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HomeMy WebLinkAboutC11-384 Immunization Program Core Services Contract STATE OF COLORADO John W. Hickenlooper, Governor Christopher E. Urbina, MD, MPH c° < Executive Director and Chief Medical Officer Dedicated to protecting and improving the health and environment of the people of Colorado * 1 ® 4300 Cherry Creek Dr. S. Laboratory Services Division * 1 Denver, Colorado 80246 -1530 8100 Lowry Blvd. � Phone (303) 692 -2000 Denver, Colorado 80230 -6928 Colorado Department Located in Glendale, Colorado (303) 692 -3090 of Public Health http: / /www.cdphe.state.co.us and Environment Colorado Department of Public Health and Environment Immunization Program General Immunization Core Services Contract Statement of Work Term: January 1, 2012 through December 31, 2012 For the BOARD OF COUNTY COMMISSIONERS OF EAGLE COUNTY, (a political subdivision of the State of Colorado), for the use and benefit of EAGLE COUNTY PUBLIC HEALTH AGENCY, hereinafter referred to as the "Contractor." To best meet the immunization needs of the citizens of Colorado and to ensure immunization best practices are provided around the state, contractors shall use this funding to augment any of the following activities: • Collaborate with community leaders to work toward formulating policies designed to solve local immunization access issues. • Follow the Standards for Child and Adolescent Immunization Practices (CDC, 2006) to assure all populations have access to appropriate immunization services and evaluate the effectiveness of the services provided. • Promote, educate, and support providers regarding the value of active participation in reminder /recall activities. • Conduct onsite clinical services with optimal access such as non - traditional clinic access, "express lane" or drop -in appointments, and use incentives to encourage completion of children's primary immunization schedule. • Develop and follow appropriate procedures for vaccine storage and handling with appropriate clinic equipment and implement written policies and procedures for vaccine storage, vaccine ordering, and emergency response. Utilize up -to -date written protocols and have them readily accessible at all locations where vaccines are administered, and ensure all persons who administer vaccines and staff who manage or support vaccine administration are knowledgeable and receive ongoing education. • Provide support for immunization initiatives through the Colorado Supplemental Nutrition Program - Women, Infants, and Children (WIC) by providing vaccinations on site, assessing immunization histories, and referring children appropriately and/or distributing educational materials regarding immunizations and locally available services. 1 BUDGET: In consideration of those services satisfactorily and timely performed by the Contractor under this Purchase Order the State shall cause to be paid to the Contractor a sum not to exceed Seventeen Thousand Forty -Four Dollars ($17,044.00). Of the total financial obligation of the State referenced above, $17,044.00 is identified as attributable to a funding source of the United States government through the Centers for Disease Control Notice of Cooperative Agreement Award number H23/CCH822564 -05 -1, (C1-DA# 93.268) and $0.00 is identified as attributable to a funding source of the state of Colorado. Reimbursement under this Purchase Order shall be made to the Contractor by the State in four (4) payments of $4,261.00 each. Accordingly, the Contractor shall be paid one fourth (1/4) of the Statt 's''aa financial obligation under this Purchase Order in March, June, September, and December . The (4 final payment for this Purchase Order is contingent upon the State's timely receipt of the annual Contract Reimbursement Certification form from the Contractor, attached hereto as Attachment A, which is incorporated herein by this reference. Contractors receiving these 2012 General Immunization Core Services funds agree to abstain from charging an office visit fee in addition to the allowable vaccine administration fee. The Contractor shall submit an online Immunization Program progress report to the State. The progress report is due within fifteen (15) calendar days of the end of the reporting period. This progress report shall document the Contractor's progress towards completion of the activities described herein. The Contractor's December payment shall not be reimbursed by the State until the requisite progress report is submitted to the State by the Contractor. Reporting period and progress report due dates are as follows: Progress Period Due Date January 1, 2012 - June 30, 2012 July 15, 2012 July 1, 2012 - December 31, 2012 January 15, 2013 Throughout the 2012 funding period, the CDPHE Immunization Program will conduct ongoing project monitoring and provide technical assistance, as needed. In the event that project performance does not meet the agency's stated goals, a follow -up work plan will be created and additional technical assistance will be provided. In an extreme situation, and in consultation with the agency, the CDPHE Immunization Program reserves the right to reduce or withhold quarterly payments due to poor project performance. Thank you for your cooperation and support. If you have any questions, please contact me at 303 -692- 2314, Teri Lindsey at 303 - 692 -2732 (teri.Lindsey @state.co.us), or Lynn McCracken at 303 - 692 -2447 (lynn.mccracken@state.co.us). Sincerely, Beth Hoffman Fiscal Manager Immunization Program Phone: (303) 692 -2314 Fax: (303) 691 -6118 Beth.hoffman @ state.co.us 2 EAGLE COUNTY PUBLIC HEALTH AGENCY total for calendar year 2012 = $17,044.00 LOCAL HEALTH PARTNER acceptance of GENERAL IMMUNIZATION CORE SERVICES requirements: I, . 1IJ1t MUNi , on behalf of R.' U hereby acknowledge that the requirements for the Immunization Services statementlof work described above have been reviewed, and are accepted and agreed to. I further acknowledge that I have the necessary authority to sign this acceptance on behalf of the entity mentioned above. Si ; • gee Title D. e 3 O F COQ r ° COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT IMMUNIZATION PROGRAM 1876 Colorado Department of Public Health 2012 CONTRACT REIMBURSEMENT CERTIFICATION FORM and Environment Please return by January 15, 2013 RE: General Immunization Core Services Contract TO: Lynn McCracken /Teri Lindsey Colorado Department of Public Health and Environment 4300 Cherry Creek Drive South, DCEED -IMM -A3 Denver, Colorado 80246 Fax: 303 - 691 -6118 FROM: Tax ID #: PROJECT PERIOD: January 1, 2012 through December 31, 2012 This is to certify that the contract services have been performed per Contract Routing Number: for the period stated above. SIGNATURE: Contractor or Authorized Designee Date For CDPHE staff to complete: I hereby certify that all contract requirements have been met and final payment of $ for contract services for the period of January 1, 2012 through December 31, 2012 is authorized. SIGNATURE: Program Director or Authorized Designee Date