HomeMy WebLinkAboutC09-208 HHS Contract Amendment Traumatic Brain Injury• •
STAT~, OF COLOIZADO
Bill Ritter, Jr., Governar
James B. Martin, Executive Director
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr. S. Laboratory Services Division
enver, o o~ac7o-8024~~330 -8100 Cowry v.
Phone (303) 692-2000 Denver, Colorado 80230-6928
TDD Line (303) 691-7700 (303) 692-3090
Located in Glendale. Colorado
http://www.cdphe.state.co. us
WORK STATUS CONFIRMATION LETTER
Vendor Name:
OF COC
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Colorado Department
of Public Health
and Environment
Contract Routing Number: ~O~' ~a~q g
CRS §24-30-202 requires the State Controller to approve all State Contracts. The above referenced Amendment is not valid
until it is signed and dated below by the State Controller or delegate. Therefore, your agency is not authorized to begin
performance until you are notified that it's signed. If your agency begins performing Contract tasks prior to that date, the
State of Colorado is not obligated to pay your agency for such performance or for any goods and/or services provided prior to
the date signed.
By signing below, your confirm that (Signature MUST be that of the person signing the Contract)
a) No work has been performed under this contract
b) No work will begin under this contract until the contract is signed by the State Controller ar on the effective
date, whichever is later.
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Signature of uthorized Officer
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Print N e of Authorized Officer
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Da~ Signed
RETURN THIS LETTER TO:
Natalie Ordonez-Campbell, Contracts Manager
Colorado Department of Public Health & Environment
Center far Healthy Families & Communities, Fiscal
Services Unit
4300 Cherry Creek Drive South
PSD-CHFGA4
Denver, CO 80246-1530
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DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLICHEALTH AND ENVIRONMENT
PSD - TBI
DEPARTMENT OR AGENCY NUMBER
FLA
CONTRACT ROUTING NUMBER
10-00298 ~
CONTRACT AMENDMENT #1
THIS AMENDMENT, made this lst day of Mav, 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 referred to as "the
State"; and, BOARD OF COUNTY COMMISSIONER5 OF EAGLE COUNTY,(a uolitical subdivision of the
state of Coloradol, whose address or principal place of business is 500 Broadwav. Eaele, CO 81631-0850 for the
use and benefit of the EAGLE CODUNTY PUBLIC HEALTH AGENCY, formerly known as EAGLE
COUNTY HEALTH AND HUMAN SERVICES whose address or principal place of business is 551 Broadwav,
Ea~le, CO 81631, 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 Master Contract, dated Januarv 23, 2007, with contract routing number 08 FAA 00016.
Pursuant to the terms and conditions of the Approved Task Order Contract, the parties entered into a Task Order
Contract, dated Au~ust 10, 2007, with contract encumbrance number PO FLA HCP090000001, and contract
routing number 09 FLA 00111, whereby the Contractor was to provide to the State the following:
Working in partnership with the State and other local agencies to provide care coordination
for families who have children with Traumatic Brain Injury (TBI) and are enrolled in the
TBI Trust Fund Program.
The purpose far this amendment is described below.
To renew the contract for one year, to modify the Statement of Work and to incorporate a new
provision to the General Provisions of the Limited Amendment 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 Apri18, 2008, with contract
routing number 09 FLA 00111 and contract encumbrance PO FLA HCP090000001, consists of the
payments which shall be made pursuant to this amendment and the promises and agreements herein set
forth.
Page t of 4 rev 4/3/09
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2. It is expressly agreed to by the parties that this Amendment is supplemental to the original limited
amendment task arder contract, contract routing number, 09 FLA OOll 1, referred to herein as the Original
Task Order Contract, 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.
3. 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 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 ariginal contract is hereby changed from EAGLE COUNTY HEALTH AND HUMAN
SERVICES 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 ariginal 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 Amendment is issued pursuant to paragraph 5. of the Original Task Order Contract identified
by contract routing number 09 FLA OOll 1. This Amendment is for the renewal term of Julv 1,
2009, through and including June 30, 2010. The revised specification to the original Statement
of Work for this renewal term is incorporated herein by this reference and identified as Exhibit E.
B. 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 requirements of
such obligations and shall include factors tailored to match the requirements of the Statement of
Project of this Task Order Contract. Such performance information shall be entered into the
statewide Contract Management 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
term. Contractor shall be notified following each performance and shall address or correct any
identified problem in a timely manner and maintain work progress.
Should the fmal performance evaluation determine that Contractor demonstrated a gross failure to
meet the performance measures established under the Statement of Project, the Executive Director
of the Colorado Department of Personnel and Administration (Executive Director), upon request
by the Colarado Department of Public Health and Environment, and showing of good cause, may
debar Contractor and prohibit Contractor from bidding on future contracts. Contractor may contest
the final 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 Task Order Contract are reaffirmed.
Page 2 of 4 rev 4/3/09
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4. The effective date of this amendment is upon approval of the State Controller or Julv 1, 2009, whichever is
later.
Except far the "Special Provisions", in the ev,ent 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 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 3 of 4 rev 4/3/09
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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:
BOARD OF COUNTY COMMISSIONERS OF
EAGLE COUNTY, (a political subdivision of the
State of Colorado) for the use and benefit of the
EAGLE COUNTY PUBLIC HEALTH AGENCY
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Signature o Authorized Officer
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Print Name of Authorized Officer
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Print Title of Authorized Of~cer
STATE:
STATE OF COLORADO
Bill Ritter, Jr. Governor
By:
For the Executive Director
DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT
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 andlor 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 E
STATEMENT OF WORK
To Contract Dated May 1, 2009 - Contract Routing Number 10 FLA 00298
These provisions are to be read and interpreted in conjunction with the provisions of the
Contract specified above.
The revised Statement of Work is effective July 1, 2009.
t. Under this Task Order, the Contractor, shall provide TBI Trust Fund Program care coordination services
for families who reside in Eagle Count~
County(ies), who have children with Traumatic Brain Injury (TBI) and are enrolled with the TBI Trust
Fund Program. TBI Trust Fund Program care coordination services are defined and described in the
Health Care Proeram for Children with Special Needs (HCP) Policies and Procedures Manual available on
the HCP website: www.hcpcolorado.or~ . The manual is periodically updated and the Contractor will be
notified by email when updates/revisions are made. The Contractor is resp"onsible for complying with
any updates/revisions. The HCP Policies and Procedures Manual is incorporated and made part hereof by
reference.
The Contractor may be required to submit periodic progress reports as requested by CDPHE. This may
include an annual report, which will be due within thirly (30) day after the termination of this contract.
2. The Contractor shall use the "HCP Policy and Procedures for Care Coordination Services for Children and
Youth with Traumatic Brain Injury" section in the HCP Policies and Procedure Manual, to implement and
document the TBI Trust Fund Program,
If the State believes in good faith that an activity or service fails to meet the standard for that particular
activity or service, or is otherwise deficient, then the State shall notify the Contractor of the failure or
deficiencies in writing. Corrective action shall be addressed through a Performance Improvement Plan
(PIP) or some other method defined by the State. Due dates for completion of activities listed in a PIP will
be negotiated on a case by case basis. If the Contractor fails to correct such deficiencies, the Contractor
shall be in default of its obligations under this Contract and the State, at its option, may elect to withhold
payment or terminate this Contract.
3. The Contractor shall make available to the State or other duly authorized agent or governmental agency, for
audits and/or inspection, TBI care coordination plans and accompanying client records for whom TBI Trust
Fund services were provided, at any reasonable time during the term of this contract and for a period of
three (3) years following the termination of this contract to assure compliance with its terms, and/or to
evaluate the Contractor's performance.
4. The Contractor shall perform and complete, in a timely and satisfactory manner, all activities and services
related to this Task Order in accordance with the HCP Policies and Procedures Manual.
5. The Contractor shall work collaboratively with the State and the assigned HCP Regional Office for
consultation, technical assistance, oversight, and training for TBI Care Coordinators including TBI
Program documentation in the Health Care Program for Children with Special Needs database (the Clinical
Health Record of Patients (CHIRP) and to ensure that all HCP/CHIRP database users follow the
HCP/CHIRP database policies and procedures outlined by the State.
Page 1 of 2
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1) Requested hearin~ date: (Fir~choice) 6/30/2009 (S~ond choice) 7
2) For County Mana~er si~~4ature: ~
3)
4) Title: Colorado Departm~t of Public Health and Environment TBI Contract
Amendment to Task Order Contract ~~d ~- ~ t~~~'g ~ ~
5) Check one: N/A Consent: On the Record:
6) Staff submittin~: Becky Larson, Epidemiologist
7) Purpose: This Task Order, from the Colorado Department of Public Health and
Environment, provides funds for the Eagle County Department of Public Health
to coordinate care to eligible families who have children with traumatic brain
injuries (TBI) and enrolled in the TBI Trust Fund Program.
8) Schedule: The task order is for the state FY 2010: July 1, 2009 - June 30,
2010.
9) Financial considerations:
This task order is based on a cost-reimbursement method where by Eagle County
is paid $320 for an initial care coordination plan, and then $80 per month for
which the child receives care coordination. In state FY 2008-2009, Eagle County
provided care coordination and received payment for one child.
9) Other: ~~~EIVED
JUN 2 6 2009
EAGLE COUNTY ATTORNEY
~P -~AS TO FORM
By:
Eagle County Attomey's Office ~
By~ Eagle County Commissloners' Office
Please return executed contract and copies to Kym Iglesias in HHS. 970-328-8847.
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• EXHIBIT E
6.. The Contractor shall attend a required HCP Gare Coordinator training and new Web-Based CHIRP
training during_the contract year.
7. The Contractor shall follow the HCP/CHIRP security policy and procedures outlined by the State and
assure that a"Data Security Use and Confidentiality Agreement" is signed by each user.
9. The Contractor shall attend regional teleconferences, meetings, and/or videoconference meetings, that the
Region and State may organize, to address priority TBI needs, promote TBI education, and increase skills
as TBI Care Coordinators.
10. The Contractor shall participate, in conference calls, site visits, and meetings with the Region and State, as
requested, to ensure that the program planning, evaluation, and monitoring requirements as described in
this Task Order and Exhibits are met.
11. The Contractor may be required to submit periodic progress reports as required by CDPHE. This may
include an annual report, which will be due within thirty (30) days after the termination of this contract.
12. If the State believes in good faith that an activity or service fails to meet the standard for that particular
activity or service, or is otherwise deficient, then the State shall notify the Contractor of the failure or
deficiencies in writing. Corrective action shall be addressed through a Performance Improvement Plan
(PIP) or some other method defined by the State. Due dates for completion of activities listed in a PIP will
be negotiated on a case by case basis. If the Contractor fails to correct such deficiencies, the Contractor
shall be in default of its obligations under this Contract and the State, at its option, may elect to withhold
payment or terminate this Contract.
Page 2 of 2
