HomeMy WebLinkAbout20242540.tiff Mariah Higgins
From: Bill Fritz
Sent: Wednesday, December 31, 2025 9:52 AM
To: CTB
Cc: Jason Chessher; Shaun May;Amanda Gomez
Subject: MCH OL#5 for Communication
Attachments: MCH Option Letter#5.pdf
Follow Up Flag: Follow up
Flag Status: Flagged
I have attached Option Letter#5 for the Maternal and Child health grant. Please communicate to the board.
Thanks Bill
•
WELW
COUNTY,CO
Bill Fritz
Finance Manager
Weld County Department of Public Health and Environment
Desk: 970-400-2122
1555 North 17th Ave., Greeley, CO 80631
011000
Join Our Team
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coM►Avn ; co,+;on S 1 2024 -251-10
°1/12-/26 1-1L 005 -7
Docusign Envelope ID:222DC71A-5776-4C5E-95DC-F2524FD9177A
Exhibit E
FOR SUBRECIPIENTS ONLY
This is a supporting document for Contract Number: 2022*0912 Option Letter#5
The updated information provided here does not modify the original contract or original task order in any way.
The information provided here informs the grantee of updated items that are required under 2 CFR 200.332.
Data Required by 2 CFR 200.332(All pass through entities must ensure that every subaward is clearly identified to
the subrecipient as a subaward and includes the following information at the time of the subaward.If any of these
data elements change,the changes are to be reflected in subsequent subaward modification.When some of this
information is not available,the pass-through entity must provide the best available information when some of the
information below is unavailable.A pass-through entity must provide the unavailable information when it is
obtained.):
A. Subrecipient name(which must match the name associated with its unique entity identifier):
Shown in Contractor box on cover page of original contract and subsequent modifications.
B. Subrecipient's unique entity identifier:MKKXT9U9MTV5
C. Federal Award Identification Number(FAIN):B0455424
D. Federal Award Date(when Federal award was signed by authorized official of the Federal
awarding agency): 12/12/2025
E. Subaward Period of Performance Start and End Date: Start date shown on cover page of original
contract and end date shown on cover page of original contract,as updated by any subsequent
modifications.
F. Subaward Budget Period Start and End Date: Start date shown on cover page of original contract
and end date shown on cover page of original contract,as updated by any subsequent
modifications.
G. Amount of Federal Funds Obligated by this action by the pass-through entity to the subrecipient:
Shown on Budget Exhibit in column matching this contract modification.
H. Total Amount of Federal Funds Obligated to the subrecipient by the pass-through entity including
the current financial obligation:Shown on cover page of this contract modification and on Budget
Exhibit.
I. Total Amount of the Federal Award committed to the subrecipient by the pass-through entity:
Shown on cover page of this contract modification and on Budget Exhibit.
J. Federal award project description,as required to be responsive to the Federal Funding
Accountability and Transparency Act(FFATA):Maternal and Child Health Services
K. Pass-through entity is shown on the cover page in the State Agency box.Name of Federal
awarding agency:Department of Health and Human Services,Health Resources and Services
Administration.Contact information for the awarding official of the Pass-through entity:
Rachel Hutson;rachel.hutson@state.co.us
L. Assistance Listing number and Title;the pass-through entity must identify the dollar
amount made available under each Federal award and the Assistance Listing Number at
time of disbursement:93.994 Maternal and Child Health Services Block Grant to the States/
$2,530,119.00
M. Identification of whether the award is R&D:No
N. Indirect cost rate for the Federal award(including if the de minimis rate is charged)per§200.414:
Shown on Budget Exhibit as indicated by indirect rate and amount.
Option Letter Contract Number:2022*0912 Option Letter#5 Ver 10/2024
Docusign Envelope ID:222DC71A-5776-4C5E-95DC-F2524FD9177A
State of Colorado Contract Modification
Option Letter
State Agency Contract Performance Beginning Date
Colorado Department of Public Health and October 1, 2021
Environment Current Contract Expiration Date
Contractor September 30, 2026
Board of County Commissioners of Weld Current Contract Maximum Amount
County Initial Term
(a political subdivision of the state of
Colorado) 10/1/2021 - 6/30/2022: $133,000.00
for the use and benefit of the 10/1/2021 - 9/30/2022: $186,054.00
Weld County Department of Public Health Extension Terms
and Environment
10/1/2022 - 6/30/2023: $133,000.00
Option Letter Number 10/1/2022 - 9/30/2023: $186,054.00
5 10/1/2023 - 6/30/2024: $165,461.20
Original Contract Number 10/1/2023 - 9/30/2024: $153,592.80
10/1/2024 - 6/30/2025: $167,000.00
2022*0912 10/1/2024 - 9/30/2025: $152,054.00
Option Contract Number 10/1/2025 - 6/30/2026: $115,604.00
2022*0912 Option Letter#5 12/30/2025 - 9/30/2026: $43,924.50
Total for All State and Federal Fiscal
Years: $1,435,744.50
1. Options:
A. Option to extend for an Extension Term
B. Option to change the quantity of Services under the Contract
2. Required Provisions:
A. In accordance with Section(s) 2C of the Original Main Task Order referenced
above, the State hereby exercises its option for an additional term, beginning
December 30, 2025, and ending on the current contract expiration date shown
above, at the rates stated in the Original Contract, as amended.
B. In accordance with Section(s) 5Bv of the Original Main Task Order referenced
above, the State hereby exercises its option to Increase the quantity of the
Services at the rates stated in the Original Contract, as amended.
Option Letter Contract Number: 2022*0912 Option Letter#5
Page 1 of 3 Version 08.2025
Docusign Envelope ID:222DC71A-5776-4C5E-95DC-F2524FD9177A
C. The Contract Maximum Amount table on the Contract's Signature and Cover Page
is hereby deleted and replaced with the Current Contract Maximum Amount table
shown above.
3. Option Effective Date:
The effective date of this Option Letter is upon approval of the State Controller or
December 30, 2025, whichever is later.
Option Letter Contract Number: 2022*0912 Option Letter#5
Page 2 of 3 Version 08.2025
Docusign Envelope ID:222DC71A-5776-4C5E-95DC-F2524FD9177A
State of Colorado State Controller
Jared S. Polis, Governor ,ReberstJa os, CPA, MBA, JD
Colorado Department of Public Health and 1C4.4 W;iG.i4.4
Environment ��aaasceeeenruar
By: Kurt Williams, Controller
rDocuSigned by:
aaSt�A. alf iti. Kurt Williams Controller
se�s� 4eszre.
By: Chelsea Gilbertson, Procurement and Option Effective Date: 2025-12-31
Contracts Section Director
Chelsea Gilbertson Procurement & Contracts sehtecordance with S24-30-202, C.R.S., this
2025-12-31 Option is not valid until signed and dated
Date: above by the State Controller or an
authorized delegate.
Option Letter Contract Number: 2022*0912 Option Letter#5
Page 3 of 3 Version 08.2025
Docusign Envelope ID.222DC71A-5776-4C5E-95DC-F2524FD9177A
Exhibit C Budget
1,,- COLORADO
Department of Public
® Health b Environment
PREVENTION SERVICES DIVISION-BUDGET JUSTIFICATION FORM
Original Contract Routing#2022'0912 Version 7.2025
Halley Byington
Contractor Name Weld County Program Contact Name,Title,Phone and Email Community Health Programs Manager
970-400-2322
hbyington@weld.gov
Bill Fritz
Budget Period upon execution-09/30/2026 Fiscal Contact Name,Title,Phone and Email Finance Manager
bfritz@weld.gov
970.400.2122
Project Name Maternal and Child Health Contract/Encumbrance Number CT FHLA 2022'0912
Expenditure Categories Budget Totals
Personal Services Modification to Total Amount
Salaried Employees Original Budget Budget in Requested from
Amendment/ CDPHE
Option Letter
Position Title Description of Work and Justification for Revision
Provides direct oversight and supervision of HCP care coordination program and staff,directs
care coordination activities,oversees HCP program planning,reporting,evaluation,and
budgetary activities,participates in HCP program outreach and represents HCP on several
HCP Program Manager community-based groups and state HCP/MCH workgroups.Full time employee in the MCH $26,077.42 $9,907.96 $35,985.38
program.Remainder of the time and effort is county-funded.Adding additional funds to bring
budget to 50%of original budget.
Provides care coordination services to HCP clients,assists with HCP program outreach and
Public Health Nurse Care attends HCP community/state meetings.MCH/HCP FTE is 1.0 funded through the state. $45,106.92 $17,138.08 $62,245.00
Coordinator
Adding additional funds to bring budget to 50%of original budget.
Modification to Total Amount
Personal Services Budget in
Hourly Employees Original Budget Amendment/ Requested from
Option Letter CDPHE
Position Title Description of Work and Justification for Revision
Administrative support to HCP program coordinator and team.Responsibilities include
HCP Office Tech interpretation and translation,CDS data entry,EMR data entry,materials preparation,assists
HCP staff with care coordination activities,etc..MCH/HCP FTE is 0.5.Adding additional funds $11,302.64 $4,294.36 $15,597.00
to bring budget to 50%of original budget.
Provides care coordination services to HCP program clients.Provides HCP population-based
HCP Public Health Case Worker program outreach as assigned by HCP program coordinator.MCH/HCP FTE is 0.3 but will likely
work more in this program as county-funded.Adding additional funds to bring budget to 50% $12,691.82 $4,822.18 $17,514.00
of original budget.
Total Personal Services
(including fringe benefits) $95,178.80 $36,162.58 $131,341.38
Modification to Total Amount
Supplies&Operating Expenses Original Budget Budget in Requested from
Amendment/ CDPHE
Option Letter
Rem Description of Item and Justification for Revision
Two HCP staff work cells phones billed at$65.355 per month per phone line.Adding
Communications-Cell Phone $568.33 $215.93 $784.26additional funds to bring budget to 50%of original budget.
Translation services:five per month($36.74 per service).Adding additional funds to bring
Translation Services $798.73 $303.47 $1,102.20
budget to 50%of original budget.
Total Supplies
&Operating Expenses $1,367.06 $519.40 $1,886.46
Modification to Total Amount
Travel Original Budget Budget in Requested from
Amendment/ CDPHE
Option Letter
Item Description of Item and Justification for Revision
Option Letter Contract Number 2022'0912 Option Letter#5 Page 1 of 2
Docueign Envelope ID 222DC71A-5776-4C5E-95DC-F2524FD9177A
Exhibit C Budget
$0.00
Total Travel $0.00 $0.00 $0.00
Modification to Total Amount
Contractual(payments to third parties or entities) Original Budget Budget in Requested from
Amendment/ CDPHE
Option Letter
Subcontractor Entity Name Description of Item and Justification for Revision
$0.00
Total Contractual $0.00 $0.00 $0.00
SUB-TOTAL BEFORE INDIRECT $%,545.86 $36,681.98 $133,227.84
Less:Expenses per OMB 2 CFR 200
Subcontractor in excess of$50,000 $0.00
Rent $0.00
Equipment in excess of$10,000 $0.00
Other Unallowable expenses $0.00
Total Expenses per OMB 2 CFR 200' $0.00 $0.00 $0.00
Modified Total Direct Costs(MTDC) $%,545.86 $36,681.98 $133,227.84
Modification to Total Amount
Indirect Ori inal Bud et Budget in Requested from
g g Amendment/ q CDPHE
Option Letter
item Description of Item
•
Modified total direct costs,consisting of all salaries and wages,fringe benefits,materials and
supplies,services,travel,and sub grants and subcontracts up to the first$50,000 of each sub
CDPHE Negotiated Indirect Cost grant or subcontract(regardless of the period covered by the sub grant or subcontract). $19,058.14 $7,242.52 $26,300.66
Rate Equipment,capital expenditures,charges for patient care,tuition remission,rental costs,
scholarships,and fellowships,participant support costs and the portion of each sub grant and
subcontract in excess of$50,000 shall be excluded from modified total direct costs.
Total Indirect $19,058.14 $7,242.52 526,300.66
TOTAL( $115,604.00 $43,924.50 $159,528.50
Option Letter Contract Number:2022'0912 Option Letter#5 Page 2 of 2
Mariah Higgins
From: Bill Fritz
Sent: Friday,September 26,2025 7:29 AM
To: CTB
Cc: Jason Chessher
Subject: MCH OL#4 for Communication
Attachments: MCH 2026 OL#4.pdf
Follow Up Flag: Follow up
Flag Status: Flagged
Good morning,I have attached the option letter for the states portion of the MCH(Maternal and Child Health)grant
for communication to the board.Please let me know if you need anything else.Thanks Bill
COUNTY,CO
Bill Fritz
Finance Manager
Weld County Department of Public Health and Environment
Desk:970-400-2122
1555 North 17'Ave.,Greeley,CO 80631
00000
Join Our Team
IMPORTANT:This electronic transmission and any attached documents or other writings are intended only for the
person or entity to which it is addressed and may contain information that is privileged,confidential or otherwise
protected from disclosure.If you have received this communication in error,please immediately notify sender by
return e-mail and destroy the communication.Any disclosure,copying,distribution or the taking of any action
concerning the contents of this communication or any attachments by anyone other than the named recipient is
strictly prohibited.
Co MWlu .Go—-:o"S 1 20.24-.25 4 O
to/oi 09 57
VVI.:UAlt�li GIIVCIU�/C IV.IC//4VUYV4Mr-'k6rV V-00.7:YJJ VOI'LY0.74M0
STATE OF COLORADO
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
OPTION LETTER#4
State Agency: Original Contract Number:
Colorado Department of Public Health and Environment 2022*0912
4300 Cherry Creek Drive South
Denver,Colorado 80246 Main Task Order Contract Number:
23 FAA 00051
Contractor: Option Letter Contract Number:
Board of County Commissioners of Weld County 2022*0912 Option Letter#4
(a political subdivision of the state of Colorado)
1150"O"Street
Greeley CO 80631
for the use and benefit of the
Weld County Department of Public Health and Environment
1555 North 17th Avenue
Greeley CO 80631
Contract Performance Beginning Date: Current Contract Expiration Date:
October 1,2021 June 30,2026
CONTRACT MAXIMUM AMOUNT TABLE
Document Type Contract Number Federal Funding State Funding Other Funding Term(dates) Total
Amount Amount Amount
Original 2022*0912 $186,054.00 $0.00 $0.00 10/1/2021- $186,054.00
Contract 9/30/2022
Original 2022*0912 $0.00 $133,000.00 $0.00 10/1/2021- $133,000.00
Contract 6/30/2022
Option Letter#1 2022*0912 $186,054.00 $0.00 $0.00 10/1/2022- $186,054.00
Option Letter#1 9/30/2023
Option Letter#1 2022*0912 $0.00 $133,000.00 $0.00 10/1/2022- $133,000.00
Option Letter#1 6/30/2023
Option Letter#2 2022*0912 $153,592.80 $0.00 $0.00 10/1/2023- $153,592.80
Option Letter#2 9/30/2024
Option Letter#2 2022*0912 $0.00 $165,461.20 $0.00 10/1/2023- $165,461.20
Option Letter#2 6/30/2024
Option Letter Contract Number:2022*0912 Option Letter#4
Page 1 of 3 Version OSCA12.24/CDPHE A1.25
✓V61.1blyII CI VCIVFIC IIJ IC!!Y✓VJ-U4P1r-Yl.,✓1.l-.70.7J-J:7✓OI,LYOV4M0
Option Letter#3 2022*0912 $152,054.00 $0.00 $0.00 10/1/2024- $152,054.00
Option Letter#3 9/30/2025
Option Letter#3 2022*0912 $0.00 $167,000.00 $0.00 10/1/2024- $167,000.00
Option Letter#3 6/30/2025
Option Letter#4 2022*0912 $0.00 $115,604.00 $0.00 10/1/2025- $115,604.00
Option Letter#4 6/30/2026
Current Contract Maximum Cumulative Amount
$1,391,820.00
1. OPTIONS:
A. Option to extend for an Extension Term
B. Option to change the quantity of Services under the Contract
2. REQUIRED PROVISIONS:
A. In accordance with Section 2C of the Original Main Task Order Contract referenced above,the State
hereby exercises its option for an additional term,beginning October 1,2025 and ending on the
current contract expiration date shown above,at the rates stated in the Original Task Order Contract,
as amended for the following reason:to extend the contract into Fiscal Year 2026.
B. In accordance with Section 5Bv of the Original Main Task Order Contract referenced above,the State
hereby exercises its option to increase the quantity of the services at the rates stated in the Original
Task Order Contract,as amended.Exhibit C-Budget is deleted and replaced in its entirety with
Exhibit C-Budget attached to this Option Letter,for the following reason:to add funds supporting
the Statement of Work activities and deliverables for the renewal term.
C. The Contract Maximum Amount table on the Contract's Cover Page is hereby deleted and replaced
with the Current Contract Maximum Amount table shown above.
3. OPTION EFFECTIVE DATE:
A. The effective date of this Option Letter is upon approval of the State Controller or October 1,2025,
whichever is later.
Option Letter Contract Number:2022.0912 Option Letter#4
Page 2 of 3 Version OSCA12.24/CDPHE A1.25
Docusign Envelope ID:1E774D03-D4AF-4CDD-9695-55D8C24894A8
STATE OF COLORADO In accordance with§24-30-202 C.R.S.,this Option is not
Jared S.Potts,Governor valid until signed and dated below by the State Controller or
Colorado Department of Public Health and Environment an authorized delegate.
Jill Hunsaker Ryan,MPH,Executive Director STATE CONTROLLER
Robert Jaros,CPA,MBA,JD
DocuSigned by:I 1 '1.1, DocuSlgned by:
CaaStA ot& EK4.41
711/15 dddAnnaRf:
t�isaitaioatatsi...
By:Signature By:Signature
Chelsea Gilbertson Kurt Williams
Name of Executive Director Delegate Name of State Controller Delegate
Procurement&Contracts Section Controller
Title of Executive Director Delegate Title of State Controller Delegate
Date: 2025-09-16 Option Effective Date: 2025-09-25
Option Letter Contract Number:2022*0912 Option Letter#4
Page 3 of 3 Version OSCA12.24/CDPHE A1.25
D...pE.dopeMIE77,1003-D.,M,9695-55MM4EINM
Exhibit C-Budget
COLORADO
ItTZtritiTIT:gunruitt
PREVENTION SERVICES DIVISION-12 MONTH BUDGET WITH JUSTIFICATION FORM
Original Contract Routing#2022.0912
Hailey Byington
Contractor Name Weld County Prograrn Contact Name,Community Health Programs Manager
Title,Phone and Email 970-409-2322
hbyington@weld.gov
Bill Fritz
Budget Period 10/01/2025-06/30/2026 Fiscal Contact Name, Finance Manager
Title,Phone and Email bfritz@weld.gov
970.400.2122
Project Name Maternal and Child Health Contract(CT or PO,
Number CT FHLA 2022.0912
Expenditure Categories
Personal Services
Salaried Employees
Gross or
Position Title Description of Work App., Frin,„ Time on Total Arnount Requested
Salary pro ject from CDPHE
Provides direct oversight and supervision of HCP care coordination
program and staff,directs care coordination activities,oversees HCP
program planning,reporting,evaluation,and budgetary activities,
participates in HCP program outreach and represents HCP on several
community-based groups and state HCP/MCH workgroups.Full time
employee in the MCH program Remainder of the time and effort is county-
HCP Program Manager funded. 116,004.00 43,931.00 16.3%. 26,077.42
Health 1,18r88 Care p7c;datetiTtrree:71 r:nndaatitTendesHCC7 t0°0 fFi'l„Pu nci Itigtsat:=419th.MHHP/HCP
Coordinator FTE is 1 0 funded through the state. 90,757.00 33,733.00 36.2% 45,106.92
Personal Services
Hourly Employees
Total#of
Position Title Description of Work Wage 'Firltul g"Ye H....3n Mth"f‘rrc",7„ugtD7H7esied
Project
Administrative support to HCP program coordinator and team.
Responsibilities include interpretation and translation,CDS data entry,
EMR data entry,matenals preparation,assists HCP staff with care
HCP Office Tech coordination activities,etc..MCH/HCP FTE is 0.5. 25.14 9.52 326.0 11,302.64
Provides care coordination services to HCP program clients.Provides
HCP population-based program outreach as assigned by HCP program
coordinator.MCH/HCP FTE is 0.3 but will likely work more in this program
HCP Public Health Case Worker as county-funded. 35.47 13.18 260.0 12,691.82
Total Personal Services(including fringe benefits) 95,178.80
Supplies 8,Operating Expenses
!tern Description of Item "t=:7"
Communications-Cell Phone Two HCP staff work cells phones billed at$65.355 per month per phone line. $130.71 4.3 568.33
Translation services:five per month($36.74 per service). 183.70 4.30 798.73
Total Supplies 8 Operating 1,67 06 Travel
Item Description of Item Rate Qua 11.Y rC'D:717"t"
Total Travel ,
Contractual
Subcontractor Name Description of Item Rate Qua etitY T'ta'Zia:VD::este
, TOial Contractual
Option Letter Contract Number 202,0912 Option Letter. Page 1 of 2
Da.sign Envelope irx 1E7741703-04AF-4CDD-9695-55D8C24894A8
Exhibit C-Budget
SUB-TOTAL OF DIRECT COSTS1 96545.86
Less:Expens.per OMB 2 CFR 200
Subcontractor in excess of$5%0e0nOt $_
5-
"'Opt rh'eernUt Irina rl eef xSple°0's°e°s 5-
5-
Mod Tfieacl TOPtearlitisr::rt fgsBt: $96,545.86
Indirect
Item Description of Item Total Arnount Requested from
CDPHE
Percentage
Modified total direct costs,consisting of all salaries and wages,fringe benefits,materials and
suppli.,services,travel,and sub grants and subcontracts up to the first$50,000 of ea.sub grant
, or subcontract(regardless of the period covered by the sub grant or subcontract).Equipment,capital
CDPHE-Neg...indirect C.st Rat.expenditures,charges for patient care,tuition remission,rental costs,scholarships,and fellowships, 19,058.14
participant support costs and the portion of each sub grant and subcontract in excess of$50,000 shall
be excluded from modified total direct costs 19.74%
Total Indirect 19,058.14
TOTAL ns,604.00
Option Letter Contract Number:202,0912 Option Letter. Page 2 of 2
Mariah Higgins
From: Amanda Gomez
Sent: Monday,September 23,2024 8:45 AM
To: CTB
Cc: Health Contracts
Subject: Communication Item:9/25/2024
Attachments: 2022-0912 Option Letter#3 MCH.pdf
Good morning,
Attached is an Option Letter to add as a communication item for Wednesday's agenda,please.
Please let me know if you need anything else.
Thank you,
Amanda Gomez
Health Finance and Contracts
Weld County Department of Public Health&Environment
1555 North 17th Avenue,Greeley,CO 80631
Direct 970-400-2100
Main Switchboard 970-400-6410
Fax 970-304-6412
agomezAweld.gov
health-ap@weld.gov
health-contracts(cweld.gov
www.weldhealth.gov
APlease think green before printing this email.
10p
Public Health
Confidentiality Notice:This electronic transmission and any attached documents or other writings are intended only for the person or entity
to which it is addressed and may contain information that is privileged,confidential or otherwise protected from disclosure.If you have
received this communication in error,please immediately notify sender by retum e-mail and destroy the communication.Any disclosure,
copying,distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than
the named recipient is strictly prohibited.
CoMMun;Co.+;anS
1
Cc:�{L�RCMP/a))�/25/2 y (
09/23/2K —11-005/
Docusign Envelope ID:CEEODB49-7C29-4DAF-B589-F3A344798DB5
STATE OF COLORADO GRANT AGREEMENT
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
OPTION LETTER#3
State Agency: Original Agreement Number:
Colorado Department Of Public Health and Environment 2022*0912
4300 Cherry Creek Dr S
Denver,CO 80246
Option Letter Agreement Number:
Grantee: 2022*0912 Option Letter#3
Board of County Commissioners of Weld County
(a political subdivision of the state of Colorado)
1150"O"Street
Greeley CO 80631
for the use and benefit of the
Weld County Department of Public Health and Environment
1555 North 17th Avenue
Greeley CO 80631
Agreement Performance Beginning Date: Current Agreement Expiration Date:
October 1,2021 September 30,2025
Agreement Authority: Fund Expenditure End Date:
FAIN&Short Description:B0440120 September 30,2025
Maternal and Child Health Services
Federal Award Date:TBD
Subaward Period of Performance:10/01/2020-09/30/2025
Subaward Budget Period:10/01/2024-09/30/2025
Total Federal Funds Obligated:TBD
CFDA#&Title:93.994
Maternal and Child Health Services Block Grant to the States
Solicitation Information:Exempt
Document Agreement Federal State Funding Other Funding Term(dates) Total
Number Funding Amount Amount
Type Amount
Original 2022*0912 $186,054.00 $0.00 $0.00 10/1/2021- $186,054.00
Contract 9/30/2022
Original 2022*0912 $0.00 $133,000.00 $0.00 10/1/2021- $133,000.00
Contract 6/30/2022
Option Letter#1 2022*0912 $186,054.00 $0.00 $0.00 10/1/2022- $186,054.00
Option Letter#1 9/30/2023
Option Letter#1 2022*0912 $0.00 $133,000.00 $0.00 10/1/2022- $133,000.00
Option Letter#1 6/30/2023
Page 1 of 3 Ver.A 27.01.20
Grant Agreement Option Letter Number:2022*0912 Option Letter#3
Docusign Envelope ID:CEEODB49-7C29-4DAF-B589-F3A344798DB5
Option Letter#2 2022*0912 $153,592.80 $0.00 $0.00 10/1/2023- $153,592.80
Option Letter#2 9/30/2024
Option Letter#2 2022*0912 $0.00 $165,461.20 $0.00 10/1/2023- $165,461.20
Option Letter#2 6/30/2024
Option Letter#3 2 Let 12 $152 05400 $0.00 $0.00 10/1/2024 $152,054.00
Optionion Letter#3 . 9/30/2025
Option Letter#3 2022*0912 $0.00 $167,000.00 $0.00 10/1/2024- $167,000.00
Option Letter#3 6/30/2025
Current Agreement Maximum $1,276,216.00
Cumulative Amount
1)OPTIONS
A.Option to extend for an Extension Term.
B.Option to change quantity of services under the Agreement.
2)REQUIRED PROVISIONS:
A. In accordance with Section 2C of the Original Main Task Order Contract referenced above,the
State hereby exercises its option for an additional term,beginning October 1,2024 and ending on
the current contract expiration date shown above,at the rates stated in the Original Task Order
Contract,as amended for the following reason:To extend the contract into Fiscal Year 2025.
B. In accordance with Section 5Bv of the Original Main Task Order Contract referenced above,the
State hereby exercises its option to increase the quantity of the services at the rates stated in the
Original Task Order Contract,as amended.Exhibit C is deleted and replaced in its entirety with
Exhibit C attached to this Option Letter,for the following reason:To add funds supporting the
Statement of Work activities and deliverables for the renewal term.
C. Exhibit E-Federal Provisions,is deleted and replaced in its entirety with Exhibit E-Federal
Provisions,attached to this Option Letter,for the following reason:to reflect changes to the
federal award identification information.
D. The Agreement Maximum Amount table is deleted and replaced with the Current Agreement
Maximum Amount table shown above.
2)OPTION EFFECTIVE DATE:
A. The effective date of this Option Letter is upon approval of the State Controller or October 1,
2024,whichever is later.
Page 2 of 3 Ver.A 27.01.20
Grant Agreement Option Letter Number:2022*0912 Option Letter#3
Docusign Envelope ID:CEEODB49-7C29-4DAF-B589-F3A344798DB5
SIGNATURE PAGE
STATE OF COLORADO In accordance with§24-30-202 C.R.S.,this Option is not
Jared S.Polis,Governor valid until signed and dated below by the State Controller or
Colorado Department of Public Health and Environment an authorized delegate.
Jill Hunsaker Ryan,MPH,Executive Director STATE CONTROLLER
Robert Jaros,CPA,MBA,JD
[DocuSigned by: DocuSigned by:
oast.aitku4sok, wit wdt4#.4.._
2C.1391241657.1 73365F4A4A0A4PC
By:Signature By:Signature
Chelsea Gilbertson Kurt Williams
Name of Executive Director Delegate Name of State Controller Delegate
Procurement&Contracts Section Controller
Title of Executive Director Delegate Title of State Controller Delegate
2024-09-03 2024-09-20
Data Option Effective Date:
--Signature Page End--
Page 3 of 3 Ver.A 27.01.20
Grant Agreement Option Letter Number:2022.0912 Option Letter#3
Docus,gn Envelope ID CEE0D1349-7C29-4DAF-B589-F3A344798DB5
Exhibtt C
PREVENTION SERVICES DIVISION-12 MONTH BUDGET VVITH JUSTIFICATION FORM
Original Contract Routing 2022.0912
MCH Contract Budget
Shaun May
Program Contact Name,Title,Phone smaY@weld.gov
970.400.2309
Contractor Name Weld County and Ernail
Bill Fritz
Fiscal Contact Name,Title,Phone bfritz@weld.gov
Budget Period io,./.24.-9/30/2025 and Email 970.400.2122
Project Name Maternal and Child Health Contract(CT or PO)Number CT FHLA 2022*0912
Expenditure Categories
Personal Services
Percent of Total Amount
Annual Time on Requested from
Position Title Description of Work Annual Salary Fringe Project CDPHE
rirgrap2;adr„stptd,:recpaorrUrec=nona,t'dtVvveZ"
iriegnsZT
Inertrand Fer',13itt":eceorunnPtlyMede'di"M"Pr"ra'.Remai"er $
HCP Prograrn Manager 118,801.00$41,580.00 60.$ 96,228.60
with HCP prograrn outreach and attends HCP
community/state meetings.MCH/HCP FTE is 1.0 funded
pHs through the state. 93,349.00$32,672.00 100%$ 126,021.00
Personal Services
Tota.of Total Amount
Hourly Hours on Requested frorn
Position Title Description of Work Hourly Wage Fringe Project CDPHE
Administrative support to HCP program coordinator and
team.Responsibilities include interpretation and translation,
CDS data entry,EMR data entry,materials preparation,
assists HCP staff with care coordination activities,etc.
HCP Office Tech MCH/HCP FTE is 0.5. 29.97$ 10.49 934.0$ 37,789.64
request from HCP staff,available to provide HCP population-
based program outreach as assigned by HCP program
coordinator.MCH/HCP FTE is 0.01 but will likely work more
Social Worker in this program as county-funded. 33.67$ 11.79 120.0$ 5,455.20
Total Personal Services(including fringe benefits)$ 265,494.44
Supplies&Operating Expenses
Total Amount
Requested from
Item Description of Item Rate Quantity CDPHE
Meeting expense Room rental fees for meetings with key community partners $ 225.00 4.00$ 900.00
Cell Phone Work cell phone for staff $ 1.00 1208.32$ 1,208,32
Language line Translation services by phone $ 50.00 12.00$ 600.00
Total Supplies&Operating$ 2,708,32
Travel
Total Amount
Requested from
Item Description of Item Rate Quantity CDPHE
Total Travel$
Contractual
Total Amount
Requested from
Subcontractor Name Description of Item Rate Quantity CDPHE
Total Contractual$ -
SUB-TOTAL OF DIRECT COSTS$ 268,202.76
Indirect
Grant Agreement Option Letter Number.2022.0912 Option Letter#3
Page 1 of 2
Docusign Env.p. CEEODB49-7C29-4DA,B589-F3A344798DB5
Exhibit C
Total Amount
Requested from
Item Description of Item CDPHE
18.96.negotiated Indirect Rate for 2024 Modified total direct costs,consisting of all salaries and wages,fringe benefits,
materials and supplies,services,travel,and sub grants and subcontracts up to the first$25,000 of each sub grant or
subcontract(regardless of the period covered by the sub grant or subcontract,Equipment,capital expenditures,charges
CDPHE-Negotlated indirect fe'arbIP:strbebrigtrcaahrte;triditsicu'rbicrceirriltiZini,reie:Cbtas'scocfs$t2sscoho'ojasrhsahl Pbe enxbdlufedieldwf:=:0=ttasuP''"'sts and the Pc'ticrt
Cost Rate $ 50,851.24
Total Indirect$ 50,851.24
TOTAL$ 319,054.00
Grant Agreernent Option Letter Number 2022.0912 Option Letter#3
Page 2 of 2
Docusign Envelope ID:CEEODB49-7C29-4DAF-B589-F3A344798DB5
Exhibit E
Federal Provisions-Maternal and Child Health Services
For the purposes of this Exhibit only,Contractor is also identified as"Subrecipient."This Contract has
been funded,in whole or in part,with an award of Federal funds.In the event of a conflict between the
provisions of these Supplemental Provisions for Federal Awards,the Special Provisions,the Contract or
any attachments or exhibits incorporated into and made a part of the Contract,the Supplemental
Provisions for Federal Awards shall control.In the event of a conflict between the Supplemental
Provisions for Federal Awards and the FFATA Supplemental Provisions(if any),the FFATA
Supplemental Provisions shall control.
1) Federal Award Identification.
a. Subrecipient:Weld County Department of Public Health and Environment
b.Subrecipient Unique Entity Identification Number:
• SAM Unique Entity ID(UEI):MKKXT9U9MTV5
c.The Federal Award Identification Number(FAIN)is B0440120
d.The Federal award date is TBD
e.The subaward period of performance start date is 10/1/2020 and end date is 9/30/2025.
f. Federal Funds:
Federal Budget Period Total Amount of Federal Amount of Federal Funds
Funds Awarded Obligated to CDPHE
10/1/2024—9/30/2025 TBD TBD
g.Federal award title of project or program:Maternal and Child Health Services.
h.The name of the Federal awarding agency is:United States Department of Health and
Human Services(USDHHS)Health Resources and Services Administration
(HRSA)and the contact information for the awarding official is Leon Harrison,Phone:
301.443.5809;Email:larrison@hrsa.gov;the name of the pass-through entity is the State of
Colorado,Department of Public Health and Environment(CDPHE),and the contact
information for the CDPHE official is Risa Friedman(CDPHE)Project Director.
i. The Catalog of Federal Domestic Assistance(CFDA)number is 93.994 and the grant name is
Maternal and Child Health Services Block Grant to the States.
j. This award is not for research&development.
k.Subrecipient is not required to provide matching funds.In the event the Subrecipient is
required to provide matching funds,Section 8 of this Attachment applies.
1. The indirect cost rate for the Federal award(including if the de minimis rate is charged per 2
CFR§200.414 Indirect(F&A)costs)is pre-determined based upon the State of Colorado and
CDPHE cost allocation plan.
Page 1of4
Grant Agreement Option Letter Number:2022.0912 Option Letter#3
Ver.25.02.20
Docusign Envelope ID:CEEODB49-7C29-4DAF-B589-F3A344798DB5
2)Subrecipient shall at all times during the term of this contract strictly adhere to the requirements under
the Federal Award listed above,and all applicable federal laws,Executive Orders,and implementing
regulations as they currently exist and may hereafter be amended.
3) Any additional requirements that CDPHE imposes on Subrecipient in order for CDPHE to meet its
own responsibility to the Federal awarding agency,including identification of my required fmancial and
performance reports,are stated in the Exhibits.
4) Subrecipient's approved indirect cost rate is as stated in the Exhibits.
5) Subrecipient must permit CDPHE and auditors to have access to Subrecipient's records and fmancial
statements as necessary for CDPHE to meet the requirements of 2 CFR§200.331 Requirements for pass-
through entities,§§200.300 Statutory and National Policy Requirements through§200.309 Period of
performance,and Subpart F-Audit Requirements of this Part.
6) The appropriate terms and conditions concerning closeout of the subaward are listed in Section 16 of
this Attachment.
7) Performance and Final Status.Subrecipient shall submit all fmancial,performance,and other
reports to CDPHE no later than 45 calendar days after the period of performance end date or sooner
termination of this Contract containing an evaluation and review of Subrecipient's performance and the
final status of Subrecipient's obligations hereunder.
8) Matching Funds.Subrecipient shall provide matching funds as stated in the Exhibits.Subrecipient
shall have raised the full amount of matching funds prior to the Effective Date and shall report to CDPHE
regarding the status of such funds upon request.Subrecipient's obligation to pay all or any part of any
matching funds,whether direct or contingent,only extends to funds duly and lawfully appropriated for the
purposes of this Contract by the authorized representatives of the Subrecipient and paid into the
Subrecipient's treasury or bank account.Subrecipient represents to CDPHE that the amount designated as
matching funds has been legally appropriated for the purposes of this Contract by its authorized
representatives and paid into its treasury or bank account.Subrecipient does not by this Contract
irrevocably pledge present cash reserves for payments in future fiscal years,and this Contract is not
intended to create a multiple-fiscal year debt of the Subrecipient.Subrecipient shall not pay or be liable for
any claimed interest,late charges,fees,taxes or penalties of any nature,except as required by
Subrecipient's laws or policies.
9) Record Retention Period.The record retention period previously stated in this Contract is replaced
with the record retention period prescribed in 2 CFR§200.333.
10)Single Audit Requirements.If Subrecipient expends$750,000 or more in Federal Awards during
Subrecipient's fiscal year,Subrecipient shall procure or arrange for a single or program-specific audit
conducted for that year in accordance with the provisions of Subpart F-Audit Requirements of the Uniform
Guidance,issued pursuant to the Single Audit Act Amendments of 1996,(31 U.S.C.7501-7507).2 CFR
§200.501.
11)Contract Provisions.Subrecipient shall comply with and shall include all of the following applicable
provisions in all subcontracts entered into by it pursuant to this Contract:
a. Office of Management and Budget Circulars and The Common Rule for Uniform
Administrative Requirements for Grants and Cooperative Agreements to State and Local
Governments,as applicable;
b. when required by Federal program legislation,the"Davis-Bacon Act",as amended(40
U.S.C.3141-3148)as supplemented by Department of Labor Regulations(29 CFR Part 5,
"Labor Standards Provisions Applicable to Contracts Covering Federally Financed and
Assisted Construction");
Page 2 of 4
Grant Agreement Option Letter Number:2022*0912 Option Letter#3
Ver_25.02.20
Docusign Envelope ID:CEEODB49-7C29-4DAF-B589-F3A344798DB5
c. when required by Federal program legislation,the Copeland"Anti-Kickback"Act(40 U.S.C.
3145),as supplemented by Department of Labor regulations(29 CFR Part 3,"Contractors
and Subcontractors on Public Building of Public Work Financed in Whole or in Part by Loans
or Grants from the United States").
d. 42 U.S.C.6101 et sue,42 U.S.C.2000d,29 U.S.C.794(regarding discrimination);
e. the"Americans with Disabilities Act"(Public Law 101-336;42 U.S.C.12101,12102,12111
-12117,12131-12134,12141-12150,12161-12165,12181-12189,12201-12213 and 47
U.S.C.225 and 47 U.S.C.611);
f. when applicable,the Contractor shall comply with the provisions of the"Uniform
Administrative Requirements for Grants and Cooperative Agreements to State and Local
Governments"(Common Rule);
g. The Federal Funding Accountability and Transparency Act of 2006(Public Law 109-282),as
amended by§6062 of Public Law 110-252,including without limitation all data reporting
requirements required there under.This Act is also referred to as FFATA.
h. Contractor shall comply with the provisions of Section 601 of Title VI of the Civil Rights Act
of 1964,as amended.
i. Except as otherwise provided under 41 CFR Part 60,all contracts that meet the definition of
"federally assisted construction contract"in 41 CFR Part 60-1.3 comply with the equal
opportunity clause provided under 41 CFR 60-1.4(b),in accordance with Executive Order
11246,"Equal Employment Opportunity:(30 FR 12319,12935,3 CFR Part,1964-1965
Comp.,p.339),as amended by Executive Order 11375,"Amending Executive Order 11246
Relating to Equal Employment Opportunity,"and implementing regulations at 41 CFR part
60,"Office of Federal Contract Compliance Programs,Equal Employment Opportunity,
Department of Labor.
j. where applicable,Contract Work Hours and Safety Standards Act(40 U.S.C.3701-3708).
k. if the Federal award meets the definition of"funding agreement"under 37 CFR§401.2(a)
and the recipient or subrecipient wishes to enter into an agreement with a small business firm
or nonprofit organization,comply with the requirements of 37 CFR Part 401,"Rights to
Inventions Made by Nonprofit Organizations and Small Business Firms Under Government
Grants,Contracts and Cooperative Agreements,"and any implementing regulations issued by
the awarding agency.
I. the Clean Air Act(42 U.S.C.7401-7671q.)and the Federal Water Pollution Control Act(33
U.S.C.1251-1387),as amended.
m. if applicable,comply with the mandatory standards and policies on energy efficiency
contained within the State of Colorado's energy conservation plan issued in compliance with
the Energy Policy and Conservation Act,42 U.S.C.6201.
n. the Contractor and all principals are not presently debarred,suspended,proposed for
debarment,declared ineligible,or voluntarily excluded from covered transactions by any
federal department or agency;the Contractor and all principals shall comply with all
applicable regulations pursuant to Executive Order 12549(3 CFR Part 1986 Comp.,p.189)
and Executive Order 12689(3 CFR Part 1989 Comp.,p.235),Debarment and Suspension;
and,
o. the Contractor shall comply where applicable,the Byrd Anti-Lobbying Amendment(31
U.S.C.1352).
Page 3 of 4
Grant Agreement Option Letter Number:2022.0912 Option Letter#3
Ver.25.02.20
Docusign Envelope ID:CEEODB49-7C29-4DAF-B589-F3A344798DB5
12)Compliance.Subrecipient shall comply with all applicable provisions of The Office of Management
and Budget Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal
Awards(Uniform Guidance),including but not limited to these Supplemental Provisions for Federal
Awards.Any revisions to such provisions automatically shall become a part of these Supplemental
Provisions,without the necessity of either party executing any further instrument.CDPHE may provide
written notification to Subrecipient of such revisions,but such notice shall not be a condition precedent to
the effectiveness of such revisions.
13)Procurement Procedures.Subrecipient shall use its own documented procurement procedures which
reflect applicable State,local,and Tribal laws and regulations,provided that the procurements conform to
applicable Federal law and the standards identified in the Uniform Guidance,including without limitation,
§§200.318 through 200.326 thereof.
14)Certifications.Unless prohibited by Federal statutes or regulations,CDPHE may require
Subrecipient to submit certifications and representations required by Federal statutes or regulations on an
annual basis(2 CFR§200.208).Submission may be required more frequently if Subrecipient fails to meet
a requirement of the Federal award.Subrecipient shall certify in writing to CDPHE at the end of the
Contract that the project or activity was completed or the level of effort was expended.2 CFR
§200.201(b)(3).If the required level of activity or effort was not carried out,the amount of the Contract
must be adjusted.
15)Event of Default.Failure to comply with the Uniform Guidance or these Supplemental Provisions for
Federal Awards shall constitute an event of default under the Contract pursuant to 2 CFR§200.339 and
CDPHE may terminate the Contract in accordance with the provisions in the Contract.
16)Close-Out.Subrecipient shall close out this Contract within 45 days after the End Date.Contract
close out entails submission to CDPHE by Subrecipient of all documentation defined as a deliverable in
this Contract,and Subrecipient's fmal reimbursement request.If the project has not been closed by the
Federal awarding agency within 1 year and 45 days after the End Date due to Subrecipient's failure to
submit required documentation that CDPHE has requested from Subrecipient,then Subrecipient may be
prohibited from applying for new Federal awards through the State until such documentation has been
submitted and accepted.
17)Erroneous Payments.The closeout of a Federal award does not affect the right of the Federal
awarding agency or CDPHE to disallow costs and recover funds on the basis of a later audit or other
review.Any cost disallowance recovery is to be made within the record retention period.
EXHIBIT END
Page 4 of 4
Grant Agreement Option Letter Number:2022*0912 Option Letter#3
Ver.25.02.20
DocuSign Envelope ID:5D967D6F-85C6-41E3-A86F-2AC85824DB7E
OPTION LETTER#:2
State Agency: Original Contract Number:
Colorado Department of Public Health and Environment 2022*0912
4300 Cherry Creek Drive South
Denver,Colorado 80246 Option Letter Contract Number:
Contractor: 2022*0912 Option Letter#2
Board of County Commissioners of Weld County
(a political subdivision of the state of Colorado)
1150"0"Street
Greeley,CO 80631
for the use and benefit of the
Weld County Department of Public Health and Environment
1555 North 17°'Avenue
Greeley,CO 80631
Contract Performance Beginning Date: Current Contract Expiration Date:
October 1,2021 September 30,2024
CONTRACT MAXIMUM AMOUNT TABLE
Document Type Contract Number Federal Funding State Funding Other Funding Term(dates) Total
Original Contract 2022*0912 $186,054.00 $0.00 $0.00 10/1/21-9/30/22 $186,054.00
Original Contract 2022*0912 $0.00 $133,000.00 $0.00 10/1/21-6/30/22 $133,000.00
Option Letter#1 2022*0912 $186,054.00 $0.00 $0.00 10/1/22-9/30/23 $186,054.00
Option Letter#1
Option Letter#1 2022*0912 $0.00 $133,000.00 $0.00 10/1/22-6/30/23 $133,000.00
Option Letter#1
Option Letter#2 2022*0912 $153,592.80 $0.00 $0.00 10/1/23-9/30/24 $153,592.80
Option Letter#2
Option Letter#2 2022*0912 $0.00 $165,461.20 $0.00 10/1/23-6/30/24 $165,461.20
Option Letter#2
Current Contract Maximum $957,162.00
Cumulative Amount
1)OPTIONS
A.Option to extend for an Extension Term
B.Option to change quantity of services under the Contract
2)REQUIRED PROVISIONS:
A.In accordance with Exhibit A,Additional Provisions,Paragraph 9 of the Original Contract referenced
above,the State hereby exercises its option for an additional term,beginning October 1,2023 and ending on
the current contract expiration date shown above,at the rates stated in the Original Contract,as amended for
the following reason:To continue developing,implementing and evaluating evidence-based Maternal and
Child Health(MCH)local action plans that promote and contribute to healthy outcomes for Colorado
women,children and youth.
B. In accordance with Exhibit A,Additional Provisions,Paragraph 10 of the Original Contract referenced
above,the State hereby exercises its option to increase the quantity of services at the rates stated in the
Original Contract as amended.Exhibit C,Budget,is deleted and replaced in its entirety with Exhibit C,
Budget,attached to this Option Letter,for the following reason:To increase funding in support of the new
term.
Page 1 of 3
Option Letter Contract Number:2022.0912 Option Letter#2 Ver.27.01.20
DocuSign Envelope ID:5D967D6F-85C6-41E3-A86F-2AC85824DB7E
C. Exhibit E,Federal Provisions,is deleted and replaced in its entirety with Exhibit E,Federal Provisions,
attached to this Option Letter,for the following reason:To reflect changes to the federal award identification
information.
D. The Contract Maximum Amount table is deleted and replaced with the Current Contract Maximum
Amount table shown above.
3)OPTION EFFECTIVE DATE:
The effective date of this Option Letter is upon approval of the State Controller or October 1,2023,
whichever is later.
Page 2 of 3
Option Letter Contract Number:2022*0912 Option Letter#2 Ver.27.01.20
DocuSign Envelope ID:5D967D6F-85C6-41 E3-A86F-2AC85824DB7E
SIGNATURE PAGE
STATE OF COLORADO In accordance with§24-30-202 C.R.S.,this Option is not
Jared S.Potts,Governor valid until signed and dated below by the State Controller or
Colorado Department of Public Health and Environment an authorized delegate.
Jill Hunsaker Ryan,MPH,Executive Director STATE CONTROLLER
Robert Jaros,CPA,MBA,JD
DocuSlpned by: DocuSioned by:
itta4VIA, C1441
2EDF870A1A7D4FC... nae
TLYCSG4 free er..
By:Signature By:Signature
Lisa McGovern Kurt Williams
Name of Executive Director Delegate Name of State Controller Delegate
Procurement&contracts Section Director ft controller
Title of Executive Director Delegate Title of State Controller Delegate
2023-09-07 2023-09-08
Date: Option Effective Date:
--Signature Page End--
Page 3 of 3
Option Letter Contract Number:2022.0912 Option Letter 1#2 Ver.03,01.20
DocuSign Envelope ID:5D967D6F-85C6-41E3-A86F-2AC85824DB7E
Exhibit C Budget
COLORADO
4440 Bepartment of Public
Ilealth fr Envirantnent
PREVENTION SERVICES DIVISION-12 MONTH BUDGET WITH JUSTIFICATION FORM
Original Contract Routing#2022.0912
Contractor Name Weld County Dept of Public Health Program Contact Name,Title,Phone Shaun May,CCH Division Director,
and Email 970-400-2309,smay@weld.gov
Budget Period 10/1/2023-9/30/2024 Fiscal Contact Name,Title,Phone and Tanya Geiser,Director Finance
Email Administration tgeiser@weld.gov
Project Name Maternal Child Health Contract(CT or PO)Number CT FHLA 2022.0912
Expenditure Categories
Personal Services
Salaried Employees
Total Amount
Position Title Description of Work Gross or Annual Fringe Percent of Time Requested from
Salary on Project
CDPHE
Provides direct oversight of MCH Positive Children
Health Communication and Youth Development priority staff activities. $ 82,676.45 $ 36,658.74 62.0%$ 73,987.82
Specialist II Oversees program planning,reporting,evaluation,
and budget.
Provides oversight of MCH Positive Children and
Division Director $ 135,315.71 $ 59,998.99 1.0%$ 1,953.15
Youth Development priority and program and staff.
Provides oversight of MCH Positive Children and
Supervisor Youth Development priority and staff,participates in $ 94,157.37 $ 41,749.38 1.0%$ 1,359.07
reporting and evaluation of priorities.'
Provides data analysis and evaluation expertise for
Health Data Specialist HI MCH Positive Children and Youth Development $ 123,807.86 $ 54,896.41 1.0%$ 1,787.04
priority.
Provides direct oversight and supervision of HCP care
coordination program and staff,directs HCP care
coordination services,and oversees program
planning,reporting,evaluation,and budgetary
activities,participates in HCP program outreach and
HCP Program Coordinator represents HCP on several community-based groups $ 114,997.18 $ 50,989.75 27.0%$ 44,816.47
and state HCP/MCH workgroups.MCH/HCP FTE is
.27(including.05 FTE commitment to CYSHCN
exploratory activities),but will work approximately
1.0 in the MCH program with the remainder of the
time county-funded.
Provides care coordination services to HCP clients,
HCP RN Care Coordinator assists with HCP program outreach and attends HCP $ 81,492.55 $ 36,133.80 81.0%$ 95,277.34
community/state meetings.
Provides oversight of HCP program and HCP staff,
Director of Clinical& participates in reporting and evaluation of HCP
Community Health Services program.MCH/HCP FTE is.01 but will likely work $ 135,315.71 $ 59,998.99 1.0%$ 1,953.15
more in this program as county-funded.
Provides oversight of HCP program and HCP staff,
participates in reporting and evaluation of HCP
program.MCH/HCP FTE is.01 but will likely work "z
Chief Nursing Officer $`�:: 162,451.19 $ 72,030.86 1.0%$ 2,344.82
more in this program as county-funded(including
.025 FTE commitment to CYSHCN exploratory `
activities). : :..:,•
Option Letter Contract Number:2022*0912 Option Letter#2 Page 1 of 2
DocuSign Envelope ID.5D967D6F-85C6-41E3-A86F-2AC85824DB7E
Exhibit C Budget
Provides social work services to HCP program clients
upon request from HCP staff,available to provide
Public Health Social HCP population-based prograrn outreach as assigned
$ 81,467.49 $ 36,122.69 1.0%$ 1,175.90
Worker by HCP program coordinator.MCH/HCP FTE is 0.01
but will likely work more in this program as county-
funded.
Personal Services
Hourly Employees
Total Amount
Position Title Description of Work Hourly Wage Hourly Fringe T'al c)f H°urs Requested from
on Project
CDPHE
Administrative support to HCP program coordinator
and team.Responsibilities include interpretation and
HCP Office Technician translation,CDS data entry,EMR data entry, 25.35 $ 11.24 1039.92$ 38,050.86
materials preparation,assists HCP staff with care
coordination artivities,etc.MCH/HCP FT E is 0.5.
Total Personal Services(including fringe benefits)$ 262,705.62
Supplies&Operating Expenses
Total Amount
Item Description of Item Rate Quantity Requested from
CDPHE
Program outreach materials for systems building adivities.May include
Meeting supplies/materials allocations for MCI printing and office supplies(i.e.brochures, $ 699.69 1.00$ 699.69
handouts,etc.).$699.69 for the year.
HCF'program phone is utilized to improve Phone communication with HCP
12.00$ 720.00
$ 60.00
clients/families.12 months @$60/month).
Language Line 20.00$ 300.00
Line utilized to communicate with non-English speaking MCH clients $ 15.00
Total Supplies&Operating$ 1,719.69
Travel
Total Amount
Item Description of Item Rate Quantity Requested from
CDPHE
Travel to and from childcare centers and community/coalition meetings
Mileage to implement action plan&travel to CYSHCN trainings/meetings $ 0.635 2567.54$ 1,630.39
reimbursed at$0.635/mile.
Total Travel$ 1,630.39
Contractual
Total Amount
Subcontractor Name Description of Item Rate Quantity Requested from
CDPHE
Total Contractual$
SUB-TOTAL OF DIRECT COSTS$ 266,055.70
Indirect
Total Amount
Item Description of Item Requested from
CDP HE
2023 Indirect Rate=19.92%.Modified total direct costs,consisting of all salaries and wages,fringe
benefits,materials and supplies,services,travel,and subgrants and subcontracts up to the first$25,000 of
each subgrant or subcontract(regardless of the period covereci by the subgrant or subcontract).
$ 52,998.30
Equipment,capital expenditures,charges for patient care,tuition remission,rental costs,scholarships,
CDPHE-Negotiated Indirect and fellowships,participant support costs and the portion of each subgrant and subcontract in excess of
Cost Rate $25,000 shall be excluded from modified total direct costs.
Total Indirect$ 52,998.30
TOTAL $ 319,054.00
Option Letter Contract Number:2022.0912 Option Letter#2 Page 2 of 2
DocuSign Envelope ID:5D967D6F-85C6-41E3-A86F-2AC85824DB7E
Exhibit E
Federal Provisions—Maternal and Child Health Services
For the purposes of this Exhibit only,Contractor is also identified as"Subrecipient."This Contract has
been funded,in whole or in part,with an award of Federal funds.In the event of a conflict between the
provisions of these Supplemental Provisions for Federal Awards,the Special Provisions,the Contract or
any attachments or exhibits incorporated into and made a part of the Contract,the Supplemental
Provisions for Federal Awards shall control.In the event of a conflict between the Supplemental
Provisions for Federal Awards and the FFATA Supplemental Provisions(if any),the FFATA
Supplemental Provisions shall control.
1) Federal Award Identification.
a. Subrecipient:Weld County Department of Public Health and Environment
b.Subrecipient Unique Entity Identification Number:
• SAM Unique Entity ID(UEI):MKKXT9U9MTV5
c.The Federal Award Identification Number(FAIN)is B0440120
d.The Federal award date is TBD
e.The subaward period of performance start date is 10/1/2020 and end date is 9/30/2024.
£ Federal Funds:
Federal Budget Period Total Amount of Federal Amount of Federal Funds
Funds Awarded Obligated to CDPHE
10/1/2023—9/30/2024 TBD $5,552,376.00(est)
g.Federal award title of project or program:Maternal and Child Health Services.
h.The name of the Federal awarding agency is:United States Department of Health and
Human Services(USDHHS)Health Resources and Services Administration
(HRSA)and the contact information for the awarding official is Leon Harrison,Phone:
301.443.5809;Email:larrison@hrsa.gov;the name of the pass-through entity is the State of
Colorado,Department of Public Health and Environment(CDPHE),and the contact
information for the CDPHE official is Risa Friedman(CDPHE)Project Director.
i. The Catalog of Federal Domestic Assistance(CFDA)number is 93.994 and the grant name is
Maternal and Child Health Services Block Grant to the States.
j. This award is not for research&development.
k.Subrecipient is not required to provide matching funds.In the event the Subrecipient is
required to provide matching funds,Section 8 of this Attachment applies.
1. The indirect cost rate for the Federal award(including if the de minimis rate is charged per 2
CFR§200.414 Indirect(F&A)costs)is pre-determined based upon the State of Colorado and
CDPHE cost allocation plan.
2)Subrecipient shall at all times during the term of this contract strictly adhere to the requirements under
the Federal Award listed above,and all applicable federal laws,Executive Orders,and implementing
regulations as they currently exist and may hereafter be amended.
Page 1 of 4
Option Letter Contract Number:2022.0912 Option Letter#2 Ver.25.02.20
DocuSign Envelope ID:5D967D6F-85C6-41E3-A86F-2AC85824DB7E
3) Any additional requirements that CDPHE imposes on Subrecipient in order for CDPHE to meet its
own responsibility to the Federal awarding agency,including identification of any required financial and
performance reports,are stated in the Exhibits.
4) Subrecipient's approved indirect cost rate is as stated in the Exhibits.
5) Subrecipient must permit CDPHE and auditors to have access to Subrecipient's records and financial
statements as necessary for CDPHE to meet the requirements of 2 CFR§200.331 Requirements for pass-
through entities,§§200.300 Statutory and National Policy Requirements through§200.309 Period of
performance,and Subpart F—Audit Requirements of this Part.
6) The appropriate terms and conditions concerning closeout of the subaward are listed in Section 16 of
this Attachment.
7) Performance and Final Status.Subrecipient shall submit all financial,performance,and other
reports to CDPHE no later than 45 calendar days after the period of performance end date or sooner
termination of this Contract containing an evaluation and review of Subrecipient's performance and the
final status of Subrecipient's obligations hereunder.
8) Matching Funds.Subrecipient shall provide matching funds as stated in the Exhibits.Subrecipient
shall have raised the full amount of matching funds prior to the Effective Date and shall report to CDPHE
regarding the status of such funds upon request.Subrecipient's obligation to pay all or any part of any
matching funds,whether direct or contingent,only extends to funds duly and lawfully appropriated for the
purposes of this Contract by the authorized representatives of the Subrecipient and paid into the
Subrecipient's treasury or bank account.Subrecipient represents to CDPHE that the amount designated as
matching funds has been legally appropriated for the purposes of this Contract by its authorized
representatives and paid into its treasury or bank account.Subrecipient does not by this Contract
irrevocably pledge present cash reserves for payments in future fiscal years,and this Contract is not
intended to create a multiple-fiscal year debt of the Subrecipient.Subrecipient shall not pay or be liable for
any claimed interest,late charges,fees,taxes or penalties of any nature,except as required by
Subrecipient's laws or policies.
9) Record Retention Period.The record retention period previously stated in this Contract is replaced
with the record retention period prescribed in 2 CFR§200.333.
10)Single Audit Requirements.If Subrecipient expends$750,000 or more in Federal Awards during
Subrecipient's fiscal year,Subrecipient shall procure or arrange for a single or program-specific audit
conducted for that year in accordance with the provisions of Subpart F-Audit Requirements of the Uniform
Guidance,issued pursuant to the Single Audit Act Amendments of 1996,(31 U.S.C.7501-7507).2 CFR
§200.501.
11)Contract Provisions.Subrecipient shall comply with and shall include all of the following applicable
provisions in all subcontracts entered into by it pursuant to this Contract:
a. Office of Management and Budget Circulars and The Common Rule for Uniform
Administrative Requirements for Grants and Cooperative Agreements to State and Local
Governments,as applicable;
b. when required by Federal program legislation,the"Davis-Bacon Act",as amended(40
U.S.C.3141-3148)as supplemented by Department of Labor Regulations(29 CFR Part 5,
"Labor Standards Provisions Applicable to Contracts Covering Federally Financed and
Assisted Construction");
c. when required by Federal program legislation,the Copeland"Anti-Kickback"Act(40 U.S.C.
3145),as supplemented by Department of Labor regulations(29 CFR Part 3,"Contractors
and Subcontractors on Public Building of Public Work Financed in Whole or in Part by Loans
or Grants from the United States").
Page 2 of 4
Option Letter Contract Number:2022*0912 Option Letter#2 Ver.25.02.20
DocuSign Envelope ID:5D967D6F-85C6-41E3-A86F-2AC85824DB7E
d. 42 U.S.C.6101 et sue,42 U.S.C.2000d,29 U.S.C.794(regarding discrimination);
e. the"Americans with Disabilities Act"(Public Law 101-336;42 U.S.C.12101,12102,12111
-12117,12131-12134,12141-12150,12161-12165,12181-12189,12201-12213 and 47
U.S.C.225 and 47 U.S.C.611);
£ when applicable,the Contractor shall comply with the provisions of the"Uniform
Administrative Requirements for Grants and Cooperative Agreements to State and Local
Governments"(Common Rule);
g. The Federal Funding Accountability and Transparency Act of 2006(Public Law 109-282),as
amended by§6062 of Public Law 110-252,including without limitation all data reporting
requirements required there under.This Act is also referred to as FFATA.
h. Contractor shall comply with the provisions of Section 601 of Title VI of the Civil Rights Act
of 1964,as amended.
i. Except as otherwise provided under 41 CFR Part 60,all contracts that meet the definition of
"federally assisted construction contract"in 41 CFR Part 60-1.3 comply with the equal
opportunity clause provided under 41 CFR 60-1.4(b),in accordance with Executive Order
11246,"Equal Employment Opportunity:(30 FR 12319,12935,3 CFR Part,1964-1965
Comp.,p.339),as amended by Executive Order 11375,"Amending Executive Order 11246
Relating to Equal Employment Opportunity,"and implementing regulations at 41 CFR part
60,"Office of Federal Contract Compliance Programs,Equal Employment Opportunity,
Department of Labor.
j. where applicable,Contract Work Hours and Safety Standards Act(40 U.S.C.3701-3708).
k. if the Federal award meets the defmition of"funding agreement"under 37 CFR§401.2(a)
and the recipient or subrecipient wishes to enter into an agreement with a small business firm
or nonprofit organization,comply with the requirements of 37 CFR Part 401,"Rights to
Inventions Made by Nonprofit Organizations and Small Business Firms Under Government
Grants,Contracts and Cooperative Agreements,"and any implementing regulations issued by
the awarding agency.
1. the Clean Air Act(42 U.S.C.7401-7671q.)and the Federal Water Pollution Control Act(33
U.S.C.1251-1387),as amended.
m. if applicable,comply with the mandatory standards and policies on energy efficiency
contained within the State of Colorado's energy conservation plan issued in compliance with
the Energy Policy and Conservation Act,42 U.S.C.6201.
n. the Contractor and all principals are not presently debarred,suspended,proposed for
debarment,declared ineligible,or voluntarily excluded from covered transactions by any
federal department or agency;the Contractor and all principals shall comply with all
applicable regulations pursuant to Executive Order 12549(3 CFR Part 1986 Comp.,p.189)
and Executive Order 12689(3 CFR Part 1989 Comp.,p.235),Debarment and Suspension;
and,
o. the Contractor shall comply where applicable,the Byrd Anti-Lobbying Amendment(31
U.S.C.1352).
12)Compliance.Subrecipient shall comply with all applicable provisions of The Office of Management
and Budget Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal
Awards(Uniform Guidance),including but not limited to these Supplemental Provisions for Federal
Awards.Any revisions to such provisions automatically shall become a part of these Supplemental
Provisions,without the necessity of either party executing any further instrument.CDPHE may provide
Page 3 of 4
Option Letter Contract Number:2022.0912 Option Letter#2 Ver.25.02.20
DocuSign Envelope ID:5D967D6F-85C6-41E3-A86F-2AC85824DB7E
written notification to Subrecipient of such revisions,but such notice shall not be a condition precedent to
the effectiveness of such revisions.
13)Procurement Procedures.Subrecipient shall use its own documented procurement procedures which
reflect applicable State,local,and Tribal laws and regulations,provided that the procurements conform to
applicable Federal law and the standards identified in the Uniform Guidance,including without limitation,
§§200.318 through 200.326 thereof.
14)Certifications.Unless prohibited by Federal statutes or regulations,CDPHE may require
Subrecipient to submit certifications and representations required by Federal statutes or regulations on an
annual basis(2 CFR§200.208).Submission maybe required more frequently if Subrecipient fails to meet
a requirement of the Federal award.Subrecipient shall certify in writing to CDPHE at the end of the
Contract that the project or activity was completed or the level of effort was expended.2 CFR
§200.201(b)(3).If the required level of activity or effort was not carried out,the amount of the Contract
must be adjusted.
15)Event of Default.Failure to comply with the Uniform Guidance or these Supplemental Provisions for
Federal Awards shall constitute an event of default under the Contract pursuant to 2 CFR§200.339 and
CDPHE may terminate the Contract in accordance with the provisions in the Contract.
16)Close-Out.Subrecipient shall close out this Contract within 45 days after the End Date.Contract
close out entails submission to CDPHE by Subrecipient of all documentation defined as a deliverable in
this Contract,and Subrecipient's fmal reimbursement request.If the project has not been closed by the
Federal awarding agency within 1 year and 45 days after the End Date due to Subrecipient's failure to
submit required documentation that CDPHE has requested from Subrecipient,then Subrecipient may be
prohibited from applying for new Federal awards through the State until such documentation has been
submitted and accepted.
17)Erroneous Payments.The closeout of a Federal award does not affect the right of the Federal
awarding agency or CDPHE to disallow costs and recover funds on the basis of a later audit or other
review.Any cost disallowance recovery is to be made within the record retention period.
EXHIBIT END
Page 4 of 4
Option Letter Contract Number:2022*0912 Option Letter#2 Ver.25.02.20
DocuSign Envelope ID:F53B02AB-78EF-4B8A-8DC7-6587B9857776
OPTION LETTER#:1
State Agency: Original Contract Number:
Colorado Department of Public Health and Environment 2022.0912
CYF/MCH
4300 Cherry Creek Drive South Option Letter Contract Number:
Denver,Colorado 80246 2022.0912 Option Letter#1
Contractor:
Board of County Commissioners of Weld County(a political subdivision
of the state of Colorado)1150"O"Street,Greeley,CO 80631 for the use
and benefit of the Weld County Department of Public Health and
Environment,1555 North 17.Avenue,Greeley,CO 80631
Contract Performance Beginning Date: Current Contract Expiration Date:
October 1,2021 September 30,2023
CONTRACT MAXIMUM AMOUNT TABLE
Document Type Contract Number Federal Funding State Funding Other Funding Term(dates) Total
Original Contract 2022*0912 $186,054.00 $0.00 $0.00 10/1/21-9/30/22 $186,054.00
Original Contract 2022*0912 $0.00 $133,000.00 $0.00 10/1/21-6/30/22 $133,000.00
Option Letter#1 2022*0912 $186,054.00 $0.00 $0.00 10/1/22-9/30/23 $186,054.00
Option Letter#1
Option Letter#1 2022*0912 $0.00 $133,000.00 $0.00 10/1/22-6/30/23 $133,000.00
Option Letter#1
Current Contract Maximum $638,108.00
Cumulative Amount
1)OPTIONS
A.Option to extend for an Extension Term
B.Option to change quantity of services under the Contract
2)REQUIRED PROVISIONS:
A.In accordance with Exhibit A,Additional Provisions,Paragraph 9 of the Original Contract referenced
above,the State hereby exercises its option for an additional term,beginning October 1,2022 and ending on
the current contract expiration date shown above,at the rates stated in the Original Contract,as amended for
the following reason:To continue developing,implement and evaluate evidence-based Maternal and Child
Health(MCH)local action plans that promote and contribute to healthy outcomes for Colorado women,
children and youth.
B. In accordance with Exhibit A,Additional Provisions,Paragraph 10 of the Original Contract referenced
above,the State hereby exercises its option to increase the quantity of services at the rates stated in the
Original Contract as amended.Exhibit C,Budget,is deleted and replaced in its entirety with Exhibit C,
Budget,attached to this Option Letter,for the following reason:To increase funding in support of the new
term.
C. Exhibit E,Federal Provisions,is deleted and replaced in its entirety with Exhibit E,Federal Provisions,
attached to this Option Letter,for the following reason:To reflect changes to the federal award identification
information.
D. The Contract Maximum Amount table is deleted and replaced with the Current Contract Maximum
Amount table shown above.
3)OPTION EFFECTIVE DATE:
The effective date of this Option Letter is upon approval of the State Controller or October 1,2022,
whichever is later.
Page 1 of 2
Option Letter Contract Number:2022.0912 Option Letter#1 Ver.27.01.20
DocuSign Envelope ID:F53B02AB-78EF-4B8A-8DC7-6587B9857776
SIGNATURE PAGE
STATE OF COLORADO In accordance with§24-30-202 C.R.S.,this Option is not
Jared S.Polls,Governor valid until signed and dated below by the State Controller or
Colorado Department of Public Health and Environment an authorized delegate.
Jill Hunsaker Ryan,MPH,Executive Director STATE CONTROLLER
Robert Jams,CPA,MBA,JD
r-DocuSipned by: DocuSigned by:
USX II/V.4%km UtAsfit,
`-2EDF870A1A7D4FC... CngcSapcge�pep5
By:Signature By:Signature
Lisa McGovern Justin Weigle
Name of Executive Director Delegate Name of State Controller Delegate
Procurement&Contracts Section Director ft Health Divisions Controller
Title of Executive Director Delegate Title of State Controller Delegate
2022-09-12 2022-09-19
Date: Option Effective Date:
--Signature Page End--
Page 2 of 2
Option Letter Contract Number:2022.0912 Option Letter#1 Ver.03.01.20
880 COLOR ADO Exhibit C Budget
117=eEtauutt,
PREVENTION SERVICES DIVISION-12 MONTH BUDGET WITH JUSTIFICATION FORM
Original Contract Routing#2022.0912
Program Contact Name,Title, Shaun May
Contractor Name Weld County Department of Public Health smay@weldgov.com
Phone and Email
970-400-2309
Tanya Geiser,Finance Director
Budget Period 10/1/2022-9/30/2023 Fiscal Contact Name,Title,Phone
tgeiser@weldgov.com
and Email
970-400-2122
Project Name Maternal and Child Health Contract(CT or PO)Number CT,FHLA,2022.0912
Expenditure Categories
Personal Services
Total Amount
Position Title Description of Work Gross or Annual Fringe Percent of Time Reoue,red from
Salary on Project cDpHE
Provides direct oversight and supervision of HCP care
coordination program and staff,directs care
coordination activities,oversees HCP prograrn
planning,reporting,evaluation,and budgetary
HCP Program Coordinator activities,participates in HCP program outreach and $ 107,096.51 $41,692.67 29.0% $ 43,148.86
represents HCP on several community-based groups
and state HCP/MCH workgroups.Full time employee
in the MCH program.Remainder of the time and
effort is county-funded.
Provides care coordination services to HCP clients,
HCP RN Care Coordinator can"rnismtsnwniittny/HstCaPt:rmnegeratimngnsutmrecaHchmacnpdFaTttEeinsds HCP $ 74,810.34 $ 29,123.67 99.0% $ 102,894.67
0.99 funded through the state.
Director of Clinical& Provides oversight of HCP program and HCP staff,
Community Health participates CH/HCP in reporting and evaluation of HCP
$ 124,169.71 $ 48,339.27 1.0% $ 1,725.09
Services program.M FTE is.01 but will likely work
more in this program as county-funded.
Provides oversight of HCP program and HCP staff,
Chief Nursing Officer narticinates rennrting and evainati"cif HCP $ 152,955.83 $ 59,545.70 1.0% $ 2,125.02
program.MCH/HCP FTE is.01 but will likely work
more in this program as county-funded.
Provides social work services to HCP program clients
upon request from HCP staff,available to provide
Public Health Social HCP population-based program outreach as assigned
Worker by HCP program coordinator.MCH/HCP FIE is 0.01 $ 76'699." $ 29
'85
9." 1." $
106558
but will likely work more in this program as county-
funded.
Provides direct oversight of MCH Positive Children
Health Communication
Specialist and Youth Development priority.Oversees program $ 77,004.00 $ 29,977.66 69.0% $ 73,817.35
planning,reporting,evaluation,and budget.
Provides oversight of MCH Positive Children and
Supervisor Youth Development priority,participates in $ 86,381.20 $ 33,628.20 1.0% $ 1,200.09
reporting and evaluation of priorities.
Provides oversight of MCH Positive Children and
'CEP Divrsinn Direct(' Youth Development priority and program and staff. $ 177'7".2° $ 49'544.34 1.D% $
Provides data analysis and evaluation expertise for
Data Specialist MCH Positive Children and Youth Development $ 116,570.34 $ 45,380.83 1.0% $ 1,619.51
priority.
Personal Services
Hourly Employees
Total Amount
Position Title Description of Work Hourly Wage Hourly Fringe Mt' H°urs Requested from
on Project cppHE
Administrative support to HCP program coordinator
and team.Responsibilities include interpretation and
HCP Office Technician translation,CDS data entry,EMR data entry, $ 23.87 $ 9.29 1040.0000 $ 34,486.40
materials preparation,assists HCP staff with care
coordination activities,etc.MCH/HCP FTE is 0.5.
, • TotalPetsariaLServicus:(kictudinefrifige,tien'eftts)' :..263;80.67
Total Amount
Item Description of Item Rate Quantity Requested from
CDPHE
Option Letter Contract Number:2022.0.2 Option Letter#1 Page 1 of 2
Program outreach and promotional materials for systerns building
Meeting supplies/materials activities.May include allocations for MCH printing and office supplies $ 1,325.000 1.00 $ 1,3x2h5i.b0i0t Budget
(i.e.brochures,handouts,etc.).
An HCP program cell phone would be utilized to improve
cornmunication with HCP clients and families.While at visits RNs could
also use phone to call/research resourc:es and community partners to
Phones coordinate services.A phone would also enable staff to meet client $ 60.00 12.00 $ 720.00
requests to text appointment information and client updates to
guardians throughout the care coordination process.(12 months @
$60/month)
Total Supplies&Operating$ 2,045.00
Travel
Total Amount
Item Description of Item Rate Quantity Requested from
CDPHE
Travel to meetings and outreach opportunities such as early childhood
Mileage council meetings and childcare centers.Mileage is reimbursed at $ 0.565 2770.25 $ 1,565.19
$0.565/mile.
Total Travel$ 1,565.19
Contractual
Total Arnount
Subcontractor Name Description of Item Rate Quantity Requested from
CDPHE
Total Contractual$
SUB-TOTAL OF DIREcr COSTS$ 267,460.86
Indirect
Total Amount
(tern Description of Item Requested from
CDPHE
CY22 negotiated indirect rate with CDPHE is 19.29%of Modified total direct costs,consisting of all ,
salaries and wages,fringe benefits,materials and supplies,services,travel,and sub grants and
subcontracts up to the first$25,000 of each sub grant or subcontract(regardless of the period covered $ 56593
60
by the sub grant or subcontract).Equipment,capital expenditures,charges for patient care,tuition
rernission,rental costs,scholarships,a.fellowships,participant support costs and the portion of each
C.P.Neg.tia.Indirect sub grant and subcontract in excess of$25,000 shall be excluded from modified total direct costs.
Cost Rate
Total Indirect$ 51,593.14
TOTAL $ 319,054.00
Option Letter Contract Nurnber:2022.0912 Option Letter#1 Page 2 of 2
DocuSign Envelope ID:F53B02AB-78EF-4B8A-8DC7-6587B9857776
Exhibit E
Federal Provisions—Maternal and Child Health Services
For the purposes of this Exhibit only,Contractor is also identified as"Subrecipient."This Contract has
been funded,in whole or in part,with an award of Federal funds.In the event of a conflict between the
provisions of these Supplemental Provisions for Federal Awards,the Special Provisions,the Contract or
any attachments or exhibits incorporated into and made a part of the Contract,the Supplemental
Provisions for Federal Awards shall control.In the event of a conflict between the Supplemental
Provisions for Federal Awards and the FFATA Supplemental Provisions(if any),the FFATA
Supplemental Provisions shall control.
1) Federal Award Identification.
a.Subrecipient:Weld County Department of Public Health and Environment
b.Subrecipient Unique Entity Identification Number:
• SAM Unique Entity ID(UEI):MKKXT9U9MTV5
c.The Federal Award Identification Number(FAIN)is B0440120
d.The Federal award date is TBD
e.The subaward period of performance start date is 10/1/2022 and end date is 9/30/2023.
£ Federal Funds:
Federal Budget Period Total Amount of Federal Amount of Federal Funds
Funds Awarded Obligated to CDPHE
10/1/2022—9/30/2023 TBD TBD
g.Federal award title of project or program:Maternal and Child Health Services.
h.The name of the Federal awarding agency is:United States Department of Health and
Human Services(USDHHS)Health Resources and Services Administration
(HRSA)and the contact information for the awarding official is Leon Harrison,Phone:
301.443.5809;Email:larrison@hrsa.gov;the name of the pass-through entity is the State of
Colorado,Department of Public Health and Environment(CDPHE),and the contact
information for the CDPHE official is Risa Friedman(CDPHE)Project Director.
i. The Catalog of Federal Domestic Assistance(CFDA)number is 93.994 and the grant name is
Maternal and Child Health Services Block Grant to the States.
j. This award is not for research&development.
k.Subrecipient is not required to provide matching funds.In the event the Subrecipient is
required to provide matching funds,Section 8 of this Attachment applies.
1. The indirect cost rate for the Federal award(including if the de minimis rate is charged per 2
CFR§200.414 Indirect(F&A)costs)is pre-determined based upon the State of Colorado and
CDPHE cost allocation plan.
2)Subrecipient shall at all times during the term of this contract strictly adhere to the requirements under
the Federal Award listed above,and all applicable federal laws,Executive Orders,and implementing
regulations as they currently exist and may hereafter be amended.
Page 1of4
Option Letter Contract Number:2022.0912 Option Letter#1 Ver.25.02.20
DocuSign Envelope ID:F53B02AB-78EF-4B8A-8DC7-6587B9857776
3) Any additional requirements that CDPHE imposes on Subrecipient in order for CDPHE to meet its
own responsibility to the Federal awarding agency,including identification of any required financial and
performance reports,are stated in the Exhibits.
4) Subrecipient's approved indirect cost rate is as stated in the Exhibits.
5) Subrecipient must permit CDPHE and auditors to have access to Subrecipient's records and financial
statements as necessary for CDPHE to meet the requirements of 2 CFR§200.331 Requirements for pass-
through entities,§§200.300 Statutory and National Policy Requirements through§200.309 Period of
performance,and Subpart F—Audit Requirements of this Part.
6) The appropriate terms and conditions concerning closeout of the subaward are listed in Section 16 of
this Attachment.
7) Performance and Final Status.Subrecipient shall submit all financial,performance,and other
reports to CDPHE no later than 45 calendar days after the period of performance end date or sooner
termination of this Contract containing an evaluation and review of Subrecipient's performance and the
fmal status of Subrecipient's obligations hereunder.
8) Matching Funds.Subrecipient shall provide matching funds as stated in the Exhibits.Subrecipient
shall have raised the full amount of matching funds prior to the Effective Date and shall report to CDPHE
regarding the status of such funds upon request.Subrecipient's obligation to pay all or any part of any
matching funds,whether direct or contingent,only extends to funds duly and lawfully appropriated for the
purposes of this Contract by the authorized representatives of the Subrecipient and paid into the
Subrecipient's treasury or bank account.Subrecipient represents to CDPHE that the amount designated as
matching funds has been legally appropriated for the purposes of this Contract by its authorized
representatives and paid into its treasury or bank account.Subrecipient does not by this Contract
irrevocably pledge present cash reserves for payments in future fiscal years,and this Contract is not
intended to create a multiple-fiscal year debt of the Subrecipient.Subrecipient shall not pay or be liable for
any claimed interest,late charges,fees,taxes or penalties of any nature,except as required by
Subrecipient's laws or policies.
9) Record Retention Period.The record retention period previously stated in this Contract is replaced
with the record retention period prescribed in 2 CFR§200.333.
10)Single Audit Requirements.If Subrecipient expends$750,000 or more in Federal Awards during
Subrecipient's fiscal year,Subrecipient shall procure or arrange for a single or program-specific audit
conducted for that year in accordance with the provisions of Subpart F-Audit Requirements of the Uniform
Guidance,issued pursuant to the Single Audit Act Amendments of 1996,(31 U.S.C.7501-7507).2 CFR
§200.501.
11)Contract Provisions.Subrecipient shall comply with and shall include all of the following applicable
provisions in all subcontracts entered into by it pursuant to this Contract:
a. Office of Management and Budget Circulars and The Common Rule for Uniform
Administrative Requirements for Grants and Cooperative Agreements to State and Local
Governments,as applicable;
b. when required by Federal program legislation,the"Davis-Bacon Act",as amended(40
U.S.C.3141-3148)as supplemented by Department of Labor Regulations(29 CFR Part 5,
"Labor Standards Provisions Applicable to Contracts Covering Federally Financed and
Assisted Construction");
c. when required by Federal program legislation,the Copeland"Anti-Kickback"Act(40 U.S.C.
3145),as supplemented by Department of Labor regulations(29 CFR Part 3,"Contractors
and Subcontractors on Public Building of Public Work Financed in Whole or in Part by Loans
or Grants from the United States").
Page 2 of 4
Option Letter Contract Number:2022*0912 Option Letter#1 Ver.25.02.20
DocuSign Envelope ID:F53B02AB-78EF-4B8A-8DC7-6587B9857776
d. 42 U.S.C.6101 et s,,42 U.S.C.2000d,29 U.S.C.794(regarding discrimination);
e. the"Americans with Disabilities Act"(Public Law 101-336;42 U.S.C.12101,12102,12111
-12117,12131-12134,12141-12150,12161-12165,12181-12189,12201-12213 and 47
U.S.C.225 and 47 U.S.C.611);
f. when applicable,the Contractor shall comply with the provisions of the"Uniform
Administrative Requirements for Grants and Cooperative Agreements to State and Local
Governments"(Common Rule);
g. The Federal Funding Accountability and Transparency Act of 2006(Public Law 109-282),as
amended by§6062 of Public Law 110-252,including without limitation all data reporting
requirements required there under.This Act is also referred to as FFATA.
h. Contractor shall comply with the provisions of Section 601 of Title VI of the Civil Rights Act
of 1964,as amended.
i. Except as otherwise provided under 41 CFR Part 60,all contracts that meet the definition of
"federally assisted construction contract"in 41 CFR Part 60-1.3 comply with the equal
opportunity clause provided under 41 CFR 60-1.4(b),in accordance with Executive Order
11246,"Equal Employment Opportunity:(30 FR 12319,129350 CFR Part,1964-1965
Comp.,p.339),as amended by Executive Order 11375,"Amending Executive Order 11246
Relating to Equal Employment Opportunity,"and implementing regulations at 41 CFR part
60,"Office of Federal Contract Compliance Programs,Equal Employment Opportunity,
Department of Labor.
j. where applicable,Contract Work Hours and Safety Standards Act(40 U.S.C.3701-3708).
k. if the Federal award meets the defmition of"funding agreement"under 37 CFR§401.2(a)
and the recipient or subrecipient wishes to enter into an agreement with a small business firm
or nonprofit organization,comply with the requirements of 37 CFR Part 401,"Rights to
Inventions Made by Nonprofit Organizations and Small Business Firms Under Government
Grants,Contracts and Cooperative Agreements,"and any implementing regulations issued by
the awarding agency.
1. the Clean Air Act(42 U.S.C.7401-7671q.)and the Federal Water Pollution Control Act(33
U.S.C.1251-1387),as amended.
m. if applicable,comply with the mandatory standards and policies on energy efficiency
contained within the State of Colorado's energy conservation plan issued in compliance with
the Energy Policy and Conservation Act,42 U.S.C.6201.
n. the Contractor and all principals are not presently debarred,suspended,proposed for
debarment,declared ineligible,or voluntarily excluded from covered transactions by any
federal department or agency;the Contractor and all principals shall comply with all
applicable regulations pursuant to Executive Order 12549(3 CFR Part 1986 Comp.,p.189)
and Executive Order 12689(3 CFR Part 1989 Comp.,p.235),Debarment and Suspension;
and,
o. the Contractor shall comply where applicable,the Byrd Anti-Lobbying Amendment(31
U.S.C.1352).
12)Compliance.Subrecipient shall comply with all applicable provisions of The Office of Management
and Budget Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal
Awards(Uniform Guidance),including but not limited to these Supplemental Provisions for Federal
Awards.Any revisions to such provisions automatically shall become a part of these Supplemental
Provisions,without the necessity of either party executing any further instrument.CDPHE may provide
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written notification to Subrecipient of such revisions,but such notice shall not be a condition precedent to
the effectiveness of such revisions.
13)Procurement Procedures.Subrecipient shall use its own documented procurement procedures which
reflect applicable State,local,and Tribal laws and regulations,provided that the procurements conform to
applicable Federal law and the standards identified in the Uniform Guidance,including without limitation,
§§200.318 through 200.326 thereof.
14)Certifications.Unless prohibited by Federal statutes or regulations,CDPHE may require
Subrecipient to submit certifications and representations required by Federal statutes or regulations on an
annual basis(2 CFR§200.208).Submission maybe required more frequently if Subrecipient fails to meet
a requirement of the Federal award.Subrecipient shall certify in writing to CDPHE at the end of the
Contract that the project or activity was completed or the level of effort was expended.2 CFR
§200.201(b)(3).If the required level of activity or effort was not carried out,the amount of the Contract
must be adjusted.
15)Event of Default.Failure to comply with the Uniform Guidance or these Supplemental Provisions for
Federal Awards shall constitute an event of default under the Contract pursuant to 2 CFR§200.339 and
CDPHE may terminate the Contract in accordance with the provisions in the Contract.
16)Close-Out.Subrecipient shall close out this Contract within 45 days after the End Date.Contract
close out entails submission to CDPHE by Subrecipient of all documentation defined as a deliverable in
this Contract,and Subrecipient's final reimbursement request.If the project has not been closed by the
Federal awarding agency within 1 year and 45 days after the End Date due to Subrecipient's failure to
submit required documentation that CDPHE has requested from Subrecipient,then Subrecipient maybe
prohibited from applying for new Federal awards through the State until such documentation has been
submitted and accepted.
17)Erroneous Payments.The closeout of a Federal award does not affect the right of the Federal
awarding agency or CDPHE to disallow costs and recover funds on the basis of a later audit or other
review.Any cost disallowance recovery is to be made within the record retention period.
EXHIBIT END
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