HomeMy WebLinkAbout20182218.tiffRESOLUTION
RE: APPROVE TASK ORDER CONTRACT AMENDMENT #2 FOR THE CONTROL AND
PREVENTION OF HEALTHCARE ASSOCIATED INFECTIONS (CLIP INITIATIVE) 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 #2
for the Control and Prevention of Healthcare Associated Infections (CLIP Initiative) 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 August 1, 2018, and
ending July 31, 2019, with further terms and conditions being as stated in said amendment, and
WHEREAS, after review, the Board deems it advisable to approve said amendment, a
copy of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that Task Order Contract Amendment #2 for the Control and Prevention of
Healthcare Associated Infections (CLIP Initiative) 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 amendment.
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113O/19
2018-2218
H L0050
RE: TASK ORDER CONTRACT AMENDMENT #2 FOR CONTROL AND PREVENTION OF
HEALTHCARE ASSOCIATED INFECTIONS (CLIP INITIATIVE)
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 16th day of July, A.D., 2018.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: da4,0 �C �
Weld County Clerk to the Board
BY:
APP
County ° torney
Date of signature:
Steve Moreno, Chair
EXCUSED
Barbara Kirkmeyer, Pro-Tem
,.ea
Julie A. Cozad
Mike Freeman
2018-2218
HL0049
Memorandum
TO: Steve Moreno, Chair
Board of County Commissioners
FROM: Mark E. Wallace, MD, MPH
Executive Director
Department of Public Health & Environment
DATE: July 3, 2018
SUBJECT: CDPHE CLIP Initiative FY18-19 Renewal
Task Order Contract
For the Board's approval is a Task Order Amendment between Colorado Department of Public
Health and Environment ("CDPHE") and the Board of County Commissioners for the County of
Weld, State of Colorado, on behalf of the Weld County Department of Public Health and
Environment ("WCDPHE") to increase the capacity in infection control and prevention of
healthcare -associated infections (HAIs) in Weld County.
HAIs are infections people get while they are receiving health care for another condition and can
happen in any healthcare facility, including hospitals, ambulatory surgical centers, and long-term
care facilities. HAIs are a significant cause of illness and death and they can have devastating
emotional, financial, and medical consequences. These infections lead to the loss of tens of
thousands of lives and cost the healthcare system billions of dollars each year. Many of these
infections are the consequence of inappropriate antimicrobial (cleaning product) use contributing
to the increasing burden of antimicrobial resistant organisms. This project serves to reduce the
burden of HAIs in Weld County through partnership, outreach, and training with healthcare
facilities. The term of this contract is from August 1, 2018, through July 31, 2019, for an amount
not to exceed $12,000, all of which is federal funding.
This Agreement has been reviewed by Assistant County Attorney, Frank Haug, and it meets with
his approval.
This contract was approved for placement on the Board's agenda via pass -around dated June 27,
2018.
I recommend approval for the renewal of this contract with CDPHE.
2018-2218
DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
DCEED-DSI
DEPARTMENT OR AGENCY NUMBER
FAAA
TASK ORDER AMENDMENT ROUTING NUMBER
19 FHHA 111750
To Original Task Order Routing Number
17 FHHA 96952
TASK ORDER AMENDMENT #2
This Task Order Amendment is made this 27th day of June, 2018, by and between the State of Colorado, acting by and
through the DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT, whose address or principal place of
business is 4300 Cherry Creek Drive South, Denver, Colorado 80246, hereinafter referred to as the "State"; and,
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), whose address
or principal place of business is 1555 North 17`h Avenue, Greeley, Colorado 80631 hereinafter referred to as the
"Contractor".
FACTUAL RECITALS
The parties entered into a Master Contract dated January 17th, 2012, with contract routing number 13 FAA 00051.
Pursuant to the terms and conditions of the Master Contract the parties entered into a Task Order Contract dated
January 24t, 2017, with encumbrance number 201800003555, and task order contract routing number 17 FHHA
96952, hereafter referred to as the "Original Task Order Contract", whereby the Contractor was to provide to the
State the following:
This project serves to increase capacity in infection control and prevention of healthcare -associated infections
in Weld County.
Changes were required to extend for an additional term.
The State promises to pay the Contractor the sum of Twelve Thousand Dollars, ($12,000.00) for the renewal term of
One (1) year, ending on July 31st, 2019, in exchange for the promise of the Contractor to perform the specifications to
the work described herein.
NOW THEREFORE, in consideration of their mutual promises to each other, stated below, the parties hereto agree as
follows:
1. Consideration for this Contract Amendment to the Original Task Order Contract consists of the payments and
services that shall be made pursuant to this Contract Amendment, and promises and agreements herein set
forth.
2. It is expressly agreed to by the parties that this Contract Amendment is supplemental to the Original Task
Order Contract, contract routing number 17 FHHA 96952, as amended by Task Order Amendment #1,
routing number 18 FHHA 102367; and Grant Funding Change Letter #1, routing number 18 FHHA 105083,
collectively referred to herein as the Original Task Order Contract, which is by this reference incorporated
herein. All terms, conditions, and provisions thereof, unless specifically modified herein, are to apply to this
Contract Amendment as though they were expressly rewritten, incorporated, and included herein.
Page 1 of 4
Amd #2 19 FHHA ill750.docx ver 27.6.18
020a- 4,2,Z /P(r)
3. It is expressly agreed to by the parties that the Original Task Order Contract is and shall be modified, altered,
and changed in the following respects only:
1. This Contract Amendment is issued pursuant to paragraph 5 of the Original Task Order Contract. This
Contract Amendment is for the renewal term of August 1s`, 2018, through and including July 315',
2019. The maximum amount payable by the State for the work to be performed by the Contractor
during this renewal term is Twelve Thousand Dollars, ($12,000.00) for an amended total contract
financial obligation of the State of Thirty Nine Thousand Seventy Five Dollars, ($39,075.001.
a. For this renewal term the maximum amount payable attributable to United States Government
funding source (see Catalog of Federal Domestic Assistance (CFDA) number 93.323) is Twelve
Thousand Dollars, ($12,000.00), and the amended total contract financial obligation
attributable to United States Government funding source (see Catalog of Federal Domestic
Assistance (CFDA) number 93.323) is Thirty Nine Thousand Seventy Five Dollars,
($39,075.00).
The modified specifications to the original Statement of Work and Budget are incorporated herein by
this reference and identified as "Exhibit G" and "Exhibit H."
4. The Effective Date of this Contract Amendment is August 1St, 2018, or upon approval of the State Controller,
or an authorized delegate thereof, whichever is later.
5. Except for the General Provisions and Special Provisions of the Original Task Order Contract, in the event of
any conflict, inconsistency, variance, or contradiction between the terms and provisions of this Contract
Amendment and any of the terms and provisions of the Original Task Order Contract, the terms and provisions
of this Contract Amendment shall in all respects supersede, govern, and control. The Special Provisions shall
always control over other provisions of the Original Task Order Contract or any subsequent amendments
thereto. The representations in the Special Provisions to the Original Task Order Contract concerning the
absence of personal interest of state of Colorado employees are presently reaffirmed.
6. FINANCIAL OBLIGATIONS OF THE STATE PAYABLE AFTER THE CURRENT FISCAL YEAR ARE
CONTINGENT UPON FUNDS FOR THAT PURPOSE BEING APPROPRIATED, BUDGETED, AND
OTHERWISE MADE AVAILABLE.
Page 2 of 4
Amd #2 19 FHHA Ill750.docx ver 27.6.18
SIGNATURE PAGE
Contract Routing Number: 19 F'HI-IA 11 1750
THE PARTIES HERETO HAVE EXECUTED THIS TASK ORDER AMENDMENT
Each person signing this Task Order Amendment represents and warrants that he or she is duty authorized to execute this Task Order Amendment and to
bind the party 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
By:
(a political subdivision of the state of Colorado)
Steve Moreno
Print Name of Authorized Individual
Chair By:
int Title of Authorized Individual
Signature of Authorized Individual
JUL 16 2018
Date
PROGRAM APPROVAL
Colorado Department of Public Health and Environment
Sigott tf leeTof Authorized
E Program Approver
�3 zolg
' Date
By:
STATE OF COLORADO
John W. Hickenlooper, Governor
Colorado Department of Public Health and
Environment
Larry Wolk, MD, MSPH, Executive Director and
Chief Medical Officer
Lisa McGovern
Purchasing and Contracting Section Director, CDPI{E
Date
LEGAL REVIEW
Cynthia H. Coffman, Attorney General
Signature — Senior A istant Attorney General
Date
In accordance with §24-30-202 C.R.S., this Task. Order Amendment is not valid until signed and dated below by the State
Controller or an authorized delegate.
Effective Date:
Amt 42 19 f HHA 111750.docx
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Page 4 of 4
al» d 42 19 FHHA I I I 750.docx
EXHIBIT G
STATEMENT OF WORK
To Original Contract Routing Number: 17 FHHA 96952
To Contract Amendment #2 Routing Number: 19 FHHA 111750
These provisions are to be read and interpreted in conjunction with the provisions of the contract
specified above.
I. Entity Name: Weld County Department of Public Health and Environment
Term: August I, 2018 — July 31, 2019
II. Project Description: This project serves to increase the capacity to control and prevent healthcare -
associated infections at the local jurisdictional level in Weld County, Colorado. The purpose of the
project is to increase awareness among health professionals of healthcare -associated infections,
antimicrobial resistance, and infection prevention in Weld County, Colorado.
III. Definitions:
I. APIC - Association for Professionals in Infection Control and Epidemiology
2. CPDHE — Colorado Department of Public Health and Environment
3. EPI - Epidemiology
4. HAI — Healthcare -associated infections
5. CDC — The Centers for Disease Control and Prevention
6. HICPAC — Healthcare Infection Control Practices Advisory Committee
7. SHEA — Society for Healthcare Epidemiology of America
IV. Work Plan:
Goal #1: Improve infection control in healthcare facilities within the Contractor's jurisdiction of Weld County,
Colorado
Objective #1: No later than the expiration date of the Contract, the Contractor shall improve knowledge among
Contractor's staff on the topics of healthcare -associated infections, antimicrobial resistance, and infection control
and increase awareness of these topics among healthcare facility staff and healthcare providers.
Primary Activity #1
The Contractor shall attend and participate in CDPHE-led calls, trainings, conferences
and webinars on the topics of healthcare -associated infections, antimicrobial
resistance, and infection prevention.
Sub -Activities #1
1. The Contractor shall attend webinar trainings offered by CDPHE per the following
criteria:
a. The Contractor shall attend webinar trainings that may include the topics
of infection prevention, antimicrobial resistance and stewardship, and
healthcare -associated infections outbreaks
b. CDPHE will notify the Contractor in advance of the trainings
c. CDPHE will record and monitor attendance
2. The Contractor shall attend conference calls coordinated by CDPHE.
a. CDPHE will notify the Contractor in advance of the trainings and will record
and monitor attendance.
3. The Contractor shall support one (1) staff member to attend a conference related to
healthcare -associated infections or infection prevention.
4. The Contractor shall provide registration information to the CDPHE Contract
Monitor for each staff member that attended a conference.
Primary Activity #2
The Contractor shall support CDPHE investigation of outbreaks of healthcare -
associated infections, antimicrobial resistant organisms and infection prevention, and
antibiotic stewardship assessments within the Contractor's jurisdiction.
version'. Contract Statement of Work - Iixhibit B
December 2015
Page I of 5
Weld HAI FY19 SOW (Final)db.doc
EXHIBIT G
Sub -Activities #2
1. The Contractor shall support CDPHE during investigations of outbreaks of
healthcare -associated infections and/or antimicrobial resistant organisms,
including participation in conference calls and site visits for the purposes of
integrating and learning.
2. The Contractor shall accompany CDPHE disease control staff during the following
events for the purposes of integrating and learning:
a. infection prevention assessments of facilities
b. antibiotic stewardship assessments of facilities
Primary Activity #3
The Contractor shall use healthcare -associated infection and antimicrobial resistant
organism resources, infection prevention and antibiotic stewardship assessments, and
outbreak investigations to inform infection prevention efforts in their Jurisdiction as
part of community partnership and outreach.
Sub -Activities #3
1. The Contractor shall identify at least one (1) following facility type as parteners
for the purposes of developing collaborative relationships:
a. acute care hospitals
b. critical access hospitals
c. ambulatory surgery centers
d. long-term acute care hospitals
e. skilled nursing facilities
f. inpatient rehab facilities
g. end -stage renal dialysis facility
h. other outpatient settings, such as clinics and urgent care centers
2. The Contractor shall provide the name of a minimum of three (3) partners for the
purposes of capacity building.
3. The Contractor shall convene facility partners through conference calls or in -
person meetings to discuss ways to improve infection prevention control in the
juruisdiction.
4. The Contractor shall develop a partnership strategic plan to enhance collaboration
between facilities.
a. The Contractor shall implement the partnership strategic plan no later than
May 31, 2019.
5. The Contractor shall disseminate information on at least two (2) of the following
topics to collaborative partners:
a. healthcare -associated infections
b. antimicrobial resistant organisms
c. infection prevention practices
d. antibiotic stewardship
Primary Activity #4
The Contractor shall provide training on infection control, healthcare -associated
infections, and antimicrobial resistance to healthcare facilities in Weld County,
Colorado.
Sub -Activities #4
1. The Contractor shall develop training materials for healthcare providers via one (1)
of the following methods:
a. webinars
b. in -person meetings
2. The Contractor shall deliver training(s) via webinar or in -person meetings for at
least three (3) healthcare facilities tailored to respond to the needs of facilities
determined by the information gathered from stakeholders.
a. The Contractor shall develop training(s) via webinar or in -person meetings for
at least three (3) healthcare facilities tailored to respond to the needs of
facilities determined by the information gathered from stakeholders if none
exists.
version, Contract Statement of Work — Exhibit R
December 2(O5
Page 2 of 5
Weld HAI FY19 SOW (Final) db.doc
EXHIBIT G
b. The Contractor shall provide the newly developed training(s) via webinar or
in -person meetings to at least three (3) healthcare facilities tailored to respond
to the needs of facilities determined by the information gathered from
stakeholders.
3. The Contractor shall address at least one (1) of the following topics in the
training(s):
a. antimicrobial resistant organisms
b. infection prevention practices
c. antibiotic stewardship
d. healthcare -associated infections
4. The Contractor shall maintain training materials.
5. The Contractor shall provide training materials to the CDPHE Contract Monitor via
email.
Standards and
Requirements
1. The Contractor shall utilize the following when providing infection prevention
guidance or education to healthcare facilities:
a. CDC Carbapenem-Resistant Enterobacteriaceae Toolkit located on the
following website https://www.cdc.gov/hai/organisms/cre/cre-toolkit/ and is
incorporated and made part of this Contract by reference.
b. HICPAC Guideline for Sterilization and Disinfection in Healthcare Settings,
HICPAC Guideline for Isolation Precautions: Preventing Transmission of
Infectious Agents in Healthcare Settings, HICPAC Guidelines for
Environmental Infection Control in Healthcare Facilities, and HICPAC
Guidelines for Hand Hygiene in Healthcare Settings. All HICPAC guidance
documents can be found on the following website
https://www.cdc.gov/hicpac/ and are incorporated and made part of this
Contract by reference.
3. The Contractor shall develop a partnership strategic plan.
a. The Contractor shall provide the partnership strategic plan to the CDPHE
Contract Monitor via email no later than March 31, 2019.
b. The Contractor shall implement the partnership strategic plan no later than
May 31, 2019.
3. The Contractor shall deliver training(s) for at least three (3) healthcare facilities
tailored to respond to the needs of facilities determined by the information gathered
from stakeholders.
a. The Contractor shall address at least one the following topics in the training(s):
i. antimicrobial resistant organisms
ii. infection prevention practices
iii. antibiotic stewardship
iv. healthcare -associated infections
4. The Contractor shall provide a copy of the training and list of the number of people
reached to the CDPHE Contract Monitor via email.
5. The Contractor shall provide training materials no later than 30 calendar days after
each convened event to the CDPHE Contract Monitor via email, and to include the
following information:
a. attendance sheets
b. agendas from each CDPHE-led calls
c. agenda from trainings
d. agenda from conferences
e. agenda from webinars led by the Contractor
6. The Contractor shall support one (1) staff member to attend a conference related to
healthcare -associated infections or infection prevention.
ver,xion: Contract Statement or Work Exhibit B
December 2015
Page 3 (A'S
Weld HAI FYI9 SOW (Final)db.doc
EXHIBIT G
a. The Contractor shall provide registration information for each staff member that
attended a conference related to healthcare -associated infections or infection
prevention.
7. 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.
Expected Results of
Activity(s)
1. Healthcare facilities will receive guidance regarding healthcare -associated
infections, antimicrobial resistance, and infection control.
2. Improved access to best practices, information and resources on the topics of
healthcare -associated infections, antimicrobial resistance, and infection prevention will
be available in Weld County, Colorado.
3. Improved use of best practices to address healthcare -associated infections,
antimicrobial resistance, and infection prevention in Weld County, Colorado.
Measurement of
Expected Results
1. Participation in CDPHE-led webinar trainings.
2. Participation in CDPHE-led conference calls.
3. Data contained in attendance sheets and agendas from each meeting or training
led by the Contractor.
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Completion Date
Deliverables
1. The Contractor shall submit the name of at least one (1)
facility type for prevention efforts to the CDPHE Contract
Monitor via email.
No later than
1/31/2019
2. The Contractor shall provide the name of a minimum of three
(3) partners for the purposes of capacity building to the CDPHE
Contract Monitor via email.
No later than
1/31/2019
3. The Contractor shall submit training materials to the CDPHE
Contract Monitor via email.
No later than 30
calendar days
after each
convened event,
and within the
contract term
4. The Contractor shall submit partnership strategic plan to the
CDPHE Contract Monitor via email.
No later than
3/31/2019
5. The Contractor shall submit registration information for each
staff member that attended a conference related to healthcare-
associated infections or infection prevention to the CDPHE
Contract Monitor via email.
No later than
7/31/2019
V. Monitoring:
CDPHE's monitoring of this contract for compliance with performance requirements will be conducted
throughout the contract period by the CDPHE Contract Monitor. Methods used will include a review of
documentation determined by CDPHE to be reflective of performance to include progress reports and
other fiscal and programmatic documentation as applicable. The Contractor's performance will be
evaluated at set intervals and communicated to the contractor. A Final Contractor Performance
Evaluation will be conducted at the end of the life of the contract.
VI. Resolution of Non -Compliance:
version: Contract Statement of Work Exhibit B
December 2_015
Page 4 of 5
Weld HAI FY19 SOW (Final) db.doc
EXHIBIT G
The Contractor will be notified in writing within 15 calendar days of discovery of a compliance issue.
Within 30 calendar days of discovery, the Contractor and the State will collaborate, when appropriate, to
determine the action(s) necessary to rectify the compliance issue and determine when the action(s) must
be completed. The action(s) and time line for completion will be documented in writing and agreed to
by both parties. If extenuating circumstances arise that requires an extension to the time line, the
Contractor must email a request to the CDPHE Contract Monitor and receive approval for a new due
date. The State will oversee the completion/implementation of the action(s) to ensure time lines are met
and the issue(s) is resolved. If the Contractor demonstrates inaction or disregard for the agreed upon
compliance resolution plan, the State may exercise its rights under the provisions of this contract.
version, Contract Statement of Work — Exhibit B
December 2015
Page 5 of 5
Weld HAI FY19 SOW (Final) db.doc
Exhibit H
Colorado Department
of Public Health
and Environment
Colorado Department of Public Health and Environment
BUDGET JUSTIFICATION FORM
To Original Contract Routing Number: 17 FHHA 96952
To Contract Amendment U Routing Number: 19 FHHA 111750
Contractor Name
Weld County Department of Public Health &
Environment
Budget Period
August 1, 2018 -July 31, 2019
Project Name
Healthcare Associated Infections
Date Completed
June 22, 2018
Program Contact Name, Title,
Phone, and Email
Carrie Hanley, PhD, MPH
Community Health Services Director
970-400-2316
chanley@weldgov.com
Fiscal Contact Name, Title,
Phone, and Email
Tanya Geiser
Administrative Services Director
970-400-2212
tgeiser@weldgov.com
Expenditure Categories
Match
Applicable)
Kind
or
(If
In-
Total
Requested
CDPHE
Amount
from
Personal
Services
Gross or
Annual Salary
Fringe
Percent of
Actual Time
(FTE) on
Contract/
_ Purchase Order
Position Title/Employee
Name
(for
Description of Work
hourly employees, please include the hourly
rate and number of hours in your description)
Description of Fringe: Medicare at 1 45%,
unemployment at 0.09%, workers' compensation at
008%, PERA at 13.7%; life/AD&D insurance at
0.33%, health insurance at 12 14%, accrual -vacation
at 4.61%; accrual -holiday at 4.23%, and accrual -sick
at 2.3%. Total fringe oenefits are 38 93%
Community Health Services
Director
The Community Health Services Director will outreach to
healthcare facilities to initiate, build, and maintain
strong collaborations and will coordinate trainings and
meetings. This salary is for the relevant grant period of
12 months.
$98,970.17
538,529.09
1.95%
$2,681.24
Communicable Disease
Program Supervisor
The Communicable Disease Supervisor will assist with
outreach efforts, conduct trainings, and coordinate and
facilitate meetings with healthcare facilities. This salary
is for the relevant grant period of 12 months.
$65,469.26
$25,487.18
2.00%
$1,819.13
Epidemiologist
The Epidemiologist will create presentations and assist
with outreach efforts and trainings. This salary is for the
relevant grant period of 12 months.
$68,756.80
i
$26,767.02
1.149%
$1,097.57
Office Technician
The office technician will assist with ordering supplies,
scheduling trainings and meetings, and coordinating
with facilities. This salary is for 26 hours at
_520.16/hour.
S2_0 19
$7.86
26.00
$729.30
Total Personal Services
(including fringe benefits)
$6,327.23
Supplies
& Operating Expenses
Item
Description of Item
Rate
Quantity
Match
or In kind
(if applicable)
Total Amount
Requested
CDPHE
from
Staff development (primary
activity 1)
The Society for Healthcare Epidemiology of America (SHEA) Spring
Conference 2019 Registration for 1 person. This conference will provide
opportunities to network and learn about infection prevention.
$799.00
1
$799.00
Partnership building (primary
activity 3)
Refreshment, snacks, meals for meetings with partners in order to build
strong relationships with community partners.
$ 50.00
4
$ 200.00
SHEA Membership (primary
activity 1)
SHEA membership fee for 1 person. SHEA supports members by
providing the highest quality education and information.
5265.00
1
$265.00
Community education and
outreach materials (primary
activities 3 & 4)
Educational materials (pamphlets, posters, etc....) to be available to
healthcare facilities to promote infection control and prevention.
S150.00
1
$150.00
Miscellaneous Office Supplies
& Printing Costs (primary
activities 3 & 4)
Miscellaneous office supplies and printing costs including allocated costs
for in house printing and office supplies (estimated at $3.42/month for
12 months).
$3.42
12
$41.04
Infection Prevention and
Control Reference Materials
(primary activities 1, 3 & 4)
Infection prevention and control reference materials and guides. These
materials will serve as a reference for important infection prevention
topics such as infectious disease microorganisms, common diagnostic
tests used in the laboratory, and disease epidemiology.
5100.00
1
$100.00
Page 1 of 2
Exhibit H
Colorado Department
of Public Health
mind Environment
Colorado Department of Public Health and Environment
BUDGET JUSTIFICATION FORM
To Original Contract Routing Number: 17 FHHA 96952
To Contract Amendment #_ Routing Number: 19 FHHA 111750
Contractor Name
Weld County Department of Public Health &
Environment
Budget Period
August 1, 2018 -July 31, 2019
Project Name
Healthcare Associated Infections
Date Completed
June 22, 2018
Program Contact Name, Title,
Phone, and Email
Carrie Hanley, PhD, MPH
Community Health Services Director
970-400-2316
chanley@weldgov.com
Fiscal Contact Name, Title,
Phone, and Email
Tanya Geiser
Administrative Services Director
970-400-2212
tgeiser@weldgov.com
Total Supplies
& Operating Expenses
$1,555.04
Travel
Item
Description of Item
Rate
Quantity
Match or In kind
(if applicable)
Total Amount
Requested from
CDPHE
In -state travel (primary
activity 1-4)
In -state mileage for meetings with partners, assisting CDPHE with
investigation of outbreaks, community outreach, and training.
$0.515
248
$127.72
Out -state travel (primary
activity 1-4)
Costs associated with traveling to the SHEA conference in Boston, MA for
1 person. These costs include airfare, lodging, meals, parking, and
transportation to and from the airport.
$2,000
1
$2,000.00
Total Travel
$2,127.72
SUB -TOTAL BEFORE INDIRECT
$10,009.99
Indirect
Item
Description of Item
State Negotiated
rate:19.88%
Indirect cost
The CDPHE negotiated indirect cost for WCDPHE is 19.88% of the total direct costs for 2018.
51,989 99
Indirect (other):
specific indirect
description if no
please list
costs in
rate exists
>0.02
Total
Indirect
$1,990.01
TOTAL
MATCH
OR IN
KIND
TOTAL
$12,000.00
Page 2 of 2
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