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HomeMy WebLinkAboutC13-098 Public Health Technical Assistance Pilot Project EAGLE COUNTY HEALTH AND HUMAN SERVICES
I. Project Description: Public Health Technical Assistance Pilot Project
Conduct a pilot project to increase the number of primary health care provider practices in Eagle County
that offer high quality immunizations as a routine part of primary patient care. This will be done by
implementing a public health technical assistance program to provide training, policy development and
adherence, regular on -site technical assistance, reminder /recall implementation, and patient population
immunization status assessment for two participating primary care provider practices.
Funding Period: May 15, 2013 through May 14, 2014.
II: Performance Requirements/Deliverables:
Work is not to begin on the proposed project until the grantee receives an approved purchase order
from the CIS.
a) Quarterly online progress reports will be completed using this link:
http:// fs9. formsite .com/ColoradolMMprogram/EaglePH TA_PilotProject /index.html
b) Online report due dates are:
April -June 2013 due July 15, 2013
July -Sept 2013 due Oct 15, 2013
Oct -Dec 2013 due Jan 15, 2014
Jan-April 2014 due April 15, 2014
c) A final, comprehensive evaluation report will be due by May 15, 2014. The link will be provided.
Goal 1 Assure children with insurance have access to high quality, age Timeline
appropriate immunizations as part of their medical home.
Objective 1 -1: Increase the number of primary health care provider practices that
offers high quality immunizations as a routine part of primary
patient care by implementing a public health technical assistance
program to provide training, policy development and adherence,
regular on -site technical assistance, reminder /recall
implementation, and patient population immunization status
assessment for two participating primary care provider practices.
Activities to 1. By June 1, 2013, research similar programs where local public May 2013
complete the health agencies provide formal and ongoing immunization rate
objective assessment, on -site technical assistance and staff training to
private health care providers to promote high quality
immunization services.
2. By July 1, 2013, assess local health care providers' needs and May- June
barriers to staff training on immunization schedules and 2013
practices, vaccine storage, implementing changes to the
recommended vaccine schedule, school immunization
requirements, and assessing immunization rates of patient
population.
0020 Eagle County Dr., Suite E I El Jebel. CO 81623 1 970.704.2.760 C10 .`' Connects �
3. By August 1, 2013, recruit one primary care provider practice, May -July
currently not offering immunizations to patients, to partner with 2013
Eagle County Public Health to pilot immunization technical
assistance program.
4. By September 1, 2013, develop a LPHA technical assistance May -Aug
program model based on research and provider assessment. 2013
5. By September 1, 2013, develop a process and outcome May -Aug
evaluation plan to evaluate effectiveness of program. 2013
6. By October 1, 2013 implement a 6 month pilot program with Aug -Sept
ongoing evaluation in one primary care practice, currently not 2013
offering immunizations.
7. By April 30, 2014, complete process evaluation of pilot Mar -April
program and report findings and recommendations to primary 2014
care providers and key stakeholders.
Reporting Activity #1 deliverable: List of local public health agencies researched with
Requirements/ summary of programs offered to promote high quality immunization services.
Deliverables Activity #2 deliverable: Summary of the information collected from the local health
care providers.
Activities #4 and #5 deliverables: Submit the technical assistance program model
developed with the subsequent process and outcome evaluation plan.
Activity #7 deliverable: By June 30, 2014 submit the final process evaluation results
including immunization rates pre and post the pilot program.
Activity #7 deliverable: Submit the final report issued to the primary care providers
and other key stakeholders.
III. Personnel:
a) Agency information:
Agency name Eagle County Public Health Agency
Agency mailing address PO Box 660 Eagle, CO 81632
Phone number 970 - 328 -9820
Fax number 855- 848 -8829
Agency DUNS # 08402447
Agency FEIN # 84- 6000762
b) Agency project contact:
Name Rebecca Larson
Phone number 970 - 328 -9820
Email address Rebecca.larson @eaglecounty.us
c) CIP project manager:
Name Teri Lindsey
Phone number 303 - 692 -2732
Email address Teri.lindsey@state.co.us
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IV: Payment/Invoicing:
Expenses Describe in detail Approved In -kind Total Budget
funding
Personal services Public Health Nurse, 0.25 FTE, hourly rate $18,500 $1,100 $19,600
including fringe 26.99 + 28% fringe = $37.56 -model
benefits research development and on -site
implementation
Disease Prevention Manager, 0.15 FTE — $0 $15,700 $15,700
evaluation and contract management and
reporting
Supplies & operating Paper and printing expenses for training $500 $0 $500
expenses materials for 2 provider practices (with 5
(include medical & sites total)
office supplies) - 4 Policy & Procedure immunization
manuals (binder, paper, printing, sheet
protectors, divider tabs) at $50 per
manual = $200
- 5 VIS Statement set — laminated
(paper, laminating pouches) = $25 x 5
= $125
- 5 The Pink Book ($35 x 5 books) _
$175
Travel Public Health Nurse to local health care $1000 $0 $1000
provider agencies (42 visits per year at 42
miles per visit, reimbursed at $0.565 per
mile)
Other Costs:
Incentives
Equipment
Marketing
Training
Contractual
Indirect 10%
Total $20,000 $16,800 $36,800
a) Total funding amount is $20,000.00.
b) Funds are 100% state dollars.
c) To receive compensation under this Purchase Order, the Contractor shall submit a signed, monthly CDPHE
Reimbursement Invoice Form. This form is accessible from the CDPHE internet website:
http://www.cdphe.state.co.us/StandardizedInvoice/index.html .
d) The Invoice Form must be submitted within 45 calendar days of the end of the billing period for which
services were rendered. Expenditures shall be in accordance with the Statement of Work and included
budget.
e) Submit the completed CDPHE Reimbursement Invoice Form via email as a PDF document to the CIP
Invoice Mailbox: CDPHE.CISInvoice @,state.co.us
f) To be considered for payment, billings for payments pursuant to this Purchase Order must be received
within a reasonable time after the period for which payment is requested, but in no event no later than 45
calendar days after the relevant performance period has passed.
g) Final billings under this Purchase Order must be received by the State within a reasonable time after the
expiration or termination of this Purchase Order; but in no event no later than sixty (60) calendar days
from the effective expiration or termination date of this Purchase Order.
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V: Monitoring:
CDPHE's monitoring of this contract for compliance with performance requirements will be conducted
throughout the purchase order period by the CIP Project Manager, Contract Monitor, and/or Evaluation
Coordinator. Methods used will include review of documentation reflective of performance to include
progress reports and invoices. The Contractor's performance will be evaluated at set intervals and
communicated to the contractor.
VI: Resolution of Non - Compliance:
The Contractor will be notified by email within 15 days of discovery of a compliance issue. Within 30 days
of discovery, the Contractor and the State will collaborate, when appropriate, to determine the action(s)
necessary to rectify the compliance issue and determine when the action(s) must be completed. The
action(s) and time line for completion will be documented by email and agreed to by both parties. If
extenuating circumstances arise that require an extension to the time line, the Contractor must email a
request to the CIP Project Manager and receive approval for a new due date. The State will oversee the
completion/implementation of the action(s) to ensure time lines are met and the issue(s) is resolved. If the
Contractor demonstrates inaction or disregard for the agreed upon compliance resolution plan, the State may
exercise its rights under the Terms and Conditions of this Purchase Order.
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Contractor Name (Print) and Ti e
Q l—
Contractor Signature
( 4 Ili
Date
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