HomeMy WebLinkAbout982026.tiff RESOLUTION
RE: APPROVE CONTRACT FOR MATERNAL AND CHILD HEALTH 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 a Contract for the Maternal and Child
Health Program between the County of Weld, State of Colorado, by and through the Board of
County Commissioners of Weld County, on behalf of the Health Department, and the Colorado
Department of Public Health and Environment, commencing October 1, 1998, and ending
September 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 Maternal and Child Health Program between the
County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld
County, on behalf of the 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 21st day of October, A.D., 1998, nunc pro tunc October 1, 1998.
BOARD OF COUNTY COMMISSIONERS
WEE COUNTY, COLORADO
/a4/ATTEST:
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Weld County Clerk to t - Bo .�� if �/�J
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BY: --, W. H. ebster, rm
Deputy Clerk to t y I . mmT"
U �.� t orge . Baxter
A V D AS FORM:
. Hall
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Barbara J. Kirkmeyer
982026
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DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF
PUBLIC HEALTH AND ENVIRONMENT
DEPARTMENT OR AGENCY NUMBER
FAA
CONTRACT ROUTING NUMBER
9900768
CONTRACT
THIS CONTRACT, made this L day of October, 1998, by and between: the State of Colorado, for the
use and benefit of the DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT, whose address or
principal place of business is 4300 Cherry Creek Drive South. Denver, Colorado. 80246, hereinafter
referred to as"the State"and The Weld County Health Department,whose address or principal place of
business is 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 subsequent encumbering
and payment in Fund number 100, Appropriation Accounts 585, and Organization 6710, under Contract
Encumbrance No.WCH9900768;
WHEREAS, as of the effective date of this Contract, the State has a currently valid Group II purchasing
delegation agreement with the Division of Purchasing within the Colorado Department of Personnel;
WHEREAS, Section 29-1-201, 8 C.R.S., as amended, encourages governments to make the most
efficient and effective use of their powers and responsibilities by cooperating and contracting with each
other to the fullest extent possible to provide any function, service, or facility lawfully authorized to each of
the cooperating or contracting entities, and to this end all State contracts with its political subdivisions are
exempt from the State's personnel rules and the State procurement code;
WHEREAS, the State has formulated a comprehensive State Plan to carry out a Maternal and Child
Health Program, funded by Federal Health and Human Services funds;
WHEREAS,this comprehensive State Plan and Federal budget allocates funds to be utilized for the
implementation of the program through various agencies in order to provide these health care services to
the people of Colorado;
WHEREAS, required approval, clearance and coordination have been accomplished from and with
appropriate agencies: and
NOW THEREFORE, in consideration of their mutual promises to each other, hereinafter stated, the
parties hereto agree as follows:
A. EFFECTIVE DATE AND TERM. The effective date of this Contract is October 1. 1998, or
on such other date as this Contract is approved by the State Controller, whichever is later. The
initial term of this Contract shall commence on October 1. 1998, and continue through and
including September 30, 1999 unless sooner terminated pursuant to the terms and conditions of
Page 1 of 14
this Contract.
B. DUTIES AND OBLIGATIONS OF THE CONTRACTOR
1. The Contractor shall provide core public health services, including public health nursing
prevention and health promotion activities designed to enhance the health status of children and
adolescents, 0-16 years of age either as direct patient care through child health clinics or home visits,
and/or a broader range of child health activities that include, but are not limited to: enabling services,
population-based services, or infrastructure-building activities as described in the pyramid examples,
(Attachment A), "Core Public Health Services Delivered by MCH Agencies", which is incorporated herein
by this reference, made a part hereof, and attached hereto. The decision by the Contractor to provide or
not to provide direct patient care services should be based on an assessment of the capacity of a
community's public and private providers to meet the direct health care needs of the children of that
community.
If the Contractor does provide direct health care services, then public health nursing assessments and
interventions shall be consistent with recommendations for child health care as delineated in the Colorado
Department of Public Health and Environment Child Health Manual, Screener Manual, and other policies
and guidelines which have or will be made available to the Contractor, and may include:
a. Child Health Clinic Services as indicated and appropriate, to include:
(1) A complete health and psychosocial history and unclothed physical exam
(2) Age-appropriate screening, including developmental screening
(3) Age-appropriate immunizations
(4) Age-appropriate anticipatory guidance and teaching of risk-reducing behaviors to
parents, including injury prevention and more specifically, prevention of motor
vehicle injury and death through the use of infant and child car seats and seat
belts
(5) Nursing management and/or referral to appropriate resources of children
exhibiting actual or potential problems in physical and/or psychosocial/emotional
status
b. Home visiting services as indicated to infants and children and their families, the primary
purpose of which is public health nursing intervention designed to reduce the risk of injury
and disease to the child and to strengthen child and family development
c. Activities in which staff have taken a leadership role and/or have actively participated that
have as their goal the improved health of children in the communities served. Such
activities will be consistent with one or more core public health functions of assessment,
assurance and policy development and implementation
d. Evidence that 92% of all 2 year old children who have been enrolled in thr Contractor's
Child Health Clinics for at least one year are current on recommended immunizations,
including Hemophilus B
e. A description of at least two activities, the primary purpose of which is the prevention of,
or early intervention in, child abuse and neglect, which the Contractor has implemented or
in which the Contractor has played an active role
f. Case finding and referral through the above Child Health activities for children eligible for
the Health Care Program for Children with Special Needs
g. A description of efforts to enhance collaboration and sharing of resources to improve
services to children in the community
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2. The Contractor shall, whenever possible, use pars-professional screeners to perform screening
components of Child Health Services. The preferred developmental screening tool is the Denver II.
Screeners using the Denver II shall be trained and evaluated as determined appropriate by the State
Screening Program Manager. The Contractor shall assign public health nurse(s)to provide day-to-day
supervision for these screeners.
3. The Contractor shall submit monthly to the State screening data utilizing the CoTrack data
system, or another system as may be approved by the State.
4. By September 30, 1999, and September 30, of any subsequent renewal year of this Contract, a
qualitative audit shall be done on 10% of currently enrolled and active Child Health Clinic records, using
the State Child Health Impact Tool or similar paper or computerized audit format approved by the Child
Health Program Director. A copy of the aggregate audit results shall be submitted to the State's Child
Health Program Director and shall demonstrate that 75% of the problems identified in Child Health Clinic
clients have shown resolution and/or improvement.
5. By December 31, 1999, and December 31, of any subsequent renewal year of this Contract, the
Contractor shall provide to the State in writing the total dollar amount that was reimbursed to the
Contractor for EPSDT/Medicaid screenings provided to children seen by the Contractor.
6. 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 criminal offense under the Medicare or any
State health care program (i.e., Medicaid, Maternal and Child Health, or Social Services Block Grant
Programs).
7. The Contractor shall: (1) inform potentially eligible applicants/recipients that the"Colorado Baby
Care/Kid's Care Program" (CBC/KCP) a program within Medicaid, exists and that potentially eligible
applicants/recipients should apply for coverage under that program through the local county department of
Social Services; (2) inform the potentially eligible applicants/recipients that Colorado Child Health Plan
Plus+ (CCHP+) exists; (3) inform the potentially eligible applicants/recipients that CBC/KCP and
CCHP+may be a potential source of payment for a child's care; (4) inform potentially eligible
applicants/recipients that in order to receive continuing coverage under CBC/KCP and/or CCHP+they
must complete an application as soon as possible (CBC/KCP allows for up to sixty (60) calendar days of
presumptive eligibility for pregnant women who are registered with Medicaid.); (5) obtain from Medicaid
and the CCHP+, and have present at their facility, current information regarding eligibility for, and services
provided under CBC/KCP; and (6) have registration forms for CCHP+available at all times.
8. The Contractor shall submit to the State, a six-month summary report detailing the achievements
of the first six months of the program by May 17, 1999 and a twelve-month final progress report by
January 25, 2000, and six-month and twelve-month reports for any subsequent renewal years of this
Contract on those same calendar dates. The twelve-month report shall include federally required data on
the number of patients served between October 1, 1998 and September 30, 1999, (or of any subsequent
year's renewal period), by class of individuals served (pregnant women, infants under one year of age,
children 1 to 22 years of age, children with special health care needs, and others) by primary source of
coverage (Title XIX, Title)CXI, Private/Other, or None). If pregnant women or infants under one year of
age are served, data on race for each group must also be submitted: number served by race(White,
Black, American Indian, Asian or Pacific Islander, Other and Unknown), and number served by Hispanic
origin (total Hispanic and total non-Hispanic). Estimates must be provided until such time as actual
numbers can be submitted
9. The Contractor shall not charge for services to those individuals of families at or below the official
poverty line as defined by the Of@ce of Management and Budget in accordance with Title V, Section 501
(B) (2) and Section 505 (2) (d). The 100% of poverty income guideline for farm or non-farm families is
currently at$8,050 for an individual; $10,850 for a family of 2; $13,650 for a family of 3; $16,450 for a
family of 4; $19,250 for a family of 5; $22,050 for a family of 6; $24,850 for a family of 7; $27,650 for a
Page 3 of 14
family of 8. For families of more than eight, add $2,800 for each additional member. These guidelines will
change during the contract year. When the new poverty income guidelines are received by the State from
the office of Management and Budget, they will be forwarded to the Contractor and should be used upon
receipt.
10. If any charges are imposed for services to clients who are above the 100% of poverty level, such
charges must be on a sliding scale which takes into account the clients family size, income and
resources. These charges and the sliding fee scale must be made available to the general public and to
all clients and must be based on the agency's usual and customary cost for the service. Clients must
understand they will not be denied services for inability to pay any of the sliding fee charges.
11. The Contractor shall protect the confidentiality of all applicant/recipient records and other
materials that are maintained in accordance with this contract. Except for purposes directly connected
with the administration of this Program/Project, no information about or obtained from any
applicant/recipient shall be disclosed in a form identifiable with the applicant/recipient without the prior
written consent of the applicant/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.
12. The Contractor agrees to provide services to all program participants and employees in a smoke-
free environment. In accordance with PL 103-227, also known as the Pro-Children Act of 1994, smoke-
free shall mean that smoking is not permitted in any portion of any indoor facility owned or leased or
contracted for by the Contractor if said facility is routinely or regularly used for the provision of child care or
health services to any child under the age of 18 when those services are funded all or in part with Federal
funds.
13. If the Contractor is a"public entity"within the meaning of the Colorado Governmental Immunity
Act("CGIA"), section 24-10-101,gf sea., C.R.S., as amended, then the Contractor shall at all times during
the term of this Contract maintain such liability insurance, by either commercial policy or self-insurance, as
is necessary to meet its liabilities under the CGIA. Upon request by the State, the Contractor shall show
proof of such insurance to the State.
14. The Contractor shall ensure that the provisions of Section 601 of Title VI of the Civil Rights Act of
1964 are carried out. That Act states that"no person in the United States shall on the ground of race,
color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to
discrimination under any program or actively receiving Federal financial assistance", The Office of Civil
Rights has concluded that it is the responsibility of any program which is a recipient of funds from the
Department of Health and Human Services to ensure that clients who do not speak or understand English
well, be provided interpretation services to ensure that the service provider and the client can
communicate effectively. The Contractor shall have policies and procedures to ensure that interpretation
services are available for clients with Limited English Proficiency and will advise such clients that an
interpreter will be provided for them. If a client has their own interpreter, they shall be advised_that the
Contractor will provide an interpreter if the client so chooses.
15. The Contractor shall submit to the State an accounting of actual expenditures for this project on
standardized forms (Attachment B), which by this reference is made a part hereof, or similar format.
Such accounting of actual expenditures for the contract period is to be sent to the Family and Community
Health Services Division, attention Administrative Section, before December 31, 1999 and December 31,
of any subsequent renewal year. Because this information will be used in part to match Federal funds, the
source of"Applicant and Other"funding must be detailed in the space provided on the form and noted as
to whether these funds are used to match other funding, and signed by a certified official.
Page 4 of 14
DUTIES AND OBLIGATIONS OF THE STATE.
1. Payment pursuant to this Contract shall be made as earned, in whole or in part, from available
State funds encumbered in an amount not to exceed FOUR HUNDRED EIGHTY-TWO
THOUSAND.AND NINETY-NINE DOLLARS, f$482.099.001, for the purchase of Child Health
Services. Of this total financial obligation of the State, f$482.099.00}is derived from a funding
source of the United States. Of this total financial obligation of the State, 1$0.001 is derived from a
funding source of the State of Colorado. It is further understood and agreed that the maximum
amount of funds available for fiscal year 1998-1999 for the purchase of Child Health Services is in
the amount of 1$482.099.001.
The liability of the State, at any time, for such payments shall be limited to the unencumbered
remaining balance of such funds. If there is a reduction in the total funds appropriated for the
purposes of this Contract, then the State, in its sole discretion, may proportionately reduce the
funding for this Contract or terminate this Contract in its entirety.
The State shall, in consideration of said services by the Contractor, cause to be paid to the
Contractor an amount not to exceed THIRTY SEVEN THOUSAND ONE HUNDRED AND
NINETY TWO DOLLARS,1$37.192.00)for the period between October 1, 1998 and September
30, 1999, upon receipt of signed monthly statements, (Attachment C)which by this reference is
made a part hereof), submitted in duplicate, to the FAMILY AND COMMUNITY HEALTH
SERVICES DIVISION,ADMINISTRATIVE SECTION requesting reimbursement 1/12th of this
contract budget per month. Of this total financial obligation of the State to the Contractor under
this Contract, $37.192.00 are identified as attributable to a funding source of the United States
and $0.00 are identified as attributable to a funding source of the State of Colorado. Payments
under this Contract are subject to verification by the State that the Contractor has fully and
satisfactorily complied with the terms and conditions of this Contract.
2. The State may prospectively increase or decrease the amount payable under this Contract
through a"Change Order Letter", a sample of which is incorporated herein by this reference,
made a part hereof, and attached hereto as"Attachment D". To be effective, the Change Order
Letter must be: signed by the State and the Contractor; and, approved by the State Controller or
an authorized designee thereof. Additionally, the Change Order Letter shall include the following
information:
A. Identification of this Contract by its contract number and affected paragraph
number(s);
B. The type(s) of service(s)or program(s) increased or decreased and the new level
of each service or program;
C. The amount of the increase or decrease in the level of funding for each service or
program and the new total financial obligation;
D. The intended effective date of the funding change; and,
E. A provision stating that the Change Order Letter shall not be valid until approved
by the State Controller or such assistant as he may designate.
Upon proper execution and approval, the Change Order Letter shall become an
amendment to this Contract. Except for the General and Special Provisions of this
Contract, the Change Order Letter shall supersede this Contract in the event of a conflict
between the two. It is expressly understood and agreed to by the parties that the change
order letter process may be used only for increased or decreased levels of funding,
corresponding adjustments to service or program levels, and any related budget line
Page 5 of 14
items. Any other changes to this Contract, other than those authorized by the contract
renewal letter process described below, shall be made by a formal amendment to this
Contract executed in accordance with the Fiscal Rules of the State of Colorado.
If the Contractor agrees to and accepts the proposed change, then the Contractor shall
execute and return the Change Order Letter to the State by the date indicated in the
Change Order Letter. If the Contractor does not agree to and accept the proposed
change, or fails to timely return the partially executed Change Order Letter by the date
indicated in the Change Order Letter, then the State may, upon written notice to the
Contractor, terminate this Contract twenty (20)calendar days after the return date
indicated in the Change Order Letter has passed. Such written notice shall specify the
effective date of termination of this Contract. In the event of termination under this clause,
the parties shall not be relieved of their respective duties and obligations under this
Contract until the effective date of termination has occurred.
Increases or decreases in the level of contractual funding made through this change order
letter process during the initial or renewal terms of this Contract may be made under the
following circumstances:
A. If necessary to fully utilize appropriations of the State of Colorado and/or non-
appropriated federal grant awards;
B. Adjustments to reflect current year expenditures;
C. Supplemental appropriations, or non-appropriated federal funding changes
resulting in an increase or decrease in the amounts originally budgeted and
available for the purposes of this Contract;
D. Closure of programs and/or termination of related contracts;
E. Delay or difficulty in implementing new programs or services; and,
F. Other special circumstances as deemed appropriate by the State.
3. The State may renew this Contract for up to an additional two, one year periods through a
"Contract Renewal Letter", a sample of which is incorporated herein by this reference,
made a part hereof, and attached hereto as"Attachment E". To be effective, the
Contract Renewal Letter must be: signed by the State and the Contractor; and, approved
by the State Controller or an authorized designee thereof. Additionally, the Contract
Renewal Letter shall include the following information:
A. Identification of this Contract by its contract number and affected paragraph
number(s);
B. The type(s)of service(s) or program(s), if any, increased or decreased and the
new level of each service or program for the renewal term;
C. The amount of the increase or decrease, if any, in the level of funding for each
service or program and the new total financial obligation;
D. The intended effective date of the renewal; and,
E. A provision stating that the Contract Renewal Letter shall not be valid until
approved by the State Controller or such assistant as he may designate.
Page 6 of 14
Upon proper execution and approval, the Contract Renewal Letter shall become an
amendment to this Contract. Except for the General and Special Provisions of this
Contract, the Contract Renewal Letter shall supersede this Contract in the event of a
conflict between the two. It is expressly understood and agreed to by the parties that the
contract renewal letter process may be used only to: renew this Contract; increase or
decrease levels of funding related to that renewal; make corresponding adjustments to
service or program levels, and, adjust any related budget line items. Any other changes
to this Contract, other than those authorized by the change order letter process described
above, shall be made by a formal amendment to this Contract executed in accordance
with the Fiscal Rules of the State of Colorado.
If the Contractor agrees to and accepts the proposed renewal term, then the Contractor
shall execute and return the Contract Renewal Letter to the State by the date indicated in
the Contract Renewal Letter. If the Contractor does not agree to and accept the proposed
renewal term, or fails to timely return the partially executed Contract Renewal Letter by
the date indicated in the Contract Renewal Letter, then the State may, upon written notice
to the Contractor, terminate this Contract twenty(20) calendar days after the return date
indicated in the Contract Renewal Letter has passed. Such written notice shall specify
the effective date of termination of this Contract. In the event of termination under this
clause, the parties shall not be relieved of their respective duties and obligations under
this Contract until the effective date of termination has occurred.
D GENERAL PROVISIONS •
1. The parties warrant that each possesses actual,legal authority to enter into this Contract. The parties further warrant that each has
taken all actions required by its applicable law,procedures,rules,or by-laws to exercise that authority,and to lawfully authorize its
undersigned signatory to execute this Contract and bind that party to its terms.The person or persons signing this Contract,or any
attachments or amendments hereto,also warrant(s)that such person(s)possesses actual,legal authority to execute this Contract,
and any attachments or amendments hereto,on behalf of that party.
2. THE CONTRACTOR SHALL PERFORM ITS DUTIES HEREUNDER AS AN INDEPENDENT CONTRACTOR AND
NOT AS AN EMPLOYEE OF THE STATE. 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. THE CONTRACTOR SHALL PAY WHEN DUE ALL REOUIRED EMPLOYMENT TAXES AND INCOME
TAX AND LOCAL HEAD TAX ON ANY MONIES PAID PURSUANT TO THIS CONTRACT. THE 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. THE CONTRACTOR SHALL HAVE NO AUTHORIZATION.EXPRESS OR IMPLIED.TO BIND THE
- - STATE TO ANY AGREEMENTS.LIABILITY.OR UNDERSTANDING EXCEPT AS EXPRESSLY SET FORTH
HEREIN. THE CONTRACTOR SHALL PROVIDE AND KEEP IN FORCE WORKERS'COMPENSATION(AND
SHOW PROOF OF SUCH INSURANCE)AND UNEMPLOYMENT COMPENSATION INSURANCE IN AMOUNTS
REOUIRED BY LAW.AND SHALL BE SOLELY RESPONSIBLE FOR THE ACTS OF THE CONTRACTOR,ITS
EMPLOYEES AND AGENTS
3. If this Contract is in the nature of personal/purchased services,then the State reserves the right to inspect services provided under
this Contract at all reasonable times and places during the term of this Contract. "Services",as used in this clause,includes
services performed or written work performed in the performance of services. If any of the services do not conform with the terms
of this Contract,then the State may require the Contractor to perfonn the services again in conformity with the terms of this
Contract,with no additional compensation to the Contractor for the reperformed services. When defects in the quality or quantity
of the services cannot be corrected by reperformance,then the State may:require the Contractor to take all necessary action(s)to
ensure that the future performance conforms to the terms of the Contract;and,equitably reduce the payments due to the Contractor
under this Contract to reflect the reduced value of the services performed by the Contractor. These remedies in no way limit the
other remedies available to the State as set forth in this Contract.
4. If,through any cause attributable to the Contractor's action(s)or inaction(s),the Contractor:fails to fulfill,in a timely and proper
manner,its duties and obligations under this Contract;or,violates any of the agreements,covenants,provisions,stipulations,or
terms of this Contract,then the State shall thereupon have the right to terminate this Contract for cause by giving written notice
thereof to the Contractor. Such written notice shall be given at least ten(10)calendar days before the proposed termination date
Page 7 of 14
and shall afford the Contractor the opportunity to cure the default or state why termination is otherwise inappropriate. If this
Contract is terminated for default,then all finished or unfinished data,documents,drawings,evaluations,hardware,maps,models,
negatives,photographs,reports,software,studies,surveys,or any other material,medium or information,however constituted,
which has been or is to be produced or prepared by the Contractor under this Contract shall,at the option of the State,become the
property of the State. The Contractor shall be entitled to receive just and equitable compensation for any services or supplies
delivered to,and accepted by,the State. If applicable,the Contractor shall return any unearned advance payment it received under
this Contract to the State. Notwithstanding the above,the Contractor is not relieved of liability to the State for any damages
sustained by the State because of the Contractor's breach of this Contract. The State may withhold any payment due to the
Contractor under this Contract to mitigate the State's damages until such time as the exact amount of the State's damages from the
Contractor's breach of this Contract is determined. If,after terminating this Contract for default,it is determined for any reason
that the Contractor was not in default,or that the Contractor's action or inaction was excusable,then such termination shall be
treated as a termination for convenience,and the rights and obligations of the parties shall be the same as if this Contract had been
terminated for convenience,as described herein.
5. The State may,when the interests of the State so require,terminate this Contract in whole or in part,for the convenience of the
State. The State shall give written notice of such termination to the other party specifying the part(s)of the Contract terminated.
Such written notice shall be given to the other party at least thirty(30)calendar days before the effective date of termination. If
this Contract is terminated for convenience,then all finished or unfinished data,documents,drawings,evaluations,hardware,
maps,models,negatives,photographs,reports,software,studies,surveys,or any other material,medium or information,however
constituted,which has been or is to be produced or prepared by the Contractor under this Contract shall,at the option of the State,
become the property of the State. The Contractor shall be entitled to receive just and equitable compensation for any services or
supplies delivered to,and accepted by,the State. If applicable,the Contractor shall return any unearned advance payment it
received under this Contract to the State. This paragraph in no way implies that a party has breached this Contract by the exercise
of this paragraph. If this Contract is terminated by the State as provided for herein,then the Contractor shall be paid an amount
equal to the percentage of services actually performed for,or goods actually delivered to,the State,less any payments already
made by the State to the Contractor for those services or goods. However,if less than sixty percent(60%)of the services or goods
covered by this Contract have been performed or delivered as of the effective date of termination,then the Contractor shall also be
reimbursed(in addition to the above payment)for that portion of those actual"out-of-pocket"expenses(not otherwise reimbursed
under this Contract)incurred by the Contractor during the term of this Contract which are directly attributable to the uncompleted
portion of the services,or the undelivered portion of the goods,covered by this Contract. In no event shall reimbursement under
this clause exceed the total financial obligation of the State to the Contractor under this Contract. If this Contract is terminated for
default because of the Contractor's breach of this Contract,then the provisions of paragraph 4 above shall apply.
6. The Contractor shall comply with the requirements of the following:
A. Office of Management and Budget Circulars A-87,A-2I,or A-I22,and A-102 or A-110,as applicable;
B. the"Hatch Act"(5 U.S.C. 1501-1508)and Public Law 95454,Section 4728. These federal statutes declare 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 mandate 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;
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 an interest in real property and displacing households or businesses in the performance of
this Contract,then 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 1011-17, 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).
H. Section 2101 of the Federal Acquisition Streamlining Act of 1994,Public Law 103-355,which prohibits the use of
federal money to lobby the legislative body of a political subdivision of the State.
7. By signing and submitting this Contract,the Contractor affirmatively avers that:
A. the Contractor is in compliance with the requirements of the"Drug-Free Workplace Act"(Public Law 100-690 Title V,
Page 8 of 14
Subtitle D,41 U.S.C.701 et seq.);and,
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. The Contractor agrees to comply with all
applicable regulations pursuant to Executive Order 12549,including,Debarment and Suspension and Participants'
Responsibilities,29 C.F.R.98.510(1990).
C. the Contractor shall comply with all applicable regulations pursuant to Section 319 of Public Law 101-121,Guidance
for New Restrictions on Lobbying,including,Certification and Disclosure,29 C.F.R.93.110(1990).
8. If this Contract involves the expenditure of federal or state funds,then this Contract is subject to,and contingent upon,the
continued availability of those funds for payment pursuant to the terms of this Contract. If those funds,or any part thereof,
become unavailable as determined by the State,then the State may immediately terminate this Contract.
9. To be considered for payment,billings for payments pursuant to this Contract must be received within a reasonable time after the
period for which payment is requested;but in no event no later than ninety(90)calendar days after the relevant performance
period has passed. Final billings under this Contract must be received by the State within a reasonable time after the expiration or '
termination of this Contract;but in no event no later than ninety(90)calendar days from the effective expiration or termination
date of this Contract.
10. Unless otherwise provided for in this Contract, "Local Match"shall be included on all billing statements,in the column provided
therefor,as required by the funding source.
1 L The Contractor shall not use federal funds to satisfy federal cost sharing and matching requirements unless approved in writing by
the appropriate federal agency.
12. In accordance with Office of Management and Budget(OMB)Circular A-133(Audits of States,Local Governments,and Non-
Profit Organizations),if the Contractor receives federal funds from any source,including State pass through money,in an
aggregate amount in excess of$300,000.00(June 24, 1997),in a State fiscal year(July 1 through June 30),then the Contractor
shall have an annual audit performed by an independent certified public accountant which meets the requirements of OMB
Circular A-133. If the Contractor is required to submit an annual indirect cost proposal to the State for review and approval,then
the Contractor's auditor shall audit the proposal in accordance with the requirements of OMB Circulars A-21(Cost Principles for
Educational Institutions),A-87(Cost Principles for State,Local and Tribal Governments),or A-122(Cost Principles for Non-
Profit Organizations),whichever is applicable. The Contractor shall furnish one(I)copy of the audit report(s)to the State's
Accounting Office within thirty(30)calendar days of issuance;but in no event later than nine(9)months after the end of the
Contractor's fiscal year. If(an)instance(s)of noncompliance with federal laws and regulations occurs,then the Contractor shall
take all appropriate corrective action(s)within six(6)months of the issuance of(a)report(s).
13. The Contractor shall grant to the State,or its authorized agents, access to the Contractor's relevant records and financial
statements. The Contractor shall retain all such records and financial statements for a period of six(6)years after the date of
issuance of a final audit report. This requirement is in addition to any other audit requirements contained in other paragraphs of
this Contract.
14. Unless otherwise provided for in this Contract,for all contracts with terms longer than three(3)months,the Contractor shall
submit a written progress report,if required by this Contract,specifying the progress made for each activity identified in this
Contract. These progress reports shall be in accordance with the procedures developed and prescribed by the State. The
preparation of progress reports in a timely manner is the responsibility of the Contractor. If the Contractor fails to comply with this
provision,then such failure:may result in a delay of payment of funds;or,termination of this Contract. Progress reports shall be
submitted to the State no later than the end of each calendar quarter,or at such other time as may otherwise be specified.
15. The Contractor shall maintain a complete file of all records,documents,communications,and other materials which pertain to this
Contract. Such materials shall be sufficient to properly reflect all direct and indirect costs of labor,materials,equipment,supplies,
and services,and other costs of whatever nature for which a contract payment was made. These records shall be maintained
according to generally accepted accounting principles and shall be easily separable from other records of the Contractor. Copies of
all such records,documents,communications,and other materials shall be the property of the State and shall be maintained by the
Contractor,in a central location as custodian for the State,on behalf of the State,for a period of six(6)years from the date of final
payment under this Contract,or for such further period as may be necessary to resolve any pending matters,including,but not
limited to,audits performed by the federal government.
16. The Contractor authorizes the State,or its authorized agents or designees,to perform audits or make inspections of its records for
the purpose of evaluating its performance under this Contract at any reasonable time during the term of this Contract and for a
Page 9 of 14
period of three(3)years following the termination of this Contract. As such,the Contractor shall permit the State,any appropriate
federal agency or agencies,or any other duly authorized governmental agent or agency,to monitor all activities conducted by the
Contractor pursuant to the terms of this Contract. Such monitoring may include,but is not limited to:internal evaluation
procedures,examination of program data,special analyses,on-site checks,formal audit examinations,or any other reasonable
procedures. All monitoring shall be performed by the State in such a manner that it shall not unduly interfere with the work of the
Contractor.
17. If the Contractor obtains access to any records,files,or information of the State in connection with,or during the performance of,
this Contract,then the Contractor shall keep all such records,files,or information confidential and shall comply with all laws and
regulations concerning the confidentiality of all such records,files,or information to the same extent as such laws and regulations
apply to the State. Any breach of confidentiality by the Contractor or third party agents of the Contractor shall constitute good
cause for the State to cancel this Contract,without liability to the State. Any State waiver of an alleged breach of confidentiality by
the Contractor,or third party agents of the Contractor,does not constitute a waiver of any subsequent breach by the Contractor,or
third party agents of the Contractor.
18. Unless otherwise agreed to in this Contract,or in a written amendment executed and approved pursuant to Fiscal Rules of the State
of Colorado,the parties agree that all material,information,data,computer software,documentation,studies,and evaluations
produced in the performance of this Contract for which the State has made a payment under this Contract are the sole property of
the State.
• 19. If any copyrightable material is produced under this Contract,then the State,and any applicable federal funding entity,shall have a
paid in full,irrevocable,royalty free,and non-exclusive license to reproduce,publish,or otherwise use,and authorize others to use,
the copyrightable material for any purpose authorized by the Copyright Law of the United States as now or hereinafterenacted.
Upon the written request of the Contractor shall provide the State with three(3)copies of all such copyrightable material.
20. If required by the terms and conditions of a federal or state grant,the Contractor shall obtain the prior approval of the State and all
necessary third parties prior to publishing any materials produced under this Contract. If required by the terms and conditions of a
federal or state grant,the Contractor shall also credit the State and all necessary third parties with assisting in the publication of any
materials produced under this Contract.
21. Neither the Contractor nor the State shall be liable to the other for any delay in,or failure of performance of,any covenantor
promise contained in this Contract;nor shall any delay or failure constitute default or give rise to any liability for damages if,and
only to the extent that,such delay or failure is caused by a supervening cause. As used in this Contract,"supervening cause"is
defined to mean:an act of God,fire,explosion,action of the elements,strike,interruption of transportation,rationing,court action,
illegality,unusually severe weather,war,or any other cause which is beyond the control of the affected party and which,by the
exercise of reasonable diligence,could not have been prevented by the affected party.
22. It is expressly understood and agreed to between the parties that the enforcement of the terms and conditions of this Contract,and
all rights of action related to such enforcement,shall be strictly reserved to the State and the named Contractor. Nothing contained
in this Contract shall give or allow any claim or right of action whatsoever to or by any third person. Nothing contained in this
Contract shall be construed as a waiver of any provision of the Colorado Governmental Immunity Act,section 24-10-101 a seo..
C.R.S.,as amended. It is the express intent of the State and the named Contractor that any person or entity,other than the State or
the named Contractor,receiving services or benefits under this Contract shall be deemed an incidental beneficiary only.
23. To the extent that this Contract may be executed and performance of the obligations of the parties may be accomplished within the
intent of this Contract,the terms of this Contract are severable. If any term or provision of this Contract is declared invalid by a
court of competent jurisdiction,or becomes inoperative for any other reason,then such invalidity or failure shall not affect the
validity of any other term or provision of this Contract.
24. The waiver of a breach of a term or provision of this Contract shall not be construed as a waiver of a breach of any other term or
provision of this Contract or,as a waiver of a breach of the same term or provision upon subsequent breach.
25. If this Contract is in the nature of personal/purchased services,then,except for accounts receivable,the rights,duties,and
obligations of the Contractor cannot be assigned,delegated,or otherwise transferred,except with the prior,express,written
consent of the State.
26. Except as otherwise provided for herein,this Contract shall inure to the benefit of,and be binding upon,the parties hereto and
their respective successors and assigns.
Page 10 of 14
27. Unless otherwise provided for in this Contract,the Contractor shall notify the State,within five(5)working days after being served
with a summons,complaint,or other pleading in a case which involves any services provided under this Contract and which has
been filed in any federal or state court or administrative agency.The Contractor shall immediately deliver copies of any such
documents to the State.
28. This Contract is subject to such modifications as may be required by changes in applicable federal or state law,or federal or state
implementing rules,regulations,or procedures of that federal or state law. Any such required modification shall be automatically
incorporated into,and be made a part of,this Contract as of the effective date of such change as if that change was fully set forth
herein. Except as provided above,no modification of this Contract shall be effective unless such modification is agreed to in
writing by both parties in an amendment to this Contract that has been previously executed and approved in accordance with
applicable law.
29. Notwithstanding anything herein to the contrary,the parties understand and agree that all terms and conditions of this Contract,
and the exhibits and attachments hereto,which may require continued performance or compliance beyond the termination date of
this Contract shall survive such termination date and shall be enforceable as provided herein in the event of a failure to perform or
comply by a party to this Contract.
30. Notwithstanding any other provision of this Contract to the contrary,no term or condition of this Contract shall be construed or
interpreted as a waiver,express or implied,of any of the immunities,rights,benefits,protections,or other provisions of the
Colorado Governmental Immunity Act(CGIA),section 24-10-101,gr seo,•C.R.S.,as now or hereafter amended. The parties
understand and agree that liability for claims for injuries to persons or property arising out of the alleged negligence of the State of
Colorado,its departments,institutions,agencies,boards,officials,and employees is controlled and limited by the provisions of
section 24-10-101 gg sea.,C.R.S.,as now or hereafter amended.
31. The captions and headings used in this Contract are for identification only,and shall be disregarded in any construction of the
terms,provisions,and conditions of this Contract.
32. The parties hereto agree that venue for any action related to this Contract shall be in the City and County of Denver,Colorado.
33. All attachments to this Contract are incorporated herein by this reference and made a part hereof as if fully set forth herein. In the
event of any conflict or inconsistency between the terms of this Contract and those of any attachment to this Contract,the terms
and conditions of this Contract shall control.
34. This Contract is 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 Fiscal Rules of the State of Colorado.
E. 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
Page 11 of 14
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 24-34402),and as required by Executive Order,Equal
Opportunity and Affirmative Action,dated April 16, 1975.Pursuant thereto,the following provisions shall be contained in all State contracts
or sub-contracts.
During the performance of this contract,the contractor agrees as follows:
(a) The contractor will not discriminate against any employee or applicant for employment because of race,creed,color,national
origin,sex,marital status,religion,ancestry,mental or physical handicap,or age.The contractor will take affirmative action to insure that
applicants are employed,and that employees are treated during employment,without 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
advertisements;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 of April 16,1975,and by the rules,regulations and Orders of the Governor,or pursuant thereto,and will permit access to
his books,records,and accounts by the contracting agency and the office of the Governor or his designee for purposes of investigation to
ascertain compliance with such rules,regulations and orders.
(e) A labor organization will not exclude any individual otherwise qualified from full membership rights in such labor organization,or
expel any such individual from membership in such labor organization or discriminate against any of its members in the full enjoyment of
work opportunity because of race,creed,color,sex,national origin,or ancestry.
(f) 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 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.
Page 12 of 14
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 are financed in whole or in part by State funds.
b. When a construction contract for a public project is to be awarded to a bidder,a resident bidder shall be allowed a preference
against a non-resident bidder from a state or foreign country equal to the preference given or required by the state or foreign country in which
the non-resident bidder is a resident. If it is determined by the officer responsible for awarding the bid that compliance with the subsection
.06 may cause denial of federal funds which would otherwise be available or would otherwise be inconsistent with requirements of Federal
law,this subsection shall be suspended,but only to the extent necessary to prevent denial of the moneys or to eliminate the inconsistency with
Federal requirements(CRS 8-19-101 and 102).
GENERAL
7. The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the interpretation,execution,
and enforcement of this contract. 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 of child support arrearages;(b)unpaid balance of tax,accrued interest,or other charges
specified in Article 22,Title 39,CRS;(c)unpaid loans due to the student loan division of the department of higher education;(d)owed
amounts required to be paid to the unemployment compensation fund;and(e) other unpaid debts owing to the state or any agency 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 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.
I I. The signatories aver that to their knowledge,no state employee has any personal or beneficial interest whatsoever in the service or
property described herein.
Page 13 of 14
IN WITNESS WHEREOF,the parties hereto have executed this Contract on the day first above written.
Contractor: Weld County Board of State of Colorado
(Full Legal Name) Commissioners ROY ROMER,GOVERNOR
cY4i By � �ro� i
Position(Title) Constance L. Harbert. Chair By ,e' V,
84-6000-813
Social Security Number or Federal I.D.Number Department of
PUBLIC HEALTH AND ENVIRONMENT
If Corporation,Town/City/County, or Equivalent:
PROGRAM APPROVAL:"—c'C ,
Attest(Affix Seal)
`n?Coxplortge<SecomBy
-
a Rw +wit3 Oro&
Deputy Clerk to the `o Th� ;
®U � � �'ROVALS:
A L� CONTIVALS:
ATTORNEY G
die F.e STATE CONTROLLER
Attornneap ARC R L' BARNH RT
B .By By U
ale A. ti� P nington Cliffor W.Hall
Assistant: omey Gener r
State S f c.rri3rq
Page 14 of 14
ATTACHMENT A
CORE PUBLIC HEALTH SERVICES
DELIVERED BY MCH AGENCIES
DIRECT
HEALTH CARE
SERVICES:
(GAP FILLING)
Examples:
Basic Health Services,
and Health Services for CSHCN
ENABLING SERVICES:
Examples:
Transportation,Translation,Outreach,
Respite Care,Health Education,Family
Support Services,Purchase of Health Insurance,
Cue Management,Coordination with Medicaid,
WIC,and Education
POPULATION-BASED SERVICES:
Examples:
Newborn Screening,Lead Screening,Immunization,
Sudden Infant Death Syndrome Counseling,Oral Health,
Injury Prevention,Nutrition
and Outreach/Public Education
INFRASTRUCTURE BUILDING SERVICES:
Examples:
Needs Assessment,Evaluation,Planning,Policy Development,
Coordination,Quality Assurance,Standards Development,Monitoring,
Training,Applied Research,Systems of Care,and Information Systems
MCHB/OSCH 10/20/97
ATTACHMENT B
ACTUAL EXPENDITURES ANNUAL REPORT
APPLICANT:
PROJECT:
ACTUAL EXPENDITURES
FOR THE PERIOD:
Annual Number Total + Source of'Funds
Salary Months Amount `Applicant Requested'`
PERSONAL SERVICES: Rate Budget Required and Other ;from C0H.
Contractual/Fee for Service:
Supervising Personnel:
Fringe Benefits: Rate =
Sub total Personal Services
OPERATING EXPENSES:
(includes Building/Facility
Cost not part of Indirect)
Sub total Operating
TRAVEL:
Sub total Travel
EQUIPMENT:
Sub Total Egiupment
Administrative/Indirect Cost
M wit.
§,-*
'Source of Funding for 'Applicant and Other' s;
Local:** $ **
Medicaid: $
Patient Fees:
Jther: $
Total Applicant and Other $
S
"Are these local funds used to match any other grant? Yes No
>ignature of Director or Authorized Representative
§ i
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D a a&,
ATTACHMENT D STATE OF COLORADO
nO
Roy Homer,Governor i �t —._-
Patti Shwayder, Executive Director pF CpP
E
Dedicated to protecting and improving the health and environment of the people of Colorado 1 -.C*,.; �Tb
4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division * 'r,�-.: ' *
Denver,Colorado 80246-1530 8100 Lowry Blvd. •
Phone(303)692-2000 Denver CO 80220-6928 *18--
—
Located in Glendale, Colorado (303)692.3090 --
Colorado Department
hup://www.cdphe state.co u; of Public Health
and Environment
state Fiscal Year _- _ Contract Routing Number Change Order Letter No.
n accordance with paragraph _of the Original Contract with contract routing number and contract encumbrance
•umber , as amended by Change Order Letter routing number , and Renewal Letter routing number
strike if inapplicable] hereinafter referred to in total as "the Original Contract" (a copy of which is attached hereto and by this
eference incorporated herein and made a part hereof) between the State of Colorado, Department of Public Health and
,nvironment, Division and, , covering the period from
hrough , _, the parties agree that the maximum amount payable by the State for the eligible services ill
'aragraph _of the Original Contract is increased/decreased [strike inapplicable] by DOLLARS ($
) for a new total of DOLLARS ($ ). This funding change is in accordance with th
wised work plan, which is incorporated herein by this reference, made a part hereof, and attached hereto as "Attachment A" and
to revised budget, which is incorporated herein by this reference, made a part hereof, and attached hereto as "Attachment B"
strike inapplicable]. The first sentence in paragraph_of the Original Contract is hereby modified accordingly. All other term
f conditions of the Original Contract are hereby reaffirmed by the parties.
'his amendment to the Original Contract is intended to be effective as of _, but in no event shall it be deem
alid until it shall have been approved by the State Controller or such assistant as he may designate.
lease sign, date and return all _originals of this letter as soon as possible to: , at the Colorado
Department of Public Health and Environment, Division, 4300 Cherry Creek Drive South.
tail Code: , Denver, CO 80246. One original of this letter will be returned to you when fully approved.
ontractor: State of Colorado
Full Contractor Name Roy Romer, Governor
Y
By:
Signature For the Executive Director
Colorado Department of
rint Name: Public Health and Environment
itle:
APPROVALS:
ROGRAM CONTROLLER
y
By:
ATTACHMENT E
State Fiscal Year - _ Contract Routing Number
Contract Renewal Letter No.
Pursuant to paragraph — of the contract with routing number and contract encumbrance number
(as amended by Change Order Letter routing number , and/or Contract Renewal Letter routing number
if any), hereinafter referred to as the"Original Contract" (a copy of which is attached hereto and by this reference
made a part hereof) between the State of Colorado, Department of Public Health and Environment and
, for the renewal term from through , _, the parties
agree that the maximum amount payable by the State for the eligible services referenced in paragraph of the
Original Contract is increased/decreased by DOLLARS ($ ) to a new total of
DOLLARS ($ ). The revised work plan, which is attached hereto as
"Attachment A", and the revised budget, which is attached hereto as "Attachment B", are both made a part hereof and
incorporated herein by this reference. The first sentence in paragraph of the Original Contract is hereby modified
accordingly. All other terms and 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 such assistant as he may designate.
Please sign, date, and return all _originals of this Contract Renewal Letter by , _to the attention of:
Colorado Department of Public Health and Environment
Mail Code:
4300 Cherry Creek Drive South
Denver, Colorado 802%.-1530
One original of this Contract Renewal Letter will be returned to you when fully approved.
Contractor: State of Colorado:
Full Legal Name Roy Romer, Governor
By:
Signature
By:
Print Name: For the Executive Director
Colorado Department of Public Health
Title: and Environment
APPROVALS:
PROGRAM
CONTROLLER
By: By:
Clifford W. Hall
46.(// , mEmORAnDUm
WI C
Constance L. Harbert, Chair
To Board of County Commissioners Date October 16, 1998
COLORADO n
From John Pickle, Director, Health Department /. Y��
Subject:
Child Health Program Contract
Enclosed for Board review and approval is a contract between Weld County Health Department
(WCHD) and the Colorado Department of Public Health and Environment for the Child Health
Program.
WCHD will provide well child clinic services to clients aged 0 to 16 years. These services
will include health and psychosocial history, age appropriate screening, physical exams,
immunizations, teaching of risk-reducing behaviors to parents, and referrals to appropriate
resources for children exhibiting actual or potential physical psychosocial/emotional problems.
For these services,WCHD will receive a total reimbursement of$37,192 for the period
October 1, 1998 through September 30, 199.
I recommend your approval of this contract.
Enclosure
982026
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