HomeMy WebLinkAbout20191179RESOLUTION
RE: APPROVE TASK ORDER CONTRACT FOR WISEWOMAN PROGRAM UNDER THE
WOMEN'S WELLNESS CONNECTION PROGRAM AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Task Order Contract for the
WISEWOMAN (Well -Integrated Screening and Evaluation for WOMan Across the Nation)
Program under the Women's Wellness Connection Program between the County of Weld, State
of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of
the Weld County Department of Public Health and Environment, and the Colorado Department of
Public Health and Environment, commencing April 1, 2019, and ending September 29, 2019, with
further terms and conditions being as stated in said contract, and
WHEREAS, after review, the Board deems it advisable to approve said contract, 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 for the WISEWOMAN (Well -Integrated Screening
and Evaluation for WOMan Across the Nation) Program under the Women's Wellness Connection
Program between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Weld County Department of Public Health and
Environment, 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 sign said contract.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 25th day of March, A.D., 2019.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, CQLORADO
ATTEST: darks)
r. jelei.�
Weld County Clerk to the Board
BY:
APP
Deputy CI
ounty Attorney
Steve Moreno
Date of signature: Li (2[I'1
arbara Kirkmeyr, Chair
Mike Freeman, Pro -Tern
CC'• pact Ilci
N��T��
. Conway
2019-1179
HL0051
0,19410.A)- ) D-44-25 1 9
Memorandum
TO: Barbara Kirkmeyer, Chair
Board of County Commissioners
FROM: Mark E. Wallace, MD, MPH
Executive Director
Department of Public Health & Environment
DATE: March 20, 2019
SUBJECT: CDPHE WISEWOMAN Program FY19
Task Order Contract
For the Board's approval is the Women's Wellness Connection WISEWOMAN Chronic Disease
Prevention Task Order Contract between the Colorado Department of Public Health and Environment
(CDPHE) and the Weld County Board of Commissioners for the benefit and use of the Weld County
Department of Public Health and Environment (WCPDHE).
The purpose and mission of the Well -Integrated Screening and Evaluation for WOMen Across
the Nation (WISEWOMAN) program is to reduce chronic disease, including but not limited to,
cardiovascular disease (CVD), prediabetes, diabetes, and high cholesterol among underserved
populations in Colorado and Weld County. This includes delivery of CVD and diabetes screenings
and implementing healthy behavior support services such as individualized health coaching to
eligible clients residing in Colorado who are insured or underinsured and are enrolled in the
Women's Wellness Connection program who meet the age, income, and lawful presence
requirements.
The period of performance for this Task Order Contract is April 1, 2019, to September 29, 2019, and
the maximum amount payable by the State for the work to be performed by the WCDPHE during this
term is $16,799.00, all of which is federal funds.
Assistant Weld County Attorney, Bob Choate, has reviewed this Task Order Contract with CDPHE
and determined that its terms are acceptable.
Furthermore, this amendment was approved for placement on the Board's agenda via pass -around
dated March 18, 2019_
I recommend approval of this task order contract with CDPHE.
2019-1179
DEPARTMENT OF PUBLIC HEALTH AND
ENVIRONMENT
CONTRACT 2019*3454
ROUTING NO.
APPROVED TASK ORDER CONTRACT - WAIVER #154
This task order contract is issued pursuant to master contract made on 11/23/2016, with routing number 18 NAA 00051.
STATE:
Slate of Colorado for the use & benefit of the
Department of Public Health and Environment
Prevention Services Division
Health Prontoiion & Chmrtlic Disease Prevention[ Brandt
4300 Cherry Gut Drove South, A - 5
Denver, Colotado 010246
CONTRACT MADE DATE 3/6/2019
TERM:
This mistreat shall he effective upon approval by
the State Controller, or designee, crop 04/01/2019,
whichever is later. The ralract shithead on 09/29/20l9.
PROCIIREMENTMEn1OD
KM 11460
BIDDRFnuSl PRICEAGRRB&Nr NUMBER:
N/A
LAW SPECIFIED VENDOR STATUTE
N/A
STATE REPREstssrATIVE
Michelle Schultz
Heart Health Consultant
Prevention Services Division
4300 Cherry Creek Drive South, A - 5
Denver, Colorado 80246
CONTRACTOR:
Boom of County Commissioners of Weld County
1150 "On Si, Greeley, CO 80631 for the use andbeneft of the
Weld County Department of Public Health and Environment
1555 Noith 17th Avenue
Greeley, Colorado 80631
CONIRACIOR t1UNs 05'757955
CONTRACTOR ENTITY TYPE:
Political Subdivision
BILLING STATEMENTS RECEIVED:
Monthly
STATUTORY AUTHORITY: Not Applicable
CLASSIFICATIONsubrecipient
-
CONTRACT PRICE NOT TO EXCEED: $16,799.00
FEDERAL FUNDINGDOLLARS: $16,799.00
STATE RJNIDING0DOLLARS: $0.00
OMERFIJNDINC.DOLIARS: $0.00
MAXIMUM AMOUNT AVAILABLE PER FISCAL YEAR:
FY19: $16,799.00
PRICE STRUCTURE Cost ReimhluXement
CONTRACTOR REPRESENTATIVE:
Tanya Geiser
Director of Public Health Adtnin. Services
1555 North 17th Avenue
Greeley, Colorado 80631
PROJECT DESCRIPTION
This project serves to implement strategies to address cardiovascular disease prevention.
2019-3454 OC ver 06.3.19
Page 1 of 6
449I 9— i/796!
t:aaamrrs:
The following exhibits are hereby incorporated:
Exhibit A - Additional Provisions (and any of its Attachments; e.g., A-1, A-2, etc.)
Exhibit B - Statement of Work (and any of its Attachments; e.g., B-1, B-2, etc.)
Exhibit C - Budget (and any of its Attachments; e.g., C-1, C-2, etc.)
Exhibit B - Option Letter
GENERAL PROVISIONS
The folbwing clauses apply to this Task Order Contract. These general clauses may have been expanded upon or made
more specific in some instances in exhibits to this Task Order Contract To the extent that other provisions of this Task
Older Contract provide more specificity than these general clauses, the more specific provision shall control.
I. This Task Order Contract is being entered into pursuant to the terms and conditions of the Master Contract
aact.
including, but not limited to, Exhibit One thereto. The total termer ibis Task Order Contract, including any
renewals or extensions, may net exceed five (5) years. The parties intend and agree Heat ail work shall be
pterfatrtned according to the standards, terms and conditions set forth in the Master Contract.
2. hk ac con/ ice with section 24-30-202(1), C.R.S., as amended, this Task Order Contract is not valid until it has
been approved by the State Controller, or an authorized delegee thereof The Contractor is not authorized lo,
and shall not; commence performance under this Task Order Contract oink this Task Order Contract has been
approved by the State Controller or delegee. The State shall have no financial obligation to the Contractor
whatsoever for any work or services or, any costs or expenses, incurred by the Contractor prior to the effective
date of this Task Outer Contract. if the State Controller approves this Task Order Contract on or befote its
proposed effective date, then the Contractor shaft commence performance under Ibis Task Order Contract on
the proposed effective date. If the State Ca niailler approves this Task Order Ckniitract after its proposed
effective date, then the Contractor shall only commence performance under this Task Order Contract on that
later date. The initial term of this'fask Order Contract shall continue through and wing the date specified
on page one ofthis Task Order Contract, unless sooner terminated by die parties pursuant to the terms and
conditions of this Task Order Contract and/or the Master Contract. Contractor's commencement of
performance under this Task Order Contract shall be deemed acceptance of the terms and conditions of this
Task Order Contract.
3_ The Master Contract and its exhibits and/or attachments are incorporated herein by this reference and made a
part hereof as if fully set forth herein. Unless otherwise stated, all exhibits and/or attachments to this Task Order
Contract are incorporated herein and made a part of this Task Order Contraact. Unless otherwise stated, the terms of
this Task Order Contract shall control over any conflicting terms in any of its exhibits. In the event of conflicts or
inconsistencies between the Master Contract and this Task Order Contract (including its exhibits and/or
attachments), or between this Task Order Contract and its exhibits and/or attachments, such conflicts or
inconsistencies shall be resolved by reference to the documents in the following order of priority: 1) the
Special Provisions of the Master Contract; 2) the Master Contract (other than the Special Provisions) and its
exhibits and attachments in the order specified in the Master Contract; 3) this Task Order Contract 4) the
2019-3454 OC ver 06.3.19
Page 2 of 6
Additional Provisions - Exhibit A, and its attachments if included, to this Task Order Contract; 5) the
Scope/Statement of Work - Exhibit B, and its attachments if included, to this Task Order Contract; 6) other
exhibits/attachments to this Task Order Contract in their order of appearance.
4. The Contractor, in accordance with the terms and conditions of the Master Contract and this Task Order
Contract, shall perform and complete, in a timely and satisfactory manner, all work items described in the
Statement of Work and Budget, which are incorporated herein by this reference, made a part hereof and
attached hereto as "Exhibit B" and "Exhibit C".
5. The State, with the concurrence of the Contractor, may, among other things, prospectively renew or extend the
term of this Task Order Contract, subject to the limitations set forth in the Master Contract, increase or
decrease the amount payable under this Task Order Contract, or add to, delete from, and/or modify this Task
Order Contract's Statement of Work through a contract amendment To be effective, the amendment must be
signed by the State and the Contractor, and be approved by the State Controller or an authorized delegate
thereof. This contract is subject to such modifications as may be required by changes in Federal or State law,
or their implementing regulations_ Any such required modification shall automatically be incorporated into and
be part of this Task Order Contract on the effective date of such change as if fully set forth herein.
6_ The conditions, provisions, and terms of any RFP attached hereto, if applicable, establish the minimum
standards of performance that the Contractor must meet under this Task Order Contract. If the Contractor's
Proposal, if attached hereto, or any attachments or exhibits thereto, or the Scope/Statement of Work - Exhibit
B, establishes or creates standards of performance greater than those set forth in the RFP, then the Contractor
shall also meet those standards of performance under this Task Order Contract
7_ STATEWIDE CONTRACT MANAGEMENT SYSTEM [This section shall apply when the Effective Date
is on or after July 1, 2009 and the maximum amount payable to Contractor hereunder is $100,000 or higher]
By entering into this Task Order Contract, Contractor agrees to be governed, and to abide, by the provisions of
CRS §24-102-205, §24-102-206, §24-103-601, §24-103.5-101 and §24-105-102 concerning the monitoring of
vendor performance on state contracts and inclusion of contract performance information in a statewide
contract management system
Contractor's performance shall be evaluated in accordance with the terms and conditions of this Task Order
Contract, State law, including CRS §24-103.5-101, and State Fiscal Rules, Policies and Guidance. Evaluation
of Contractor's performance shall be part of the normal contract administration process and Contractor's
performance will be systematically recorded in the statewide Contract Management System. Areas of review
shall include, but shall not be limited to quality, cost and timeliness. Collection of information relevant to the
performance of Contractor's obligations under this Task Order Contract shall be determined by the specific
requirements of such obligations and shall include factors tailored to match the requirements of the Statement
of Project of this Task Order Contract. Such performance information shall be entered into the statewide
Contract Management System at intervals established in the Statement of Project and a final review and rating
shall be rendered within 30 days of the end of the Task Order Contract term. Contractor shall be notified
following each performance and shall address or correct any identified problem in a timely manner and
maintain work progress.
Should the final performance evaluation determine that Contractor demonstrated a gross failure to meet the
performance measures established under the Statement of Project, the Executive Director of the Colorado
Department of Personnel and Administration (Executive Director), upon request by the Colorado Department
of Public Health and Environment and showing of good cause, may debar Contractor and
Page 3 of 6
2019-3454 OC ver 063.19
prohibit Contractor from bidding on future contracts. Contractor may contest the final evaluation and result by:
(i) filing rebuttal statements, which may result in either removal or correction of the evaluation (CRS §24-105-
102(6)), or (ii) under CRS §24-105-102(6), exercising the debarment protest and appeal rights provided in
CRS §§24-109-106, 107, 201 or 202, which may result in the reversal of the debarment and reinstatement of
Contractor, by the Executive Director, upon showing of good cause.
8. If this Contract involves federal funds or compliance is otherwise federally mandated, the Contractor and its
agent(s) shall at all times during the term of this contract strictly adhere to all applicable federal laws, state
laws, Executive Orders and implementing regulations as they currently exist and may hereafter be amended.
Without limitation, these federal laws and regulations include the Federal Funding Accountability and
Transparency Act of 2006 (Public Law 109-282), as amended by §6062 of Public Law 110-252, including
without limitation all data reporting requirements required there under. This Act is also referred to as FFATA.
2019-3454 OC ver 06.3.19
Page 4 of 6
SIGNATURE PAGE
Contras Routing Number. 2019"3454
THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT
Each person signing this Contract represents and mutants that he or she is duly authorized to execute this Contract aid to Muddle patty authorizing his or her
signature.
CONTRACTOR
Board of County Commissioners of Weld County for
the use and benefit of the Weld County Department of
Public Health and Environment
(a political subdivision of the state of Colorado)
Barbara Kirktneyer
Print Name of Authorized I dividual
BOCC Chair
Print Title of Aid hnlividital
S
441
MAR 2 5 2019
Date
PROGRAM APPROVAL
Colorado Deplar trnent of Public Health and Environment
By:
STATE OF COLORADO
Jared S. Polls, Governor
Colorado Department of Public Health and
Environment
Jill Hunsaker Ryan, MPH
Executive Director
la McGovern
Procurement and Contracts Section Director, CDPHE
Date
hi 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 CO
Robert ro
Effective Date:
2019-3454 OC ver 06.3. l9
Page 5 of 6
This page left intentionally blank.
Page 6of6
2019-3454 OC ver 06.3.19
EXHIBIT A
ADDITIONAL PROVISIONS
To Contract Dated 03/06/2019 - CMS Contract Routing Number 2019*3454
These provisions are to be read and interpreted in conjunction with the provisions of the Contract specified above.
1. This Contract contains state and federal funds (see Catalog of Federal Domestic Assistance (CFDA)
numbers 93.435, 93.426 and 93.436).
2. The United States Department of Health and Human Services ("USDHHS"), through the Center for
Disease Control and Prevention ("CDC") has awarded as of 12/13/2018 anticipated federal funds of
$1,800,000.00 under Notice of Cooperative Agreement Award, hereinafter "NCAA", number
NU58DP006615, to perform the following — Innovative State and Local Public Health Strategies to Prevent
and Manage Diabetes and Heart Disease and Stroke.
The United States Department of Health and Human Services ("USDHHS"), through the Center for
Disease Control and Prevention ("CDC") has awarded as of 12/06/2018 anticipated federal funds of
$1,641,838.00 under Notice of Cooperative Agreement Award, hereinafter "NCAA", number
NU58DP006553, to perform the following — Preventing and Managing Diabetes, Heart Disease and Stroke
in Colorado_
The United States Department of Health and Human Services ("USDHHS"), through the Center for
Disease Control and Prevention ("CDC") has awarded as of 10/31/2018 anticipated federal funds of
$795,000.00 under Notice of Cooperative Agreement Award, hereinafter "NCAA", number
NU58DP006656, to perform the following — Colorado's WISEWOMAN Program.
If the underlying Notice of Cooperative Agreement Award "NCAA" authorizes the State to pay all
allowable and allocable expenses of a Contractor as of the Effective Date of that NCAA, then the State
shall reimburse the Contractor for any allowable and allocable expenses of the Contractor that have been
incurred by the Contractor since the proposed Effective Date of this Contract If the underlying NCAA does
not authorize the State to pay all allowable and allocable expenses of a Contractor as of the Effective Date
of that NCAA, then the State shall only reimburse the Contractor for those allowable and allocable
expenses of the Contractor that are incurred by the Contractor on or after the Effective Date of this
Contract, with such Effective Date being the later of the date specified in this Contract or the date the
Contract is signed by the State Controller or delegee_
3. To receive compensation under the Contract, the Contractor shall submit a signed Monthly CDPHE
Reimbursement Invoice Form_ This form is accessible from the CDPHE intemet 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
Scan the completed and signed CDPHE Reimbursement Invoice Form into an electronic document. Email
the scanned invoice and the Expenditure Details page and to: CDPHE Program Assistant, at
cdphe_ehroniediseaseRFA@state.co.us.
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.
Page 1 of 4
Contract Exhibit -A AdditionalProvisions 17.5.3
EXHIBIT A
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_
The Contractor shall not use state funds to satisfy federal cost sharing and matching requirements unless
approved in writing by CDPHE.
4. If identified in the Implementation Plan under this Contract, the Contractor shall provide cardiovascular
screening, risk reduction counseling, referral and healthy behavior support options to eligible clients during
the term of this Contract in order to receive compensation for screening services provided to eligible
individual clients.
The Contractor shall be paid in accordance with rates as outlined in the WISEWOMAN Bundled Payment
System This document is incorporated and made a part of this Contract by reference and is available on the
following WISEWOMAN website under "Billing and Reimbursement" at
https://www.colorado.gov/cdphe/wisewoman-provider-resources.
Contractors shall be paid only for cases that meet eligibility, performance and data requirements. Rates may
be revised or updated during the contract term. Reimbursement policies are defined in the WISEWOMAN
Program Manual. This manual is located at the following website:
https://www.colorado.eov/pacific/cdphe/wisewoman-provider-resources and is incorporated and made a
part of this Contract by reference.
Data entered into the electronic cancer surveillance and tracking (eCaST) data system are the basis for
calculating reimbursement for each client screened through WISEWOMAN. To be considered for payment,
all WISEWOMAN services must be entered into eCaST within thirty (30) days of service being performed.
WISEWOMAN cases that exceed sixty (60) calendar days in screening length and negatively affect the
program's Performance Measures may or may not be reimbursed at the discretion of the State. Contractors
shall only be paid for cases that meet eligibility, performance and data requirements. Reimbursement is
determined by the outcome of the case.
If identified in the Implementation Plan under this Contract, the Contractor shall receive a contracted
eCaST funding amount each fiscal year to provide WISEWOMAN services to individual clients. Once the
eCaST funding cap is reached, the WISEWOMAN program will not pay for additional expenses incurred
by Contractor unless CDPHE opts to increase funding. Based on performance, the WISEWOMAN
Program may unilaterally change the groups of eligible clients who may be served with eCaST funding.
The Contractor shall request prior approval in writing from the WISEWOMAN Program for any
modification to the eCaST budget line item.
5. Time Limit For Acceptance Of Deliverables.
a. Evaluation Period. The State shall have fifteen (15) 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 fifteen (15) 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.
Page 2 of 4
Contract_Exhibit-A AdditionalProvisions 17.5.3
EXHIBIT A
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 fifteen (15)
calendar days, to correct the noted deficiencies.
6. 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.
7. This award does not include funds for Research and Development
8_ The State, at its discretion, shall have the option to extend the term under this Contract 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 Contract. In order to exercise this option, the State shall provide written notice to Contractor in a
form substantially equivalent to Exhibit D. If exercised, the provisions of the Option Letter shall become
part of and be incorporated in the original contract. The total duration of this contract shall not exceed 5
years.
9. 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 Contract, and increase the maximum amount
payable accordingly. In order to exercise this option, the State shall provide written notice to Contractor in
a 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 Contract.
10. All data collected, used or acquired shall be used solely for the purposes of this Contract. The Contractor
and its subcontractors agree not to release, divulge, publish, transfer, sell, or otherwise make known any
such data to unauthorized persons without the express prior written consent of the State or as otherwise
required by law. This includes a prior written request by the Contractor to the State for submission of
abstracts or reports to conferences, which utilize data collected under this Contract.
Notwithstanding the foregoing, the Contractor shall be entitled to retain a set of any such data collected or
work papers necessary to perform its duties under this Contract and in accordance with professional
standards.
11. If Contractor indicates full expenditure of funds under this Contract by March 31g of each grant year and
the full expenditure does not occur, CDPHE has the option to reduce current or upcoming Contract by said
amount or a percent deemed reasonable by CDPHE. CDPHE will notify the Contractor of the potential
need to decrease the current or upcoming budget. If the Contractor indicates at a later date than March 31st
of each grant year an expectation of surplus of fiords or inability to fully expend said funds for unforeseen
circumstances that Contractor had not anticipated by March 31st CDPHE will reallocate unspent funds
without any penalties to the Contractor.
Upon receipt of timely written notice of an objection by the State for inability to fully expend funds, the
Contractor shall have a reasonable period of time not to exceed ten (10) calendar days to respond to the
action. If no dispute is received by the State within ten (10) calendar days, the State has the option to
reduce the current budget for the current year and any upcoming budget for future contractual agreements.
12. Contractor shall request prior approval in writing from the State for all modifications in the Statement of
Work/Work Plan or for any modification to the direct costs in excess of twenty-five percent (25%) of the
total budget for direct costs shall be submitted to CDPHE at least ninety (90) days prior to the end of the
contract period and may require an amendment in accordance with General Provisions, Section 16,
Contract Modifications, of this Contract.
13. The State of Colorado, specifically the Colorado Department of Public Health and Environment, shall be
the owner of all equipment as defined by Federal Accounting Standards Advisory Board (FASAB)
Page 3 of 4
Contract_Exhibit-A AdditionalProvisions_ 17.5.3
EXHIBIT A
Generally Accepted Accounting Principles (GAAP) purchased under this Contract. At the end of the term
of this Contract, the State shall approve the disposition of all equipment.
14. Contractor shall not use funds provided under this Contract for the purpose of lobbying as defined in
Colorado Revised Statutes (C.R.S.) 24-6-301(3.5)(a).
15. Neither the U.S. Department of Health and Human Services (HTIS) nor the Centers for Disease Control
(CDC) logo may be displayed on any conference materials if such display would cause confusion as to the
conference source or give false appearance of Government endorsement. Use of the HHS name or logo is
governed by U.S.C. 1320b-10, which prohibits misuse of the HHS name and emblem in written
communication. A non-federal entity is unauthorized to use the MIS name or logo governed by U.S.C.
1320b-10. The appropriate use of the HHS logo is subject to review and approval of the Office of the
Assistant Secretary for Public Affairs (OASPA).
16. Notwithstanding the terms contained in the General Provisions of the Master Contract, Section 25,
Conformance with Law, the Contractor shall comply with the provisions of Section 601 of Title VI of the
Civil Rights Act of 1964, as amended, which states that "no person in the United States shall on the
grounds of race, color or national origin, be excluded from participation in, be denied the benefits of or be
subjected to discrimination under any program actively receiving Federal financial assistance." The Office
for Civil Rights has established that it is the responsibility of any program that is a recipient of federal
funds to ensure that any Limited English Proficient (LEP) person or beneficiary have meaningful access to
programs, services and information_ The Contractor and contract personnel shall adopt and implement
policies and procedures in which reasonable steps are taken to provide language assistance in order to
ensure equal access to LEP persons or beneficiaries. The Contractor and contract personnel shall advise
LEP individuals that language assistance will be provided at no cost to the LEP person or beneficiary.
17. The Contractor agrees to provide services to all Program participants and employees in a smoke free
environment in accordance with Public Law 103227, also known as "the ProChildren Act of 1994", (Act).
Public Law 103227 requires that smoking not be permitted in any portion of any indoor facility owned or
leased or contracted for by an entity and used routinely or regularly for the provision of health, day care,
early childhood development services, education or library services to children under the age of 18, if the
services are funded by Federal programs either directly or through State or local governments, by Federal
grant, contract, loan, or loan guarantee.
18. Notwithstanding the terms contained in the General Provisions, Section 10, Confidential or Proprietary
Information, Contractor shall protect the confidentiality of all applicant or recipient records and other
materials that are maintained in accordance with this Contract Except for purposes directly connected with
the administration of this Contract, no information about or obtained from any applicant or recipient shall
be disclosed in a form identifiable with the applicant or recipient without the prior written consent of the
applicant or recipient, or the parent or legal guardian of a minor applicant or recipient with the exception of
information protected by Colorado Statute as it applies to confidentiality for adolescent services in which
case the adolescent minor and not the parent or legal guardian must provide consent or as otherwise
properly ordered by a court of competent jurisdiction. Contractor shall have written policies governing
access, duplication, and dissemination of all such information. Contractor shall advise its employees,
agents, servants, and any subcontractors that they are subject to these confidentiality requirements.
Page 4 of 4
Contract Exhibit -A AdditionalProvisions_17.5.3
EXHIBIT B
STATEMENT OF WORK
To Original Contract Routing Number 2019*3454
I. Entity Name: Weld County Department of Public Health and Environment
IL Project Description:
This project serves to implement strategies to address cardiovascular disease prevention. Heart disease and stroke
together kill more Coloradans than any other disease, with uncontrolled hypertension as the leading cause
(Colorado Health Information Dataset [CoHID], 2016). The strategies incorporated into this project include
prevention, direct screening, outreach, disease management and systems -level interventions for underserved
populations relating to the prevention and management of cardiovascular and related chronic diseases. The aim of
this work is for health care systems and community based organizations to prevent and manage chronic disease,
leading to improved health outcomes. Activities will reflect the Evidence -Based Interventions and best or
promising practices included in the Clinic Quality Improvement portfolio and WISEWOMAN (Well -Integrated
Screening and Evaluations for Women Across the Nation) program manual.
III. Definitions:
1. CDPHE: Colorado Department of Public Health and Environment_
2. CQI Portfolio: A collection of evidence -based interventions created by the Clinic Quality Improvement
program that contains best and promising practices used to guide and support a health system in the
prevention and management of chronic disease.
3. CRISPeR: Community Resource Inventory for Patient e -Referral program; facilitates bidirectional e -
referrals through a secure hub between a health system electronic health record and community based
organization.
4. Designated CDPHE Contact CDPHE staff member assigned to monitor the contract.
5. Evidence -Based Interventions (EBIs): Activities and strategies that have been tested and reviewed as
effective at improving chronic disease health outcomes.
6. Health systems Individual health clinic (includes provider -owned clinic), Federally Qualified Health Center,
community health center, hospital, hospital network for the use and benefit of a hospital within their
network (may include hospital foundations), safety net clinic, rural health center, or local public health
agency.
7. Healthy Behavior Support Program: Evidence -based lifestyle program, health coaching or community
resource that supports self -management and healthy lifestyle changes_
8. Quarters: Quarter 1 - September 30 — December 31; Quarter 2 - January 1— March 31; Quarter 3 - April 1 —
June 30; Quarter 4 - July 1— September 29.
9. WISEWOMAN: Well -Integrated Screening and Evaluation for WOMen Across the Nation; a
cardiovascular disease prevention program for low-income women run by the Colorado Department of
Public Health and Environment, Prevention Services Division.
IV. Work Plan:
Goal #1: Improves the health, well-being and equity of all Coloradans through health promotion, prevention and ensuring
access to health care by focusing on reducing the rate of chronic disease risk among Coloradans.
Objective #1: No later than the expiration date of this contract, draft an implementation plan and implement EBIs to reduce
chronic disease in Colorado.
Primary Activity #1
The Contractor shall, in collaboration with the Designated CDPHE Contact, draft an
implementation plan outlining:
1. the straiegy(ies) in which the project will focus; and
2. the detailed steps and tasks which the Contractor shall take to address the objectives of this
agreement.
Primary Activity #2
The Contractor shall, update the implementation plan at a minimum annually.
Primary Activity #3
The Contractor shall implement strategies and services from the WISEWOMAN Program,
Clinic Quality Improvement program, CRISPeR program or a Healthy Behavior Support
Program followingprogram requirements.
version: Contract Statement of Work - Exhibit B
December 2015
Page 1 of 3
Contract_S0W Exhibit B_December 2015.doe
EXHIBIT B
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 contract term. The contractor shall monitor documents and website content for
updates and comply with all updates.
2. The Contractor shall comply with changes to any aspect of relevant programs subject to
changes, revisions, inclusions, exclusions, etc. as needed and/or pursuant to directives or
changes required by rule, regulation, statute or guidance.
3. The Contractor shall comply with all program activities and requirements stated in the
implementation plan and its referenced documents.
4_ The Contractor shall attend a post -award meeting provided by CDPHE as well as other
required meetings, trainings, webinars and telephone calls for the purpose of information -
sharing, training, technical assistance and contract monitoring, as outlined in the
implementation plan_
5. The Contractor shall participate in mandatory program reporting processes such as online
written reports or progress calls at an interval outlined in the implementation plan.
6. The Contractor shall participate in CDPHE evaluation and performance measurement
efforts.
7. The Contractor shall use all CDPHE-required forms.
8. The Contractor shall adhere to the following regulations for the implementation plan:
a. The Contractor shall develop an annual implementation plan to adopt and
implement prioritized strategies approved by CDPHE. CDPHE will inform the
Contractor of necessary modification or provide approval of the implementation
plan within 30 business days.
b. The Contractor shall use the implementation plan developed with CDPHE.
c. CDPHE's evaluation of the Contractor's performance will be determined by the
Contractor's adherence to the established implementation plan_
9. The Contractor shall identify and support key personnel as outlined in the implementation
plan and referenced documents_
10. The Contractor shall notify CDPHE within 15 days of a change in key staff responsible for
the performance of services provided during the contract period.
11. The Contractor shall have new staff members receive required training within two (2)
months of hire.
12. The Contractor shall report all subcontractor changes during the contract period to the
Chronic Disease Prevention and Management Program within 15 calendar days of
occurrence.
13. Contractors that provide direct services to individuals 18 years of age and older shall only
provide services of benefit to individuals lawfully present in the United States. The
Contractor shall maintain documentation demonstrating the individual's establishment of
lawful presence, which shall include documentation of an appropriate identification
document and an affidavit as required by Colorado Revised Statutes (CRS.), Section 24-
76.5-103_ [This does not apply to Non-profit charitable organizations, S U.S.C §
1642(d). In addition, Federally Qualified Health Centers (FQHCs) that are not solely
government owned are also exempt from verifying lawful presence, 42 U.S.C. §
254b(b)(1).J
14_ The Contractor shall use measures endorsed by the National Quality Forum Measures,
Reports, & Tools. This information is incorporated and made part of this contract by
reference and located on the following website: www.qualityforum.org.
15. If purchasing gift cards, the Contractor shall provide to CDPHE upon request written
procedures related to gift card purchasing and handling. At a minimum, the procedures
must include the following:
a. How the gill card inventory is tracked and maintained
b. Gift card storage and safeguards against theft
c. The primary person responsible for securing and distribution of gift cards
d. A gift card distribution log that records each gift card number, dollar amount, and
the printed name and signature of each gift card recipient
version: Contract Statement of Work — Exhibit B
December 2015
Contract_SOW Exhibit B_December 2015.doc
Page 2 of 3
EXHIBIT B
16. When corresponding with CDPHE, the Contractor shall use all privacy and security
measures to protect the client's personal health information. Accepted forms of
commnnication include:
a. Unencrypted email conversations using the client identification number;
b. Mail or fax clearly marked "Confidential" and using the client identification
number;
c. HIPAA compliant files transmitted via secure File Transfer Protocol (FTP) sites;
and
d. Secure encrypted email.
17. The Contractor shall submit fmal reports after the contract term as a non -reimbursable
deliverable.
18. The Contractor shall submit all deliverables, unless otherwise stated, via email to the
Designated CDPHE Contact.
19. The Contractor shall not begin activities outlined in the implementation plan until
approved by CDPHE.
Expected Results of
Activity(s)
1. Increased number of individuals screened for chronic disease.
2. Increased number of quality chronic disease screenings provided within priority
populations
3. Increased number of individuals participating in evidence -based healthy behavior support
programs
4. Improved chronic disease measurements among service delivery populations
Measurement of
Expected Results
1. Data from required program submissions, including:
a progress reports;
b. data submissions;
c. annual assessments; and
d. evaluation information.
Completion Date
Deliverables
I. The Contractor shall submit an implementation plan that includes
each of the strategies selected and referenced in this Statement of
Work
No later than the
first business day in
June, annually_
2. The Contractor shall submit a draft budget to coincide with the
implementation plan.
No later than the
first business day in
June, annually.
3. The Contractor shall submit a progress report in a CDPHE
approved format.
No later than 15
business days
following the last
day of each quarter.
V. Monitoring:
CDPHE's monitoring of this contract for compliance with performance requirements will be conducted throughout
the contract period by 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 timeline for completion will be documented in writing and agreed to by both parties. If extenuating
circumstances arise that requires an extension to the timeline, 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 timelines 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.
version: Contract Statement of Work - Exhibit B
December 2015
Contract SOW_Exhibit B_December 2015.doc
Page 3 of 3
Exhibit C Budget
COLORADO
Department of Public
Health & Environment
PREVENTION SERVICES DIVISION - LESS THAN 12 MONTH BUDGET WITH JUSTIFICATION FORM
Contract Routing # 2019-3454
Contractor Name
Weld County Department of Public Health and
Environment
Program Contact Name,
Title, Phone and Email
Cynthia Horn, Program Coordinator
970-400-2433
chorn@weldgov.com
Budget Period
April 1, 2019 - September 29, 2019
Fiscal Contact Name, Title,
Phone and Email
Tanya Geiser, Director, Admin Services
970-400-2122
tgeiser@weldgov.com
Project Name
Chronic Disease Prevention and Management
RFA #11460
Contract (CT or PO)
Number
Cr FHLA 2019'3454
Expenditure Categories
Personal Services
Salaried Employees
Position Title
Description of Work
Gross or
Annual Salary
Fringe
Percent of
Time on
Project
Number of
Months
Total Amount
Requested from
CDPHE
$0.00
Personal Services
Hourly Employees
Position Title
Description of Work
Hourly
Wage
Hourly
Fringe
Total # of
Hours on
Project
Total Amount
Requested from
CDPHE
Health Coach
Attend Patient Navigator and/or Motivational Interviewing training
$ 20.46
$ 7.97
24.0
$682.20
Total Personal Services (including fringe benefits)
.26
Supplies & Operating Expenses
Total Amount
Requested from
CDPHE
Item
Description of Item
Rate
Quantity
Point of Service Supplies
Point of service device testing supplies - Alc & Lipid cartridges and controls
$ 500.00
3.00
$1,500.00
Healthy lifestyle supplies
Education materials and supplies to engage clients in healthy behavioral lifestyles
$ 90.00
6.00
$540.00
Total Supplies & Operating
$2,040.00
Page 1 of 2
March 2018
Exhibit C Budget
PREVENTION SERVICES DIVISION - LESS THAN 12 MONTH BUDGET WITH JUSTIFICATION FORM
Contract Routing # 2019-3454
Contractor Name
Weld County Department of Public Health and
Environment
Program Contact Name,
Title, Phone and Email
Cynthia Horn, Program Coordinator
970-400-2433
chorn@weldgov.com
Budget Period
April 1, 2019 - September 29, 2019
Fiscal Contact Name, Title,
Phone and Email
Tanya Geiser, Director, Admin Services
970-400-2122
tgeiser@weldgov.com
Project Name
Chronic Disease Prevention and Management
RFA #11460
Contract (CT or PO)
Number
CT FHLA 20193454
Travel
Item
Description of Item
Rate
Quantity
Total Amount
Requested from
CDPHE
Mileage
Health Coach travel expenses for training and Post Award Meeting
(124 miles x 4 trips = 496 miles)
$ 0.56
496.0
$277.76
Total
Travel
$277.76
Contractual
Subcontractor Name
Description of Item
Rate
Quantity
Total Amount
Requested from
CDPHE
$0.00
Total
Contractual
$0.00
eCaST
Item
Description of Item
.
Rate
Quantity
Total Amount
Requested from
CDPHE
Service Delivery
Billed in eCaST
S 13,170.00
1.0
$13,170.00
eCaST
Total
$13,170.00t70.00
SUB -TOTAL
OF DIRECT
COSTS
$16,169.96
Indirect
Item
Description of Item
Total
Requested
CDPHE
Amount
from
CDPHE-Negotiated Indirect
Cost Rate
20.98% Total Direct Costs for CY2019
$629.04
Total
Indirect
$629.04
$16,799.00
TOTAL
Page 2 of 2
March 2018
EXHIBIT D
OPTION LETTER #: Click here to enter text.
State
Agency :
Original
Contract
4
Click
here to enter
text.
Colorado
Department Of
Public Health and Environment
4300 Cherry
Denver,
Creek Dr S
CO 80246
Contractor
(Name
and
Address)
Option
Contract
Number
Click
here
to enter
text.
Click
here to enter
text.
Contract
Performance Beginning Date
:
Current
Click
Contract
here to enter
Expiration
a date.
Date
:
Click here
to enter a date.
CONTRACT
MAXIMUM
AMOUNT
TABLE
Document
Type
CMS Routing #
Federal
Funding
State
Amount
Funding
Other Funding
Term (dates)
Total
Amount*
Amount
OL
#1
S
Original
S
* Federal
Funds to United States Government finding
S
attributed
source Current Contract Maximum
Catalog
of Federal Domestic Assistance (CFDA) Number Click
here to Amount
(YTD)
enter text.
1) OPTIONS
A. Option to extend for an Extension Term
B. Option to change quantity of goods under the Contract
C. Option to change quantity of services under the Contract
D. Option to change Contract rates
E. Option to initiate next phase of Contract
2) REQUIRED PROVISIONS:
A. In accordance with Section(s) Click here to enter text. of the Original Contract referenced
above the State hereby exercises its option for an additional term, beginning Click here to enter a
date. and ending on the current contract expiration date shown above, at the rates stated in the
Original Contract, as amended.
B. In accordance with Section(s) Click here to enter text. of the Original Contract referenced
above, the State hereby exercises its option to Choose an item. the quantity of Choose an item. at
the rates stated in the Original Contract as amended for the following reason: Click here to
enter text..
C. In accordance with Section(s) Click here to enter text. of the Original Contract referenced
above the State hereby exercises its option to modify the Contract rates specified in Click here to
enter text. for the following reason: Click here to enter text.. The Contract rates attached to this
Option Letter replace the rates in the Original Contract as of the Option Effective Date of this
Option Letter.
D. In accordance with Section(s) Click here to enter text. of the Original Contract referenced
above, the State hereby exercise its option to initiate Phase Click here to enter text., which shall
begin on Click here to enter a date. and end on Click here to enter a date. at the cost/price
specified in Section Click here to enter text..
E. The Contract Maximum Amount table is deleted and replace with the Current Contract
Maximum Amount Maximum Amount table shown above.
3) OPTION EFFECTIVE DATE:
A. The effective date of this Option Letter is upon approval of the State Controller or Click here
to enter a date. whichever is later.
Ver. 27.2.18
EXHIBIT D
PROGRAM APPROVAL
By:
Date:
STATE OF COLORADO
John W. Hickenlooper, Governor
Department of Public Health and Environment
By: Lisa McGovern, Purchasing & Contracts Section
Director
Date:
ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER
CRS §24-30-202 requires the State Controller to approve all State Contracts. This
Contract is not valid until signed and dated below by the State Controller or delegate.
Contractor is not authorized to begin performance until such time. If Contractor begins
performing prior thereto, the State of Colorado is not obligated to pay Contractor for
such performance or for any goods and/or services provided hereunder.
STATE CONTROLLER
Robert Jaros, CPA, MBA, JD
By:
Date:
Ver. 27.2.8
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