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HomeMy WebLinkAboutC09-182 CO Family Planning Initiative Expansion Grant, Amd#2C~~[g~ DEPARTMENT OR AGENCY NAME COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT Colorado Family Planning Initiative DEPARTMENT OR AGENCY NUMBER FLA CONTRACT ROUTING NUMBER 10-00227 CONTRACT AMENDMENT #2 THIS AMENDMENT, made this 20th day of Anril, 2009, 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 Cherrv Creek Drive South, Denver, Colorado 80246, hereinafter refened to as "the State"; and, BOARD OF COUNTY COMMISSIONERS OF EAGLE COUNTY, whose address or principal place of business is 500 Broadwav, Eagle, Colorado 81631, for the use and benefit of the EAGLE COUNTY PUBLIC HEALTH AGENCY formerly known as, EAGLE COUNTY HEALTH & HUMAN SERVICES, a political subdivision of the state of Colorado), whose address or principal place of business is 551 Broadwav, Ea~le, Colorado 81631, hereinafter referred to as "the Contractor". FACTUAL RECITALS Atrthority 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 froin and with all appropriate agencies; and The parties entered into a Master Contract, dated Januarv 23, 2007, with contract routing number 08 FAA 00016. Pursuant to the terms and conditions of the Master Contract, the parties entered into a Task Order Contract, dated Au~ust 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 inen 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. To renew the contract for one year, to modify the Additional Provisions and the Statement of Work and to incorporate a new provision to the General Provisions of the Task Order Contract, concerning the monitoring of vendor performance on state contracts and inclusion of contract performance information in a statewide contract management system. NOW THEREFORE, it is hereby agreed that 1. Consideration for this amendment to the original task order contract, dated August 15, 2008, with contract routing nuinber 09 FLA 00663, and contract encumbrance PO FLA FPP0900663, consists of the payments which shall be made pursuant to this amendment and the promises and agreements herein set forth. Page 1 of 4 rev 4/3/09 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, as amended by Contract Amendment #1, Contract Routing Number 09 FLA 00854, collectively referred to herein as the Original Task Order Contract, which is by this reference incorporated herein. All terms, conditions, and provisions thereof, unless specifically inodified herein, are to apply to this Amendment as though they were expressly rewritten, incorporated, and included herein. 3. It is agreed the original task order contract is and shall be modified, altered, and changed in the following respects only: A. This AmendmenY is issued pursuant to paragraph 16.b. of the Original Contract identified by contract routing number 08 FAA 00016, dated Januarv 23. 2007. The Contractor's legal name in the original contract is hereby changed form EAGLE COUNTY HEALTH & HUMAN SERVICE5 to the Contractor's new legal name of EAGLE COUNTY PUBLIC HEALTH AGENCY. The Contractor's FEIN remains the same as it was under the original contract. The State desires to continue working with the Contractor under the new name and EAGLE COUNTY PUBLIC HEALTH AGENCY desires to continue working with the State. B. This ainendment 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 renewal term of Ju1v 1, 2009, through and including June 30, 2010. Exhibit A, Additional Provisions, of the Original Task Order Contract is hereby revised for the renewal term and incorporated herein by this reference and identified as Exhibit H. C. The maximum amount payable by the State for the work to be performed by the Contractor during this renewal term is One Hundred Fortv-Seven Thousand, Five Hundred Twentv-Five Dollars, ($147,525.00) for an amended total financial obligation of the State of TWO HUNDRED THIRTY-THREE THOUSAND, FIVE HUNDRED FIFTEEN DOLLARS, ($233,515.00). This is an increase of One Hundred Fortv-Seven Thousand. Five Hundred Twentv-Five Dollars ($147,525.00) of the amount payable from the previous term. The revised specification to the original Statement of Work for this renewal term is incorporated herein by this reference and identified as Exhibit I. The revised Budget for this renewal term is incorporated herein by this reference and identified as Attachment I-1. D. The General Provisions of the Contract are hereby modified to incorporate the following language: By entering into this Task Order Contract, Contractor agrees to be governed, and to abide, by the provisions of CRS §24-102-205, §24-102-206, §24-103-601, §24-103.5-101 and §24-105-102 concerning the monitoring of vendor performance on state contracts and inclusion of contract performance information in a statewide contract management system. Contractor's performance shall be evaluated in accordance with the terms and conditions of this Task Order Contract, State law, including CRS §24-103.5-101, and State Fiscal Rules, Policies and Guidance. Evaluation of Contractor's performance shall be part of the normal contract administration process and Contractor's performance will be systematically recorded in the statewide Contract Management System. Areas of review shall include, but shall not be limited to quality, cost and timeliness. Collection of information relevant to the performance of Contractor's obligations under this Task Order Contract shall be determined by the specific requireinents of such obligations and shall include factors tailored to match the requireinents of the Statement of Project of this Task Order Contract. Such performance information shall be entered into the statewide Contract Manageinent System at intervals established in the Statement of Project and a final review and rating shall be rendered within 30 days of the end of the Task Order Contract tenn. Contractor shall be notified following each performance and shall address or correct any identified problem in a timely manner and inaintain work progress. Should the final performance evaluation determine that Contractor demonstrated a gross failure to meet the performance measures established under the Statement of Project, the Executive Director Page 2 of 4 rev 4/3/09 of the Colorado Department of Personnel and Administration (Executive Director), upon request by the Colorado Department of Public Health and Environment, and showing of good cause, may debar Contractor and prohibit Contractor from bidding on future contracts. Contractor inay contest the fmal evaluation and result by: (i) filing rebuttal statements, which may result in either removal or correction of the evaluation (CRS §24-105-102(6)), or (ii) under CRS §24-105-102(6), exercising the debarment protest and appeal rights provided in CRS §§24-109-106, 107, 201 or 202, which may result in the reversal of the debarment and reinstatement of Contractor, by the Executive Director, upon showing of good cause. The original Task Order contract is modified accordingly. All other terms and conditions of the Original Contract are reaffirmed. 4. The effective date of this amendment is upon approval of the State Controller or July 1, 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 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 reaffinned. 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 3 of 4 rev 4/3/09 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. CONTRACTOR: STATE: BOARD OF COUNTY COMMISSIONERS OF EAGLE STATE OF COLORADO COUNTY for the use and benefit of the Bill Ritter, Jr. Governor EAGLE COUNTY PUBLIC HEALTH AGENCY (a political subdivision of the state of Colorado) ~ Signatur of Authorized Officer ~,~Zi ~.. . ~ ~ Print N e of Authorized Officer C~~'~ .~ ,~~~) ~f~ ~`~ By: For the Executive Director DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT Print Title of Authorized Officer Signatory avers to the State Controller or that Contractor has not begun performance or that a Statutory Violation waiver has been. requested under Fiscal Rules PROGRAM APPROVAL: By: ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER CRS §24-30-202 requires the State Controller to approve all State Contracts. This Contract is not valid until signed and dated below by the State Controller or delegate. Contractor is not authorized to begin performance until such time. If Contractor begins performing prior thereto, the State of Colorado is not obligated to pay Contractor for such performance or for any goods and/or services provided hereunder. STATE CONTROLLER David J. McDermott, CPA By: ^Kevin Edwards ^Yvonne Anderson ^Robert Jaros ^Donald Rieck Date: Page 4 of 4 rev 4/3/09 EXHIBIT H ADDITIONAL PROVISIONS To Contract Dated 04/20/2009 - Contract Routing Number 10 FLA 00227 These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above. The revised Additional Provisions are effective Ju(y 1, 2009. 1. Health Insurance Portability and Accountability Act (HIPAA) Business Associate Determination. The State has determined that this contract does not constitute a Business Associate relationship under HIPAA. 2. To receive compensation under this Task Order Contract, the Contractor shall submit a signed Monthlv . Colorado Family Planning Initiative (CFPI) Cost Reimbursement Statement in a format acceptable to the State. A CFPI Cost Reimbursement Statement is incorporated and made part hereof by reference. This document is located at: http://www.cd~he.state.co.us/pp/woinensfFPNursingConsntsForms.html?col2=open. A Cost Reimbursement Statement must be submitted within sixty (60) calendar days of the end of the billing period for which services were rendered. CFPI Cost Reimbursement Statements must be accompanied by detailed cost ledger to reflect all purchases being invoiced under that contract and should include date of payment, payee name and amount, and check or voucher number, when available: Expenditures shall be in accordance with the Statement of Work attached hereto as Exhibit I and in accordance with allocable expenses outlined in Cost Reimbursement Guidelines attached hereto as Attachment H-1. These items may include, but are not limited to, the Contractor's salaries, fringe benefits, supplies, travel, operating, indirect costs which are allowable, and other allocable expenses related to its performance under this Task Order Contract. CFPI Cost Reimbursement Statements shall: 1) reference this Task Order Contract by its contract routing number, which is located on page one of this Task Order Contract; 2) state the applicable perfonnance dates; 3) state the names of payees; 4) include a brief description of the services performed during the relevant performance dates; and, 5) show the total requested payment. Payment during the initial, and any renewal or extension, term of this Task Order Contract shall be conditioned upon affirmation by the State that all services were rendered by the Contractor in accordance with the terms of this Task Order Contract. CFPI Cost Reimbursement Stateinents shall be sent to: Serafin Diaz, Fiscal Officer Family Planning Program Prevention Services Division Colorado Department of Public Health and Environment PSD - A4 4300 Cherry Creek Drive South Denver, CO 80246 Final billings under this Task Order Contract must be received by the State within a reasonable time after the expiration or termination of this Task Order Contract; but in no event no later than sixty (60) calendar days from the effective expiration or termination date of this Task Order Contract. 4. The Contractor is authorized to make limited transfers of fiinds from one line item in its Budget to another line item in its $udget but must notify the Program Director by email prior to the transfer. A transfer from one line item to another line item may not exceed ten percent (10%) or One Thousand Dollars ($1000), which ever amount is less, of the total amount of the line item from which the transfer is inade unless prior written approval is received from the Program Director. If the Contractor desires to transfer more than ten percent (10%) or One Thousand Dollars ($1000), which ever amount is less, from one line itein in its budge.t to another line item in its budget then the Contractor shall request and receive prior written approval froin the Program Director by completing and submitting a Budget Revision Request Form, incorporated and made part hereof by reference. This document is located at: http://www.cdphe. state.co. us/~p/woinens/FPNursingConsntsFoi7ns.html?co] 2=o~en. To be attached to CDPHE Page 1 of 2 Revised: 4/1/04 Version 1.0 (4/04) contract template EXHIBIT H The services ar activities under this Contract may be carried out by the Contractor, or through subcontracts with other providers or, through collaborative parfierships with other community partners. The State authorizes the Contractor to subcontract some, or all, or the services that are to be performed under this Contract. However, a subcontractor is subject to all of the tenns and conditions of this Contract. Additionally, the contractor remains ultimately responsible for the timely and satisfactory completion of all work performed by any subcontractor(s) under this Contract. If the Contractor desires to subcontract some, or all, of the services that are to be performed under this Contract, the Contractor shall obtain the prior, express, written consent of the State before entering into any subcontract. The Contractor shall maintain, at a minimum a Memorandum of Understanding or other binding contractual agreement, and provide a copy to the Family Planning Program Director fifteen (15) calendar days from the date the agreement is executed. The Contractor shall maintain records of any subcontractors for a minimum of three years. 6. Contractor agrees to provide services to all Program participants and employees in a smoke-free environment in accordance with Public Law 103-227, also known as "the Pro-Children Act of 1994", (Act). Public Law 103-227 requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by Federal programs either directly or through State or local governments, by Federal grant, contract, loan, or loan guarantee. The law also applies to children's services that are provided in indoor facilities that are constructed, operated, or maintained with such Federal funds. The law does not apply to children's services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment; service providers whose sole source of applicable Federal funds is Medicare or Medicaid; or facilities where Women Infant and Children (WIC) coupons are redeemed. Failure to comply with the provision of Public Law 103-227 may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. By signing this Contract, the Contractor certifies that the Contractor will comply with the requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act. The Contractor agrees that it will require that the language of the Act be included in any subcontracts which contain provisions for children's services and that all contractors shall sign and agree accordingly. 7. Contractor shall ensure that the provisions of Section 601 of Title VI of the Civil Rights Act of 1964 are carried out. That Act states that "no person in the United States shall on the ground of race, color, ar national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance." The Office of Civil Rights has concluded that it is the responsibility of any program which is a recipient of funds froin the Department of Health and Human Services to ensure that clients who do not speak or understand English well, be provided interpretation services to ensure that the service provider and the client can communicate effectively. The Contractor shall have policies and procedures to ensure that interpretation services are available for clients with Limited English Proficiency and will advise such clients that an interpreter will be provided for them. If a client has their own interpreter, they shall be advised that the Contractor will provide an interpreter if the client so chooses. 8. The State may require fonns attached to this contract and incorporated herein by reference by updated during the term of this contract. The Contractor will be informed of the new fo~ns as they are developed. Fonns may be sent to contractors or will be available on the Family Planning Administrative Manual website: http://www.cdphe.state.caus/pp/womens/famplan.htlnl. _ 9. Notwithstanding anything herein to the contrary, the parties understand and agree that all terms and conditions of this Task Order Contract and the exhibits and attachments hereto which may require contimied perfonnance, coinpliance or effect beyond the termination date of this Task Order Contract shall survive such termination date and shall be enforceable by the State as provided herein in the event of such failure to perform or comply by the Contractor. 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The revised Statement of Work is effective July 1, 2009. 1) The Contractor, in accordance with the terms and conditions of this contract, shall perform and complete, in a timely and satisfactory manner, all activities described in this approved Statement of Work and incorporated in accordance with the associated Budget, which is attached hereto as Attachment I-1. 2) The Contractor shall continue to conduct a comprehensive family planning program ("the program"). This program shall comply with section 1001 of the federal Act and all applicable federal regulations, as amended, contained in Title X, 42 C.F.R., Subpart A, Part 59, as well as all applicable state regulations. (Federal funding from HHS, CFDA #93.217 FP Services). The program shall offer the following under the Title X family planning program: A. Outreach services and/or other program efforts designed to improve client recruitment. B. Nursing and medical services, which shall include a comprehensive health and social history and physical examination administered in accordance with all applicable Title X regulations and, all applicable nursing-medical policies or procedures which have been, or may be, established by the State's Women's Health Unit (WHU). C. Contraceptive information, education, and supplies regarding all family planning methods. D. Education and counseling services regarding family planning, family planning methods, child spacing, infertility, sterilization, nutrition, sexually transmitted diseases, Human iriununodeficiency virus (HIV)/ Acquired immunodeficieny syndrome (AIDS), adolescent counseling and other related health issues, as outlined in the Nursing and Administrative Manual. E. Follow-up and/or referral services, as appropriate. 3) A,11 money received by the Contractor from the State under the Colorado Family Planning Initiative (CFPI) shall be used by the Contractor to provide contraceptive services. The Contractor shall make its program available to inen and women in their reproductive years and shall offer the following services under the CFPI: A. Utilize CFPI funding to purchase long acting reversible methods of contraception and contraceptive rings. These are limited to Intrauterine Devices (IUD) Mirena and Paraguard, contraceptive implants and contraceptive rings. B. Utilize CFPI funding to provide the referral process and cover the actual costs of tubal ligation and vasectomy procedures. C. Utilize CFPI funding for Family Planning staff to attend reproductive health related training with preference to those related to long acting reversible methods of contraception. D. Provide comprehensive family planning services to increase the total number of family planning clients receiving services (fertile clients receiving contraceptive services). E. Expand cuirent Title X Family Planning services to reduce unintended pregnancy through increased services in six pre-approved activities to include: 1) Expanding capacity; 2) Outreach; 3) Media and Marketing; 4) Training and Education; 5) Information Technology and Data Management; and 6) Other approved activities. Services are in accordance with the Agency Work Pian attached hereto as Attachment I-2. To be attached to CDPHE Page 1 of 3 Revised: 4/1/04 Version 1.0 (4/04) contract template EXHIBIT I 4) The services provided by the Contractor to the clients it serves shall be performed pursuant to law in accordance with prevailing medical standard of care for the same or similar medical, nursing and professional services. The services provided shall also coinply with applicable Title X regulations, WHU nursing-medical policies and ~ procedures, and any applicable fiscal or administrative policies of the State or Federal government which can be located at htt~//www.cdpl~e.state.co.us/~p/woinens/fampl.an.html?col2=open. Contractor acknowledges that it has reviewed these policies and procedures. 5) The Contractor shall provide the State's family planning program consultants and administrators with reasonable access to its operations to perform: periodic site reviews, data reviews, fiscal reviews or other evaluations of the Contractor's family planning program. Evaluations of the Contractor's program shall be based on established standards and policies of the State or the Federal government. The Contractor shall cooperate during all periodic site visits, data reviews, fiscal reviews or other evaluations conducted by the State. The established standards and policies for the Fainily Planning Prograin can be located in the Family Planning Administrative Manual and the Family Planning Nursing Manual located on the Family Planning website at http://www. cdphe. state.co.us/pp/womens/famplan.hhnl. 6) If necessary, the Contractor shall comply with all recommendations made by the State's family planning program consultants and/or administrators after a periodic site visit, data review, fiscal review or other evaluations that are necessary to bring its program into compliance with all applicable federal and state laws, policies and regulations. The Contractor shall be in full compliance with a recommendation, if any, within three (3) months of the date a recommendation is made by the State. If the Contractor cannot obtain full compliance within this three (3) inonth period, then on or before the expiration date of thaYthree (3) inonth period the Contractor shall present sufficient written evidence to the State: to show that continuing progress is being made towards full compliance; and, the date when full compliance shall occur. In no event, however, shall full compliance with a recommendation occur any later than six (6) months after the date that a recommendation was initially inade by the State. Notwithstanding the foregoing provisions, the State may disregard these cure periods and immediately terminate the contract without liability if it has solely determined that Contractor's noncompliance places the health, safety or welfare of persons receiving services in jeopardy. 7) During the term of this Contract, the Contractor agrees to provide the State with the semi-annual Family Planning Expenditure/Revenue Reports. The Expenditure/Revenue Report (ERR) is located on pages 19-21 in the Financial Management Section of the Fainily Planning Administrative Manual, this information can also be accessed online on the CDPHE Family Planning website at ' http://www.cdphe.state.co.us/~/womens/fa~nplan.htii~l. The first report is for the months of October to December will be due no later than February 5. January through June and will be due no later than August 6. 8) The Contractor shall protect the confidentiality of all client records and other materials that are obtained, created, or maintained by the Contractor under this contract. Except for purposes directly related to the administration of this contract, no information about, or obtained from, any client shall be disclosed by the Contractor in any form that would identify that client without the prior written consent of that client. As of the acceptance date of this contract by the Contractor, the Contractor shall have written policies governing the access to and, the duplication and dissemination of, all such information. The Contractor shall advise its directors, officers, employees, agents, servants, and subcontractors, if any, that they are subject to these confidentiality requirements. 9) Maintenance of Effort (MOE) Colorado Family Planning Initiative fiznding is expected to provide new funding for providing services to additional family planning clients and increasing the total number of clients utilizing efficacious methods of contraception. This is a teinporary funding source, and therefore shall not be used to supplant other traditional fiinding sources. Therefore, the contractor shall show Maintenance of Effort (MOE) for revenue provided by local government as documented on the required family planning program Expenditure Revenue Reports (ERR), for the three years previous to any year in which funding froin the Colorado Family Planning Initiative To be attached to CDPHE Page 2 of 3 Revised: 4/1/04 Version 1.0 (4/04) coniract template EXHIBIT I is received. This revenue, provided by local government (county and city grants and contracts) shall be equal to, or in excess of, 90% of the average of the last 3 year's Expenditure Revenue Reports. Defmition: Maintenance of Effort (MOE) - A measure intended to preserve funding for the base program. This ensures that fiscal resources are not supplanted and that new funding creates an expansion in the program. MOE shall be determined by averaging the revenue provided by local government in the last 3 years' Expenditure/Revenue Reports (ERR) for the entity's family planning program, and then multiplying by ninety percent (90%). The result is the ininimum amount that the entity must spend in order to illustrate MOE. In an instance where there is not three years' data, MOE shall be 90% of previous two years' local government revenues from the ERR, or 95% of the last year's results, as applicable. In the case of an anomaly where local government revenue level from the previous three years' ERR varies more than 30% in any two of the three years, an explanation of the variance must be provided by the Contractor. The Family Planning Director shall use this information to decide if the anomaly should be eliminated from the calculation of the MOE level. In any year in which the Contractor will not attain MOE, according to the formula described in the definition the Contractor shall notify the Family Planning Director. Should MOE not be obtained, in special hardship cases, a Maintenance of Effort Waiver to this clause may be requested from the CDPHE Family Planning Director, in conjunction with the Women's Health Director, attached hereto as Attachment B-2. Should a Maintenance of Effort Waiver not be granted, the Colorado Family Planning Initiative funding may be reduced. 10) Funding adjustments may be made during the term of this contract. The State makes funding adjustments on this contract using a Funding Letter substantially equivalent to Exhibit D and bearing the approval of the State Controller or his designee; the funding letter shall not be deemed valid until the State Controller or his designee has approved it. 11) The services provided by the Contractor must be deemed acceptable, in good faith, by WH. For a service to be "acceptable" it must comply with all applicable: Title X regulations, WH nursing-medical policies and procedures, and any applicable fiscal and administrative policies and procedures of the State and Federal government. All applicable Title X regulations, WH nursing-medical policies and procedures, and all applicable fiscal or administrative policies of the State have been provided to the Contractor by the State as of the effective date of this Contract. 12) During the tenn of this Contract, the Contractor agrees to provide the State with quarterly reports to the Family Planning Program Coordinator. To be attached to CDPHE Page 3 of 3 Revised: 4/1/04 Version 1.0 (4/04) eontract template ' Attachment I-1 COLORADO FAMILY PLANNING INITIATIVE BUDGET ----- -- - APPLICANT; Eagle County Public Health Agency , _.. _ . . _ _ . _. . _.. __ _ FOR THE PERIOD:; July 1, 2009 - June 30, 2010 ,' ' Salary % Time CDPHE-WHU __ _ _ _ _. _ _ .. __ PLEASE ROUND ALL FIGURES TO THE NEAREST FTE ~1LY 1, 2009 - JUNE 30, 2010 DOLLAR CFPI NPlProgram Coordmator I _ _-- --- --- $ --_ 90 000.00 -- -- - --_ 0.35 / 0.45 _.. --- - $ 31,500 _... Clmic Ass~stant 1 $ 46 000.00 0.65 $ 29,900 Chmc Ass~stant I $ 46 000.00 0.65 $ 29,900 _ _ _ _ ._ ~. ~ ~ ~` ` ~ ~ ~ ' Su7a~tota~~5ala~ ~ Ex .e~?ses ~~'~~ .' `. ~; _~ ., ~ . ;,~ ~ ; . ,~ . ~. ° ~ ? ' - ~,f ~'~:~-= ~ $91,300 Frin e Benefit Rate and Ex enses ~ Tota1T'erso~nei~ enses $> - i$2,006.[?Q $91,300 CONTRACTUAL: (Independent contractor for tubal ligation, Essure - ---- vasectomy, physicians, nurse practitioners, e[c) ........._ ._ ___..-----. ...____._.. . ...------.. ._._._ ... ..__.--- -- . ._.___ ---- _ ------- -.__.---- --......_._.. .. ------- --__._- 27,497 ~- -- . Medical Office $27,497 Contraceptive Methods '; - ----- ~-----.._ ..._........_.. ...___.._.. .-------- --._...... ._....- -...... ...._..._._ ___---_. Training costs - which includes registration fees, travel) ~ ~v,7o~ 2,000 . . ... . . . _ ._.. . ... ... . . _ . .~ . _ . . . . , .. Chlamydia tests ~~~.. _ ..___.._._.__ . ._______. .-__._.._... . .___. .__.__ . ___..___ ______._ ........._._.. _..___-.- _._ Other Lab tests _ __ ___ _____, __ ______ _ Educational materials (brochures, etc) j _.,__ - - - ---------- -I- - Clinical supplies ~, ~ ------ - --- - -----__ .. . _..._..___ , --------- t--- ------- - Office operatingsupplies (papers, charts, pens, etc) ! ~ ~ . .. . . .. . ... .. . ~ . . . . . . t . . . Office expense (rent, utilities, maintenance) -. ----`- ---.-_. i ..._----- ...... . . ----- .___ . ---- _.. ----- .._---- .....-~-------~~ ------ ~ ----....__._ ______- -~----. . OTHER (Specify) - Outreach/Marketing ~ ~ ' _ - ,500 ----- - --- -J------ - , ------ -- - ------ Tot~1 af()p'earating~Xpetises ,. _ $24,463 Computers, Office furnitures) - ---- - - ------- - ---- New Site Equipment __ 143,260 Indirect rate: Indirect Ex ense ADMINISTRATIVE (10% CFPT Ex ansion Grant) ' ' ONE-TIME EXPENSE (For CFPI Expansion Grant only) ' Medical $765 $147,525 Page 1 of 1 N ~ N ~ U .i~ ~ ~ ~ F-~+ F"~ 4--~i z ~ ~--a a ~ ~ w Q ~ ~ ~ ~ ~ ~ O .~ ~ ~ W ~ 0 O N O ~ N ~ O M ~~., N ~ ~ ~ ti ~ ~~""o ~ O ~ N ~ ~ '-'~i ti ~ U ~ N bQ ~ ~ ~ N x ~ a ~ cd ~ U ~ N bA ~ ~ ~ ~ ~ ~ ~~•~ ~ ~ w ~ ~~~ •? ~ ~ L" ~, O N .:, v ~ ~ ~ ~ . ~ ~ ~ ~ ' ~ N '^" C>A ~ ~ ~ ~~ ~ ~ .F; ~ . c n , C ~ ~ ~ ~ C~A ~ ? ~ p ~ ~ ~ ~ ~ v ~ a'~ ~ o ~ ~ ~ a'~ ~ ~ ~ ' ~ ti o c~ ~ ~ . ~ .~ "a '. ~ •N W~~~~~ ~ ~ ~ '~ >, s~ ~ 'a ~ ,~ ~ . ~ ~ ~ y '~ o a ~ ~ ~ ~ ~ ~ ° ~ ~ ° ~ ~ ~ ~ ~ ~ ~ ~ 'N u a4 ~ ~ a i ~: ~ `~' o 4-+ ° --• ~ b4 ~ ~ ~ ~ o ~ ~ U r.~'+ '~ . ~ O ~ ~ ~ ~ ~ ~ '~ ct3 ~ ~ 4-r :~ O N .."'~r ~ '~, CC «3 ~ ~" ~, , ~ ~ ~-+ ~ ~ 'y.." «S U y. p '~ ~ ~n ~ ~ ~ ~ ~ L~'. ~ cd ~ ~ ¢'' ~ ~ ' ~ O .~ ~ 'U •~ W ~ ~bQ O ^ ~ 'C3 ,~~., \ CC S: ~ >, . ,~ y~ ~ ' ~ ~ ~ ~ ~ ~ ~ ~ ^ ~ ~ U ~ V ~ .D > . 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Q.+ •~ ~1i O ~+ r Q , t~ ~ V U ~"" ~" ~"' N '~>' ,.., ~ O ~ ~ ~ ~ U ~ .~ 'O ~ ~ ~ .~ ~ ~~ ~,~ ~ •~~~~~a, °'~~~, ~ ~., p, ~ ~- ~-, ~ ~ s . ~ ~ o ;~ ~ ~; ~ a~ N ~ ~ ~"~ vi ^t3 ¢+ ' ~ c~ •'" ~ •'" p S"'"' p 'd ~'1 ~ ' ~ , ~ b~lp ~ .-. cd ~'' ~ N .~~~ Q ~ ~" ^'d r, ~~ ~~~~ U O ... a~3~° ^' s~, , O ~ N ~ r-. ~ ~ Q ~ N ~ ~ ~' ~ ~ U~ Q~ O O U U N U U~i ~~ ~~ O U d' v~ ~O (~ 00 N ~ ~--~ ~" ~ ~ ~ U ~ ~--~ ~--~ ~ N ~+-i O N N bA cd ~ ~ , TERM SHEET 1) 2) 3) 4) 5) 6) Requested hearing date: 06/02/09 or ~ ~ For Countv Manager signature?: No I Requesting department: Department of Public Health Title: Colorado Family Planning Initiative Expansion Grant, Contract Amendment #2 Check one: Consent: X On the Record: Staff submitting: Becky Larson 7) Pur ose: These dollars were provided to the Colarado Department of Public Health and Environment by a private donor, for the purpose of expanding Family Plannin~ services statewide. This is year 2 of the grant award. These new dollars will be used to pay for equipment, training, supplies, and two clinic assistants, which are new positions to Public Health, approved by the BOCC on 2/2/09. 8) Schedule: This Amendment #2 is for the time period 07/O1/09-06/30/10. 9) Financial considerations: This contract, in the amount of $147,525, runs through the state fiscal year of June 30, 2010. 10) Other: 1 ~~~r , ~ i> ~~~c ~~~~-~~-~ (~ , l~ ~~ ~ ~ ~ ~ ~ r, ,~~~~e ~~~ , - ~' _4 ~ r. G ~~..~ ~^~' .~. E m ~s~ ~9 < < ~ ~. ~ , o d~ 'r~~ ~-~ ~~a:=.~9 i ~ ~.~.~..~~ ~~ ~ ~ ~ ~' ~ ~-~~~ -~ ~ ~ ~\ , ~~ ~ APP A FORM By~ Eagle County Attorney's Office B~I: _ p~ ~ oU~ty O~lt~ ~~ ~n~P~" C~ffiee