HomeMy WebLinkAbout20140479.tiff RESOLUTION
RE: APPROVE CHRONIC DISEASE SELF-MANAGEMENT EDUCATION (CDSME)
LICENSE HOLDER AGREEMENT AND AUTHORIZE CHAIR TO SIGN - CENTRAL
COLORADO AREA HEALTH EDUCATION CENTER
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 Chronic Disease Self-Management
Education (CDSME) License Holder Agreement between the County of Weld, State of Colorado,
by and through the Board of County Commissioners of Weld County, by and through the Board of
County Commissioners of Weld County, on behalf of the Department of Human Services' Area
Agency on Aging, and Central Colorado Area Health Education Center (CC AHEC) commencing
February 15, 2014, and ending August 31, 2014, with further terms and conditions being as stated
in said agreement, and
WHEREAS, after review, the Board deems it advisable to approve said agreement, 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 Chronic Disease Self-Management Education (CDSME) License
Holder Agreement between the County of Weld, State of Colorado, by and through the Board of
County Commissioners of Weld County, by and through the Board of County Commissioners of
Weld County, on behalf of the Department of Human Services' Area Agency on Aging, and
Central Colorado Area Health Education Center (CC AHEC) be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said agreement.
CC. ti-S15
3•�.1� 2014-0479
H R0085
CHRONIC DISEASE SELF-MANAGEMENT EDUCATION (CDSME) LICENSE HOLDER
AGREEMENT - CENTRAL COLORADO AREA HEALTH EDUCATION CENTER
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 19th day of February, A.D., 2014
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: ea d _ , SC ;ok
6��+�/ Douglas ademac er, Chair
Weld County Clerk to the Board { � �P�
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(� n rbara Kirkmeyer, o-Tem
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BYe uty Clerk to the Boar P
Sean P. Conway
APP,OV DORM: � )'1 kG —
Mike Fre�rttan
Count Attorney '4A C
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�..liam F. Garcia
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2014-0479
HR0085
MEMORANDUM
1861
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DATE: February 13, 2014
TY
O T TO: Douglas Rademacher, Chair, Board of County Commi sioners
FROM: Judy A. Griego, Director, Department um an ery e
RE: CDSME (Chronic Disease Self-Management Education)
License Holder between the Weld County Department of
Human Services' Area Agency on Aging and Central
Colorado Area Health Education Center(CC AHEC)
Enclosed for Board approval is a CDSME(Chronic Disease Self-Management Education)
License Holder Agreement between the Deparlment's Area Agency on Aging and Central
Colorado Area Health Education Center(CC AHEC). This Memorandum of Agreement was
reviewed under the Board's Pass-Around Memorandum dated January 30, 2014, and
approved for placement on the Board's Agenda.
This agreement allows the Area Agency on Aging to implement the Stanford's Chronic Disease
Self-Management Education series under a grant from the Department of Human Services,
Division of Aging and Adult Services,to older adults 60 years and older and adults with
disabilities age 18 and older in Weld County. We will receive reimbursement for each
participant that has completed the class at a rate of$160.00 per person.
This Agreement will be effective as of the date of signing and shall be effective until August 31,
2014, for year 2 and renewal for year 3 based on funding availability. This is the second year of
the grant.
If you have additional questions, please contact me at extension 6510.
2014-0479
Developing Community-Academic Partnerships to
Promote Healthier Colorado Residents
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CDSME License Holder Agreement
This memorandum of agreement is entered into this 3`d day of December, 2013 by Central Colorado
Area Health Education Center (CC AHEC), a non-profit corporation incorporated in the state of
Colorado with a principal business address of 10200 East Girard Avenue, Suite C252, Denver,
Colorado 80231, and
Weld County Area Agency on Aging (WCAAA) (970) 346-6950
Name of Agency telephone
PO Box 1805/315 North 11"' Avenue#C Greeley, CO 80632
Address City Zip Code
Whereas, the CC AHEC is the Implementation agency for the Department of Human Services,
Division of Aging and Adult Services, to implement Chronic Disease Self-Management Education
(CDSME) series.
Whereas, WCAAA desires to participate as a License Holder for this initiative;
Thus, through our mutual premises and the mutual undertakings herein contained, the parties agree:
To implement Stanford's CDSME series under a grant from the Department of Human Services,
Division of Aging and Adult Services, to expand access to Stanford's CDSME series to older adults
age 60 years and older, and adults with disabilities, age 18 years and older throughout Colorado.
WCAAA has been selected to become a License Holder for this grant initiative.
License Holder responsibilities include:
a) Maintain ongoing communication with CC AHEC.
b) When offering the series through the License Holder's agency, operate under a license
issued by Stanford to the agency.
c) Be held accountable to follow the rules and regulations regarding instruction and
administration of the CDSME series in accordance with the Stanford licensing
requirements.
d) Conduct series in accordance with the CDSME series Leaders Manual, without changes.
e) Provide a suitable space for series (complying with Americans with Disabilities Act
standards), healthy snacks and water for attendees.
f) Actively recruit participants to attend the series.
g) Be responsible to recruit and train lay leaders and master trainers to conduct the series for
the License Holder's agency.
h) Submit a calendar of scheduled CDSME series to CC AHEC no later than 30 days prior
to the start of the series. Information needed: license holder agency name, location of
Central Colorado Area Health Education Center(AHEC) 303-481-8686
10200 E. Girard Ave, C252 303-481-8554 Fax
Denver, CO 80231
Developing Community-Academic Partnerships to
Promote Healthier Colorado Residents
series, the time series is being held, dates of series, and lay leaders who will be leading
series.
i) Submit calendar of scheduled CDSME series to the CDSME Statewide Collaborative to
be placed on the Self-Management Colorado website no later than 30 days prior to the
start of the series.
j) Ensure related current data forms (Attendance Log, Participant Information Survey,
Workshop Information Cover Sheet) are collected and submitted to CDSME Data
Coordinator at the Department of Public Health and Environment (CDPHE) within 30
days following the completion of each CDSME series.
k) Submit completed attendance log to CC AHEC following completion of each CDSME
series.
1) Follow fidelity check guidelines as outlined in the Statewide CDSMP Fidelity Visit
Policy. As necessary, submit fidelity check documentation to CC AHEC.
m) Request payment of$160.00 for each participant"completer" (attendance at 4 of 6
sessions) of the six week fidelity authenticated CDSME series. Invoice should be
submitted directly to CC AHEC. CC AHEC will not pay invoice until all appropriate
data is received by CDPHE and a completed attendance log and appropriate fidelity
check documentation are received by CC AHEC.
n) Have up to 8 participant completers by August 31, 2014.
o) Participate in the Colorado Statewide CDSMP Collaborative.
p) Maintain privacy and confidentiality of all participant protected health information (PHI)
as described by the National Council on Aging and outlined in the CDSME Privacy
Training webinar.
q) All license holder staff members who assist in CDSME data collection and processing
must view the CDSME Privacy Training webinar and submit webinar quiz answers to CC
AHEC.
r) All license holder staff members who assist in CDSME data collection and processing
and submission must sign the Non-Disclosure Agreement and return to CDPHE.
s) Participate in a survey to document how reimbursement funds were applied within
license holder agency. The survey will be sent to license holders by CC AHEC near the
end of the grant year.
The License Holder Agency WCAAA, in performing the services as specified in this service
agreement, shall act as an independent contractor. Any and all employees of WCAAA shall be
considered to be, at all times, employees of WCAAA, under its sole authority.
Further, WCAAA shall indemnify and hold CC AHEC harmless from any and all claims, liabilities,
losses and causes of action which may arise from acts, errors or omissions of WCAAA or any of its
employees or agents in conjunction with its obligations under this service agreement.
Central Colorado Area Health Education Center(AHEC) 303-481-8686
10200 E. Girard Ave, C252 303-481-8554 Fax
Denver, CO 80231
Developing Community-Academic Partnerships to
Promote Healthier Colorado Residents
Responsibilities of CCAHEC:
a) Maintain communications with License Holders and offer technical assistance as needed.
b) Provide $160.00 reimbursement for each participant"completer" (attendance at 4 of 6
sessions) of the six week fidelity authenticated Chronic Disease Self-Management
Education programs series once all appropriate data is received by CDPHE and a
completed attendance log and appropriate fidelity check documentation are received by
CC AHEC.
c) Track utilization of reimbursement funds and report this information to the Department of
Human Services, Division of Aging and Adult Services.
The terms of this agreement will be effective as of the date of signing and shall be effective until
August 31, 2014 for year 2 and renewal for year 3 based on funding availability.
This agreement for services is contingent upon the receipt of adequate revenue by identified in
Section 1: Department of Human Services, Division of Aging and Adult Services.
Acknowledgement of Service Agreement with License Holder Agency: WCAAA
Signatures affixed below indicate agreement to the terms and conditions stated herein:
5) €b- 44w IT I- a�-aofy
Lindsey ackwelder Taylor Date
Project Director, Central Colorado AHEC
L; /Wet) .6a4 Welk IoI0—
Print Name
BOARD OF COUNTY COMMISSIONERS
.r, • WELD COUNTY, COLORADO
ATTEST: d, w � y. Lea La
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ougl.s Radem.cher, Chair Date
Weld County Clerk to the Boa
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Deelty Clerk to the B,.r6 W' rr
WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
J A. ieg , irect Datt
Central Colorado Area Health Education Center(AHEC) 303-481-8686
10200 E. Girard Ave, C252 303-481-8554 Fax
Denver, CO 80231
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