HomeMy WebLinkAbout951036.tiff RESOLUTION
RE: APPROVE CONTRACT FOR CANCER PREVENTION BETWEEN HEALTH
DEPARTMENT AND 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 a Contract for Cancer Prevention 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 February 1, 1995, and ending July 31, 1996, 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 Cancer Prevention 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 Chairman 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 17th day of May, A.D., 1995, nunc pro tunc February 1, 1995.
iny` g I \ BOARD OF COUNTY COMMISSIONERS
1 ' LD COUNTY, •LORADO
' ..u4 if /LTV%cc�c l rl/./I,
^tic, K .,,d ► Dale K. Hall, Chairman
,,d ••r y Clerk to the Board K7 / y
ec/cAi( , ,e ( ) /I:� L4�
i . `04 - 'Barbar J. Kirkmeyer, -Tem �
BY: I/ . II. . . I/ . Il, .
Deputy Cl IT to the Board tg ., . '7J- `,
George E'axter
APPROVED AS TO FORM:
(/ Fxri is
�— Constance L. Harbert
nn
nt Attorney • %' 'X
W. H. Wee
bster
(V ` 577QJf J j/L 951036
HL0021
Form 6-AC-02A(R 5/91) Department or Agency Name
Public Health and Environment
Department or Agency Number
260000—FLA
Contract Routing Number
950782
CONTRACT
THIS CONTRACT, made this la day of February 1995, 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 80222-
1530 hereinafter referred to as the State and Weld County Health Department. 1517 16th Avenue Ct.. Greeley. Colorado 80631
hereinafter referred to as the contractor.
WHEREAS,authority exists in the Law and Funds have been budgeted, appropriated and otherwise made available and a
sufficient uncommitted balance thereof remains available for encumbering and subsequent payment of this contract under Encumbrance
Number PLA PP0950782 , in Fund Number 100, Appropriation Account 773, and Organization 7340.
WHEREAS,required approval,clearance and coordination has been accomplished from and with appropriate agencies:and
WHEREAS, the State has entered into a Cooperative Agreement with the Centers for
Disease Control to provide breast and cervical cancer screening and diagnostic services; and
WHEREAS, the intent of the Cooperative Agreement is to increase screening and
diagnosis among all groups of women in the state, with special efforts to reach those women who
are of low income, uninsured, underinsured, minority, Native American and/or served by Health
Resources and Services Administration primary care centers and/or Tide X Family Planning fund
recipients; and
WHEREAS, the Contractor is considered by the State to be an appropriate agency which
has the facilities, personnel and capability to provide the 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 will provide cervical cancer screening and diagnostic services to women
aged 20 to 39 who receive family planning services provided by the Contractor.
2. Breast and cervical cancer screening and diagnostic services will include the following:
• Screening breast and pelvic exams, and Pap tests per the budget for new screens,
a copy of which is attached and by reference made part hereof as Exhibit A.
• Colposcopies with biopsy per the budget, which is attached and by reference made
part hereof as Exhibit B.
• Other diagnostic procedures as allowed by the program including diagnostic
mammograms, repeat breast exams, fine needle aspirations, surgical/medical
consultations, repeat pelvic exams and repeat Pap tests which must be allocated out
of the budget included in Exhibit A.
• Maintain a tracking and follow-up system which will assure patients with abnormal
screening results receive appropriate diagnostic follow-up and treatment services,
and rescreening on a timely basis.
Page 1 of 8 Pages
3. The Contractor agrees to utilize nationally accepted guidelines for women as the standard
for breast and cervical cancer screening as follows:
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. (For purposes of this contract only a physical breast exam can
be done yearly in conjunction with the pelvic exam whereas the national guidelines allow
one every three years for women from ages 20-39 and yearly thereafter).
4. 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.
Cytology laboratories must be in compliance with the federal Clinical Laboratory Improvement
Act of 1988 (CLIA-88).
If the Contractor continues to utilize a facility after receiving notification that the cytology
laboratory is found not to be in compliance with CLIA-88 regulations the Cancer Control
Program may deny reimbursement for services provided by the laboratory after the date of
notification. This paragraph does not preclude the State from any other remedy provided by the
law.
If a diagnostic or repeat mammogram must be performed on a woman covered by this contract,
the mammography center must be accredited by the American College of Radiology (ACR).
Mammography centers must be certified by the Food and Drug Administration (FDA) certified
in accordance with the Mammography Quality Standards Act of 1992, which took effect October
1, 1994. A mammography facility who is American College of Radiology (ACR) accredited is
automatically certified by the FDA.
5. The Contractor agrees to receive prior approval from the Cancer Control Program to enter
into agreements with, or to change providers of cytology laboratory services.
6. The Contractor agrees to seek reimbursement for services only for those women who meet
the following eligibility criteria:
• Bea women aged 20 to 39;
• Family income at or below 200% of the federal poverty level:
• Be a recipient of family planning services;
• Be a resident of Colorado as defined by the Colorado Resident Discount Program.
7. The Contractor agrees to provide data to the Colorado Women's Cancer Control Initiative
including total number of women screened for breast and cervical cancer, clinical results of
abnormal exams, and all tracking and follow-up data to be integrated with the cervical cancer
tracking and follow-up system (CCTFS) and the Colorado Mammography Advocacy Project
(CMAP) maintained by the Cancer Control Program.
8. The Contractor agrees to share information with the Colorado Cancer Control Program
for federal matching funds requirement purposes.
Page 2 of 8 Pages
9. The administrators of the Colorado Cancer Control Program shall have the authority to
conduct annual program performance reviews 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.
10. The State will, in consideration of said services by the Contractor, cause to be paid to the
Contractor a sum not to exceed THREE THOUSAND NINTY TWO Dollars ($3,092.00) for
new screenings and diagnostic services per Exhibit A and THREE THOUSAND TWENTY
Dollars ($3,020.00) for Colposcopy services per Exhibit B, for the period beginning 1 February
1995 and ending 15 July 1996. Total contract amount SIX THOUSAND ONE HUNDRED
AND TWELVE Dollars ($6,112.00).
a) In accordance with P.L. 101-345, patient charges for services provided will be
made according to a schedule of charges that 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.
b) Any program 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 budget (Exhibit A).
11. Changes in reimbursement amounts for the above-named services in consideration of
increased or decreased levels of utilization and/or the Medicare rate change from the levels
funded in the original contract shall be made with approval of the Contractor, the State (Cancer
Control Program) and the State Controller as evidenced by a mutually signed Letter of Approval
a copy of which is attached and by reference made part hereof as Exhibit C.
12. The Contractor 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 or 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.
Page 3 of 8 Pages
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.
13. The term of this contract is beginning 1 February 1995, and continuing through July 15,
1996.
Page 4 of 8 Page"
)LORADO DEPARTMENT OF HEALTH - hereinafter, under she General Provisions referred to as
"Health".
GENERAL PROVISIONS -- page 1 of 2 pages
. The contractor shall perform its duties hereunder as an independent contractor and
)t as an employee. Neither the contractor nor any agent or employee of the contractor
tall be or shall be deemed to be an agent or employee of the state. Contractor shall
ay when due all required employment taxes and income tax withholding,_ shall provide and
Sep in force worker's compensation (and show proof of such insurance) and unemployment
,mpensation insurance in the amounts required by law. Contractor will be solely
:sponsible for its acts and the acts of its agents, employees, servants and
ibconcractors during the performance of this contract.
. Contractor authorizes Health, or its agents, to perform audits and to make
ispections for the purpose of evaluating performance under this contract.
. tither party shall have the right to terminate this agreement by giving the other
arty thirty days notice by registered mail, return receipt requested. If notice is so
iven, this agreement shall terminate on the expiration of the thirty days, and the
Lability of the parties hereunder for the further performance of the terms of this
;reement shall thereupon cease, but the parties shall not be relieved of the duty to
:rform their obligations up to the date of termination.
This agreement is intended as the complete integration of all understandings
:tween the parties. No prior or contemporaneous addition, deletion, or other amendment
!rev) shall have any force or effect whatsoever, unless embodied herein in writing. No
ibsequent novation, renewal, addition, deletion, or other amendment hereto shall have
iy force or effect unless embodied in a written contract executed and approved pursuant
the State Fiscal Rules.
If this contract involves the expenditure of federal funds, this contract is
)ntingent upon continued availability of federal funds for payment pursuant to the
!rms 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
-110. whichever is applicable; '
b) the Hatch Act (5 USC 1501-1508) and Public Law 95-454 Section 4728. These
:atutes state that federal funds cannot be used for partisan political purposes of any
.nd by any person or organization involved in the administration of federally-assisted
-ograms;.
c) the Davis-Bacon Act (40 Stat. 1494, Mar. 3, 1921, Chap. 411, 40 USC
'6A-276A-5) . This act requires that all laborers and and mechanics employed by
intractors or sub-contractors to work on construction projects financed by federal
:sistance must be paid wages not less than those established for the locality of the
-object by the Secretary of Labor; -
d) 42 USC 6101 et seq. 42 USC 2000d, 29 USC 794. These acts require that no
trson shall, on the grounds of race, color, national origin, age, or handicap, be
:eluded from participation in or be subjected to discrimination in any program or
tivity funded, in whole or in part, by federal funds; and
Page 5 of 8 Pages
v. 06/01/92
r)
t
GENERAL PROVISIONS—Page 2 of 2 pages
e) the Americans with Disabilities Act (Public Law 101-336; 42 USC 12101, 12102,
2111 - 12117, 12131 - 12134, 12141 - 12150, 12161 - 12165, 12181 - 12189, 12201 - 12213
nd 47 USC 225 and 47 USC 611_
f) if the contractor is acquiring real property and displacing households or
usinesses in the performance of this contract, the contractor is in compliance..with the
niform 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);
g) when applicable, the contractor is in compliance with the provisions of the
Uniform Administrative Requirements for Grants and Cooperative Agreements to State and
ocal Governments (Common Rule) .
. By signing and submitting this contract the contractor states that:
a) the contractor is in compliance with the requirements of the Drug-Free
orkplace Act (Public Law 100-690 Title V. Subtitle D, 41 USC 701 et seq. ) ;
b) the contractor is not presently debarred, suspended, proposed for debarment,
eclared ineligible, or voluntarily excluded from covered transactions by any federal
epartment or agency; and
. To be considered for payment, billings for payment pursuant co this contract must
e received within 60 days after the period for which payment is being requested and
inal billings on the contract must be received by Health within 60 days after the end
f the contract term.
If applicable-, Local Hatch is to be submitted on the monthly payment statements, in
he column provided, as required by the funding source.
. If Contractor receives $25,000.00 or more per year in federal funds in the
ggregate from Health, Contractor agrees to have an annual audit, by an independent
ertlfied public accountant, which meets the requirements of Office of Management and
udget Circular A-128 or A-133, whichever applies. If Contractor is required to submit
n annual indirect cost proposal to Health for review and approval, Contractor's auditor
ill audit the proposal in accordance with the requirements of OMB Circular A-87, A-21
r A-122. Contractor agrees to furnish one copy of the audit reports to the Health
epartment Accounting Office within 30 days of their issuance, but not later than nine
onths after the end of Contractor's fiscal year. Contractor agrees to take appropriate
orrective action within six months of the report's issuance in instances of
oncompliance with federal laws and regulations. Contractor agrees to permit Health or
is agents to have access to its records and financial statements as --necessary, and
urther agrees to retain such records and financial statements for a period of three
ears after the date of issuance of the audit report. This contract does (100%)
ontain federal funds as of the date it is signed. This requirement is in addition to
ny other audit requirements contained in other paragraphs within this contract.
0. . Contractor agrees to not use federal funds to satisfy federal cost sharing and
etching requirements unless approved in writing by the appropriate federal agency.
Page 6 of 8 Pages
CI
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,provender 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 annurd 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 cat 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 24-34402),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 subtonrracts-
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 arc treated dining employment without tganl to the above mentioned characteristics.Such action shall include,but not be limited to the foUowing:
employment upgrading,demotion,or transfer.recruitment or recruitment advetisings;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 sad 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 rule.,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 vice,creed.color.
sex,national origin,or ancestry. -
(O 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 Of 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.
Form 6-AC-02B
Radscd 1/93
395-S3-01-1022
page 7 of 8 pages
(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.
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 pan by State funds.
b.When a construction contract for a public project is to be awarded to a bidder,a resident bidder shall be allowed a preference against a non-resident bidder from
a state or foreign country equal to the preference given or required by the state or foreign country in which the non-resident bidder is a resident.If it is determined by
the officer responsible for awarding the bid that compliance with this subsection.06 may cause denial of federal funds which would otherwise be available or would
otherwise be inconsistent with requirements of Federal law,this subsection shall be suspended,but only to the extent necessary to prevent denial of the moneys or to
eliminate the inconsistency with Federal requirements(CRS 8-19-101 and 102)
GENERAL
7.The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the interpretation,execution,and enforcement of this
contract.Any provision of this contract whether or not incorporated herein by reference which provides for arbitration by any extra-judicial body or person or which
is otherwise in conflict with said laws,rules,and regulations shall be considered null and void.Nothing contained in any provision incorporated herein by reference
which purports to negate this or any other special provision in whole or in past shall be valid orenforceable a available in any action at law whether by way of complaint,
defence,or otherwise.Any provision rendered null and void by the operation of this provision will not invalidate the remainder of this contract to the extent that the
contract is capable of execution -
8.At all times during the performance of this contract,the Contractor shall strictly adhere to all applicable federal and state laws,rules,and regulations that have
been or may hereafter be established.
9.The signatories aver that they are familiar with CRS 18-8-301,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.
10.The signatories aver that to their knowledge,no state employee has any personal or beneficial interest whatsoever in the service or property described herein
IN WITNESS WHEREOF.the panics hereto have executed this Contract on the day first above written.
Contractor: Weld County Health Department
(Full Legal Name) WELD COUNTY, COLORADO STATE OF COLORADO
WELD CO i Y BOARD OF OMMISSIONERS OY ROMER,GOVERNOR
BY: li. .�/i.
;y� By Lac_- for
fl , CHA RMAN (5 17/95) -5 FXEfeOTIVE RECTOR
Position(Title) h . .r -
na
84 .0f.Q$ +e ,._
s:i it, signora.• or Es j'FI.D.N bet DEPARTMENT ,
If Corporation:) IF ,,/r`'/ s OF HEALTH
Attest(Seal) /� n
By 'i-!LL'.--27/J/LTG'C1 ee t--
)
R tnerturatee/MX.74R€l0§Ex 9oXTbMnunry Clerk to Board - -
•
... 7f?fafP,P rot..
APPROVALS ' rr., CO TROLL.ER
ATTORNEY GENE' . -�?a' T d
�J . %� CONTROLLER 1/ ,� l�
W. I � i`
/� re
Form 6-ACA2C Page 8 which is the last of 8 e 0�-e 4 - C .✓. /
Revised 1/93 8 pages ,q4 "'���LLL----.
39$-53-01-1030 'Sec instructions on reverse side / -
- PROGRAM APPROVAL:
EXHIBIT A
COLORADO WOMEN'S CANCER CONTROL INITIATIVE
ANNUAL EXPENDITURE REPORT 1994 - 95
Women Aged 20 to 39
AGENCY: Weld County Health Department FISCAL Y R: 95
SERVICE REIMBURSEMENT NUMBER TOTAL
PROVIDED RATE OF AMOUNT
PROCEDURES
SCREENING
Clinical Breast Exam/Pelvic Exam $54.23 50 2,711.50
Pap Lab(by Cytotech) 7.60
50 380.00
Mammogram 59.63
SUBTOTALS
DIAGNOSTIC
Repeat Clinical Breast Exam 29.80
Surgical/Medical Consultation 76.58
Diagnostic/Repeat Mammogram 62.44
Fine Needle Aspiration(FNA) 161.44
Repeat Pelvic Exam 29.80
Pap Lab(by Pathologist) 19.05
Colposcopy 89.32
Colposcopy with Biopsy 201.36
SUBTOTALS
TOTAL ANNUAL COSTS
3,091.50
7/5/94 SDMERANN.FRM
. . EXHIBIT B
•
COLORADO WOMEN'S CANCER CONTROL INITIATIVE
ANNUAL EXPENDITURE REPORT 1994 - 95
Women Aged 20 to 39
AGENCY: Weld County Health Department FISCAL YEAR: 95
SERVICE REIMBURSEMENT NUMBER TOTAL
PROVIDED RATE OF AMOUNT
PROCEDURES
SCREENING
Clinical Breast Exam/Pelvic Exam $54.23
Pap Lab(by Cytotech) 7.60
Mammogram 59.63
SUBTOTALS
DIAGNOSTIC
Repeat Clinical Breast Exam 29.80
Surgical/Medical Consultation 76.58
Diagnostic/Repeat Mammogram 62.44
Fine Needle Aspiration(FNA) 161.44
Repeat Pelvic Exam 29.80
Pap Lab(by Pathologist) 19.05
Colposcopy - 89.32
Colposcopy with Biopsy 201.36 15 3,0 20.4i1
SUBTOTALS
TOTALANNUAL COSTS
3,020.10
•
•
7;5/94 SDMEMNN.FRM
EXHIBIT C.
LETTER OF APPROVAL
Date
Routing Number -
Change Order Letter No.
Contract PPG , Routing Number , (copy attached and by this reference made a part
hereof) between the State of Colorado, Department of Public Health and Environment, Prevention Division,
Cancer Prevention and Control Program and .the
maximum amount of is hereby Increased/decreased by$_
to a new total of$
per paragraph (s) _and_. A copy of the new budget is attached as revised Exhibit_.
The first sentence in Paragraph_is hereby modified accordingly. The terms and conditions of the
original contract shall remain the same.
This letter of amendment to the contract is intended to be effective date , but in no event shall this
amendment be deemed valid until it shall have been approved by the State Controller or such assistant as
he may designate.
Please sign all four (4) copies of this letter and return to me by date to:
Colorado Department of Public Health and Environment
PPD-CCP-AS
4300 Cherry Creek Drive South
Denver, CO 80222-1530
An executed copy of this letter with all the required signatures will be returned to you.
Please call me at (303) 692-7O0X7C if you have any questions.
Sincerely,
Agency State of Colorado:
Roy Romer,Governor
By:
By:
Name For the Executive Director
Colorado Department of Public Health and
Environment
Title
Approvals: By:
State Controller or
By: Authorized Designee
Division/Department/Program Representative
`j mEmoRAnDum 1 -, .
Dale Hall, Chairman t � �� �
WIlD C� to Board of County Commissioners Dote May I5, 1�99 ._! 1 .
COLORADO `'��
From John Pickle, Director, Health Departm
Subject:
Cancer Prevention Contract for Women Under 40 Years of Age
Approximately one month ago, the Weld County Board of Commissioners approved a contract
between the Colorado Department of Public Health and Environment (CDPHE) and Weld
County Health Department (WCHD) for breast and cervical cancer screening and diagnostic
services for women aged 20 to 39. This contract was for the time period March 1, 1995 through
July 31, 1995 and for a sum not to exceed $6, 112. In the meantime, CDPHE realized the
beginning date of the contract was incorrect, and they also received notification from the Centers
for Disease Control that additional funding will be available in August 1995.
Therefore, CDPHE has issued a new contract for the time period February 1, 1995 through
July 31, 1996. This contract is initially for the same amount of funding, $6,112 as the previous
contract. However, a letter of approval will be issued on or before August 1, 1995 to increase
the amount of funding to cover the time period ending July 31, 1996. The CDPHE has advised
us this new contract must be approved and signed in order for WCHD to be eligible for the
increased funding available in August 1995.
I recommend your approval of the contract.
Enclosure
951036
Hello