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Home My WebLink About20221624.tiffRESOLUTION RE: APPROVE TASK ORDER CONTRACT AMENDMENT #4 FOR TUBERCULOSIS PREVENTION AND CONTROL 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 Task Order Contract Amendment #4 for the Tuberculosis Prevention and Control 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 July 1, 2018, and ending June 30, 2023, 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 the Task Order Contract Amendment #4 for the Tuberculosis Prevention and Control 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 13th day of June, A.D., 2022, nunc pro tunc July 1, 2018. BOARD OF COUNTY COMMISSIONERS WEL,p COUNTY, COLORADO ATTEST: ditifet) .Jr,LtO t1 t K. James, Chair Weld County Clerk to the Board BY: Deputy Clerk to the Boar APPROVED A County Attorney Date of signature: 67/6/22 7/1 V.2.2 2022-1624 HL0054 Con-lva Ck (1)11 639 cQ Memorandum TO: Scott James, Chair Board of County Commissioners FROM: Mark Lawley, Executive Director Department of Public Health & Environment DATE: May 26, 2022 SUBJECT: CDPHE FY22-23 Tuberculosis Prevention & Control Program Contract Amendment #4 For the Board's approval is a contract amendment #4 between the Colorado Department of Public Health and Environment ("CDPHE") and the Board of County Commissioners for the County of Weld, State of Colorado, on behalf of the Weld County Department of Public Health and Environment ("WCDPHE"). This contract amendment is for the continuation of the Tuberculosis (TB) Prevention and Control Program to assist in preventing and controlling TB in Weld County. The term for this task order contract is from July 1, 2022, through June 30, 2023, in the amount of $50,000, all of which is State funding. Additional funding from the Directly Observed Therapy and Diagnostic Blanket funds will be granted as necessary for the treatment of active TB disease and for contact investigations. Activities will be conducted by current staff; no additional FTE is being requested. Assistant Weld County Attorney, Karin McDougal, has reviewed this contract amendment and determined that its terms are acceptable. The Board approved placement of this contract amendment on the Board's agenda via pass -around dated May 24, 2022. I recommend approval of this contract amendment with CDPHE. 2022-1624 0U9/I 3 4,0054-1 BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW TITLE: CDPHE FY22-23 Tuberculosis Prevention & Control Program Contract Amendment #4 DEPARTMENT: PUBLIC HEALTH & ENVIRONMENT DATE: May 24, 2022 PERSON REQUESTING: Mark Lawley, Executive Director Brief description of the problem/issue: For the Board's review and approval for placement on the agenda is a contract amendment #4 between the Colorado Department of Public Health and Environment ("CDPHE") and the Board of County Commissioners for the County of Weld, State of,Colorado, on behalf of the Weld County Department of Public Health and Environment ("WCDPHE"). This contract amendment is for the continuation of the Tuberculosis (TB) Prevention and Control Program to assist in preventing and controlling TB in Weld County. The term for this task order contract is from July 1, 2022, through June 30, 2023, in the amount of $50,000, all of which is State funding. Additional funding from the Directly Observed Therapy and Diagnostic Blanket funds will be granted as necessary for the treatment of active TB disease and for contact investigations. Activities will be conducted by current staff; no additional FTE is being requested. This contract is undergoing review by Assistant Weld County Attorney, Karin McDougal, and we will await that approval prior to placement on the Board's agenda. What options exist for the Board? (include consequences, impacts, costs, etc, of options): Approval of this contract amendment allows for continued TB control and prevention activities in Weld County. These activities include QuantiFERON blood testing, skin testing, chest x-ray interpretation, contact investigations, Class B TB activities for newly arriving immigrants, treatment for latent tuberculosis infection and active tuberculosis disease and serving as a resource for community education/outreach regarding TB prevention and control. If this contract is not approved, WCDPHE will not receive external funding to provide the public health core service of TB control and prevention in Weld County and these services would then become 100% county funded. Recommendation: I recommend approval of this contract amendment with CDPHE. Approve Schedule Recommendation Work Session Perry L. Buck Mike Freeman, Pro-Tem Scott K. James, Chair Steve Moreno Lori Saine Other/Comments: DocuSign Envelope ID: 3FC3B866-8AE1-4D3A-AE1E-1E5861E1774E CONTRACT AMENDMENT #4 SIGNATURE AND COVER PAGE(S) State Agency: Colorado Department Of Public Health and Environment 4300 Cherry Creek Drive South Denver, Colorado 80246 Original Contract Number: 19 FHHA 109285 Contractor: Amendment Contract Number: Board of County Commissioners of Weld County 2022*3280 Amendment #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: July 1, 2018 June 30, 2023 CONTRACT MAXIMUM AMOUNT TABLE Document Contract Number Federal Funding State Funding Amount Other Funding Amount Term (dates) Total Type Amount Original 19 FHHA 109285 $7,5000.00 $45,000.00 $0.00 07/01/2018- $52,500.00 Contract 06/30/2019 Contract 2020*134 $0.00 $53,000.00 $0.00 07/01/2019- $53,000.00 Amendment #1 Amendment #1 06/30/2020 Option Letter 2020*134 Option $7,500.00 $0.00 $0.00 09/01/2019- $7,500.00 #1 Letter #1 12/31/2019 Contract 2020*3598 $0.00 $52,500.00 $0.00 07/01/2020- $52,500.00 Amendment #2 Amendment #2 06/30/2021 Contract 2021*3673 $0.00 $55,000.00 $0.00 07/01/2021- $55,000.00 Amendment #3 Amendment #3 06/30/2022 Contract 2022*3280 $0.00 $50,000.00 $0.00 07/01/2022- $50,000.00 Amendment #4 Amendment #4 06/30/2023 Current Contract Maximum $270,500.00 Cumulative Amount Page 1 of 3 Amendment Contract Number: 2022*3280 Amendment #4 Ver 06.05.20 0o.22ai -/z,,e724 DocuSign Envelope ID: 3FC3B866-8AE1-4D3A-AE1E-1E5861E1774E 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 authorizing his or her signature. 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: S'off �awtt,S ‘.--E04467D642AE4A7... By: Signature Scott K. James Name of Person Signing for Contractor Chairman of the Board Title of Person Signing for Contractor Date: 2022-06-13 STATE OF COLORADO Jared S. Polls, Governor Colorado Department of Public Health and Environment Jill Hunsaker Ryan, MPH, Executive Director e—DocuSigned by: \-2EDF870AtA7D4FC... By: Signature Lisa McGovern Name of Executive Director Delegate Procurement & Contracts Section Director ft Title of Executive Director Delegate Date: 2022-06-14 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 r—o.usignstgbert Jaros, CPA, MBA, JD \---(`,4RA540FRA74405 By: Signature Justin weigle Name of State Controller Delegate Health Divisions Controller Title of State Controller Delegate Contract Effective Date -- Signature and Cover Pages End -- Page 2 of 3 Amendment Contract Number: 2022*3280 Amendment #4 Ver 06.05.20 Qua -1649 DocuSign Envelope ID: 3FC3B866-8AE1-4D3A-AE1E-1E5861E1774E 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 July 1, 2022, whichever is later and shall terminate on the termination of the Contract or June 30, 2023, whichever is earlier. 4. PURPOSE The Parties entered into the agreement provide diagnostic, patient education and treatment services for individuals with suspected/known latent TB infection (LTBI) and those classified with Class A and Class B TB status or who are suspected of having active TB. Also for individuals who are identified as newly arrived refugees, asylees and other high risk persons with LTBI. The Parties now desire to renew for an additional term and change current Contract Maximum Total for the following reason: to renew. 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 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 A, Additional Provisions. Exhibit A, Additional Provisions, is deleted and replaced in its entirety with the Exhibit A, Additional Provisions, attached to this Amendment, for the following reason: to add the Holdover provisions. D. The Parties now agree to modify Exhibit F, Statement of Work of the agreement. Exhibit F, Statement of Work, is deleted and replaced in its entirety with Exhibit F, Statement of Work, attached to this Amendment for the following reason: to update the work plan for the renewal period. E. The Parties now agree to modify Exhibit H, Budget of the agreement. Exhibit H, Budget, is deleted and replaced in its entirety with Exhibit H, Budget, attached to this Amendment for the following reason: to add funds for the renewal period. 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 3 of 3 Amendment Contract Number: 202*3280 Amendment #4 Ver 06.05.20 DocuSign Envelope ID: 3FC3B866-8AE1-4D3A-AE1E-1E5861E1774E EXHIBIT A ADDITIONAL PROVISIONS To Original Contract Routing Number: 19 FHHA 109285 Amendment Contract Number: 2022*3280 Amendment #4 These provisions are to be read and interpreted in conjunction with the provisions of the Contract specified above. 1. Invoicing Provisions: To receive compensation under the Contract, the Contractor shall submit a signed CDPHE Reimbursement Invoice Form. This form is accessible from the CDPHE internet website, https://www.colorado.gov/pacific/cdphe/standardized-invoice-form-and-links and is incorporated and made part of this Contract by reference. CDPHE will provide technical assistance in accessing and completing the form. The CDPHE Reimbursement Invoice Form and Expenditure Details page must be submitted no later than forty-five (45) calendar days after the end of the billing period for which services were rendered. Expenditures shall be in accordance with the Statement of Work and Budget. CDPHE will provide invoice submission requirements after the contract is executed. Final billings under the Contract must be received by the State within a reasonable time after the expiration or termination of the Contract; but in any event no later than forty-five (45) calendar days from the effective expiration or termination date of the Contract. Unless otherwise provided for in the Contract, "Local Match", if any, shall be included on all invoices as required by funding source. The Contractor shall not use federal funds to satisfy federal cost sharing and matching requirements unless approved in writing by the appropriate federal agency. 2. Time Limit For Acceptance Of Deliverables: a. Evaluation Period. The State shall have forty-five (45) calendar days from the date a deliverable is delivered to the State by the Contractor to evaluate that deliverable, except for those deliverables that have a different time negotiated by the State and the Contractor. b. Notice of Defect. If the State believes in good faith that a deliverable fails to meet the design specifications for that particular deliverable, or is otherwise deficient, then the State shall notify the Contractor of the failure or deficiencies, in writing, within thirty (30) calendar days of: 1) the date the deliverable is delivered to the State by the Contractor if the State is aware of the failure or deficiency at the time of delivery; or 2) the date the State becomes aware of the failure or deficiency. The above time frame shall apply to all deliverables except for those deliverables that have a different time negotiated by the State and the Contractor in writing pursuant to the State's fiscal rules. c. Time to Correct Defect. Upon receipt of timely written notice of an objection to a completed deliverable, the Contractor shall have a reasonable period of time, not to exceed thirty (30) calendar days, to correct the noted deficiencies. Amendment Contract Number: 2022*3280 Amendment #4 Page 1 of 2 Ver. 01.11.19 DocuSign Envelope ID: 3FC3B866-8AE1-4D3A-AE1E-1E5861E1774E EXHIBIT A 3. Health Insurance Portability and Accountability Act (HIPAA) Business Associate Determination. The State has determined that this Contract does not constitute a Business Associate relationship under HIPAA. 4. Transfer of funds within the Budget: a. Transfer funds between budget lines if the total of all cumulative transfers is less than 25 percent (25%) of the budgeted amount does not require Communicable Disease Branch approval. However the Contractor shall notify the Section of the changes in writing prior to the transfer of funds. b. When the cumulative total of all transfers equals or exceeds 25 percent (25%) of the total budgeted amount, the Contractor must obtain written permission from the Communicable Disease Branch to move any funds between lines. The Contractor shall submit the Communicable Disease Branch approved budget modification form prior to making revised expenditures. The Communicable Disease Branch staff will evaluate the request and inform the Contractor of a decision within 15 calendar days of receiving the request. 5. The State, at its discretion, shall have the option to extend the term under this Task Order beyond the Initial Term for a period or for successive periods, of 1 year at the same rates and under the same terms specified in the Task Order. In order to exercise this option, the State shall provide written notice to Contractor in as form substantially equivalent to Exhibit D. If exercised, the provisions of the Option Letter shall become part of and be incorporated in the original Task Order. The total duration of this Task Order shall not exceed 5 years. 6. The State, at its discretion, shall have the option to increase or decrease the statewide quantity of Goods and/or Services based upon the rates established in this Task Order and modify the maximum amount payable accordingly. In order to exercise this option, the State shall provide written notice to Contractor in as form substantially equivalent to Exhibit D. Delivery of Goods and/or performance of Services shall continue at the same rates and terms as described in this Task Order. 7. HOLDOVER In the event that the State desires to continue the services provided for in this Agreement and a replacement contract has not been fully executed by the expiration date of the Agreement, this Agreement may be extended unilaterally by the Paying Agency for a period of up to two (2) months upon written notice to the Performing Agency under the same terms and conditions of the original Agreement including, but not limited to, prices, rates, and service delivery requirements. However, this extension terminates when the replacement contract becomes effective when signed by the State Controller or an authorized delegate. Amendment Contract Number: 2022*3280 Amendment #4 Page 2 of 2 Ver. 01.11.19 DocuSign Envelope ID: 3FC3B866-8AE1-4D3A-AE1E-1E5861E1774E EXHIBIT F STATEMENT OF WORK To Original Contract Routing Number: 19 FHHA 109285 Amendment Contract Number: 2022*3280 Amendment #4 These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above. I. Entity Name: Weld County Department of Public Health and Environment II. Project Description: This project serves to implement a Tuberculosis (TB) preventive health service program to decrease widespread incidence of TB disease via pass -through funds to the Local Public Health Agencies (LPHAs) experiencing an elevated burden of TB infection and TB disease. TB remains the primary infectious disease killer in the world, only surpassed during the current pandemic by deaths from COVID-19. The Colorado Department of Public Health and Environment (CDPHE) is funded by state general fund dollars and the Centers for Disease Control and Prevention (CDC) to address the potentially life -threatening TB illness, which is spread through the air from one person to another, impacts the lungs and any other part of the body, and can cause serious sickness and even death in humans. The Division of Disease Control and Public Health Response (DCPHR) supports TB health service activities as a part of the mandatory Class A and B medical testing process for Refugees entering the United States. The project seeks to screen, test, and treat TB infection (LTBI) and prevent onward transmission of the TB bacterial infection by offering appropriate treatment to all at elevated risk for TB infection and onward progression to TB disease as well as those presumptive for or with confirmed TB disease. The project also seeks to offer guidance and resources to help confirmed TB disease patients through to completion of appropriate TB disease treatment. The funds exist to reduce rates of illness, and increase use of the Tuberculosis Data Base (TBdb) among LPHAs caring for patients statewide. The project will collect vital statistics, and enable the technological capability needed to track and evaluate patient cases. The program seeks to identify latent TB illness in at - risk patients including close contacts to pulmonary TB patients through active surveillance, provide free TB medications, and reimburse LPHAs managing or ruling -out patients for Medicaid rate diagnostic testing recommended by the TB program. The project will improve the ability to evaluate TB cases, and bolster access to data for the medical community. A key program goal is to connect at -risk individuals including Refugees born in endemic areas to appropriate medical care, control epidemiologic outbreaks, and protect the health of the residents of Colorado. III. Definitions: 1. Active surveillance: Active disease surveillance is the process of actively searching for information through clinical testing and data management. For the purposes of this contract, active surveillance means the monitoring of testing class B1 and B2 Refugee patients, and entering relevant data to the TBdb system. 2. AFB smear: Acid -Fast Bacilli; a rapid test used to detect infectious mycobacteria 3. Asylee: Individuals who, on their own, travel to the United States and subsequently apply for and receive a grant of asylum. 4. CDPHE: Colorado Department of Public Health and Environment 5. Chest X-ray: a type of high-energy radiation that can go through the body and onto film, making pictures of areas inside the chest, which can be used to diagnose disease. 6. Class A: defines Refugee applicants who have medical conditions that render a person inadmissible and ineligible for a visa or adjustment of status. Page 1 of 7 Amendment Contract Number: 2022*3280 Amendment #4 Ver. 01.11.19 DocuSign Envelope ID: 3FC3B866-8AE1-4D3A-AE1 E-1 E5861 E1774E EXHIBIT F 7. Class B 1: Immigrant with an abnormal chest X -Ray with evidence of TB, and/or the individual has a history of treatment for active TB disease. 8. Class B2: The individual was diagnosed with latent TB infection (LTBI). These are typically children whose Tuberculin Skin Test result was positive and Chest X-ray was normal. 9. DOT: Directly Observed Therapy is a process where a trained health care worker or other designated individual (excluding a family member) provides the prescribed TB drugs and watches the patient swallow every dose. 10. HIV: Human Immunodeficiency Virus - Human immunodeficiency virus is a virus that attacks the body's immune system. If HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome). Learning the basics about HIV can keep you healthy and prevent HIV transmission. TB is the primary killer of people with AIDS globally. 11. IGRA: Interferon gamma (y) release assay is a whole blood TB test. 12. LEP: Limited English proficiency (Over -the -Phone Interpretation (OPI) - lets you communicate with Limited -English Proficient (LEP) individuals using a phone interpreter. People use phone interpreters when they don't have an onsite interpreter, and to make phone calls to people who speak limited English. 13. LTBI: Latent Tuberculosis Infection commonly referred to as TB infection 14. OPI: Over -the -phone interpretation 15. Refugee: Any person who is outside his or her country of nationality or habitual residence and is unable or unwilling to return to or seek protection of that country due to a well-founded fear of persecution based on race, religion, nationality, membership in a particular social group, or political opinion 16. Pulmonary disease: A type of disease that affects the lungs and other parts of the respiratory system. Pulmonary sites of TB disease is the primary public health concerns as TB is spread through the inhalation of airborne bacilli. 17. RVCT: Report of Verified Case of Tuberculosis; a CDC surveillance report 18. Screening: the act of performing a test on a patient or patient's sputum, blood, urine, etc., to look for evidence of a disease. For the purposes of this contract, screening involves the testing and identification of at -risk persons including class B1 and B2 Refugees with LTBI, HIV, pulmonary disease, and those without health insurance. 19. Service area: The jurisdiction (typically one or more counties) for with the LPHA is responsible. 20. Spirometry: A test that can help show how well lungs are working. 21. Tuberculosis (TB): An infectious bacterial disease characterized by the growth of nodules (tubercles) in the tissues, especially the lungs. 22. TB -18: CDPHE Tuberculosis Surveillance and Case Management Report 23. TBdb system: CDPHE Tuberculosis Data Base Page 2 of 7 Amendment Contract Number: 2022*3280 Amendment #4 Ver. 01.11.19 DocuSign Envelope ID: 3FC3B866-8AE1-4D3A-AE1E-1E5861E1774E EXHIBIT F IV. Work Plan: Goal #1: Support public health disease control and intervention through the provision of public health monitoring. Prevent and control tuberculosis infection and active TB disease throughout the Contractor's jurisdiction. Objective #1: No later than the expiration date of the contract, improve tuberculosis prevention and control through the provision of TB health services and active surveillance. Primary Activity #1 The Contractor shall locate all patients with suspected or confirmed TB. Sub -Activities #1 1. The Contractor shall provide TB health screening for the following patient groups: a. Refugee Class B1 b. Refugee Class B2 c. All other persons found to be at elevated risk for TB infection or TB disease 2. The Contactor shall provide the following medical screening services to each patient: a. Medical evaluation b. Tuberculin skin test or IGRA (IGRA is preferred) c. Chest X-ray d. Three spontaneous sputum specimens for AFB smear to determine the biological culture of cells on consecutive days 3. The Contractor shall administer TB disease testing to all patients to identify individuals with LTBI. a. The Contractor shall administer LTBI testing to 95% of patients identified with elevated risk. b. The Contractor shall document 95% of confirmed LTBI cases. c. The Contractor shall administer the following LTBI evaluation methods to all patients: i. Chest x-rays ii. Chest x-ray interpretations 4. The Contractor shall test patients for HIV. a. The Contractor shall administer HIV antibody tests to 95% of B 1 and B2 Refugee patients. b. The Contractor shall administer HIV antibody tests to 95% of all patients presumptive for or with confirmed TB infection or TB disease. c. The Contractor shall identify patients with HIV. d. The Contractor shall inform those individuals whom refuse HIV testing of the risks associated with HIV/TB co -infection. e. The Contractor shall document HIV testing results for all patients in TBdb. 5. The Contractor shall monitor patients for adverse reactions from TB drugs. 6. The Contractor shall monitor patients for other clinical concerns. 7. The Contractor shall offer limited English proficiency services to patients who do not speak English. a. The Contractor shall provide translation services in the patient's preferred language. i. The Contractor shall offer in -person, certified translation services. ii. The Contractor shall offer Over -the -Phone Interpretation (OPI) services. Primary Activity #2 The Contractor shall ensure that all contacts to newly identified infectious TB cases are identified, investigated, and receive appropriate evaluation. Page 3 of 7 Amendment Contract Number: 2022*3280 Amendment #4 Ver. 01.11.19 DocuSign Envelope ID: 3FC3B866-8AE1-4D3A-AE1E-1E5861E1774E EXHIBIT F Sub -Activities #2 1. The Contractor shall provide, or arrange for the following for individuals with newly identified suspected or confirmed TB, as well as patients with LTBI: a. Chest x-rays b. Chest x-ray interpretations 2. The Contractor shall provide, or arrange for, the treatment of patients, including DOT, and ensure the completion of therapy for all TB patients. 3. The Contractor shall provide, or arrange for, an HIV antibody test for all persons with LTBI with HIV risk factors including those who originate from an HIV - endemic area. 4. The Contractor shall inform all individuals whom refuse HIV testing of the risks associated with HIV/TB co -infection. 5. A minimum of once a month, the Contractor shall evaluate patients face-to-face who are on LTBI treatment. 6. Throughout LTBI treatment, the Contractor shall monitor patients for adverse reactions or other clinical concerns. 7. The Contractor shall ask all TB clients about current health insurance enrollment and offered materials on how to become insured if not currently insured. 8. The Contractor shall complete a preliminary Tuberculosis Contact Investigation Record for all pulmonary TB patients. Primary Activity #3 The Contractor shall participate in an electronic TB surveillance process (TBdb or other designated TB database). Sub -Activities #3 1. The Contractor shall enter data for each patient tested, treated, and cared for into the TBdb. a. The Contractor shall report each data element specified in the "Report of Verified Case of Tuberculosis (RVCT) for all patients who test positive for LTBI. b. The Contractor shall enter laboratory results for each patient tested for LTBI. c. The Contractor shall enter laboratory results for each patient tested for HIV. d. The Contractor shall enter laboratory results for each patient tested for pulmonary TB disease. e. The Contractor shall enter into TBdb other clinical concerns identified during testing. f. The Contractor shall enter current medical insurance enrollment status information. 2. The Contractor shall complete a preliminary Tuberculosis Contact Investigation Record (TB -18) for all presumptive or confirmed TB disease and LTBI patients. a. The Contractor shall complete a Class B tuberculosis Follow Up worksheet for: i. Class B1 patients ii. Class B2 patients 3. The Contractor shall complete the Semi-annual Progress Report that includes the following information: a. Number of patients screened, tested and treated with LTBI. i. All report info should be de -identified. The Contractor shall identify patients by TBdb number only. ii. The Contractor shall include medical insurance information for insured patients. iii. The Contractor shall identify patients without medical insurance. b. Number of Class B1 Refugees with confirmed LTBI c. Number of Class B2 Refugees with confirmed LTBI Page 4 of 7 Amendment Contract Number: 2022*3280 Amendment #4 Ver. 01.11.19 DocuSign Envelope ID: 3FC3B866-8AE1-4D3A-AE1E-1E5861E1774E EXHIBIT F d. Number of Class B1 patients confirmed with HIV e. Number of Class B2 patients confirmed with HIV e. Number of Class B1 patients with TB disease f. Number of Class B2 patients with TB disease g. Number of patients with adverse reactions h. Other clinical concerns identified per patient i. Number of uninsured patients guided to medical insurance resources j. Number of patients that used the OPI interpretation services Primary Activity #4 The Contractor shall offer printed resource and referral materials to clients that direct them to the nearest community Medicaid and Connect for Health Colorado enrollment location(s), including online enrollment options. Sub -Activities #4 1. The Contractor shall discuss current health insurance enrollment status with each client for the purposes of becoming insured if not currently insured. a. The Contractor shall ask all TB patients about current health insurance enrollment status, including Medicaid and offer resource materials no later than the last business day of each month. b. The Contractor shall document that all TB patients were asked about current health insurance enrollment and offered materials no later than the last business day of each month. Standards and Requirements 1. The content of electronic documents located on CDPHE and non-CDPHE websites and information contained on CDPHE and non-CDPHE websites may be updated periodically during the purchase order term. The Contractor shall monitor documents and website content for updates and comply with all updates. 2. CDPHE will provide access to the CDPHE TBdb system to the Contractor. a. CDPHE will register the Contractor. i. CDPHE will provide user log -in to the Contractor. 3. CDPHE will provide written notification to the Contractor a minimum of 30 calendar days of the arrival of: a. Class B 1 Refugees b. Class B2 Refugees 4. The Contractor shall initiate treatment with patients in accordance with CDC guidance found at the following links, incorporated and made part of this Contract by reference: https://www.cdc.aov/tb/topic/treatment/ltbi.htm and https://www.cdc.gov/tb/topic/treatment/tbdisease.htm 5. The Contractor shall complete the appropriate treatment as stated in the CDPHE TB Manual. The CDPHE TB Manual is available on the State of Colorado website https://www.colorado.gov/pacific/cdphe/colorado-tb- manual and is incorporated and made part of this Contract by reference. 6. The Contractor shall include all data elements identified in the "Report of Verified Case of Tuberculosis (RVCT)", found at: RVCT, incorporated and made part of this contract by reference. a. The Contractor shall complete 100% of all RVCT fields no later than the end date of this contract. 7. The Contractor shall guide each patient to following insurance resource websites: a. https://www.colorado.gov/pacific/hcpf/how-to-apply, and Page 5 of 7 Amendment Contract Number: 2022*3280 Amendment #4 Ver. 01.11.19 DocuSign Envelope ID: 3FC3B866-8AE1-4D3A-AE1E-1E5861E1774E EXHIBIT F b. http://connectforhealthco.com/resources/person-help/, incorporated and made information for using the WU0/view, part of this Contract by reference. 8. The Contractor shall provide CDPHE with the medical insurance those patients who have medical insurance. 9. The Contractor shall complete the Semi-annual Progress Report following website: https://drive.google.com/file/d/0B0tmPQ67k3NVbk8xemFPN3Fp incorporated and made part of this Contract by reference. 10. The Contractor shall arrange for the placement of patients who a. The Contractor shall contact CDPHE TB Program for patients who need isolation. b. The Contractor shall contact CDPHE to request reimbursement CDPHE for those costs incurred by the Contractor in 11. The Contractor shall administer LTBI testing to 95% of patients elevated risk using the Colorado risk assessment tool. This link is require isolation. assistance with from isolating a patient. identified with incorporated and Contact of each contact Program after made part of this made part of this Contract by reference. 12. The Contractor shall complete a preliminary and final Tuberculosis Investigation Record for all pulmonary TB patients after initiation investigation: a. Tuberculosis Contact Investigation Record to the CDPHE TB initiation of each contact investigation. This link is incorporated and Contract by reference. Expected Results of the Activity 1. Sustained TB disease testing for all at -risk persons identified in Colorado. 2. Sustained identification of at -risk persons with LTBI. 3. Increased identification of presumptive or confirmed TB patients with HIV. 4. Increased identification of Refugees with pulmonary TB disease. 5. Increased identification of persons at -risk for TB with other medical concerns. 6. Sustained and correct use of the TBdb case management database. 7. Improved adherence to national standards that govern health services for Refugees and others with TB disease. 8. Increased medical insurance information provided to Refugees and other uninsured persons. Measurement of Expected Results 1. Increase HIV antibody tests to 95% of all patients. 2. Document 95% of confirmed LTBI cases. 3. Data contained in the CDPHE TBdb. 4. Data contained in the TB -18 Tuberculosis Surveillance and Case Management Report. 5. Data contained in the Semi -annual Progress Reports. {^ -t Completion Date Deliverables 1. The Contractor shall submit the TB health services point of contact to the CDPHE Contract Monitor via email. No later than ten (10) days after the start date of the contract 2. The Contractor shall submit the Semi-annual Progress Reports to the CDPHE Contract Monitor via email. No later than one (1) month after the July -Dec and Jan - June reporting Page 6 of 7 Amendment Contract Number: 2022*3280 Amendment #4 Ver. 01.11.19 DocuSign Envelope ID: 3FC3B866-8AE1-4D3A-AE1E-1E5861E 1 774E EXHIBIT F periods, and by the end date of the contract V. Monitoring: CDPHE's monitoring of the 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 monthly reports and invoices 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 Terms and Conditions of this Contract. Page 7 of 7 Amendment Contract Number: 2022*3280 Amendment #4 Ver. 01.11.19 DocuSign Envelope ID: 3FC3B866-8AE1-4D3A-AE1E-1E5861E1774E EXHIBIT H Budget To Original Contract Routing Number: 19 FHHA 109285 Weld Countv Department of Public Health and Environment — Prevention and Control Description Funding Source Amount TB Prevention & Control State $50,000 Total $50,000 Amendment Contract Number: 2022*3280 Amendment #4 Page 1 of 1 Contract Request Enter Information Entity Name* COLORADO DEPT OF PUBLIC HEALTH (ENVIRONMENT Entity ID* 00001926 Li New Entity? Contract Name* Contract ID CDPHE TUBERCULOSIS CONTROL PROGRAM FY2'2-23 TASK 5896 ORDER CONTRACT AMENDMENT Ac4 Contract Status CTB REVIEW Contract Lead* KJAKUS-HOTCHKISS Contract Lead Email k)akus- hatchki ss iDweldgov.com Parent Contract ID Requires Board Approval YES Department Project # tract Description* TASK ORDER CONTRACT AMENDMENT #4 FOR THE TUBERCULOSIS TREATMENT & CONTROL PROGRAM FY2'2-23 WITH CDPHE 2022'3280A4 Contract Description 2 PREVIOUS TASK ORDERS: 2021"3673A3, 2020"3598A2, 202001 34A1; 19 FHHA 109285 Contract Type "* CONTRACT Amount* 550,000,00 Renewable * NO Automatic Renewal NO Grant YE5 IGA NO Depar tm HEALTH Department Email CM -Health a+veldgov.eom Department Head Email CM-Health- DeptHead=1,P weldgov.c©m County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYA 1 1 ORNEYgWELDG OV.COM Grant t"h-line to 1# this is a renewal enter previous Contract ID 4848 If this is part of a MSA enter MSA Contract I© Requested BC)CC Agenda Date* 06 r 1 3,=`2022 Due Date 06109 2022 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 it those contracts are not in OnBase_ Contract Dates Effective Date 07'01/2022 Termination Notice Period Contact Information Contact Info Contact Name Purchasing Purchasing Approver Approval Process Department Head TANYA GEISER DH Approved Date 06x'02;2022 Final Approval ' BOCC Approved BOCC Signed Date BOCC Agenda Daze 06,' 1 3,'2022 Originator KJAKIJS-HOTCHKISS Review Date* 03(31,`2023 Committed Delivery Date Contact Type Purchasing Finance Approver CHERYL PATTELLI Finance Approved Date 06 02(2022 Tyler Ref # AG 061 322 Renewal Date Expiration Date2' 06, 30,`2023 Contact Phone 1 Contact Phone 2 ved Date Legal Counsel BRUCE BARKER Legal Counsel Approved Date 06 02 202'2 Hello