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HomeMy WebLinkAbout992041.tiff RESOLUTION RE: APPROVE INVITATION TO BID FOR FAMILY PLANNING 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 an Invitation to Bid for the Family Planning Program from 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, to the Colorado Department of Public Health and Environment, with further terms and conditions being as stated in said contract, and WHEREAS, after review, the Board deems it advisable to approve said invitation to bid, 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 Invitation to Bid for the Family Planning Program from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, to 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 16th day of August, A.D., 1999. BOARD OF COUNTY COMMISSIONERS nse % LD COUNTY 00 ATTEST: 4j12/ v �� 3allohai "rr Weld County Clerk to t =, � ) itijiat J • 4 ,, ` �, �"f` i Barbara J. Kirkmeyer, o-Tem BY: Deputy Clerk to the Bo- a- f / "" �"� eorge . axer ,-APPRp'V AS TO FORM: 11.1,(4.2 J. &le/ /County Attorneyi eiat Glenn Vaad 992041 cc: fit- HL0025 INVITATION TO BID DATE: July 1, 1999 RFP NO: RO-FPP0001 • DIRECT INQUIRIES TO: ROBERT M. O'NEILL PHONE NO: (3031 692-2074 DATE REP DUE: Monday, 08/09/99 (Q3:00 PM MDT Bids properly marked as to REP NO., DATE and HOUR of opening, subject to the conditions herein stipulated and in accordance with the specifications set forth and/or attached hereto, will be accepted at the address listed below, prior to the date and time listed for the bid opening. All bids shall be quoted F.O.B. destination, unless otherwise specified, to the delivery location or jobsite listed herein. SEALED COMPETITIVE PROPOSAL FOR: ADMINISTERING A STATE FUNDED FAMILY PLANNING PROGRAM RETURN PROPOSAL TO: COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT ASD-PURCH-A2 4300 CHERRY CREEK DRIVE SOUTH DENVER, CO 80246-1530 Prices shall be quoted F.O.B destination and include delivery to the CDPHE. SEE ATTACHED PAGES FOR TERMS AND CONDITIONS AND RFP REQUIREMENTS. IMPORTANT: Bidders should read the entire bid document before submitting bid. RFP'S MUST BE SIGNED IN INK VENDOR ADDRESS TYPED OR PRINTED SIGNA'-URE . • Handwritten Signature by Authorized Officer or Agent of Vendor TERMS Terms of less than 30 calendar days will not be considered. TITLE DATE PHONE N FAXN The above bid is subject to Terms and Conditions on attached sheets. RETURN THIS COPY 99ao41 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT: A GRANT PROPOSAL FOR ADMINISTERING OF FAMILY STATE PLANNING FUNDS FROM THE COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT RFP NO: RO-FPP0001 August, 1999 APPLICANT QUALIFICATIONS (4.2.1) Introduction The County of Weld encompasses 4,004 square miles in the northeastern corner of Colorado. Wald is an agricultural county, centered around livestock production and farming. About 50% of its population of 151,000 (1996, est.) lives in or near Greeley, the county seat. Estimates of Weld's Hispanic population range from 23% (Chamber of Commerce) to 45% (public school district). About 15-30% of Weld Hispanics, or 5,209 - 10,419 individuals, speak Spanish as their primary language. An unknown proportion of this subpopulation is illiterate. Major health care resources in Weld County include one hospital ( North Colorado Medical Center), the Weld County Department of Public Health and Environment, Sunrise Community Health Clinic (Greeley area), Salud Family Health Clinic (Ft. Lupton), and nine private provider clinics. Organizational Structure Weld County Department of Public Health and Environment (WCDPHE) was established in 1938. It is a local public health jurisdiction under authority of Colorado State Statutes and is accountable to the Weld County Board of Commissioners. WCDPHE's mission statement is: to preserve, promote and protect a healthy life and safe environment for the residents of Weld County. The agency's governing board is the County Commissioners, whose elected members represent the population of Weld. The members exercise executive and administrative powers over county agencies, determine policies, and enact legislation. The current members of the Weld County Board of Commissioners are: 4. Dale Hall •b Barbara Kirkmeyer • Glenn Vaad George Baxter •S Michael Geile Commissioner Vaad is delegated specifically to oversee the Health Department's functioning, and attends all executive staff meetings. The Health Department is divided into three main service divisions, Page 1 of 12 Environmental Health, Health Education and Nursing, and Administration. An organizational chart is provided in Appendix A. Under the umbrella of Weld County government, WCDPHE is non-profit and tax- exempt (see Appendix B). Financial Resources Weld County's Public Health Fund is supported by taxes and other revenues earmarked for public health matters. These include health care, health education, health monitoring, and other related activities. This fund is an independent fiscal and accounting entity with a self-balancing set of accounts recording cash and other financial resources together with all related liabilities, residual equities and balances. These are segregated for the purpose of providing specific program activities or attaining certain objectives in accordance with special regulations, restrictions, or limitations. For FY 1998, the sources of revenue for WCDPHE programs were from fees for services, licenses, and permits; contracts and grants; County funds; and miscellaneous sources. Financial management of WCDPHE funds is the joint responsibility of the division directors and the Administrative Services staff. Annually, the fees for services are reviewed and adjusted to help meet the cost of providing these services. No problems for long term funding prospects are anticipated for WCDPHE, especially in light of a predicted increase in the county's population of 20% over the next five years. The Health Department anticipates continued funding from grants, contracts, county taxes and other revenues that will allow continued funding of services at the current level. As in the past, the largest part of the Family Planning Program costs not covered by the Colorado Department of Public Health and Environment (CDPHE) Federal Title X funds will be paid by County tax dollars. Also, the Department staff will continue to encourage donations from our Title X clients, collect fees from clients when applicable, and bill Medicaid for covered services for eligible clients. Programmatic Resources WCDPHE has demonstrated a strong commitment to family planning by providing services since 1964. In 1974 the agency began its Title X clinics in accordance with Federal and State guidelines. Periodic audits by the Women's Health Division of CDPHE have demonstrated that WCDPHE has an established record of providing quality service while meeting program requirements. No other agency in Weld County receives Title X funds, so a plan for coordinating administrative and clinical services with these similar agencies is not necessary. However, WCDPHE is committed to working with the entire health-care community to provide cost-efficient family planning services without duplication of services for County residents, as evidenced by: ❖ WCDPHE regularly attends quarterly policy meetings with the Women's Health Division of CDPHE. ❖ WCDPHE is a member of the Weld County Community Health Coalition, Page 2 of 12 an organization devoted to ensuring collaboration among agencies and discussing community health issues. WCDPHE solicits advice from the county's Board of Health when determining its services and programs. Description of Staff Appendices C and D provide job descriptions and resumes, respectively, for Family Planning medical director, program coordinator, nurse practitioners and fiscal manager. Compliance with Federal, State, and Program Regulations WCDPHE is currently a Title X provider and has been since 1974. The agency has demonstrated compliance with applicable Federal and State requirements via regular audits made by staff of the Women's Health Division of CDPHE. To further ensure compliance with Federal and State requirements, WCDPHE performs regular internal audits of Its family planning program. Community (4.2.2) Community Providers Besides W'DCPHE, other providers of family planning in Weld County which receive public funding are given below. None of these agencies receive Title X funding. ❖ Sunrise Community Health Center 1028 5th Avenue Greeley, CO 80631 ❖ Plan de Salud 115 2nd Street Fort Lupton, CO 80621 ❖ Planned Parenthood of the Rocky Mountains 3487 West 10' Street Greeley, CO 80631 Outreach and Education WCDPHE is active in outreach efforts. One of several programs to decrease the number of adolescent pregnancies in Weld County was begun in October,1997. This program, called F'eerVention, is a collaborative community effort by WCDPHE, the public schools and Child Advocacy Resource and Education, Inc. (c.a.r.e.). A group of trained peer educators provides one-on-one counseling and support to low-income adolescents at risk of unintended pregnancy. This counseling is offered at a variety of settings, including WCDPHE's family planning and sexually transmitted disease (STD) clinics. Educational presentations are also given to groups of teens at schools and other agencies serving youth. The curriculum includes topics about birth control, STD's, sexual assault, community resources and communication. Health Educators at WCDPHE began another teen pregnancy prevention outreach effort in early 1998. This program is called "Building Bright Futures." The Page 3 of 12 project provides teens the education and skills to choose abstinence over sexual activity. Through a contract with Friends First, presentations are given to students, parents, community groups and teachers, utilizing the WAIT training program. The program will be evaluated using the Youth Risk Behavior Survey pre- and post- intervention. Another outreach effort, provided for the past two years, has been a weekly teen outreach family planning service local, non-profit Monfort Children's Clinic. Adolescents visiting the clinic are offered education and birth control methods with a delayed pelvic exam option by bilingual public health nurses. Gift certificates are given to teens who keep their subsequent FPP clinic appointments at WCDPHE. Yet another outreach program to prevent subsequent pregnancies among teenagers is in the planning stage this year. The Nursing Division will provide public health nurse home visitation to first-time teen moms, using the model proposed by David Olds. Referrals to this program will be made by a variety of agencies, including Social Services. Acquiring Community Support To generate awareness and support for family planning services in Weld County, WCDPHE collaborates with a variety of agencies and committees, including: • The Weld County Board of Health ❖ The Weld County Community Health Coalition ¢• The Teen Advisory Committee d• Public School District#6 Health Education Standards Committee d• The Women, Infants and Children (WIC) federal food supplementation program d• First Steps, which offers free pregnancy testing and home visitation by a nurse to high-risk clients ❖ North Colorado Medical Center's breast-feeding clinics, which are partially staffed by WCDPHE nurses • The public health prenatal clinic for uninsured women, whose postpartum moms receive home visits by WCDPHE nurses emphasizing family planning, well-baby care and immunizations • The Medical Residency Program at North Colorado Family Medicine. • Greeley Interfaith Association to emphasize abstinence programs and immunization clinics • The University of Northern Colorado's Department of Communinity Health and Nutrition and the School of Nursing Internally, family planning is promoted by offering education and birth control methods to clients utilizing other WCDPHE services, including: ❖ Free pregnancy testing clinic ❖ Sexually transmitted disease clinic • Well-child check-up and immunization clinics ❖ RN home visits to new mothers and babies for post-partum assessments Page 4 of 12 and education ❖ Tuberculosis diagnosis and management clinic • Telephone public health information service staffed by nurses d• Case management program for children with special needs • Nurse home visitation program for families whose children are at risk of health problems or abuse. ❖ Rural communities public health nursing clinics ❖ Cornmunity presentations by WCDPHE health educators Community Collaboration WCDPHE collaborates with other agencies and groups regarding a number of other public health issues, including migrant health, communicable disease, environmental toxins, cancer prevention and screening, geriatrics, public safety, nutrition, child abuse and suicide prevention. WCDPHE services as a clinical training site for nurse and nurse practitioner students, community health interns, and medical residents. Community Letters of Support Three letters of support for the Health Department's providing CDPHE/Title X family planning services are given in Appendix E. The letters are from Weld's Board of County Commissioners, Robert Francella for the non-profit Monfort's Children Clinic, and Mark Wallace, M.D., as medical director of the Health Department. Program Management (4.2.31 Program Services Demographics of WCDPHE's Family Planning Patients 4. An estimated 1350 unduplicated patients will be seen during the proposed nine-month grant funding period (equivalent to 1800 per year). ❖ 23%, or approximately 310 clients, are predicted to be adolescents (19 years old and younger, equivalent to approximately 400 per year). ❖ 40% of all patients, or 720 individuals, are expected to be Spanish- speaking only (equivalent to 720 per year). ❖ A very small (<1%) portion of clients are likely to speak languages other than English or Spanish ❖ Income code distribution is expected to be similar to1998's: 86% code 1 = 1161 clients/9 mos or 1548/yr 10% code 2 = 135 clients/9 mos or 180/yr 2.5% code 3 = 34 clients/9 mos or 45/yr 1.5% code 4 = 20 clients/9 mos or 27/yr Page 5 of 12 Family Planning Clinic Hours MONDAYS 1 pm to 7 pm TUESDAYS (twice per month for MD consult) 1 pm to 5 pm WEDNESDAYS 8 am to 12 pm; 1 pm to 5 pm FRIDAYS 8amto12 pm; 1 pm to5pm Client requests for urgent family planning services during non-clinic days and for clients without appointments are triaged by nurses 40 hours a week and managed on a case-by-case bass. Walk-in clients are accepted for pregnancy testing (with a method initiation if desired) on Wednesday afternoons. Clinic Location The main family planning clinic is located in a newly-built public health building in the county complex in north Greeley. Services were moved in May of 1999, per voter mandate, from the clinic's previous location in central Greeley, adjacent to NCMC. Advantages to being in this new location include having spacious new facilities and plenty available parking spaces for clients. The new building is now close to several factories where our clients work, to the non-profit Children's Clinic and to lower- income housing where many of our clients live. The city bus has a stop in front of the building. Other County buildings such as the Jail, Job Service, Human Resources, Planning and Zoning, Youth Corrections, the Coroner's Office and Vehicle Registration are in the same county complex area as our clinic. The clinic's former location was next-door to one of Greeley's two high schools, making it very accessible to those teens. The impact of the new location will not be known for some time, however, because that high school will be closed for a year for remodeling. A new high school is being built in north Greeley, and although not within walking distance, students should have easy access by bus or car. The issue of location and access will be evaluated over the next 18 months. Clinic Setting and Design Finished in 1999, the new WCDPHE clinic has: ❖ Seven examination rooms equipped for OB/GYN, STD and child health exams • Two additional examination rooms for immunizations ❖ A negative-pressure tuberculosis testing room ❖ Seven private interview rooms • Laboratory in the clinic for microscopy, urine testing, ❖ Laboratory on second floor for cultures, STD testing ❖ Immunization preparation room ❖ Medication dispensing room ❖ Large reception and waiting area ❖ Spacious nurses' station ❖ Nursing and Health Education offices adjacent to clinic Page 6 of 12 ❖ Accessability per the Americans with Disabilities Act Serving Culturally Diverse Populations The vast majority of non-English-speaking Weld County residents speak Spanish. WCDPHE has always actively solicited and preferentially hired bilingual employees because we do not wish to limit the number of Spanish-speakers receiving health services. A current estimate is that at least 40% of WCDPHE clients speak only Spanish. Many of these clients have a very limited educational background and some are illiterate. The percentage of Spanish-speaking staff in the Nursing Division for each job classification is given below (with the actual number of FTEs given in parentheses). • 100% of social workers (1.0) ❖ 33% of nurse practitioners (1.5) ❖ 32% of nurses (2.5 fluently, 2.0 learning) ❖ 85% of support staff(11.5) In addition, several of our consultant physicians speak Spanish, as does our medical director. It is our pleasure to provide barrier-free services to the Spanish-speaking population and so we employee a large bilingual staff for verbal interpretation and written translation of a variety of health information topics. On the rare occasions we have had clients who spoke neither English nor Spanish, staff at the University of Northern Colorado (UNC) has helped us with interpreting. UNC also assists with access to services for hearing-impaired patients. Clinic Appointments and Service Delivery WCDPHE offers the following options for clients seeking appointments for reproductive health concerns: NURSE PRACTITIONER (NP) CLINIC All appointments are 20 minutes. Staffing is one NP, one RN, and a shared clinic aide. Hours are: Monday 1:00-6:40 pm (18 total appointment slots) Wednesday & Friday 8:30-11:10 am; 1:00-4:00 pm Eighteen total appointment slots are available each clinic day for approximately 2700 slots per year. Two slots each clinic day are allotted for urgent care patients. This clinic provides: d• Annual physical exams and health history for women ages 12 and up. ❖ Birth control method initiation, including IUD, pills, depo provera, Norplant, diaphragms and referrals for natural family planning. ❖ Postpartum care ❖ Education and evaluation of family planning patients regarding issues such as abdominal pain, dysuria, vaginal bleeding, breast lump or discharge, premenstrual syndrome, preconceptual counseling, amenorrhea, infertility, menopause, cervical/breast cancer screening, obesity, nutrition, disease risk factors, genetic counseling, psychosocial assessment and counseling referrals, and a medical history which impacts their contraceptive use. ❖ Examinations of pregnant women with urgent complaints who have not Page7of 12 yet had their first appointment in the public prenatal clinic. The wait for non-urgent appointments for this clinic ranges from three to six weeks. Clients may begin pills or Depoprovera much sooner than this using the delayed pelvic option by making an appointment in the supplies clinic (below). A high no-show rate, despite reminder calls and postcards, is a significant factor in causing the waiting time for appointments. This issue will be extensively studied over the next few months. BIRTH CONTROL METHOD SUPPLIES (RN) CLINIC: All appointments are 20 minutes. Staffing is one RN and a shared clinic aide. Hours are: Monday 1:00-6:40 pm Friday 8:30-11:10 am; 1:00-4:00 pm Eighteen total appointment slots are available each clinic day for approximately 900 slots per year. Two appointment slots are available each clinic day for urgent requests. Services of this clinic include: 4• Reproductive health education and referrals ❖ Supply pickup, including Depoprovera injections. • Pregnancy testing ❖ Blood pressure checks d• Emergency contraception The wait for non-urgent appointments in this clinic is from one to four days. PREGNANCY TESTING Walk-in service, no appointment needed. Staffed by 1-2 RN's and a shared clinic aide. Hours are: Wednesday 1:00-4:00 pm. Services include: ❖ Sensitive urine pregnancy test d• Preconceptual counseling ❖ Referrals and counseling for pregnant patients ❖ Delayed pelvic option for birth control method initiation • Barrier method supplies • Emergency contraception ❖ Reproductive counseling and referrals MD CONSULT CLINIC Faculty and resident physicians from North Colorado Family Medicine provide a consultation clinic four hours twice a month at WCDPHE. Referrals into this clinic are made by FPP staff. This service provides reproductive health evaluation and consultation for FPP patients who do not have access to another primary care provider (PCP). The vast majority of our clients do not have a PCP, and WCDPHE seeks to assist patients with accessing the community's health care system. SEXUALLY TRANSMITTED DISEASE (STD) CLINIC Male and female patients with concerns about sexually transmitted infections can be seen in STD clinic Mondays and Fridays from 1:00-5:00 pm if no urgent appointments are available in the FPP Nurse Practitioner Clinic. Page 8 of 12 Data Collection System The clinic uses a database software system called "Acclaim" for its clinic functions. This system is a customization of FoxPro. There have been problems with extracting data from Acclaim, as well as in designing appropriate billing forms. The County has hired a consulting firm to either renovate the Acclaim system or implement a different software system for our needs. WCDPHE also uses the CoTrack data collection system in collaboration with CDPHE. Clinical Services The Weld County Department of Public Health and Environment's philosophy is to maintain health and prevent disease, utilizing a public health model. Its Health Promotion section is exclusively prevention-based, with areas of interest in HIV/AIDS, STDs, birth control, teen pregnancy, abstinence, assets building, community health needs assessment, diabetes, child injury prevention, tobacco use prevention, blood borne pathogens, chronic and infectious disease, and health leadership. Our entire agency's efforts and activities are directed toward this goal. Needs Assessments WCDPHE has considerable experience in performing needs assessments since 1991, and serves as an advisor to other health departments on this topic. Currently, the Health Education section staff is implementing phase two of a community needs assessment begun in 1996, called APEXPH: Assessment Protocol for Excellence in Public Health. This tool was developed by the Centers for Disease Control and the National Association of City and County Health Officials for use by local health departments. Phase two, the community process, will be completed in the year 2000 and provide much-needed data for evaluation of our County's family planning needs and services. In addition, WCDPHE was awarded three years of Preventive Block Grant monies to collaborate with Northeast Colorado Health Department. This project utilizes the Colorado Health Information Dataset (COHID) to identify health-related indicators for community needs assessment in three northeastern Colorado counties. Patient Care Services Delivery Model WCDPHE follows the service delivery model given in the CDPHE/Title X Guidelines, an outline of which is given as Appendix F. All services specified by the CDPHE/Title X protocols are provided by WCDPHE's FPP clinic. Registered nurses with experience in public health and family planning provide education, counseling and clinical care along with family nurse practitioners and/or women's health nurse practitioners. More information about services provided is given in the previous section, "Clinic Appointments and Service Delivery". An in-house outlet pharmacy dispenses a wide variety of contraceptives, as well as necessary antthiotics in accordance with CDPHE/Title X regulations and the State Board of Pharmacy Regulations. WCDPHE's formulary is given in Appendix G. Page 9 of 12 Confidentiality Policy WCDPHE uses the confidentiality protocol given by CDPHE/Title X. Each new employee signs this protocol upon being hired. To preserve her privacy, every client is asked how she wants to be contacted by our clinic. Medical charts and computer records are flagged with these instructions. Adolescents are encouraged and counseled to talk io parents about their reproductive health, but are advised that their visits with us are strictly confidential. Frequently, parents accompany teens to their FPP appointments. The agency's confidentiality policy is presented as Appendix H. Referrals WCDPHE follows the referral system as outlined in CDPHE/Title X guidelines. Family planning patients who need additional services are referred to one of the following agencies: d• WCDPHE's MD consult clinic • North Colorado Family Medicine's (NCFM's) residency program and colposcopy clinic • Sunrise Community Health Center ❖ Plan de Salud Health Clinic • Private providers ❖ WCDPHE's genetic counseling clinic North Range Behavioral Health ❖ Natural Family Planning League Tracking Patients who are referred for consultation are given an accompanying referral form, a copy of which is kept in a log book until the consulting clinician sends the completed form back. Clients who fail to keep appointments in the MD consult clinic are sent reminder letters. Other clients who do not follow-up with recommended referral or lab tests are contacted on a case-by-case basis, depending on the nature of the problem. A pap smear log book and tracking system is maintained to ensure that all pap smear results are received, and that all patients who need repeat paps are sent reminder letters on a regular basis. Additionally, designated laboratory tests are logged and tracked according to the Clinical Laboratory Improvement Amendments (CLIA) and CDPHE/Title X guidelines. The program coordinator receives and initiates follow up on test results for sexually transmitted diseases. Nurse practitioners review all abnormal lab tests and pap smears, with consultation available from the medical director, as necessary. Quality Assurance (QA) Review WCDPHE uses CDPHE's clinical QA review process for Title X/State-funded family planning clinics. Bi-annual medical chart audits and site visits are performed by CDPHE staff. Additionally, internal audits are performed on specialized topics chosen Page 10 of 12 annually by CDPHE, with results forwarded to the State FPP Nursing Consultant. Quality assessment and review of each patient's chart is also performed after every visit by a WCDPHE family planning nurse. Appendix I lists the criteria for chart review. Computerized Clinical Service Systems WCDPHE:'s database system, Acclaim, allows computerized patient records to be "flagged" for special purposes. Acclaim also allows for a computerized appointment system. WCDPHE does not use other computerized clinic service systems at the present time. Financial Management WCDPHE: was awarded a Title X family planning contract for $54,693 to serve 900 targeted unduplicated clients from July 1, 1999 to December 31, 1999. An additional $975 was included to provide colposcopy to 13 clients. The current request for proposal (RFP) offers a funding period from 10/1/99 to 6/30/00, a period of nine months. Based on the above projection of serving 900 clients per six months, WCDPHE proposes to serve in this nine month period: 1350 unduplicated clients in 9 months @ $76.99 per client= $103,936 A detailed budget is given in Appendix J. Budget Discussion WCDPHE's per patient costs may be higher than other Title X clinics because of the large number of Spanish-speaking and poverty-level patients served. At least 540 (40%) of family planning clients are expected to be Spanish-speaking during the nine-month grant period. The cost per patient is higher for non-English speaking patients for a variety of reasons: ❖ Time: The time necessary for clinic visits is increased by 50%-100% as a result of interpreting services. ❖ Education: Many Spanish-speakers have had very limited education about their bodies and health matters, and our nurses typically spend 509'-100% more teaching time with these patients. ❖ Literacy: New written patient information materials must be translated by our staff into Spanish. Also, patients who cannot read or write receive one-on-one assistance. At least 1,161 (85%) of family planning clients are expected to be at or below the Federal Poverty Level during 9 months. The cost per patient to deliver services is higher because of increased needs for: Access: This population typically has increased urgent needs for cornmunity services for emergency food provision, housing, medical care, and psychosocial issues. These clients often have Page 11 of 12 difficulty accessing health care, and sometimes have been turned away from other clinics because of non-compliance with appointments. WCDPHE family planning clinic staff are sensitive to these issues, and provide the time and interventions necessary to support and empower these patients. ❖ Rescheduling: Transportation problems, child-care issues, lack of employer support, family conflicts, and other multiple stressors in lower- income populations result in missed clinic appointments. Rescheduling these appointments consumes clinic resources. • Education: Decreased literacy levels and lack of knowledge about reproductive health means increased teaching time is necessary for this population. ❖ Transiency: Often, this population lives in a state of crisis orientation due to lack of stability in housing, employment, income, residence and immigration issues. Our clinic strives to be flexible to assist patients when these factors affect their reproductive health. Financial System WCDPHE's Acclaim software records program-specific charges, payments and donations for clinical services. When fees are not paid at time of service, Acclaim generates bills monthly for patients, Medicaid and other third-party payors. Patient charges are automatically discounted to the applicable sliding fee. The system also produces a report for aging accounts which are considered uncollectible after one year and are written off. The charges and receipts from Acclaim are interfaced into Weld County Government's Banner Accounting System. This system records all expenditures by program and is capable of producing a variety of reports to aide in the tracking of contract and grant management. The system also provides accounts receivable, accounts payable, inventory, and purchase requisition services. Expenditures follow the annual budget and financial plan of the Health Department, and are tracked by Weld County Government. Sliding Fee Scale WCDPHE uses a cost-based sliding fee scale consistent with Title X regulations, a copy of which is provided in Appendix K. This scale is currently being updated with input from CDPHE Women's Health Division staff. Other Benefits or Considerations The staff of WCDPHE is committed to providing comprehensive reproductive services to low income women in Weld County. Thank you for your consideration in this endeavor. This RFP is printed on Eureka Brand 30% post consumer recycled paper. Page 12 of 12 WCDPHE RO-FPP 0001 APPENDIX A - E - o 2 .„. `o o a _Ed o c gc0 bgE v. m p_ EE o n ow j o mA _ o au v .s = ' NUac". 3 F- ta' `Ec - E oc Eu 8 * Lift p „c n m E LuFco ~m or 0 a€ ctE9 , oe - c Cll t E nu aF„a 22 a c 0 o , 1 a • au e P t - Z „ c. a . = 9 ` a a O e o - a m u ,„ro- to u v H = m — u — E 2 E V'a o C u., o co ZO Q To- " d0F 2 v a °E Z 5 o nEu "u EggtiN..-r U _ W 4 Ct = a .E 8 �., g o u d ,.. in F4 C� o c = a- u C u 3 J,• 0 c A.. o 3 n o c Vc0 n — „ _ _ �-'+ ■�\ E W e co m Z, to =o c `ueo a 'c . g tO E o c ti •- U V c. t S Y o 9 W = u n u u W > d u 0 6 c ct >. — � a U u w U Et L .X 1p F Fi = a = w Q-1 c c 3 0 t o `o m y m a „1-o W K 4, '_' w cs. = .- '„ 0 O o o v $ ac3 _ = m„ _ EI- V V wo m ° E 2 ='-y a = O i-y N 9 TO 2 0.. ooV < a> i Vy' 'MCA OC � C < oO N 9 3 a F E u „ n c `° W E o e _, « c ... {yC�) h�i� cp A. I- a '�^ o w cr ,o, n=y m u W .v o '2 M` m e a a�O E � '��WeaS . o 'a 3.>2 U auoE I aWU� ,52-4--i Pc, w o o „ o e o 0 • T EU o f 1.. m ym °r A . �a t ry TV Y : C N F!Ili O W WK O C Y = a nyVFin I.,... i „ = 000i-nI 9 >U NU V oW o „ in „+ .2E uro � f-. Y OVa 2' Y rl ___ i 2O' =a e U Y P. "o- c c OhrC E-to2> —.0 OOO C W " e - - o o n O OO o a c ti= c < m Y n r, N O u t N W o o a oE _ ' na aa mo 2 E e U i ti o e ' a o >:Ea.a c c ri w WCDPHE RO-FPP 0001 APPENDIX B WCDPHE TAX-EXEMPT CERTIFICATE DR 160(WV) State of Colorado DEPARTMENT OF REVENUE 1375 SHERMAN STREET DENVER.COLORADO B0261 THIS LICENSE IS NOT TRANSFERABLE CERTIFICATE OF EXEMPTION FOR SALES AND USE TAX ONLY WELD COUNTY 915 10TH ST GREELEY CO 80632-1117 • LIABILITY INFORMATION ACCOUNT NUMBER - -- - ISSUE DATE 98-03551 03 057 599; 9 010181 OCT i4 1988 915 10TH ST GREELEY CO ExetutHe Diredut Department of Revenue WCDPHE RO-FPP 0001 APPENDIX C WCDPHE FAMILY PLANNING PROGRAM JOB DESCRIPTIONS (6) Provides counseling and teaching about family planning methods to include: a. hormonal contraceptive method (oral or implant) b . intrauterine device c.. diaphragm, cervical cap C . foam, jelly, condom, and other over-the-counter methods e . coitus interruptus f . natural family planning g. sterilization - male and female h. abstinence (7) Provides counseling and instruction about related health needs to include, but not be limited to: a. infertility b. human sexuality C. nutrition d. self-breast examination e. sexually transmitted diseases, including AIDS f. other minor gynecologic concerns (8) Performs appropriate laboratory screening tests. (9) Refers clients with suspected abnormal conditions to medical resources. (10) Refers clients to other professionals or community resources as indicated. (11) Conducts family planning education sessions for -professional, community, and client groups. (12) :taintains and reviews client records, including referral and follow-up systems. (13) Participates in the quality assurance component of family planning, e.g. , chart audit of nursing/medical care standards. (14) Participates in inservice education for agency staff. (15) Allocates time regularly to update professional practice, e.g. , reading, conferences, professional meetings, etc. (16) Adheres to the minimum medical guidelines for Title X funded programs. CDH FPP 10/91 Revised WCDPHE RO-FPP 0001 APPENDIX C WCDPHE FAMILY PLANNING PROGRAM JOB DESCRIPTIONS Family Planning Nurse Practitioner. Definition of Position: The family planning nurse practitioner is a public health nurse, specializing in the health needs of family planning clients. The family planning practitioner provides primary health care in the area of family planning, assuming the responsibility for the initiation and maintenance of clients in the family planning regime. The family planning nurse practitioner participates in an interdisciplinary approach to health care, being cognizant of and responsive to the experience of other disciplines and personnel involved with client services. The family planning nurse practitioner may also provide ' leadership in all aspects of the family planning program. She/he maintains the right to refuse to examine and/or manage a client, based on professional judgment. The family planning nurse practitioner collaborates with a physician and follows protocols signed by a physician. Level of Responsibility: Directly responsible to the family planning program coordinator and/or nursing director in the local agency. The Colorado Department of Health Family Planning Nursing Consultant provides consultation and technical guidance, and participates in the evaluation process as appropriate. Examples of Duties and Responsibilities: (1) Practices sound principles of public health nursing. (2) Participates in the decision-making processes concerning the delivery of family planning services. (3) Assesses the client's family planning needs by obtaining and/or evaluating a medical and social history. (4) Performs appropriate health assessment procedures , including but not limited to evaluation of the heart, lungs, thyroid, extremities, abdomen. breast, and pelvic area. (5) Develops and/or utilizes written protocols for the performance of activities related to initiation or modification of medical therapeutic regimes. WCDPHE RO-FPP 0001 APPENDIX C WCDPHE FAMILY PLANNING PROGRAM JOB DESCRIPTIONS Level of Responsibility: (1) Within an organized health department, directly responsible to the Health Officer or Nursing Director, and indirectly responsible to the Family Planning Program Director, Colorado Department of Health. (2) Within local county nursing services, directly responsible to both the Nursing Generalists and the Family Planning Program Director, Colorado Department of Health. The Colorado Department of Health Nursing Consultant provides consultation and technical guidance. Examples of Duties and Responsibilities : (1) Supervises and schedules nursing personnel for clinics where applicable. (2) Initiates conferences with family planning and agency personnel relative to client services. (3) Orients agency personnel to family planning services and duties within the program. (4) Evaluates work performance of personnel assigned to the family planning services. Meets frequently with staff and indicates modification of activity as needed for their continued education and supervision. (5) Conducts inservice education for district community health nurses, community health workers, RN's and LPN's , as well as giving consultation and inservice to local agencies and groups such as schools and welfare agencies. (6) Coordinates the family planning services with the generalized nursing program by establishing a communication system whereby a district community health nurse is informed about her clients and the needed follow-up. (7) In general, is responsible for all aspects of the local program, client care and education, and community development. Minimal Qualifications: Baccalaureate degree in nursing from a school accredited by the National League of Nursing, with at least one year of appropriate nursing experience with the expanded nursing function evidenced by completion of an organized educational program in either adult health or women's health care, or as a family planning nurse practititioner with a certificate; OR WCDPHE RO-FPP 0001 APPENDIX C WCDPHE FAMILY PLANNING PROGRAM JOB DESCRIPTIONS Minimal Qualifications: Baccalaureate degree in nursing from a school accredited by the National League for Nursing, with at least one year of appropriate nursing experience, with the expanded nursing function evidenced by completion of an organized educational program in either adult health or women's health care, or as a family planning nurse practitioner with a certificate; OR Graduation from a National League for Nursing approved school of nursing with at least two years of appropriate nursing experience and with the expanded nursing role as evidenced by completion of an organized educational program in adult health or women's health care , or as a family planning nurse practitioner with a certificate. Desired Skills, Knowledge, Attitudes: Knowledge of needs of clients in regard to sexuality, family planning concepts, family, and interpersonal relationships . Knowledge of public health nursing principles and practices . Knowledge of women's needs, psychosocial health, etc. Knowledge of clinic organization and its implementation. Knowledge of family planning practices, philosophies, and concerns . Special Requirements: Current license to practice as a registered nurse within Colorado. Family Planning Coordinator Definition of Position: Insures the provision of family planning services, counseling, and education to clients served by the agency. This position may be assigned full or part time status, depending upon the size of the local program. Within an organized health department, it may be assumed by the director of nursing, the clinic nursing director, or a designee. In county nursing services it may be assigned to the community health nurse or other staff assigned to the family planning program. WCDPHE RO-FPP 0001 APPENDIX C WCDPHE FAMILY PLANNING PROGRAM JOB DESCRIPTIONS Graduation from a state/NLN approved school of nursing, and three years experience, at least one of which includes supervision. Family planning nursing experience is desirable with the expanded nursing role as evidenced by completion of an organized educational program in adult health or women's health care, or as a family planning nurse practitioner with a certificate; OR A college degree and/or work experience within the social sciences or related field as deemed appropriate by the program personnel, Colorado Department of Health. Desired Skills, Knowledge, Attitudes: Knowledge of needs of clients in regard to sexuality, family planning concepts, family and interpersonal relationships. Knowledge of community health nursing principles and practices. Knowledge of women's needs, psychosocial health, etc. Knowledge of clinic organization and its implementation. Knowledge of family planning practices, philosophy and concerns. Special Requirements: Current license to practice as a registered nurse within Colorado, or other college degree as described above. Physician Service;. A. Physician's Qualifications. Physician shall meet or exceed all of the qualifications and requirements of Colorado law and the Rules of the Colorado Department of Health. During temporary periods during the year, such as a vacation, when the Physician is not available, his duties, responsibilities, and obligations under. this Agreement may be delegated to any faculty physician with the North Colorado Family Medicine group participating in the Residency Program, and whicl designee shall also meet or exceed the qualifications and requirements of Colorado law and the Rules of the Colorado Department of Health. Physician shall use reasonable efforts to notify the Weld County Department of Health of any anticipated vacations or other times when Physician may not be available. WCDPHE RO-FPP 0001 APPENDIX C WCDPHE FAMILY PLANNING PROGRAM JOB DESCRIPTIONS B. Professional Services. Physician agrees to provide the following professional services, including but not limited to: (I) Conduct random, periodic chart review, at such times as the public health administrator requests such review. (2) C onduct periodic review and approval of nursing policies, procedures, and protocols. (3) Provide general medical consultation to nursing staff at the request of the public health administrator. (4) Provide general medical consultation to the public health administrator upon the public health administrator's request. (5) Provide Medicaid billing as needed, pursuant to Medicaid requirements. (6) Provide any additional or other medical advisor services as requested by the public health administrator. BUSINESS MANAGER DESCRIPTION OF WORK General Statement of Duties: Performs a variety of highly complex administrative, technical and supervisory work in the operations- of a community services program involving the exercise of considerable independent judgment concerning division operations. Supervision Received: Works under general guidance and direction of a department head or elected official. Supervision Exercised: Exercises supervision over the administrative division of the Department. EXAMPLES OF DUTIES (any one position may not include all of the duties listed nor do the listed examples include all duties which may be found in position of this class. ) Prepares statistical reports for a variety of grant programs. Insures that individual contracts are meetingstandards. Provides for the tracking and coordination of workload measures, FTE's, and hudver WCDPHE RO-FPP 0001 APPENDIX C WCDPHE FAMILY PLANNING PROGRAM JOB DESCRIPTIONS Monitors program and financial reports; develops and submits necessary budgetary information; develops budget proposals; administers program budgets. Handles unique or complex work related problems or coordination of programs; advises staff on policy and procedure. Acts as fiscal liaison to the federal, state, public, or private agencies and other appropriate parties . Plans, directs and/or attends appropriate meetings, conferences or workshops. Investigates and proposed new funding sources including coordinator of medicaid funding. Responds to RFP's with assistance of other division heads. Performs related work as required. MINIMUM QUALIFICATIONS Required Knowledge, Skills and Abilities: Considerable knowledge of budgeting. Ability to develop and.write grant proposals. Ability to perform complex problem solving operations. Ability to supervise employees. Ability to understand and interpret complex regulations and statutes. Ability to communicate effectively orally and in writing. Ability to establish and maintain effective working relationships with employees, other agencies and the public. Knowledge of health program budgeting and funding sources. Computer fluency. Education: Bachelor's degree with major course work in public administration, management, health financing or related area. Experience: Five years of increasingly responsible job-related administrative duties with at least two years in a supervisory capacity. OR Any equivalent combination of education and experience. WCDPHE RO-FPP 0001 APPENDIX D WCDPHE FAMILY PLANNING PROGRAM STAFF RESUMES MEDICAL DIRECTOR WCDPHE RO-FPP 0001 APPENDIX D WCDPHE FAMILY PLANNING PROGRAM STAFF RESUMES PROGRAM COORDINATOR 3315 26th Street Vicky Krizant R.N., B.S.N. Greeley, CO 80631 (970) 330-4620 Work History: Registered Nurse 1/94 - Present Weld County Department of Public Health& Environment; Greeley, CO - Family Planning Program Coordinator 9/98 - Present in charge of coordinating care and management of staff in relation to the medical and psychological aspects of low-income women. - Maternity Nurse 1/94 - 8/98 provided direct services to prenatal patients. - Cross-trained to provide medical services spanning the lifetime, including diagnosis and treatment of sexually transmitted disease, HIV counseling and testing, postpartum home visitation. Registered Nurse 1/92 - 1/94 North Colorado Medical Center; Greeley, CO - Provided care to cancer patients in Oncology Unit Trainer 3/85 - 10/90 Mc:Donalds; Greeley, CO - Trained fellow employees in all areas. - Production caller, cashier, food preparation Shipping & Receiving Clerk/Cashier ,9/87 - 5/90 Country General; Greeley, CO - Customer Service - Priced merchandise, loaded/unloaded trucks Education: Bachelor Science in Nursing University of Northern Colorado; Greeley, CO August 1991 Bachelor of Arts in Sociology University of Colorado; Boulder, CO May 1978 References: Available upon request WCDPHE RO-FPP 0001 • APPENDIX D WCDPHE FAMILY PLANNING PROGRAM STAFF RESUMES BUSINESS MANAGER JUDY M. NERO 16504 Weld County Road 72 Eaton, CO 80615 Phone: (970) 454-2686 EDUCATION: Regis University. Bachelor of Science in Business Administration with Management Emphasis, December 1995 Graduated Summa Cum Laude Aims Community College Associate of Arts Degree. December 1992 EXPERIENCE: Weld County Health Department Business Office Manager September 1993 - Present Weld County Health Department Office Technician IV (Administrative Secretary) August 1985 - September 1993 Weld County Elections Department Office Technician II July 1983 - August 1985 H & R Block Income Tax Preparer January 1992 - April 1992 and January 1993 - April 1993 ATTRIBUTES: Responsible for developing budget proposal for Health Department for past six years. Provided supervision and leadership to Administration Division during reorganization of Health Department. High expectations of self for accuracy and thoroughness. Inspired the respect and trust of others through openness and integrity. Helped develop harmonious working relationships with various divisions in the Health Department. REFERENCES: Available upon request WCDPHE RO-FPP 0001 APPENDIX D WCDPHE FAMILY PLANNING PROGRAM STAFF RESUMES NURSE PRACTITIONERS DEBBIE DREW, RN-C, BSN 21259 WCR 45,LaSaile, CO 80645 Women's Health Care Nurse Practitioner Ph. (970) 284-5374 Summary of Qualifications Twenty three years nursing experience; 8 yr. in hospital (psychiatric, medical, postcaartrlIat, Gyn Post-Surgical,Labor/Delivery, Newborn Care,float) and 10 years in Community Health (08, GYN outpatient, child health, supervisory, administration), 8 years as an 0B/GYN nurse practitioner and preschool health nurse. Strengths Include effective communication skills, creativity in problem solving and Academic Credential as OB/GYN Nurse Practitioner. Education NP 1985-86 Certificate Education Women's Health Care Nurse Practitioner, Colorado University, Boulder, Colorado. BSN 1971-76 Major: Nursing, Minor: Psychology University of Northern Colorado License# 56825 Certifications: Nurse Practitioner 08/GYN Newborn Resusitation Fetal Monitoring CPR,BLS Experience September 1995 to Pre-sent: Labor/Delivery Nurse: Worked as staff nurse at Monfort Family Birth Center. Responsibilities; included labor nursing and providing couplet care to morn and babe. Trained In care of health newborn and postpartum care. Also worked on post surgical gynecology. 0B/GYN Nurse Practitioner: Continued to work at Planned Parenthood as described below and at the Weld County Health Department providing family planning-services, diagnosis and treatment of sexually transmitted diseases and limited low risk prenatal care. WCDPHE RO-FPP 0001 APPENDIX D WCDPHE FAMILY PLANNING PROGRAM STAFF RESUMES September 1990 to September 1995: GYN Nurse Practitioner at Rocky Mountain Planned Parenthood. Responsibilities include exams, pap smears, diagnosis and treatment of uncomplicated acute illness related to reproductive health, sexually transmitted disease and birth control management. Clinic Nurse: Relief work as R.N. at University of Northern Colorado in Student Health Center. Responsibilities included immunizations, health histories, assess and treat or refer for acute illness ( eg. UTI, URI). School Nurse: Practiced in-Preschool—Day Care setting. Responsibilities included pediatric assessment and referral of minor acute illness, protocol development in Gastrostomy Tube Feeding Training, member of interagency diagnostic team, health education for staff and students, provide education and nursing support to teachers of medical ly/developmentally disabled children. July 1986 to Septembor.1989 Director of Community Health Services, Weld County Health Department. Responsibilities: Budget development, contracts, program development, state grant management, staff recruitment and hiring. December 1982 to July 1986 Health Services Coordinator, Weld County Health Department Responsibilities: Supervision and scheduling of R.N.staff as well as wor`king`in the field. Women's Health Care Nurse Practitioner: Developed Nurse Practitioner protocols and established a low risk 08 Clinic for indigent care in the Health Department setting. June 1982 to December 1985 Public Health Nurse III, Weld County Health Department Responsibilities: Supervisory duties for staff of 14 R.N.s and 3 clinic aides. March 1980 to June 1982 Public Health Nurse I, Weld County Health Department Responsibilities: health screening and counseling in Family Planning, Maternity, Immunization clinics, Well Oldster and Child Health Clinics. Physical assessment sk ills and teaching extensively. Member of Child Abuse Team. WCDPHE RO-FPP 0001 APPENDIX D WCDPHE FAMILY PLANNING PROGRAM STAFF RESUMES June 1976 to March 1980 Staff Nurse, Weld County General Hospital, Greeley, CO Duties: Team nursing on a psychiatric unit. Worked in the float pool for one year. Primary care nurse In post cardiac, isolation and more extensively In medical nursing in,respiratory care and diabetes. HONORS AND6WARDS President, 1989, Colorado Community Health Nursing Director's Association COMMUNITY ACTIVITIES SIDS Support Group,Weld County, Co—Founder Girl Scout Leader; 10 yr.award, active for 21 years. REFERENCES Available on Request. RESUME Linda H. Spangenberg, MSN, FNP 1319 Cranford Place Greeley, CO 80631 (970) 356-5266 EDUCATION B.A. Distributed Studies: Psychology, Biology & Chemistry University of Colorado, Boulder, 1981 B.S.N. Nursing (Cum laude) • University of Northern Colorado, Greeley, 1991 M.S.N. Family Nurse Practitioner Regis University, Denver, July 1997 PROFESSIONAL EXPERIENCE 7/97 - present Family Nurse Practitioner Weld County Health Department (WCHD), Greeley, Colorado. Responsibilities: To provide clinical care in an independent setting to low- income clients, including many Spanish-speakers and many teens. Physician consult is available by phone and by site visit three hours per week. While not yet fluent in Spanish, I require only occasional interpreter assistance. Prenatal Clinic - I see women with low- to moderate-risk pregnancies. Significant complications are common. Family Planning Clinic - I provide routine gynecologic exams and birth control services for teens and adults. Sexually Transmitted Disease Clinic - I provide exams, diagnosis an d treatment of men and women following the model of the CDC STD training site/clinic in Denver. I read my own wet preps. Child Health Clinic - I give well-child exams, school physicals, and immunizations for newborns through age eleven. I will also treat incidental acute conditions found on exam. General consultation - I serve as a consultation resource to WCHD's staff of community health nurses and to the general public via telephone. (I) 1993 - 7/97 Community Health Nurse II Weld County Health Department, Greeley, Colorado. Responsibilities: Sexually Transmitted Disease Clinic - Histories, physical exams, diagnoses and treatment. Maternity Program - Charge nurse. Child Health Program -Histories, physical exams and immunizations of well children, newborn to age 12. Home visits - Postpartum physical exams of mother and newborn, breastfeeding support, education, community liaison. Family Planning -. Histories, contraception education. Communicable disease - Adult immunizations, TB medications, PPD placement and evaluation, telephone information, travel immunizations advice. 1992-1993 Home Health Nurse and Interim Nursing Director Greeley Center for Independence, Greeley, Colorado Responsibilities: Staff supervision and training, Medicaid billing. Care of patients with chronic disabilities: ventilator-dependent, quadriplegia, head injuries, multiple sclerosis, muscular dystrophy 1991 Staff Nurse Poudre Valley Hospital, Ft. Collins, Colorado Responsibilities: Medical and cardiovascular acute care. CLINICAL PRACTICUMS Spring, 1996 Denver Metro Health Network, Aurora, Colorado Summer, 1996 Weld County Health Department, Greeley, Colorado Fall, 1996 Monfort Children's Clinic, Greeley, Colorado Spring, 1997 Student Health Center, Colorado State University, Ft. Collins, CO PROFESSIONAL ORGANIZATIONS Sigma Theta Tau, Nursing Honor Society American Nurses Association/Colorado Nurses Associat Colorado Breastfeeding Task Force Association of Nurse Practitioners in Reproductive Health References and list of continuing education credits available upon request. (2) 4/98 WCDPHE RO-FPP 0001 APPENDIX D WCDPHE FAMILY PLANNING PROGRAM STAFF RESUMES WCDPHE RO-FPP 0001 APPENDIX E LETTERS OF COMMUNITY SUPPORT Letter 1: Weld County Board of Commissioners Letter 2: Robert Francella Business Manager Monfort Children's Clinic Letter 3: Mark Wallace, M.D. Medical Director Weld County Department of Public Health and Environment and Medical Residency Program North Colorado Family Medicine North Colorado Family Medicine ratit \ OFFICE OF BOARD OF COMMISSIONERS 1 PHONE (970) 356-4000, EXT. 4200 �J FAX: (970) 352-0242 WI II 915 10TH STREET O' P.O. BOX 758 GREELEY, COLORADO 80632 1i COLORADO July 20, 1999 Colorado Department of Public Health and Environment Attn: Robert O'Neill, Director of Purchasing ASD-Purch-A2 4300 Cherry Creek Drive Denver, CO 80248 Dear Mr. O'Neill: The Weld County Board of County Commissioners fully supports our county's application for the continuation of federal funding for provision of family planning services to low income individuals. The Weld County Department of Public Health and Environment is making application for this funding. We feel, as a board of county commissioners, that early and comprehensive family planning services offered to our citizens considerably enhances their health, safety, and welfare. Our County Department of Public Health and Environment has established exemplary programs of health services for our citizens who, for financial limitation reasons would otherwise go without vital health care. We sincerely encourage your positive consideration of this grant request on behalf of Weld County citizens. Very truly yours, BOARD OF COUNTY COM ISSIONERS V ! _ 15ale K. all, Chair arbara J. ' kme er, Pro m �Geo e E. Baxter . . Geile enn Va MONF OR T + elt♦ 4p. 0 �^, 0 dd' ' Chi Idre 1'1'S CLINIC C A N I N G F O N S I D S August 6, 1999 Colorado Department of Public Health and Environment Attention - Robert O'Neill, Director of Purchasing ASD-PURCH-A2 4300 Cherry Creek Drive Denver, Colorado 80222 Dear Mr. O'Neill, The Monfort Children's Clinic enthusiastically supports the Weld County Department of Public Health and Environment's application for funding to continue its family planning program. The Monfort Children's Clinic was created in 1995 and provides complete pediatric and adolescent healthcare services for low-income families. Approximately 20% of our clients are adolescents and we have many young moms who frequently have several children and utilize the services offered. Since 1997, the Health Department has deployed staff members to the Monfort Children's Clinic on a regular basis to provide medical and social supports and referrals to appropriate community agencies. During their clinics here, they promote male and female reproductive health including testing, blood pressure screening, contraception dispensing and education, STD testing and treatment and are partners with us in providing immunizations. This fine organization has proven its ability and commitment to providing these services to low-income individuals. In fact, we are in the process of expanding our partnership with the Health Department to offer a greater level of these services, and I am excited about the Health Department's increased presence in our facility. Finally, it is important to note that the Weld County Health Department is culturally sensitive in its staffing and programming, works cooperatively to offer a wide range of quality services with many community agencies. Please do not hesitate to call if you would like any further information. Best Regards, Wiat4(efil/ Bob Francella Executive Director 100 North 11th Avenue • Greeley, CO 80631-2011 • (970)352-8898 • FAX (970) 351-7075 • E-P3All mccllnic@pawneenet.com North Colorado Family Medicine A service of North Colorado Medical Center Residency Training Program 1600 23rd Ave. Greeley,CO 80631 (970)356-2424 August 9, 1999 Robert O'Neill Director of Purchasing Colorado Department of Public Health and Environment 4300 Cherry Creek Drive South Denver, Colorado 80246-1530 Dear Mr. O'Neill: This letter serves as my strongest support for the family planning services provided by the Weld County Department of Public Health and Environment. Without this agency's active role in providing crucial services to residents of our county, the family planning needs of many, many people in our county would be unmet. As a family physician actively seeing men and women desiring contraception I know first-hand how critical a role our local health department plays in providing a safety-net for the residents of Weld County. As much as I am impressed with the commitment local physicians and practitioners make to meeting the needs of the under-served in our community,the reality remains that the local health department plays a key role in providing basic preventive health services to hundreds and hundreds of clients each year. I urge the Colorado Department of Public Health and Environment to renew grant support for the family planning services provided by the Weld County Department of Public Health and Environment. Without this ongoing financial support services to needy men and women would be eliminated resulting in devastating outcomes such as increased numbers of undesired pregnancies. Our county and its residents cannot afford to see such integral and valuable services eliminated for a lack of funding. Sincerely, k sk, ^ Mark E. Wallace, MD, MPH Assistant Administrator for Graduate and Continuing Medical Education, NCMC Program Director,North Colorado Family Medicine A member of Western Rains Health Network WCDPHE RO-FPP 0001 APPENDIX F OUTLINE OF WCDPHE'S FAMILY PLANNING CLINIC/TITLE X PATIENT CARE SERVICES DELIVERY MODEL Health Care Services Outline I. Initial Visit A. Education (group or individual) B. Financial information C. Complete medical history D. Weight and height E. Pap smear F. Hematocrit C. Chlamydia screening for women 21 years and under H. Blood pressure I. Interview from medical history J. Complete physical examination K. Post-exam interview L. Supplies as needed M. Return appointment made II . Annual Visit A. Update data base , including medical history and financial information, as needed B. Weight C. Pap smear D. Hematocrit, if IUD present E. Indicated laboratory tests F. Chlamydia screening for women 21 years and under G. Blood pressure H. Interview I. Physical examination J. Post.-exam interview/education K. Supplies as needed L. Return appointment made III. Revisit A. Update data base B. Weight, if applicable C. Blood pressure D. Interview E. Indicated laboratory tests F. Indicated physical. exam G. Post interview/education H. Supplies I. Return appointment, as indicated IV. Problem A. Update data base WCDPHE RO-FPP 0001 APPENDIX F OUTLINE OF WCDPHE'S FAMILY PLANNING CLINIC/TITLE X PATIENT CARE SERVICES DELIVERY MODEL B. Weight C. Blood pressure D. Interview E. Indicated laboratory tests F. Indicated physical exam G. Post interview/education H. Supplies I. Return appointment or referral, as indicated V. Supply Visits A. Record verified for date of last examination B. Order verified for oral contraceptive pills, number of cycles already dispensed, and number of cycles left on prescription C. Update on any problems or concerns VI. Visits by method contraceptives A. Oral contraceptives 1. New to method 3 cycles, then return for 3-month pill evaluation 10 cycles (maximum) if pill evaluation normal 2. Annual Up to 13 cycles (maximum) 3. Revisits High risk every 6 months (see Special Risk Factors Consent OCP.003) Individual discretion for more frequent visits may be made for saecial circumstances, i.e. , teens, changing eligibility status, slightly elevated B/P, heavy smoking, etc. B. IUD 1. New insertion 6-12 week post-insertion exam 2. Annual 3. Revisits, as needed C. Diaphragm 1. Return within 2-4 weeks for evaluation and fit check 2. Annual or bi-annual visit 3. Revisits, as needed D. Cervical cap 1. 3 months after initial fitting, for repeat Pap smear 2. Annual visit 3 . Revisits, as needed WCDPHE RO-FPP 0001 APPENDIX F OUTLINE OF WCDPHE'S FAMILY PLANNING CLINIC/TITLE X PATIENT CARE SERVICES DELIVERY MODEL E. Foam and condoms 1. Annual or bi-annual visit 2. Revisits, as needed F. Natural family planning 1. Annual or bi-annual visit 2. Revisits, as needed G. Sterilization 1. Annual or -bi-annual visit 2. Revisits, as needed H. Norplant 1. 2 weeks after insertion 2. 3 months after insertion 3. Annual visit 4. Revisits, as needed I. DMPA (Depo Provera) 1. Every twelve weeks for re-injection 2. Annual visit 3. Revisits, as needed WCDPHE RO-FPP 0001 APPENDIX G WCDPHE'S OUTLET PHARMACY FORMULARY Drug Formulary Ihr Weld County Public Health Department 3-26-99 Oral : amoxicillin 250 mg capsule (pa) clindamycin 150 mg capsule (po) doxycycline 100 mg tablet/capsule (po) erythromycin 250 mg & 500 mg tablet/capsule (pa) ferrous fluconate 300 mg tablet (po) metronidazole 500 mg tablet (po) trimethoprini/pulfamethoxg ole US tablet (po) cefixime 400 mg tablet (pq) vitapiins-prpplttal with (blip acid tablet (pa) azithromycin 1 cm powder packet Tor reconstitution (pa) acyclovir 400 m3 tablet (po) oflnxacin 4q0 mg tablet (po) nitrofurantoln macro crystals tablet/capsule (Macrobid) (po) Iluconazole 150 mg tablet Oral Birth Control tablets : Damien 1/35-28 (po) (senora-28 (pa) Loestrin FR 1/51 (po) La Ovral-28 (pa) Nordetle-28 (po) Ortho-Cept 28 (pa) firth() Novum 1/35-28 (pa) Ortho-Novum 7/7/7-28 (pa) Oveon-28 (po) Micronor-28 (progestin only) (pa) Ovrettc-28 (progestin only) po Triphasil-28 (po) 'Fri-Cyclen-28 (po) Otho-C:yc len-28(po). Alesse (levonorgestrel 0.Img/estradiol 0.02mg) (po) * '[apical agents: clotrimazole 1% vaginal cream(intravaginul) nystatin cream (topical) lice shampoo 0.3% Pyrethins (topical shampoo) APPROVED 25% Podophyllin in tincture of Benzoin (topical) trichloroacetic acid in 50�%o alurhol 60/90 (topical) STATE BOARD OF FfARMACY9 WCDPHE RO-FPP 0001 APPENDIX G VVCDPHE'S OUTLET PHARMACY FORMULARY WCPH Dept Formulary list continued: Igjeetables: diphenhydramine (Benadryl) 50 mg/lml ampullvial epinephrine 1:1,000 ampul (parenteral) medroxyprogcsterone acetate 150 mg suspension (IM) penicillin 13 benzathine suspension 1.2 million units(IM) (regliigerated) ceflrlaxone 250 mg powder vial (TM) lidocaine 1% solution (local injectable anesthetic) Immunization vaccines (all vaccines arc properly stored under refrigeration/freezer): Cholera 0.5 ml(subcutaneous injection —SQ) Diptheria, tetanus and Pertussis vaccine (DP'I') 0.5 ml (IM) Ilemophaelis linfluenza B (HID) vaccine conjugate 0.5 ml (1M) InfIttema vaccine 0.5 ml (IM) Immune Globillin(1G) dose varies by patient weight (TM) Injectable polio vaccine(IPV) 0.5 ml (IM) Measles, Mumps, Ruehella vaccine(MMR) powder to reconstitue (1M) Live trivalent oral polio vaccine(' dose per vial (po-liquid) I'neumoccal vaccine,polyvalent 0,5 ml (TM) 'l uberculen purified proteins derivative-Mantoux(PPD) 0.1 ml (iniradermal) Tetanus, Diptltcria vuuane(TD) 0.5 ml (IM) Typhoid vaccine(q tablets) (po) Japanese Encephalitis phaliitis vaccine 1 ml powder for rceonstitution(subcutancuus) Meningococcal Polysacharide vaccine, groupA,C,Y & W 135 eomhined,0.5 ml (SQ) Rabies vaccine I ml (lb) Typhoid Vi polysaccharide vaccinc('I'yphoid) 0.5 ml (SQ) Yellow Fever 0.5 ml powder to reconstitute (SQ) Varicella(varivax) 0,5 nil (SQ Diptheria, tetanus, Accellular Pertussis vaccine(DTaP) 0.5 ml (IM) [WI' combined with Ilemophaclis Influenza B(Tetramune) 0.5 ml ((M) Hepatitis A vaeeine(adult) (1-lavrix) I rnI (IM.) Itepant's A vaccine, inactivated (age 2) 0.5 ml (I M) Hepatitis 13 vaccine 1 ml adults, 0.5 ml Adolescents or infants (TM) liemophaclis 13 conjugate vaccine 0.5 nil (IM) Ilaemophilus h Conjugate (Meningocoecal Protein Conjugate) and I lepatitis 13 Vaccine (IM) Rain Virus Vaccine, (yo )+' �y p y uj� APPROVEDc S STATE BOARD OF r WCDPHE RO-FPP 0001 APPENDIX H WCDPHE'S CONFIDENTIALITY POLICY SUBJECT: Confidentiality PURPOSE: To document that each staff member has been oriented to and agrees to abide by the strictest rules of confidentiality. To that end, all CI-IN staff will read the following policy. POLICY STATEMENT: Custody of Records The director at the Weld County Department of Public Health & Environment is considered to be the designated legal custodian of all patient records. Questionable disclosures to persons other than the patient and/or his or her legal guardian must be approved by the Director prior to release. Furthermore, the public health agency is responsible for the provision of a safe place for storage of patient records to prevent disclosure to unauthorized persons. Patient records will be kept in a locked room when not in use and must not be left where other than authorized persons have access to them. Disclosure of Confidential Information- Conditions and Limitations 1. The law states that the custodian of records (defined as any authorized person having personal cusl:ody and control of the public records in question, e.g., the public health nurse) shall deny the right of inspection of the patient records except to the "person in interest." The person in interest means and includes the person who is the subject of record or any representative designated by said person. A parent or duly appointed legal representative will be the person in interest if the subject of the record is under legal disability. The law further states that either the custodian or person of interest may request a professionally qualified person to be present to interpret records. If it is the opinion of the custodian of a public record that disclosure of the contents of said record could produce substantial injury to the public interest, he may apply to the district court of the district in which the record is locate for an order permitting him to restrict such disclosure. The foregoing provision applies to the inspection of records, as contrasted with the release or contrasted with the release of transmittal records. The law, however, provides that in all cases in which a person has the right to inspect a public record, he may request that he be furnished copies of such record. The custodian can charge a reasonable fee for this duplication. The custodian may make such rules and regulations with reference to the inspection and duplication of records as shall be reasonable necessary for the protection of such records and the prevention of necessary interference with the regular discharge of the duties of the custodian or his office. WCDPHE RO-FPP 0001 APPENDIX H WCDPHE'S CONFIDENTIALITY POLICY 2. Release of Information will only occur with the original signature of"person in interest" on a Release of Information form. Copies of an R.O.I. therefore, will not be accepted. 3. The exceptions to disclosure of confidential material is when abuse or neglect is suspected. Then information will be turned over to proper legal authorities. No informatio:a will be released to a court, and no staff member may attend a hearing unless he/she receives a subpoena. This subpoena must be submitted to the County Lawyer for review. Other considerations in maintaining Confidentiality 4. All person employed in the public health agency should be oriented to the importance of safeguarding the confidential nature of the record and any other patient information by interview or any other means is essential. Office and clinic facilities should he such that patient information is not inadvertently revealed to persons in the waiting room or any place in his home or on the street while neighbors, relatives, or other persons are present. Only those staff of the public health agency with a"need to know" should have access to the client's record. "Need to know" is defined as that information necessary to carry out the plan of care for the client and such related activities as billing procedures for reimbursement. Upon employment all staff of the public health agency shall be oriented to the policy of confidentiality with documentation in the staff personnel file of such orientation. 5. Each staff member will be required to sign a statement that he/she has read and agrees to abide by the confidentiality policy as stated. A copy will be kept in each individual's employee file. 6. Any failure to comply with this confidentiality policy by any employee of the Weld County Department of Public Health & Environment will be grounds for disciplinary action; up to and including termination of employment. 7. I have read and I understand all of the above provisions of this Confidentiality Policy. WCDPHE Employee Signature Date WCDPHE Witness Signature Date Formulated: (Date: 01/1994) Reviewed: (Date: Month/Year) Rrviceri• (r)nte 05/19991 WCDPHE RO-FPP 0001 APPENDIX I WCDPHE'S FAMILY PLANNING PROGRAM QUALITY ASSURANCE CRITERIA FOR CHART REVIEW CRITERIA FOR CHART REVIEW A. Vital Signs 1. Blood pressure 2. Weight 3. ' Height 4. Last menstrual period B. Lab Results - done as indicated and entered in chart 1. Hematocrit/hemoglobin 2. Urine screening for protein and sugar 3. Pap smear 4. Gonorrhea culture 5. Pregnancy test 6. Special chemistries 7. Wet smears 8. Chlamydia screen C. Appropriate Physical Exam 1. Standards for routine visits met 2. Appropriate exam for problems D. Health Issues Addressed Evidence that medical history was complete and reviewed Clinical Diagnosis/Impression/Assessment Recorded Problem areas from history, physical examination, and interviewer's notes identified and recorded, if applicable F. Treatment Plan Outlined (Excluding any BC method) 1. Medication orders correctly written and dispensed 2. Other measures outlined - psycho-social follow-up 3. Referrals documented G. Procedures described (IUD Insertion, Diaphragm Fitting, Cap Fitting, etc. ) H. Follow-up Specified (Return to clinic, etc. ) I. Clinical Judgement (Based on patient: statements, laboratory, physical exam, etc. ) 1 . Accuracy of clinical impression 2. Appropriateness of prescription and person writing it 3. Appropriate consultation obtained and noted, as applicable 4. Appropriate referral made if applicable J. Method Noted 1. OCP prescription correctly written and dispensed 2. Diaphragm type and size written 3. Cap type and size correctly written and dispensed L Tim tuna and avniraf-inn dahn written WCDPHE RO-FPP 0001 APPENDIX I WCDPHE'S FAMILY PLANNING PROGRAM QUALITY ASSURANCE CRITERIA FOR CHART REVIEW 5. Continuation of a method noted 6. Reason for any method change or reason method deferred t. Signature and Title , 1. Provider signature and title 2. Co-signature and title as indicated 3. Legible L. Subsequent Follow-Up - Medical referral response/report in chart M. Consent Forms Appropriate consent forms (complete and in ink) related to patient visit in chart N. Income Information Complete 0. Education 1. All methods discussed, at the initial exam and as indicated 2. Nutrition education, specific to history, physical findings, and birth control method 3. SEE 4. AIDS education (See AIDS Policy regarding content) 5. Reproductive A&P, at initial exam and as indicated 6. Appropriate other education given as indicated by history and physical exam to include but not be limited to: a. Rubella b. DES c. Vaginal infection/STD treatment d. UTI WCDPHE RO-FPP 0001 APPENDIX J DETAILED BUDGET PROPOSAL FOR WCDPHE'S FAMILY PLANNING PROGRAM 10/1/99 - 6/30/00 I APPLICANT I REQUESTED FTE TOTAL I & OTHER I FROM CDPHE PERSONAL SERVICES I I Coordinator(MGR) I I Nurse Practitioner 1.20 $ 52,724 I $ I $ 52,724 Nurse 3.05 88,667 58,242 I- :30,425 Aide (LPN) Clerk (Secty) 2.40 38,890 I 38,890 Social Worker I I Physician I I Lab. Technician Director(Supervisor) .79 28,407 28,407 Educator I I Direct P.S. 7.44 $208,688 I $125,539 I $ 83,149 I i FRINGE 52;172 I 31,385 I 20,787 Subtotal P.S. I I $260,860 I $156,924 I $103,936 CONTRACTUAL SERVICES I I Nurse Practitioner I I I I Physician 3,300 I 3,300 Pharmacist 263 I 263 Nurse I I Aide Subtotal C.S. 3,563 3,563 I I OPERATING EXPENSES Lab Services & Supp. 42,469 I 42,469 Educational Supp Drugs & Cont. 57,956 57,956 Other Supp & Exp. 5,248 I 5,248 I Staff Training 975 I 975 I Outreach I I Malpractice Ins. I I Telephone I I I I Subtotal O.E. 106,648 I 106,648 TRAVEL 724 724 EQUIPMENT 386 386 INDIRECT 27,704 27,704 I I TOTAL PROGRAM COSTS $399,885 $295,949 i $103,936 WCDPHE RO-FPP 0001 APPENDIX J DETAILED BUDGET PROPOSAL FOR WCDPHE'S FAMILY PLANNING PROGRAM 10/1/99 - 6/30/00 REVENUE SOURCES: CDPHE - Women's Health $103,936 Medicaid 5,192 Patient Donations 7,080 Patient Fees 30,292 In-Kind (Weld County Government) 253,385 TOTAL $399,885 WCDPHE RO-FPP 0001 APPENDIX K WCDPHE'S FAMILY PLANNING PROGRAM SLIDING FEE SCALE 1999 Developed From CDPHE/Title X Guidelines Family Annual Income Monthly Income Weekly Income INCOME Size CODE < 8,240 < 687 < 158 1 1 8,240 - 12,360 687-1,030 158 -238 2 12,361-16,480 1,031-1,373 239-317 3 > 16,480 1,374-2,060 > 317 4 < 11,060 < 922 < 213 1 2 11,060 - 16,590 922 - 1,383 213-319 2 16,591 -22,120 1,384 - 1,843 320-425 3 > 22,120 1,844 -2,765 >425 4 < 13,880 < 1,157 < 267 1 3 13,1380-20,820 1,157- 1,735 267 -400 2 20,1321 -27,760 1,736 -2,313 401 - 534 3 > 27,760 2,314-3,470 > 534 4 < 16,700 < 1,392 < 321 1 4 16,700-25,050 1,392 -2,088 321 -482 2 25,051 - 33,400 2,089 -2,783 483 -642 3 > 33,400 2,784-4,175 >642 4 < 19,520 < 1,627 < 375 1 5 19,520 -29,280 1,627 -2,440 375- 563 2 29,281 -39,040 2,441 -3,253 564 -751 3 > 39,040 3,254-4,880 > 751 , 4 < 22,340 < 1,862 <430 1 6 22,340 -33,510 1,862 -2,793 430 -644 2 33,511 -44,680 2,794 - 3,723 645 -859 3 >44,680 3,724 -5,585 > 859 4 < 25,160 < 2,097 <484 1 7 25,160 -37,740 2,097- 3,145 484 - 726 2 37,741 -50,320 3,146-4,193 727 -968 '3 > 50,320 4,194-6,290 > 968 4 <27,980 <2,332 < 538 1 8 27,1390 -41,970 2,332 - 3,498 538 -807 2 41,971 - 55,960 3,499 -4,663 808- 1,076 3 >55,960 4,663-6,995 > 1,076 4 eNorth Colorado Family Medicine A service of North Colorado Medical Center Residency Training Program 1600 23rd Ave. Greeley,CO 80631 (970)356-2424 August 9, 1999 Robert O'Neill Director of Purchasing Colorado Department of Public Health and Environment 4300 Cherry Creek Drive South Denver, Colorado 80246-1530 Dear Mr. O'Neill: This letter serves as my strongest support for the family planning services provided by the Weld County Department of Public Health and Environment. Without this agency's active role in providing crucial services to residents of our county, the family planning needs of many, many people in our county would be unmet. As a family physician actively seeing men and women desiring contraception I know first-hand how critical a role our local health department plays in providing a safety-net for the residents of Weld County. As much as I am impressed with the commitment local physicians and practitioners make to meeting the needs of the under-served in our community, the reality remains that the local health department plays a key role in providing basic preventive health services to hundreds and hundreds of clients each year. I urge the Colorado Department of Public Health and Environment to renew grant support for the family planning services provided by the Weld County Department of Public Health and Environment. Without this ongoing financial support services to needy men and women would be eliminated resulting in devastating outcomes such as increased numbers of undesired pregnancies. Our county and its residents cannot afford to see such integral and valuable services eliminated for a lack of funding. Sincerely, k Mark E. Wallace, MD, MPH Assistant Administrator for Graduate and Continuing Medical Education, NCMC Program Director,North Colorado Family Medicine A member of Western Plains Health Network "v/ North Colorado family Medicine A service of North Colorado Medical Center Residency Training Program 1600 23rd Ave. Greeley,CO 80631 (970)356-2424 August 9, 1999 Robert O'Neill Director of Purchasing Colorado Department of Public Health and Environment 4300 Cherry Creek Drive South Denver, Colorado 80246-1 53 0 Dear Mr. O'Neill: This letter serves as my strongest support for the family planning services provided by the Weld County Department of Public Health and Environment. Without this agency's active role in providing crucial services to residents of our county, the family planning needs of many, many people in our county would be unmet. As a family physician actively seeing men and women desiring contraception I know first-hand how critical a role our local health department plays in providing a safety-net for the residents of Weld County. As much as I am impressed with the commitment local physicians and practitioners make to meeting the needs of the under-served in our community, the reality remains that the local health department plays a key role in providing basic preventive health services to hundreds and hundreds of clients each year. I urge the Colorado Department of Public Health and Environment to renew grant support for the family planning services provided by the Weld County Department of Public Health and Environment. Without this ongoing financial support services to needy men and women would be eliminated resulting in devastating outcomes such as increased numbers of undesired pregnancies. Our county and its residents cannot afford to see such integral and valuable services eliminated for a lack of funding. Sincerely, Mark E. Wallace, MD, MPH Assistant Administrator for Graduate and Continuing Medical Education,NCMC Program Director,North Colorado Family Medicine A member of Western Plains I Iealih Network 0 North Colorado Family Medicine A service of North Colorado Medical Center Residency Training Program 1600 23rd Ave. Greeley,CO 80631 (970)356-2424 August 9, 1999 Robert O'Neill Director of Purchasing Colorado Department of Public Health and Environment 4300 Cherry Creek Drive South Denver, Colorado 80246-1530 Dear Mr. O'Neill: This letter serves as my strongest support for the family planning services provided by the Weld County Department of Public Health and Environment. Without this agency's active role in providing crucial services to residents of our county,the family planning needs of many, many people in our county would be unmet. As a family physician actively seeing men and women desiring contraception I know first-hand how critical a role our local health department plays in providing a safety-net for the residents of Weld County. As much as I am impressed with the commitment local physicians and practitioners make to meeting the needs of the under-served in our community, the reality remains that the local health department plays a key role in providing basic preventive health services to hundreds and hundreds of clients each year. I urge the Colorado Department of Public Health and Environment to renew grant support for the family planning services provided by the Weld County Department of Public Health and Environment. Without this ongoing financial support services to needy men and women would be eliminated resulting in devastating outcomes such as increased numbers of undesired pregnancies. Our county and its residents cannot afford to see such integral and valuable services eliminated for a lack of funding. Sincerely, l ""o ket Mark E. Wallace, MD, MPH Assistant Administrator for Graduate and Continuing Medical Education, NCMC Program Director, North Colorado Family Medicine A member of Western Plains I lealih Network "'--'/ North Colorado Family Medicine A service of North Colorado Medical Center Residency Training Program 1600 23rd Ave. Greeley,CO 80631 (970)356-2424 August 9, 1999 Robert O'Neill Director of Purchasing Colorado Department of Public Health and Environment 4300 Cherry Creek Drive South Denver, Colorado 80246-1530 Dear Mr. O'Neill: This letter serves as my strongest support for the family planning services provided by the Weld County Department of Public Health and Environment. Without this agency's active role in providing crucial services to residents of our county, the family planning needs of many, many people in our county would be unmet. As a family physician actively seeing men and Women desiring contraception I know first-hand how critical a role our local health department plays in providing a safety-net for the residents of Weld County. As much as I am impressed with the commitment local physicians and practitioners make to meeting the needs of the under-served in our community, the reality remains that the local health department plays a key role in providing basic preventive health services to hundreds and hundreds of clients each year. I urge the Colorado Department of Public Health and Environment to renew grant support for the family planning services provided by the Weld County Department of Public Health and Environment. Without this ongoing financial support services to needy men and women would be eliminated resulting in devastating outcomes such as increased numbers of undesired pregnancies. Our county and its residents cannot afford to see such integral and valuable services eliminated for a lack of funding. Sincerely, ig autt 1416 Mark E. Wallace, MD, MPH Assistant Administrator for Graduate and Continuing Medical Education,NCMC Program Director,North Colorado Family Medicine A member of Western Plains Health Network 9-0 North Colorado Family Medicine A service of North Colorado Medical Center Residency Training Program 1600 23rd Ave. Greeley,CO 80631 (970)356-2424 August 9, 1999 Robert O'Neill. Director of Purchasing Colorado Department of Public Health and Environment 4300 Cherry Creek Drive South Denver, Colorado 80246-1530 Dear Mr. O'Neill: This letter serves as my strongest support for the family planning services provided by the Weld County Department of Public Health and Environment. Without this agency's active role in providing crucial services to residents of our county, the family planning needs of many. many people in our county would be unmet. As a family physician actively seeing men and women desiring contraception I know first-hand how critical a role our local health department plays in providing a safety-net for the residents of Weld County. As much as I am impressed with the commitment local physicians and practitioners make to meeting the needs of the under-served in our community, the reality remains that the local health department plays a key role in providing basic preventive health services to hundreds and hundreds of clients each year. I urge the Colorado Department of Public Health and Environment to renew grant support for the family planning services provided by the Weld County Department of Public Health and Environment. Without this ongoing financial support services to needy men and women would be eliminated resulting in devastating outcomes such as increased numbers of undesired pregnancies. Our county and its residents cannot afford to see such integral and valuable services eliminated for a lack of funding. Sincerely, f - o - At Mark E. Wallace, MD, MPH Assistant Administrator for Graduate and Continuing Medical Education, NCMC Program Director,North Colorado Family Medicine A member of Western Plains Health Network 4111 mEmORAnDum wilk To Dale Hall, Chair Date Augus 13, 1999 COLORADO Board of County Commissioners From John Pickle, Director, Department of Public Health and Environment Subject: State funds for Family Planning Program 17 , Enclosed for Board review and approval is a proposal for non-Federal funding of the Family Planning Program for the Weld County Department of Public Health and Environment from the State of Colorado. This is the first time that Family Planning agencies were required to submit a bid for funding from the State. Weld County seeks to continue provision of Family Planning Services to the increasing number of Weld County residents who seek this vital service. The funding period for this request runs from October 1, 1999 to June 30, 2000. The resulting contract may be renewed for one additional year at the sole discretion of the State. I recommend your approval of this bid. Enclosures Crg2c 1 Hello