HomeMy WebLinkAbout20211570.tiffRESOLUTION
RE: APPROVE TASK ORDER CONTRACT AMENDMENT #3 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 #3 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, 2022, 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 Task Order Contract Amendment #3 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.
CC: L- (T&)
07/06/2
2021-1570
HL0053
TASK ORDER CONTRACT AMENDMENT #3 FOR TUBERCULOSIS PREVENTION AND
CONTROL PROGRAM
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 16th day of June, A.D., 2021.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: r .i
Weld County Clerk to the Board
BY
AP
)--cr
Deputy Clerk to the Board
ounty Attorney
Date of signature: it -7
Steveair
Scot
Lori S
2021-1570
HL0053
6�n1-atc-t- =p 4t,--1898-
Memorandum
TO:
FROM:
DATE:
SUBJECT:
Steve Moreno, Chair
Board of County Commissioners
Mark Lawley, Executive Director
Department of Public Health & Environment
June 8, 2021
FY22 Tuberculosis Prevention & Control
Program Task Order Contract Amendment
#3 with CDPHE
For the Board's approval is a Task Order Contract Amendment #3 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 task order 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, 2021, through June 30, 2022, in the amount of $55,000, 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 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 26, 2021.
I recommend approval of this FY22 Tuberculosis Prevention & Control Program Task Order
Contract Amendment #3 with CDPHE.
2021-1570
OCo/1 Co
1-1 L0053
BOARD OF COUNTY COMMISSIONERS
PASS -AROUND REVIEW
RE: FY22 Tuberculosis Prevention & Control Program Task Order Contract Amendment #3 with CDPHE
DEPARTMENT: PUBLIC HEALTH & ENVIRONMENT DATE: May 26, 2021
PERSON REQUESTING: Mark Lawley, Executive Director
Brief description of the problem/issue:
For the Board's review and approval is a Task Order Contract Amendment #3 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 task order 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, 2021, through June 30, 2022, in the amount of $55,000, 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 and determined that its terms are
acceptable.
What options exist for the Board? (include consequences, impacts, costs, etc. of options):
Approval of this task order 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 TB Prevention and Control Program task order contract with
CDPHE.
Approve Schedule
Recommendation Work Session Other/Comments:
Perry L. Buck
Mike Freeman
Scott K. James, Pro -Tern
Steve Moreno, Chair
Lori Saine
att ois ice,
DocuSign Envelope ID: C41 B2E1 E-4717-4887-9AF6-E81 D8FA60DDD
CONTRACT AMENDMENT #3
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
2021*3673 Amendment #3
1150 "O" Street
Greeley, Colorado 80631
For the use and benefit of the
Weld County Department of Public Health and Environment
1555 North 17th Avenue
Greeley, Colorado 80631
Contract Performance Beginning Date:
Current Contract Expiration Date:
July 1, 2018
June 30, 2022
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
Current Contract Maximum
$220,500.00
Cumulative Amount
Page 1 of 3
Amendment Contract Number: 2021*3673 Amendment #3 Ver 06.05.20
DocuSign Envelope ID: C41 B2E1 E-4717-4887-9AF6-E81 D8FA60DDD
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
Weld County Department of -Public Health and
Environment
r—DocuSigned by:
gum- hei^ua
`—E04467D642AE4AA' ..
By: Signature
STEVE MORENO
Name of Person Signing for Contractor
COUNTY COMMISSIONER CHAIR
Title of Person Signing for Contractor
Date:
2021-06-17
STATE OF COLORADO
Jared S. Polis, Governor
Colorado Department of Public Health and Environment
Jill Hunsaker Ryan, MPH, Executive Director
r—DocuSigned by:
Lisa kti,ovalA,
`-2EDF870A1A7D4FC...
By: Signature
Lisa McGovern
Name of Executive Director Delegate
Procurement & Contracts Sect
Title of Executive Director Delegate
Date:
2021-06-17
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 tirePPI,bMBA, JD
368F8AFC06514C4...
By: Signature
Travis Yoder
Name of State Controller Delegate
Controller
Title of State Controller Delegate
2021-06-23
Contract Effective Date:
-- Signature and Cover Pages End --
Page 2 of 3
Amendment Contract Number: 2021 *3673 Amendment #3
Ver 06.05.20
ion Directs
O?Oal- /57o
DocuSign Envelope ID: C41 B2E1 E-4717-4887-9AF6-E81 D8FA60DDD
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, 2021,
whichever is later and shall terminate on the termination of the Contract or June 30, 2022, 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 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 renew.
D. 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
renew.
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: 2021 *3673 Amendment #3 Ver 06.05.20
DocuSign Envelope ID: C41 B2E1 E-4717-4887-9AF6-E81 D8FA60DDD
EXHIBIT F
STATEMENT OF WORK
To Original Contract Number: 19 FHHA 109285
Amendment Contract Number: 2021*3673 Amendment #3
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 provide diagnostic, patient education and treatment services
for individuals with suspected/known latent Tuberculosis (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.
III. Definitions:
1. AFB smear — Acid -Fast Bacilli; a rapid test used to detect infectious mycobacteria
2. Asylee — individuals who, on their own, travel to the United States and subsequently apply for and
receive a grant of asylum.
3. CDPHE — Colorado Department of Public Health and Environment
4. Class A — Pulmonary TB, the applicant has an abnormal chest radiograph suggestive of
active TB disease, and one or more sputum smears positive for acid -fast bacteria
5. Class B1 - Immigrant with an abnormal CXR with evidence of TB, and/or the individual has a
history of treatment for active TB disease.
6. Class B2 — The individual was diagnosed with latent TB infection (LTBI). These are typically
children whose TST result was positive and CXR was normal.
7. DOT — Directly Observed Therapy
8. HIV— Human Immunodeficiency Virus
9. IGRA — interferon gamma (y) release assay (whole blood TB test)
10. LEP — limited English proficiency (Over -the -Phone Interpretation (OPI) provider only)
11. LTBI — Latent Tuberculosis Infection
12. OPI — over -the -phone interpretation
13. PO — Purchase Order
14. 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
15. RVCT — Report of Verified Case of Tuberculosis
16. Target Population: Newly arrived refugees, asylees and other eligible individuals with Class B TB
designation.
17. TB — Tuberculosis
18. TB -18— CDPHE Tuberculosis Surveillance and Case Management Report
19. TBdb — CDPHE Tuberculosis Data Base
20. TST — Tuberculin Skin Test
IV. Work Plan:
Goal #1: 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, the Contractor shall assist in supporting tuberculosis prevention and
control activities throughout the agency's jurisdiction.
Primary Activity #1
The Contractor shall locate all patients with suspected or confirmed TB.
Page 1 of 6
Amendment Contract Number: 2021*3673 Amendment #3
Ver. 01.11.19
DocuSign Envelope ID: C41B2E1E-4717-4887-9AF6-E81D8FA60DDD
EXHIBIT F
Sub -Activities #1
1. The Contractor shall provide, or arrange for, chest x-rays and interpretations for
individuals with suspected or confirmed TB.
2. The Contractor shall provide interpretations for individuals with suspected or confirmed
TB, as necessary.
3. The Contractor shall collect specimens for mycobacteriology testing on all persons
suspected of having TB.
4. The Contractor shall arrange for the transportation of the specimens to the CDPHE
laboratory for testing.
5. The Contractor shall arrange for the placement of patients who require isolation.
a. The Contractor shall contact CDPHE TB Program for assistance.
b. The Contractor shall contact CDPHE to request reimbursement from CDPHE for
those costs incurred by the Contractor in isolating a patient if funds exist.
6. The Contractor shall provide, or arrange for, the treatment of patients with suspected or
confirmed active TB, including ongoing DOT services.
7. The Contractor shall ensure patients' adherence to TB treatment.
8. The Contractor shall inform those individuals whom refuse HIV testing of the risks
associated with HIV/TB co -infection.
9. The Contractor shall monitor those persons with suspected or confirmed active TB
disease by in -person assessment initially and ongoing throughout treatment for all
confirmed TB patients.
10. As needed, the Contractor shall offer limited English proficiency services via an
accredited Over -the -Phone Interpretation (OPI) provider to be reimbursed using TB
DOT/Diagnostic reimbursement invoice template by the CDPHE TB Program at a rate
not to exceed $0.75/minute.
a. The instructions are incorporated and made part of this Contract by reference and is
available on the following website under the Over -the -phone (OPI) section,
https://vvww.colorado.gov/pacific/cdphe/tb-lpha.
Primary Activity #2
The Contractor shall ensure that all contacts to newly identified infectious TB cases are
identified, investigated, and receive appropriate evaluation.
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.
a. The instructions are incorporated and made part of this Contract by reference and
is available at the following link, Tuberculosis Contact Investigation Record to the
CDPHE TB Program after initiation of each contact investigation.
Primary Activity #3
The Contractor shall provide or arrange for newly arrived refugees, asylees and other eligible
individuals with Class B TB designation to complete a TB screening.
Page 2 of 6
Amendment Contract Number: 2021 *3673 Amendment #3
Ver. 01.11.19
DocuSign Envelope ID: C41 B2E1 E-4717-4887-9AF6-E81 D8FA60DDD
EXHIBIT F
Sub -Activities #3
1. A minimum of 30 calendar days of the Contractor's receipt of written notification from
CDPHE of the arrival of a Class B immigrant or refugee, the Contactor shall provide, or
arrange for a TB screening that includes the following:
a. medical evaluation
b. tuberculin skin test or IGRA
c. chest radiograph
d. three spontaneous sputum specimens for AFB smear and culture collected on
consecutive days
2. Upon completion of testing and examination, the Contractor shall complete, sign, and
date the CDC 75.17 form or Class B tuberculosis Follow Up worksheet, and return it
within ninety (90) days to:
Colorado Department of Public Health and Environment
Tuberculosis Program
Attn: Class B Coordinator
4300 Cherry Creek Drive South
Denver, CO 80246
or via secure fax: 303-759-5538 to the attention of the Class B Coordinator
Primary Activity #4
The Contractor shall identify, investigate, and evaluate persons with a high risk of LTBI.
Sub -Activities #4
1. The Contractor shall offer an HIV antibody test to 100% of persons with LTBI and
provide, or arrange for, HIV antibody test with a test result rate >80%.
a. The Contractor shall record 80% of all HIV antibody testing result rates
for LBTI patients into the CDPHE TBdb.
b. The Contractor shall record 95% of all HIV testing result rates among
suspect and confirmed cases of active TB disease, and enter that information
into the CDPHE TBdb.
2. The Contractor shall offer an HIV antibody test to 100% of persons diagnosed
with active TB disease.
a. The Contractor shall provide an HIV antibody test for those clients with a
test result rate >95%, regardless of their age or the apparent absence of risk
factors for I -11V infection.
3. A minimum of once a month, the Contractor shall monitor and evaluate persons
with LTBI during treatment for all such patients.
4. For those persons identified with LTBI or active TB, the Contractor shall initiate
treatment in accordance with CDC guidance found at the following links,
incorporated and made part of this Contract by reference:
https://www.cdc.ov/tb/topic/treatment/Itbi.htm;
https //www cdc Gov/tb/topic/treatment/tbdisease htm
5x .,'x
.�"l,
cr""`r".u'.r`-f .i �i''` ter" ,3
.F' yyxys..*'S *
N.1':
" .' w ,f"`S"'•bs" nt '�{'J f P'v `sC°x.'' ,�' . {, d,,, '' t f1sf g"y, a�iv ',` 3
Primary Activity #5
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 #5
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 guide each patient to following websites:
https://www.colorado.gov/pacific/hcpf/how-to-apply and
http://connectforhealthco.com/resources/person-help/, incorporated and
made part of this Contract by reference.
b. 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.
c. The Contractor shall document that all TB patients were asked about
current health insurance enrollment and offered materials no later than the
Page 3 of 6
Amendment Contract Number: 2021 *3673 Amendment #3
Ver. 01.11.19
DocuSign Envelope ID: C41 B2E1 E-4717-4887-9AF6-E81 D8FA60DDD
EXHIBIT F
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. 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.
3. CDPHE will provide templates and instructions for any additional
information requests. Report forms are subject to revision and the
Contractor agrees to use the most recent version.
4. The Contractor shall make efforts to increase the percentage of persons that
complete LTBI treatment and maintain or improve on that rate thereafter.
5. The Contractor shall share data of suspected or confirmed active TB
disease results, and include the following information in the state TB
database or similar electronic health record:
a. reason for initiating
b. patient name
c. date of birth
d. country of birth
e. date arrived in U.S.
f. demographic information
g. locating information
h. provider information
i. TB risk factors
j. results of diagnostic testing
k. results of mycobacteriology including susceptibility results
1. dates of infectious period
m. treatment information
n. changes in patients' status
o. diagnosis
p. any other information as appropriate.
6. For those persons identified with active TB, the Contractor shall report to CDPHE:
q. patient name
r. date of birth
s. country of birth
t. date arrived in the U.S.
u. demographic information
v. locating information
w. provider information
x. TB risk factors
y. results of diagnostic testing
z. treatment information
aa. any other information deemed appropriate by the Contractor.
7. The Contractor shall complete tests including the following:
bb. smears for acid -fast bacilli, (using concentrated fluorescent method)
cc. isolation of mycobacteria (using rapid methods)
dd. identification of Mycobacterium Tuberculosis complex (MTB) (using rapid
methods)
Page 4 of 6
Amendment Contract Number: 2021 *3673 Amendment #3
Ver. 01.11.19
DocuSign Envelope ID: C41B2E1E-4717-4887-9AF6-E81D8FA60DDD
EXHIBIT F
ee. susceptibility testing (isoniazid, rifampin, ethambutol, and pyrazinamide) on
isolates of MTB.
8. The Contractor shall obtain and document an HIV testing result for 95% of suspect and
confirmed cases of active TB disease, and enter that information into the Contractor's
electronic medical record before TB treatment begins, and no later than the end date of this
Contract.
9. The Contractor shall obtain and document an HIV testing result for 80% of all LBTI
patients in the Contractor's electronic medical record no later than the end date of this
Contract.
10. The Contractor shall provide culturally appropriate patient education and information
pertaining to TB treatment and the follow-up plan.
11. The Contractor shall provide services in patient's preferred language using medical
interpretation resource.
12. The Contractor shall complete 100% of all RVCT fields no later than the end date of this
Contract.
13. The Contractor shall discuss current health insurance enrollment and offered materials
with the client for the purposes of becoming insured if not currently insured.
a. The Contractor shall ask all TB clients about current health insurance enrollment
including Medicaid, and offer resource materials no later than the last business
day of each month.
14. The Contractor shall provide or arrange for treatment and ensure completion of therapy.
15. The Contractor shall provide a final report via email or CDPHE TBdb to the TB
Program's Data Coordinator when a contact investigation is completed.
16. The Contractor shall provide all other necessary laboratory testing and medical
evaluation services to identify TB.
17. The Contractor shall report information as requested by CDPHE via a secure web -based
TB case/contact management system (CDPHE TB database or the Contractor's electronic
medical record)
18. For confirmed cases of TB, the Contractor shall include all data elements identified in
the "Report of Verified Case of Tuberculosis (RVCT)", which is incorporated herein by
this reference, made a part of this Contract and is available at the following link:
RVCT and is incorporated and made part of this contract by reference.
19. The Contractor shall provide CDPHE with the medical insurance information for those
patients who have medical insurance.
20. The Contractor shall provide consultation services, as needed, to providers in its
service area regarding TB reporting, screening, treatment, and follow-up.
21. The Contractor shall provide printed resource, referral and Medicaid and Connect for
Health Colorado enrollment materials for clients with Limited English Proficiency
(LEP).
a. Contractors that routinely offer enrollment services on -site are exempt from this
requirement because the services provided go beyond this minimum requirement.
22. The Contractor shall use LEP, Over -the -Phone Interpretation (OPI) to communicate
with clients.
a. The Contractor shall provide a monthly reimbursement DOT/Diagnostic
invoice according to the following criteria:
i. The monthly DOT/Diagnostic invoice must be provided
with supporting documentation confirming use is TB -related.
ii. The Contractor shall request monthly DOT/Diagnostic reimbursement no
later than the last business day of each month.
23. The Contractor shall complete the Semi -Annual Progress Report per the following
criteria:
a. The Semi -Annual Progress Reports must cover July -December and January -
June.
b. The Contractor shall complete the Semi -Annual Progress Report using the
following website:
https://drive.google. com/file/d/0B0tmPQ67k3N Vbk8xemF PN3 Fp W U 0/view
Page 5 of 6
Amendment Contract Number: 2021 *3673 Amendment #3
Ver. 01.11.19
DocuSign Envelope ID: C41 B2E1 E-4717-4887-9AF6-E81 D8FA60DDD
EXHIBIT F
which is incorporated and made part of this Contract by reference.
24. The Contractor shall use information on enrollment resources, referral
outreach and promotional materials is available at
https://coloradopeak.secure.force.com/CPCLA which is incorporated
locations, LEP and
and made a part of
insurance,
with the
Colorado
for services
printed resource
and Connect
options. These
(LEP). To help
websites are
and made
this Contract by reference.
25. In order to facilitate and improve client access and enrollment in health
CDPHE is asking all state contractors and sub -recipients who contract
department for direct patient care clinical service programs to provide
Medicaid and Connect for Health Colorado information to clients presenting
at their agencies. At a minimum, CDPHE Contractors must offer clients
and referral materials that direct them to the nearest community Medicaid
for Health Colorado enrollment location(s), including online enrollment
materials must be available for clients with limited English proficiency
locate the nearest enrollment locations in the community, the following
available: https://www.colorado.gov/pacific/hcpf/how-to-apply
http://connectforhealthco.com/resources/person-help/, and are incorporated
part of this Contract by reference.
Expected Results of the Activity
1. New TB cases shall be diagnosed, documented and treated.
2. Improved TB diagnosis and treatment rates for the target population.
Measurement of Expected Results
1. Data contained in the CDPHE TBdb.
2. Data contained in the Tuberculosis Surveillance and Case Management Report.
3. Data contained in Semi -Annual Progress Reports.
�� � � �.. .�..W�.., �.. �.. �.�:..� w � �
Completion Date
Deliverables
1. The Contractor shall submit the Semi -Annual Progress Report
covering July -December and January -June to the CDPHE Contract
Monitor via email.
No later than seven
(7) and 13 months
after execution of
this 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 6 of 6
Amendment Contract Number: 2021 *3673 Amendment #3
Ver. 01.11.19
DocuSign Envelope ID: C41 B2E1 E-4717-4887-9AF6-E81 D8FA60DDD
EXHIBIT H
FY 2022 Budget
To Original Contract Routing Number: 19 FHHA 109285
Weld County Department of Public Health and Environment — Prevention and Control
Description
Funding Source
Amount
TB Prevention & Control
State
$55,000
DOT, Diagnostic, and OPI
encumbrances as needed
State
As available
Total
$55,000
Amendment Contract Number: 2021 *3673 Amendment #3 Page 1 of 1
Contract Form
New Contract Request
Entity Information
Entity Name*
COLORADO DEPT OF PUBLIC
HEALTH? ENVIRONMENT
Entity ID*
:'00001926
❑ New Entity?
Contract Name .x Contract ID
TUBERCULOSIS CONTROL PROGRAM FY21 -22 TASK ORDER 4848
CONTRACT AMENDMENT #3
Contract Status
CTB REVIEW
Contract Lead*
TGEISER
Contract Lead Email
tgeiserAco.weld.co.us
Parent Contract ID
Requires Board Approval
YES
Department Project #
Contract Description*
TASK ORDER CONTRACT AMENDMENT #3 FOR THE TUBERCULOSIS TREATMENT & CONTROL PROGRAM FY21-22
2021'"3673M
Contract Description 2
PREVIOUS TASK ORDERS. 2020" 359842, 2020'01 34A1 ; 19 FHHA 109285
Contract Type*
CONTRACT
Amount *
$55,000.00
Renewable*
NO
Automatic Renewal
NO
Grant
YES
IGA
NO
Department
HEALTH
Department Email
CM -Health Qweldgov.com
Department Head Email
CM-Health-
DeptHead Pyveldgov.com
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
CM-
COUNTYATTORNEY. WELDG
OV.COM
Grant Deadline Date
If this is a renewal enter previous Contract ID
3710
If this is part of a MSA enter MSA Contract ID
Requested BOCC Agenda
Date*
06;' 14,E 2021
Due Date
06 10 2021
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 he left blank if those contracts are not in
OriBase
Contract Dates
Effective Date
07 01:2021
Review Date*
03 31 2022
Termination Notice Period Committed Delivery Date
Contact Information
Contact Info
Contact Name
Purchasing
Contact Type Contact Email
Renewal Date
Expiration Date'
06 30x2022
Contact Phone 1 Contact Phone 2
Purchasing Approver Purchasing Approved Date
Approval Process
Department Head
TANYA GEISER
DH Approved Date
06/10:2021
Final Approval
BOCC Approved
BOCC Signed Date
BOCC Agenda Date
06, 16 ,2021
Originator
TGEISER
Finance Approver
CHRIS D'OVIDIO
Legal Counsel
BOB CHOATE
Finance Approved Date Legal Counsel Approved Date
06a 10:2021 06,'14'2021
Tyler Ref
AG 061621
Hello