HomeMy WebLinkAboutC09-421 Special Needs Contract (Rtng 10.3357)DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
PSD-HCP
DEPARTMENT OR AGENCY NUMBER
FLA
CONTRACT ROUTING NUMBER
10-3357
CONTRACT AMENDMENT #1
THIS AMENDMENT, made this 1st day of August, 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 Cherry Creek Drive South, Denver, Colorado 80246, hereinafter referred to as "the
State"; and, BOARD OF COUNTY COMMISSIONERS OF EAGLE COUNTY, (a political subdivision of the
state of Colorado), whose address or principal place of business is 500 Broadwav, Eagle, CO 81631-0850, for
the use and benefit of the EAGLE COUNTY PUBLIC HEALTH AGENCY, formerly known as EAGLE
COUNTY HEALTH AND HUMAN SERVICES, whose address or principal place of business is 551 Broadwav,
Eagle, 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 January 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
August 10, 2007, with contract encumbrance number PO FLA HCP0800343, and contract routing number 08 FLA
00343, whereby the Contractor was to provide to the State the following:
Working in partnership with other community organizations, facilitate in the development and
enhancement of community-based systems of care for children with special health care needs
population.
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 10, 2007, with contract
routing number 08 FLA 00343, and contract encumbrance PO FLA HCP0800343, 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 08 FLA 00343, as amended by Limited Amendment #l, Contract
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~`~~'~~l
Routing Number 09 FLA 00596 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
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 January 23, 2007. The Contractor's legal name
in the original 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 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 Amendment is issued piu•suant to paragraph 5. of the Original Task Order Contract identified
by contract routing number 08 FLA 00343. This Amendment is for the renewal term of October
1, 2009, through and including September 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 D.
C. The maximum amount payable by the State for the work to be performed by the Contractor during
this renewal term is Thirteen Thousand, Six Hundred Twenty-Two Dollars, ($13,622.00) for
an amended total financial obligation of the State of FORTY THOUSAND, EIGHT HUNDRED
SIXTY-SIX DOLLARS, ($40,866.00). This is an increase of Thirteen Thousand, Six Hundred
Twenty-Two Dollars, ($13,622.00) 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 E.
D. 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 X24-102-205, §24-102-206, §24-103-601, §24-103.5-101 and X24-105-102
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
teen. 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 final 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 Colorado Department of Public Health and Environment, and showing of good cause, may
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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 X24-105-102(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.
4. The effective date of this amendment is upon approval of the State Controller or October 1, 2009,
whichever is later.
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 df 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.
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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, for the use and benefit of
the EAGLE COUNTY PUBLIC HEALTH
AGENCY (a political subdivision of the
state of Colorado)
STATE:
STATE OF COLORADO
Bill Ritter, Jr. Governor
By:
Signatut~e of Authorized Officer
~. _~ r - -
~ U ~ I ~~ ,: ~ ,~ .
Print Name of Authorized Officer
Print Title of Authorized Officer
ec~~,ultc~, _
~pu~u~,,~ C~,,x~v~u ~~ ~~er~
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 and/or services provided hereunder.
STATE CONTROLLER
David J. McDermott, CPA
By:
^Kevin Edwards ^Yvonne Anderson ^Robert Jaros ^Donald Rieck
Date:
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EXHIBIT D
ADDITIONAL PROVISIONS
To Contract Dated 08/01/2009 -Contract Routing Number 10 FLA 3357
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 October 1, 2009.
The United State Department of Health and Human Services ("HHS"), through the Maternal and Child
Health Services Block Grant (MCH) has awarded the State Title V federal funds under Notice of Grant
Award ("NGA) number B04MC04248 (See, Catalog of Federal Domestic Assistance ("CFDA") number
93.994). The State's Prevention Services Division (PSD) is charged with the administration of funds from
the Title V MCH Block Grant to improve the health and well being of the maternal and child/children with
special needs populations through assessing population needs and coordinating/implementing best practices
and evidenced-based programs.
The authority for the administration of the Title V MCH Block Grant, including the maternal, child and
children with special health care needs resides in Title V of the Social Security Act, §§ 501-509.
Each state that receives MCH funds from the HHS must demonstrate to the HHS that it has served the
distinct population group of children with special health care needs (CSHCN)which is defined to include
infants, children, and adolescents from birth through age twenty (20); and, which is defined as those
children who have, or are at increased risk for a chronic physical, developmental, behavioral, or emotional
condition and who also require health and related services of a type or amount beyond that required by
children generally.
The State has formulated a comprehensive statewide plan to carry out a CSHCN Program, funded by Title
V MCH dollars and state general funds. As part of the comprehensive plan, it is the express intent of the
state to support local public health agencies in contributing to a coordinated, efficient statewide program
which focuses on specific MCH performance measures set by the MCH state and Federal agencies. Local
public health agencies, working in partnership with other community organizations, facilitate the
development and enhancement of community-based systems of care for CSHCN. The goal of these systems
is to ensure that families with CSHCN have access and ease of use for direct care services, as well as,
enabling and population-based services.
If the underlying Award authorizes the State to pay all allowable and allocable expenses of a contractor as
of the effective date of that Award, then the State shall reimburse the Contractor for any allowable and
allocable expenses of the Contractor that have been incurred by the Contractor since the proposed effective
date of this Contract. If the underlying Award does not authorize the State to pay all allowable and
allocable expenses of a contractor as of the effective date of that Award, then the State shall only reimburse
the Contractor for those allowable and allocable expenses of the Contractor that are incurred by the
Contractor on or after the effective date of this Contract, with such effective date being the later of the date
specified in this Contract or the date the Contract is signed by the State Controller or delegee.
In consideration of those CSHCN services, set forth in Exhibit A satisfactorily and timely performed by the
Contractor under this contract, the State shall cause to be paid to the Contractor a sum not to exceed
THIRTEEN THOUSAND SIX HUNDRED AND TWENTY-TWO DOLLARS ($13,622.00). Of the
financial obligation for CSHCN services, SIX THOUSAND, ONE HUNDRED AND THIRTY
DOLLARS ($6,130) are identified as attributable to a finding source of the federal government and,
SEVEN THOUSAND FOUR HUNDRED AND NINETY-TWO DOLLARS ($7,492) are identified as
attributable to a funding source of the state of Colorado.
To receive compensation under this Contract, the Contractor shall submit a signed Quarterly or Monthly
Contract Reimbursement Statement in a format acceptable to the State. The Contractor shall declare; the
frequency with which they plan to submit their Contract Reimbursement Statement in writing by the
beginning of the contract period. A Contract Reimbursement Statement is incorporated and made part if
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EXHIBIT D
part herein. The Contract Reimbursement Statement is available at www.h~colorado.orQ. A Contract
Reimbursement Statement must be submitted within sixty (60) calendar days of the end of the billing
period for which services were rendered. Contract Reimbursement Statements must be accompanied by a
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 E. These iterns inay include, but are
not limited to, the Contractor's salaries, fringe benefits, supplies, travel, operating, allowable indirect costs,
and other allocable expenses related to its performance under this Contract.
Contract Reimbursement Statements shall: 1) reference this Contract by its contract routing number, which
the number is located on page one of this Contract; 2) state the applicable performance dates; 3) state the
names of payees; and, 4) show the total requested payment. Payment during the term of this Contract shall
be conditioned upon affirmation by the State that all services were rendered by the Contractor in
accordance with the terms of this Contract. Contract Reimbursement Statements shall be sent via email to:
CSHCN Fiscal Officer
Prevention Services Division
Colorado Department of Public Health and Enviromnent
PSD - A4
4300 Cherry Creek Drive South
Denver, CO 80246
To be considered for payment, billings for payments pursuant to this Contract must be received within a
reasonable tune after the period for which payment is requested, but in no event no later than sixty (60)
calendar days after the relevant performance period has passed. Final billings under this Contract
must be received by the State within a reasonable time after the expiration or termination of this Contract;
but in no event no later than sixty (60) calendar days from the effective expiration or termination date of
this Contract. Contractors may not receive payment for billings that exceed sixty (60) the calendar day
period.
The Contractor shall not use federal funds to satisfy federal cost sharing and matching requirements unless
approved in writing by the appropriate federal agency.
4. Contractor shall retain and use all revenues generated by Health Care Program for Children with Special
Needs (HCP) for services in HCP.
5. Title V, Section 504 (b) (6). Title V funds may not be used to pay for any item or service (other than an
emergency item or service) furnished by an individual or entity convicted of a criminal offense under the
Medicare or any State health care program (i.e., Medicaid, Maternal and Child Health, or Social Services
Block Grant Programs).
The 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 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
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EXHIBIT D
any subcontracts which contain provisions for children's services and that all contractors shall sign and
agree accordingly.
The Contractor certifies, to the best of its knowledge and belief, that no federally appropriated funds have
been paid or will be paid by or on behalf of the Contractor, to any person for influencing or attempting to
influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in connection with the awarding of this contract, and
the extension, continuation, renewal, amendment, or modification of this contract, or any grant, loan, or
other cooperative agreement that utilizes Federal funds. If any funds other than federally appropriated funds
have been paid or will be paid to any person for influencing or attempting to influence an officer or
employee of any agency, Member of Congress, an officer or employee of Congress in connection with this
contract, or any other grant, loan, or other cooperative agreement, then the Contractor shall complete and
submit Standard Form - LLL, "Disclosure Form to Report Lobbying" in accordance with its instructions.
The Contractor shall require that the language of this certification be included in the award documents for
subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative
agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material
representation of fact upon which reliance was placed when this transaction was rnade or entered into. This
certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31,
U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not
less than $10,000 and not more than $100,000 for each such failure.
The Contractor shall not charge for services those individuals of families at or below the official poverty
guidelines, updated periodically in the Federal Register by the U.S. Department of Health and Human
Services Lmder the authority of 42 U.S.C. 9902(2), in accordance with Title V, Section 501 (1) (B) and
Section 505 (5) (D). The most current version of this document is available on the HCP website:
www.hcpcolorado.org. If the State receives new poverty guidelines from the DHHS during the term of this
Contract, then the State shall immediately update the guideline on the HCP website. The Contractor shall
use these new poverty guidelines, if any, upon receipt thereof from the State.
9. If any charges are imposed for services to clients who are above the one hundred percent (100%) of
poverty level, such charges must be on a sliding scale which takes into account the client's family size,
income and resources. These charges and the sliding fee scale must be made available to the general public
and to all clients and must be based on the agency's usual and customary cost for the service. Clients must
understand they shall not be denied services for inability to pay any of the sliding fee charges.
10. The Contractor shall protect the confidentiality of all applicant or recipient records and other materials that
are maintained in accordance with this contract. Except for purposes directly connected with the
administration of this contract, no information about or obtained from, any applicant or recipient shall be
disclosed in a form identifiable with the applicant or recipient without the prior written consent of the
applicant or recipient, or the parent or legal guardian of a minor applicant or recipient with the exception of
information protected by Colorado statute as it applies to confidentiality for adolescent services in which
case the adolescent minor and not the parent or legal guardian must provide consent or, as otherwise
properly ordered by a court of competent jurisdiction. The Contractor shall have written policies governing
the access to, and duplication and dissemination of, all such information. The Contractor shall advise its
employees, agents, servants, and subcontractors, if any, that they are subject to these confidentiality
requirements.
11. 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, or
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 from 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
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EXHIBIT D
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.
12. The services or activities under this Contract may be carried out by the Contractor, or through subcontracts
with other providers or, through collaborative partnerships with other community partners. The State
authorizes the Contractor to subcontract some, or all, or the services that are to be performed tinder this
Contract. However, a subcontractor is subject to all of the terms 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 tinder 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 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.
13. Notwithstanding anything herein to the contrary, the parties understand and agree that all terms and
conditions of this contract and the exhibits and attachments hereto which may require continued
performance, compliance or effect beyond the termination date of this 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.
14. The State tnay require forms attached to this contract and incorporated herein by reference be updated
during the term of this contract. The Contractor will be informed of the new forms as they are developed.
Forms may be sent to contractors or will be available on the CDPHE Maternal and Child Health website:
www mchcolorado orV or the HCP website: www.hcpcolorado.ortr.
15. The State may increase or decrease funds available under this Contract using a Grant Funding Letter
substantially equivalent to Exhibit F. The Grant Funding Letter is not valid tmtil it has been approved by
the State Controller or designee.
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EXHIBIT E
STATEMENT OF WORK
To Contract Dated 08/01/2009 -Contract Routing Number 10 FLA 3357
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 October 1, 2009
1. Contractor shall provide outreach to families and CSHCN, HCP Care Coordination
within a Medical Home approach and collaborate with community partners to assure
that community resources and services are easy to use for families with children with
special health care needs (CSHCN).
2. Contractor shall provide the core public health services of assessment, policy
development, and assurance on behalf of the CSHCN population as described and
defined in the "Core Public Health Services Delivered by MCH Agencies" a
component of the County Nursing Service (CNS) Guidelines for Maternal and Child
Health (MCH) Services.
3. The CNS Guidelines are available on the MCH website, www.mchcolorado.or~ and
the Health Care Program for Children with Special Needs (HCP) website,
www.hcpcolorado.or~. The guidelines are periodically updated and the Contractor
will be notified by email when updates/revisions are made. The Contractor is
responsible for complying with any updates/revisions. The MCH Guidelines are
incorporated and made part hereof by reference.
4. The Contractor shall perform and complete, in a timely and satisfactory manner, all
reporting related to this Task Order Contract in accordance with the MCH Guidelines.
All services and activities related to this Task Order are in accordance with The
Health Care Program for Children with Special Needs (HCP) Policy and Procedures,
HCP Guidance, HCP CHIRP User Guide and Medical Home Action Guide available
on the HCP website: www.hcpcolorado.org.
5. The Contractor shall contribute to the HCP Regional Office's Plan for CSHCN.
Contributions shall consist of, but are not limited to, completing requests from the
HCP Regional Office to provide county specific data related to county services,
resources and needs of the county CSHCN population.
6. The Contractor shall work with the State's delegated HCP Regional Office (RO) staff
for orientation and training of new staff; consultation and technical assistance on HCP
Guidance and Procedures, outreach, Medical Home approach, ease of use for
community systems, and community needs assessment activities; ensuring adequate
and timely communication with the HCP Regional Office team and meeting at least
once annually with HCP RO staff.
7. The Contractor shall work with the State's delegated HCP Regional Office (RO) staff
for consultation, technical assistance, oversight and training on documentation in
HCP CHIRP data base and to ensure that all database users follow the HCP/CHIRP
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EXHIBIT E
procedures in the HCP CHIRP User Guide and HCP Guidance which are available on
the HCP web site: www.hcpcolorado.or~.
8. The Contractor shall follow the HCP/CHIRP Security policy and procedures outlined
in the CHIRP User Guide and Data Security Use and Confidentiality Agreement
signed annually by each user.
9. The HCP/CHIRP database, as provided by HCP, shall be used to document the
contractor's core HCP strategies: care coordination and collaboration with partners
for easy to use community services and resources as described in the HCP CHIRP
User Guide and HCP Guidance on the HCP web page: www.hcpcolorado.org.
10. The Contractor shall attend teleconferences, meetings, and/or HCP training that the
state and regional office may organize to address priority HCP strategies and increase
skills as HCP practitioners.
11. The Contractor shall participate in activities in conjunction with the State to ensure
that program activities, reporting and monitoring requirements as described in this
Task Order and Exhibits and Attachments are met.
12. The Contractor shall provide State HCP staff and other State administrators with
reasonable access to its operations to perform: periodic site visits, data reviews, fiscal
reviews or other evaluations of the contractor's program. The contractor shall
cooperate during all periodic site visits, data reviews, fiscal reviews and other
evaluations or audits conducted by the State.
13. The Contractor shall provide all requested records regarding recipients for whom
services were provided under this Task Order Contract.
14. The Contractor shall complete HCP questions on the Office of Planning and
Partnerships (OPP) Annual Reporting Template to report how HCP Funding is being
used for care coordination, improving communication with primary care and
improving community resources and services for CSHCN. This annual report is
submitted to the Office of Planning and Partnerships (OPP), upon request from OPP.
15. The Contractor shall submit to Office of Planning and Partnerships (OPP) but not
limited to, the following reports, incorporated by reference. These documents,
including instructions for completion and submission are available in the MCH
Guidelines located on the MCH website: www.mchcolorado.or~:
• Number of Individuals Served (Unduplicated) Under Title V Report
• Table I Number of Individuals Served (Unduplicated)
• Core Public Health Services Form
16. The Contractor shall utilize CSHCN and their families as the consumer voice when
serving CSHCN population by referencing to the national outcome measures,
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Medical Home Action Guide and HCP Guidance available on the HCP web site:
www.hcpcolorado.org.
17. The Contractor shall follow HCP Clinic Guidance and the HCP Specialty Clinics
Physician Guide located on HCP web site: www.hc~colorado.or~, when referring to
HCP Specialty Clinics.
18. 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.
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Exhibit F
SAMPLE GRANT FUNDING CHANGE LETTER
Date: State Fiscal Year: Grant Fundin Chan a Letter # CLIN Routin #
TO: Insert Grantee's name
In accordance with Section of the Original Contract routing number between the State of
Colorado, Department of Public Health and Environment and Contractor's Name beginning Insert start
date and ending on Insert ending date, the undersigned commits the following funds to the Grant:
The amount of grant funds available and specified in Section is ^ increased or ^ decreased by
$amount of change to a new total funds available of $ for the following reason: .Section
is hereby modified accordingly.
This Grant Funding Change Letter does not constitute an order for services under this Grant.
The effective date of hereof is upon approval of the State Controller or ,whichever is later.
STATE OF COLORADO
Bill Ritter, Jr. GOVERNOR
Department of Public Health and Environment
PROGRAM APPROVAL:
By: Lisa Ellis, Purchasing & Contracts Unit Director BY~
Date:
ALL GRANTS REQUIRE APPROVAL BY THE STATE COlS'TROLLER
CRS §24-30-202 requires the State Controller to approve all State Grants. This Grant is not valid until signed and dated below by
the State Controller or delegate. Grantee is not authorized to begin performance until such time. If Grantee begins performing prior
thereto, the State of Colorado is not obligated to pay Grantee for such performance or for any goods and/or services provided
hereunder.
STATE CONTROLLER
David J. McDermott, CPA
By:
Donald Rieck
Date:
