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Home My WebLink About20194297.tiff RESOLUTION RE: APPROVE TASK ORDER CONTRACT AMENDMENT #1 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 Amendment #1 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 upon full execution of signatures, and ending September 29, 2020, with further terms and conditions being as stated in said contract, 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 #1 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. Cc•.HL-Ci) 2019-4297 3/as/21 H L0051 TASK ORDER CONTRACT AMENDMENT #1 FOR WISEWOMAN PROGRAM UNDER THE WOMEN'S WELLNESS CONNECTION PROGRAM PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 30th day of September, A.D., 2019. BOARD OF COUNTY COMMISSIONERS 4rkyer, LD COUNTY, CO O ADO ATTEST: dia...0 w ; , C air Weld County Clerk to the Board Mike Freeman, Pro-Tern BY: Deputy Clerk to the Board C E.L.0 Seam;. Conwa APP 0 ED AS 1861, rifl*L?- c• t K. James ounty orney 6,1 Steve Moreno Date of signature: )0/03/ict 2019-4297 HL0051 / 0 ,1861, Memorandum �� TO: Barbara Kirkmeyer, Chair � N .� .� Board of County Commissioners c _uFR0M: Mark E. Wallace, MD, MPH Executive Director Department of Public Health & Environment DATE: September 12,2019 SUBJECT: WISEWOMAN Chronic Disease Prevention Contract Amendment#1 with the Colorado Department of Public Health and Environment Enclosed for the Board's approval is the WISEWOMAN Chronic Disease Prevention Contract Amendment #1 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 goal of the WISEWOMAN project 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 to eligible clients and implementing healthy behavior support services such as individualized health coaching. The purpose of this Amendment#1 is to renew the contract to perform chronic disease prevention work and include updated funding and invoicing information. The period of performance is September 30, 2019, to September 29, 2020, and the maximum amount payable by the State for the work to be performed by the WCDPHE during this term is $3,000.00. Assistant County Attorney, Karin McDougal, has reviewed this contract amendment and determined that the terms are acceptable. Furthermore,this amendment was approved for placement on the Board's agenda via pass-around dated September 11, 2019. I recommend approval of this contract amendment with CDPHE for our WISEWOMAN program. 2019-4297 cc O n Fre f-1 L C9(30 O9 /3a / 1 9 Huoo5 t CONTRACT AMENDMENT#1 SIGNATURE AND COVER PAGE(S) State Agency : Original Contract Number Colorado Department Of Public Health and Environment 2019*3454 PSD/Chronic Disease 4300 Cherry Creek Drive South Denver,CO 80246 Contractor Amendment Contract Number Board of County Commissioners of Weld County 2019*3454 Amendment#1 1150 "O" St.,Greeley,CO 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 : The later of the Effective date or April 1,2019 September 29,2020 CONTRACT MAXIMUM AMOUNT TABLE Document Contract Federal State Funding Other Funding Term(dates) Total Number Funding Amount Amount Type Amount Original 2019*3454 $16,799.00 $0.00 $0.00 4/1/19-9/29/19 $16,799.00 Contract Option Letter#1 2019*3454 $4,568.00 $0.00 $0.00 7/24/19-9/29/19 $4,568.00 Option Letter#1 Amendment #1 2019*3454 $3,000.00 $0.00 $0.00 9/30/19-9/29/20 Amendment $3,000.00 #1 Current Contract Maximum $24,376.00 Cumulative Amount Amendment Contract Number: 2019*3454 Amendment#1 Page 1 of 3 version 31.1.19 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 STATE OF COLORADO Board of County Commissioners of Weld County for the use Jared S.Polls,Governor and benefit of the Wel •linty Department of Pu Colorado Department Of Public Health and Environment nment is j 1 Jill Hunsaker Ryan,MPI-I .i/li�• !� Ir t �J` Executive Director Barbara Kirkigeyer, CM' By:Print Name&Title isa McGovern, 'incurement, d Contracts Section Date: $EP S 0 2019 C. " ( � Di imeritnr„fit Date: ' w l PROGRAM APPROVAL In accordance with§24-30-202 C.R.S.,this Amendment is Colora. • p meat of P • ealth and Environment not valid until signed and dated below by the State Controller or an authorized del By: _ ST C 01. PR Sign• re' . . 'r PHE Program Approver Ro Jaro A,MB 1 D By: vid t5,Controller, DP E Date: Amendment Effective Date: q - • I. 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 Amendment Contract Number.2019'3454 Amendment#1 Page 2 of 3 version 31.1.19 t2©/9- X02976) Controller Signature or September 30, 2019, whichever is later and shall terminate on the termination of the Contract or September 29,2020, whichever is earlier. 4. PURPOSE The Parties entered into the agreement to implement strategies to address cardiovascular disease prevention. The Parties now desire to increase funding and change Statement of Work for the following reason: renew and include updated funding and invoicing information. 5. MODIFICATIONS The Contract and all prior amendments thereto, if any, are modified as follows: A. The Contract Maximum Amount is deleted and replaced with the Current Contract Maximum Amount shown on the Signature and Cover Page for this Amendment. I3. 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 Amendment and all prior amendments thereto, if any, are modified as follows: i. The Parties now agree to modify Exhibit: Exhibit A, Additional Provisions, of the agreement. Exhibit A,Additional Provisions, is deleted and replaced in its entirety with Exhibit E to include updated funding and invoicing information. ii. The Parties now agree to modify Exhibit: Exhibit B, Statement of Work, of the agreement. Exhibit B, Statement of Work, is deleted and replaced in its entirety with Exhibit F, Statement of Work, to include updated funding and invoicing information. iii. The Parties now agree to modify Exhibit: Exhibit C, Budget, of the agreement. Exhibit C, Budget, is deleted and replaced in its entirety with Exhibit G, Budget, to include updated funding and invoicing information. 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. Amendment Contract Number:2019*3454 Amendment#1 Page 3 of 3 version 31.1.19 EXHIBIT E ADDITIONAL PROVISIONS To Contract Dated 03/06/2019-CMS Contract Routing Number 2019*3454 Contract Amendment#1 Routing Number 2019*3454 Amendment#1 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 93.435,93.426,93.436,and 93.366). 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. The United States Department of Health and Human Services("USDI-II-IS"),through the Center for Disease Control and Prevention("CDC")has awarded as of 06/21/2019 anticipated federal funds of $1,139,706.00 under Notice of Cooperative Agreement Award,hereinafter"NCAA",number NU58DP006470,to perform the following—Colorado Plan of Action to Improve Oral Health Outcomes by Decreasing Dental Caries,Oral Health Disparities,and Other Co-Morbid Chronic Diseases. 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 internet website https://www.colorado.gov/pacific/cdphe/standardized-invoice-form-and-I inks 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_chronicdiseaseRFA@state.co.us. Page 1 of 5 Contract_Exhibit-A AdditionalProvisions_17.5.3 EXHIBIT E 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. 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 WISEWOMAN 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 WISEWOMAN services provided to eligible individual clients. a. eCaST Data System Data entered into the electronic cancer surveillance and tracking(eCaST)data system are the basis for calculating reimbursement for each client receiving WISEWOMAN services.To be considered for payment,all WISEWOMAN services must be entered into eCaST within thirty(30)days of service being performed.WISEWOMAN services that 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 WISEWOMAN services that meet eligibility,performance and data requirements.Based on performance,the WISEWOMAN Program may unilaterally change the groups of eligible clients who may be served. b. Bundled Payment System(BPS) 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 at https://www.colorado.Qov./cdphe/wisewoman-provider-resources. Contractors shall be paid only for WISEWOMAN services 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.gov/pacific/cdphe/wisewoman-provider-resources and is incorporated and made a part of this Contract by reference. c. Payment Procedures Payment to Contractor for WISEWOMAN services is made from available funds encumbered and shared across multiple contractors.The State may increase or decrease the total funds encumbered at its sole discretion and without formal notice to Contractor.No minimum payment is guaranteed to Contractor.The liability of the State for such payments is limited to the encumbered amount remaining of such funds. Payment to Contractor for expenses not included in the WISEWOMAN BPS is made from available funds encumbered and in accordance with the Statement of Work and Budget set forth under this Contract. d. WISEWOMAN service expenditure cap CDPHE will set the individual Contractor WISEWOMAN service expenditure cap for each budget period. CDPHE may increase or decrease the Contractor service expenditure cap at its sole discretion based on the Page 2 of 5 Contract Exhibit-A AdditionalProvisions_17.5.3 EXHIBIT E Contractor's spending rate.The Contractor may request to increase or decrease this service expenditure cap.Once the service expenditure cap is reached or the shared program funds are fully expended,the State will not reimburse for additional expenses incurred by the Contractor unless CDPHE opts to increase the cap. 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. 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 31st of each grant year and the full expenditure does not occur,CDPHE has the option to reduce current or upcoming Contract by said Page 3 of 5 Contract Exhibit-A AdditionalProvisions_17.5.3 EXHIBIT E 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 funds 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) 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(HHS)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 I-11-IS name and emblem in written communication.A non-federal entity is unauthorized to use the HHS 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 Page 4 of 5 Contract Exhibit-A AdditionalProvisions_17.5.3 EXHIBIT E 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 5 of 5 Contract_Exhibit-A AdditionalProvisions_l 7.5.3 EXHIBIT F STATEMENT OF WORK To Original Contract Routing Number 2019*3454 Contract Amendment#1 Routing Number 2019*3454 Amendment#1 Entity Name: Board of County Commissioners of Weld County for the use and benefit of the Weld County Department of Public Health and Environment II. 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 system: 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. The Contractor shall,in collaboration with the Designated CDPHE Contact,draft an implementation plan outlining: Primary Activity#1 1. the strategy(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. version:Contract Statement of Work—Exhibit B December 2015 Page 1 of 4 2019*3454 Amendment#1 Exhibit F EXHIBIT F The Contractor shall implement strategies and services from the WISEWOMAN Program, Primary Activity#3 Clinic Quality Improvement program,CRISPeR program or a Healthy Behavior Support Program following program 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. Standards and 9. The Contractor shall identify and support key personnel as outlined in the implementation Requirements 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(C.R.S.),Section 24- 76.5-103.[This does not apply to Non-profit charitable organizations,8 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.qualityfonim.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 gift 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 version Contract Statement of Work—Exhibit B December 2015 Page 2 of 4 2019*3454 Amendment#1 Exhibit F EXHIBIT F 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 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 communication 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 final 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. 1. Increased number of individuals screened for chronic disease. 2. Increased number of quality chronic disease screenings provided within priority Expected Results of populations Activity(s) 3. Increased number of individuals participating in evidence-based healthy behavior support programs 4. Improved chronic disease measurements among service delivery populations 1. Data from required program submissions,including: a. progress reports; Measurement of b. data submissions; Expected Results c. annual assessments;and d. evaluation information. Completion Date 1. The Contractor shall submit an implementation plan that includes No later than the each of the strategies selected and referenced in this Statement of last business day in Work. June,annually. Deliverables 2. The Contractor shall submit a draft budget to coincide with the No later than the implementation plan. last business day in June,annually. 3. The Contractor shall submit a progress report in a CDPHE No later than 15 approved format. 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 version:Contract Statement of Work—Exhibit B December 2015 Page 3 of 4 2019*3454 Amendment#1 Exhibit F EXHIBIT F 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 Page 4 of 4 2019*3454 Amendment#1 Exhibit F Exhibit G Budget A CDPHE COLORADO CO Department of Public Health & Environment PREVENTION SERVICES DIVISION- 12 MONTH BUDGET WITH JUSTIFICATION FORM Contract Routing#2019*3454 Amendment#1 Cynthia Horn,Program Coordinator Weld County Department of Public Health and Program Contact Name, Contractor Name 970-400-2433 Environment Title,Phone and Email chorn@weldgov.com Tanya Geiser,Director, Admin Fiscal Contact Name,Title, Services Budget Period 9/30/2019-9/29/2020 Phone and Email 970-400-2122 tgeiser@weldgov.com Contract(CT or PO) CT FAAA FHLA 201900003454 Number Project Name WISEWOMAN GAE GAE FHLA 2020'"2109 Expenditure Categories Personal Services Salaried Employees Percent of Total Amount Gross or Position Title Description of Work Fringe Time on Requested from Annual Salary Project CDPHE Personal Services Hourly Employees Total#of Total Amount Hourly Position Title Description of Work Hourly Wage Hours on Requested from Fringe Project CDPHE Health Coach Attend Motivational Interviewing training $ 20.27 $ 7.89 16.0 $ 450.56 Total Personal Services(including fringe benefits) $ 450.56 Supplies&Operating Expenses Total Amount Item Description of Item Rate Quantity Requested from CDPHE Point of service device testing supplies-A1c and Lipid cartridges, Point of Service supplies $ 550.00 3.0 $ 1,650.00 controls,and gloves Education materials and supplies to engage clients in healthy Healthy lifestyle supplies $ 125.00 2.00 $ 250.00 behavioral lifestyles Total Supplies &Operating $ 1,900.00 Page 1 of 2 January 2018 Exhibit G Budget PREVENTION SERVICES DIVISION- 12 MONTH BUDGET WITH JUSTIFICATION FORM Contract Routing#2019*3454 Amendment#1 Cynthia Horn,Program Coordinator Weld County Department of Public Health and Program Contact Name, Contractor Name 970-400-2433 Environment Title,Phone and Email chorn@weldgov.com Tanya Geiser,Director, Admin Fiscal Contact Name,Title, Services Budget Period 9/30/2019-9/29/2020 Phone and Email 970-400-2122 tgeiser@weldgov.com Contract(CT or PO) CT FAAA FHLA 201900003454 Number Project Name WISEWOMAN GAE GAE FHLA 2020*2109 Travel Total Amount Item Description of Item Rate Quantity Requested from CDPHE Mileage Travel expenses for motivational interviewing training $ 0.56 231.0 $ 129.36 Total Travel $ 129,36' Contractual Total Amount Subcontractor Name Description of Item Rate Quantity Requested from CDPHE Total Contractual $ - SUB-TOTAL OF DIRECT COSTS $ 2,479.92 Indirect Total Amount Item Description of Item Requested from CDPHE Federally-Negotiated Indirect Cost Rate CDPHE Negotiated Indirect 20.98%Total Direct Costs for CY2020 520.08 Cost Rate De minimis Indirect Cost Rate Total Indirect $ 520.08 t arlj Plax analffll, e"gA r!l .'.,.."a»,.../O A10 =a ifMhgti.t�,..:�,�',r,c1i3 .sPideNglia:x'„=rO ..,V 3,:tN.+'.z � '��".,•q'`'r.£f.y .. '``� ��,r",.�.,r r�.�,ei�y4,� �: '�4 Page 2 of 2 January 2018 Contract Form New Contract Request Entity information Entity me* Entity ID" ❑New Entity? COLORADO DEPT OF PUBLIC Ci192f HEALTH/ENVIRONMENT Contract Name* Contract ID Parent Contract ID WOMEN'S WELLNESS CONNECTION WISEWOMAN POGRAM 3125 FY20 AMENDMENT#1 Contract Lead* Requires Board Approval Contract Status TGEISER YES CTB REVIEW Contract Lead Email Department Project tgeiser@co weld co us Contract Description* RENEWAL CONTRACT AMENDMENT#1 FOR THE WOMEN'S WELLNESS CONNECTION i'"A'Wei Jd'iSEWOMAN PROGRAM FY19- 20 Contract Description 2 2019-3454 AMENDMENT#1. 19 FHLA 113511, 18 FHLA. 100917: 1`J FHLA 871348 15 FHLA 77051 Contract Type* Department Requested BOCC Agenda Due Date GRANT HEALTH Date* G9%14/2019 09i18/2019 AmountDepartment Email $3,000.00 CM-Health@weldgov corn Will a work session with BOCC be required?* Re < .le* r,• int Head Email NO NO CM-Health- Does Contract require Purchasing Dept. to be included? DeptHead@,weicgo',icam NO Automatic Re NO County Attorney GENERAL COUNTY Grant ATTORNEY EMAIL YES County Attorney Email IGA M- COUNTYAT T ORNEY@WELD GOV.COM Grant Deadline Date If this is a ren enter previous Contract ID 2519 if this is part of a enter MSA Contract ID Note. the Previous Contract Number and Master services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Review Date* Renewal Date 009'"30/2019 06(03/2020 Termination Notice Period Committed Delivery Date Expiration Date* 09129'2020 Contact Information Contact info Contact Name Contact Type Contact Email Contact Phone I Contact Phone 2 Purchasing Purchasing >,<+• over Purchasing t troved Date Approval Process Department Head Finance Approver Legal Counsel T A GEISER CHRIS D' 1MDIO KARIN MC OUGAL OH Approved Date Finance Approved Date L Counsel • •*roved Date 09/16/2019 09/20/2019 09 23 2011 Final Approval ROCC App/ Tyler Ref# AG 093019 . BOCC Signed Date *_.C nda Date O/3O/2019 Originator TGEISER Submit Hello