Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutC87-133 Dept. of Health Medical Affairs and Special Programs6
m Forth 6 -AC -02A (R 5/85) � - -
Ut:PAR N'f OR AGENCY NUMB
,C£17-133-22
CONTRACT ROC'FING NUM R
77
CONTRACT C 1�}
THIS CONTRACT, made this 1St day of Jul Y 198 7 . by and between the
State of Colorado for the use and benefit of the Department of 't HEALTH, Division of Medical
-Affairs and Special Programs, 4210 East 11th Avenue, Denver Colorado 80220
hereinafter referred to as the State, and .2 _THE BOARD OF COUNTY COMMISSIONERS
EAGLE COUNTY, Eagle, Colorado 81631
hereinafter referred to as the contractor,
WHEREAS, authority exists in the Law and Funds have been budgeted, appropriated and otherwise made
available and a sufficient unencumbered balance thereof remains available for payment in Fund Number 1001
G/L Account Number 53627 , Contract Encumbrance Number 376035 : and
WHEREAS, required approval, clearance and coordination has been accomplished from and with appropriate
agencies: and
WHEREAS, -3 the State has been awarded monies to implement "A Protocol
to Accompany a Contract to Provide Non -Medical Case Management and Outreach
to Eligible E.P.S.D.T. Families (Early and Periodic Screening, Diagnosis
and Treatment)" by the Colorado Department of Social Services; and
WHEREAS, '`the said "Protocol" calls for non-medical case management
and outreach activities to be implemented through subcontracts with local
health agencies; and
WHEREAS, the State' will contract with the contractor to assure that
clients who are eligible for EPSDT receive preventive and curative health
care and treatment and that the families of said children are informed about
the benefits of health prevention and promotion in such a way as to encourage
their participation in the EPSDT Program.
NOW THEREFORE, it is hereby agreed that for and in consideration of
their mutual promises to each other hereinafter stated, the parties hereto
agree as follows:
1. The contractor will perform an EPSDT non-medical outreach component
by contacting EPSDT-eligible families in Eaqle
county(ies) on the priority basis as designated in the "Protocol" to explain
the value of EPSDT and the importance of preventive health care measures
and to offer and provide assistance in overcoming obstacles for obtaining
EPSDT services.
2. The contractor shall be responsible for carrying out the activities
defined by the current EPSDT Regulations and making any changes in procedures
which may be warranted by Federal reviews.
3. The contractor shall provide to the Colorado Department of Health
on a monthly basis information documenting contact and case management proce-
dures, in accordance with the written directives of the State.
4. Upon written notification by Social Services of implementation
of Medicaid Management Information System (MMIS), contractor shall utilize
the MMIS information for individual case management activities where appropri-
ate.
5. The contractor shall document and make available the following
information to the Colorado Department of Social Services and/or federal
reviewers upon receipt of written request from the State:
a. The date a recipient was enrolled in the Primary care Physician
Program or in an HMO, if available.
b. The names of the selected Primary Care Physicians or HMO's
and the date the names were forwarded to Social Services.
c. The date the recipient was initially contacted by the EPSDT
outreach worker.
d. The date(s) a recipient was offered assistance for EPSDT services
and the date(s) a recipient refused assistance for EPSDT services.
39553.01.1014
Page I of 6 pages
"(See in:�trucTume cn tever:e of last Page.)
0
CONTRACT
The declination of assistance will be accompanied by the reason
for refusal.
e. The date(s) the recipient was offered initial or periodic
screening services and the date(s) of the declination of the
services. The declination for screening services will be
accompanied by the reason for refusal.
f. The name, address, and/or telephone number of the physician
chosen by the recipient/household as the continuing care pro-
vider.
g. The date the recipient/household was offered assistance in
the selection of the continuing care provider as requested
by the recipient.
h. The date the recipient/household was offered assistance in
the selection of the provider for vision or dental care as
requested by the recipient.
i. The type of support services provided to the recipient; e.g.
transportation,scheduling of appointments for screenings and
related follow-up treatments.
j. The dates EPSDT services were provided for screenings and
follow-up treatments as reported by the recipient.
k. Documentation of efforts to re -schedule broken appointments
which are mutually agreeable to the provider and the recipient.
1. Documentation of follow-up to ascertain if --treatment -was pro-
vided.
m. Documentation of date(s), method(s), and reason for periodic
recontact.
n. The names of the recipients who required treatment for conditions
not covered by the plan and documentation of the efforts to
refer them to providers willing to treat them at little or
no expense to the family.
o. Documentation of referral, when needed, to Title U programs.
6. The contractor shall assist families requiring transportation
to providers of EPSDT services in obtaining said transportation in the most
cost efficient and resonable manner possible.
7. The contractor shall assure that all personnel employed to provide
EPSDT non-medical outreach and case management activities will receive pro-
fessional supervision by public health nursing personnel or other skilled
medical personnel.
8. The contractor will assure that all personnel assigned to perform
EPSDT non-medical outreach and case management activities will be available
for all training to be deemed necessary.
9. The State will, in consideration of said services and reporting
by the contractor, cause to be paid to the contractor a sum not to exceed
Five Thousand One Hundred Fifty and no/100 Dollars ($5,150.00)
in the following manner, subject to verification by the State of full and
satisfactory compliance with the terms of the contract; including, but not
limited to:
a. Upon receipt by the State of a signed monthly statement in
duplicate from the contractor requesting reimbursement, in accordance
with the categories and line items of the budget set forth in
Attachment A of this contract. Said statement shall also report
amounts expended from matching funds if such funds have been stipu-
lated in the budget, Attachment A, of this contract. Monthly
statements shall be rendered by the contractor to the State
with the format to be supplied to the contractor by the State.
An initial supply of the subject statement forms will be supplied
to the contractor and additional forms as requested thereafter.
b. Satisfactory compliance with all reporting requirements as
set forth in this contract.
10. This contract is not assignable without written consent of the
State.
Page 2 of 6 Pages
CONTRACT
11. Expenditures of funds by the contractor shall be governed by the
budget, Attachment A, which by this reference is incorporated herein. Trans-
fers of funds from one category or line item by the contractor must have
the prior, written approval of the State.
12. The term of this contract is from July 1, 1987 through June 30,
1988.
13. Time is of the essence in the performance of this contract.
14. All material and information provided to the contractor by the State
or obtained by the contractor pursuant to its duties hereunder shall be re-
garded as confidential and all necessary steps shall be taken by the con-
tractor to safeguard the confidentiality of such material and information
in conformance with Federal and State laws and regulations.
Page 3 of 6 Pages
COLORADO DEPARTMENT OF HEALTH - hereinafter, under the General Provisions
referred to as "Health".
GENERAL PROVISIONS
(1) The parties of this contract intend that the relationship between them
contemplated by this contract is that of employer -independent contractor. No
agent, employee or servant of Contractor shall be or shall be deemed to be an
employee, agent or servant of Health. Contractor will be solely and entirely
responsible for its acts and the acts of its agents, employees, servants and
subcontractors during the performance of this contract.
(2) At all times during the performance of this contract, the Contractor shall
strictly adhere to all applicable federal and state laws that have been or may
hereafter be established.
(3) Contractor authorizes Health to perform audits and to make inspections for
the purpose of evaluating performance under this contract.
(4) Either party shall have the right to terminate this agreement by giving the
other party thirty days notice by registered mail, return receipt requested. If
notice is so given, this agreement shall terminate' on the expiration of the
thirty days, and the liability of the parties hereunder for the further
performance of the terms of this agreement shall thereupon cease, but the parties
shall not be relieved of the duty to perform their obligations up to the date of
termination. .
(5) This agreement is intended as the complete integration of all understandings
between the parties. No prior or contemporaneous addition, deletion, or other
amendment hereto shall have any force or effect whatsoever, unless embodied
herein in writing. No subsequent novation, renewal, addition, deletion, or other
amendment hereto shall have any force or effect unless embodied in a written
contract executed and approved pursuant to the State Fiscal Rules.
(6) If this contract involves the expenditure of federal funds, this contract is
contingent upon continued availability of federal funds for payment pursuant to
the terms of this agreement. Contractor also agrees to fulfill the requirements
of Office of Management and Budget Circulars A-87 and A-102 or A-110, whichever
is applicable.
(7) To be considered for payment, billings for reimbursement pursuant to this
contract must be received within 60 days after the period for which reimbursement
is being requested and final billings on the contract must be received by the
State Health Department within 60 days after the end of the contract term.
(8) If applicable, Local Match is to be submitted on the monthly reimbursement
statements, in the column provided, as required by the funding source.
(9) If Contractor receives $25,000.00 or more per year in Federal funds in the
aggregate from Health, Contractor agrees to have an annual audit, by an
independent certified public accountant, which meets the requirements of Office
of Management and Budget Circular A-128 or Office of Management and Budget
Circular A-110: Attachment F, whichever is applicable. Contractor agrees to
furnish one copy of the audit report to the Health Department Accounting Office
within 30 days of its issuance. Contractor agrees to take appropriate corrective
action within six months of the report's issuance in instances of noncompliance
with Federal laws and regulations. Contractor agrees to permit Health or its
agents to have access to its records and financial statements as necessary, and
further agrees to retain such records and financial statements for a period of
three years after the date of issuance of the audit report. This
contract does contain Federal funds as of the date it is signed. This
requirement is in addition to any other audit requirements contained in other
paragraphs within this contract.
(10) If applicable, Contractor agrees to not use Federal funds to satisfy Federal
cost sharing and matching requirements unless approved in writing by the
appropriate Federal Agency.
Page 4 of 6 Pages
Rev. 01/13/87
W6712D
Form 6 -AC -02B SPECLAL PROVISIONS
CONTROLLER'S APPROVAL
1. This contract shall not`be deemed valid until it shall have been approved by the Controller of the State of
Colorado or such assistant as he may designate. This provision is applicable to any contract involving the pay-
ment of money by the State.
FUND AVAILABILITY
2. 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.
BOND REQUIREMENT
3. If this contract involves the payment of more than fifty thousand dollars for the construction, erection,
repair, maintenance, or improvement of any building, road, bridge, viaduct, tunnel, excavation or other public
works for this State, the contractor shall, before entering the performance of any such work included in this con-
tract, duly execute and deliver to and file with the official whose signature appears below for the State, a good
and sufficient bond or other acceptable surety to be approved by said official in a penal sum not less than one-
half of the total amount payable by the terms of this contract. Such bond shall be duly executed by a qualified
corporate surety, conditioned for the due and faithful performance of the contract, and in addition, shall provide
that if the contractor or his subcontractors fail to duly pay for any labor, materials, team hire, sustenance, pro-
visions, provendor or other supplies used or consumed by such contractor or his, subcontractor in performance of
the work contracted to be done, the surety will pay the same in an amount not eceeding the sum specified in the
bond, together with interest at the rate of eight per cent ger.annuin.. Unless such bond,. -when so required., Is
executed, delivered and filed; no claim in favor of the contractor arising under this contract shall be audited,
allowed or paid. A certified or cashier's check or a bank money order payable to the Treasurer of the State of
Colorado may be accepted in lieu of a bond. This provision is in compliance with 38-26-106 CRS, as
amended.
4. To the extent authorized by law, the contractor shall indemnify, save and hold harmless the State, its
employees and agents, against any and all claims, damages, liability and court awards including costs, expenses,
and attorney fees incurred as a result of any act or omission by the contractor, or its employees, agents, subcon-
tractors, or assignees pursuant to the terms of this contract.
DISCRIMINATION AND AFFIRMATIVE ACTION
5. The contractor agrees to comply with the letter and spirit of the Colorado Antidiscrimination Act of 1957,
as amended, and other applicable law respecting discrimination and unfair employment practices (24-34-402.
CRS 1982 Replacement Vol.), and as required by Executive Order, Equal Opportunity and Affirmative Action,
dated April 16, 1975. Pursuant thereto, the following provisions shall be contained in all State contracts or
sub -contracts.
During the performance of this contract, the contractor agrees as follows:
(1) The contractor will not discriminate against any employee or applicant for employment because of
race, creed, color, national origin, sex, marital status, religion, ancestry, mental or physical handicap, or
age. The contractor will take affirmative action to insure that applicants are employed, and that employees
are treated during employment, without regard to the above mentioned characteristics. Such action shall
include, but not be limited to the following: employment, upgrading, demotion, or transfer, recruitment or
recruitment advertising; lay-offs or terminations; rates of pay or other forms of compensation; and selec-
tion for training, including apprenticeship. The contractor agrees to post in conspicuous places, available
to employees and applicants for employment, notices to be provided by the contracting officer setting forth
provisions of this non-discrimination clause.
(2) The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the
contractor, state that all qualified applicants will receive consideration for employment without regard to
race, creed, color, national origin, sex, marital status, religion, ancestry, mental or physical
handicap, or age.
(3) The contractor will send to each labor union or representative of workers with which he has collective
bargaining agreement or other contract or understanding, notice to be provided by the contracting officer,
advising. the, labor union -or workers' representative of the contractor's committment under the Executive
Order, Equal Opportunity and Affirmative Action, dated April 16-,1975-, and of the rules, regulations, and
relevant Orders df the Govefrior.
(4) Tfie chi tradtoi and labof'uI WIS will ftitnish;all iitfortn'a4iorl Arid r8pnrts required b} 1✓xe'cutive Order;
1�grial0.ppoilriitj andAfliranati�e'•Aetion iSf'A'p il.,lb,. 975,`2nd 4'the rules, regulations and Orders of
the•Governor; of ptrr$t1a$t'therett�; arid.itpet�nit'access Lo.i`iis hooks; tcords, •arjd accot}nts by tete con
.. ....
fracting agency..,n{I tiie.pffige'df t#ie Cbve'rriof or• hls:desigriee trot purposes oP irivestigaUon to asceitam
compliance - with` such ides,' re.Qttlatjoa'drdrs
(5) A labor orgaraiiatioii �viFl n(it eXblittc e any ndividital otheru'#se.qualifred from full member§hip rights in
such labor•oigar�ization,: or :expel:any: Stich individual from membership in such labor organization: or.dis-
criminate against 'anv bf its. members in the full enjoyment of work opportunity,. because of race, creed,
...color, .sex, national' ongin, or ancestry..
(6) .A•Iabor,organrgaticsn; oY lite piiiplb .ees or irternbgts Llief eof 4,111 riot aiti; abet, incite: c6mpel or coerce; .
the doing of 'ail j att de iued in this, ctifltraci fo •be•dismi tipatotj, or• obstr{ict of prEveiif anY: person from. .
comp)virig wifli the �royrsiods of IliiS cQritracf of ay'urtiei iSSue th'ereuhde't or attempt either directly or
-indiredtly, to commit ariy' aCt def ned m .this contract to be- discriminatory.
395,S304-1'02;2page 5 of•., 6 pages-
Revised 1' 1-85
I ForM 0 -AC -02C
(7) In the event of the contractors• non-compliance with the non-discrimination clauses of this con-
tract or withany of such rules. regulations, or orders, this contract may be cancelled, terminated or sus-
pended in whole or in pari,and the contractor may be declared ineligible for further State contracts in
accordance with procedures, authorized in Executive Order, Equal Opportunity and Affirmative
Action of April 16. 1975 and the rules, regulations, or orders promulgated in accordance therewith, and
such other sanctions as may be imposed and remedies as may be invoked as provided in Executive
Order, Equal Opportunity and Affirmative Action of April 16, 1975, or by rules, regulations, or orders
promulgated in accordance therewith, or as otherwise provided by law.
(8) The contractor will include the provisions of paragraph (1) through (8) in every sub -contract and
subcontractor purchase order unless exempted by rules, regulations, or orders issued pursuant to
Executive Order, Equal Opportunity and Affirmative Action of April 16, 1975, so that such provisions
will be binding upon each subcontractor or vendor. The contractor will take such action with respect to
any sub -contracting or purchase order as the contracting agency may direct, as a means of enforcing
such provisions, including sanctions for non-compliance; provided, however, that in the event the con-
tractor becomes involved in, or is threatened with, litigation with the subcontractor or vendor as a result
of such direction by the contracting agency, the contractor may request the State of Colorado to enter
into such litigation to protect the interest of the State of Colorado.
COLORADO LABOR PREFERENCE
6 a. Provisions of 8-17-101 &: 102, CRS for preference of Colorado labor are applicable to this contract if public
works within the State are undertaken hereunder and are financed in whole or in part by State funds.
b. When a construction contract for a public project is to be awarded to a bidder, a resident bidder shall be
allowed a preference against a non-resident bidder from a state or foreign country equal to the preference given or
required by the state or foreign country in which the non-resident bidder is a resident. If it is determined by the
officer responsible for awarding the bid that compliance with this subsection .06 may cause denial of federal funds
which would otherwise be available or would otherwise be inconsistent with requirements of federal law, this sub-
section shall be suspended, but only to the extend necessary to prevent denial of the ntoneys or to eliminate the
inconsistency with federal requirements (section 8-19-101 and -102, CRS).
GENERAL
7. The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the
interpretation, execution and enforcement of this contract Any provision of this contract whether or not incor-
porated herein by reference which provides for arbitration by any extra -judicial body or person or which is other-
wise in conflict with said laws, rules and regulations shall be considered null and vokL Nothing contained in any
provision incorporated herein by reference which purports to negate this or any other special provision in whole or
in part shall be valid or enforceable or available in any action at law whether by way of complaint, defense or other-
wise. Any provision rendered null and void by the operation of this provision will not invalidate the remainder of
this contract to the extent that the contract is capable of execution.
8. At all times during the performance of this Contract. the Contractor shall strictly adhere to all applicable
federal and state laws, rules and regulations that have been or may hereafter be established.
9. The signatories hereto aver that they are familiar with 18-8-301, et seq., (Bribery and Corrupt Influences)
and 15-8-401. et. seq.. (Abuse of Public OfFice), CRS 1978 Replacement VoL, and that no violation of such pro-
visions is present
10. The signatories aver that to their knowledge, no state employee has a personal or beneficial interest what-
soever in the service or property described herein:
IN WITNESS WHEREOF, the parties hereto have executed this Contract on the day first above
written. -
Contractor :
(Full Legal Name)
THE BOARD OFC NTY COM ISSIONERS
t
EAGLE COUNTY
Position (Title) CH R N
Sstal Secuntn Numacr w Peueral I.U. Nummr
(If Corporation:)
Attest (Seal)
B_yv
C.wp.rate Secretin. a Euu..amnt. T.—it. City Cohn y C1en
ATTORNEY GENERAL
By
STATE OF COLORADO
ROY ROME -R, GOVERNOR
By
UTIVE DIRECTOR
DEPARTMENT
OF HEALTH
APPROVALS
CONTROLLER
M
PROGRAM APPROVAL:
— zlzx�
P.." 6 -inch a me le.i ,a 6 paces
$or the
m Form h-AC-O=C
(7) In the event of the contractor's non-compliance with the non-dlscriMina tion clauses of this con-
tract or`with ani, of such rules. regulations, or orders. this contract may be cancelled, terminated or sus-
pended in whole or in pan and the contractor may be declared ineligible for further State contracts in
accordance with procedures, authorized in Executive Order, Equal Opportunity and Affirmative
Action of April 16, 1975 and the rules, regulations, or orders promulgated in accordance thereU'ith. and
such other sanctions as may be imposed and remedies as may be invoked as provided in Executive
Order, Equal Opportunity and Affirmative Action of April 16, 1975, or by rules, regulations, or orders
promulgated in accordance therewith, or as otherwise provided by law.
(8) The contractor Will include the provisions of paragraph (1) through (8) in every sub -contract and
subcontractor purchase order unless exempted by rules, regulations, or orders issued pursuant to
Executive Order, Equal Opportunity and Affirmative Action of April 16, 1975, so that such provisions
will be binding upon each subcontractor or vendor. The contractor will take such action with respect to
any sub -contracting or purchase order as the contracting agency may direct as a means of enforcing
such provisions, including sanctions for non-compliance; provided, however, that in the event the con-
tractor becomes involved in, or is threatened with, litigation with the subcontractor or vendor as a result
of such direction by the contracting agency, the contractor may request the State of Colorado to enter
into such litigation to protect the interest of the State of Colorado.
COLORADO LABOR PREFERENCE
6 a. Provisions of 8-17-101 L 102, CRS for preference of Colorado labor are applicable to this contract if public
works within the State are undertaken hereunder and are financed in whole or in part by State funds.
b. When a construction contract for a public project is to be awarded to a bidder, a resident bidder shall be
allowed a preference against a non-resident bidder from a state or foreign country equal to the preference given or
required by the state or foreign country in which the non-resident bidder is a resident. If it is determined by the
off icer responsible for awarding the bid that compliance with this subsection .06 may cause denial of federal funds
which would otherwise be available or would otherwise be inconsistent with requirements of federal law, this sub-
section shall be suspended, but only to the extend necessw-N, to prevent denial of the ntoneys or to eliminate the
inconsistency with federal requiremenu (section 8-19-101 and 102, CRS).
GENERAL
7. The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the
interpretation, execution and enforcement of this contras Any provision of this contract whether or not incor-
porated herein by reference which provides for arbitration by any extra judicial body or person or which is other-
wise in conflict with said laws, rules and regulations shall be considered null and void- Nothing contained in anv
provision incorporated herein by reference which purports to negate this or any other special provision in whole or
in part shall be valid or enforceable or available in any action at law whether by way of complaint, defense or other-
wise. Any provision rendered null and void by the operation of this provision will not invalidate the remainder of
this contract to the extent that the contract is capable of execution.
8. At all times during the performance of this Contract- the Contractor shall strictly adhere to all applicable
federal and state laws, rules and regulations that have been or may hereafter be established -
9. The signatories hereto aver that the\' are familia: with 18-8-_O1. et seq.. (Bribery and Corrupt Influences)
and 18-8-401, et. seq., (Abuse of Pubiic Omce), CRS 1978 Replacement Vol., and that no violation of such pro-
visions is present-
10.
resent
10. The signatories aver that to their knowledge. no sate employee has a personal or beneficial interest what-
soever in the service or properry described herein:
IN WITNESS WHEREOF, the parties hereto have executed this Contract on the day first above
written, -
Contractor :
(Full Legal Name)
CI'•i 1
EAGLE COU
Position (Title)
ISSIONERS
5 a! Sccurn) Numrcr w Fw,w I.D. N
(If Corporation:) a i
STATE OF COLORADO
ROY ROMER, GOVERNOR
E " 1;Tij'E DIRECTOR
DEPARTMENT
OF HEALTH
Attest (Seal) `4tptt.�p,"Z�"y35
Bv«q�2G�
(_1WTX.al[ ScRcun, m Eu rcnL T. n Cuy mnty 0cm
APPROVALS
ATTORNEY GENE V C N T R LLER
ODA RD
By By
Li
H8. JEWELL, JAMES A. STROUF
a--
ral
Legal Services
PROGRAM, APPROVAL:
P.— 6 �n en > me j_ .0 6 paces
for the
Attachment A
E.P.S.D.T. BUDGET
Eagle County
July 1, 1987 to June 30, 1988
Case Managers .25 FTE . . . . . . . . . . . . . . . . . $ 4,300
Fringe Benefits . . . . . . . . . . . . . . . . . . . . $ 250
Administrative Cost . . . . . . . . . . . . . . . . . $ 400
Travel . . . . . . . . . . . . . . . . . . . . . . . . . S 200
TOTAL
Date: April 2�-� 1987
Y
S 5,150