HomeMy WebLinkAbout971881.tiffRESOLUTION
RE: APPROVE 1997/1998 CANCER PREVENTION CONTRACT WITH THE COLORADO
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT AND AUTHORIZE
CHAIRMAN 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 the 1997/1998 Cancer Prevention
Contract between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Weld County Health Department, and the
Colorado Department of Public Health and Environment, commencing August 15, 1997, and
ending August 14, 1998, with further terms and conditions being as stated in said contract, and
WHEREAS, after review, the Board deems it advisable to approve said contract, a copy
of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, that the 1997/1998 Cancer Prevention Contract between the County of
Weld, State of Colorado, by and through the Board of County Commissioners of Weld County,
on behalf of the Weld County Health Department, and the Colorado Department of Public
Health and Environment, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said contract.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 20th day of August, A.D., 1997, nunc pro tunc August 15, 1997.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTES
Weld
BY
Dep
onstance L. Harbert'Pro=Tem
EXCUSED
Dale K. Hall
APP'
W. H.`Webster
unty Atto n y
de: Ht -
gv
971881
HL0023
Approved Waiver Form
CONTRACT
Department or Agency Number
260000 -- FLA
Contract Routing Number
9807372
THIS CONTRACT, made this 1st day of July, 1997, by and between the State of Colorado
for the use and benefit of the Department of PUBLIC HEALTH AND ENVIRONMENT, 4300
Cherry Creek Drive South, Denver, Colorado 80246-1530 hereinafter referred to as the State and
WELD COUNTY DEPARTMENT OF HEALTH, 1517 16th Avenue Court, Greeley, CO
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 FLA
PPG9807372, in Fund Number 100, Appropriation Account 773, and Organization 7340;
WHEREAS, required approval, clearance and coordination has been accomplished from and
with appropriate agencies;
WHEREAS, the State has entered into a Cooperative Agreement with the Centers for
Disease Control and Prevention (CDC) for a project entitled the Colorado Women's Cancer
Control Initiative (CWCCI) to provide breast cancer screening, cervical cancer screening, and
diagnostic services;
WHEREAS, the intent of the Cooperative Agreement is to increase screening and diagnosis
among low income older women who are uninsured and under insured including those who are
racial, ethnic and cultural minorities, such as American Indians, African Americans, Hispanics,
Asian/Pacific Islanders, Lesbians, and women with disabilities, and women who live in hard to
reach communities in urban and rural areas; and
WHEREAS, the Contractor is considered by the State to be an appropriate agency which has
the facilities, personnel and capability to provide services as herein set forth.
NOW THEREFORE, it is hereby agreed that for and in consideration of their mutual
promises to each other, hereinafter stated, the parties hereto agree as follows:
1. The Contractor agrees to provide the services as described on the attached Statement
of Work which is attached hereto as Exhibit A and incorporated herein by this reference.
2. The Contractor agrees to provide matching funds information that is required to
maintain the covenants of the grant from the CDC. The Colorado Women's Cancer Control
Initiative (CWCCI) will request this information not less than twice per year. The matching funds
will normally be of in -kind nature.
Page 1 of 7
3. The administrators of the CWCCI shall have the authority to conduct annual program
performance reviews/ audits of services provided through this project. Administrative and clinical
records of patients receiving services through this project shall be made available to the reviewers
for this purpose.
4. Payment pursuant to this contract will be made as earned, in whole or in part, from
available funds encumbered in an amount not to exceed ONE MILLION, EIGHT HUNDRED
SIXTY NINE THOUSAND, NINE HUNDRED SIXTY NINE AND 00/100ths DOLLARS
($1,869,969.00) for the purchase of eligible health services.
It is further understood and agreed that the maximum amount of funds available for the period
of August 15, 1997 to August 14, 1998 for the purchase of breast and cervical cancer screening
and diagnostic services is One Million, Eight Hundred Sixty Nine Thousand, Nine Hundred Sixty
Nine and 00/100ths Dollars ($1,869,969.00). The liability of the State, at any time, for such
payments shall be limited to the unencumbered amount remaining of such funds.
The reimbursement rates for services under this Program are listed on the Schedule of
Services attached hereto as Exhibit B and incorporated herein by this reference, and as stated in
the attached Statement of Work. Payment will be made by the State based on submission of the
required CWCCI forms indicating that services were rendered with the necessary results indicated.
Monthly reports will be generated from the Fiscal Management System; one to indicate the total
amount of services rendered by procedure, and a second one giving specific details on the women
served and the procedures performed. The State will monitor statewide activity to ensure that
the total funding available is not exceeded and that the Contractor will receive full payment for
all services rendered that are reimbursable through this program. A second report, Procedure
Done/Planned by Cagency (Contract Agency), will be generated monthly showing all screening
services provided to women from the starting date of the fiscal year to the current date to aid in
reconciliation of service activity. Additional covenants covering payments made under this
contract are as follows:
a) In accordance with P.L. 101-345, patient charges for services provided will be made
according to a schedule of charges /hat is made available to the public, and that is
adjusted to reflect the income of the women involved. No patient charges will be
imposed on any woman with an income of 200% or less of the federal poverty line
as shown on Poverty Guidelines attached hereto as Exhibit D and incorporated herein
by this reference.
b) Any contractor income generated such as donations shall be used by the program for
cancer prevention and control purposes which further the objectives of the legislation
under which this contract is made.
c) The Contractor agrees that Medicare rates, which are changed on an annual basis,
will be used for establishing the reimbursement rates for breast and cervical cancer
screening and diagnostic services. The current year's rates are those contained on the
attached Schedule of Services.
5. The State may prospectively increase or decrease the total reimbursement amount
Page 2 of 7
payable under this contract for the services covered by this contract as a result of an increase or
decrease of funding from the CDC through a Change Order Letter, a copy of which is attached
and by reference made part hereof as Exhibit C. The Change Order Letter shall include the
following:
a) identification of the original contract by encumbrance number and the number of the
affected paragraph;
b) original amount granted, the amount of the increase or decrease in funding for the
program and the new total amount for the contract;
c) intended effective date of change;
d) a provision stating that the change shall not be valid until approved by the State
controller or such assistant as he may designate; and
e) authorized signatures of the State, the Contractor and the State Controller or his
designee.
6. The Contractor hereby acknowledges and agrees, to the best of his or her knowledge
and belief, that:
a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the
contractor 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
Federal contract, the making of any Federal grant, the making of any Federal loan,
the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal contract, grant, loan, or
cooperative agreement.
b) 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, or an employee
of a Member of Congress in connection with this Federal contract, grant, loan, or
cooperative agreement, the Contractor shall complete and submit Standard Form-
LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
c) The Contractor shall require that the language of this certification be
included in the award documents for all subawards at all tiers (including
subcontracts, subgrants, and contracts under grants, loans and
cooperative agreements) and that all subrecipients shall certify and
disclose accordingly.
7. The term of this contract is beginning August 15,1997, and continuing through August
14, 1998.
Page 3 of 7
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
1. THE CONTRACTOR SHALL PERFORM ITS DUTIES HEREUNDER AS AN INDEPENDENT CONTRACTOR AND
NOT AS AN EMPLOYEE. NEITHER THE CONTRACTOR NOR ANY AGENT OR EMPLOYEE OF THE CONTRACTOR
SHALL BE OR SHALL BE DEEMED TO BEAN 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-110, whichever is applicable;
b) the Hatch Act (5 U.S.C. 1501-1508) and Public Law 95-454 Section 4728. These statutes state that federal funds
cannot be used for partisan political purposes of any kind by any person or organization involved in the administration of
federally -assisted programs;
c) the Davis -Bacon Act (40 Stat. 1494, Mar. 3, 1921, Chap. 411, 40 U.S.C. 276A -276A-5). This act requires that all
laborers and mechanics employed by contractors or sub -contractors to work on construction projects financed by federal
assistance must be paid wages not less than those established for the locality of the project by the Secretary of Labor;
d) 42 U.S.C. 6101 et seq, 42 U.S.C. 2000d, 29 U.S.C. 794. These acts require that no person shall, on the grounds of
race, color, national origin, age, or handicap, be excluded from participation in or be subjected to discrimination in any program
or activity funded, in whole or in part, by federal funds;
Page 4 of 7 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. 61 I;
f) if the contractor is acquiring real property and displacing households or businesses in the performance of this contract,
the contractor is in compliance with the Uniform Relocation Assistance and Real Property Acquisition Policies Act, 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 arrrgs to its records and fmancial 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 / I ESX (Xl) 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 5 of 7 Pages
Rev. 05/07/97 (GEN)
SPECIAL PROVISIONS
CONTROLLER'S APPROVAL
1 . This contract shall not be deemed valid until it shall have been approved by the Controller of the State of Colorado or such assistant as he may designate.
This provision is applicable to any contract involving the payment of money by the State.
FUND AVAILABILITY
2. Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted,
and otherwise made available.
BOND REQUIREMENT
3. If this contract involves the payment of more than fifty thousand dollars for the construction, erection, repair, maintenance, or improvement of any building,
road. bridge, viaduct, tunnel, excavation or other public work for this State, the contractor shall, before entering upon the performance of any such work included
in this contract, duly execute and deliver to the State official who will sign the contract, a good and sufficient bond or other acceptable surety to be approved
by said official in a penal sum not less than one-half of the total amount payable by the terms of this contract. Such bond shall be duly executed by a qualified
corporate surety conditioned upon the faithful performance of the contract and in addition, shall provide that if the contractor or his subcontractors fail to duly
pay for any labor, materials, team hire, sustenance, provisions, 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 act or omission by the contractor, or its employees,
agents, subcontractors, or assignees pursuant to the terms of this contract.
DISCRIMINATION AND AFFIRMATIVE ACTION
5. The contractor agrees to comply with the letter and spirit of the Colorado Antidiscrimination Act of 1957, as amended, and other applicable law respecting
discrimination and unfair employment practices (CRS 24-34-402), and as required by Executive Order, Equal Opportunity and Affirmative Action, dated April
16, 1975. Pursuant thereto, the following provisions shall be contained in all State contracts or sub -contracts.
During the performance of this contract, the contractor agrees as follows:
(a) The contractor will not discriminate against any employee or applicant for employment because of race, creed, color, national origin, sex, marital stains,
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 advertisings; lay-offs or terminations; rates of pay or other forms of compensation; and selection
for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to
be provided by the contracting officer setting forth provisions of this non-discrimination clause.
(b) The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive
consideration for employment without regard to race, creed, color, national origin, sex, marital status, religion, ancestry, mental or physical handicap, or age.
(c) The contractor will send to each labor union ar representative of workers with which he has a collective bargaining agreement or other contract or
understanding, notice to be provided by the contracting officer, advising the labor union or workers' representative of the contractor's commitment under the
Executive Order, Equal Opportunity and Affirmative Action, dated April 16, 1975, and of the rules, regulations, and relevant Orders of the Governor.
(d) The contractor and labor unions will furnish all information and reports required by Executive Order, Equal Opportunity and Affirmative Action of April
16, 1975, and by the rules, regulations and Orders of the Governor, or pursuant thereto, and will permit access to his books, records, and accounts by the
contracting agency and the office of the Governor or his designee for purposes of investigation to ascertain compliance with such rules, regulations and orders.
(e) A labor organization will not exclude any individual otherwise qualified from full membership rights in such labor organization, or expel any such individual
from membership in such labor organization or discriminate against any of its members in the MI enjoyment of work opportunity because of race, creed, color,
sex, national origin, or ancestry.
(0 A labor organization, or the employees or members thereof will not aid, abet, incite, compel or coerce the doing of any act defined in this contract to be
discriminatory or obstruct or prevent any person from complying with the provisions of this contract or any order issued thereunder, or attempt, either directly
or indirectly, to commit any act defined in this contract to be discriminatory.
(g) In the event of the contractor's non-compliance with the non-discrimination clauses of this contract or with any of such rules, regulations, or orders, this
contract may be canceled, terminated or suspended in whole or in part and the contractor may be declared ineligible for further State contracts in accordance
with procedures, authorized in Executive Order, Equal Opportunity and Affirmative Action of April 16, 1975 and the rules, regulations, or orders promulgated
Form 6 -AC -028 (GEN060197) Revised 06/01/97
6
Page of pages
in accordance therewith, and such other sanctions as may be imposed and remedies as may be invoked as provided in Executive Order, Equal Opportunity and
Affirmative Action of April 16, 1975, or by rules, regulations, or orders promulgated in accordance therewith, or as otherwise provided by law.
(h) The contractor will include the provisions of paragraphs (a) through (h) in every sub -contract and subcontractor purchase order unless exempted by rules,
regulations, or orders issued pursuant to Executive Order, Equal Opportunity and Affirmative Action of April 16, 1975, so that such provisions will be binding
upon each subcontractor or vendor. The contractor will take such action with respect to any sub -contracting or purchase order as the contracting agency may
direct, as a means of enforcing such provisions, including sanctions for non-compliance; provided, however, that in the event the contractor becomes involved
in, or is threatened with, litigation, with the subcontractor or vendor as a result of such direction by the contracting agency, the contractor may request the State
of Colorado to enter into such litigation to protect the interest of the State of Colorado.
COLORADO LABOR PREFERENCE
6a. Provisions of CRS 8-17-101 & 102 for preference of Colorado labor are applicable to this contract if public works within the State are undertaken hereunder
and arc financed in whole or in part by State funds.
b. When a construction contract for a public project is to be awarded to a bidder, a resident bidder shall be allowed a preference against a non-resident bidder
from a state or foreign country equal to the preference given or required by the state or foreign country in which the non-resident bidder is a resident. If it is
determined by the officer responsible for awarding the bid that compliance with the subsection .06 may cause denial of federal funds which would otherwise
be available or would otherwise be inconsistent with requirements of Federal law, this subsection shall be suspended, but only to the extent necessary to prevent
denial of the moneys or to eliminate the inconsistency with Federal requirements (CRS 8-19-101 and 102).
GENERAL
7. The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the interpretation, execution, and enforcement of this
contract- Any provision of this contract whether or not incorporated herein by reference which provides for arbitration by any extra judicial body or person
or which is otherwise in conflict with said laws, rules, and regulations shall be considered null and void. Nothing contained in any provision incorporated herein
by reference which purports to negate this or any other special provision in whole or in part shall be valid or enforceable or available in any action at law whether
by way of complaint, defense, or otherwise. Any provision rendered null and void by the operation of this provision will not invalidate the remainder of this
contract to the extent that the contract is capable of execution.
8. At all times during the performance of this contract, the Contractor shall strictly adhere to all applicable federal and state laws, rules, and regulations that
have been or may hereafter be established.
9. Pursuant to CRS 24-30-202.4 (as amended), the state controller may withhold debts owed to state agencies under the vendor offset intercept system for:
(a) unpaid child support debt or 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.
I0. The signatories aver that they are familiar with CRS 18-8-301, et seq., (Bribery and Corrupt Influences) and CRS 18-8-401, et seq., (Abuse of Public Office),
and that no violation of such provisions is present.
11. The signatories aver that to their knowledge, no state employee has any personal or beneficial interest whatsoever in the service or property described herein.
IN WITNESS WHEREOF, the parties hereto have executed this Contract on the day first above written.
Contractor. WELD COUNTY
(Full Legal Name)//�ARTMENT OF HEI47 44
By
Position (Title)
t>nR-7n—q7
BOARD OF COIINTt' COMMISSIONERS
CHAIR PRO—TEM
846
Social Secu
If Corporation, To
Attest (A
By
ATTORNEY GENERAL
rate Secre
Gale A. Norton
State of Colorado
ROY ROMER, GOVERNOR
PUBLIC HEALTH AND ENVIRONMENT
PROGRAM APPROVAL: La 1 ' 1
APPROVALS
CONTROLLER
By
WELD COUNTY_
BY.
Clifford W. Ha
Form 6 -AC -02C (GEN060197) Revised 06/01/97 Page 7 which is the last of 7 pages
ALT�E�✓ct�
0HN S. PICKLE, M.S.E.H.
DIRECTOR
Exhibit A
STATEMENT OF WORK
Contract dated July 1, 1997, between the Department of Public Health and Environment,
hereinafter referred to as State,
and WELD COUNTY DEPARTMENT OF HEALTH, hereinafter referred to as Contractor
1. The Contractor will provide breast and cervical cancer screening and diagnostic
services for women aged 40 and above as per the Schedule of Services, attached to this contract
as Exhibit B.
2. The Contractor agrees to utilize the following guidelines as the standard for
screening women for breast and cervical cancer:
Uterine Cervix
Women aged 40 and older can receive an annual Pap smear with a pelvic examination.
After three or more consecutively satisfactory normal annual examinations, the Pap smear
may be performed less frequently at the physicians discretion.
Breast
An annual physical breast examination.
Mammography screening should be targeted to women aged 50 and older. At least
85% of the women who are enrolled in the CWCCI for the first time must be 50 years
and older.
Among the asymptomatic women ages 40-49 who are screened by the CWCCI for the first
time, priority should be given to those who have a personal history of breast cancer or a
first degree -relative with pre -menopausal breast cancer.
Women under 40 can receive a physical breast exam and / or mammogram if they have
symptoms of breast cancer or have had a first degree family history of pre -menopausal
breast cancer. In order to receive reimbursement for services provided to women under
40 years of age, prior approval must be obtained from the CWCCI.
Contractors who provide services under the CWCCI are required to use the "Evaluation of
Common Breast Problems: A Primer for Primary Care Providers" as a guide for following women
with breast abnormalities. In addition, the criteria below must be followed to receive CWCCI
reimbursement for breast ultrasounds:
a. Normal Physical Exam -- Normal mammogram
Page 1 of 4
Routine Follow-up for age and risk group
b. No Palpable Lesion -- Questionable mammographic lesion
Ultrasound is indicated. If solid, refer for biopsy; if cystic regular follow-up
c. Palpable Lesion -- Needle aspiration if mammogram is negative, biopsy if mammogram
is suspicious or yields no fluid or lesion persists after aspiration. Ultrasound is of little
value. If lesion is aspired an resolves with removal of fluid, follow-up in 6 weeks is
indicated to check for recurrence.
The Contractor agrees that only qualified personnel who are licensed or certified professionals will
conduct medical examinations, operate the equipment, conduct the tests and interpret results.
Medical personnel performing the physical breast examinations must be Physicians, Nurse
Practitioners, Physicians Assistants or Nurse Midwives or be deemed qualified by the Contractor's
Medical Director and have received formal training to perform the clinical services.
Cytology laboratories must be in compliance with the federal Clinical Laboratory Improvement
Act of 1988 (CLIA-88).
Mammography centers must be certified by the Food and Drug Administration (FDA) and in
compliance with the Mammography Quality Standards Act of 1992.
3. The Contractor is required to notify the CWCCI to enter into agreements with, or
to change providers of mammography and cytology laboratory services.
4. The Contractor agrees to send at least one agency representative to a mandatory
annual Service Provider meeting.
5. The Contractor agrees to provide culturally sensitive services to the target priority
populations as defined by the program: uninsured and under -insured older women who are racial,
ethnic and cultural minorities, such as American Indians, African -Americans, Hispanics,
Asian/Pacific Islanders, Lesbians, and women with disabilities, and women who live in hard to
reach communities in urban and rural areas.
6. The Contractor agrees to seek reimbursement for services only for those women
who meet the following eligibility criteria:
a) Be a resident of Colorado as defined by the Colorado Resident Discount Program;
b) Have family income at or below 200% of the federal poverty level and receive
appropriate documentation from the women to assure her income qualifies her for
the program;
Page 2 of 4
c) Not have health insurance that would cover these services;
d) Not have had a mammogram or Pap in the past 12 months; and
e) Meet the Clinical Eligibility Criteria established by the program.
7. The Contractor agrees to provide data on the program designated forms to the
CWCCI including total number of women screened for breast and cervical cancer, clinical results
of all exams, and results from tracking and follow-up for symptomatic women or those with a
screen detected abnormality. This data will be integrated into the Service Delivery System,
Tracking and Follow-up System, Case Compliance Summary system, and the Fiscal Management
System that are maintained by the CWCCI.
8. The Contractor agrees to identify available sources of diagnosis and treatment and
to refer all women with abnormal findings who require diagnostic and treatment services not
covered by the program to appropriate medical practitioners for prompt diagnosis, evaluation and
treatment. The Contractor agrees to perform the necessary tracking of women with abnormal
findings, and report all diagnostic and treatment services provided to such women to the CWCCI
unless the women are lost to follow-up. Adequate tracking includes evidence of a certified letter
sent and received by the woman in need of further care, or returned due to lack of a forwarding
address.
9. Funding for a Case Manager is being provided in the Schedule of Services attached
to this contract. This funding is to facilitate case enrollment, data completion, and data
submission to the CWCCI. This funding is based on $50 per case annually and consistent
adherence to the following standards of performance. Failure to accept funding for the Case
Manager does not exempt the Contractor from meeting these compliance standards.
a) Case enrollment forms must be submitted to the program for 90% or more of the
cases within 60 days of the dates of the most recent service performed.
b) Case enrollment forms must be submitted with essential information properly
completed in 90% or more of the cases.
c) Mammogram results must be submitted to the CWCCI in 90% or more of the cases
within 60 days of the service being provided. This information must be submitted on the
CWCCI designated form completed by mammography centers which include all required
data elements.
d) Mammogram results must have the essential information reported properly and
accurately in 90% or more of the cases submitted.
e) Cases involving screening breast or cervical abnormalities must have diagnostic
Page 3 of 4
follow-up information including planned follow-up procedures provided to the CWCCI in
90% or more of the cases within 60 days from the date of detection of the abnormality.
This includes women who are referred to outside health care providers for diagnostic
procedures.
0 Breast and Cervical Diagnostic Follow-up Reports must be submitted with essential
information properly completed in 90% or more of the cases.
g) Women with screening abnormalities will be required to have either completed
diagnostic follow-up or have documentation of lost to follow-up submitted to the CWCCI
on every case (100%). A copy of the documented follow-up efforts must be submitted to
the CWCCI with the appropriate diagnostic follow-up form. The minimum follow-up
effort accepted will be one registered/certified letter, but also could include telephone and
regular mail contacts.
h) Planned diagnostic follow-up procedures must be completed and submitted to the
CWCCI in 90% of the cases within 60 days of the planned date. The completed procedure
does not have to be the same as the one planned, but follow-up must be completed in the
recommended time frame to allow for continuity of care.
I) Women with cervical abnormalities of CIN II or more severe, or a breast
malignancy must have completed or initiated treatment information submitted to the
program in 90% of the cases within 60 days following the date of diagnosis.
j) Women with cervical abnormalities of CIN II or more severe, or a breast
malignancy will be considered lost to follow-up in. 10% or less of cases. A copy of the
documented follow-up efforts must be submitted to the CWCCI with the appropriate
diagnostic follow-up/treatment form. The minimum follow-up effort accepted will be one
certified letter with patient receipt, but also could include telephone and regular mail
contacts which will be documented and submitted to the CWCCI on the follow-up form.
k) The CWCCI computer generated breast and cervical follow-up forms must be
accurately completed and submitted for 90% or more of the cases within 60 days of the
date of form production.
Payment for the Case Manager fee is predicated on the Contractor's continued complianc e
with the above standards. Any of the above standards on which there has been non-compliance
will require the Contractor to develop, submit and adhere to a remediation plan and bring the
standard(s) into compliance within thirty days. More than two breaches of compliance regardless
of remediation, or any one without an approved remediation plan within thirty days during the
term of this amendment may result in cessation of funding for the Case Manager.
Page 4 of 4
EXHIBIT B
SCHEDULE OF SERVICES
Fiscal Year 1998
SCREENING
REIMBURSEMENT
RATE
Clinical Breast Exam
Pelvic Exam
Pap Lab (by Cytotech)
Mammogram
$ 31.46
7.34
$ 63.34
DIAGNOSTIC
Repeat Clinical Breast Exam
Surgical/Medical Consultation
Diagnostic Mammogram
Repeat Mammogram
Breast Ultrasound
$ 35.55
$ 86.82
$ 69.96
63.34!
$ 59.89
Fine Needle Aspiration (FNA)'
Repeat Pelvic Exam
$ 35.55
Repeat Pap Lab •
Colposcopy
$ 66.84
Colposcopy with Biopsy
$161.53'
Tracking and Follow-up @ 15% of total services provided monthly
Travel Allowances at 1% of the total services provided monthly
Case Manager at $50.00 per new screen
h:/sd/reimb.tbl
EXHIBIT C
STATE OF COLORADO
Roy Romer, Governor
Patti Shwayder, Executive Director
Dedicated to protecting and improving the hea/th and environment of the people of Colorado
4300 Cherry Creek Dr. S. Laboratory and Radiation Services Division
Denver, Colorado 80222-1530 8100 Lowry Blvd.
Phone (303) 692-2000 Denver CO 80220-6928
(303) 692-3090
, 1997
State Fiscal Year 19_ - _ Contract Routing Number
Change Order Letter No.
Colorado Department
of Public Health
and Environment
In accordance with Paragraph _ of the contract with routing number and contract number (as amended
by Change Order Letter routing number , and/or Renewal Letter routing number ), hereinafter referred to
as the Original Contract (copy attached and by this reference made a part hereof) between the State of Colorado, Department
of Public Health and Environment ( Division) and covering the period
of 199_ through 199_ the parties agree that the maximum amount payable by the State
for the eligible services in Paragraph _ of the Original Contract is being increased/decreased by
DOLLARS ($ ) to a new total of DOLLARS ($ ) in accordance with the
revised work plan attached hereto as Attachment A and revised budget attached hereto as Attachment B, both incorporated
herein. The first sentence in Paragraph _ of the Original Contract is hereby modified accordingly. 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 199 but in no event shall it be
deemed valid until it shall have been approved by the State Controller or such assistant as he may designate.
Please sign, date and return all _ originals of this letter as soon as possible to:
Colorado Department of Public Health and Environment
Division
Mail Code:
4300 Cherry Creek Drive South
Denver, Colorado 80222-1530
One original of this letter will be returned to you when fully apprbved.
Contractor: State of Colorado:
Full Contractor Name Roy Romer, Governor
By:
Signature
By:
Print Name: For the Executive Director
Colorado Department of Public Health
Title: and Environment
APPROVALS: APPROVALS:
PROGRAM CONTROLLER
By: By:
Clifford W. Hall
EXHIBIT D
1998 UNITED STATES DEPARTMENT OF HEALTH AND
HUMAN SERVICES POVERTY GUIDELINES
HOUSEHOLD
100% POVERTY
200% POVERTY
Size
Annual
Monthly
Annual
Monthly
1
$ 7,890
$ 658
$15,780
$1315
2
$10,610
$ 884
$21,220
$1768
3
$13,330
$1111
$26,660
$2222
4
$16,050
$1338
$32,100
$2675
5
$18,770
$1564
$37,540
' $3128
6
$21,490
$1791
$42,980
$3582
7
$24,210
$2018
$48,420
$4035
8
$26,930
$2244
$53,860
$4488
h:\sd\poverty.tbl
WilDe.
COLORADO
Antlim
mEmoRAMuM= ?'
George Baxter, Chairman
To Board of County Commissioners
From
Subject:
Date
Augulil T$; 1997
John Pickle, Director, Health Department
Cancer Prevention Contract
Enclosed for Board review and approval is a contract between the Colorado Department of
Public Health and Environment and Weld County Health Department for breast and cervical
cancer screening and diagnostic services for women aged 40 and over.
The State has received excess funding for this program in the past few years. Therefore, there is
no limit to the amount of screenings we may perform and be reimbursed for. The schedule of
reimbursable expenses meets or exceeds Weld County Health Department's expenses to provide
these service.
The term of the contract is from August 15, 1997 through August 14, 1998. I recommend your
approval of this contract.
I recommend your approval of this contract.
Enclosures
Hello