individuals in northeast Colorado.
Collaborative Efforts
Objective#1: NCAP, WCHD, and NCHD will collaborate on a monthly newsletter that
will be distributed to all clients in the Consortium's catchment area.
Objective#2: NCAP, WCHD,and NCHD will initiate a client advisory board made up
of infected clients, who will meet quarterly to assess the services provided by the
consortium agencies.
Objective#3: NCAP staff will coordinate with WCHD to expand services in Weld
county, including dividing current support group into Infected Persons and Friends and
Family groups, and expanding the Buddy program and other volunteer services.
Objective#4: NCAP, WCHD, and NCHD will continue working together in developing
a formal referral system to appropriately document HIV status.
Objective#5: NCAP, WCHD,and NCHD will provide case management and other
Ryan White services to 120 individuals (including clients without client-level
information) in northern Colorado.
961524
ATTACHMENT F
Colorado Ryan White Title II 1994 Consortium Assurances
In order to receive assistance from the State, the Consortium hereby assures the State that:
A. Within the established locality in which the consortium will operate, the population and
subpopulations of individuals and families with HIV disease have been identified by the
consortium;
B. The consortium's service plan addresses the special care and service needs of the
populations and subpopulations identified in the established locality;
C. The consortium will comply with all data collection and reporting requirements as mandated
by HRSA and the Colorado Department of Health;
D. The consortium will be a single coordinating entity that will integrate the delivery of
services among the populations and subpopulations identified in the established locality;
E. The consortium will coordinate and expand existing programs before any new programs are
created;
F. The consortium shall deliver case management services that link available community
support services to appropriate specialized medical services;
G. The consortium will include participation by individuals with HIV disease in the assessment
of service needs and the planning of the delivery of services;
H. The consortium has or will create a mechanism to evaluate the success of the consortium
in responding to the identified needs and the cost effectiveness of the mechanisms employed
by the consortium to deliver comprehensive care;
I. The consortium has or will adopt by-laws by which the consortium will operate. The by-
laws will include the definition of a "member" of the consortium and a description of the
process the consortium must follow in including new members. Membership defmitions and
processes will clearly demonstrate an open and inclusionary intent which will give all
segments of the HIV service provider community an opportunity to participate on a
continuous and ongoing basis. By-laws will also include a description of the process for
selecting a lead agency; this process will ensure all consortium members have an
opportunity to be considered for the role of lead agency, if interested, and to participate in
selection of the lead agency; and
961.524
J. All non-profit agencies receiving$25,000.00 or more in Title II funds will ensure an annual
independent financial audit is conducted and a report submitted as specified in Section
II,F, of the 1995-96 Title II Consortia Workplan Guidance document. (The CFDA number
for Title II funds is 93-9170).
� lul�c 0116;'1 02- 20 - qlo
Signature 00 Date
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961594
ATTACHMENT G
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
GUIDANCE FOR THE DEVELOPMENT OF TITLE II FUNDED
CONSORTIA WORKPLANS, 1996-97
9615°
I. GENERAL INFORMATION
A. Introduction:
The Colorado Department of Health is receiving a 12-month grant under the federal Ryan
White C.A.R.E. Act of 1990 to "improve the quality, availability and organization of health
care and support services for individuals and families with HIV disease." [Sec. 2611] Grant
funds are restricted to specific types of activities and services. Grant funds. may be used
for the development and operation of HIV care consortia; home- and community-based care
services; continuum of health insurance coverage; and the provision of treatments. It is the
intention of the Act that funds be distributed in a manner consistent with the epidemiology
of reported AIDS cases within the State. Fifteen (15) percent of funds must be used to
serve infants, children, women and families with HIV.
B. Definitions:
1. HIV Care Consortia: An HIV care consortium, as defined in the Ryan White
C.A.R.E. Act, is "an association of one or more public, and one or more nonprofit
private, health care and support service providers and community-based organizations."
[Sec. 2613 (a) (1) and (2)] Consortia are established and operate within areas most
affected by HIV disease to provide a comprehensive continuum of care to individuals
and families with HIV disease.
2. Home- and Community-based Care: Home- and Community-based Care is defined as
those skilled health services provided to an individual with HIV disease in his/her home
pursuant to a written plan of care established by a case management team.
3. Continuum of Health Insurance Coverage: Continuum of Health Insurance Coverage
is defined as financial assistance provided to eligible low-income individuals with HIV
disease in maintaining a continuity of health insurance or receiving medical benefits
under a health insurance program, including risk pools.
4. Provision of Treatments: Provision of Treatments is defined as the provision of
treatments that have been determined to prolong life or prevent the serious deterioration
of health arising from HIV disease.
C. Overview:
Under the auspices of the Governor's AIDS Council a subcommittee was formed to
determine general disbursements of Title II funds. Determinations were made of funding
amounts for each consortia area. Individual consortium will make their own decisions of
how best to disburse those funds within their own geographic area.
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961,524
D. Goal of the Program:
It is the goal of the Colorado Department of Health to fund activities and services
throughout the State in order to "improve the quality, availability and organization of health
care and support services for individuals and families with HIV disease." [Sec. 2611]
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961.524
II. STATEMENT OF WORK
A. Period of Performance: The period of performance for this project is from April 1, 1996,
through March 31, 1997.
B. General Responsibilities:
I. To the maximum extent possible, ensure that HIV-related health care and support
services provided will be without regard to the ability of the individual to pay for such
services and without regard to the current or past health condition of the person with
HIV disease.
2. Ensure that services will be provided in a setting that is accessible to low-income
individuals with HIV disease and provide outreach to low-income individuals with HIV
disease to inform them of the services available through this grant.
3. Conduct all programs in accordance with the accepted workplan, including remaining
within the proposed budget and performing tasks within the specified time-frame.
4. Identify a project staff member to work with the Colorado Department of Health.
5. Work cooperatively with the Colorado Department of Health with the review and
evaluation of program progress and the independent peer review program designed to
assess the quality and appropriateness of health and support services provided through
this grant.
C. Specific Responsibilities and Eligibility Requirements:
1. Responsibilities:
a) To provide comprehensive outpatient, essential health and support services for
individuals and families with HD/ infection. Services include (but are not limited
to):
i) essential health services: case management; medical, nursing and dental
care; diagnostics; monitoring; medical follow-up services; mental health;
developmental and rehabilitation services; home health; and hospice care.
ii) essential support services: transportation; attendant care; homemaker
services; day or respite care; benefits advocacy; advocacy services provided
through public and nonprofit private entities; nutrition; housing referral; child
welfare and family services (including foster care and adoption); and provision
of information and counseling on living with HD/.
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961.594
b) To coordinate and expand existing services, and to identify service gaps. The
consortium is the single coordinating body that will integrate the HIV services
within a particular locality. If a locality has sub-populations with unique service
requirements which cannot be adequately met by a single coordinating body, an
additional consortium could receive Title II funds.
2. Eligibility Requirements: A consortium does not have to provide the services directly.
Alternatively, it can coordinate the services. In addition, a consortium is not required
to become a legally incorporated entity. Funds can be received by a lead member
agency, on behalf of a consortium. In order to be eligible to receive funding, a
consortium must comply with the following requirements:
a) Membership: A consortium must include agencies and community-based
organizations which provide services to populations and sub-populations with HIV
infection within the community; represent the populations and sub-populations
affected by HIV in the community; and are located in areas where these groups
reside. Additionally, a consortium should include representation by persons with
HIV infection.
b) Service Plan:.
i) A consortium must undertake a needs assessment and establish a service
plan based on the results of the needs assessment in consultation with the
public health agency that provides or funds ambulatory and outpatient
HIV-related health services; other entities that directly provide ambulatory
HIV health services; community-based organizations that are organized
solely for the purpose of providing HIV-related support services to
individuals with HIV infection; and in Ryan White Title I cities, the HIV
Health Services Planning Council.
ii) The consortium triust assure that persons with HIV infection participate in
the planning process, and that needs will be addressed through the
coordination and expansion of existing programs before new programs are
created; in metropolitan areas, the geographic area to be served by the
consortium corresponds to the boundaries of local health and support
service delivery systems, to the extent practicable; in rural areas, the
consortium will provide case management services to link support services
to specialized medical services; the full continuum of health and social
services needed for persons with HIV infection has been considered; and
adequate planning has occurred to meet the special needs of families with
HIV infection, including family centered care.
c) Reporting and Evaluation: The consortium must create a mechanism to evaluate
its success in responding to identified needs and the cost-effectiveness of the
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9615I4
mechanisms employed by the consortium to deliver comprehensive care. The
results of these evaluations must be reported to the State. Data and information
about the evaluation methodology the consortium used must also be available to the
State.
D. Reporting Requirements: Contractors must provide statistical and program achievement
information and assurances to the Colorado Department of Health in a manner that meets
the requirements of the Health Resources and Services Administration (HRSA) of the U.S.
Department of Health and Human Services (DHHS). This information includes:
1. Statistical and Program Achievement: All contractors receiving Title II funds MUST
comply with the reporting requirements of the AAR and provide quarterly narrative
reports and up-to-date fiscal information..
a) Four quarterly narrative and statistical reports must be submitted for the period of
April 1 to June 30; July 1 to September 30; October 1 to December 31, 1996; and
January 1 to March 31, 1997. These reports will be due by July 15 and October 15,
1996 and January 15 and April 15, 1997, respectively. Narrative reports should
include discussions of: progress in achievement of goals and objectives; problems and
• concerns encountered in completing activities within each category of service; plans to
respond to any barriers encountered; and highlights of noteworthy achievements and
developments.
b) Contractors are required to submit monthly reports meeting the requirements of the
AAR/URS. For the upcoming grant year, just a few changes have been made, along
with the necessary instructions and will be sent to you as soon as possible.
c) Contractors are also required to produce an annual aggregate AAR to be submitted
to HRSA. The reporting period is based on the calendar year, e.g., January 1 through
December 31 of any given year. However, in the event a contract is not renewed for
the new project period commencing April 1, 1996, the reporting period for calendar
year 1996 shall be from January 1, 1996, to March 31, 1996. All contractors must
plan to complete standard scannable AAR which will be sent to you as soon as
possible. Mayatech has been unable to mail out the new forms due to the federal
government furloughs. The year-end form will be completed for the January 1, 1995
through December 31, 1995 time period and will be due in our office in March, 1996.
E. Assurances: Consortia submitting workplans are required to sign the enclosed assurances
and include them as an attachment to the workplan.
F. Annual financial audit: All non-profit agencies receiving $25,000.00 or more in Ryan
White Title II funds must have an annual financial audit conducted by an independent
auditor. The audit report must be received by CDH no later than 90 days after the last day
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III. WORKPLAN GUIDELINES
A. Workplan Submission: Submit two (2) copies of the workplan, including the original, to
Karen Ringen, at the address below, no later than 2:30 p.m. on February 23, 1996. Please
note it will take approximately 4-6 weeks to process contracts within CDPHE; therefore,
if it is possible to submit workplans earlier, final contracts will be available sooner. The
address is:
Colorado Department of Public Health and Environment
DCEED-STD-A3
4300 Cherry Creek Drive So.
Denver, CO 80222-1530
B. Guidelines for Writing the Workplan:
1. The workplan narrative should not exceed ten (10)pages, be single spaced, in standard
10 or 12 point type, and use one-inch top, bottom and side margins.
2. The workplan shall have a cover-page which indicates:
a. the HIV Care Consortium name which, in further references, shall be referred to
as "Contractor";
b. the list of agencies, including federal tax identification numbers, to receive funds
under this grant; and
c. the name, address and phone number of a contact person appointed by the
submitting consortium.
3. The workplan should clearly and concisely address how the contractor "improve[s] the
quality, availability and organization of health care and support services for individuals
and families with HIV disease." [Sec. 2611]
4. The worlcplan should include, as an addendum, evidence of strong local community
support from persons with HIV disease, local health authorities and medical providers.
5. The workplan should include, as an addendum, the signed assurances included with this
document.
6. The proposal should be clear and specific since it will serve as the basis for evaluation
and will be included in the performance-based contract when awarded.
C. Workplan Format: Agencies submitting workplans are required to write a narrative
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9615M',M
of the project period. Necessary and reasonable costs associated with this audit may be paid
from the agency's grant funds.
G. Responsibilities of the Colorado Department of Health:
1. Designate a contact person to coordinate the work of the contractors.
2. Assist contractors in the preparation of reports.
3. Provide training, technical assistance and guidance in the implementation of the
AAR/URS reporting systems.
4. Regularly monitor the progress of the work under the contract.
5. Conduct at least one evaluation session with the contractor.
6. Provide additional technical assistance as requested by the contractor.
H. Compensation: The Colorado Department of Public Health and Environment will reimburse
the contractor all contract-related expenses incurred during the quarter following the
submission of a financial status and program achievement report and a signed request for
reimbursement.
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961.5
describing the consortium and to submit budgets which reflect the responsibilities and
eligibility requirements of the consortium.
I. Narrative
a) Description of the locality to be served, including:
1) the geographic boundaries and how they correspond to the boundaries of the
local health and social services delivery systems;
2) the characteristics of the populations affected by HIV in the locality, based on
the incidence of AIDS and the prevalence of HIV;
3) the existing HIV services available in the geographic area; and
4) service gaps, based on the assessment of existing service capacity and unmet
needs.
b) Description of the service plan, including:
1) the planning process by which the service plan was developed, including a
description of how the public health agency, other local providers of
ambulatory services (if the public health agency is not a direct service
provider), and AIDS service organizations were consulted; and how persons
with HIV infection participated in the development of the plan;
2) the service plan: what services will be provided and by which organizations;
how many persons with HIV infection will be served by the proposed service;
and what the methodology will be for reaching and serving persons newly
diagnosed with HIV disease in the service area. Please include the
demographic information that is used in the AAR;
3) the service integration: how referrals between agencies will be made; a
" description of the plan for case management; and
4) the implementation plan: based on the service plan, what activities will be
undertaken and when; and which organization will be responsible for
coordinating the specific activities in the implementation plan.
c) Description of the consortium membership, including:
1) name of lead agency and documentation that all consortium
members had the opportunity to be considered for the role
of lead agency and agree to the selection of the designated
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961594
lead agency in their region;
2) a list of members and what services they provide, including a description of
the coordination between member agencies in order to provide a quality and
continuum of care;
3) a description of member agencies which will be receiving HIV care consortium
funds; and
4) a description of the form of agreement between the agencies.
d) Description of the plan for reporting and evaluation, including the mechanism the
consortium will use to collect data from consortium members to evaluate its
success in responding to the identified needs; and to evaluate the cost-effectiveness
of the services provided.
2. Budget: Submitting agencies must submit completed budget tables and justifications
which reflect the consortium budget as a whole and completed budget tables and
justifications from each individual agency requesting funds under this program.
a) Budget Tables: The enclosed budget tables should be completed according to the
attached instructions.
b) Budget Justification: The budget justification must reflect the amounts requested
in the budget tables. The budget justification shall be broken out into two parts:
1) Table I: Description and Justification of Budget: Each object class/category
should be justified by responding to these points:
a) Object Class/Category
b) Total funds requested for the Object Class/Category
c) What percent of the total budget does this represent?
d) Describe how the proposed object class/category will "improve the quality,
availability and organization of health care and support services for
individuals and families with HIV disease." [Sec. 2611]
2) Table II: Description and Justification of Planned HIV Service: The amounts
in each of the object class/categories can be broken down into direct and
indirect costs for service. Each of the proposed HIV services should be
justified by responding to these points:
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961504
a) Planned HIV service
b) Total funds requested for this service (direct plus indirect costs)
c) What is the number of full time equivalent employees (FTEs) that will be
supported with the specified funds?
d) Number of clients to be served by this service (4/1/96 - 3/31/97). At least
15 percent of services shall be provided to "infants, children, women and
families with HIV disease." [Sec. 2612 (b)] Provide the number of clients
to be served in each of these categories.
e) Describe how the service will "improve the quality, availability and
organization of health care and suppolt services for individuals and
families with HIV disease." [Sec. 2611]
0 Explain the plan, including specific tasks to be performed, for providing
the planned HIV service: How will clients benefit?
g) Using quarterly objectives, what measurable units of service will be
provided with these funds (e.g., number of clients, number of client
contacts, etc.)?
h) If planning an expansion of existing services, how many additional clients
will be served?
i) Describe the methods that will be used to monitor and assure the quality
of the service.
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961.52/1
f itt f`' , mEmoRAnDum
Barbara Kirkmeyer, Chair
To Board of County Commissioners Date August 22, 1996 GI
COLORADO ,
From John Pickle, Director, Health Department ')
Subject: Northern Colorado AIDS Project Purchase of Services Agreement
Enclosed for Board approval is an agreement between Weld County Health Department and
the Northern Colorado Health Network, Inc., doing business as Northern Colorado AIDS Project
(NCAP).
The Health Department was awarded Ryan White Title II funds from the Colorado Department
of Public Health and Environment to continue the consortium of care services for persons
infected and affected by the HIV virus in Northeastern Colorado. As part of the effort, the
Health Department is entering into an agreement with NCAP to provide case management
services to such persons in Larimer County and to provide coordination of the Northern Colorado
Care Consortium.
For these services, NCAP will receive an amount not to exceed $52,932 for the period April 1,
1996 through March 31, 1996
I recommend approval of this agreement.
Enclosures
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