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Home My WebLink AboutC09-004 CDPHE_immunization programSTATE OF COLORADO Bill Ritter, Jr., Governor James B. Martin, Executive Director Dedicated to protecting and improving the health and environment of the people of Colorado 4300 Cherry Creek Dr. S. Denver, Colorado 80246-1530 Phone (303) 692-2000 TDD Line (303) 691-7700 Located in Glendale, Colorado http://www.cdphe.state.co. us Laboratory Services Division 8100 Lowry Blvd. Denver, Colorado 80230-6928 (303)692-3090 OF' ~~< _ o y~'i ~o * ~ ~ ~ *ls~s ~ Colorado Department of Public Health and Environment Colorado Department of Public Health and Environment Immunization Program General Immunization Core Services Contract Statement of Work Term: January 1, 2009 through December 31, 2009. For the BOARD OF COUNTY COMMISSIONERS OF EAGLE COUNTY, (apolitical subdivision of the State of Colorado), for the use and benefit of EAGLE COUNTY NURSING SERVICE, hereinafter referred to as the "Contractor." To best meet the immunization needs of the citizens of Colorado and to ensure immunization best practices are provided around the state, contractors shall use this funding to augment any of the following activities: • Collaborate with community leaders to work toward formulating policies designed to solve local immunization access issues. • Follow the Standards for Child and Adolescent Immunization Practices (CDC, 2006) to assure all populations have access to appropriate immunization services and evaluate the effectiveness of the services provided. • Promote, educate, and support providers regarding the value of active participation in reminder/recall activities. • Conduct onsite clinical services with optimal access such as non-traditional clinic access, "express lane" or drop-in appointments, and use incentives to encourage completion of children's primary immunization schedule. • Develop and follow appropriate procedures for vaccine storage and handling with appropriate clinic equipment and implement written policies and procedures for vaccine storage, vaccine ordering, and emergency response. Utilize up-to-date written protocols and have them readily accessible at all locations where vaccines are administered, and ensure all persons who administer vaccines and staff who manage or support vaccine administration are knowledgeable and receive ongoing education. • Provide support for immunization initiatives through the Colorado Supplemental Nutrition Program- Women, Infants, and Children (WIC) by providing vaccinations on site, assessing immunization histories, and referring children appropriately and/or distributing educational materials regarding immunizations and locally available services. BUDGET: In consideration of those services satisfactorily and timely performed by the Contractor under this Purchase Order the State shall cause to be paid to the Contractor a sum not to exceed Nine Thousand Four Hundred Seventy-Seven Dollars ($9,477.00). Of the total financial obligation of the State referenced above, $9,477.00 is identified as attributable to a funding source of the United States government through the Centers for Disease Control Notice of Cooperative Agreement Award number H23/CCH822564-OS-1, (CFDA# 93.368) and $0.00 is identified as attributable to a funding source of the state of Colorado. Reimbursement under this Purchase Order shall be made to the Contractor by the State in four (4) payments of $2,369.00 each. Accordingly, the Contractor shall be paid one quarter (1/4) of the State's financial obligation under this Purchase Order in March, June, September and December 2009. The final payment for this Purchase Order is contingent upon the State's timely receipt of an annual statement from the Contractor in the form attached hereto as Attachment A, which is incorporated herein by this reference. Contractors receiving these 2009 General Immunization Core Services funds agree to abstain from charging an office visit fee in addition to the allowable vaccine administration fee. The Contractor shall submit an online Immunization Program progress report to the State. The progress report is due within fifteen (15) calendar days of the end of the reporting period. This progress report shall document the Contractor's progress towards completion of the activities described herein. The Contractor's December payment shall not be reimbursed by the State until the requisite progress report is submitted to the State by the Contractor. Reporting period and progress report due date is as follows: Progress Period Due Date January 1, 2009 -June 30, 2009 July 15, 2009 July 1, 2009 -December 31, 2009 January 15, 2010 Throughout the 2009 funding period, the CDPHE Immunization Program will conduct ongoing project monitoring and provide technical assistance as needed. In the event that project performance does not meet the agency's stated goals, afollow-up work plan will be created and additional technical assistance will be provided. In an extreme situation, and in consultation with the agency, the CDPHE Immunization Program reserves the right to reduce or withhold quarterly payments due to poor project performance. Thank you for your cooperation and support. If you have any questions, please contact me at 303-692-2314, Teri Lindsey at 303-692-2732 (teri.Lindse~(a,state.co.us), or Lynn McCracken at 303-692-2447 (lynn.mccracken@state.co.us). Sincerely, Beth Hoffman Fiscal Manager Immunization Program Phone: (303) 692-2314 Fax: (303) 691-6118 Beth.hoffman(c~,state.co.us 2 EAGLE COUNTY NURSING SERVICE TOTAL FOR FY2009 = $9,477.00 LOCAL HEALTH PARTNER ACCEPTANCE OF CORE SERVICE DELIVERY IMMUNIZATION REQUIREMENTS I, ~2 ~ ~ ~ , on behalf of ~ .~~- hereby acknowledge that the requi ents for the Immunization Servic statement of wor described above have been reviewed, and are accepted and agreed to. I further acknowle ge that I have the necessary authority to sign this acceptance on behalf of the entity mentioned above. %/D Title Attachment A COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT DIVISION OF DISEASE CONTROL & ENVIRONMENTAL EPIDEMIOLOGY IMMUNIZATION PROGRAM YEARLY CONTRACT REIMBURSEMENT CERTIFICATION FORM DUE DATE: January 15, 2010 TO: ('O]nrarln TlPnartmPnt of Pilhlir Health and Rnvirnnment Imr 43C DC Deg ~ 1~=~~ `~ ~< C~ `' ~-~ G ~ W ~ ~~ FROM: ~G~- ~ ~~ ~~~ ~~1 ~~ Tax ID#: This is to certi Number SIGNATURE Contra I hereby certil December 31, 2009 is authorized. SIGNATURE State Program Director or Authorized Designee Date act Routing ;tuber 31, 2009. ~ment of through C \Documents and Set[ingsUciglesias\LOCaI Settings\Temporary Internet Files\OLKSCU 2-15-08 Attchmt A Annual Reimbursement Certification Form CY08 doc