HomeMy WebLinkAbout20171653.tiffRESOLUTION
RE: APPROVE CONTRACT AMENDMENT #4 FOR NURSE HOME VISITOR 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 Contract Amendment #4 for the Nurse
Home Visitor Program between the County of Weld, State of Colorado, by and through the Board
of County Commissioners of Weld County, on behalf of the Department of Public Health and
Environment, and the Colorado Department of Human Services, Office of Early Childhood,
commencing on July 1, 2016, and ending June 30, 2017, 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 Contract Amendment #4 for the Nurse Home Visitor Program between the
County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld
County, on behalf of the Department of Public Health and Environment, and the Colorado
Department of Human Services, Office of Early Childhood, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said amendment.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 31st day of May, A.D., 2017, nunc pro tunc July 1, 2016.
BOARD OF COUNTY COMMISSIONERS
ATTEST: diMiev ,. ..' 'eik.
Weld County Clerk to the Board
APP
WELD COUNTY, COLORA
Julie A.
Steve Moreno, Pro -Tern
C -
Sean P. Conway
County Attorney
(►�����B'rbara Kirkmeyer/
Date of signature: CV ( t 3r/ I^7
Cc: HL (3T/TG/Mw)
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2017-1653
HL0049
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Memorandum
TO: Julie A. Cozad, Chair
Board of County Commissioners
FROM: Mark E. Wallace, MD, MPH
Executive Director
Department of Public Health & Environment
DATE: May 17, 2017
SUBJECT: FY16-17 Nurse Home Visitor Program (NHVP)
Contract Amendment #4
For the Board's review and approval is an amendment to the FY16-17 Nurse Home Visitor
Program (NHVP) Contract between the Colorado Department of Human Services, Office of Early
Childhood ("CDHS"), 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").
At no cost to the client, specially -trained registered nurses provide home visits to vulnerable low-
income, first-time mothers residing in Weld County beginning in pregnancy and continuing until
the client's child reaches the age of two years. Clients are educated on positive maternal/child
health practices, infant/toddler developmental needs, effective parenting, and maternal
economic self-sufficiency. This evidence -based program has shown multi -generational positive
outcomes that benefit both families and the community as a whole.
Due to staff vacancies and a State -mandated shift from Medicaid to State funding for this
contract, certain line items in the budget were modified. Overall State funding is increasing by
$30,461 for a total new contract amount of $860,027 for the remainder of fiscal year 2016-2017.
The contract term remains the same at July 1, 2016, through June 30, 2017.
This contract amendment was approved for placement of the Board's agenda via pass -around
dated May 10, 2017. I recommend approval of this FY16-17 Nurse Home Visitor Program contract
amendment.
2017-1653
5/ 31
H Loo( -1 9
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CONTRACT AMENDMENT #4
SIGNATURE AND COVER PAGE
State Agency
State of Colorado for the use & benefit of the
Department of Human Services
Office of Early Childhood
1575 Sherman Street, 1st Floor
Denver, CO 80203
Original Contract Number
15 IHIA 68641
Contractor
Weld County Department of Public Health and Environment
1555 North 17th Avenue
Greeley, CO 80631
Amendment Contract Number
17 IHIA 99245
Current Contract Maximum Amount
Initial Term
State Fiscal Year 2015 $745,418
Extension Terms
State Fiscal Year 2016 $727,077
State Fiscal Year 2017 $860,027
Total for All State Fiscal Years $2,332,522
Contract Performance Beginning Date
July 1, 2014
Current Contract Expiration Date
June 30, 2017
THE PARTIES HERETO HAVE EXECUTED THIS AMENDMENT
Each person signing this Amendment represents and warrants that he or she is duly authorized to execute this Amendment
and to bind the Party authorizing his or her signature.
CONTRACTOR
Weld County Department of Public Health and Environment
By: Chair, Weld County Bof County Commissioners
Julie A. Cozad
Date: MAY 3 1 2 017
STATE OF COLORADO
John W. Hickenlooper, Governor
Department of Human Services
Reggie Bicha, Executive Director
Date: G ' 5' 1'1
, Director, Office of Early Childhood
In accordance with §24-30-202 C.R.S., this Amendment is not valid until signed and dated below by the State Controller or an
authorized delegate.
By:
STATE CONTROLLER
Robert Jaros, CPA, MBA, JD
Clint Woodruff/ V Iri Gimple
Amendment Effective Date:
Amendment Contract Number 17 IHIA 99245 Page 1 of 3
0.2 G / /6. 5_3(2
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 on the Signature and Cover Page for this Amendment. 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 on the
Signature and Cover Page for this Amendment or May 1, 2017, whichever is later and shall
terminate on the termination of the Contract.
4. PURPOSE
The Parties entered into the Contract for/to provide trained visiting nurses to help educate
mothers on the importance of nutrition and avoiding alcohol and drugs, including nicotine, and to
assist and educate mothers in providing general care for their children. This amendment will
increase funds by $30,461 for services to be provided in FY 17, and amends Exhibits B and C.
5. MODIFICATIONS
The Contract and all prior amendments thereto, (Original Contract CMS 15 IHIA 68641; Option
Letter #1 CMS 15 IHIA 77080; Option Letter #2 CMS 16 IHIA 79371; Amendment #1 CMS 16
IHIA 79372; Amendment #2 CMS 16 11--IIA 87817; Amendment #3 CMS 17 IHIA 88727), are
modified as follows:
A. Increase budget by $30,461 from $829,566 to $860,027 for FY17
i. The "Contract Price Not to Exceed' of $2,302,061 is increased by $30,461 for a new
"Contract Price Not to Exceed" amount of $2,332,522.
ii. The Contract Maximum Amount table on the Contract's Signature and Cover Page of
this Amendment is hereby added to the contract.
B. Exhibit B - Budget
Exhibit B — Amendment #4, which is attached and incorporated into this Amendment,
hereby replaces Exhibit B — Amendment #3
Amendment Contract Number: 17 MIA 99245 Page 2 of 3
C. Exhibit C — Additional Provisions
Exhibit C - Additional Provisions of the Original Contract, Section 4 — Current
language states: "Contractor shall request prior approval from the State for all
modifications to direct costs in excess of ten percent (10%) of the total budget for
direct costs. Contractor shall submit a Budget Revision Request Form to request prior
approval for all budget modifications in excess of then percent (10%) of the total
budget for direct costs."
a. This language shall be replaced to read: "Contractor shall request prior
approval from the State for all modifications to direct costs. Contractor shall
submit a Budget Revision Request Form to request prior approval for any and
all budget modifications to the direct costs."
ii. Exhibit C — Amendment #4, which is attached and incorporated into this Amendment,
is hereby added to Exhibit C of the Original Contract.
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: 17 II -HA 99245 Page 3 of 3
Exhibit B - Amendment #4
NHVP FY2016-17 Budget
FOR THE PERIOD:
Budget Period: July 1, 2016 — June 30, 2017
FUNDED CASELOAD:
COUNTIES SERVED:
July 1, 2016 - June 30, 2017
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
125
WELD
Ju y 1, 2016 to June 30, 2017
A. Other
Sources of
Funding
- C. CDHS
Funding
(NHVP)
PERSONNEL COSTS (Detail Expenses)
Base Salary
(Annual)
Fringe
Benefits
% Effort
(CDHS NHVP
ONLY)
Total
Nurse Home Visitor 1- LD/TZ
556,610
$22,038
35.284%
527,750
$27,750
Nurse Home Visitor 2- DG
$65,005
$25,306
100%
$90,311
$10,766
$79,545
Nurse Home Visitor 3 - KH
$66,715
$25,972
100%
$92,687
$92,687
Nurse Home Visitor 4 - GH
$70,726
$27,534
100%
$98,260
$98,260
Nurse Home Visitor 5 - ARD
$70,726
$27,534
100%
$98,260
$98,260
Nurse Home Visitor 6 - JHH
$54,083
$21,055
100%
$75,138
$75,138
Office Technician 1 - ST
$41,223
$16,048
54.84%
$31,407
$31,407
Office Technician 2 - MM
$36,080
$14,046
18.456%
$9,251
$9,251
Office Technician 3 - RV
$10,731
$4,177
45%
$6,709
$6,709
NHV Supervisor - AAB
$64,607
$25,152
26.782%
$24,039
$1,041
$22,998
Interim NHV Supervisor - AA
$24,916
$9,700
100%
$34,616
$34,616
NHV Supervisor - TBD
$10,429
$4,060
100%
$14,489
$14,489
Office Technican Supervisor - IV
$62,760
$24,432
0.229%
$200
$200
Community Health Manager - CH
$84,098
$32,739
42.483%
549,636
549,636
Public Health Services Director - DD
$113,419
$44,154
1%
$1,576
$1,576
Electronic Medical Records Coordinator
$118,075
$45,967
0.183%
5300
$300
1. TOTAL PERSONNEL COSTS
$0
$11,806
$642,822
OPERATING (Detail Expenses)
Office Operating Expenses (i.e. supplies, pens, etc.)
$1,500
Client Support Materials
$3,000
Printing & Publications
$1,000
Postal & Shipping Services
$1,375
Communications (i.e. long distance, cellular and network service)
56,000
Medical Supplies
$200
Required model materials (i.e. Keys to Care Giving, Beginning Rhythms, etc.)
$4,800
Electronic Medical Records (approx $1,667 per month)
$26,339
2. TOTAL OPERATING
$0
$0
$44,214
Training and Technical Assistance
Fee
#
Total Cost
Nurse Initial Education Tuition
Per NHV
$4,400
3
$13,200
$13,200
Nurse Education Materials (New Supervisor/RN ONLY
Per NHV & Sup
$559
2
$1,118
$1,118
Administrator Orientation
Per NHV
$535
1
5535
$535
Supervisor Initial Education Tuition
Per Sup
$818
1
$818
$818
Supevisor Expansion
Per Sup
$843
2
$1,686
51,686
DANCE Education
Per NHV & Sup
$625
2
$1,250
$1,250
DANCE Licensing
Per NHV & Sup
$60
S
$300
$300
Program Support Fee
Per Sup
$7,620
1
$7,620
$7,620
Nurse Consultation Fee
Per First Sup
$2,748
1
$2,748
$2,748
Professional Development
Per Nurse & Sup
5300
5
$1,500
$1,500
3. TOTAL TRAINING and TECHNICAL ASSISTANCE
$0
$0
$30,775
Equipment (Over $5,000 Per Item)
No Costs in this Category will be reimbursed by CDHS.
$0
4. TOTAL EQUIPMENT
$0
$0
$0
Exhibit B - Amendment #4
NHVP FY2016-17 Budget
FOR THE PERIOD:
Budget Period: July 1, 2016 - June 30, 2017
FUNDED CASELOAD:
COUNTIES SERVED:
July 1, 2016 - June 30, 2017
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
125
WELD
Ju
y 1, 2016 to June 30, 2017
A. Other
Sources of
Funding
C. CDHS
Funding
(NHVP)
TRAVEL (Detail Expenses)
Visit Outreach Mileage
$18,796
NFP Training and Meeting Travel (Supervisors, Nurses)
$850
5. TOTAL TRAVEL
$0
$0
$19,646
Contractual (Include Contractual Services)
Mental Health Consultation for Nurses
$1,440
6. TOTAL CONTRACTUAL
$0
$0
$1,440
TOTAL DIRECT PROGRAM COSTS (Add budget categories 1-6)
$0
$11,806
$738,897
ADMINSTRATIVE COSTS (Detail Administrative Costs) OR Indirect (if applicable)
Indirect Rate at 16.37% for 10 months of the Fiscal Year and 18.08% for 2 months of the Fiscal Year, subtract $1,933 as covered by
Medicaid Estimate
$1,933
$121,130
TOTAL ADMINISTRATIVE COSTS
$0
$1,933
$121,130
TOTAL PROGRAM COSTS (Direct Program + Administrative Costs)
$0
$13,739
$860,027
Page 2 of 4
Exhibit B - Amendment #4
Weld County Department of Public Health and Environment
NHVP FV2016-17 Budget
Budget Period: July 1, 2016 —June 30, 2017
PERSONNEL: $ 642,822
FY 16-17 budget includes salary increases due to projected COLA of 3% for 2017 and step increases for 2016-2017. Revised budget to reflect 5
active NHVs per CDHS/IIK directive, and have accounted for all NHV staff changes (hires/terminations/substitutions) througout the current fiscal
year. Continued structure of having two Office Technicians (OT) working up to 0.75 FTE, revised downward from 1.0 FTE per direction of
CDHS/IIK, to ensure that all program needs are continually and adequately met in accordance with NFP requirements. Interim NHV Supervisor
has been added to the budget for March -June during regular Supervisor vacancy transition. Community Health Manager (CHM) provides direct
oversight to assure fidelity and quality of program delivery. For purposes of this revision, FTE for CHM has been revised upward to accurately
reflect time spent in this program to direclty supervise the NFP team, aggressively manage the PIP and actively support the interim supervisor until
the regular Supervisor vacancy is filled. Revision reflects minimal FTE for our OT Supervisor. Revision reflects minimal FTE for our Electronic
Medical Records Coordinator who assists with the set-up and technical assistance to the NVHP staff for EMR-related issues. Minimal FTE for
Public Health Services Director who provides oversight of the management team. Fringe includes medicare. unemployment, workers comp.
PERA, life insurance. ADD, health insurance, dental coverage, and PTO.
OPERATING EXPENSES: $44,214
Office Operating Expenses costs cover miscellaneous office supplies which are necessary to perform the critical functions in this program.
Printing and Publications covers costs for printing hard copies of documents as required by the program.
Postal and Shipping Services covers costs of postage & shipping. With our new improved referral, client retention, and outreach processes. w; e
will be mailing more letters and materials.
Client support materials includes books, educational toys for clients, and items the team deems necessary for client support. Per the
recommendation of IIK/CDHS, this line item is being increased to align with NSO recommendations to provide approximately $40 per year in
support materials to each NHV client. We have been advised that most other NFP sites have this at $55 per client, per year.
Communications costs includes cell phones that include unlimited texting and WIFI for laptop computers. This allows for the NFP nurses to
communicate with each other, clients, and chart while in the clients' home through use of the cell phone as a 'hot spot.'
Medical Supplies covers items purchased for NFP client visits.
Required model materials In a recent evaluation of our required model materials, we learned that some of our PIPE curiculum materials were
damaged in a flood and are no longer usable. Also, the materials we have are outdated (2002 & 2011) and we are low on books for PIPE training
with clients. Furthermore, our client educational DVDs are scratched and outdated. Additional funding will allow us to purchase these critical
materials.
Electronic Medical Records covers computer and data processing expenses related to maintainance & upgrades to the Electronic Medical Record
database, EMR licenses, operation and tech support (outside tech support) in order to keep up with a technology driven norm in the medical
community and go from double charting to single charting in an electronic format.
TRAINING AND TECHNICAL ASSISTANCE: $30,775
Nurse Initial Education Tuition is used to cover costs for new nurses and/or supervisor to complete required training. We have increased this
line to cover the costs of unanticipated vacancies during FY16-17 which resulted in the need to train a new NHV, a new supervisor and the interim
supervisor.
Nurse Education Materials cover the costs for NFP Guidelines and Faciliators. Not originally budgeted, we need this to train the interim
supervisor.
DANCE Education covers required training costs for Dyadic Assesmnet of Naturalist Caregiving Experiences tool, DANCE.
DANCE Licensing will cover the cost of recertification for nurse home visitors to continue using the Dyadic Assessment of Naturalistic
Caregiving Experiences tool, DANCE.
Program Support fee covers the fee charged by the Nurse -Family Partnership National Service Office to maintain funding, improve nurse
recruitment, provide ongoing training, and expanded assistance for pubic affairs, marketing, and communication.
Professional Development funds are used to cover training that is not provided by the NSO or IIK to deepen the skills and expertise of nurses in
areas where there is need and/or interest. Per IIK/CDHS suggestion, we are requesting additional funding in this line item to increase it to $300 per
nurse/per year for 5 nurses.
Nurse Consultation fee covers the cost for Invest in Kids to provide routine consultation to the supervisor of our program and advocacy for
Colorado NH' nurses.
Supervisor Initial Education Tuition - added to budget to provide for Interim Supervisor
Administrator Orientation - added to budget to provide CHM with this critical orientation.
Supervisor Expansion/Replacement Fee - added to budget to provide for Interim Supervisor
EQUIPMENT: $ 0
No Costs in this Category will be reimbursed by CDI-IS.
Page 3 of 4
Exhibit B - Amendment #4
TRAVEL: $19,646
Visitor Outreach Mileage- costs cover mileage and costs associated with travel for service delivery.
NFP Training & Meeting Travel (Supervisors. Nurses) $850 added to budget to account for interim supervisor travel for trainings, meetings.
CHM orientation training and attendance at meetings, new supervisor training and/or attendance at meetings.
CONTRACTUAL $1,440
Mental Health Consultation for Nurses- The NFP team has utilized these services in order to consult with a maternal/fetal mental health specialist
for issues with clients due to the sometimes volitale situations they find themselves and their clients in. We are revising the budget to reflect a $20
per month increase from the mental health specialist that went into effect after the original FYI6-17 budget was developed. 12 monthly visits at
$120 per month.
ADMINISTRATIVE COSTS or INDIRECT: 8121,130
Indirect costs at a rate of 16.37% for 2016; we would like to update to our 2017 negotiated rate of 18.08%, for 10 months of the FY amount of
indirect at 16.37%, for 2 months of the FY amount of indirect at 18.08%, minus the Medicaid Estimate which covers $1,933 of the indirect.
GRAND TOTAL COSTS TO BE BILLED I'O ('DEIS: $860,027
Page 4 of 4
Exhibit C — Amendment #4
ADDITIONAL PROVISIONS
1. SERVICE PROVISIONS
The Contractor shall provide the services according to the plans submitted in the "Statement of Work",
attached and incorporated herein by this reference as EXHIBIT A. In all cases, the descriptions, plans,
timetables, tasks, duties, and responsibilities of the Contractor as described in the Statement of Work, shall
be adhered to in the performance of the requirements of this contract. In the event of a conflict, the terms
and conditions of this contract shall control over the Statement of Work.
2. GOALS AND OBJECTIVES
The Contractor shall be responsible for the achievement of any goals and objectives as specified within the
Statement of Work (EXHIBIT A) of this contract unless written notice of any modifications are furnished
by the State to the Contractor allowing adequate time for compliance during the term of this contract.
3. COPY OF SUBCONTRACT
The Contractor shall provide to the State a copy of any executed subcontract between the Contractor and
any provider of services to fulfill any requirements of this contract. Subcontracts shall be emailed to the
Contract Representative upon execution.
4. PAYMENT
In consideration of the provision of services and reporting and subject to all payment and price provisions
and further subject to verification by the State of full and satisfactory compliance with the terms of this
contract, the State shall pay to the Contractor an amount not to exceed the amount specified in the Budget
(EXHIBIT B), of this contract.
a. The Contractor shall submit requests for payment to CDHS OEC Invoicing@state.co.us no less than
monthly on forms prescribed and provided by the State.
b. Payment shall be made on a cost reimbursement basis for services rendered. Advances will not be
approved except in documented situations of cash flow emergency, for a specified term, with the prior
written approval of the State, and in accordance with State fiscal rules and procedures.
c. The Contractor shall maintain source documentation to support all payment requested pursuant to this
contract. All source documentation shall be provided to the State by the Contractor upon request.
d. It is understood that the State reserves the right to offset funds pursuant to this contract based on the
discovery of overpayment or improper use of funds by the Contractor. Overpayment or improper use of
funds is interpreted to apply to specific terms of prior year contracts, and includes without limitation
requirements of the Generally Accepted Accounting Principles (GAAP) issued by the American Institute
of Certified Public Accountants, and applicable sections of the Colorado Revised Statutes.
5. SUPPLANTING
Payments made to the Contractor under this contract will supplement and not supplant other state, local or
federal expenditures for services associated with this contract.
6. BUDGET CHANGES
Changes to the Budget, EXHIBIT B of this contract, shall be made only with the prior written approval by
the State in the form of a budget revision, contract amendment or option letter as applicable. Any changes to
the Budget shall not exceed the total amount of the contract as described on page one of the contract.
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