HomeMy WebLinkAbout20231632.tiffRESOLUTION
RE: APPROVE AMENDMENT #1 TO TASK ORDER CONTRACT FOR WOMEN'S
WELLNESS CONNECTION CANCER PREVENTION AND EARLY DETECTION
PROGRAM, AND AUTHORIZE CHAIR TO SIGN AND SUBMIT ELECTRONICALLY
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 Amendment #1 to the Task Order
Contract for the Woman's Wellness Connection Cancer Prevention and Early Detection Program
between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Public Health and Environment,
and the Colorado Department of Public Health and Environment, commencing January 1, 2023,
and ending June 29, 2024, with further terms and conditions being as stated in said amendment,
and
WHEREAS, after review, the Board deems it advisable to approve said amendment, 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 Amendment #1 to the Task Order Contract for the Woman's
Wellness Connection Cancer Prevention and Early Detection Program between the County of
Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on
behalf of the Department of Public Health and Environment, and the Colorado Department of
Public Health and Environment, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to electronically sign and submit said amendment.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 12th day of June, A.D., 2023, nunc pro tunc January 1, 2023.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: do:4A) w „d,/ ;.4.
Weld County Clerk to the Board
BY: Oft&M. OM kt JC
Deputy Clerk to the Board
APP; VED
County Attorney
Date of signature: LeI231zoz3
CC'. HL
07/12/23
3�-
eman, Chair
Perry .:fck, Pro-Tem
on Saine
2023-1632
H L0056
Co i fka0-H irk -10 c
BOARD OF COUNTY COMMISSIONERS
PASS -AROUND REVIEW
TITLE: CDPHE WOMEN'S WELLNESS CONNECTION - CANCER PREVENTION AND EARLY DETECTION
CONTRACT AMENDMENT # 1
DEPARTMENT: PUBLIC HEALTH & ENVIRONMENT DATE: May 23, 2023
PERSON REQUESTING: JASON CHESSHER, EXECUTIVE DIRECTOR
Brief description of the problem/issue:
For the Board's review and approval for placement on the agenda is Contract Amendment #1
between the Colorado Department of Public Health and Environment (CDPHE) and the Board of
County Commissioners of Weld County for the use and benefit of the Weld County Department of
Public Health and Environment (WCDPHE) for the Women's Wellness Connection (WWC) Cancer
Prevention and Early Detection (CPED) program.
The WWC program provides low-income, uninsured, and underserved women in Colorado access to
timely, high -quality screening and diagnostic services to detect breast and cervical cancer at the
earliest stages. In addition, the Targeted Outreach component of the program helps recruit
qualifying women and reduce barriers to screenings, while providing education about the
importance of breast and cervical cancer screenings to all eligible women.
This contract amendment shall be effective July 1, 2023, through June 29, 2024, with funding not to
exceed $57,169 during the contract period. Of this amount, $25,898 is Federal funding and $31,271 is
State funding.
Activities will be conducted by current staff; no additional FTE is being requested.
What options exist for the Board? (include consequences, impacts, costs, etc. of options):
With the approval of the Board, this will allow WCDPHE to continue to provide breast and cervical
cancer education and help reduce barriers to screenings for Weld County women. It will also allow
WCDPHE to screen women for breast and cervical cancer who otherwise may not be screened, due
to inability to pay at private facilities.
If the Board declines approving this contract amendment, may result in more women in Weld County
needing treatment for cancer at a later stage, rather than diagnosing and treating cancer earlier,
increasing health care costs, and cancer related morbidity/mortality.
Recommendation: I recommend approval of this contract amendment with CDPHE.
Approve Schedule
Rec emendation Work Session Other/Comments:
Perry L. Buck, Pro-Tem
Mike Freeman, Chair
Scott K. James
Kevin Ross
Lori Saine
2023-1632
DocuSign Envelope ID: 60718F2E-C8B9-41AA-8D36-525C065E7F1E
CONTRACT AMENDMENT #: 1
SIGNATURE AND COVER PAGE(S)
State Agency:
Colorado Department Of Public Health and Environment
PSD / WWC
4300 Cherry Creek Drive South
Denver, Colorado 80246
Original Contract Number:
2023*2330
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 17th Avenue
Greeley CO 80631
Amendment Contract Number:
2023*2330 Amendment #1
Contract Performance Beginning Date:
January 1, 2023
Current Contract Expiration Date:
June 29, 2024
CONTRACT MAXIMUM AMOUNT TABLE
Document
Type
Contract
Number
Federal
Funding
Amount
State Funding
Amount
Other Funding
Amount
Term (dates)
Total
Original Contract
2023*2330
$0.00
$19,253.00
$0.00
1/01/2023 -6/29/2023
519,253.00
Original Contract
2023*2330
$23,620.00
$0.00
$0.00
1/01/2023 —6/29/2023
$23,620.00
Contract
Amendment #1
20 0
Amendment #1
$25,898.00
$0.00
$0.00
6/30/2023 — 6/29/2024
025,898.00
Contract
Amendment #1
2023onont
Amendment #1
$0.00
$31,271.00
$0.00
7/01/2023 — 6/29/2024
S31,271.00
Current Contract Maximum
Cumulative Amount
$100,042.00
Page l of
Amendment Contract Number: 2023*2330 Amendment #1
Ver 01.11.19
DocuSign Envelope ID: 60718F2E-C8B9-41AA-8D36-525C065E7F1E
SIGNATURE PAGE
THE PARTIES HERETO HAVE EXECUTED THIS AMENDMENT
Each person signing this Amendment represents and warrants that he or she is duly authorized to execute this Amendment
and to bind the Party authorizine his or her sienature.
CONTRACTOR
Board of County Commissioners of Weld County
(a political subdivision of the state of Colorado)
for the use and benefit of the
Weld County Department of Public Health and
Environment
, -DocuSigned by:
hat, Fln,t wt5It,
`-E04467D642AE4A7..
STATE OF COLORADO
Jared S. Polls, Governor
Colorado Department of Public Health and Environment
Jill Hunsaker Ryan, MPH, Executive Director
c-DocuSigned by:
Lila IlitiAmapt,
,-2ED,870A,A7D^C...
By: Signature
Mike Freeman
By: Signature
Lisa McGovern
Name of Person Signing for Contractor
Chair, Commissioners
Name of Executive Director Delegate
Procurement & Contracts Section Director ft
Title of Person Signing for Contractor
2023-06-12
Date:
Title of Executive Director Delegate
2023-06-12
Date:
In accordance with §24-30-202 C.R.S., this Contract is not valid until signed and dated below by the State Controller or
an authorized delegate.
STATE CONTROLLER
Robert Jaros, CPA, MBA, JD
DDocuSigned by:
OUAI& S. (Uri"
8CA04B14546748A
By: Signature
Jannette Scarpino
Name of State Controller Delegate
Chief Financial Officer
Title of State Controller
Amendment Effective Date:
Delegate
2023-06-12
-- Signature and Cover Pages End --
Page 2 of 4
Amendment Contract Number: 2023*2330 Amendment #I
Ver. 06.05.20
DocuSign Envelope ID: 60718F2E-C8B9-41AA-8036-525C065E7F1E
1. PARTIES
This Amendment (the "Amendment") to the Original Contract shown on the Signature and Cover
Page for this Amendment (the "Contract") is entered into by and between the Contractor, and the
State.
2. TERMINOLOGY
Except as specifically modified by this Amendment, all terms used in this Amendment that are
defined in the Contract shall be construed and interpreted in accordance with the Contract.
3. AMENDMENT EFFECTIVE DATE AND TERM
A. Amendment Effective Date
This Amendment shall not be valid or enforceable until the Amendment Effective Date
shown under the State Controller Signature. The State shall not be bound by any provision of
this Amendment before that Amendment Effective Date, and shall have no obligation to pay
Contractor for any Work performed or expense incurred under this Amendment either before
or after of the Amendment term shown in §3.B of this Amendment.
B. Amendment Term
The Parties' respective performances under this Amendment and the changes to the Contract
contained herein shall commence on the Amendment Effective Date shown under the State
Controller Signature or June 30, 2023, whichever is later, and shall terminate on the
termination of the Contract or June 29, 2024, whichever is earlier.
4. PURPOSE
The Parties entered into the agreement to reduce cancer health disparities, and morbidity and
mortality rates in Colorado.
The Parties now desire to renew for an additional term and change current Contract Maximum
Total for the following reason: amend Statement of Work (SOW) to fix an administrative error
in Primary Activity #2, Sub -Activities #2, and add funds to support the activities and deliverables
as set forth in the renewal term SOW.
5. MODIFICATIONS
The Contract and all prior amendments thereto, if any, are modified as follows:
A. The Contract Maximum Amount table is deleted and replaced with the Current Contract
Maximum Amount table shown on the Signature and Cover Page for this Amendment.
B. The Contract Initial Contract Expiration Date on the Contract's Signature and Cover Page
is hereby deleted and replaced with the Current Contract Expiration Date shown on the
Signature and Cover Page for this Amendment.
C. The Parties now agree to modify Exhibit B., Statement of Work, of the agreement. Exhibit
B., Statement of Work, is deleted and replaced in its entirety with Exhibit B., Statement of
Work, attached to this Amendment for the following reason: correct the reference of Sub -
Page 3 of 4
Amendment Contract Number: 2023*2330 Amendment #1 Ver 27.01.20
DocuSign Envelope ID: 60718F2E-C8B9-41AA-8D36-525C065E7F1E
Activities 2.1 to Sub -Activities 2 and delete "uninsured/underinsured" from Sub -Activities
#2 and replacing the term with "insured" as shown in the attached revised SOW.
D. The Parties now agree to modify Exhibit C., Budget, of the agreement. Exhibit C., Budget,
is deleted and replaced in its entirety with Exhibit C., Budget, attached to this Amendment
for the following reason: add funds for FY24 renewal.
6. LIMITS OF EFFECT AND ORDER OF PRECEDENCE
This Amendment is incorporated by reference into the Contract, and the Contract and all prior
amendments or other modifications to the Contract, if any, remain in full force and effect except
as specifically modified in this Amendment. Except for the Special Provisions contained in the
Contract, in the event of any conflict, inconsistency, variance, or contradiction between the
provisions of this Amendment and any of the provisions of the Contract or any prior modification
to the Contract, the provisions of this Amendment shall in all respects supersede, govern, and
control. The provisions of this Amendment shall only supersede, govern, and control over the
Special Provisions contained in the Contract to the extent that this Amendment specifically
modifies those Special Provisions.
Page 4 of 4
Amendment Contract Number: 2023*2330 Amendment #1 Ver 27.01.20
DocuSign Envelope ID: 60718F2E-C8B9-41 AA-8D36-525C065E7F1 E
EXHIBIT B
STATEMENT OF WORK
To Original Contract Number 2023*2330
These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above.
Entity Name: Weld County Department of Public Health and Environment
II. Project Description:
This project serves to reduce cancer health disparities, and morbidity and mortality rates in Colorado.
Cancer screening will increase in Colorado Department of Public Health and Environment (CDPHE)-
identified priority populations, especially women who are eligible for CDPHE-paid Clinical Services, by
implementing one or more approved strategies (community outreach, health navigation, CDPHE-paid
clinical services) to address cancer prevention and early detection.
Citizens of Colorado in the Contractor's service area will benefit from this project by receiving cancer
screening prevention and early detection services. CDPHE is funding this project to meet the goal of
reducing cancer health disparities, morbidity and mortality in Colorado by increasing cancer screening and
early detection.
III. Definitions:
1. Action Plan: Identifies the strategy(ies) the Contractor is approved to plan or implement and the
detailed steps the Contractor will take to address the objectives of this agreement.
2. CDPHE: Colorado Department of Public Health and Environment.
3. CDPHE-Paid Clinical Services: The Clinical Services component of the Health Navigation and
Clinical Services strategy funds breast and cervical cancer screening and diagnostic procedures for
eligible, low-income uninsured or underinsured clients.
4. CDPHE Contract Monitor: CDPHE staff member assigned to monitor the contract.
5. Health navigation: Individualized assistance offered to clients to help overcome health care system
barriers and facilitate timely access to quality screening and diagnostics as well as initiation of
treatment services for persons diagnosed with cancer.
IV. Work Plan:
Goal
#1: Facilitate
health
care services among
people
who face barriers
to good health.
Objective
rates,
Clinical
in
#1:
Colorado
Services
No
later
eligible
by
increasing
than
the
women.
expiration
cancer
screening
date
of this contract,
among
CDPHE-identified
reduce
cancer health
priority
disparities,
populations,
and morbidity
especially CDPHE-paid
and
mortality
Primary Activity #1
The
outlining:
1.
2.
Contractor
the
the
the
agreement.
strategy(ies)
project
detailed
shall,
will
steps
in
(community
focus;
which
collaboration
the
outreach;
Contractor
with
the
CDPHE
health
shall
take
navigation
Contract
address
and
Monitor,
the
clinical
objectives
draft an action
services) in which
of this
plan
to
Sub
-Activities
#1
1.
2.
The
The
with
Contractor
CDPHE.
Contractor
shall
shall
record
update
their
approval
the action
plan
by
at
signing
a minimum
the
final
annually.
action
plan
agreed upon
Page 1 of 4
Amendment Contract Number: 2023*2330 Amendment #1
Vcr. 01.11.19
DocuSign Envelope ID: 60718F2E-C8B9-41 AA-8D36-525C065E7F1 E
EXHIBIT B
3. The
changes.
Contractor
shall
record their
approval
by signing the
action
plan each time it
Primary Activity #2
The
prevention
Contractor
and
shall
early
implement
detection
one
in Colorado.
or more
strategies and
sub
-strategies
to address cancer
Sub
-Activities
#2
1.
2.
strategies
by
action
The
The
Contractor
CDPHE
a.
b.
Contractor
plan.
to
address
in
the
shall
action
implement
cancer
outreach
plan.
prevention
and
at
clinical
least
one (1)
and early
services
of
detection
the
following
in
strategics
Colorado,
as
and
approved
the
sub
eligible
approved
-
Community
Health
navigation
i.
Health
navigation only
among eligible
insured
clients
ii.
shall
Health
clients
report
navigation
and
required data
CDPHE-paid
related
to
the
clinical
strategies
services among
listed in
Primary Activity
#3
The Contractor shall
participate
in CDPHE-required
meetings.
Primary Activity
#4
The
Contractor shall
complete
Progress Reports.
Standards
Requirements
and
1.
2.
4.
5.
6.
7.
information
during
updates
The
the
Prevention
inclusions,
rule,
3.
The
The
The
action
The
The
written
The
Prevention
https://cancerplan.colorado.gov/help-for-grantees.
CDPHE
made
content
Contractor
regulation,
Contractor
Contractor
Contractor
plan
Contractor
the
and
Contractor
reports,
part
contract
of
contained
comply
Cancer
and
of
and
electronic
shall
Early
exclusions
shall
shall
shall
its
shall
data
statute
this
referenced
term.
shall
Early
with
comply
Prevention
contract
use
submit
comply
comply
submission
Detection
on
or
comply
all
all
Detection
documents
CDPHE
The
as
guidance.
CDPHE-required
all
updates.
needed
by
with
with
contractor
with
documents.
and
Program
final
with
reference
or
and
any
all
Early
Program
data
located
and/or
all
program
non-CDPHE
changes,
shall
is
requirements
and
Detection
and
subject
pursuant
reports
on
Manual.
is
forms
activities
monitor
revisions,
available
at
CDPHE
at
an
Program.
and
websites
any
to
stated
This
as
reporting
documents
interval
inclusions,
time
directives
templates.
non
and
and
may
The
to
the
outlined
non-CDPHE
changes,
be
and
CDPHE
or
CDPHE
and
changes
updated
is
website
incorporated
in
exclusions
stated
Cancer
revisions,
Cancer
website:
deliverables.
such
the
websites
required
periodically
action
content
in
the
to
and
plan.
and
by
for
in
the
on
document
-reimbursable
requirements
and
and
following
processes
program
calls
as online
mandatory
progress
Page 2 of 4
Amendment Contract Number: 2023*2330 Amcndmcnt #1
Vcr. 01.11.19
DocuSign Envelope ID: 60718F2E-C8B9-41 AA-8D36-525C065E7F1 E
EXHIBIT B
13.
14.
15.
16.
17.
18.
8.
9.
10.
11.
12.
The
action
the
The
required
sharing,
The
CDPHE
reporting
The
referenced
The
responsible
The
(2)
The
efforts.
The
The
CDPIIE
If
procedures
shall
a.
b.
c.
d.
e.
purchasing
a.
b.
c.
d.
performance
Contractor
Contractor
Contractor
months
Contractor
Contractor
Contractor
Contractor
Contractor
Contractor
include
the
plan
Develop
approved
modification
Modify
needed.
Obtain
plan.
Use
CDPHE's
Contractor's
training,
meetings,
will
on
Cancer
gift
printed
the
documents.
related
card
primary
within
for
of
the
provide
strategies
the
the
approval
hire.
gift
shall
shall
shall
an
action
shall
shall
the
shall
shall
shall
shall
gift
storage
period.
technical
by
evaluation
Prevention
cards,
following:
distribution
name
30
annual
action
to
training,
CDPHE.
or
adherence
performance
card
person
report
attend
adhere
the
identify
communicate
plan
comply
collect
submit
days
plan
gift
provide
from
and
and
and
required
of
a
assistance
action
webinars
to
CDPHE
of
have
with
all
and
service
post
CDPHE
in
to
and
purchasing
log
the
approval
the
deliverables
-award
data
delivery
and
to
prior
with
evaluation
tracked
of
and
will
in
staff
for
records
Detection
shall
against
adopt
of
the
CDPHE
during
related
orientation
telephone
contract
inform
requirements
and
and
beginning
personnel
handling.
action
with
performance
to
action
and
the
within
the
no
monitoring.
implement
and
provided
calls
the
contract
receive
program
later
Contractor
plan
and
strategies
Report
action
recipient.
CDPHE
plan.
15
via
CDPHE
distribution
card
activities
as
At
than
for
performance
for
within
outlined
days
the
Manual.
a
the
by
the
prioritized
60
Contract
listed
purpose
of
30
be
days
CDPHE
action
outlined
a
necessary
in
of
business
determined
change
request
dollar
the
training
indicated
gift
in
after
the
as
of
Monitor,
in
action
data.
cards
approved
the
well
information
days.
the
requires
in
procedures
amount,
written
key
within
by
end
action
plan
in
as
as
staff
the
of
other
the
the
two
and
and
-
that
plan:
strategies
measurement
plan
collaboration
the
listed
of
Early
following
plan
Contractor
to
the
card
inventory
developed
tasks
required
Contractor
safeguards
signature
the
to
CDPHE.
the
key
members
to
Progress
approved
provide
and
will
template
plan.
period.
required
monitoring
support
new
CDPHE
is
that
Contractor's
with
work
established
with
How
Gift
The
A
method
of
the
CDPHE
evaluation
each
and
securing
the
Program
maintained?
card
upon
to
minimum,
number,
responsible
each
gift
theft
card
gift
Results
of
1.
2.
Increased
Increased
priority
populations
number
number
of
of
individuals
quality
of
screened
CDPHE-approvcd
for
CDPHE-approved
cancer
screenings
cancers.
provided
within
Expected
Activity(s)
Page 3 of 4
Amendment Contract Number: 2023*2330 Amcndmcnt #1
Vcr. 01.11.19
DocuSign Envelope ID: 60718F2E-C8B9-41 AA-8D36-525C065E7F1 E
EXHIBIT B
3.
4.
Analysis of
Assessments,
programmatic
data
data submissions.
along
evaluation
information.
submissions,
with
1. Progress
Reports.
Measurement
of
2. CDPHE
received
programmatic
data submissions.
Expected
Results
3. CDPHE
received assessments,
along
with evaluation information.
Completion
Date
Deliverables
1.
The
Contractor
shall
submit
an action plan that
No
later
than
the
first business
includes
each
of
the strategies selected
and
referenced
day in March
in the
first budget
in
this
Statement
of
Work.
period
of the
contract,
and
then
the
first
business day
in
August,
annually.
2. The
Contractor shall
submit
a signed
action plan.
Within
15
calendar
days after
CDPHE
approval
action
of
the
plan.
initial
or
modified
3. The Contractor shall
submit
CDPHE-approved
No later
than
3/15 in
the first
Progress
Report.
budget
and
period
no
annually.
later
of
than
the contract,
1/15
V. Monitoring:
CDPHE's monitoring of this contract for compliance with performance requirements will be conducted
throughout the contract period by the CDPHE Contract Monitor. Methods used will include a review of
documentation determined by CDPHE to be reflective of performance to include progress reports and other
fiscal and programmatic documentation as applicable. The Contractor's performance will be evaluated at
set intervals and communicated to the contractor. A Final Contractor Performance Evaluation will be
conducted at the end of the life of the contract.
VI. Resolution of Non -Compliance:
The Contractor will be notified in writing within 15 calendar days of discovery of a compliance issue. Within
30 calendar days of discovery, the Contractor and the State will collaborate, when appropriate, to determine
the action(s) necessary to rectify the compliance issue and determine when the action(s) must be completed.
The action(s) and time line for completion will be documented in writing and agreed to by both parties. If
extenuating circumstances arise that requires an extension to the time line, the Contractor must email a
request to the CDPHE Contract Monitor and receive approval for a new due date. The State will oversee the
completion/implementation of the action(s) to ensure time lines are met and the issue(s) is resolved. If the
Contractor demonstrates inaction or disregard for the agreed upon compliance resolution plan, the State may
exercise its rights under the provisions of this contract.
Page 4 of 4
Amcndmcnt Contract Number: 2023*2330 Amcndmcnt #1 Vcr. 01.11.19
DocuSign Envelope ID: 60718F2E-CSB9-41 AA-8D36-525C065E7F1 E
Exhibit C., Budget
COLORADO
Department of Public
Health & Environment
PREVENTION SERVICES DIVISION- 12 MONTH BUDGET WITH JUSTIFICATION FORM
Original Contract Routing 2023*2330
Contractor
Name
Weld
County
Program
Title,
Phone
Contact
and
Name,
Email
Program
chorn@weldgov.com
Cynthia
Coordinator
2433
Horn
970-400-
Budget
Period
6/30/2023 - 6/29/2024
Title,
Fiscal
Phone
Contact
and
Name,
Email
Administration/Finance
tgeiser@weldgov.com
Tanya
Geiser,
970-400-2122
Director,
Project
Name
Health
Cancer
Navigation
The
Prevention
and
Community
and
Clinical
Outreach
Early
Services
Detection:
(TCO)
(HNCS)
Contract
Number
(CT
or PO)
CT
FHLA
2023*2330
Expenditure
Categories
Salaried
Personal
Services
Employees
Position
Title
Description of
Work
Gross
Annual
Salary
or
Fringe
Percent
of
on
Total
Requested
CDPHE
Amount
from
Time
Project
Supervisor
For
the
reports,
webinars
TCO.
TCO staff
evaluation
Provide
and
and
site
supervision
program;
visits.
of
and
assist
program,
oversight
with
participate
progress
to
in
$
100,798.27
$44,693.95
2.50%
$ 3,637.31
Chief
Nursing
Officer
For
oversight;
client.
HNCS.
Provide
assure
clinic
clinical
is
supervision
prepared
and
to serve
grant
$ 161,261.07
$71,503.16
0.45%
$
1,047.44
Community
Worker
Health
identification
For
assessment
of
breast
health
direct
TCO.
assistance
and
system.
The
CHW
of
of
cervical
barriers
eligible
will
to
cancer
reduce
be
community
and
responsible
need,
screening
barriers
and
members,
services
for
provision
to access
in a
$ 75,124.61
$33,310.25
31.00%
$ 33,614.81
Division Director
For
TCO
evaluation
program
TCO.
staff
Provide
and
of
calls.
the
oversight
program.
program
and
Assist
and
direction
with
participate
the
to the
in
$133,843.25
$59,346.10
1.80%
$ 3,477.41
Page 1 of 1
Amendment Contract Number: 2023*2330 Amendment #1 January 2018
DocuSign Envelope ID: 60718F2E-C8B9-41AA-8D36-525C065E7F1E
Exhibit C., Budget
COLORADO
Department of Public
Health Et Environment
PREVENTION SERVICES DIVISION- 12 MONTH BUDGET WITH JUSTIFICATION FORM
Original Contract Routing 2023*2330
Contractor
Name
Weld
County
Program
Title,
Contact
Phone
Name,
and Email
Program
chorn@weldgov.com
Cynthia
Coordinator
2433
Horn
970 -400 -
Budget
Period
6/30/2023 - 6/29/2024
Fiscal
Title,
Contact
Phone and
Name,
Email
Tanya
Administration/Finance
tgeiser@weldgov.com
Geiser,
970-400-2122
Director,
Project
Name
Health
Cancer
Navigation
The
Prevention and
and Clinical
Community Outreach
Early
Services
Detection:
(TCO)
(HNCS)
Contract
Number
(CT
or PO)
CT
FHLA
2023*2330
Personal
Hourly
Employees
Services
Position Title
Description of
Work
Hourly
Wage
Hourly
Fringe
Total
Hours
Project
# of
on
Total
Requested
CDPHE
Amount
from
Program Coordinator
For
reports,
webinars,
HNCS.
Coordinate
program
site visits
evaluations,
and
and
chart
complete
participate
audits.
progress
in
$ 23.36
$ 10.36
55.0
$ 1,854.48
Office
Technician
For
Community
portal
answering
TCO.
The
and
provide
phones
office
Outreach
technician
office
and
data
support
making
will
into the
copies.
enter
TCO
such
data
as
$ 23.36
$ 10.36
52.0
$ 1,753.33
Total
Personal
Services (including
fringe
benefits)
$ 45,384.78
Supplies
& Operating Expenses
Item
Description of
Item
Rate
Quantity
Total
Requested
CDPHE
Amount
from
Operating/supplies
For
on the
purchase
Detection
grantees/health-navigation-and-clinical-services/health-
navigation-and-clinical-services
HNCS.
Health
document
Allowable
website:
Navigation
purchase
on
https://cancerplan.colorado.gov/help-for-
the
and
Cancer
of
Clinical
supplies/operating
Prevention
Services
allowable
and
items
Early
listed
$ 340.00
1.0
$ 340.00
Outreach
Expenses
and
Education
and
cervical
items
outreach
For
TCO.
outreach
to
cancer
improve
Development
events.
supplies
prevention
engagement
and
to
purchase
promote
and
early
of
the
awareness
detection.
of education
community
of
breast
This
materials
includes
during
and
$ 50.00
8.0
$ 400.00
Postage
For
codes,
TCO.
Postage
reminder
letters.
for mailing
$0.63
of
x
small
25
pieces
media
to targeted
zip
_
$ 0.63
25.0
$ 15.75
Page 2 of 2
Amendment Contract Number: 2023*2330 Amendment #1 January 2018
DocuSign Envelope ID: 60718F2E-C8B9-41AA-8O36-525C065E7F1 E
Exhibit C., Budget
COLORADO
Department of Public
Health £t Environment
PREVENTION SERVICES DIVISION- 12 MONTH BUDGET WITH JUSTIFICATION FORM
Original Contract Routing 2023*2330
Contractor
Name
Weld
County
Program
Title,
Contact
Phone
and
Name,
Email
Program
chorn@weldgov.com
Cynthia
Coordinator
2433
Horn
970 -400 -
Budget
Period
6/30/2023 - 6/29/2024
Title,
Fiscal
Phone
Contact
and
Name,
Email
Tanya
Administration/Finance
tgeiser@weldgov.com
Geiser,
970-400-2122
Director,
Project
Name
Health
Cancer
Navigation
The
Prevention
and
and
Clinical
Outreach
Early
Services
Detection:
(TCO)
(HNCS)
Contract
Number
(CT
or PO)
CT
FHLA
2023*2330
Community
attend
disparities
For
TCO.
relevant
Registration costs
trainings, such
trainings.
for
Community
as
health
literacy
Outreach
or
staff
health
to
$ 50.00
1.0
$
50.00
Registration
Interpretation
Translation
and
Services
For
culturally
education
of
and
the
TCO.
community.
events
Translation
and
materials
and
liguistically
other
of
to
Interpretation
meetings.
be
outreach
appropriate
distributed
materials
during
Estimated
relevent
for
educational
educational
as
1
needed
small
item/event
for
media
benefits
sessions
at
and
$50
$ 50.00
1.0
$
50.00
Office
Supplies
For
in indirect)
TCO. Office supplies
for Community Outreach
(not included
$ 6.21
12.0
$
74.52
Electronic
(EMR)
Fees
Medical
Record
For the
events
for clients
$50.00/month
and
TCO.
will
who
The
utilize
qualify
for
TCO
12
months.
worker
EMR
for
will
to schedule
direct
take
assistance.
a laptop
screening
to
appointments
Estimated
outreach
at
$ 50.00
12.0
$ 600.00
Cell
Phone
Services
For
and
addition,
community
the
contacting
TCO.
the
The
phone
events.
clients
TCO
will
Estimated
program
who
qualify
be used
at
will
as
$30.00/month
use
for direct
a WIFI
a
cell
hot
phone
assistance;
spot
for
for
when
12
outreach
In
months.
at
$ 30.00
12.0
$
360.00
Printing
For
appropriate
educational
appropriate
cervical
prints
the
@
TCO.
cancer
$0.50/each.
Printing
relevant
benefits
and
approved
screening
costs
small
of the
for
media
community.
education
and
culturally
early
to
prevention.
be
distributed
materials
and
This
linguistically
include
for
Estimated:
for
breast
and
100
$ 0.50
100.0
$
50.00
Total
Supplies
& Operating
$ 1,940.27
Page 3 of 3
Amendment Contract Number: 2023*2330 Amendment #1 January 2018
DocuSign Envelope ID: 60718F2E-C8B9-41 AA-8D36-525C065E7F1 E
Exhibit C., Budget
COLORADO
Department of Public
Health £t Environment
PREVENTION SERVICES DIVISION- 12 MONTH BUDGET WITH JUSTIFICATION FORM
Original Contract Routing 2023*2330
Contractor Name
Weld
County
Program
Title,
Phone
Contact
and
Name,
Email
Program
chorn@weldgov.com
Cynthia
Coordinator
2433
Horn
970 -400 -
Tanya Geiser,
Director,
Budget
Period
6/30/2023 - 6/29/2024
Title,
Fiscal
Phone
Contact
and
Name,
Email
Administration/Finance
970-400-2122
tgeiser@weldgov.com
Project
Name
Health
Cancer
Navigation
Prevention
and
and
Clinical
Early
Services
Detection:
(HNCS)
Contract
(CT
or PO)
CT
FHLA
2023*2330
The
Community Outreach
(TCO)
Number
Travel
Item
Description of
Item
Rate
Quantity
Requested
Total
CDPHE
Amount
from
Mileage
trainings
as
For TCO
needed.
and
and
Current
HNCS.
to
travel
Mileage
mileage
to other
for staff
community
reimbursement
to attend
and
rate
in
clinic
-person
locations
is $0.635/mile.
$ 0.635
398.0
$ 252.73
Participant travel
expenses
For
cards
system
TCO and
(2 x $10)
for screening.
HNCS.
to
Taxi, Uber
assist participants
and
Lyft vouchers
in traveling
to
(2
x $10)
health
or gas
$ 10.00
2.0
$ 20.00
Total
Travel
$ 272.73
Contractual
Subcontractor
Name
Description of
Item
Rate
Quantity
Total
Requested
CDPHE
Amount
from
LanguageLink
For
telephone
screening
materials.
TCO
and
to
services.
HNCS.
assist
Interpretation
with
Translation
education,
of
services
educational
direct
in
assistance
person
and
or via
or
outreach
$ 28.02
1.0
$ 28.02
CTS
North
Alliance
Colorado
Health
data
progress
For the
collection
TCO
and
to
reports.
HNCS.
complete
EMR
vendor
internal
support
program
for
evaluation
reports
and
and
$ 50.00
1.0
$ 50.00
Total
Contractual
$ 78.02
SUB
-TOTAL
OF
DIRECT
COSTS
$ 47,675.80
Indirect
Item
Description of
Item
Total
Requested
CDPHE
Amount
from
Indirect
CDPHE-Negotiated
Cost Rate
Indirect
MTDC
costs. Weld
effective January
County
1,
2023.
Health
Department's
approved
indirect
cost rate is 19.92% of
sa
9,493.20
Total
Indirect
$ 9,493.20
TOTAL
$ 57,169.00
Page 4 of4
Amendment Contract Number: 2023*2330 Amendment #1 January 2018
Contract Form
New Contract Request
Entity Information
Entity ID*
;000001926
New Entity?
Entity Name*
COLORADO DEPT OF PUBLIC
HEALTH /ENVIRONMENT
Contract Name* Contract ID
CDPHE WOMEN'S WELLNESS CONNECTION - CANCER 7038
PREVENTION AND EARLY DETECTION CONTRACT
AMENDMENT #1 Contract Lead*
AGOMEZ
Contract Status
CTB REVIEW
Contract Lead Email
agomezWweldgov.com
Parent Contract ID
6593
Requires Board Approval
YES
Department Project*
Contract Description*
CDPHE WOMEN'S WELLNESS CONNECTION - CANCER PREVENTION AND EARLY DETECTION CONTRACT AMENDMENT #1
Contract Description 2
2023.2330A1;2023-2330
Contract Type*
AMENDMENT
Amount*
S57,169.00
Renewable*
NO
Automatic Renewal
NO
Grant
YES
IGA
NO
Department
HEALTH
Department Email
CM-HealthWweldgov.com
Department Head Email
CM-Health-
DeptHeadgweldgov.com
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
CM-
COU NTYATTO RN EYY'WELDG
OV.COM
Grant Deadline Date
If this is a renewal enter previous Contract ID
6593
If this is part of a NSA enter MSA Contract ID
Requested BOCC Agenda
Date*
06/07 2O23
Due Date
06;03,'2023
Will a work session with BOCC be required?*
NO
Does Contract require Purchasing Dept. to be included?
NO
Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in
OnBase
Contract Dates
Effective Date
06/30/2023
Review Date
03,01;2024
Renewal Date
Termination Notice Period Committed Delivery Date
Contact Information
Contact Info
Contact Name
Purchasing
Purchasing Approver
Approval Process
Department Head
TANYA GEISER
DH Approved Date
06/05/2023
Final Approval
BOCC Approved
BOCC Signed Date
BOCC Agenda Date
06,12/2023
Originator
AGOMEZ
Expiration Date.
06/29/2024
Contact Type Contact Email Contact Phone 1 Contact Phone 2
Finance Approver
CHERYL PATTELLE
Purchasing Approved Date
Legal Counsel
BRUCE BARKER
Finance Approved Date Legal Counsel Approved Date
06/06/2023 05/06/2023
Tyler Ref #
AG 061223
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