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HomeMy WebLinkAboutC09-066 CDPHEDEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
Colorado Family Planning Initiative
DEPARTMENT OR AGENCY NUMBER
FLA
CONTRACT ROUTING NUMBER
09 FLA 00854
CONTRACT AMENDMENT #1
THIS AMENDMENT, made this 4th day of December, 2008, by and between the State of Colorado for the use and
benefit of 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 EAGLE COUNTY, for the use and benefit of the
EAGLE COUNTY HEALTH & HUMAN SERVICES, (a political subdivision of the state of Colorado),
whose address or principal place of business is 500 Broadway, Eagle, CO 81631-0850, hereinafter referred to as
"the Contractor".
FACTUAL RECITALS
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; and
Required approval, clearance, and coordination has been accomplished from and with all appropriate agencies; and
The parties entered into a contract dated August 15, 2008, with contract encumbrance number PO FLA
FPP0900663, and contract routing number 09 FLA 00663, whereby the Contractor was to provide to the State the
following:
The contractor will provide a comprehensive family planning program with an emphasis on
increasing the total number of men and women accessing services and increasing utilization of long
acting reversible methods of contraception (LARC) among existing clients.
The purpose for this amendment is described below.
The contractor will increase services to expand current Title X Family Planning services to reduce
unintended pregnancy. Contractors can increase services through six pre-approved activities:
1) Expanding capacity; 2) Outreach; 3) Media and Marketing; 4) Training and Education; 5)
Information Technology and Data Management; and 6) Other approved activities.
NOW THEREFORE, it is hereby agreed that
1. Consideration for this amendment to the Original Task Order Contract, 09 FLA 00663, PO FLA
FPP0900663 ,dated August 15, 2008 consists of the payments which shall be made pursuant to this
amendment and the promises and agreements herein set forth.
2. It is expressly agreed to by the parties that this Amendment is supplemental to the Original Task Order
Contract, contract routing number 09 FLA 00663, referred to herein as the Original Task Order Contract,
Page 1 of 3
which is by this reference incorporated herein. All terms, conditions, and provisions thereof, unless
specifically modified herein, are to apply to this Amendment as though they were expressly rewritten,
incorporated, and included herein.
It is agreed the Original Task Order Contract is and shall be modified, altered, and changed in the following
respects only:
A. This Amendment is issued pursuant to paragraph 5. of the Original Task Order Contract identified
by contract routing number 09 FLA 00663. This Amendment is for the current term of January
12, 2009, through and including June 30, 2009. The maximum amount payable by the State for
the work to be performed by the Contractor during this current term is increased by Fifty_
Three Thousand, Five Hundred Ninety-Two Dollars, ($53,592.001 for an amended total
financial obligation of the State of EIGHT-FIVE THOUSAND, NINE HUNDRED NINETY
DOLLARS, ($85,990.00). The revised specifications to the original Scope of Work and the
revised Budget and Budget Narrative, if any, are incorporated herein by this reference and
identified as "Exhibit E" and "Exhibit F". A revised Cost Reimbursement Form is
incorporated herein by this reference and identified as "Exhibit G". The Original Task Order
Contract is modified accordingly. All other terms and conditions of the Original Task Order
Contract are reaffirmed.
4. The effective date of this amendment is upon approval of the State Controller or January 12, 2009,
whichever is later.
5. Except for the "Special Provisions", in the event of any conflict, inconsistency, variance, or contradiction
between the provisions of this amendment and any of the provisions of the Original Task Order Contract,
the provisions of this amendment shall in all respects supersede, govern, and control. The "Special
Provisions" shall always be controlling over other provisions in the contract or amendments. The
representations in the Special Provisions concerning the absence of bribery or corrupt influences and
personal interest of State 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 3
IN WITNESS WHEREOF, the parties hereto have executed this amendment on the day first above written.
* Persons signing for Contractor hereby swear and affirm that they are authorized to act on
Contractor's behalf and acknowledge that the State is relying on their representations to that effect
and accept personal responsibility for any and all damages the State may incur for any errors in
such representation.
CONTRACTOR:
BOARD OF COUNTY COMMISSIONERS OF
EAGLE COUNTY, for the use and benefit of the
EAGLE COUNTY HEALTH & HUMAN SERVICES
(a political subdivision of the state of Colorado)
By:
Name: ! w /~i' t +e
Title:
STATE:
STATE OF COLORADO
Bill Ritter, Jr. Governor
By:
For the Executive Director
DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT
PROGRAM APPROVAL:
By:
ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER
CRS 24-30-202 requires that the State Controller approve all state contracts. This limited amendment is not
valid until the State Controller, or such assistant as he may delegate, has signed it. The contractor is not
authorized to begin performance until the contract is signed and dated below. If performance begins prior to
the date below, the State of Colorado may not be obligated to pay for goods and/or services provided.
STATE CONTROLLER
David J. McDermott, CPA
By:
^Kevin Edwards ^Yvonne Anderson ^Robert Jaros ^Donald Rieck
Date:
Page 3 of 3
Exhibit E
COLORADO FAMILY PLANNING INITIATIVE
2009 Expansion Grant
Agency Work Plan
Year 1
January 12, 2009-June 30, 2009
Agency Name: Eagle County Health & Human Services
Goal Reduce unintended pregnancies in Colorado.
To serve _175 number of additional total family planning clients as stated by the delegate in the
Objective 1 proposal for Year 1, January 1-June 30, 2009, over the total number of clients served by the same agency from
January 1-June 30, 2008.
Increased numbers verified through existing methods of agency data collection (IRIS).
Evaluation Plan of
Objective 1
Instructions: Complete only the yellow boxes. Describe each activity that will result in achieving the program goal and objective.
Activities Dates Plan for Evaluating Activities Evaluation of Activities
(For Progress Report)
~
°o May also be evaluated at
''" N family planning medical
~ ~ and/or administrative site
~" ~' visits.
~
1. Increase the family planning coordinator position by 1/2009 Both Positions increased and
0.35 FTE to a 0.8 FTE public health nurse practitioner. number of additional clients.
Exhibit E
2. Recruit and hire two bilingual clinic assistants to 1/2009 2 qualified bilingual clinic assistants
intake patients, process labs, call backs, provide are hired.
medical translation, and ensure follow up care for three
clinic sites.
3. Develop clinic assistant training protocols for family 1/2009 Comprehensive training plan
planning. developed.
4. Train two bilingual clinic assistants and public health 2/2009 Clinic assistants receive
nurses using a competency based orientation and comprehensive training based
previous experience and education. on training plan and are
proficient in skills after 90
da s from date of hire.
5. Increase family planning clinics in the county from 3.5 2/2009- Additional client appointments
days per week to 6 days per week. Avon site will 3/2009 are available as of 3/1/2009
increase the number of hours per week from 14 to 20. and number of additional
Eagle site will increase the number of hours of per clients.
week from 14 to 20. El Jebel will add 2 days per
month.
6. Order family planning equipment and medical supplies 2/2009 Equipment and medical
for new family planning clinic in El Jebel. supplies ordered, received, and
or anized.
7. Set up Ahler's software and train staff in El Jebel. 2/2009 Staff are proficient on Ahler's
software.
8. Outreach of expanded clinic hours and new location. 2/2009- Expanded clinic hours and
Quarter page ads will be placed in Vail Daily for 3/2009 services in new location are
English speaking population and 15 second radio spots advertised.
featured on La Nueva Mix to target the Spanish
s eakin o ulation.
Exhibit E
9. Expand family planning services to El Jebel site with 3/2009 El Jebel offers family planning
appointments available every other Friday 8 am-5 pm. services by 3/30/2009 and
An estimated number of 60 clients will be served in El number of additional clients.
Jebel based on our prenatal client numbers. Currently,
the population in El Jebel does not have access to
Family Planning services within 30 miles. The two
clinic exam rooms already meet the Family Planning
clinic idelines.
10. Increase inventory of long-term contraceptives. 3/2009 Inventory of long term
contraceptives is increased.
11. Increase patient education of long-term contraceptives. 3/2009 Community and patient
education materials are
develo ed and distributed.
12. Provide long-term contraceptive methods to patients. 3/2009 Number of patients receiving
long-term contraceptives.
13. Develop an annual strategic plan for family planning 4/2009- Strategic plan is developed by
outreach and community based health education. 6/2009 health educator and family
tannin team.
14. Complete quarterly progress report. 4/15/09 Progress reports submitted to
& CDPHE.
7/15/09*
* The quarterly progress report is due 15 days after the June 30, 2009 contract effective date. Contractor understands this work falls
outside of contract start and end dates.
Exhibit F
`^
.~ttF.ic~ ~2':2C1,1t1t3~b'~}:. - _
Agenc Eagle Count Health & Human Services
Instructions: Refer to instructions for completion of this form in the Expansion Grant Application. Enter text and numbers in yellow
highlighted areas below
pC T COSTS
E ~ -CAT~la~41ES
Annu81 t _ limo
Fu#'t'Tiiu~ lta_ - . ~' _
~i+#!i~l tfstim
C~'I
PERSONAL SERVICES Titles & Names
Roberta Mitch, WHNP $90,000.00 0.35 $15,750.00
Bilin ualClinicAssistant $46,000.00 0.65 $14,950.00
Bilin ualClinicAssistant $46,000.00 0.60 $13,800.00
SUBTOTAL --- --- $44,500.00
Fringe Benefits: Rate = % N/A N/A
~p ,~ 1. .1#0
OPERATING EXPENSES
Contrace tives -Lon Term Methods $8,592.00
Outreach /Marketing Plan $500.00
CONTRACTUAL EXPENSES
TOTAl. ~ A1. ~
TOTAL DIRECT COSTS $53,592.00
ADMMNISTRATIVE COST
RATE (may not exceed 10% of Total Direct Costs) _ % N/A
TOT
TOTAL DIRECT AND ADMINISTRATIVE COSTS (Total Direct + Administrative $53,592.00
-TYNE E3CPEQISES
t~E CATEtit?RIE$ Dial A-i»1t~t
#egtie:~'k~Cllrott'e
CFPi
ONE-TIME EXPENSES
TOTAL ONE-TIME EXPENSES $0.00
OTAi. PR{>JECT COST $5S 592.tIQ
um er o i Iona ien s•
Year 1 175
Cost ~er;Addi~anai Cll~etNe~ 2
Shoutd-nc~i exceed $31t~1
C(ist'tt ~.
Exhibit F
COLORADO FAMILY PLANNING INITIATIVE
2009 Expansion Grant
Budget Narrative
Year 1 January 12, 2009 -June 30, 2009
Personal Services•
1. Roberta Mitch, Nurse Practitioner, $15,750: 0.35 FTE /6 months
(Year-long, Family Planning time = 0.35 FTE funded by the grant and 0.45 FTE funded by Eagle County/Title
X Grant. Annual salary is $90,000). Fringe benefits will be provided in-kind at 25% of salary: $3938 / 6
months. Roberta Mitch is the new Family Planning Coordinator. The previous coordinator was a 0.45 FTE.
The 0.35 FTE increase will allow an expansion of hours in our Eagle and Avon offices from 3.5 to 6 days a
week, and establish a new Family Planning program in the El Jebel office with clinics held 1 - 2 days per
month. In addition, Roberta Mitch will provide coverage in the Avon office, when the other NP is absent, to
replace the current practice of canceling clinic. Roberta will have roles of family planning lead nurse, lead
trainer, administrative coordinator, family planning budget manager, state liaison, and practitioner.
2. Two Bilingual Clinic Assistants, $23,000: 1.0 FTE/6 months
These two new positions would cover all three clinic locations. Position One's salary is $14,950/6 months
(Year-long Family Planning time = 0.65 FTE funded by this grant. Annual salary of $46,000). Position Two's
salary is $13,800/6 months (Year-long Family Planning time = 0.60 FTE funded by the grant and 0.05 funded
by Eagle County/Title X Grant. Annual salary of $46,000). Fringe benefits will be provided in-kind at 25% of
the salary = $5,750 / 6 months. These two positions would take over lower-level activities currently being
performed by Nurse Practitioners (chart preparation, blood pressures, height/weight, filing), thereby re-directing
nurse time and reducing the cost per hour of family planning service. They will also absorb duties from front
desk/reception staff, including: patient intakes, processing labs, call backs, medical translation, and ensuring
follow-u care. An EMT or CNA certification will be re uired.
eratin E nses:
1. Contraceptives -Increase Availability of Long Term Methods: $8,592.
IUDs: (Mirena - $350 each x 12/6 months; Paraguard - $200 each x 12/6 months = $6,600), Implanon: ($300
each x 6/6 months = $1,800), & Nuva Ring ($16 each x 12/6 months = $192). With the expansion of clients,
there will be a need for additional contraceptives. CFPI fiznding is based on the previous year's client numbers.
This amount will help offset the difference until the next CFPI funding year.
Outreach/Marketing Plan - $500 will cover marketing of additional family planning clinic days in Avon and
Eagle, new clinic in El Jebel, as well as health education outreach regarding long term contraceptives. Marketing
and outreach tactics include: 2 Spanish ads/day on La Nueva mix radio for 8 days ($15 per ad X 8 days = $240); 3
color Vail Daily ads = $258 ($106 (4X2.5 full color), $76 (2X2.5 full color), $76 (2X2.5 full color)); and press
releases and radio PSAs at no cost.
Contractual:
N/A
Administrative Costs:
N/A
One-Time E enses:
Exhibit G '
2009 CFPI EXPANSION GRANT-YEAR 1
NOTE: The following information is necessary in order to process your request. If the information is incomplete, your request will be returned. Please only submit SIGNED copies via FAX
or MAIL.
CONTRACT/PO #:
TO: Colorado Department of Public Health and Environment INVOICE #:
Prevention Services Division -PSD-TGYS-A4 AGENCY NAME:
ATTN: Serafin Diaz Address:
4300 Cherry Creek Drive South, PSD-MCH-A4 City, State Zip:
Denver, CO 80246-1530
Phone: 303-692-2391 Fax - 303-753-9249 CONTACT NAME:
CONTACT PH #:
EXPENDITURE DATES: FROM TO
FINAL BILL? ^ YES ^ No
a es o Reimbursable Amount from
Service Inv# or Check# Description Name of Payee and type of service) CDPHE
PERSONAL SERVICES (Titles and Names)
SUB-TOTAL $ -
Frin a Benefits
Total Personnel (FTE and Fringe): $ -
OPERATING EXPENSES:
Total Operating: $ -
Total Contractual: $ -
TOTAL DIRECT COSTS: $ -
TOTAL ADMINISTRATIVE COSTS: $ -
Total Direct and Administrative Costs: $ -
ONE-TIME EXPENSE:
~ TOTAL Amount Requested for this period: $ -
Exhibit G
CONTRACTORNENDOR: I/We affirm the claimed expenses comply with the budget provisions of the contract and are reasonable and necessary, that all relevant progress or other reports have been
timely filed, and all contract milestones and/or tasks related to the billing period have been achieved.
Title Date
ContractorNendor Signature
CDPHE PROGRAM DIRECTOR/DELEGATED PROGRAM STAFF: I affirm that I or my staff have reviewed the contractor's invoice and suppporting documentation (as required), progress reports and
other communication with the contractor, and believe to the best of my knowledge, that the contractor is in compliance with all contract provisions.
Title Date
CDPHE Program Director/Delegated Program Staff Signature
CDPHE PROGRAM FISCAL OFFICER: I certify that the claimed expenses have been reviewed by me for compliance with requirements of the funding source and State of Colorado's Fiscal Rules, and
are charged to the appropriate funding source.
Title Date
CDPHE Program Fiscal Officer
Instructions:
Do not delete rows from the spreadsheet. Deleting rows will disable the formulas. You may however add rows to the spreadsheet. This
Submit invoices monthly or quarterly.
Submit signed copies via fax or mail. Payment will usually be processed within two weeks.
Enter Agency name.
If a partner agency is submitting the expense reimbursement, please indicate the name of the agency on Partner Agency line.
Enter the name and phone number of the person to contact in the event of questions pertaining to the submitted reimbursement request.
Indicate whether this is the Final Bill.
Enter your Agency's billing period (dates) in the Expenditures from/to section.
Enter Vendor's Invoice # or your Agency's Check # for each reimbursable item.
Enter your Colorado Department of Public Health and Environment Contract # or Purchase Order #.
The grantee must maintain records of revenues and expenditures by funding source, anti produce verification of expenses upon request.
A budget category may be overspent by no more than 10%. A Budget Modification Request is required for a variance of > 10%.
The grantee may request a quarterly financial status report from the State.